91

Correspondence.

THE CULTIVATION OF PFEIFFER’S BACILLUS.

11 Audi alteram partem."

To the Editor of THE LANCET. SIR,-The paper by Captains Little, Garofalo, and

Williams, in THE LANCET of July 13th, is interesting in thatit records the recovery of a hitherto unrecognised cause of" influenza" in a series of cases of the present epidemic.But their conclusions that the epidemic is not caused byPfeiffer’s bacillus are at least open to question.Hitherto it has never been suggested, as far as I am aware,

that Pfeiffer’s bacillus will grow on a medium devoid ofblood, except in symbiotic relationship with other organisms,notably xerosis and staphylococcus, and perhaps after manysubcultures. Serum alone is of no use, the bacillus musthave blood or derivatives of blood. Captain Little and hisfellow workers also rely on not recognising Pfeiffer’s bacillusin direct smears, but in the case of such a minute organismas influenza bacillus the evidence derived from direct smearsis apt to be fallacious. The fact that no leucocytosis wasobserved is taken as evidence that the infection was due tosome organism other than Pfeiffer’s bacillus, whereas it isgenerally held that the reverse is the case ; indeed, in mosttext-books influenza is usually coupled with typhoid fever asa cause of leucopenia.The authors lay emphasis on the fact that they have

fulfilled two of Koch’s postulates, but they have neglectedthe elementary precaution of demonstrating that the diplo-coccus referred to is not to be found in normal individualsunder the same conditions as their I I influenza " cases.My experience of a smaller number of cases than those

examined by Captains Little, Garofalo, and Williams is thatI have recovered Pfeiffer’s bacillus in every case, a resultpartly attributable perhaps to the use of an improvedmedium, an account of which I hope to publish in theimmediate future.-I am, Sir, yours faithfully,Wimpole-street, W., July 14th, 1918. JOHN MATTHEWS.

EPIDEMIC ENCEPHALITIS.To the Editor of THE LANCET.

SiR,-May I be allowed the briefest comment on Dr. F. G.Crookshank’s letter in THE LANCET of July 13th a proposof my paper on epidemic encephalitis ? It is well knownthat occasionally epidemics of acute poliomyelitis occur

at other times of the year than summer and autumn, thatoccasionally cases like those of the present epidemic ofencephalitis are met with during poliomyelitis epidemics,that occasionally meningeal symptoms are prominent in

epidemic encephalitis, and so on. What I did was to

compare the average case of acute poliomyelitis with theaverage case of epidemic encephalitis and point out the dis-tinctions, and these distinctions are not invalidated bycitation of the exceptional cases in either group.

I am, Sir, yours faithfully,Harley-street,’,W., July 15th, 1918. S. A. KINNIER WILSON.

QUICK DIAGNOSIS IN MENINGOCOCCUSINFECTION.

To the Editor of THE LANCET.

SIR,-The article, " A Quick Method of Diagnosing theType of Meningococcus in Cases of Cerebro-spinal Fever,"by Major A. S. Gordon Bell and Miss 1. M. Harmer, inTHE LANCET of July 13th, is strikingly important from theclinical as well as the laboratory point of view, enabling thephysician to exhibit the homologous serum at least 48 hoursearlier than has been the case with the ordinary method of"type agglutination."There is one point, however, on which I do not feel clear,

and in regard to which perhaps the writers will enlighten ]me. Is it not possible that the results obtained were due toantibodies contained in the curative serum which was

administered intrathecally, and that these antibodies hadfound their way into the blood stream ?

I am, Sir, yours faithfully,A. E HODGSON. M D.,

Bacteriological Laboratory, Military Hos- Captain, R.A.M.C.pital, —, N. Wales, July 15th, 1918.

The War.THE CASUALTY LIST.

THE following medical officers appear among the casualtiesannounced since our last issue :-

Died.

Capt. R. A. Sillar, Australian A.M.C.Wounded.

Lieut. G. Hull, New Zealand A.M.C.Capt. H. M. Drake, R.A.M.C.Capt. F. H. Goss, R.A.M.C.Lieut.-Col. A. H. Moseley, D.S.O., Australian A.M.C.Lieut. W. S. Gross, R.A.M.C.Major J. A. Pridham, M.C., R.A.M.C.

Missing, believed Drorvned (through the Torpedoing of theCanadian Hospital SAio "Llandovery Castle ").

Lieut.-Col. T. H. MacDonald, Canadian A.M.C.Major G. M. Davis, Canadian A.M.C.Capt. W. J. Enright, Canadian A.M.C.Capt. A. V. Leonard, Canadian A.M.C.Capt. G. L. Sills, Canadian A.M.C.

Missing.Capt. W. A. Rees, R.A.M.C.

Previously reported Missing, now reported Prisoners inGerman Hands.

Lieut. J. Findlay, R.A.M.C, attached Wore. Regt.Capt. J. M. MoEenzie, M.C., R.A.M.C., attd. Northd. Fils.

CASUALTIES AMONG THE SONS OF MEDICAL MEN.The following additional casualty among the sons of

medical men is reported :-Capt. N. C. Swift, D.S.O., M.C., East Lancashire Regiment,

youngest son of Dr. H. Swift, of Adelaide, South Australia.

___

FOREIGN DECORATIONS.Belgiail.

Croix de Guerre.-Capt. F. D. Annesley, R.A.M.C., S.R.; Temp.Capt. A. Climie, R.A.M.C. ; Temp. Capt. R. A. H. Fulton, R.A.M.C. ;Lt.-Col. H. C. R. Hime, D.S.O., R.A.M C. ; Temp. Capt. G. D. Maclean,R.A.M.C. ; Col. C. C. Manifold, C.B., C.M.G., I.M.S.; Capt. (acting

Lt.-Col.) W. Tyrrell, D.S.O., R.A.M.C.. S.R. ; Col. A. E. Ross, C.M.G.,Canadian A.M.C. ; Maj. J. H. Wood, Canadian A.M.C.; Capt. C. C.Simson, M.C.,Australian A.M.C.; .Lt.-Co!.J.H.Neil, New Zealand M.C.

MEDICAL PRACTITIONERS AND AN APPEAL AGAINSTGRADING.

The position of the medical practitioner who is not satisfiedwith his grading by a National Service Medical Board ispractically that of any other man liable to military service.He may make an application to the Appeal Tribunal for thedistrict in which he lives for leave to be re-examined and

graded by the Medical Assessors. The application is requiredto be made not later than five clear days after the date onwhich written notice of his grading by the National ServiceMedical Board is given or sent to him, unless the AppealTribunal, for good reason shown, allow an application to bemade after that period.Such examination is, however, quite different from re-

examination by a National Service Medical Board. If a

practitioner desires to be re-examined by a National ServiceMedical Board the Ministry of National Service is usuallywilling for this to be done upon application being made tothat department.

-

AUXILIARY R.A.M.C. FUNDS. - The usualquarterly meeting of the committee was held at 11, Chandos-street, W., on July 12th, Major Ewan Maclean being in the- chair, Amongst other members present was Major-GeneralT. H. Goodwin, Director-General Medical Services. Fromthe benevolent branch for the relief of children of officers ofthe Auxiliary R.A.M.C. who died as a result of the presentwar grants were made in three cases. The amount grantedwas .6176. Grants from the relief branch for the relief ofthe’widows and orphans of the rank and file of the AuxiliaryR.A.-M.C. were also made. Subscriptions and applicationsfor relief from either branch should be made to the honorarysecretary, Auxiliary R A.M.C. Funds, 11, Chandos-street,Cavendish-square, W. 1.