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and the occurrence of the disease during the summer insupport of the view that they were cases of poliomyelitis.In only 9 cases was the cerebro-spinal fluid withdrawn bylumbar puncture, and in only 4 of these was it examined,and in all of them an excess of polynuclear leucocytes waspresent, which would seem to point to a meningitis. In con-clusion, Dr. Farrar says that pathological investigation, sofar as it was carried out in respect to the 74 cases

under consideration, gave no support to the view that

any of these were cases of cerebro-spinal fever, and hehas no hesitation in concluding that the outbreak was

one of epidemic poliomyelitis, and not of cerebro-spinalfever.The outbreak at Cerne Abbas and Up Cerne in Dorset

occurred between Sept. 29th and Oct. 21st, 1910. Inthese little hamlets 16 cases occurred with 2 deaths. The

history of these cases is given in detail. Multiple attacksoccurred in three households-viz., three cases in one house-hold and two in each of the others. The cerebro-spinalfluid was not examined in any case. The origin ofthe outbreak could not be discovered, but the villageis a frequent resort of visitors from Dorchester and

Weymouth.Experimental and Pathological Investigations.

In the third section Dr. Mervyn Gordon gives a good digestof the work on experimental poliomyelitis in monkeys, anddetails as to the nature of the virus. He states that the

recogniticn of poliomyelitis in fatal cases is easy, owing tothe very characteristic histological lesions which occur inthe cord. He gives a table showing the chief points ofdistinction between a meningococcal meningitis, a septicmeningitis, a tuberculous meningitis, and a poliomyelitis.

In the fourth section Dr. Mervyn Gordon gives the resultsobtained from examination of material received from the casesin Devon and Cornwall. He states that the cells present inthe cerebro-spinal fluid were lymphocytes, but he does notgive the number of specimens examined. He suggests thatthe retention of the capacity of the cerebro-spinal fluid inpoliomyelitis to reduce Fehling’s solution may be of valuein the distinction between the cerebro-spinal fluid of polio-myelitis and that of tuberculous meningitis. A series ofexcellent photographs are given illustrating the changesfound in cases of acute poliomyelitis. He acknowledges hisindebtedness to the courtesy of Professor Levaditi, of Paris,for the animal experiments he has carried out with thematerial from this outbreak. Professor Levaditi reportedthat two monkeys injected with emulsions of the cord fromtwo cases developed typical poliomyelitis.

Clinical and Epidemiological Aspects.The fifth section is a digest of the clinical and epidemio-

logical aspects of acute poliomyelitis compiled by Dr.Macewen from various sources.

Dr. Newsholme in his introduction notes the importance ofwatching for the occurrence of epidemic poliomyelitis inEngland in order to take a suitable opportunity to makea comprehensive study of its clinical and epidemiologicalcharacters. He summarises the facts which have alreadybeen given in the above report, and states that "it is evidentthat much further research work is needed both in the

laboratory and by exact and painstaking inquiry into thecircumstances of local outbreaks, with a view to the moreexact determination of means of communication of thisdisease, and to the discovery of practically available methodsof recognising the presence of infection in early cases ofsuspected disease, and in contact with known cases of thedisease. "

EIGHTH CONGRESS OF THE GERMAN ROENTGENSOCIETY.-This Congress will take place at Berlin (Langen-beckhaus) on Sunday, April 14th, commencing at 9 A.M.

punctually. On the previous evening at 8 P M. any projec-tions which may be necessary to show in connexion with thenext day’s papers will be then exhibited in order to un-burden the proceedings on the Sunday. Papers and demon-strations must be sent before March 1st to Herr Dr.Immelmann, Ltitzowstrasse, 72, Berlin, W. 35. Communi-cations with respect to membership and subscriptions shouldbe made to Herr Melzer, Ziegelstrasse, 10/11, Berlin, N. 24.Dr. A. Kohler, of Wiesbaden, is the President for theyear 1912.

VENTILATION AND OZONE.

AT a meeting of the Royal Society of Arts held on Feb. 7th,Lord Sanderson being in the chair, Dr. Leonard Hilread a paper entitled ’’ The Influence of Ozone in Ventila-tion. "

Chemical Purity of the Air.At the commencement of the paper, which was a joint

communication by himself and Dr. Martin Flack, andoccupied about an hour in delivery, Dr. Hill said that thegood effects which resulted from efficient ventilation andopen-air treatment were generally supposed to be due to thechemical purity of the air, but this was an error, because theeffects in question were really due to the movement, coolnessand relative humidity of the air, and to the ceaselessvariations of these qualities. The chemical purity of theair could be considered from three points of view-

namely, the concentration - of carbon dioxide, the con-

centration of oxygen, and the supposed presence of organicpoison exhaled in the breath.

Concentration of Carbon Dioxide.It was an error to imagine that respired air was ren-

dered poisonous by the presence of carbon dioxide inamounts exceeding a very few parts per 1000. Thetruth of the matter was quite otherwise, for whateverthe percentage of carbon dioxide in the atmospheremight be, that in the pulmonary air was kept constant atabout 5 per cent. of an atmosphere by the action ofthe respiratory centre. At each breath a person re-

breathed into his lungs the air in the nose and largeair-tubes (the dead space air), and about one-thirdof the air which was inhaled into the lungs was

"dead space air. This re-breathing of one’s own breath,was a natural and inevitable performance for both humanI beings and the lower animals. By a series of observationsmade on rats confined in cages with small ill-ventilatedsleeping chambers Dr. Hill and Dr. Flack found that the

temperature and humidity of the air-not the carbon dioxideand oxygen concentration of the air-determined whether theanimals stayed inside the sleeping chamber or came outside.If the air was cold they stayed inside, even when the carbondioxide rose to 4 or 5 per cent. of an atmosphere. When thesleeping chamber was made too hot and moist they cameoutside.

In breweries the men who tended the fermentationvats worked for long hours in concentrations of carbondioxide of 0-5 5 to 1. 5 per cent., and such men were noless healthy and long-lived than those engaged inother processes of the brewing trade. It was onlyat higher concentrations of carbon dioxide, such as

3 to 4 per cent. of an atmosphere, that the respirationwas increased so as to become noticeable to the in--dividual himself; the limit of panting was then soon

reached and the power to do work was checked. Diverswho followed their occupation in diving dresses and menemployed in compressed-air caissons constantly worked inconcentrations of carbon dioxide higher than 1 per cent. ofan atmosphere, and so long as the carbon dioxide was keptbelow 2 to 3 per cent. of an atmosphere they were capableof doing efficient work.

Concentration of Oxygen.Turning now to the question of the percentage of oxygen

present in inhaled air, Dr. Hill said that the oxygen in theworst ventilated schoolroom, chapel, or theatre was never

lessened by more than 1 per cent. of an atmosphere, but in anthe noted health resorts of the Swiss mountains, such asSt. Moritz, the concentration of oxygen was considerably lessthan this. In Potosi, a city of 100,000 inhabitants at analtitude of 4165 metres in the Andes, the barometric pressurewas only about 450 millimetres of mercury, but the peoplenevertheless displayed great agility in dancing and in bull-fights. Dr. Hill and Dr. Flack had watched students shut upin an air-tight chamber until they came to breathe air

containing 3 - 5 per cent. of carbon dioxide and only about16 per cent. of oxygen-air in which they found they wereunable to light a match and smoke a cigarette. There wasthen too low a percentage of oxygen to support combustion,but of this the occupants of the chamber were quite unaware.All the evidence went to show that it was only when oxygen

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was lowered below a pressure of 14 to 15 per cent. of anatmosphere that signs of bodily distress for want of oxygenarose.

Supposed Presence of Organic Poisons.The facts already mentioned with regard to the atmo-

sphere in which certain brewery workers, caisson workers,and divers followed their occupation proved that concentra-tions of carbon dioxide such as occurred in the most crowdedand worst ventilated rooms were not directly injurious tohealth. Forced to admit this, the hygienist has fallen backon the hypothesis that organic chemical poisons were exhaled

in the breath, and that the percentage of carbon dioxidewas a valuable guide to the concentration of these. Itwas necessary, said the hygienist, to keep the carbondioxide below 0.1 part per 1000, so that the organicpoisons might not collect to a harmful extent. The supposedexistence of organic chemical poison in the expired airwas based upon experiments made by Brown-Sequard andd’Arsonval, who injected into guinea-pigs and rabbits eitherthe condensation water obtained from the breath or waterwhich they had used several times over to wash out thetrachea of dogs. The water was injected subcutaneously andin large amounts, and produced in their hands signs of illness,collapse, and death. A few confirmatory results have beenobtained by some experimenters who used such absurdmethods of investigation as to collect condensation water bybreathing through a cooled flask and to inject 1 or 2 cubiccentimetres of this fluid into a mouse weighing about13 grammes, a proceeding equivalent to injecting 5 litres ofwater into a man weighing 65 kilogrammes. Who would notbe made ill by the injection of about 9 pints of cold waterbeneath his skin ? The experiments of Brown-S6quard andd’Arsonval have been repeated by many others, and withnegative results by those whose methods of work demandmost respect-Dastre and Loye, Van Hofmann, Wellenhof,Lehmann and Jessen, Haldane and Smith, and Weir Mitchelland Borgey.Brown-Sequard and d’Arsonval in their experiments either

(1) gave intravenous or subcutaneous injections of condensa-tion water from the breath or washings from the trachea, or(2) they kept animals in cages communicating in series, acurrent of air being drawn throughout the entire length ofthe series. Dr. Hill and Dr. Flack suggested that the deathsof injected animals were due either to the excessive amountof the fluid injected or to the inclusion in it of droplets ofsaliva which produced the well-known phenomena of theanaphylactic shock. Anaphylaxis signified the condition inwhich an animal became sensitised by the subcutaneousinjection of a protein derived from an animal of a differentspecies, and an animal thus sensitised might be poisoned bya subsequent injection of the same protein. When theanimals in the last of the series of cages died, the fatal effectwas probably due to suffocation from the proportion ofcarbon dioxide in the air having been allowed to rise to 10 or12 per cent. Dr. Hill and Dr. Flack, after studying theliterature of the subject and making various experiments,have come to the conclusion that there was not at presentany trustworthy evidence of the presence of organic chemicalpoisons in exhaled air.

Effects of Electric Fans.

They enclosed eight students in a small chamber holdingabout three cubic metres of air and kept them therein untilthe carbon dioxide had reached 3 or 4 per cent. and theoxygen had fallen to 17 or 16 per cent. The wet-bulbthermometer rose meanwhile to about 85° F. and the dry-bulb thermometer to one or two degrees higher. The dis-comfort was very great, but this was relieved to an astonishingextent when electric fans placed in the roof were set inmotion, whirling the air in the chamber, and so cooling thebodies of the students. In a crowded room the air confinedbetween the bodies and clothes of the people was almostwarmed up to body temperature and saturated with moisture,so that cooling of the body by radiation, convection, orevaporation became nearly impossible. This led to sweating,wetness and flushing of the skin, and a rise of skin tempera-ture. The blood was sent to the skin and stagnated thereinstead of passing through the brain and viscera. Hencearose the feelings of discomfort and fatigue, but the fanswhirled away the layer of stationary wet air round thestudents’ bodies, replacing it by the somewhat cooler and

drier air in the rest of the chamber, and so relieved the heatstagnation from which they suffered.

Prophylaxis of Catarrhal Infections.Catarrhal infections of bacterial origin were spread by the

expulsion of droplets of saliva during the acts of speaking,coughing, or sneezing, and could not be prevented by ventila-tion. The true prophylactic against such infections was theavoidance of whatever might diminish the natural immunisingpower of the animal organism. Exposure to overheated dryair dried up not only the skin but the membranes of the noseand throat, and so lessened immunity. Exposure to over-

heated moist air brought the blood into the skin, lessened thecirculation through the viscera, and decreased the evapora-tion from the respiratory tract ; the system also suffered fromthe absence of the stimulating effect of cold on the cutaneousnerves. Hence arose diminished health and strength togetherwith increased susceptibility to catarrh. Those who habitu-

ally exposed themselves to cold rarely took cold. Confine-ment in overheated stagnant air, which too often pervadedplaces of business and amusement, was one of the chiefcauses of the depressed physical and mental vigour of towndwellers.

Properties of Ozone.Dr. Hill here showed an automatic ventilating fan to be

inserted in the window of an"apartment ; at temperaturesbelow 600 F. it remained closed but above 600 it remainedopen. He also showed some ozone-generating apparatus of theOzonair Company. Each co-mplete element of this apparatusconsisted of a thin sheet of micanite covered on each side bya square of gauze made of an aluminium alloy and having40 meshes to the inch. Ozone was produced by the silentdischarge of a high-tension electric current from one sheet ofgauze to the other across the micanite. Mammals exposed todifferent concentrations of ozone in a closed chamber were killedby prolonged breathing of an atmosphere containing about20 parts of ozone per 1,000,000 parts of air, the cause ofdeath being an acute irritative inflammation of the respira-tory tract. The ozone in such concentrations made the eyeswater and caused coughing. When ozone was employed inventilation it was arranged so as to produce none of thesesymptoms of irritation. Ozone could be used in high con-centrations for sterilising water, this being one of its mostvaluable applications. It also destroyed all disagreeablesmells. Ozone itself had a peculiar odour, which could beperceived by the nose in concentrations of far less than

1 part in 1,000,000, and for continuous breathing it shouldbe present in concentrations not greater than that which wasscarcely perceptible by the nose. Its powerful deodorisingproperties made it useful in places where offensive tradeswere carried on, and in improving the atmosphere of tuberailways.

MEDICINE AND THE LAW.

Thirty 1èars of Unqualified Practice.BEFORE the stipendiary magistrate at Leeds, William

Henry Gisburne Bowell, 72 years of age, was recentlycharged upon five summonses with offences under Section 40of the Medical Act of 1858, and having been convictedupon one was fined £10, including costs, the other fourcharges not being proceeded with. Section 40, it will beremembered, is directed against persons who falsely andwilfully pretend to be qualified medical practitioners, thetaking or using of titles implying medical qualificationsbeing a manner of committing the offence specially mentionedin the section in the form of an alternative. The career ofthe defendant has been somewhat remarkable, for he hasapparently been generally regarded among his lay neighboursfor many years as a qualified medical practitioner, although,presumably, such medical men as were aware of hisexistence knew that his name was not on the MedicalRegister.

In the case which was gone into before the magistratethe defendant’s lack of qualification and his readi-ness to give certificates in his assumed character ofmedical practitioner were brought to light by the navalauthorities at Sheerness in a manner unfortunate for thepatient implicated in the transaction. A young seaman inthe Royal Navy had gone to Leeds on furlough, and on the