154 
NATURE 
[JUNE 15, 1899 
and the structure of the chain for a considerable distance 
to the south and the east must be taken into consider- 
ation. That great earth movements had preceded the 
Carboniferous period, and that mountains of a sort existed 
during it, and that this period was followed by very 
acute folding, are certain. We think, however, that the 
folds in this part of Europe (for reasons which have been 
published elsewhere) ran approximately from N.N.E. to 
S.S.W. Evidence of this may indeed be found in the 
district of which the authors are writing. Such flexures 
may have been the cause of the frequent trend of 
outcropping masses along almost the whole of the Alpine 
chain. During the Triassic period, as has often been 
observed, highlands, if not mountains, must have existed 
over more than one large area on the present site of the 
Alps, which afterwards disappeared beneath a wide- 
spreading sea. Then came the great Tertiary move- 
ments which formed the present chain. The authors 
apparently treat these as one, but most geologists hold 
that there were two epochs of maximum disturbance 
separated by one of comparative rest. The “ building ” 
of the present masszf and the neighbouring mountains 
should have been treated, we think, in greater detail ; 
for there is more than one interesting problem connected 
with the courses of the main streams, the positions of 
watersheds, and the localities chiefly affected by the 
-different movements, which are practically unnoticed. 
Still the memoir, as a whole, is a very valuable con- 
tribution to our knowledge of Alpine geology. 
T. G. BONNEY. 
THE BERLIN TUBERCULOSIS CONGRESS 
(1899).1 
Il. 
(Section IV. Therapeutics. Section V. Sanatorium 
Treatment.) 
HE fact that 2000 doctors met together and discussed 
for two days the treatment, using this term in its 
broadest sense, of phthisis will, to the observant layman, 
be of evil omen. When a number of remedies or methods 
of cure for one disease are all guaranteed by their 
advocates as being efficacious, the attitude that one 
at once adopts is one of scepticism. How many doctors 
would meet together to discuss the treatment of primary 
syphilis, a disease which can be cured, and how long 
would it take them to do so if they did? Ina multitude 
of counsellors there may be wisdom, but in a multitude 
of treatments there is rarely a cure. 
The subject-matter of this Section was very fittingly 
opened by a paper of Dr. Curschmann’s (Leipzig) on the 
curability of phthisis. In the narrow anatomo-histo- 
logical sense, phthisis is rarely if ever cured; in the 
clinical sense, however, we can often accurately speak of 
a cure as having taken place, since the local signs in the 
lungs not only become arrested, but a certain amount of 
cepair takes place, and the attacked individual becomes 
practically normal. The majority of cases of cure, how- 
ever, are relative. In these cases, the local disease, 
although not coming to an absolute standstill, is of such 
a nature as to allow of the general condition of the 
patient remaining good. 
The congress listened with great attention to a paper 
read by Prof. Kobert, of Rostock, on the medical treat- 
ment of tuberculosis. The results formulated by the 
author were of especial value, since they were not con- 
fined to his own clinical experience at Gérbersdorf, but 
were derived from a series of inquiries addressed by him 
to general practitioners and lung specialists throughout 
Europe—2o0o0 in number. These specialists and prac- 
titioners had treated during 1898, the year to which the 
inquiry related, 50,000 cases of tuberculosis. The most 
interesting of these results are as follows: (1) that we 
1 Concluded from p. 109. 
NO. 1546. VOL. 60] 
have in our possession no drug which exerts what may 
be termed a specific action in tuberculosis ; (2) that the 
early stages of phthisis can sometimes be met and cured 
without medicine of any kind; (3) in acute cases of 
phthisis, the fatal termination is neither avoided nor 
appreciably hindered by any kind of medicinal treat- 
ment; (4) that in the majority of cases of consumption 
medicinal treatment along with hygienic treatment is of 
the greatest possible use in allaying and easing cough, 
keeping up nutrition, and exerting a controlling action on 
the tubercle bacillus and its products. Dr. Brieger 
(Berlin) read a paper upon the treatment of pulmonary 
tuberculosis by means of tuberculine and allied methods. 
The author regarded Koch’s tuberculine as of distinct 
value in cases of pure pulmonary tuberculosis, asserting 
that in several cases an active tuberculous process had 
by its means been brought to a standstill. 
A valuable communication upon the climatic treatment 
of phthisis was made by Sir Hermann Weber ; but since 
this was reported at length in the British Medical 
Journal, no further mention will be made of it here. A 
paper of great interest was read by Dr. Dettweiler 
(Falkenstein), the subject being the hygienic, dietetic and 
sanatorium treatment of phthisis. Dr. Dettweiler, being 
the chief physician to one of the largest private sanatoria 
in Germany, spoke upon this subject out of the fulness 
of his experience. The author, after emphasising the 
fact that in phthisis we had to deal, not with a local con- 
dition, but a symptom complex, considered in how special 
a manner a sanatorium could meet the individual re- 
quirements of each case, and that by this means alone 
—viz., meeting every special want or symptom of the 
patient as it arose—could we hope to be successful in our 
treatment. It was not from open air, baths, exercise, 
alcohol, or feeding that we were to expect a “cure,” but 
from the co-operation each day, according to the state-of 
the patient, of all these means. Prof. Winternitz (Vienna) 
discussed the hydrotherapy of phthisis, and was followed 
on this subject by Dr. Carl Schitze. Dr. Holscher 
(Miilheim) read an interesting paper on the treatment 
of phthisis by guiacol carbonate and creosotal. The 
author, after giving a short 7véswé of the results of 
the continued use of guiacol, emphasised the fact that 
this method must be used in conjunction with forced 
feeding, especially in so far as concerns proteids. The 
guiacol is eliminated in combination with sulphur, and 
the sulphur thus used can only result from the breaking 
down of proteid material ; hence the importance of the 
strength of the patient being maintained by a plentiful 
supply of proteid material in the food. Dr. Cervello 
(Palermo) described his method of treatment, which con- 
sists in the inhalation of a formic aldehyde gaseous com- 
pound. Prof. Landerer gave the results he had obtained 
by the injection of cinamic acid (Zimmtsaure C;H;—CH 
=CH—CO,H) This substance, according to Prof. 
Landerer, acts by causing an increased leucocytosis, 
especially in the regions affected by the tubercular pro- 
cess. The action of many other antiseptics in tuberculosis 
was also considered, including iodoform and glycerine 
(Dr. R.' Hammerschlag) and Izal (Dr. Tunnicliffe), a 
few preliminary observations with the latter drug tending 
to show that it acted, as would be expected from its 
composition, similarly to guiacol and creosote. 
The serum treatment of tuberculosis was discussed by 
Prof. Maragliano (Genoa). This investigator’s interesting 
researches in this field have already attracted consider- 
able attention. The author, after having postulated from 
his own and Behring’s researches the existence of tuber- 
culous antitoxines and their presence in the blood of 
normal animals and man, stated that the quantity of 
these could be increased by injection. The injection of 
such antitoxines rendered animals partially or entirely 
immune to injections of tuberculous material, and lessened 
in man the reaction to tuberculine (Koch?). He further 
