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the action of certain reagents found in the pancreatic glandsand known as ferments which hydrolyse the albumin. This

decomposition process is known to the lay mind as diges-tion. Since albumin decomposes into peptones, the lecturerproceeded, the conclusion may be drawn that albumin isbuilt up of many

" peptines," the name given to the anhy-drides of amido-acids from their great resemblance to pep-tones. The lecturer stated that he had by synthesis of sevenpeptines produced a compound bearing much resemblance toalbumin. This product froths and can be beaten into foamand is decomposed or digested when treated with the juicetaken from the pancreatic duct of a dog. Professor Fischer,therefore, supposes that from 30 to 40 peptines form apeptone and that albumin is the compound of several

peptones. The lecture was heard with great attention bythe assembly.

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THE CARE AND TREATMENT OF THE INSANEIN NEW ZEALAND.

THE report of the Inspector-General of Mental Hospitalsof the Colony of New Zealand for the year 1904 presentsmany interesting features. It is pleasing to note that in-stitutions for the treatment of mental disorders, of whichthere were eight at the date of the report, are not called" asylums " nor are the patients designated as " lunatics,"and it is therefore permissible to conclude that these uncouthterms have no place in the official nomenclature of the

colony. The boarding-out system appears as yet to be un-developed in New Zealand and there is need for after-

care associations to find homes for, and generally to super-vise, harmless patients who might be discharged fromthe hospitals had they homes to go to. Dr. D. Mac-

gregor, the inspector-general, combats the allegation thatinsanity is increasing in the colony, and his figuresshow that the progressive increase in the proportion of

the insane to the population since 1878 is due to diminu-tion in the number of deaths and discharges in the hospitals,to increase in the number of people resident over 50 years ofage, and to the increased percentage of admissions of personsover 50 to the total admissions. On the other hand, theproportion of admissions to population is less than in 1878and has not varied much since 1893. But although there is

no increase in insanity the Inspector-General considers thatit cannot be denied that with the selected population of thecolony and with its evenly distributed prosperity and lessstrenuous life there is too high a proportion of mentaldisorder in the community. For this statement there is

ground, since we find that the proportion of the insaneto the population in New Zealand in 1904 was 1 in285 or 3’51 per 1000, which figures, curiously enough,were precisely those officially recorded for England andWales on Jan. lst, 1905. The report goes on to describeinstitutions for the insane as " the monuments of failure " inthe effort to deal with the problem of insanity. It cannot

be denied that they indicate the failure of prophylaxis.Dr. Macgregor takes the view that it would be too greatan interference with the liberty of the subject to forbid themarriage of unsuitable persons. But it would be idle to

ignore the fact that there are at the present time manywhose opinion is entitled to consideration who believe that itwould be a mild measure to forbid the marriage of certainof the insane or the mentally defective and who do notadvocate that measure simply because they recognisethat it would not hinder the transmission of insanityin the case of children born out of wedlock. By suchfar more radical methods of prevention are advocated.Dr. Macgregor himself recognises that two preach thedoctrine of heredity and stress is to speak to the deaf."The remedy he suggests is a State insurance system underwhich, "on the principle that the issue of such unions

may become chargeable to the State, a proportionately

higher premium" might be fixed and thus the contractingparties enlightened "by the most forceful of arguments."This suggestion requires, perhaps, some further elaborationin order that it may be understood properly. A system ofcompulsory insurance is apparently suggested and if so the"liberty of the subject "is threatened in another way. In

any case it is by no means clear how such a system couldexercise an effectual deterrent influence upon the

irresponsible masses of the unsound and feeble in mind.It is of interest to note that the idea of the receptionhouse for cases of mental disorder in the initial stages, whichhas of late years been brought forward at home, has beenput into practice in New Zealand, an estate with two housesavailable for patients having been attached to one of themental hospitals. Into these houses patients are received,and spend the whole of the time for which they are undertreatment unless they become obviously unfit, in whichcase they are transferred to the main hospital. The

report states that the time has come to deal with the

question of the separate accommodation of the criminalinsane of the colony. The mental hospitals of New Zealandare to be congratulated upon the high recovery-rate whichthey are able to show with but few exceptions since 1876and which amounted to 45’ 34 per cent. of the admissions in1904. The death-rate has been uniformly low since 1876,being 6’ 38 per cent. of the average number resident in 1904.

THE INTERNATIONAL CONGRESS OF MEDICINEAND THE SEA JOURNEY TO LISBON.

IT is well to take time by the forelock and we are

pleased to hear that the Booth line of Royal Mail steamershas already made arrangements for the British members ofthe Fifteenth International Congress of Medicine who elect toproceed to Lisbon by sea. One of the best and newest ships ofthe company, the Ambrose, will leave Liverpool on April 9th.From London the passengers are booked through ’C’iâ Havre,leaving Waterloo on the evening of April llth, and they willbe on board the Ambrose at Havre next morning in time forbreakfast. The ship is due at Leixoes for Oporto early onthe 14th and the passengers will have the best part of two daysto see the Roman and Moorish remains, and the picturesqueand populated banks of the Douro, the prosperous capitalof the port wine trade. Finally, the ship is due at Lisbonon the morning of the 17th, so that the passengers willbe able to instal themselves comfortably and see some

of the sights of the Portuguese capital before the congressbegins. To those who have not made sure of their roomsit will be an advantage to arrive early. It is doubtfulwhether the better class hotels of Lisbon possess, if taken

altogether, 1000 beds. But some of the purely Portuguesesecond-class hotels are very clean and comfortable, and thecooking is not spoilt by abortive attempts to imitate Englishdishes. But so that its passengers should not be home-less on landing, the Booth line has secured 50 beds in a

newly built hotel, where all the modern conveniences andimprovements will be found, together with 20 more

beds at the well-known Central Hotel. It is need-less to add that the journey by sea, especially ifa return ticket is taken, is some 40 to 50 per cent.

cheaper than the overland route and includes board.The Pacific Steam Navigation Co. is also running a steamerfrom Liverpool on April 12th, which might be convenient,especially to members proceeding to the Congress from thenorth of England. From Liverpool this steamer sails directlyto La Rochelle-Pallice, which is within four miles of LaRochelle. Then it proceeds to Corunna and Oporto, reachingLisbon on April 18th-that is, one day before the Congress.

LECTURES will be given at the Hospital for Sick Children,Great Ormond-street, London, W.C., on Thursday after-

noons, at 4 o’clock, by members of the staff. The course will

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commence on Thursday, Jan. 25th, when Mr. T. H. Kellockwill lecture on Abscesses in Connexion with Spinal Cariesand their Treatment.

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Mr. Jonathan Hutchinson’s Reminiscences of the Hun-

terian Society, which he will give in the form of an addressto the society on Wednesday next, Jan. 24th, should be fullof interest to members of the medical profession. The

society cordially invites the presence of all practitioners.

Sir William H. Bennett has resigned his position as surgeonto St. George’s Hospital and in recognition of his long servicesto the institution has been appointed consulting surgeon.

A NEW PLAGUE PROPHYLACTIC.

Professor E. Klein has made a preliminary report to Mr.W. H. Power, Principal Medical Officer of the Local Govern-ment Board, upon the subject of a new plague prophylactic,and the report is of such great medical interest that we

publish it practically in full.Professor Klein commences by showing that the principle

underlying the preparation of plague prophylactics such ashave hitherto been employed has its basis in the well-knownfact that immunity of an animal to plague may be inducedby injecting into it a certain dose of culture of dead plaguebacilli or their extracts. "Thus," he says, " Haffkine usesa broth culture containing a large amount of bacillarygrowth, which culture has previously been subjected to heat(70° C.) sufficient to kill the bacilli. As Haffkine hasshown, and as is generally the practice wherever thisprophylactic is used, the amount of bacillary growthdetermines in a somewhat rough and ready manner theefficacy, and therefore the dosage, of the prophylactic. WithCalmette, as also at the Pasteur Institute, the prophylactic isan emulsion of the bacillary growth taken from the surface ofsolid agar cultures. On the other hand, Lustig uses in prepara-tion of his prophylactic, or rather his curative serum, the pre-’cipitate obtained from an alkaline emulsion of an agar cultureof B. pestis. Similar processes are employed by others inpreparation of their plague prophylactic. According tonumerous results hitherto published in India, South Africa,and elsewhere, the first two prophylactics-viz., Haffkine’sand prophylactic prepared in the, manner adopted byCalmette and the Pasteur Institute-are those which aremost reliable. Such disadvantages as are attached to themare the disadvantages generally inherent to all fluids pre-pared from artificial cultures, viz., the difficulty of preserva-tion and above all the diffioulty of securing, when large.amounts of material are prepared at one time, uniformity ofstrength-i e., efficacy for every single dose."The above disadvantages have led Professor Klein to

investigate the matter in a new direction ; to attempt,that is, to obtain a prophylactic free from the above defects.The results so far obtained by him in a large number ofexperiments carried out with this view justify, he considers,a claim to .uccess in his object. The following is hisreport :-The procedure which I adopt in preparing this new prophylactic is

based on the following considerations and observations :—1. Investigating the vitality of B. pestis in certain organs (bubo,

spleen, lung) of animals dead of plague, organs which had beensubjected to drying on various materials (wood, cloth, linen) atvarious temperatures over sulphuric acid, I found that after allbacilli pestis originally contained in such plague organs had beenIdlled in the process of drying, emulsion made of these dried organsand injected in definite amount into mice and rats was capable ofcausing death of these rodents within 20 hours or less-the animalsexhibiting phenomena not differing from those observed in acuteplague, except, Of course, that their tissues did not after death containany B. pestis. Also I found, when employing for injection an amountof emulsion insufficient to cause speedy death, that the animals,though made ill- exhibiting, for instance, local tumour and more orless constitutional disturbance&mdash;commonly recovered; and furtherthat these recovered animals when tested later on by injection withvirulent B. pestis were refractory to plague infection. From this itwould seem that the <ried plague organs, though not containing anyliving B. pestis are, nevertheless, imbued with a powerful plague toxinwhich in appropriate dosage may serve as a prophylactic.

2. I have shown in my reports to the Local Government Boardfor 1901-1902 and 1902-1903 that guinea-pigs inoculated cutaneouslywith plague material (bv an abrasion or a scratch of ’the cutis)develop as a general rule (unless, indeed, the infective material’be of extreme virulence) plague in what I have termed the

subacute form"; a form marked by necrotic bubo, necroticnodules in the spleen and liver, and particularly by necrotic nodulesand necrotic patches in the.lungs. In these cases death occurs gene-rally in from four to-seven or nine days (rarely earlier than four or laterthan nine days), provided the infecting material be of a moderatedegree of virulence, such, for instance, as on subcutaneous injectioncauses death in three to four da.ys, without the above necrotic changes.(Professor Klein has elsewhere pointed out that there exists in respectof cutaneous inoculation a marked difference of reaction between theguinea-pig and the rat; in the latter animal cutaneous inoculation isthe most reliable way of causing acute plague with fatal issue in two tothree days.)Examining sections of the organs containing the necrotic nodules and

necrotic patches of guinea-pigs dead of subacute plague, it is seenthat while the central parts ot the necrotic nodules are crowded withB. pestis, the peripheral portions (except their vessels), although quitebroken down into dead debris, contain few, if any, bacilli. From this itmay be inferred that, as is the case in other bacterial diseases associatedwith necrotic changes of the tissues, such necrosis is not caused by themere presence of the bacilli themselves but by the toxin produced bythem. As an illustration may be mentioned the necrotic action of thediphtheria toxin on a mucous membrane.

In view of the above two considerations I determined to inject intoa series of animals the dried organs (containing organ-toxin and deadbacilli) of various rodents dead of plague with the purpose of ascertain-ing the ability of these materials to protect similar rodents againstsubsequent infection with virulent B. pestis.A considerable number of experiments and observations were in the

first instance made by me in order to ascertain the best mode of pre-paring and preserving prophylactic material of this nature, as well as todetermine which portions of the body of an animal dead of plague arethe most efficacious for the purpose. It is not nece, sary to describein detail here all the steps adopted ; they comprised experiments with:(a) dried material of all the organs of mice, of guinea-pigs, and of ratsdead of acute virulent plague; (6) dried material (,f the bubo and spleenalone of mice, guinea-pigs, and rats dead of acute plague; (c) driedmaterial of all the organs of guinea-pIgs dead of subacute plague-i.e.,of guinea-pigs iu which death occurred after four or five days withnecrosis of the bubo, necrotic nodules of the spleen, liver, an1. lungs ;and (d) dried material of those organs alone which showed necroticchanges that is, bubo, spleen, lungs, and liver of guinea-pigs dead ofsubacute plague. These several materials were dried: -(e) at the tem-perature of the laboratory over sulphuric acid ; (f) at the temperatureof 200 C. over sulphuric acid ; (g) at the temperature of 37&deg; C. oversulphuric acid; and (h) at -the temperature of 46-47&deg;C. over sulphuricacid.The result of these experiments showed that a variety of tissues-the

bubo, the enlarged spleen, and the affected lung containing abundanceof necrotic masses, as also the liver when it contains abundance ofnecrotic nodules-of guinea pigs dead of subacute plague (i.e., deadafter five and nine days), cut out and finely minced aseptically, spreadout in thin layers in sterile glass plate dishes and dried over sulphuricacid at 46-47&deg; C., yield a material which not only can be very easilyand rapidly prepared but which is of a uniform and reliable efficacy, andin every way, indeed, superior to any of the other prophylactics.The guinea-pig, as compared with the rat, being a "clean "’animal,

appears greatly preferable for the above purpose. There is no difficultyin preparing and preserving the above necrotic organs, which yield com-paratively the greatest amount of material, in a clean manner, and theexposure to 46&deg; C. prevents growth and multiplication in them of anystray or accidental bacteria. A guinea-pig- of about 300-400 grammesweight will ield five to seven grammes of dry powder prepared fromthe bubo, spleen, lungs, and liver, and as the reliably protective dosefor an adult rat (see below) is 10-15 milligrammes, it follows, therefore,that one large guinea-pig can yield about 400-600 doses. Three days’drving in thin layers over sulphuric acid at 46&deg;C. was found-more thansufficient to devitalise all B. pestis contained in these organs. Afterthree days’ drying the dry scales of material are rubbed down to a finepowder in a sterile mortar; this powder is then transferred to a sterilewide-mouthed bottle, plugged with sterile cotton wool, which is placedfor two to three days at 370 C. in order to thoroughly complete-theprocess.of drying. At the end of these three additional day s the cotton-wool plug is replaced by a glass stopper and the prophylactic is readyfor use. It can be thus preserved indefinitely jn a dry state by a layerof paraffin over the stopper. Such material tested by cultivation isfound sterile; it yields no growth of any kind.In preparing the prophylactic for use the desired amount of powder

is weighed out, well rubbed down in a desired amount of -sterile warmdistilled water, and the turbid emulsion thus obtained is injectedsubcutaneously. The principal consideration is, of course, the amountof dry powder, the amount of water used per dose is immaterial. I

generally use c.c. of water per dose, but there is no reason w hy ; c.c.or 1 c c. should not be used.As I have indicated, the material contains not only the acutely active

toxin but also the dead bodies of all the bacilli pestis originally presentin large numbers in the necrotic organs (bubo, spleen, liver, and lungs),with addition probably of other substances of an undeterminednature and action. That the prophylactic efficacy of the materialis not solelv due to the bacillary bodies (known to possess both toxicand prophvlactic action) retained after drying, can be gathered fromthe fact that an amount of dead bacilli from culture considerablylarger than the quantity contained, say, in 10 milligrammes of dryspleen material, possesses neither the same toxic nor equal immunisingefficacv as the latter. For instance, 5 c.c. of Haffkine prophylacticstrongly turbid with flakes and masses of bacilli does not confer immu-nity on an adult rat; 10 c-c. is the required dose. On the other hand,10-15 milligrammes of the dry powder above referred’ to does conferimmunity on the adult rat.

I now summarise the results obtained by using the above describeddried material in a large number of experiments, comprising severaldozen white mice. five to six dozen guinea-pigs, and considerably over150 rats, chiefly white. ,

1. The above prophylactic kills a large percentage of mice within20-24 hours in doses of 1-5 milligrammes.

2. It kills a percentage (12-25) of half-grown white rats in doses of5-8 milligrammes, if the material is derived from acute virulent cases ;but if obtained from the necrotic organs of guinea-pigs dead of sub-acute plague (death 5-9 days) as much as 10-12 milligrammes are

required for fatal effect. The dead animals show local swelling, with