report of the medical officer of the local government board

2
454 REPORT OF THE MEDICAL OFFICER OF THE LOCAL GOVERNMENT BOARD. These facts point to the vital importance of preventive measures against the infection of anthrax in connexion with the wool industry and afford a ready explanation of the keen interest that centres upon the work of the Anthrax Investigation Board in Bradford. The reports presented from time to time to the board by its able bacteriologist, Dr. F. W. EURICH, indicate the scope of the work and the valuable results already obtained. Last month’s report in particular is of considerable importance, for in it, after mentioning that during the months from May to October nine firms had submitted samples of wool for examination to a total of 116, and of these 10, including samples of Peking camel hair, Bagdad skin wool, mohair, and Cape mohair, contained anthrax germs, Dr. EURICH shows that the blood-stained wool and hair are the actual carriers of the germs of anthrax and not the dust found in the wool as formerly believed ; but that although the dust per se is harmless it may become dangerous by reason of its admixture with scales of dried blood derived from the tainted hairs. Hence the amount of blood staining of a fleece forms a rough measure of its danger to health. This observation is quite in accord with the experience of other bacteriologists who are interested in the occurrence of anthrax spores in hides rather than in wool, and with whom it is customary to select for examination the blood-stained edges of the hide, which mark the original incision, and to search for the blood-stained patch of hair which marks the place or places where the skinning knife was wiped. Dr. EURICH further poirits out that blood may remain on the wool fibres even after washing and may thus be a source of danger to carders, combers, and the like, who manipulate it after it has passed the wash bowls ; and he emphasises the necessity for detecting blood-stained material before the wool is washed or willowed so that it may be at once removed and either effectually disinfected or, better still, destroyed. The action of various disinfectants, including formalde- hyde and cyllin, upon the blood-stained and infective material has also been carefully studied but the results are somewhat disappointing, for owing to the protection afforded to the anthrax spores by the matting together of the blood-stained fibres neither reagent could be relied upon to effect the destruction of the spores, even after exposures greatly in excess of those required to kill anthrax spores simply suspended in water. Formaldehyde, however, possesses this valuable property-by its action upon the albuminous constituents of the blood it fixes the blood stains to the fibres and so prevents diffusion of the virus into healthy fleeces, and this property, Dr. EURICH thinks, might well be utilised in the treatment of scheduled wools, Van mohair and Persian locks, which the Home Office regulations prescribe must be steeped "in the bale " before the latter is opened. Needless to say, the board at its last meeting heartily endorsed Dr. EuRicH’s recommendations, whilst its chairman stated that every endeavour would be made to insure the continuance of its work beyond the period of three years, now at an end, for which the board was originally appointed. Although, as we have shown, much has already been achieved, much more yet remains to be done before adequate methods of pro- phylaxis can be devised, and we can only hope that the exertions of the Lord Mayor of Bradford, Mr. J. E. FAWCETT, who is the chairman of the Anthrax Investigation Board, may be crowned with success. Report of the Medical Officer of the Local Government Board. THERE is an apparently inexorable rule in the Civil Service that when the clock of a man’s life strikes 65 he must lay down the pen which he has wielded for his country for perhaps 40 years or more and close his official career; and it was in accordance with this edict that Sir WILLIAM H. POWER, KC.B., F.R.S., to the infinite regret of all who knew his work, signed his last report and retired at the beginning of the present year. In what is nominally his first annual report Dr. ARTHUR NEWSHOLME, the present medical officer, pays a graceful tribute to his very dis- tinguished predecessor, a tribute which will be appreciated by that somewhat limited circle who had the privilege of Sir WILLIAM POWER’S acquaintance as well as by that very large number of the more scientific epidemiologists who learnt to regard the late medical officer of the Board as a man of altogether exceptional calibre. In his dislike for all ostenta- tion and advertisement Sir WILLIAM POWER evinced the highest qualities of the civil servant and raised the department over which he presided to one in which the country had complete trust. Fortunately, as Dr. NEWSHOLME adds in his report, the State still retains the services of Sir WILLIAM POWER as chairman of the Royal Commission on Tuberculosis and as a member of the Royal Commission on Sewage Disposal. The auxiliary scientific investigations which are conducted annually for the Board by workers presumably not otherwise officially connected with it deal as usual with subjects of considerable interest only some of which can be briefly touched upon here. Dr. E. E. KLEIN has continued his valuable researches into the prophylaxis of plague. It will be remembered that last year his experimental work showed that when the dried material from the necrotic organs of the guinea-pig in which subacute plague had been induced was injected into white rats such rats were rendered immune against subsequent infec- tion with a fatal dose of bacillus pestis. It has been shown, too, that a clear filtrate of a watery extract of these necrotic organs, even when heated to 65° C. for ten minutes to destroy all living bacilli or cocci, was similarly efficacious in a prophylactic sense, the filtrate possessing the additional advantage that it may be preserved at least for many months in sealed tubes and used in this and foreign countries. Dr. KLEIN has recently been study- ing the use of these organic extracts in a curative as well as in a prophylactic sense and he has discovered that although the actual blood of an animal which has recovered from an attack of plague does not contain any appreciable amount of antibodies capable of neutralising the action of specific microbes the watery extracts of the organs chiefly affected in the disease and which belonged to rabbits which had recoverd from an attack of the malady possess considerable therapeutic potency, a subject upon which, it is to be

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Page 1: Report of the Medical Officer of the Local Government Board

454 REPORT OF THE MEDICAL OFFICER OF THE LOCAL GOVERNMENT BOARD.

These facts point to the vital importance of preventivemeasures against the infection of anthrax in connexion withthe wool industry and afford a ready explanation of

the keen interest that centres upon the work of the

Anthrax Investigation Board in Bradford. The reportspresented from time to time to the board by its able

bacteriologist, Dr. F. W. EURICH, indicate the scope of

the work and the valuable results already obtained. Last

month’s report in particular is of considerable importance,for in it, after mentioning that during the months from Mayto October nine firms had submitted samples of wool for

examination to a total of 116, and of these 10, includingsamples of Peking camel hair, Bagdad skin wool,mohair, and Cape mohair, contained anthrax germs, Dr.

EURICH shows that the blood-stained wool and hair are

the actual carriers of the germs of anthrax and not the dust

found in the wool as formerly believed ; but that althoughthe dust per se is harmless it may become dangerous byreason of its admixture with scales of dried blood derived

from the tainted hairs. Hence the amount of blood stainingof a fleece forms a rough measure of its danger to health.This observation is quite in accord with the experience ofother bacteriologists who are interested in the occurrence ofanthrax spores in hides rather than in wool, and with whomit is customary to select for examination the blood-stained

edges of the hide, which mark the original incision, and tosearch for the blood-stained patch of hair which marks the

place or places where the skinning knife was wiped. Dr.

EURICH further poirits out that blood may remain on the

wool fibres even after washing and may thus be a source of

danger to carders, combers, and the like, who manipulateit after it has passed the wash bowls ; and he emphasises the

necessity for detecting blood-stained material before the woolis washed or willowed so that it may be at once removed and

either effectually disinfected or, better still, destroyed.The action of various disinfectants, including formalde-

hyde and cyllin, upon the blood-stained and infective

material has also been carefully studied but the results

are somewhat disappointing, for owing to the protectionafforded to the anthrax spores by the matting together of theblood-stained fibres neither reagent could be relied upon toeffect the destruction of the spores, even after exposures

greatly in excess of those required to kill anthrax spores

simply suspended in water. Formaldehyde, however,possesses this valuable property-by its action upon the

albuminous constituents of the blood it fixes the blood

stains to the fibres and so prevents diffusion of the

virus into healthy fleeces, and this property, Dr. EURICH

thinks, might well be utilised in the treatment of

scheduled wools, Van mohair and Persian locks, which

the Home Office regulations prescribe must be steeped "inthe bale " before the latter is opened. Needless to say, the

board at its last meeting heartily endorsed Dr. EuRicH’s

recommendations, whilst its chairman stated that everyendeavour would be made to insure the continuance of its

work beyond the period of three years, now at an end, forwhich the board was originally appointed. Although, as wehave shown, much has already been achieved, much more

yet remains to be done before adequate methods of pro-

phylaxis can be devised, and we can only hope that the

exertions of the Lord Mayor of Bradford, Mr. J. E. FAWCETT,who is the chairman of the Anthrax Investigation Board,may be crowned with success.

Report of the Medical Officer of

the Local Government Board.THERE is an apparently inexorable rule in the Civil

Service that when the clock of a man’s life strikes 65 he

must lay down the pen which he has wielded for his countryfor perhaps 40 years or more and close his official career;

and it was in accordance with this edict that Sir WILLIAM

H. POWER, KC.B., F.R.S., to the infinite regret of all whoknew his work, signed his last report and retired at the

beginning of the present year. In what is nominally hisfirst annual report Dr. ARTHUR NEWSHOLME, the presentmedical officer, pays a graceful tribute to his very dis-

tinguished predecessor, a tribute which will be appreciatedby that somewhat limited circle who had the privilege of SirWILLIAM POWER’S acquaintance as well as by that very largenumber of the more scientific epidemiologists who learnt to

regard the late medical officer of the Board as a man of

altogether exceptional calibre. In his dislike for all ostenta-

tion and advertisement Sir WILLIAM POWER evinced the

highest qualities of the civil servant and raised the

department over which he presided to one in which

the country had complete trust. Fortunately, as Dr.

NEWSHOLME adds in his report, the State still retains

the services of Sir WILLIAM POWER as chairman of

the Royal Commission on Tuberculosis and as a memberof the Royal Commission on Sewage Disposal.The auxiliary scientific investigations which are conducted

annually for the Board by workers presumably not otherwise

officially connected with it deal as usual with subjects ofconsiderable interest only some of which can be brieflytouched upon here. Dr. E. E. KLEIN has continued

his valuable researches into the prophylaxis of plague.It will be remembered that last year his experimentalwork showed that when the dried material from the

necrotic organs of the guinea-pig in which subacute

plague had been induced was injected into white rats

such rats were rendered immune against subsequent infec-tion with a fatal dose of bacillus pestis. It has been

shown, too, that a clear filtrate of a watery extract of

these necrotic organs, even when heated to 65° C. for ten

minutes to destroy all living bacilli or cocci, was similarlyefficacious in a prophylactic sense, the filtrate possessingthe additional advantage that it may be preserved at

least for many months in sealed tubes and used in this

and foreign countries. Dr. KLEIN has recently been study-ing the use of these organic extracts in a curative as well asin a prophylactic sense and he has discovered that althoughthe actual blood of an animal which has recovered from an

attack of plague does not contain any appreciable amountof antibodies capable of neutralising the action of specificmicrobes the watery extracts of the organs chiefly affectedin the disease and which belonged to rabbits which had

recoverd from an attack of the malady possess considerable

therapeutic potency, a subject upon which, it is to be

Page 2: Report of the Medical Officer of the Local Government Board

1455

hoped, Dr. KLEIN will be afforded further opportunities forresearch.

Another of the more practically important matters dealtwith in the volume under review is an investigation into

the bacterial contents of sewer air. In this connexion it now

appears we have been for several years past living in a some-what insecure paradise. It has been a commonly acceptedaxiom of the epidemiologist on the basis of bacteriologicalinvestigations that the air of sewers and drains contained

but very few micro-organisms and that such as were presentresembled more closely the flora of the outside air than thatof the sewage. In consequence of this belief the etiologicalstudent has viewed with scepticism any hypothesis which

sought to explain the spread or prevalence of specific diseasessuch as enteric lever or diphtheria by the escape of sewergases. But Dr. F. W. ANDREWES as the result of recent

investigations carried on with great care is satisfied that the

imperfect technique and culture methods of former years ledto erroneous conclusions, and that as a matter of fact the

streptococci of sewage as well as colon bacilli are to be

found in the air of drains and sewers in many ordinary cir-cumstances. The fresh light thus shed upon this problem byDr. ANDREWES as well as by Major W. H. HoRROCKS workingquite independently will have a decided influence upon ques-tions affecting the ventilation of sewers and drains, and itwill have to be considered in connexion with a movement

amongst some engineers for the abolition of the inter-

cepting trap between the house drain and the street sewer.Question will arise as to the desirability of allowing commonsewer air to pass up viii the house drain ventilator if such

air is likely to contain organisms of sewage origin. The

President of the Local Government Board has taken

prompt action in the matter and, as we announced last week,has already appointed a departmental committee to inves-

tigate the question of the desirability of discarding or

retaining the intercepting trap. The matter is largely onefor the physicist and we have no doubt that the committeewill secure the services of a thoroughly competent expert in

physics to aid them in their deliberations. We questionwhether a really scientific solution of the problem is possiblewithout further research both in physical and bacteriologicaldirections, and in the meantime most epidemiologists will,we imagine, sleep more soundly with the knowledge thattheir ventilating pipes are not used for ventilating the sewers.It will be interesting to watch the results of these new

conclusions upon etiological speculations and we foresee the

production of diagrams illustrating the manner in whichenteric fever follows the course of sewers. There is fashion

in epidemiology as well as in matters feminine and witheach new discovery or correction of former impressions thependulum swings unduly in the new direction. Yesterdayenteric fever was all water-borne, soil-borne, and sewer-

borne ; to-day it is due to shell-fish, carrier cases, flies,and personal infection ; and to-morrow the disease will,perhaps, be sewer-borne again. There is a strange wantof proportion in the application of new ideas.The bacterial contents of milk form the subject of in-

vestigation at the hands of Dr. W. G. SAVAGE who tells

us, amongst much else that is of value, that milk drawn

directly from the udder is free from the bacillus coli,

a further argument, if one was needed, for the better controlof the transit and storage of milk. The bacteriology of rheu-matic fever has been made the subject of an investigation byDr. T. J. HORDER. He has been unable to discover in the

blood of patients suffering from that disease any micro-

organisms, those found in some cases post mortem being, itis thought, merely the organisms of terminal infection.

He clearly thinks that in some of the alleged positiveresults malignant endocarditis and not rheumatic fever

has been in question. The only other investigationwhich we have the space to mention is that relatingto the conservation of vaccine lymph, a matter of

primary importance in the event of small-pox occurringunder the facilities now afforded by the State for

the evasion of vaccination. Dr. F. R. BLAXALL and

Mr. H. S. FREi4LiN have found that sustained subjection of

glycerinated calf lymph to temperatures below freezingpoint leaves the activity of the lymph quite unimpairedeven after a relatively long period of time. This is a

very satisfactory result and apparently large quantities of

lymph can by this method be always kept in stock againstemergencies. Thus does science provide for the wayward-ness of human nature and the weakness of politicians.It is very useful for us to have previous conclusions

revised and new claims examined under the auspices of acentral department of the State and everyone must

acknowledge that the funds available are well spent. At

the same time, having regard to the great advances whichhave been made in recent years in the subject of proto-zoology, it might prove profitable were some encouragementafforded to workers in this field, more especially in con-nexion with diseases and conditions with which no bacteria

have been detected or where the claims made by the

bacteriologist have not received final sanction.

Annotations.

THE BIRTHDAY HONOURS.

"Ne quid nimis."

THE list of birthday honours is a fairly long one and inthe eyes of many it is only saved from mediocrity by thedistinguished men of science whom it includes. It shouldin this respect receive the approval of all thoughtful persons,for some of the names thus brought prominently before thepublic are eminent in those branches of science the develop-ment of which tends most directly towards the improvementof the human race. The veteran biologist, Dr. Alfred

Russel Wallace, has been appointed by the King to the

Order of Merit, for which no worthier recipient could havebeen named amongst living scientists. The value of his

work, no less than the rare self-effacement with which Dr.Wallace yielded the chief honours of the doctrine of

evolution to Darwin at a time when his own claims to themwould have urged many a smaller man in a like positionto contest them bitterly, renders it all the more gratify-ing that in the evening of his days he should be crownedwith one of the highest distinctions within the bestowalof his Sovereign. Dr. Wallace is one whom the nationno less than the King delights to honour. Professor

Joseph John Thomson, who has received the honour of

knighthood, is Cavendish Professor of Experimental Physics