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diseases were injected into guinea-pigs had no fatal result. i

The alleged yellow fever bacillus is very small, its length 1

being about 1!1-, = 2.oho of an inch, and its breadth from 1

()-3!1- to 0-5 /t. It id straight, and is for the most part c

isolated, the cohesion of two individuals being rather rare. i

The outlines of its extremities are especially well marked. lIt is easily stained by basic aniline colours, but not by i

Gram’s method. It has not yet been ascertained whether it i

13 motile or not. It can be grown on a gelatin plate, forming 1

in twenty-four hours a white spot which in from twenty-four Ito forty-eight hours becomes larger and assumes the form of apin’s head. The gelatin is not liquefied. In a test tube the ibacillus penetrates into the gelatin, giving the appearance of 1a white thread, and forms a thick white coating on the sur- 1face. On agar round white discs are developed, which may 1either remain isolated or may join together. Koch’s bouillon lis rendered opalescent by the bacillus in twenty-four hours, ]with formation of a g’ey, cloudy sediment. Broth containingsugar undergoes fermentation. In agar mixed with sugara gas is produced which causes fissures in the agar. Thebacillus coagulates milk within twelve hours ; on potatoes itsgrowth is rather slow ; on blood serum it grows without anycharacteristic feature, producing opalescence and a sediment ;on coagulated serum a pale grey film is formed.

Farther Observations on the X Rays.Professor Roentgen has again made a communication to

the Royal Academy of Sciences on his great discovery. Hestates that while the x rays are passing through the air theytraverse it in every direction. When a plate impervious tothe rays is placed between a fluorescent screen and a sourceof the rays, so that the screen is overshadowed by the plate,the platinocyanide of barium nevertheless becomes luminous,and this luminosity is visible even when the screen lies’directly upon the plate, so that one might imagine that somerays had traversed the plate; but if the screen placed on theplate is covered by a thick piece of glass the fluorescencebecomes weaker and disappears completely when the glass isTeplaced by a cylinder of lead 0-1 cm (=-<}&otilde; of an inch) in thick-mess surrounding the fluorescent screen. Professor Roentgen’sexplanation of this phenomenon is that x rays emanate fromthe irradiated air. He considers that if our eyes were assensible to the x rays as to ordinary light the appearancewould be as if a candle were burning in a room filled withtobacco smoke. Professor Roentgen has, moreover, inventeda new apparatus for measuring the intensity of the x rays.He has succeeded in ascertaining by means of this apparatusthat the intensity of the rays is influenced : (1) by the courseof the primary current ; (2) by the interposition of a Teslatransformer; (3) by the rarefaction of the air in the tube ;and (4) by some other agencies not yet known. He concludesi(l) that the rays issuing from a discharging apparatusconsist of a mixture of rays of different absorbability andintensity; (2) that the combination principally depends on*the course of the discharging current ; (3) that the

absorption of the rays varies according to the absorbingmedium; and (4) that as the x rays are produced by thekathode rays, and have similar fluorescent, photographic,and electrical qualities, it is very probable that they areboth phenomena of the same nature.

The late Pastor Kneipp.Pastor Kneipp, the founder of the therapeutical system

called the Kneipp cure, died last week at Worishofen, inBavaria. He must not be confounded with the ordinaryquacks-unfortunately so numerous in this country-firstly,because he took no fees for his attendance, but was recom-pensed only by donations given by his patients to charitiesunder his patronage ; and, secondly, because m’my personsreally derived some benefit from his advice. His injunctions ofplain diet, cold bathing, walking barefooted on wet grass, and<3arly going to bed and early rising were undoubtedly usefulto patients with nervous troubles brought on by an injudiciousway of life ; but as he paid little attention to diagnosis histreatment often did harm to patients with organic diseases,whom he caused to live like the robust peasants of theBavarian mountains. Nevertheless, the number of peoplecoming from every part of the world increased from year toyear, so that the little village of Worishofen in course oftime was changed into a modern health resort, provided withlarge and comfortable hotels. With the money he receivedPastor Kneipp founded asylums, infirmaries, and otherbenevolent institutions, which, however, according toan inquiry conducted by the Munich Medical Society,<did not by any means fulfil the requirements of

modern hygiene. He never left his village except whenae was once summoned to attend the Pope and on

;he very rare occasions when he visited some of thecities of Germany for the purpose of addressing publicmeetings and propagating his views. His theoretical know-

ledge of medicine being far beneath that of a first year’smedical student, the speeches which he delivered at thesemeetings were a source of amusement to the medical menwho happened to be present ; but, strange to say, manysanatoria have, nevertheless, been formed throughoutGermany by medical men and others where his treatment isfully carried out. His personal character was recognised asblameless even by his adversaries. Although raised to thehigh rank of a prelate of the Church of Rome, he continued toLive as an ordinary country clergyman, and died withouthaving made any personal pecuniary profit out of the greatpopularity he enjoyed.June 28th.

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ROME.

(FROM OUR OWN CORRESPONDENT.)

The Bacillus Icteroides.

THE LANCET has already told its readers the circum-stances under which Dr. Giuseppe Sanarelli, sometime privat-docent at the University of Siena, now Professor of Hygienein the Medical School of Montevideo, set himself to discoverthe bacillus of yellow fever j how he conducted his observa-tions, clinical and bacteriological, at the Lazzeretto of theIsland of Flores and at the hospital of S. Sebastiano at RioJaneiro ; and how, after having himself contracted the feverand fortunately recovered, he continued his researches until,in the later months of last year, he satisfied himself thathe had found the bacillus, and embodied his conclusionsand the investigations that led up to them in a mono-

graph which he deposited with the Accademia Medica diRoma. Thereafter, having by fresh studies checked hisprevious ones and confirmed his conclusions, he thought fitto give the result to the profession and the world. This hedid lately before a scientific audience at Montevideo, andthe substance of his lecture, first announced in the laypress by telegraph, I can now supplement by minuter details.It was at the Lazzeretto on the Island of Flores that hefirst came upon the microbe of yellow fever." At the out-set he had difficulty in distinguishing among a varyingnumber of microbes the unvarying one of which he was inquest ; but at last he found it-never, indeed, unaccompaniedby others, but always preserving its characteristic features,while its occasional companions were protean. Contrary toexpectation, it was not in the alimentary canal that he cameupon it. Never, indeed, has he detected it there ; but in thecirculation and in the tissues he found it invariably, and sowas able to correct the current belief that the poison of yellowfever resides in the intestinal tract, showing, on the contrary,that it is formed in the vie intime of the tissues and in thecirculation itself. Morphologically, the microbe, to which hehas given the name of Bacillus Icteroides " presents atfirst sight little or nothing characteristic. Closer investiga-tion identifies it as a very small " baston. cino" " (rod) withrounded extremities, generally combined in pairs in thecultures and in little groups in the tissues; in length fromtwo to four thousandths of a millimetre, and for the mostpart twice or thrice as long as it is broad. It is pathogenicfor the majority of the domestic animals-a conclusion arrivedat by Professor Sanarelli after experiments made on 2000 ofthese. Few microbes, indeed, have a wider diffusion, everymammal on which he experimented having shown itselfmore or less sensitive to its pathogenic action, while thefeathered tribe, on the other hand, were quite irresponsive.White rats it kills in five days, the infection gaining afoothold through every channel, including that of respiration.Once admitted into the organism the microbes collect ingreatest force in the spleen, where they remain during thewhole evolution of the malady without noteworthy multi-

plication. After from six to seven days they all at oncepass into the circulation, enter on a period of proliferation,and kill by septicssmia. The rabbit is highly sensitive tothis pathogenic action, dying in from four to five days ifthe poison has entered by the subcutaneous tissue, and in

1 THE LANCET, Jan. 9th and April 3rd, 1897.

61

two days if it has been injected into the blood. In the

dog are obtained results showing the fever to be " aninfective malady due to a micro-organism well definedand susceptible of being cultivated by means of the ordinaryartificial nutrients." The bacillus, moreover, may be isolated,not only from the corpse, but even during the life of thepatient. Once isolated, its bacteriological diagnosis can becompleted in twenty-four hours, possessing as it doescharacters so distinct as to make it readily recognisableamong all the microbes hitherto brought to light. The

scanty number in which it is found in the organism and theviolence of the symptoms point to its action as that of a veryenergetic poison. The dog, as already stated, illustrates thisaction most significantly-scarcely less so the goat, the

ass, and the horse; while the cat is curiously refractory.The fever which he claims to have reproduced in man hasnot a few points in common with typhoid fever, and heemphasises the fact that the diffusion of the virus maybe effected through the air as well as by water, con-

tagion being possible through the respiratory system.The bacillus favours the entrance into the organism ofseptic microbes while its own action on the liver is pecu-liarly energetic, inducing rapid atheromatous degenerationwith other anatomical lesions, to which is due, in somemeasure, the icterus characteristic of the disease. Theliver loses all functional activity. Performing a conservativer6le against the poisons and microbes which would otherwiseattack the organism from the intestines, that P61,p fails whenthese microbes overcome its resisting power. They thusconquer and eliminate from the organism the bacillusicteroides, and in this way Dr. Sanarelli explains those casesin which the bacillus is no longer found on post-mortemexamination, or, if found at all, found only in a medley ofother species of microbes.The bacillus acts on the kidney by inducing inflammation

of peculiar intensity. This is followed by lesions evinced bythe albuminuria characteristic of the last period of the

yellow fever ; then anuria supervenes, the result of a " true

and idiopathic urasmia." Thus it happens that patients whenthey do not directly succumb to the poison and the lesionscaused by the "bacillus icteroides" may die by the secondaryinfection or by ursemia.The modus operandi of the bacillus having thus been

demonstrated Dr. Sanarelli next investigates its mode ofentering the organism. As already stated, he denies that its" sede elettiva " (elective seat) is the alimentary canal. Heis even inclined to doubt (what elsewhere he provisionallygranted) that it may find admission through the water.Atmospheric transmission is the channel he favours. Whiledenying that the alimentary canal is the "elective seat" ofthe malady, he is far from ignoring the possibility of itsbeing a mode of entrance for the bacillus. " The catarrhalprocesses of the liver," he maintains, " to which new-comersin tropical regions are subject, and the apparently triflingdisturbance of the digestive tract may in this case facilitatethe passage of the bacillus into the organism. At this pointhe enlarges on another I fenomeno biologico," which illus-trates the action of the bacillus and the genesis of yellowfever on board-ship. Badly-aired vessels are impregnatedwith a 11 fetid umidita which, with heat and the want ofventilation, forms the " coefficient of epidemics developed atsea." This atmosphere, on experiment, proved particularlyfavourable to the energising effect of the bacillus icteroides.In certain cultures, continues Dr. Sanarelli, when this micro-organism, sown for some time, seemed not to have caughton," the "mufEa" (or air mildew) sufficed to develop the"colonie caratteristiche" of the bacillus of yellow fever,and it is probable that on board-ship the preservation and"pullulazione" (germination) of the bacillus are due lessto moist heat considered as a physical agent than to thegeneration of "muffe" favoured by the condition of

temperature and humidity prevalent in ships at sea. Onthe other hand (Dr. Sanarelli proceeds), the notable resist-ance the bacillus icteroides oiters to the principal factorof natural disinfection, desiccation, to wit, and the greatlongevity it achieves during voyages, sufficiently explain theready acclimatisation of yellow fever and its stubbornpersistence on seaboards which have been visited by it.On the prophylactic and therapeutic aspects of yellow fever

Dr. Sanarelli promises special work. In the latter field hehas, I believe, a serum in contemplation from which heanticipates results not less satisfactory than those -yieldedin diphtheria. Meanwhile, we may echo the congratulationsvoiced by his compatriot, Dr. Alberto Guidi (whose notes

e from Dr. Sanarelli’s monograph I have freely made use of)),n and record our admiration for the thoroughness, the patience,d and the courage with which the young Sienese physician hasy " broken ground " in a difficult and dangerous field.l, June 26th.

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EGYPT.(FROM OUR OWN CORRESPONDENT.)

Pilgrims and Quarantin".THE Q tiarantine Board at Alexandria has had plenty to

occupy it during this month. The discovery of typhusfever among several flocks of recently imported sheepnecessitated the destruction of many hundreds in thequarantine parks. If it is true that typhus fever or

rinderpest can be introduced into Egypt as easily bysheep as by cattle it is a pity that stringent measures

are not adopted to prevent the importation of all sheepfrom infected ports. In 1884 regulations of this kind weremade in Egypt for cattle, and it is noteworthy that.bovine typhus fever has never appeared in this country .

since that date, the last epidemic having been in 1883. Butveterinary diseases are as nothing compared to humancholera and plague. The Board, after several meetingsand much anxious deliberation, decided not to interferewith this year’s pilgrimage in spite of the presence of cholerabacilli at E1 Tor. This decision was apparently based on theidea that when clinical symptoms do not coincide with thebacteriological diagnosis the latter is to be entirely dis-regarded. This is a dangerous precedent and somewhatsubversive of the modern system of allowing bacteriologiststo have a casting vote in cases of doubt. Imagine a manwith a cough, but all other symptoms and signs of doubtfulobscurity. If tubercle bacilli are found in his sputa thecase would surely be treated for the time being as one oftubercle. It does not seem irrational to expect that aman with diarrhoea and cholera bacilli in his dejectashould be considered-temporarily at least-as suffer-ing from cholera. But the Board decided otherwise,and the Bosnian and Herzegovinian pilgrims in ques-tion passed on to Turkey unmolested. The EgyptianGovernment, in spite of the absence of suspicious cases

among Egyptian pilgrims, noted the names and addressesof all returning pilgrims, and had them visited for five daysby the medical man of their own district. Hardly had thecholera scare died away than some cases of plague werereported at Jeddah, and this time the Board promptly settledthat the pilgrimage must be declared "unclean." It isunknown how the plague reached Jeddah, but one of theobvious possibilities is that it was brought there from Assir,the plateau between Hedjaz and the Yemen, where plague issaid to be always endemic. The existence of this districtis an additional reason for starting some bacteriological workin Jeddah or Mecca. A Mussulman might be sent there thisautumn to begin preliminary investigations. In the mean-time Egypt is free from cholera and plague and in manyways prepared to receive these unwelcome visitors ifnecessary.

Infectious Diseases.During the last six weeks three specific fevers have been

reported from the provinces. Small-pox has broken out inmost of the Lower Egypt provinces and half those of UpperEgypt ; 795 cases have been reported and 183 deaths. Typhusfever, including probably a few cases of relapsing fever,has occurred in ten places, causing 35 deaths out of a totalof 195 cases. Measles has been present in five provinces,accounting for the high death-rate of 122 out of 178cases. It must be remembered that the native doctors’diagnosis is often made after death, and should always bereceived with suspicion.

Cairo, June 20th, 1896.

NEW YORK.(FROM OUR OWN CORRESPONDENT.)

Deaths of Dr. J. Lewis Smith and Dr. T6m. Lusk.

l DURING the last week the medical profession of this city

and country has lost by death two of its most prominent-members. Dr. J. Lewis Smith died on June 9th at the