Under the title “Is Cancer Mortality increasing or decreasing?” Wolff (1935) has discussed a problem of world-wide interest. He comes to the conclusion that, in German-speaking countries the risk of dying from cancer is not increasing in the sense that the ordinary man attaches to the phrase. He enquires whether the undoubted absolute increase in cancer mortality may not be a mere function of the ageing of the population, a feature common to all civilised countries; and he concludes that, for Berlin, the altered age structure of the population has caused the increase in the general rate of mortality from cancer, and that—taking certain other factors also into con sideration—it may fairly be concluded that in Berlin the rate of mortality from cancer has declined.

Our knowledge of the antigens of the typhoid bacillus has recently been enlarged by the investigations of Felix & Pitt (1934).

It has been recognized that the Vi antigen, newly established by these workers, is not only a very important factor in immunity, but also apparently a more labile substance than the O antigen hitherto regarded as the portion of the typhoid soma vitally concerned with the production of prophylactic immunity.

1. Two hundred and ten blood samples were obtained from workers in the fish trade. Of these, fifty-one, or 24·2 per cent., gave positive sero-reactions in dilutions of the serum ranging from 1/30 to 1/1000.

2. There was no significant difference in the number of positive sero-reactions occurring in male or female workers.

3. In a control series of 406 blood specimens from individuals not engaged in the fish trade, no positive sero-reactions were obtained.

4. Evidence is adduced that leptospiral infections occur in three grades: (a) severe infections associated with jaundice; (b) mild infections with pyrexia and no jaundice; and (c) latent or inapparent infections with no clinical manifestations.

5. Preventive methods have been detailed which, if put into practice, would, it is believed, reduce the incidence of this disease.

6. Sufficient evidence has been produced to show that this disease is occupational in nature, and as such should be scheduled under the Workmen's Compensation Act.

Acknowledgements. We are indebted to Drs Hill, Goldie and Fullerton of the Department of Medicine for much help in the collection of specimens.

1. The strains of B. typhosus, which are inagglutinable, or non-sensitive to somatic O agglutinins, are virulent, whereas the agglutinable, or sensitive strains, show a low virulence.

2. Virulence and inagglutinability of strains seem to depend upon the presence in them of a virulence (Vi) antigen.

3. A considerable protective action, observed by means of active and passive immunisation, is exerted by the inagglutinable strain used (205 D), because it contains Vi antigen.

4. When the O and H agglutinins are eliminated through absorption, the agglutination reaction may serve to demonstrate in vitro the presence of the Vi antibody.

Two batches of pooled antisera obtained from rabbits injected with crystalline egg albumin have been fractionated with ammonium sulphate in order to investigate the distribution of the antibody to this antigen in the serum proteins.

The albumin fractions contained no antibody.

All the globulin fractions examined contained antibody, and flocculated readily when mixed with appropriate dilutions of the antigen.

The distribution of antibody throughout the serum globulin was fairly uniform, the ratio of the antibody content to the protein concentration being the smallest in a fraction with a solubility in ammonium sulphate slightly lower than that of pseudoglobulin.

A fluid medium is described, containing in every 100 c.c. of peptone water 0·25 g. lactose, 0·5 g. boric acid and 1 g. sodium sulphite (anhydrous). It shows a marked selective action.

The test gives satisfactory readings within 24 hours of incubating at 37°C. I am of the opinion that all strains capable of growth in this medium may be regarded as of definite sanitary significance; they are most likely of faecal origin, while those which fail to grow are of minor sanitary importance.

I hope that the boric sulphite test may prove a useful adjunct to the bacteriological examination of samples of water.

There has appeared a considerable amount of literature attesting to the increasing frequency of primary intrathoracic neoplasm arising from the respiratory tract—lung and bronchi. This has emanated from various centres, both in Europe and in America. It had been thought that a similar increase was noticeable in Edinburgh, and some years ago Dr J. Davidson, then pathologist in the Royal Infirmary, did some work on the incidence of the disease as shown by the records of the institution. This was not recorded at the time, and it seemed desirable to extend that work and to publish yearly and quinquennial tables on the lines of Bonser's work, with very brief deductions, in order to ascertain so far as possible the actual state of affairs here and to give figures for comparison with those of other places. It is necessary to define the meaning of the term “intrathoracic tumours”. It has been chosen instead of “primary lung tumours” because in the earlier cases the “oat-celled” carcinomata were regarded as primary mediastinal gland sarcomata and have, therefore, had to be included, a point which recent microscopical examination of some of these earlier cases has shown to be justified. The records from 1904 to 1934 inclusive have been carefully searched, and only those cases have been included which were described as malignant and as arising from lung or mediastinal glands; cases of Hodgkin's disease, cancer of the oesophagus and thymic tumours were excluded.

In reply to Gardner and Venkatraman's rejection of the use of biochemical reactions in the grouping of vibrios according to Heiberg's method, it is shown that in forty-five of the strains examined by Gardner and Venkatraman it is possible to exclude twenty-four as being classical cholera vibrios by means of fermentation reactions with certain sugars, i.e. mannose, saccharose and arabinose. The author believes that it is not possible to deny the value of such reactions in attempting to group vibrios. The constancy of the reactions is emphasised.

1. Our experiments show that an intravenous injection of antigen immediately after an intravenous injection of antiserum in the guinea-pig were followed by:

(a) Acute shock and death within 5 min. The signs and post-mortem appearances were indistinguishable from acute anaphylactic shock as typically seen in the guinea-pig. Some control animals injected with antiserum only died in a way similar to those which received both antiserum and antigen. These are discussed in detail in the body of the paper.

(b) Delayed shock and death some hours later. The post-mortem appearances were those of gastro-intestinal congestion and haemorrhage resembling the changes seen in dogs dying of anaphylactic shock. Such changes were never seen in the control animals.

(c) Recovery. Practically all the animals which recovered had symptoms of respiratory embarrassment immediately following the injections of anti-serum and antigen and many had later symptoms of abdominal shock. The animals which were given an injection of antiserum only rarely had any symptoms and never abdominal symptoms.

2. It is necessary to test the antisera used by control inoculation since some antisera are toxic.

Conditions are described under which late death from active anaphylaxis occurred in the guinea-pig. The post-mortem appearances were those of gastrointestinal congestion and haemorrhage resembling the changes seen in dogs dying of anaphylactic shock.

Late deaths can be produced by the intravenous injection of antigen but more easily by intraperitoneal injections.

By careful investigation of the somatic antigens of the true cholera vibrios —the strains containing O factor I according to Gardner's grouping (1935)— it was found, as did Scholtens (1933), that the cholera vibrios may be divided into two serological groups: one containing the antigenic factor A and the other the antigenic factors AB.

This finding may be of importance in epidemiological investigations and in the preparation of vaccines.

1. Two groups of typhi-phages, one lysing typhoid bacilli only, the other Gaertner bacilli also, have been studied. Each phage stimulated, in Salmonella typhi, resistance to all phages of its own group but none to those of the opposing group.

2. It is probable from the range of their activity, that typhi-phages of the second group attack the receptor IX (of the Kauffmann-White system of Salmonella antigens).

3. There are strong grounds for believing that the phages of the first group, the specific typhi-plages, attack the Vi-antigen of Felix, for

(a) typhoid cultures which are readily agglutinated by Uaertner antiserum are relatively or entirely insensitive to these specific typhi-phages,

(b) the specific typhi-phages transform O-inagglutinable cultures into O-agglutinable forms, and

(c) the Vi-antigen is the only known element of the typhoid bacillus which is peculiar to that organism and so corresponds in specificity with the phage.

4. The fact that resistance acquired against a particular bacteriophage does not prevail against all other bacteriophages is not to be ascribed to the quantitatively differing potency of phages as suggested by d'Hérelle but to their qualitatively different activities. Each type of phage has its particular “point of attack” in the bacterium and the distinct “points of attack” of different phages develop their resistance independently. It seems that, as Marcuse has urged, the “points of attack” are located in the bacterial receptors.

In a previous paper (Maddock, 1934), it has been shown that healthy calves may be infected with bovine tubercle bacilli when grazed upon pasture infected at intervals with emulsions of the virulent organisms. These infections were designedly heavy, and it was felt that this orientating experiment should be followed by one in which pasture infection was secured in a way more closely approximating to the natural.

Various writers (Burnet, 1928; Burnet and Conseil, 1929; Vercellara, 1929; Huddleson and Hallman, 1929; Meyer and Eddie, 1929,1930; and Weigmann, 1931) using strains of Brucella abortus, have shown that this species is very slightly pathogenic for certain species of monkeys, while Br. melitensis possesses a high degree of virulence for the same animal. I have conducted a few experiments with a view to confirming these results, using a bovine abortus and a human melitensis strain isolated in Tanganyika.

1. The difficulty of isolating Br. abortus from samples of “dirty” milk by means of guinea-pig inoculation is noted. This has been shown to be due in certain instances to the presence of tubercle bacilli in the inoculum, though this is probably not the full explanation.

2. Following the simultaneous inoculation of virulent tubercle bacilli and Br. abortus into guinea-pigs, the latter infection generally failed to become established, whereas control animals inoculated under the same conditions with Brucella, but without tubercle bacilli, became infected.

Results of the inoculation of the two organisms into opposite sides of guinea-pigs indicate a generalized as well as a local increase of resistance to Br. abortus.

3. It is suggested that the mononuclear cell reaction stimulated by the tubercle bacilli destroyed Br. abortus.

I am indebted to the Directors of the United Dairies, Limited, for their interest and financial support. My thanks are due to Dr W. S. Gordon, Moredun, for sending a virulent strain of Br. abortus.

Physiologists have recognized for a long time that stuffiness in a close atmosphere is not due to diminution of oxygen or excess of carbon dioxide in the air breathed, or to any other impurity in the air. Such feelings are now shown to be due to the effect of longer infra-red rays on the skin, and are accompanied by a reflex narrowing of the air-ways of the nose and lungs. These effects are set aside by cool air acting on the skin and in many people also by shorter infra-red rays from bright sources of heat. This is why some people are much more comfortable with a bright source of heat than with a dark or dull red one. When people go out of doors to get a “breather”, or stand before an open window during physical exercises, they are instinctively using the stimulus of cold to widen their air-tubes. In open air treatment, and when sleeping with an open window, the same effect is obtained.

All rooms should be adequately ventilated with cool air to prevent stuffy feelings, and keep the air-ways open. Such ventilation will, at the same time, sweep away infection spread by “carriers”.

Partial obstruction of the air-tubes hinders the passage of blood through the lungs; it is this which causes failure of breathing when the obstruction is considerable.

Bleeding is of value because it relieves to a certain extent the impeded circulation.

Breathing through a narrow tube can be used as a test of fitness. An airway gauge has been designed for making such a test.