A MEDICAL CONGRESS IN THE ROCKY MOUNTAINS

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    still living at the time of publication (41 mice withan average age of 11-5 months) and no tumours havedeveloped. A few mice from the C.57 Black strainhave been fostered by mothers from a high cancerstrain and have developed cancer. Bittner and Littletherefore advanced the hypothesis that " the extra-chromosomal or maternal influence may tentativelybe attributed as due to a breast-cancer-producinginfluence obtained by the progeny from the milk ofhigh cancer line mothers." This " influence " wouldprobably be described as a virus by many workers,and future work may do much to strengthen thisidea, but there are certain facts which are extremelydifficult to explain satisfactorily on any hypothesis.For example, Bittner (1936) crossed two high cancerstrains, with an incidence in breeding females of60 and 75 per cent. respectively. When the mothercame from the former strain the incidence in F 1breeders was about 60 per cent., but when the recip-rocal cross was performed the incidence was about80 per cent. Furthermore, there is evidence thatgenetic factors influence the sensitivity of individualsto the milk-borne agent. Cloudman and Little (1936)showed that if different low cancer males are crossedto the same high cancer female, the incidence invirgin females is different in the two F generations.In one such cross the incidence in the F hybrid wasactually higher than in the high cancer pure line(77 per cent. as contrasted with 50 per cent.). Forfurther discussion on this finding the original papermust be consulted. Strong (1936) has also obtainedevidence that genetic factors are important byselecting four pure lines with widely different tumourincidences from the progeny of one hybrid femalethat developed 3 mammary tumours.The study of leukaemia throws an interesting light

    on these problems. MacDowell and Richter crosseda pure line with 90 per cent. leukaemia to anotherline with only a sporadic incidence of the disease.If the female came from the leukaemic line the incidencein Fl was about 62 per cent., whilst in the reciprocalcross it was about 42 per cent. The existence of extra-chromosomal factors was confirmed by backcrossing.It was shown that no agent was passed during suckling(see MacDowell 1936, MacDowell and Richter 1935,and Richter and MacDowell 1935). In this casethere is no information as to the nature of the maternalinfluence, and the evidence for the importance ofchromosomal factors is rather more clear than is thecase with mammary cancer. It may be mentioned thatcases are known in which extra-chromosomal factorsappear to be involved but in which the presenceof any agent need not be considered-e.g., in thedetermination of body size.

    Susceptibility to lung tumours seems definitely todepend upon chromosomal factors. Lynch (1926,1931), whose lines were not as closely inbred as couldbe desired, gave evidence to show that this was so,and her finding has been confirmed by Bittner andLittle. It appears as though one or two partiallydominant genes have a very marked effect on theincidence of this type of growth.

    Other types of growth have been less thoroughlystudied than those listed above. In some cases itmay be found that the genetic basis is quite simple,but it is obvious that the theories put forward byMaud Slye (1928, 1931) are no longer tenable.

    SUMMARY AND CONCLUSIONS

    1. Genetic factors must be regarded as influencingthe sensitivity of the organism to environmentalfactors capable of initiating malignancy.

    2. Some of the difficulties involved in an analysisof the genetic factors are pointed out and the necessityfor genetically purified stocks is stressed.

    3. Pure lines of mice can be obtained in which theincidence of mammary tumours may take almost anyvalue from less than 1 per cent. to over 80 per cent.This fact alone eliminates the hypothesis of a singlegene for mammary cancer.

    4. The differences observed between pure linescannot be satisfactorily explained along mendelianlines. The incidence of mammary cancer is in partdetermined by an agent passed in the mothers milkduring suckling. It is probable that chromosomalfactors (genes) determine the susceptibility to thisagent.

    5. Leukaemia shows some of the features exhibitedby mammary tumours, but no agent is passed duringsuckling. There is strong evidence that chromosomal.factors play a part in the incidence of the disease.

    6. Susceptibility to lung tumours does not appearto be influenced by non-chromosomal factors. It isprobable that one or two partially dominant genesplay an important part in the incidence of suchgrowths

    7. Other types of growth have not yet been ade.quately analysed. No form of cancer in the mousehas yet been shown to behave as a mendelian recessive.

    REFERENCES

    Bernstein, F. (1930) Med. Klin. 26, pp. 1583 and 1621.Bittner, J. J., and Little, C. C. (1937) J. Heredity, 28, 117.Cloudman, A. M., and Little C. C. (1936) J. Genet. 32, 487.Haldane, J. B. S. (1936) Ibid, 32, 375.Korteweg, R. (1936) Genetica, 18, 350.- (1937) Acta de lUn. internat. contre Cancer, 2, 136.

    Lathrop, A. E. C., and Loeb, L. (1918) J. exp. Med. 28, 475.Little, C. C. (1933) Science, 78, 465.Lynch, C. J. (1926) J. exp. Med. 43, 339.- (1931) Ibid, 54, 747.

    MacDowell, E. C. (1936) Amer. J. Cancer, 26, 85.- (1937) J. Heredity, 28, 131.- and Richter, M. N. (1935) Arch. Path. 20, 709.

    Murray, W. S., and Little, C. C. (1935) Genetics, 20, 466.- - (1936) Amer. J. Cancer, 27, 516.

    Pybus, F. C., and Miller, E. W. (1936) Rep. Brit. Emp. CancerCamp. p. 171.

    Richter, M. N., and MacDoWell, E. C. (1935) Phys. Rev. 15, 509.Slye, M. (1928) J. Cancer Res. 12, 133.- (1931) Amer. J. Cancer, 15, 267.

    Strong, L. C. (1934) J. Heredity, 25, 119.- (1936) Brit. J. exp. Path. 17, 60.

    A MEDICAL CONGRESS IN THE

    ROCKY MOUNTAINS

    (FROM AN OCCASIONAL CORRESPONDENT)

    I HAVE referred previously to the difficulties ofholding medical conventions in the wide open spacesof the West : physicians are scattered so thinly overso vast an area that even a State medical society hastrouble in collecting an annual audience large enoughto make a good conference. In September, 1935, theColorado State Society adopted a resolution suggest-ing to its neighbour States of Utah, Wyoming, andNew Mexico, that a joint meeting be held in thesummer of 1937. The suggestion was approvedformally by the medical societies of each of theseStates, and the first Rocky Mountain Medical Con-ference has just been held in Denver (July 19th, 20th,and 21st). I was told at the registration desk on thelast day of the conference that at that time 786physicians had registered. A list of names and

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    addresses showed that quite a number had come fromother than the sponsoring States. Kansas was wellrepresented and there were several delegates fromTexas and Nebraska. If some members of the con-ference travelled 1000 miles to the meeting at Denver,some of the speakers travelled double that distance,from New York, Baltimore, and Washington. Thehighest praise is due to the organising committee forthe quality of the lecture programme, the excellenceof the scientific exhibits, and the clockwork organisa-tion which started and ended every event exactly onschedule. The new film on syphilis prepared by theAmerican Medical Association and the U.S. PublicHealth Service was shown for the first time this sideof the Mississippi. It is an excellent presentationfor medical education, and deserves the widestexhibition in medical circles. The presence of

    Surgeon-General Parran of the United States PublicHealth Service at this conference reinforced the

    teaching of this film. He pointed out that 60,000babies are still born every year with congenitalsyphilis, although we know very well how to preventthis disaster. He emphasised also the necessity forusing serological tests at every opportunity : on allhospital admissions, at every physical examination,as a routine before marriage, and so forth. Dr. Parrancalculates that 1 in every 5 men and 3 in every5 women are ignorant of the fact that they havesyphilis when they get to the doctors office. Only1 in 4 who start treatment receive sufficient to preventinfectious relapse. Prof. C. C. Dennie of the Univer-sity of Kansas showedsome slides illustratingthe remarkable success of

    pyrotherapy as an adju-vant to chemotherapeuticmethods in the treatmentof syphilis, and especiallyin the treatment of kera-titis and other forms of

    congenital syphilis. In theabsence of the more expen-sive apparatus such as isused in Dayton, Ohio, Dr.Dennie has been able toreach his desired goal inbody temperature by theuse of hot baths.

    Prof. Walter Alvarez

    (Mayo Clinic, Rochester),insisting that 4 out ofevery 5 cases of indigestionare functional in origin,said that the diagnosis offunctional disorder shouldbe made from the case-

    history and not by exclu-sion. He told a numberof dramatic stories to illus-strate how often useless

    surgery is performed forwant of thorough historytaking. A reaction is veryevident in the UnitedStates at the present timeagainst over-reliance onlaboratory reports and are-emphasis of the classicalmethods of diagnosis.The second Rocky

    Mountain Medical Con-ference is to be held inUtah in 1939.

    A HUNTER MEMORIAL

    A MEMORIAL in honour of William and John Hunterwas unveiled at East Kilbride on July 28th by SirHector J. W. Hetherington, principal of GlasgowUniversity, who paid high tribute to the brothersachievements. The enterprise, he said, was begunsome years ago, when it was thought that to com-memorate these great men a visible memorial shouldbe erected in the parish of their birth. The brothersdiffered in opinion but their careers ran strangelyparallel courses; they were admitted to the RoyalSociety of London in the same year, both didremarkable work for medical science. Both werefounders of a great museum, and both of them werehonoured in the institutions with which their nameshave become associated.

    Considered as men of science there was no doubt,however, that John, the younger brother, was thegreater of the two. In experiment and observationhe was a man of original and outstanding genius.William was also distinguished in science but he wasmore catholic in learning and taste, more varied inhis collecting, and more firmly attached to his placeof origin. He was the greatest benefactor the Univer-sity of Glasgow had known, and his collections werethe foundation not only of the Hunterian Museumitself but of many collections associated with differentdepartments of science in the University.The memorial is to be placed in the charge of the