February 15, 1906] 



NA TURE 



309 



the anti-microbic sera seem to neutralise through the 

 interaction of two substances, one present in the 

 serum, the other a constituent of the patient's body 

 and limited in amount, so that when the whole of 

 the latter has taken part in the neutralisation, no 

 additional amount of the therapeutic serum produces 

 a further neutralisation. 



Again, an anti-streptococcic serum prepared with 

 streptococcus A, though active against A, does not 

 necessarily neutralise another streptococcus B. In 

 diphtheria also, a local and visible lesion generally 

 enables a diagnosis to be made, and serum treatment 

 to be applied, before any great amount of tissue 

 damage has been done, whereas in tetanus, for which 

 a very potent antitoxin has also been prepared, it is 

 the results of tissue damage which lead to a diagnosis. 

 No therapeutic serum can, of course, repair tissue 

 damage, and if this has proceeded beyond a certain 

 degree the condition becomes incompatible with life. 

 It is noteworthy that even in diphtheria, if treatment 

 be delayed beyond the third day, antitoxic treatment 

 produces results little better than treatment without 

 antitoxin, tissue damage having proceeded to too 

 great an extent during the interval. 



The fearful prevalence of plague in India during 

 the last few years, which has caused the death of 

 hundreds of thousands of the inhabitants of that great 

 Empire, has naturally directed attention to the serum 

 therapy of this disease, since no ordinary form of 

 treatment has any particularly beneficial effect, and 

 the Government of India has therefore been well 

 advised to devote one of its scientific memoirs 1 to 

 the subject, under the editorship of Lieut. -Col. 

 Bannerman, M.D., I. M.S., who has had much experi- 

 ence of plague. Various forms of anti-plague serum 

 were the subjects of trial, the Roux-Yersin, Lustig, 

 Haffkine, Terni, and Brazil, the details of the pre- 

 paration of which are given, and tables of the results 

 obtained. Col. Bannerman concludes from a study 

 of the circumstances and of the case-mortality of 

 the various series of cases treated with the dif- 

 ferent sera that (i) the Roux-Yersin serum did 

 not affect the case-mortality in the slightest degree, 

 (2) in three out of the four trials made with Lustig's 

 serum the case-mortality of the serum cases was 

 higher than among those receiving ordinary treat- 

 ment, (3) with Haffkine's serum there is no certain 

 evidence of its efficiency, (4) with Terni 's serum there 

 is a difference of 0-91 per cent, only in favour of the 

 serum-treated cases, and (5) with Brazil's serum, 

 though there is a difference of 2.85 per cent, in favour 

 of the serum-treated cases, it is problematical if this 

 can definitely be ascribed to the serum. 



As regards case-mortality, therefore, these trials do 

 not suggest that serum therapy in plague is of much, 

 if of any, value, but clinically there is an amelioration 

 in the symptoms, and the cases when treated with 

 serum live for a longer period than without it. YVe 

 might add that the series of cases treated with Terni 's 

 and with Brazil's ■.(•rum (no and 70 respectively) are 

 too small to warrant any definite conclusions. Banner- 

 man from these results considers that it will be 

 necessary to commence anew the study of the serum 

 therapy of plague, and with this we cordially agree. 

 At the same time we cannot help thinking that it 

 would be desirable to make a much more extended 

 use than has been done of the intravenous method 

 of administration of the serum. 



R. T. Hewlett. 



1 Scientific Memoirs of the Government 0/ India, No. 20, 1905. Serum 

 Therapy of Plague in India. Reports bv Mr. W. M. Haffkine, C.I. E., and 

 various Officers of the Plague Research Laboratory. Bombay. Edited with 

 an Introduction bv Lieut.-Col. Bannerman, M.D., B.Sc, I. M.S., Director, 

 Plague Research Laboratory, Bombay. 



A 



SEA COAST PROTECTION. 

 CONFERENCE of local authorities having 

 districts situated on the seaboard of England 

 l= held in London on February 6 on the subject 

 of the defence of the coasts against erosion by the 

 sea, and the national responsibility in regard to the 

 matter. This conference was convened by the chair- 

 man of the Heme Bav District Council. The matter 

 had been taken up by the sea-side towns on the east- 

 coast in 1903, and a deputation was then appointed 

 to wait on Mr. Balfour, but nothing came of this. 

 The conference recently held consisted chiefly of re- 

 presentatives of towns on the south coast, and a 

 resolution was adopted " That representatives of this 

 conference be appointed to approach the Prime 

 Minister and President of the Board of Trade, to 

 request the Government to introduce into Parliament 

 a Bill declaratory of the aforementioned principles 

 and defining wavs and means whereby some relief 

 towards, or" allowance in respect of, the cost and 

 maintenance of protective works might be contributed 

 by the Government." The report of the meeting that 

 appeared in the public journals does not say what 

 " the aforementioned principles " consist of. 



The members who attended this conference con- 

 sisted almost entirely of representatives of sea-side 

 towns, where prome'nades and similar works have 

 been constructed for the purpose of enhancing the 

 attractions of these places. 



The Engineer, in an article on this conference, 

 points out that to protect efficiently long stretches 

 of purely agricultural land, the sea margin of which 

 consists of 'friable and easily eroded material exposed 

 to the inroads of the sea, would (as shown in the 

 book on "The Sea Coast," published by Messrs. 

 Longmans and Co.) involve a capital and maintenance 

 expenditure out of proportion to the advantages 

 secured, the value of the land preserved during the 

 life of the protective works not being equal to one- 

 third of the outlav required for protecting it. 



In the case of' sea-side resorts or other localities 

 where the coast-line is of considerable value, the 

 Engineer points out that while the preservation of 

 the littoral is an absolute necessity, the benefits to 

 be derived by protection are almost wholly local, and 

 the owners of agricultural land not worth the cost 

 of protection would have a perfectly legitimate 

 grievance if Imperial funds were spent for the benefit 

 of their wealthier neighbours. It may also be added 

 that all inland towns would have an equal right to 

 protest against contributing towards money spent on 

 these sea-side towns, where promenades and other 

 works have been constructed to attract visitors, and 

 thereby have enormously increased the value of the 

 property of those whose land is adjacent. 



There was one part of the subject of coast erosion 

 alluded to at the meeting which might with more 

 reason be pressed on the attention of the Govern- 

 ment, that is, the prevention of the removal of sand 

 and shingle from the beach, which now forms a 

 natural protection to the shore. As the law now 

 stands, the Board of Trade, on being applied to, will 

 order a local inquiry where complaint is made of 

 injury done by such removal, and if as the result of 

 such inquiry "it is shown that such removal is in- 

 jurious, the Board can, under its statutory powers, 

 issue an order forbidding any further removal. The 

 cost of these inquiries, however, is considerable. 



In some cases the Government itself is the offender, 

 shingle being taken for making concrete for its coast 

 works. In many cases the local authorities, who are 

 now asking for State relief, have been the worst 

 offenders in this respect, by placing their sea walls so 



NO. 1894, VOL. 73] 



