The occurrence of a general cutaneous eruption consequent upon vaccination, that is to say the inoculation of vaccine virus upon an abraded skin surface, is a possibility generally recognised. But the meagre literature of the subject, and the scanty and brief references in present-day text-books of medicine indicate that the condition is only occasionally encountered.

In previous reports (vol. vi. p. 470 and vol. vii. p. 421), we described several series of experiments the results of which went to show that fleas and fleas alone were the transmitting agents of the infection of plague. It will be remembered that these experiments were carried out in a series of small godowns, the construction of which has been described in detail. The animals employed in the majority of previous experiments were guinea-pigs, though a limited number of experiments were carried out with monkeys. Gottschlich (Kolle and Wassermann's Handbuch der Pathogenen Mikroorganismen, Suppl. vol. ii., 1907, p. 52) considers that the results obtained with guineapigs cannot be applied to rats as the latter animals, unlike guineapigs, feed on the carcases of their dead companions. Gottschlich while admitting that fleas may transmit the disease from rat to rat considers this method of spread to be of only subsidiary importance. He is of opinion that, among rats, plague is chiefly spread by the healthy animals feeding on the carcases of the plague infected. In order to examine the validity of these criticisms we decided to repeat the godown experiments using wild Bombay rats instead of guinea-pigs.

(1) 855 primary cases of typhoid fever in households in Birmingham were investigated.

(2) In 124 or 14·5% of these cases a history of mussel eating within four weeks of the onset of the disease was obtained.

(3) In 17 instances the histories were conclusive of mussel infection.

(4) The curve of mussel-typhoid cases arranged in their weeks of commencement tallies closely with the importation of mussels into Birmingham.

(5) Mussel infection is one of the causes contributing to the autumnal rise of enteric fever.

(6) Some of the sources from which mussels are sent to the Birmingham market are known to be exposed to dangerous sewage contamination.

(7) 65 samples of mussels obtained on entering the Birmingham market from 22 different known sources were analysed bacteriologically.

(8) The results in terms of (a) the total number of organisms, (b) the number of glucose-fermenters, (c) the number of spores of Bacillus enteritidis sporogenes, and (d) the number of Streptococci shew that pollution to a dangerous degree of a large proportion of mussels placed on the market for human consumption exists.

(9) 14 experiments were carried out in relation to mussels subjected to mussels subjected to moist heat at 100°C.

(10) These shew that the ordinary method of cooking to mussels does not remove the risk of typhiod infection and that mussels may be heated in a steam steriliser at 100° C. continuously for as long as four and a half hours without sterilisation.

(11) Legisaltion is necessary to prohibit the gathering of mussels for human consumption from mussel beds exposed to sewage contamination.

The causes of death of the grouse are, of course, various. We ourselves have seen pleuropneumonia (in a bird long kept in captivity in Cambridge), pericarditis, necrotic patches in the liver, an obscure chronic disease of the peritoneum, and septic infection from a gangrenous fracture of the wing. On the other hand the great majority of birds, either picked up dead on the moor, or caught by keepers when weak and unable to fly, have been found to be all more or less in the same condition; they were wasted, badly infested with Trichostrongylus pergracilis, and often also with Davainea urogalli or Hymenolepis microps, or with both. More or less pathological change was seen in the caeca; the mucous membrane was often reddened, and under the binocular microscope considerable changes were seen, though we did not observe gross ulceration. Sections examined under the higher powers showed serious chronic inflammatory changes particularly in the immediate neighbourhood of the worms.

Up to the year 1906 tubercle bacilli were considered to occur in the faeces only in pulmonary or abdominal tuberculosis, due to ingestion of the infected sputum or to ulceration of the intestinal tract.

Unexpected contamination of several jars of a culture-medium was traced to some red rubber stoppers which had been washed and boiled and then kept for some days in 1:1000 potassium mercuric iodide solution, which was exposed to aerial contamination. An examination of this solution showed that it had very greatly diminished antiseptic properties. Not only did a mixture of equal volumes of the solution and broth support the growth of Staphylococcus but living organisms were actually present in it. These observations were repeated with a second solution of pure mercuric iodide and potassium iodide and other samples of red rubber, and their confirmation led to the investigation of the action of several kinds of rubber upon potassium mercuric iodide solutions.

(1) Dysentery strains from various sources have been examined with respect to their power of reducing nitrates to nitrites and of further destroying nitrites. All the strains with one exception (B. Neisser Ac.) reduced nitrates to nitrites. None of the strains which fail to ferment mannite (Shiga type) destroyed nitrites. Those dysentery strains which form acid from mannite differ amongst themselves in regard to their action on sugars and also in their effect on nitrites. Of the eight mannite-fermenting strains examined, two (B. dysenteriae Jürgens and B. Neisser Nc.) failed to destroy nitrites.

(2) B. dysenteriae Jürgens, although closely related to B. dysenteriae Flexner, differs from it both in its action on litmus-whey and in failing to destroy nitrite. It must therefore be considered a different strain. B. dysenteriae Jürgens is remarkable as being the only one of the strains examined which forms indol and at the same time fails to destory nitrites. It is consequently the only one which gives the cholera-red reaction.

(3) The addition of glucose (i.e. of a carbohydrate from which acid can be formed) enables Shiga strains to destroy nitrite.

(4) In the presence of an abundant supply of oxygen all the strains fail to destroy nitrites and nitrates.

(5) In glucose-containing media the inhibitory effect of oxygen is less marked.

(6) Under anaerobic conditions Shiga strains and B. dysenteriae Jiirgens still fail to destroy nitrites.

1. The abscesses in the viscera, especially the spleen, and in the peripheral lymphatic glands, some of which contain living plague bacilli, which have been previously described as “chronic plague in rats” are shown to be plague lesions in the process of healing. The name “resolving plague” is more appropriate.

2. These lesions are found most frequently towards the close of, and immediately after, the acute plague epidemic.

3. They have been found frequently in rats in Belgaum and Poona, and a re-examination of Bombay rats shows that they also occur there. We had previously only found them in the Punjab villages.

No hypothesis hitherto advanced with regard to the origin of Beri–Beri, has up till now found sufficient experimental confirmation to warrant its general acceptance. This applies especially to the conception of the disease as due to the presence of bacteriaor parasites in the blood, further to the infection theory as well as to the miasmatic theory1.

It is well established that plague, once it has gained a foothold in a place, tends to recur every year at the same season and that the plague season varies in different places. It has been demonstrated that in Bombay City the periods between the epidemics are bridged over by cases of acute plague amongst the rats accompanied by a few cases in man. Knowing, then, the factors which determine the rise and fall of the epizootic amongst the rats, once the infection is present, we have a fairly complete conception of the seasonal prevalence of human plague in a city such as Bombay. In the case, however, of a large province, such as the Punjab, with scattered villages, the question of the annual recrudescence in the several villages is not so simply answered. For, it will be remembered that in the two Punjab villages of Dhand and Kasel, which were under close observation by the Commission for a whole year, no acute plague was found amongst either man or rats in the long interval between the epidemics. While this is so, a certain number of rats were caught alive, which, although apparently in good health, harboured living and virulent plague bacilli in chronic abscesses (see above, p. 335).

Typhus Fever is a disease which modern sanitary reform has banished from the midst of progressive communities. As a result few opportunities are now afforded for investigating the disease by the bacteriological methods of to-day. Sporadic cases and small epidemics occur from time to time in the few insanitary districts that remain in Belfast. Dr Ernest H. Milligan and I made some observations of a bacteriological nature on this disease which we communicated to the Ulster Medical Society in 1908. Since that time I have continued the investigations when any opportunity occurred and in this paper are recorded the results which have been obtained. Recently some new light has been thrown on the etiology of typhus fever, so the present time appeared to me to be opportune to publish our own observations, to analyse the findings of other observers and to discover what is truly established with regard to this subject.

The United States has been fortunate in never having had any extensive epidemics of plague. With the exception of a few cases, not over a dozen, that are directly chargeable to the infection of the indigenous rodents (ground squirrels), the disease has been confined to the two largest and most important cities on the Pacific Coast, San Francisco and Seattle. In each city the disease has yielded promptly to vigorous sanitary measures carried out by the public health arm of the Federal Government. Under the political organization of the Government, direct control of measures for the suppression of a disease is taken by the central sanitary authority only when a request is made by the local authorities, but it has been the experience that local authorities are prompt to make requests for assistance whenever any serious epidemic appears.

The ultimate problem underlying many applications of the precipitin test, whether it be the determination of biological relationships, the identification of blood stains and other animal traces, or the detection of adulteration in food, is the recognition of the homologous protein (antigen) and its separation from closely allied heterologous proteins. Recognising that the antiserum is the main source of the precipitate in a precipitin reaction and having regard to the exact quantitative relations of antiserum, antigen and precipitate we have been able to arrange methods for the differentiation of proteins of closely related species and, we believe, to render more accurate the diagnosis of the source of individual proteins. To take a crucial instance, by means of an antiserum prepared with hen egg-white we have been able clearly to distinguish solutions of hen egg-white from all other avian egg-whites tested, including those of the duck, quail, partridge, pheasant and ostrich. So far as we know, Nuttall and Graham Smith alone have previously been successful in differentiating homologous and heterologous avian egg-albumens, and their methods appear to be more cumbersome than ours. Incidentally we have found that our results are not only consistent inter se but consistent also with the interpretation of the precipitin reaction which our previous observations had led us to adopt.

(a) General description and geographical position. Belgaum is a small town and military cantonment situated in the southern division of the Bombay Presidency, 75 miles inland from the western sea coast of India. It is situated 15° 51′ N. and 74° 31′ E. It lies on a plateau 2500 feet above the sea level on the northern slope of a water-course. The town is built on laterite which lies upon Deccan trap. The country round is fertile and well wooded.

In a preliminary report (Hewlett, Villar and Revis, 1909, p. 278) published last year a summary of conclusions at which we had arrived with regard to the nature of the cellular elements present in milk was set forth. These conclusions were formulated on results obtained during a prolonged quantitative and qualitative examination of these cellular elements in milks obtained from known sources under veterinary supervision, and possess, we believe, a chronological significance which, with the exception of results published by Russell and Hoffmann (1907), has been somewhat lacking in many investigations. For this purpose we selected four dairy farms at which milk was being produced for sale on ordinary commercial lines, but under various conditions of environment, both architectural and sanitary. Together with these we were also enabled, through the kindness of Professor Percival, to make use of cows in the experimental herd of the University College of Reading.

The following observations upon the Natural History of Epidemic Diarrhoea were made in Mansfield during the summer and autumn of 1908. The fact that at the time the writer was engaged in preparing a paper—to which the present paper is to some extent complementary—upon the epidemiological relations of season and disease, lent special interest to the enquiries regularly made from the Health Department of this town into the circumstances attending fatal attacks of diarrhoea. Early in the season a more than usually extensive enquiry was made into one of these fatal attacks in an area where an outbreak of diarrhoea appeared to be spreading outwards from a group of old privy-middens. To test how far the condemnation of the latter was justifiable another area was taken on the other side of the town, where the houses were newly built and provided exclusively with water-closets; and records, collected by house-to-house visitation, were obtained of all cases of epidemic diarrhoea, whether non-fatal or otherwise, occurring in these localities. The enquiries thus begun were afterwards extended so as to embrace two fairly large districts, a chance of doing this being provided by the opportune postponement of the addition to the department of certain work of inspection which had been impending at the beginning of the summer. These districts were several times revisited and scattered observations were also made throughout the other parts of the town. During 1909, while there was no opportunity of making extended observations, there were valuable opportunities during the course of the routine inspections of the summer of testing and re-testing the principal results obtained during 1908.

(1) The premises of 50 manufacturers of ice-cream were inspected, their methods investigated, and bacteriological examinations made of samples taken

“a” immediately after heating,

“b” after cooling,

“c” after freezing.

(2) The trade is not carried on under the conditions or with the precautions necessary to secure a clean product.

The sources of the contamination of ice-cream.

(3) Bacteriologically polluted ice-cream is due to

(A) Insufficient initial heating;

(B) Contamination during cooling and freezing from

(a) unclean vessels and covers,

(b) the addition of unclean ice to hasten freezing,

(c) the unclean hands of the manufacturer,

(d) dirty surroundings.

The scientific method of the manufacture of ice-cream.

(4) To secure a pure ice-cream:

(a) All vessels should be thoroughly cleansed immediately before use and reserved for the manufacture of ice-cream. They should be stored in a clean place.

(b) The manufacturer's hands and forearms should be thoroughly scrubbed and cleansed before each stage of the process. The clothing likely to come in contact with the ice-cream should also be clean.

(c) Fresh milk should be used in its manufacture.

(d) The ingredients should be boiled directly over a fire for ten minutes, or heated by means of a water-bath at boiling point for 30 minutes. The latter method is the better as the former is liable to burn the mixture.

(e) The mixture should be frozen, immediately after boiling preferably in a freezer of the American pattern. Thereafter the ice-cream should be kept frozen while in the vendor's possession.

(f) No ice-cream should be exposed for sale 48 hours after boiling.

(g) The premises on which ice-cream is manufactured should be approved and registered by the local authority and should be constantly supervised.

The term “Isolysin” was first employed by Ehrlich and Morgenroth in the third of their now classical series of papers entitled “Studies on Haemolysis(1).” It had been shown by Bordet that if the red blood corpuscles of an animal A are injected into another animal B, of a different species, the serum of B develops a haemolysin for the corpuscles of A. This haemolysin being produced in a different species of animal from that yielding the corpuscles, is termed, according to Ehrlich's nomenclature, a heterolysin.

Poona, the most important city of the Deccan, is situated 75 miles S.E. of Bombay on the eastern watershed of the range of Western Ghats, 1850 feet above the sea level. It lies on the Basalt Rock, with a surface layer of Deccan Trap and Black-Cotton Soil.