Immediately following on the International Plague Conference held in Mukden in April, 1911, the Chinese Government, anxious to carry out the recommendations of the Conference, instituted the North Manchurian Plague Prevention Service. The chief of these recommendations were briefly:

(a) Systematic investigations should be made as to whether epizootic plague occurs among Tarbagans and other rodents, and, if such exists, an accurate investigation should be made of the nature of the infection.

(b) A general improvement in the sanitary condition of cities and villages, especially with regard to overcrowding, is desirable.

(c) Education of the public by lectures and the issue of pamphlets and handbills, explaining preventive measures in simple language.

(d) The need for isolation of pneumonic-plague patients being urgent, permanent hospitals should be available.

(e) Hospital accommodation for suspected cases of plague should be provided.

(f) Contact quarantine stations should be constructed.

In these experiments the hook-worm anaemia of dogs does not appear to be exactly analogous to the corresponding disease in man, but differs from it in two essential particulars, namely, that only young animals suffer and that in them its course progresses much more rapidly to a fatal termination.

Older dogs, although not altogether insusceptible, acquire infection only to a moderate extent, which gives rise to a minor degree of anaemia. From this they gradually recover, even in spite of repeated and continued attempts at re-infection.

The anaemia in young dogs was characterised by great loss of weight, emaciation, prostration and intestinal haemorrhage, but in no case was expistaxis observed.

The blood volume of dogs suffering from the minor degree of hookworm anaemia is not materially altered, but if anything is somewhat diminished. The oxygen capacity of the blood per unit of body weight is also, on the average, somewhat decreased.

Infection is generally accompanied by distinct though not profuse haemorrhage, which is most marked in the early stages, but tends to disappear.

Eosinophilia was not a constant sign either of infection or of disease.

Evidence of blood regeneration was furnished by the appearance of large numbers of erythroblasts (normoblasts) which increased with the progress of the disease.

Cats are much less easily infected than dogs, and monkeys are altogether insusceptible. Man, also, were found to be insusceptible to infection with the dog hook-worm.

The opportunities of a pathologist at a large Eastern Hospital are many; but his time for research work is short, and his conveniences are few. I, therefore, feel that we, at the Laboratory of the Rangoon General Hospital, are more than usually fortunate to be able to give, within the first two years of the official existence of the Laboratory, an account of a strange disease. Doubtless it is to chance that we owe the first discrimination of the disease; but I hope that it has been by accurate observation and precise experiment that we have sought to fulfil our knowledge. The guidance and application of our observations have been my care, and upon me rests the responsibility for the accuracy of our work; but the work itself has been carried out entirely by my assistants, and to them belongs the credit for the zeal and patient perseverance with which the task has been performed.

In 1902 the investigations on hay-fever undertaken by me many years previously were brought to a temporary conclusion and their results published. I advanced the theory that hay-fever is a disease caused by vegetable poisons contained in the pollen of certain plants. These substances were connected with the proteid of the pollen grain and of a highly specific character. It was thus possible to decide by means of the isolated poisonous pollen proteid, whether a given disease is identical with hay-fever or not. In 1903 I asserted more forcibly that it was possible to obtain a specific antidote by inoculating pollen proteid into animals, e.g., rabbits or horses. With such an antidote it would be possible (1) to neutralise the pollen poison in vitro so that it would no more produce morbid symptoms in hay-fever patients. Further it would be possible (2) by this specific antidote to cure symptoms of the disease already developed. By the timely application of the antidote it would (3) be possible to prevent the onset of hay-fever symptoms.

1. B. coli (Escherich) produces papillated colonies and shows marked variability in the size of its colonies whenit is grown on agar to which phenylacetic acid has been added in the form of the sodium salt.

The big and little colonies produce about the same amount of gas when tested on glucose.

2. When B. coli (Escherich) is grown on agar containing monochlorhydrin it throws off variants similar to those produced when grown on monochloracetate of soda media. Speaking broadly they ferment alcohols with gas formation, and sugars without gas formation.

3. B. lactis aerogenes grown on monochlorhydrin agar gives rise to variants unable to ferment glycerine.

4. In cases of inhibitory bacterial selection by chemical agents a careful comparison of the surviving cells with the orginal strain from which they were derived is calculated to indicate that portion or function of the cell which is implicated in the cell's intoxication. This question does not seem to have been attacked hitherto from this standpoint.

5. The cell ferments by virtue of their specific chemical affinities mayplay a part in cell intoxication.

Almost from the time when pellagra was first described, a connection between the disease and maize as an article of diet has been noted, and a wordy and voluminous literature has arisen in the countries afflicted concerning the nature of this suggested relationship between maize and pellagra. Most of what has hitherto been written about pellagra is based upon observations on clinical material and epidemics. Probably the most neglected side of the disease is its morbid anatomy and histology; and the effects of feeding animals on preparations of maize are but scantily described.

Of the many methods employed to render a serum inactive, that by means of mechanical agitation has been the subject of several recent works, but the real nature of this phenomenon, as it occurs in shaken sera, is still unknown. The reason is the uncertainty regarding the nature of complement itself, and even the most satisfying explanation of the inactivation of complement by shaking would not probably throw much light on the nature of the complement. I give in the following a brief summary of the literature dealing with the inactivation of complement by mechanical agitation.

My friend Major Wesley Clemesha, I.M.S., in a recent contribution1 to the Journal of Hygiene is good enough inter alia to say:

“It may be safely stated that anything which Dr A. C. Houston writes on the subject of water bacteriology is received with very great interest and respect, and his recent report on the bacteriological characters of Bacillus coli in raw, stored and filtered river water (Metropolitan Water Board, 7th Report on Research Work) is no exception to the rule. The report is of very great interest to all engaged in the study of water bacteriology, particularly in England.”

In recent years immunity reactions have come to be regarded more particularly from the physico-chemical standpoint. Many of the phenomena occurring in immunity reactions are shown to be of the nature of colloidal chemical processes, and the laws which govern such processes have been found to hold, at least partially, for reactions occurring in sera, which belong to the class of colloidal protein solutions. Thus the application to immunity reactions, of such conceptions as viscosity and surface tension, has afforded a more reasonable explanation of these reactions. In the following paper special reference will be made to the surface tension, changes of which play an important part in all immunity reactions.

1. It has been shown that certain nitrite-destroying organisms when grown along with V. Cholerae prevent the appearance of the cholera-red reaction. This is not due to the non-formation of nitrite, but to its rapid destruction by the enitrite-destroying organisms.

2. Certain nitrite-destroying organisms fail to prevent the cholera-red reaction.

3.It has been shown in the case of the B. dysenteriae (Flexner) that the failur to prevent the cholera-red reaction is due to an inhibition of the growth of both organisms when grown together.

The following investigation was undertaken during November and December 1911 with the object of determining the source of infection in a series of cases of anthrax which occurred in the same yarn mill. The investigation resulted in proving that anthrax spores were present in a variety of East India wool and in the yarn manufactured therefrom.

Jerusalem is the resort of so many tourists and pilgrims who chiefly visit the country in the healthy spring season and see little of the conditions in which the poor of the land live, that it may be difficult for them to realize that it is a city where malaria is exceedingly rife and where the most elementary sanitary regulations are utterly neglected.There is no proper public water supply, no sewers worth the name, vaccination is not enforced even when small-pox is epidemic and there is no attempt to isolate those suffering from infectious diseases. This state of things is undoubtedly largely due to remissness and ignorance on the part of the Turkish Government, but the situation is made very complicated and difficult on account of the “ Capitulations ” by which all foreign subjects are practically independent of the Local Authority "and accept no orders except through their own Consuls.

The use of glycerine, oil and similar substances finds a constantly increasing application in modern surgery and medicine. Accordingly the adequate sterilisation of these fluids becomes a matter of considerable importance.

Inagglutinable strains of B. typhosus are of considerable interest bacteriologists both from a practical and theoretical aspect. These strains present the usual characteristics of the typhoid bacillus, with exception that they are not agglutinated by anti-typhoid sera, if and such a contingency be overlooked one may fail to recognise that one dealing with a typhoid infection. This feature persists in the subcultures for many months, thus differentiating the inagglutinable strains from the many strains of B. typhosus which agglutinate with difficulty when freshly isolated but which regain their full agglutinability after one or two subcultures. Since their discovery these inagglutinable strains have been investigated on several occasions without any definite agreement as to the condition being arrived at.

(1) Brilliant green exerts an inhibitory effect on the growth of bacilli of the coli group commonly occuring in faeces, which is in general more marked than its action on B.typhosus and paratyphiod bacilli.

(2) By taking advantage of this property of brilliant green a method has been devised is the inoculation B. typhosus from faeces. The procedure adopted is the inoculation of a series of tubes of peptone-water medium containing varying amounts of brilliant green, incubating for 20–24 hours, and then inoculation on a suitable solid medium from each tube.

(3) The reason for employing a series of concentrations of brilliant green is that the optium concentration for the growth and isolation of B. typhosus varies from case to case, depending probably both on the proportion of typhoid bacilli present and on the number and character of the accompnying bacteria as well as on the organie faecal material.

(4) The method is very easily and rapidly carried out.

One of the fundamental features of Ehrlich's method of standardising diphtheria antitoxic serum is the recognition of the so-called Lo and L+ limits, the L+ dose being the quantity of a toxin which when mixed with one unit of antitoxin and injected subcutaneously into a guinea-pig leaves sufficient excess of toxin free to cause the death of the animal about the fifth day after injection, the Lo dose being the largest quantity which when similarly mixed with one unit of antitoxin fails to produce a local reaction. In the region between the two doses, the so-called “ Differential-Region ” of Ehrlich, one can obtain a series of mixtures which, while they kill the guinea-pig later than the fifth day or not at all, cause local reactions of varying severity increasing as the L+ limit is reached.

Variations in bacteria may be said to fall into two classes (1) those which are temporary, and dependent on the environment, the bacteria tending to return to the original type when subculture is made on ordinary media; and (2) those which are fixed, and persist after repeated subcultures on ordinary indifferent media.

(1) The type of summer diarrboea usually seen in the wards of general hospitals was rare in Warrington in the summer of 1911.

(2) Multiple invasion of houses occurred in 19 (29%) of 67 fatal cases investigated.

(3) Consecutive onset of the disease among the members of the household was the rule.

(4) The average diarrhoeal rate for the several wards of the town varied directly as

(a) the average birth rate;

(b) the zymotic rate corrected for zymotic diarrhoea;

(c) the relative poverty of the inhabitants of the ward.

(5) Relative overcrowding existed in the houses in which deaths took place from diarrhoea.

(6) Cleanliness of houses is an important factor in the prevention of diarrhoea.

Forty-one rats examined—internal organs and intestinal contents—for presence of Gaertner group bacilli. Bacilli identical with B. enteritidis isolated from five rats in each case from the spleen (in two from liver also). No members of this group isolated from the intestinal contents.

Several of the rat sera were capable of agglutinating Gaertner group bacilli in high dilution. These facts point to the view that old infection with Gaertner group bacilli had taken place.

The general result of the investigation is in favour of the view that while rats are lible to be infected with Gaertner group bailli and to be ill in consequence these bailli are not natural intestnal inhabitants. If this be accepted it may be stated that this group of bacilli are not natural intestinal inhabitants, of any known animal species.

Rats infected with Gaertner group bacilli may serve as a means of infecting meat with these bacilli and may possibly in this way be a cause of meat poisoning outbreaks.

Circumstances in connection with the recent census have again directed my attention to the laws which govern human life. I have long been of the opinion that the old ideas that birth rates and death rates had no biological relationship beyond the obvious ones, that many infants mean more deaths, etc., usually found stated in public health text books, were based on a very imperfect induction. On one aspect of this I published a paper a number of years ago in the Transactions of the Royal Philosophical Society of Glasgow (1), and last summer Sir Shirley Murphy(2) read a paper on another aspect of the same subject before the Sanitary Congress held at York. But I have hitherto refrained from publishing theories because I believe that until quantitative measures are applied no scientific results worthy of discussion can be obtained. Now that such seem to be possible, I propose to discuss in a series of papers the different relationships which I have investigated. No mathematics will be introduced in the earlier papers, but the results of all will be summarised and dealt with in their mathematical and physico-chemical relationships in a concluding communication. The first paper relates to the connection between the “corrected” death rates and the “true” death rates as found by constructing a life table.