the role of the bowel flora in chronic disease

THE BRITISH HOM(EOPATHIC JOURNAL 3

T H E ROLE OF T H E BOWEL FLORA IN CHRONIC DISEASE

By DR. JOHN P / ~ T ~

British Homc~opathic (3qngr~ss, Glasgow ( S ~ t e m ~ r , 1948)

MR. CHAIRMAN, LADIES AND GENTLEMEN, '~ I consider it a great honour to be the first speaker on the programme of this congress, which has as its theme " Homceopathy and Modern Research ", What I have to "offer you to-day is the result of twenty years observations as physician and bacteriologist upon the role played by the non-lactose fermenting bacilli of the bowel in chronic disease. The subject mat te r of this paper then will necessarily require to be considered under two heads--(1) Bacteriological, (2) Clinical.

BACTERIOLOGICAL

ID In 1880 the bacteriologist Eber th succeeded in isolating and identifying the B. typhosus--a non-lactose fermenting gram negative bacil lus--and it was easy to provide the experimental evidence of the role this played when found in the intestinal tract.

From tha t date onwards other organisms were noted as present in the intestinal tract, and their isolation and identification as members of the coil- typhoid group easy to establish, but as they failed to give any experimental evidence of pathogenesis, they were dismissed as having no significance in the bowel flora.

The publication of the work by Bach and Wheeler, under the title Chronic Disease, A Workin 9 Hypothesis in 1925 is therefore of some importance and must be the starting point for my contribution of this afternoon. The book is unfortunately out of print, and even second-hand copies hard to come by, so I may be permitted to quote and briefly to summarize their work, as their conclusions were in opposition to the then accepted theories, as the following quotation shows. " A point which we particularly wish to stress is that a non- lactose fermenting gram negative bacillus in the f~eces, whether it falls into a known variety or not, may be the cause of toxzemia even though it may not give rise to obvious lesions. In fact the great majori ty never do, nor can, cause locally anything more than at the most, a little mucous colitis or some affection of tha t nature."

" Vaccine therapy principles warrant the belief tha t if disease symptoms disappear or are much ameliorated after the use of a vaccine made from a particular organism, then tha t organism counts at least for something in the production of the disease symptoms."

Acting on tha t assumption a polyvalent vaccine of all types of non-lactose bacilli from the bowel was prepared for hypodermic use, and the results of t rea tment of 500 cases of a variety of chronic diseases published. The results are rather striking :

Swift and striking . . . . . . . . . . . . . . . 15 per cent. Gradual and excellent . . . . . . . . . . . . . . . 65 per cent. Some definite effect . . . . . . . . . . . . . . . 15 per cent. Unaffected . . . . . . . . . . . . . . . . . . . . 5 per cent.

CONCLUSIONS

" Our conclusions are based on ten years work, BacteriologicaI and Clinical, and our results are such tha t we desire to invite as wide a testing as possible of both conclusions and practice. For if our colleagues can confirm us out of their experience they will find themselves possessed of a new and powerful weapon for t reatment of chronic disease, and if they cannot confirm us

4 T H E B R I T I S H H O M ( E O P A T H I C J O U R N A L

then one more hopeful path will be Shown to be a blind alley and we can turn to new explanations."

Have we tested, as widely as possible, their conclusions ; have we found by experience a new and powerful weapon in the t reatment of chronic disease ? I t rust tha t in the discussion to follow there may be many who can give of their experience and thus contribute to this Congress upon Homoeopathy and Modern Science, keeping in mind the new standard---the clinical test--set up by their colleagues Bach and Wheeler.

I t is not the lot of all to participate in this work in the bacteriological laboratory, but it was my great privilege to take up the work as bacteriologist and physician immediately after the International Homceopathic Congress (London) 1927, when it may be said that the potentized bowel vaccines {Bowel Nosodes) were first introduced to Homceopathy.

I shall not neglect to give anyone interested in the technical side of the bacteriological data opportunity for discussion, but at the moment I ask that they accept the s ta tement tha t there was a standard technique and nomenclature in use, which I shall call the Bach technique when I took over the work in 1928. With this technique it was possible to isolate and identify the types of non- lactose fermenting bacilli which formed the polyvalent bowel vaccine, and to proceed to the clinical s tudy of each as to its pathogenesis.

Within the homceopathic schoolthe oral vaccine displaced the hypodermic preparation, and the potentized vaccine (nosode) the bacterial emulsion.

The names of the organisms which designate the l~owel nosodes are familiar to most of you, but to assist any who are not acquaint,, and for purposes of reference later, I offer each member of Congress a list of names of the organisms so far identified in the laboratory and clinically proved, with a list of associated remedies.

This you will note is an extract from a paper published in April, 1936, entitled " The Potentized Remedy and the Bowel Flora ". This has been amended and brought up-to-date by the addition of many more remedies.

By the cross checking method of (1) observing the clinical symptoms present when a particular organism was identified in the bowel and (2) observing the clinical symptoms which were ameliorated or disappeared after the giving of a particular bowel nosode, it was possible even at that t ime (after some eight years work) to give some tentat ive indications of the pathogenesis of certain types.

Now, after twenty years work, combining clinical and laboratory observations, I can with confidence record the pathogenesis of each of the named types on tha t list. I hope you do not expect me to give you the pathogenesis now, the subject mat ter of which takes up a full week's course of Post-Graduate Class of the Faculty of Homceopathy.

After ten years ' work Bach and Wheeler invited as wide a testing as possible of both their conclusions and practice.

Mte r twenty years ' of clinical and bacteriological research I h e r e b y confirm their hypothesis, tha t the non-lactose fermenting gram negative organisms of the intestinal t ract do have a role in the causation of chronic disease, and that in the bowel nosodes I find myself possessed of a new and powerful weapon for t reatment .

I have no doubt that many of you will likewise confirm the therapeutic value of the bowel nosodes, and so add your evidence to the proof that the bowel nosodes have stood up to " t h e clinical test "

But I must also, to satisfyfl4~odern ~cience, submit the clinical evidence to the laboratory test and for tha t purpose I shall take the first group of organisms on the list : B. Morgan (Bach).

B. Morgan (Bach). This non-lactose fermenting organism occurs with the greatest frequency in the stool, and thus offers greatesr opportunity for clinical observation. Accordingly i t s " proving " i s not only extensive but also detailed.

T H E B O W E L F L O R A I N C H R O N I C D I S E A S E 5

To the homceopathie physicians the " mentals " and finer details are of prime importance, but for the purpose of this paper I must pass these over and mention only the more gross pathology. The Morgan (Bach) group--which includes all the sub-types--has action mainly on the vegetative system of the body : on the mucous membrane of the whole alimentary tract from the mouth to the anus, and the prolongation of the tract into the liver.

I t also acts on the mucous membrane of the whole of the genito-urinary tract. While internally it acts on mucous membrane, it has also marked action on the skin.

From the list you will notice that the main Morgan group has been sub- divided into (a}Morgan (pure) and (b) Morgan-Gaertner. Is there any clinical significance of this sub-typing ?

In the laboratory technique introduced by Dr. Bach the organism was named according to the sugar reaction at the end of eighteen hours incubation. An organism which produced acid and gas in ~lucose only, irrespective of what happened thereafter, would be named Bacillus Morgan.

In my laboratory observations I noted that some types thus named B. Morgan (Bach) remained true to the usual maximum period of incubation of seventy-two hours, and to this I gave the name B. Morgan (pure). In other cases after the initial eighteen hour period a change was noted, so that at the maximal period of seventy-two hours the sugar reaction was that of B. Gaertner, and to this type I gave the name Bacillus Morgan-G~rtner.

All the members of the Morgan group have selective action on the liver, but ther~ is a difference in the degree of action of the sub-types. B. Morgan- Gaertner has been found in the stool more often in the case of acute inflammation of the gall-bladder, acute cholecystitis, and B. Morgan (pure) is usually associated with the more chronic phase of gallstones. The more acute action of Morgan-Gaertner is also noted throughout the genito-urinary tract, but its main action is upon the kidney with the formation of renal calculus. B. Morgan has outstanding action upon the skin.

Here then is a clinical distinction which is in accord with the classification and technique of the bacteriological laboratory. And so throughout the organisms on this list, each has its own characteristic symptom complex or pathogenesis and definite sugar reaction according to the standard adopted in the laboratory.

What is this laboratory standard and why was it adopted in the first instance ? For those who are partieularly interested in the technique and nomenclature, details will be found in the Transactions' of the Eleventh Congres$ of the International Homeopathic 1,ez~jue which was held in Glasgow in these rooms, August, 1936.

The choice of sugars to constitute the test in any instance is purely an arbitrary one, and thus it follows that if one group of carbohydrates is used, one classification is obtained : if another group of sugars is selected an entirely different classification is possible, hence the confusion in assessing the pathogenesis of any named organism and comparative analysis between different teams of workers.

Even with the adoption of agreed standard sugars it was found t h a t many factors caused variation even with the most rigid control of purity of sugars, temperature and time factor, and all possible extrinsic factors. There still remained an intrinsic factor which caused variation in fermenting powers.

" The only justification-for founding a classification upon one series of experiments rather than upon the other is the fact that the classification so obtained corresponds more closely to differences brought out in other ways, such as differences in agglutination or pathogenicity " - - so writes Gurney- Dixon in his very excellent book The Transmutation of Bacteria.

" The day has passed when agglutination tests with the patient's serum

6 T H E B R I T I S H H O M ~ J O P A T H I C J O U R N A L

can be acceptecl as diagnostic evidence " states a modern writer on the Bacteri- ology of the Typhoid Salmonella.

The justification for the arbitrary choice of sugars in any work on the non- lactose fermenting gram negative bacilli of the bowel must lie in the clinical observations of pat]Jogenesis for each type.

One important factor, namely the source from which it comes, in other words the nature of the media from which it is is61ated, may determine certain variations---the organism carrying, as it were, the imprint of the media. Conversely the sugar reactions of an organism immediately it is capable of being isolated, may give the bacteriologist the clue as to whence it has come, a fact sometimes of value in tracing epidemic outbreaks.

I t was with this fact in mind tha t a departure was made from the more usual seventy-two hours incubation period and an eighteen hours period adopted as the standard t ime for identification and naming. I t was hoped tha t variations in fermenting power at this stage might have some pathogenic significance. So it proved to be, as in the case of the sub-typos of the Morgan (Bach) group.

I t is now recognized tha t the fermentation of any particular carbohydrate is dependent upon the act ivi ty of a particular ferment or enzyme, indeed the splitting process takes place in three stages with a particular enzyme responsible for each phase. Failure to produce either acid or gas may be due either to the absence or the inhibition of a particular ferment. There is some support for the theory t h a t the loss of power to split carbohydrate compounds is in direct ratio to the increase of pathogenicity.

Variations in sugar reactions may then be considered to have biochemical significance, since enzymes are known to be very complex protein substances, and this in turn must be considered to have relationship to pathogenesis. The study of the biochemistry of the bacterial cell thus becomes of prime importance to the modern scientist in bacteriology.

I confess I am unable to follow the chemical formulae which is to be found in the very recent publication The Chemical Kinetic~ of the Bacterial Cell, but I am encouraged to know tha t this work is being undertaken.

I would, however, draw your at tention to the list of organisms of the bowel flora with their associated remedies, and explain to you tha t they have been placed there because, in each case, the respective bacillus has appeared in the stool of a patient subsequent to the administration of tha t particular remedy. The remedy was chosen according to HOM(ZO-t'A'rmC principles, i.e. because it was known to have pathogenic power to produce symptoms similar to those . observed in the patient.

Looking down this list one is struck by the varying degrees of chemical combinations, varying from a simple element like Sulphur, through salts, carbonates and chlorides, to complex substances from the vegetable and animal kingdoms. Their association in this grouping must have some significance since they have relationship to a common organism possessing specific fermentive power. I t is now recognized that a sequence of cell reactions may begin with very simple chemical substances, and that from this raw material complex and varied products can be built up.

" A natural hypothesis is tha t compounds similar to these various growth factors are intermediate in the chain of processes occurring in cells which can start with simpler materials " - - so says the author I have just mentioned, and he further offers a useful analogy by asking the reader " to think of the chemical operation of the cell less as the piecing together of a jig-saw cut into large fragments which will fit together only in one way, than as a formation of a mosaic from simple units which can be combined in innumerable ways."

I find this hypothesis very at tractive as it affords me a basis upon which to formulate my theory regarding the appearance of these non-lactose fermenting


bacilli following the administration of a remedy. I can conceive tha t such an elementary remedy as Sulphur may set up a chain of reactions which ultimately results in the formation of a complex substance---an enzyme--and it is known tha t the bowel mucosa has its peculiar enzymes which act as a barrier to the bacterial invasion of the body proper.

I t is reasonable to presume tha t the chain of reactions set up may affect these enzymes and thus finally affect the BOWEL FLO~. In the laboratory the change would be noted by the peculiar sugar reaction, which we have noted is due to specific enzyme action. From the sugar reactions of the gram negative non- lactose fermenting bacilli it is possible to formulate not only the degree of pathogenesis but also to recognize something of the biochemistry of the process.

On this hypothesis each of the bowel nosodes--products of bacterial cell ac t iv i ty - -can be assumed to be a very complex structure of the nature of a mosaic with each of-the remedies in each of the particfilar groups forming the units which make the pattern. I t matters not if they are simple or compound, animal or vegetable each has a part in the completed structure.

In my paper " Sycosis and Sycotic Co." published in B.H.J., April, 1933, I made the s ta tement t h a t " ms the result of one's observation there is warrant for making a very definite s ta tement of great importance to Homoeopathy and to Bacter iology-- that homceopathie potencies are capable of altering the flora of the bowel". I would add a quotation from a further contribution " The Potentized Drug and its Action on the Bowel Flora " published three years later (1936). " I t is a doubtful compliment to one's work tha t so far such a definite claim for the potentized remedy given according to the laws of similars has remained unchallenged."

t tomoeopathy has something to offer to the modern research worker in the bacteriological field and to the student of biochemistry. The work on the bowel flora has opened up a new approach, and I have tried to indicate tha t in modern scientific literature there is accumulating evidence to offer some explanation for the clinical observations I have made, and which I t rust will give some satisfaction to the modern scientist who demands such evidence.

I have no doubt tha t I shall be met with the criticism tha t it is generally accepted that diet can alter the bowel flora, and tha t m y observations might have been influenced by that fact.

Since the days of Metchnikoff (about seventy years ago) many a t tempts have been made to change the bowel flora--all of which had some success, but all had the same fault, the change achieved was of a temporary nature; and persisted only so long as t rea tment was maintained. Metchnikoff advanced his sour milk t heo ry - - tha t the B. Bulqaricus found in sour milk could alter the flora of the bowel, and by supplanting harmful organisms promote good health and long life. I t is~I think, rather of interest to note, tha t although his clinical observations were sound, as proved by the fact tha t the sour milk t rea tment is still accepted as modern t reatment , his bacteriological technique was at fault. He confused two very similar organisms. The B. Bulqaricus which he found in sour milk cannot live in the intestinal tract, whereas the B. ~idophilu~ is an intestinal organism which can be trained to ferment milk. I t was not the organism in the sour milk but the organism in the bowel which received dietary stimulus which caused activi ty and rapid increase in numbers to the exclusion of all other bowel organisms.

There is a record of some very detailed experiments to be found in A Treatise on the Transformation of the Intestinal Flora with special Reference to the Implantation of B. Acidophilus, published by Yale University Press (1921). The work was conducted at the Sheffield Scientific School of Yale University.

The conclusions briefly summarized are as follows :. (1) B #[cidophilus given in whey broth cultures in sufficient amounts

{300 c.c.) c~n alter the bowel flora by suppressing or supplanting other organisn)s.


(2) Lactose (sugar of milk) when given in sufficient quantities,300 to 500 grams per day, can also change the bowel florajwith the appearance and pre- pondel ance of B.~rcidophilus.

(3) Combining the administration of B..Jfcidophilus with r~actose~comparatively small amounts were required to maintain the change in the bowel flora. (150 grams lactose and 150 c.c. whe~ bIoth.)

" The simple character of the new flora persists so long as one or other diet or preparatior~ is continued, but reverts gradually to the normal or usual mixed type within five or six days after a return to the basal diet."

Keeping in mind the point made earl'er in this paper---that bacteria arc peculiarly adaptable to environment, and indeed must train themselves to utilize whatever media is available in order to survive, it is not difficult to explain the change of bowel flora under such a set of experiments. If one made up a mixed culture of bacteria containing but a small proportion of B s and inoculated this into whey broth to which lactose had been added, there would be an immediate reaction. Subsequent plating would show that there was an overwhelming preponderance of B. Agidophilus even to the suppression of all other types.

In these Yale University experiments the intestinal canal was used as a test tube, and it has to be noted that it required 500 grams of lactose daily in the human subject to maintain the B. A~cidophilus, and that Lactose was the only sugar capable of thus altering the bowel flora, the reason given being that this sugar is incompletely absorbed in the intestine and can be found in the large intestine and give reaction on test in the stool. The lactose thus acts as a particularly utihzable pabulum for the growth of this particular organism. In the laboratory the standard strength of all sugar solutions for the growth of organisms is only 1 per cent.

In these experiments the conclusions reached must be my answer to the diet crit ic--that in a matter of days after the return to the normal basic diet, the bowel flora returned to what it was before. The change was due entirely to the supply of sufficient pabulum.

Contrast the change in the bowel flora which follows the potentized remedy. By no strateh of imagination can one suggest that the administration of a single dose of 1~ potency, say of Sulphur, supphes any pabulum for the production of B. Morgan.

Furthermore, the change does not usually take place until a more or less definite latent period of ten to fourteen days, and when the change does take place it may persist for weeks and even into months. There is record of cases where the change has persisted over fourteen months and in this phase my experience has been that nothing that I know of in diet or medicinal treatment will effect a change : it seems to run its own course. Such a change must be due to other than the mere change of pabulum iri the intestine, and must be attributed to some disturbance of the enzyme balance of the host which with- draws or inhibits the ferment responsible for splitting up of lactose---hence the change to non-lactose frementing bacilli.

So much for the non-lactose fermenting bacilli of the intestinal tract and the role they play in the causation of chronic disease.

But the investigations should not stop there : the question arises as to the type of bowel flora present before the change over. Whence cometh the non-lactose bacilli ? Were they present before, but in such small amounts as to escape attention ?

I think the control examination made over considerable periods negatives this suggestion in numerous cases, and the general opinion would be to accept the fact that the change is an example of mutation of bacteria. The role played by the B. Colisgenerally considered to be a normal inhabitant of the large bowel, is little understood or even taken notice of. From the moment the infant is put on to other than mother's milk, coliform organisms appear in the


stool and persist throughout life in great numbers. So long as the mucosa and its enzymes remain in a healthy state the B. ~ol i cannot enter the body proper. They are considered non-pathogenic and their main function is to break down the waste material of the bowel into simpler substances.

As a class their variety is legion, the number of possible variants increasing in direct proportion to the number of fermentable substances used for classification. I t is calculated that with eight characters (sugar reactions) there are 256 possible variations, and the number rises to 65536 when sixteen characters are taken as standard.

Is there any wonder that the bacteriologist has given up the seemingly hopeless task of attempting 'to classify fully the B. f~oli of the intestinal tract, and without classification the study of pathogenesis becomes impossible--and here I had better add in parenthesis (so it would seem), as I am about to attempt the impossible.

In 1905 to 190.9 MacConkey adopted as his standard a very simple classification which is now generally accepted, and is to be found detailed in the System of Bacteriology, Vol. 4, published by the Medicat Research Council.

MEDICAL RESEARCH COUNCIL--BACTERIOLOGY--VOL. 4, PAGE 260

MacConkey (1905)---Colon. Group.

Typek/ Glucose. Lactoses. Dulcite, Example~

Types

AG AG AG AG

AG ~I Sacciar~ 1 - - O

AG AG AG AG / AG AG A O

Bach-Paterson Group (1928)/

!

Glucose, , Lactose/

AG AG AG AG

Sacchaxosef

O O

AG AG

Dulcitcl

O AG AG O

B. Acidi Lactici B. Coli Communis B. Coli Communior B. Lactis Aerogenes

Exampl 9.

B. Morgan (pure) B. Gaertner B. "No. VII " B. Proteu.9

I t is encouraging to read that " in the classification of intestinal organisms the fermentation tests have in practice proved to be sufficiently constant to be of great value ". ~' There is something more than mere chance behind the fact that the majority of the pathogerdc races are unable to ferment lactose."

On the reverse side of the list of non-lactose organisms and the associated remedies I have copied out for you the MacConkey table, and underneath I have added for comparison, a table of members of this non-lactose group.

If you place a pencil over and down the lactose columns you will note that the tables become exactly alike. If by any disturbance the MacConkey group lost its power to ferment lactose B. Coli No. I would mutate to B. Morgan (pure) ; B. Coli No. I1 to B. Gaertner ; B. Coli No. I I I to B. No. V I I ; B. Coli No. I V to B. Proteus.

Has this any significance or is it a mere coincidence ? Since 1906 when l~leisser called attentioli to a curious variant B. ~oli-mutabile--the phenomenon has been noted as indicating that the B. )~oli which normally ferments lactose temporarily loses this power when first isolated from the bowel. On a lactose acid solid medi~t white colonies appear which after a time show small red daughter colonies, the redness indicating that the individual bacteria therein have regained their power to ferment lactose. If these colonies are replated they do not change but retain this property.

1 0 T H E B R I T I S H H O M G ~ O P A T I ~ I I C J O U R N A L

On the other hand if the white colonies are replated, again there will appear some white colonies which later give red daughter colonies.

From my observations on the plating of the non-lactose over several generations, it would seem that each of the non-lactose types in this Bach- Paterson group tend to revert to lactose fermenters--that B. Morgan reverts to B. Coli I ; B. Gaertner to B. Coli I I ; B. No. V l l to B. Coli I I I ; B. Proteus to B. Coli I V.

I put this forward not as an established fact, but as a possible avenue for further investigation by a team of laboratory workers.

Meantime I offer you, like my predecessors in this work, a working hypothesis for you to test out as widely as possible as to my conclusions and practice.

I t may come as a surprise to many of you to know that you personally have been assisting in working out and testing the soundness of this hypothesis. During the past ten years or so, those of you who have sent me specimens of patients' stool for report may have noticed that in many cases the report definitely stated t ba t - -~o non-lactose bacilli ha~been found in the specimens, but in each case you may have been given the suggestion to t ry the corresponding non-lactose nosode and its associated remedies. For example : if B. Coli I was found Morgan was advised, if B. Coli I I , Gaertner ; if B. Coli I I I , No. VI I , if B. Coli IV, Proteus. With what success, or lack of success, I now await your verdict. From my own clinical experience I have found this working hypothesis of considerable value in the treatment of chronic disease.

Clinical observation makes me hazard the opinion that every organism found in the intestinal tract has pathogenic power, the bowel flora forms a physiological unit and is not a miscellaneous collection of germs.

I know that I shall be met at once by strong criticism that in the plating of a stool specimen, it would be a false hypothesis to assume that every B. Coli which forms a colony on a MacConkey plate has the same characteristics as evidenced by sugar reactions, and hence has the same pathogenic power. How then can one suggest treatment from the isolation and identification of a solitary B. Coli colony.

In my working hypothesis I accept the fact that o~ganisms which live together on the same media, in this case the intestinal tract, are either in symbiotic or anti-biotic relationship to one another and if one can isolate a single type of organism and from the culture prepare and administer the potentizcd remedy (nosode) it may be possible to disturb the balance and set up a chain of reactions in the manner I have already described.

I would remind you that for a long period, bacteriologists relying upon their experimental evidence, mainly on animals, that non-lactose fermenting bacilli of the intestinal tract did not produce any par lesion, induced the physician to accept the idea that these organisms played no part in causing disease.

I think it can now be established that the non-lactose fermenting bacilli of the intestinal tract do play a part in chronic disease, and the proof has come, not horn the laboratory but from the clinical success which has followed the administration of the potentized vaccine (nosode) made from these organisms.

The bacteriologist must now accept the evidence of the physician that these organisms are pathogenic--and here may I give my interpretation of the word " pathogenic ". In derivation it means " originating disease ", but I would prefer to modify this for the purpose of this paper, as meaning " associated with disease ". I visualize the germs as being present but not necessarily causing the symptom complex--the disease. Such an interpretation'may not be literally accurate but I suggest that it is more scientifically correct, and in any case it will help me to discuss with vou the more practical aspect of this paper. You have. before you a list witch two columns, one under the heading " organisms " and the other " associated remedies ". From this it becomes possible for any physician engaged in general practice, without the technical

T H E B O W E L F L O R A I N C H R O N I C D I S E A S E l l

T ~ E POTENTIZED t~EMEDY A~D THE BOWEL FLORA

(Paterson) Brit ish Homceopathic Journal (April, 1936)

AMENDED LIST (AUGUST, 1948),,.

Organismp Associated Remedies~,

I. B. MOROAN (BActI) (a) B. Morgan (pure)

(Paterson)

(b) B. Morgan-Gaertner

A l u m i n a Crraphites Baryta carb. K a l i Carb. Calc. carb. May. Carb. Calc. s'ulph. Nat . carb. Carbo veq. Petroleum Carbo 8"ulph. Sep ia Digitali.~ S U L P H U R Ferrous carb.

Medorrhinum, Psor inum, Tuberc. boy. Chelid~on. L Y C O P O D I U M Chenop. Mere. sulph. Hellebore Sanguinar ia Hepar 8ulph. Taraxavum l ~ h e M . ,

II. B. PROTEUS A u r u m tour. Ignatia A p i s Ka l i tour. Baryta tour. Mag. mur. Calc. m~r. Muriat ic acid Conjure Natr~m tour. Cupr~on Secale Ferr. tour.

I I I . B . * " N o . vH " Arsen. iod. K a l i carb. Bromine K A L I IOD. Cede. iod. Ka l i nit. Ferr. iod. Mere. iod. K a l i bichrom. Nat . iod. K a l i brom.

I V . B . GAERTNER Calc. fluor. Nat . phos. Calc. hypoph. Nat . sil. fluor. Calc. phos. P H O S . Calc. sil. Phytolacca K a l i phos. Pulsati l la May . phos. S I L 1 C A M E R C . V I V . Zinc phos.

Syph i l i num

V. B. DYSENTERIAF. A R S E N 1 C U M A L B . Verazrum alb. and vir. K A L M I A

VI. SYCoCcus (Paterson) Ant im. tart. Nitr ic acid Calc. met. Rhzav. tox. Ferr. met. T H U J A Nat . 8ulph.

Baci l l inum

VII. Cocci (Bowel) Tubercul inum Baci l l inum

VIII. " No GROWT~ " M E R C . SOL.

knowledge, or the'facilities, of a bacteriological laboratory, to determine for himself the role played by any of the organisms named in the first column.~ k I n this the physician who has been fortunate enough to acquire a knowledge of homceopathic practice and is acquain~ with the homceopathic materia medica has a peculiar advantage. In the second column he will find many remedies used in homoeopathic practice, and of which he has

1 2 T H E B R I T I S H H O M ( E O P A T H I C J O U R N A L

formed a mental picture of their pathogenesis--or " proving ". By compounding the symptom complexes of each of the group remedies, he can form a symptom picture of pathogenesis of the individual organism. With this Jn mind he may then use the product-- the potentized vaccine--the nosode in the treatment of disease and by his results determine whether the organism does play any role in chronic disease. He may also, by clinical trial, determine if the nosode does complement and enhance, as I suggest it does, the action of the remedies in the group. The bowel nosodes have been available and been used by homceopathic physicians since 1928 and thus there should be opportunity for many of you now present to give evidence of the therapeutic value--or otherwise, of these nosodes.

This table can also be of service to the physician in hospital or specialist

~ ractice, in interpreting and putting to practical use a bacteriological report. hould there be a particular non-lactose organism reported as present, practical

guidance is afforded in two directions. Note should be made of the actual percentage of the non-lactose to other organisms present and this detelmines according to a proposition I formulated in a previous paper " The Potentized Drug and its Action on the Bowel Flora ", B.H.J., April, .1936, whether it is advisable to give or to withhold the administration of a vaccine or nosode at that moment.

Probably of greater importance is the fact that the finding of a particular type of non-lactose organism at onbe indicates to the physician a small group of remedies which he may consider as applicable to the case. Experience has shown that where a specific non-lactose organism has been identified, a remedy from that group has given evidence of clinical action. In chronic disease it is often impossible to get a c]in]cal picture from which to choose a remedy and the stool examination is thus of great value in giving guidance to a possible group of associated remedies, in such cases.

The clinical test has pioved that the non-lactose fermenting bacilli of the intestinal tract do play a role in chronic disease.

As I have already mentioned, the bacteriological investigation should not stop there and I have offered for your future interest and assistance a working hypothesis founded upon the typing of the B. f2"oli. You must no longer accept a bacteriological report which states, " no pathogenic organisms, B. jg'~li only .

The lactose fermenting bacilli of the intestinal tract the group known as B. Coli--can be I"ATHOGE~IC and this assertion is made not on experimental work in a laboratory but on clinical observation on the sick human.

I suggest that in asking for bacteriological reports on stool specimens, you request that the B. ~oli be typed according to the MacConkey grouping, which you will find on the reverse side of the paper before you. I have suggested that the B. ~oli according to that grouping is related to a corresponding non- lactose type and t h a t the nosode of that non-lactose type with its group of associated remedies, can be used with clinical bcnefit in chronic disease.

From my clinical observations, I then assert that B. r can be pathogenic - - t h a t they may play a role in chronic disease.

I appeal, not to the bacteriologist, but to the clinician to test out this working hypothesis.

In conclusion I would borrow from Chronic Disease, .4 Working Hypothesis by Bach and Wheeler, the publication with which I introduced this paper and with slight modification I would say. " My conclusions are based on twenty years' work, bacteriological and clinical, and my results are such that I desire to invite as wide testing as possible of both conclusions and practice.

" For if my colleagues can confirm me out of their experience~ they will find themselves possessed of a new and powerful weapon for treatment of chronic disease, and if they cannot confirm me, then one more hopeful path will be shown to be a blind alley and we can turn to new explanations."

T H E " B O W E L F L O R A I N C H R O N I C D I S E A S E 13

REFERENCES

BACR and WHEELER. Chro~ic Disease--A Working Hypothesis. 1925, GUR~EY-DLxoN. Transmutation of Bacteria. 1919. I~r:TTOER and CH~I"IJ~'. Intestinal Flora. (With special ~{erenee to the Implantation

of the Bacillus Acidophilus.) Yale University Bt,~s. 1921. HAVEI~-S. The Bacteriology of Typhoid, Salmane2ltt and Dysentery Infectio'ns. 1935. HINSHELWOOD. Chemical Kinetics o/tl~e Bq~grial Cell. 1946. PATERSON. " The Potentized Drug and i ts Action on the Bowel Flora." B.H.J., April,

1936. - - Sycosis and Sycotic Ce ~" B.H.J., April, 1933. - - - " Technique in th~ l~reparation of the Non-lactose Fermenting Nosodes of the

Bowel and the lrul~ations for their use." Transactions of Eleventh Congress of International I-Jamceovathic Leag~e, Glasgow, August, 1936.

DISCUSSION

Dr. HA~tmTO~ : I would l ike to t h a n k Dr. Pa te r son ve ry much for his mos t in teres t ing paper . I t h i n k we all agree t h a t we look fo rward with an t ic ipa- t ion to his address and we are r a re ly d i sappoin ted . His inves t iga t ions are alxvays br inging fresh l ight to bear on the p rob lems of chronic disease and these inves t iga t ions of t he sc ient is t u l t ima t e ly g ive va luab le ass is tance to the clinician in his e v e r y d a y pract ice .

I do no t i n t end to discuss the bacter iological aspects of our subjec t - - - these have been adequa t e ly dea l t wi th b y Dr. Pa t e r son himself . R a t h e r would I supp lemen t his observa t ions by focussing your a t t en t ion on the use of t he nosodes in prac t ice .

I t has been shown t h a t the non- lac tose fe rment ing organisms have been found in t he stool associa ted with some cases of chronic disease, and in considering the app l ica t ion of the nosodes in t r e a t m e n t i t seems to me t h a t the following genera l pr inciples should be borne in mind.

(1) Each of the non- lactose fe rment ing organisms i s associa ted with a specific form of chronic disease and has i ts own par t i cu la r and pecul ia r g-ymptomatology.

E.g. t he s y m p t o m a t o l o g y of Morgan is different from t h a t of (~aertner or P~oteus, etc.

Also, i t has been found t h a t t h e s y m p t o m a t o l o g y of each of these organisms is s imilar in m a n y ways wi th t h a t of o ther remedies .

E.g. Morgan with Sulplrur, Proteus with Nat. mur., Morgan-Gaertner with Lycopodium.

These remedies have been found to be comple me n ta ry to t he nosodes. (2) Often in a difficult case, one cannot decide which r emedy to give, even

a f te r t he mos t careful reper tor iza t ion . Two or more remedies m a y have equa l ly s t rong indicat ions in t he case. I n these c i rcumstances , a nosode is of ten useful since in i ts own s y m p t o m a t o l o g y i t combines the s y m p t o m s of t he o the r remedies.

E.g. the use of Dys. Co. which m a y combine the s y m p t o m s of Arsenicum, Lycopodium and Argentum nit.

Later , a f te r the nosode has acted, the s y m p t o m s of a par t i cu la r r e m e d y will be demons t r a t ed and this ind ica ted r e m e d y should now be adminis tered .

(3) The nosodes should be admin i s t e r ed in t he same manner as a n y homoeopathic remedy . They should no t be given empi r ica l ly bu t only on the basis of the homceopathic law " Simil ia simflibus curen tur ". Since each nosode has i ts own symptomato ]ogy , t he nosode should be given only when the s y m p t o m s of t h e pa t i en t ' s i l lness correspond to those of t h e nosode. The m a n y fai lures of our o r thodox b re th ren are due to the i r omissions in th is respect . Unt i l recent ly , when Dr. Pa te r son gave his course of lectures to t he F a c u l t y of Homceopa thy in London few of us knew the s y m p t o m a t o l o g y of t he nosodes.

Prev ious ly we would admin i s t e r t he nosodes on a pa thologica l basis :


E.g. Dys. Co. in cardiac disease and duodenal ulcer. Morgan Co. in eczemas. Proteus Co. in spasmodic conditions and epilepsy. In these conditions we were ignorant of the fact that other nosodes may be indicated.

We may have been fortunate in obtaining a good result, but often failure was our portion and then the nosode would fall into disrepute.

However, if Dr. Paterson's notes were published, I am sure they would be of inestimable value in stimulating the proper appreciation and use of the nosodes.

(4) Repetition of the nosode is similar to repetition of any homceopathie remedy. I t must not be done indiscriminately nor empirically. The changes in health following administration of the remedy should be carefully noted and only when evidence is found tha t improvement has ended=--ouly then should repetition be considered. Usually improvement after a nosode lasts two to three months and often much longer.

(5) Potency of remedy. I have based my experience on the use of the 30th potency and have obtained excellent results. Other potencies may also be used. Where there is gross pathological change the low potency of a nosode should be given. But in the early stages of disease where only toxic symptoms are present, then the higher potencies may be used~,. ,

I'N illustration, 1 should Iike to present" the tlrt-gf ~ s of a few cases who have made positive changes in health following the administration of a nosode. The nosodes were administered according to the s imi la r ly of the pat ient 's illness to the symptom complex of the nosode with no reference to stool culture.

Case 1. Mr. H. B., act. 60. 8.4.48 C/o Eczematous eruption for two years.

Eruption generalized over body and limbs. Watery discharge and crusts. Worse in summer. I tch and irritation in bed and with heat. Bowel. Costive. Mentals. " Nervous " and " High strung ". Apprehensive. Had very great nervous anxiety twenty years ago.

Ars. alb. 200/i. 6.5.48 Nervous tension I.S.Q. Marked apprehension. Eczematous

eruption v.m.b, on legs. Arms I.S.Q. S.L.

20.5.48 Anxiety and apprehension both worse. Eczema was better, now worse.

Dys. Co. 30/vi. 8.7.48 Mentals. Anxiety and apprehension both improved. Eruption

on legs and aVms almost clear. Some scarring and pigmentation. S.L.

5.8.48 Anxiety acad apprehension much better. Eruption was cleared, but now slight recurrence of erythema in hot weather.

Dys. Co. 30/vi.

Case 2. 28.7.48

Mr$( F. T., aet. 75. /

C/o Flexural cczematous eruption for seven days. Erupt ion--papular , vesicular and pomphylox. Has yearly attacks, usual/y in summer. Eruption irritable and itchy, worse in heat and water. O/e Skin is cracked and moist with crusts. Bowel. Costive. Bilious at times. Flatulence and nausea. Mentals. Anxious and worried. Apprehensive. Rheumat ism:

T H E B O W E L F L O R A I N C H R O N I O D I S E A S E 15

11.8.48

25.8.48

Case 3. 15.7.48

26.8.48

Feet. Pains aching, worse in damp and easier with contd, motion. Hands and feet cold and cyanotic. Peripheral circulation poor.

For acute phase. Rhus tox. 30 Acute phase healing. Skin. Eruption healing. Discharge and crusts v.m.b.

Morgan Co. 30/vi. Eczema healing. No vesicular eruption, only papular. Moistness less. No crusts. I tch and irritation only slight. Bowel. Less costive. Stomach. Flatulence and nausea less. Hands and feet less cold and cyanotic,

S.L. Even though patient has had nosode for only two weeks at time of last report, the general health had improved and peripheral circulation much better, that one hopes for even greater improvement in the future.

V.L. Male, act. 7-12 years. Complaint. Infantile eczema. Child the second in the family. Mother and other child also suffer from eczema. Eruption on face, .scalp, chest, arms and legs since 6/52 old. Vesicular with sticky discharge and crusts. I tchy and irritable, worse with heat, after food and with teething. Less with tepid bathing. Stomach. Ravenous appetite. Craves milk. Allergic to eggs. Urticaria with eggs. Bowel. N6rmal action. Mentals. Irritable with skin eruption. O/e peripheral circulation poor. Acrocyanosis and coldness of feet.

Morgan Co. 30/vi. V.M.'B. in all ways. Eczematous eruption cleared on face, scalp, che'st and legs. Very slight on forearms. No discharge or crusts - :on ly erythema. Itch only slight, but worse after food. Stomach. Nausea with eggs still, but less severe, associated with urticaria. O/e acrocyanosis and coldness of feet both much better,

S.L.

These three cases are illustrations of the use of the nosodes where the totali ty of the patients' symptoms was similar to the symptom picture of the nosodes. May I emphasize that it is only when the nosodes are given in strict aocordance with the rules of homceopathie prescribing that successful results are possible with their use.

]Yfay I once more thank Dr. Paterson for his paper and congratulate him on his masterly exposition of the problem of the bowel flora in chronic disease ? I am sure he has elucidated for us many of the difficulties which have beset us, and I, for one, look forward to put to practical use the many scientific facts which he has brought before us to-day.

Dr. BRIOGS : I must thank Dr. Paterson for the latest interesting paper of a series of interesting papers which has to a great extent influenced, I might say, my life during the past ten to twenty years. I was an orthodox bacteriologist of the 1908 school and in those days we were all taught that the germ caused the disease and that was such a plausible explanation of disease that it was eagerly seized upon. We add the germ to the subject and we get disease. Fortunately we had a few deeper thinking people in the profession who saw


beyond what seemed to be a really very plausible theory. Even to-day we think of the B. Typhus as the cause of typhoid. But, is it ? We know that so many people take it and never have the disease. Other factors enter--immunity, etc. Even to-day these factors are not fully elucidated. ~ I .r.,~ a . , , aI

about 1.92~, .o~.eaxlia~ W& ~lw.~. . . . . ~.,~'~ ~,,,,,u~,~,'~ _t.,.,.~l.___-.v,~ Di~c,~e, t-hel~-Ope'ir~t~p before me visions of a whole new field of work. I was not a doctor in those days, I am one of the yomager members of the profession, but chancing to get hold oi~a-copyof an old Congress Proceedings, I read Dr. Paterson's woIk and when I first met with the members of the then Scottish branch of the British Homceopatkiic Society, I was delightod to find one of the first men I met was Dr. John Paterson. I had tried out in conjunction with one of our late member~, Dr. MacKenzie Murray~ the preparation of those bowel nosodes from stools,supplied and while, at tha~ time, not conversant with the clinical details of t~e results he got, he led me to believe that he was quite satisfied with the resnlts that I was able to give him. So that, passin 8 rapidly over the darker years af m . y - l ~ - m the ~..-fidernczs, +_.here o~m~- th~ ~ ~ t h c ~ being a

an~ it was decided by Dr. Paterson and myself that it would be a good thing if we could produce some evidence of the action of the remedies on the bowel flora and a good thing to put before you. Unfortunately if we had th'e facilities to do this we did not have the necessary support, but I am glad to say that this was forthcoming in May of this year and we then decided to get togethcr and work together to carry out some investigations into the role of the bowel flora. At present we are engaged in the work. We regret that it has not been possible to give you anything definite enough to satisfy such a Congress as this in the time we have had at our disposal. We have investigated approxi- mately between 150 and 250 stools per month since May and we hope that before another year comes round we shall be able to get something out of it. The trouble is that we get interesting stools and then we go for the next sample and are told that the patient has been dismissed from the hospital. Stools are. taken from Glentower (Adult Section) and from .the Children's Hospital

ha~-~,~e,-~ txrsxrpp~ ~s wi~h ~I . . . . , ~ l ~ - - t t ~ I~ a gre~t . . labe!~he~,-f~ ~axxd_l wamt also-to.thn,nk_t~r do_et~rs w-ho.havedetivered themto

faithfully' We had some qmte interesting results. For instance, I had one stool which was completely negative, i.e. showing no non-lactose bacteria: a week later it showed 100 per cent. non-lactose organisms and three days later it was back againicompletely negative. Well, we want to know the reason for that. 1 looked up the clinical record in this case and found that the patient had not received any treatment in hospital but she had had a long string of remedies given at various intervals, from 24 hours to two or three weeks, from the medical at tendant before she had been admitted to hospital. These are question marks we want to get at. Why should these bowel flora alter like that so rapidly ? Had one of these remedies given a fortnight before been in action for that period in which the stool showed the presence of a non- lactose organism ? These are the type of questions we are trying to answer and I think by the time we have collected a thousand or so stools, in conjunction with the clinical records, we shall be able to arrive at something we can put in front of you. t S ~ thz~t~ may 1~ of gre~t v~tu~ ~ tzo fine homc~opm4ni~ p r o ~ ~ to the attotmtrb. ~ t ~ ! l y ]~ would like t o say t h ~ I ~hink light is creeping into the eyes of the allopathic sphere. While I was at Sheffield University this July I heard a paper read by Dr. Joan Taylor of the London Central Public Health Laboratory entitled " The Pathogenesis of the Para ColonBaciUi." A very interesting paper it was but in-it she confessed that there was no clear picture of pathogenic changes e~osed by the B. Coll. Sometimes we are apt to generalize. I am looking forward to reading that paper when it is pttl~shed as I am to Dr. Jo!m Paterson's paper as it was read this morning. I must thank him again.

T H E B O W E L F L O R A I N C H R O N I C D I S E A S E 17 ['r

Dr. Mc'CRAE : When I get a list of drugs referring to a particular subjeor I always enjoy their examination from the point of view of their electro-physical relationships. I t will interest Dr. Paterson and those who are acquainted with his work that we can discern something which is quite remarkable about his different lists. When we examine the drugs associated with :

B. Morgan. No. of drugs in Group 1 - - 2 drugs. No. of drugs in Group 4 - - 3 drugs. No. of drugs in Group 5 - - 2 diugs. No. of drugs in Group 6 - - 1 drug. No. of drugs in Group 7 - - 1 drug. No." of drugs in Group 8 - - 7 drugs. No. of drugs in Group 10 - - 2 drugs.

We know from our work that there is a certain relationship between the 4th, 5th and 8th Groups. In this list, when we take these together we see that of the eighteen drugs mentioned there are no less than twelve that come into this group relationship. Of these twdve, Sulphur of the 8th Group is noted as the particular drug. In this work of Dr. Paterson's therefore he has struck a law of relationship in the bacteriok)gical sphere which corresponds in a striking manner to the law of electro-physical relationships.

When we go through his lists we find the same strong tendene$. If we take the strain of :

B. Gaertner No. of drugs in Group 4 - - 2 drugs. No. of drugs in Group 5 - - 9 drugs. No. of drugs in Group 8 - - 3 drugs. No. of drugs in Group 7 - - 1 drug.

ttere we find fifteen drugs, and fourteen of these fall into the 4, 5, 8 group series of emanometer classification. The predominant group is the 5th and Silica of the 5th group is noted as the particular drug:

We also know very clearly that of all the electro-physical group relationships by far the most common is the 4, 5, 8 and 11 Group series. I t is not unexpected to find that the 5, 8 Group relationship occurs most often amongst the examples which Dr. Paterson presents. When we examine B. Dysenteriae and its associated drugs we find Arsenicum alb., Votatrum alb., and Veratrum viride. These belong to a series quite different to all the others, namely, the 1st and 6th electro-physical group series. We could deduce from this that B. Dysenteriae belong to a class of organism with a clinical association which is quite outstanding in its difference, and probably much more characteristically acute than the clinical picture of all the other bowel flora which are noted in this presentation. I t will be interesting to hear Dr. Paterson's-opinion on this point.

Dr. Paterson has adde d evidence of great value to our annals of homceopathie research. His meticulous work has pointed to a very remarkable laboratory technique which shows the influence of potency energy on the human body before any other customary laboratory investigation can do so. We are greatly indebted to him for this outstanding contribution.

Dr. KV.RR : Besides thanking Dr. Paterson for his paper, I have just two remarks. The first is not medical at all. If this creation (I think we can assume that) is the,~vork of one creator, I think it necessarily follows that one law must traveJ wRh any other law and consequentl~ if the law that we, all of us, follow " Similia similibus curentur " is a fundamental law, I think i~ follows that if the work of different branches as the electro-physical and the bacteriological work that we have just listened to, if those are correct, they will mesh in somewhere when we know sufficient about them. I think the kno~ing sufficient about them is rather essential.

The other side was Dr. Briggs. He mentioned that it is the patient who is ill and not necessarily the germ. I had personally an interesting experience once at a time when there was no cholera about. I t was not a cholera season

18 T H E B R I T I S H H O M ~ O P / k T H I C J O U R N A L

at all and I went down with what my assistant surgeon, who was an Indian, a clever fellow and well-versed in cholera, s05d.~vas cholera. 1 had all the symptom8 of the disease. I don' t know much about it (being the patient), but he reported it as cholera and said that I would have to be sent home. Actually I was not, but there was the illness and there was no germ at ~ll. Nobody had cholera after me and nobody~ra~l~c b~fu~ , ~ L

Dr. J ~ I A ~ : I have had no experience whatever with the nosodes though I have been interested in the sub]6ct and have listened to Dr. Paterson and read in the JOURNAL of his work but there are two or three points about the significance of the bowel flora in disease about which I am rather puzzled. The first is that the appearance of those non-lactose ferments in quantity in the bowel has

.been assumed to have some definite significance with regard to the patient's illness, i.e. with regard to the pathogenesis of t~he illness and I want to a~k whether a s~ries of control experiments have been carried out in apparently normal individuals with variations in the bowel flora. Dr. Briggs has told us of a casecoming into hospital in whose flora there were at one time no non- lactose fermenters and then 100 per cent. and then none at all. Have these changes any real significance with regard to the production of the illness or are they accompaniments of the illness that have no necessary part in the pathogenesis ? I think one can only arrive at the truth by the provision of a sufficient number of control~. If one can take, for example, 100 people who are apparently in normal health, ff there is such a thing, and examine their stools periodically over a very long period and see what changes there were in the bowel flora then some information might be gained. Again, it seems to me even although you can show in a diseased case that there is variation in the bowel flora, the explanation of the disease does not lie so much in the changes of the flora as in the conditions of the bowel which made those changes in the flora possible. That is to say, the patient is not ill because he has pathogenic~l organisms, but the pathogenic~ organisms are there because he is ill ! That raises the question of the pathogenesis of these organisms. One associates a significance with the presence of these flora but the point is that one takes these associated symptoms that are found _with the symptoms of these flora as the pathogencsis of the particular organisms. But are they ? In our provings we demonstrate certain drugs and a certain series of symptoms arc produced and we call these symptoms the pathogenesis of the drug. But is it possible to produce pathogenesis by the administration of suspensions of these organisms ? I don' t know. I want this question answered. If you simply find an organism. it is an assumption that the organism is the cause of the disease. You may find

�9 that the patient is very ill when there are no particular members of these flora present and thepat ient may be better and you may find a considerable number. I t is this relationship that I think is interesting.

Then I would like to know Whether in the course of treatment of a case when one gets the peculiar phenomenon of the cropping up of old complaints ; whether that cropping up is associated with changes in the bowel flora. I would like to t ry some of these but infortunately it means that one must be prepared to accept the statement that these particular nosodes have a particular pathogenesis just like our drugs I would like more evidence before I decided that one would have to submit stools to a bacteriologist. Dr. Paterson has told us that if one does this, one gets a report based on the MacConkey plan, one trans- mutes this evidence into the Paterson group by taking four types and making the necessary transference but will the bacteriologist give you these reports according to the MacConkey groups ? I don' t know. I have never asked a bacteriologist to do this. But if one has to send a stool to Glasgow when one wants to find out, then it is going to be a very tedious process, I am quite prepared to believe anything~provided sufficient evidence is produced but I still feel that I must practice a certain suspension of judgment with regard to this particular method of treatment.


�9162 very ~ ~ Dr. ~ tm~ understand the amount~ ot ~ work be-ha~-lmt.ia_aad shall he ~z.y4~lad to ~ .

Dr. MITCHELL : I shauld [ike~ to add my a p p r ~ t~ Dr. Pat=, ~,6i, f6r ttm-paper_~.e have . ~ t heard and there are only three ~pbints I shoukt-like to bviag up.

The firm h-t lm.subiect .of the. publishing, of symptomaWlogy which Dr, Patersov mentioned. I do hope t~at this is going to be brat3ght about. I t not possible for all of us to attend weekly lectures and it would be a great help.

With regard to the repetition of dosage ; I notice that Dr. P a~rson has given in every-ease, ~ x ~ s e s . Is i t ~ -ma~e r of~xvperience or will-one single dose ~ ~ tn ord'maryTvmedle~ ~.

�9 I am not very clear about Morgan Co. Does it include Morgan and Bach, or ~s it a separate nosode ?

Dr. ~ ; I am terry I missed ~ zarlier ~ Dr.. P z t e ~ o , ' s ~ers excellent paper but I think [ may be safe in refut ing to one point which I don't think he has mentioned. He dealt with the question of food being able to alter the nature of the bowel flora. I think everyone will realize that, but there is one food which is particularly evident in that respect gnd that is sugar. Before Hahnemann's time, the consumption of sugar in Europe was comparatively low and the health of the people in general, apart, from specific infective diseases, was comparatively good. With the introduction of sugar to the diet at the time of the Napoleonic Wars, a large group.of diseases began to appear. In 1819 in Britain, the consumption of sugar was about 18 lbs. per head per annum. In 1926 it was I06 Ibs. per head per annum. Appendicitis is said to have appeared as a disease at a time when the sugar consumption was about 60 lbs. per head per annum, about 1880. If we consider the bowel flora associated with cholera and other intestinal disorders, it is of considerable importance to realize that when the sugar consumption reaches 3-4 ozs. per diem per person, the intestinal reaction is converted from normal alkalinity to intermigtent or constant acidity. " Dr. Paterson will agree bhat, an intestinal reactAon which is perpetually acid must have an effect on the intestinal flora, as normally the intestinal contents should be alkaline. When sugar consumption reached 60 lbs. Per head per annum, appendicitis appeared as a disease and it is about that figure, roughly 3 ozs. per diem, that we get this change from alkalinity to acidity. In connection with diet, it is of interest to take patients who have had the operation of appendicostomy performed. One can, by varying the sugar consumption , have a varying reaction. In our struggle to overcome the ravages o f chronic disorders, we lose sight of certain foods in our bodies. In particular we lose sight of the fact that sugar has only recently become a part of our diet. The primitive races, who consume practically no sugar, are almost entirely free from the chronic disorders which affect the civilized races and b~ore I could accept Dr. Paterson's evidence with regard to changes in the bowel flora from his angle, I should like to know what checks have been made on

Dr. M_aso.~ : One or two things have come into my mind. Besides Vitamin B which takes in the food, has work been done on Vitamin B by Dr. Paterson ? I wondered if Dr. P a t e r s o n h a d done any work on the relationship o f Vitamin B in the bowel and non-lactose fermenting organisms.

Whether b a ~ causes disease or disgase causes bacteria~. I~ the 1920's I think Beanmrd Shaw thought that organisms did nat ~ause disease. I also remember a friend of rome Ixterr~ioning that this theory was bei~tg considered in h~spital at the time wfren I was studyintg.for my degree.

Dr. WILsOrr ; Dr. Brown has raised a-question that has interested me and that is his qpaestion of sugar. I come ~rom Belfas~ and it n ~ t interest you to know tlvat 1 am a lone Voice ~ere . I t would he very d4-fllcult for me, like Dr. Jul~n, to send specimens ~o Glasgow. I hava fomad that during the last year


or two, people are eatinga great amount of jam and there is hardly a patient who has come to me with acidity, bilious upsets, and fermentation, but that I have cut out jam ; and it might interest you to know, that a great many have recovered. One man, a policeman, kept off jam for a year or two. He took very little sugar, but he developed a perforation ; and on being questioned, he said that his wife had been absent and he had had the freedom of the table, during wl~ch time he had taken a quantity of jam. I am quite convincr in myself ghat sugar, jam, etc., have a great deal to do with causing acidi~y, bile and fermentation. I think it is quite right to know something gbout the org~misms, but even after we have the organisms, what about tha symptoma- tulogy of the organisms ? I would like Dr. Paterson to gi~e some of the symptoms that these bacteria produce, and then in line with these nosodes it would be very valuable r have some of the symptoms of thgse nosodes and then the remedy. I feel I don' t know very much about the bacteria but I know something about the symptoms. I t is good to know the symptoms. I have been at a few of bhese meetings and I think it would help if someone had to take a case of colitis, say, in the presence of us all and let some of us who are listeiling know what remedy should be given. My leafing is that what we hav~ been discussing is all very good. There is a good deal of theory but when we come down to the symptoms and the remedy, we come down to something very practical. In my anatomy examination a man was brought in and I really felt it helpful to see a living subject. I am out for help and I think it would be a very good thing to work a case ~ut before all present and ~hen suggest the remedy.

Dr. Ross : ~ methe4 of prevenCL~.g ehildz~ f-ram ~,th~g ~am-~oald bc welcome ! One thing about sugar. I sappose that sugar waS used from the earliest days -we get it in the :Bible. All that Dr. Brown means i~that refined or purified sugar begtm to be used. Perhaps that has gomething the crude

~ ncA MTe. About the practical side of nosodes. I do assure Dr. Julian and any

others who have similar doubts that these preparations called nosedes do act. In fact I think they are very powerful. I suggest that they be given a chance. So often one turns to a thing like the bowel nosede when the remedics previously given have failed to cure. I t may be that there is a complication of drugs still working in the patient's body. The time may not be opportune for giving a nosode and then one is disappointed. I have found this pretty frequently, but I have seen good results when the nosode was given in a clear field.

As to the different sub-tyl)es I cannot assure myself that these special types are necessary. They may well be. I am not in a position to say. I do agree , l i b ]~. ~ that the nosede made from the Dysentery group is something quite distinct from the others. I t is one of my favourite remedies and I have used it for twenty years and I Would not be without it. I t is a magnificent remedy. If Dr. Paterson could give us a little precis of all the details of Dysentery Co. ~t would be very valuable. I am not certain that when B. Gaertner or Proteus are found the Dysentery would not act. I t is possible that they are similar enough.

I ~ :L-~-vn~-~:~ ' I~ ~h~rw ~ry ~ ~clationshiir of ~ flar~ in diabetes ?

Dr. L~.ES : I ~ghould like to thank D~ Paterson for his contr ib~ion in" this sphere of medicine in which he haS worked for so many years. I was interested in the cases reported by Dr. Hamilton. All the cases had mental symptoms; but the other symptoms of each case were either digestive or skin. This suggests that there may he an alternation of skin ~ d digestive symptoms similar to the alternation wefind with asthma and skin, and I should be glad to know if Dr. Paterson has any experience of such al~rnations.

When we consider the individual (and we should be eternally grateful to

THE BOWEL FLORA IN CHRONIC D I S E A S E 21

Hahnemann that he always dealt with the sick individuals and not with the diseases) we find two quite different par ts- - the head and the metabohc parts. They stand opposite one another even in the it anatomical structure and one part has a counteraction on the other if a ~orrying excitable person develops a duodenal ulcer, etc. This interaction should be held in mind.

Drs. Brown and Wilson both spoke about the effect of taking sugar. Dr. Brown omphasizing the difference of the bowel flora in primitive races and civilized peoples because the latter consumed so much sugar. I thi~tk we must take into consideration here the quite different mental attitudes of these people as the nervous tension and pace of living in civilized conntries affects the bowel flora.

An interesting point was brought out by Dr. Henderson Patrick namely that the remedy connected with " no growth " is Mercury. Mental symptoms are imponderable and physical symptoms are as i~were ponderable. In Mercury we have something which is not gaseous and yet is not solid. The area between the head and the metabohc system is the throat and larynx, and I should like to know if Dr. Paterson found th is" no growth "particularly in cases which showed this region as the one most affected.

Dr. KENNEDY : Dr. Patersot~mentioned the remedy Mutabile and it is not on his list of associated remedies. I was interested in it because we had a stool specimen in London which had 20 per cent. Mutabile and no suggested associated r a m ~ wa~4ve~. I-was wonder--mg ff there wa~ an:." irAorm~ion on thut:

Dr . BOYD : W ~ a ~ ~ ~ tLo ]~r~ P_~,exsoD. for h ~ ~ 4nfor~v~tive paper. W~th regard to ~ils remarks or~enzymology. H~ mentions the questio~ ~ff enzymes and the variations in their action being B~ some way

t~ the homceopathic remedy and I think that he issuggea~ing something oi~cecmiderable-importance, but while he does that he, at the ~ m e tim~, raises a problem of an extraordinarily intricate nature. I am a~rry I have not the figures here but I hope to mention in my presidential address tho number of single e ~ y m e s ~ h i c h am estimated to he in one single ~ell, and I think you will be r~ther astonished when you hear the figures. My mind ratlaer quails when you hear of the nun/her of r i r l~ .~y c-vii, n~ . baeCTr~! buvLu ofher eelIs as ~ ~a ~ffcrcnt p r . ~ of r body.

I do think out of this discussion there has come one very clear issue put by Dr. Julian and by some other speakers. I think the point at issue which I should just like to sum up is that there has been put forward the view that these organisms are pathogenic. At the same. time there has been put forward the point of view that organisms cannot cause disease, i.e. that they cannot deter- mfne the pathogenesis. There is also the point by Dr. Julian that the organisms may be accompaniments. They do not cause disease but they are present when the patient is ill.

The other point, a practical one, is an opinion based on a great number of cases by the emanometer. I am quite convinced that the general nosodes as supplied, i.e.the Morgan Co., Morgan(pure)and so on which havebeenproduced, I beheve, by collecting a large number of cultures of the particular type and then by the potency eventually being made from these, are of much greater value than what I would call auto-nosodes. My reason is that taking it for what it is worth i have noticed repeatedly that if a culture is made when a patient is under the influence of a remedy, the auto-nosode has no permanent or continuous effect at all and I am almost dogmatic on it as I have come across it in so many cases. If the patient is under the influence of a remedy I find that the dose of the auto-~osode is merely antidotal. I t is far better to get a culture potentized, give it, wait so long and then a second culture and tincture from it is much more likely to give effect. The auto-nosodes vary from day to day according to the state of the patient and therefore potencies from them are not apt to be of such general use as the general nosodes.

Dr. PATERSON in reply said he wished to thank all the speakers who bad


taken part in the discussion and would t ry to answer the questions raised seriatim.

I~ vrv~k~ .~ ~ ~ , Dr. ~ had goae str~igh~ ~o ~ho poim, avoiding the technical, and concentrating his remarks upon the clinical value of the investigations on the bowel flora in every day practice, and he had given a number of actual cases.

The firgs case offered a good example in practice. While in London he (Dr. Paterson) had paid a visit to the Skin Depar tment at the HoSpital while Dr. Hamilton conducted the usual dispensary cases, No. 1 ca~e because of its history, tha t Arsenicum ]lad been given with benefit but tl~e improvement did riot hold, suggested according to notes he had published relating bowel nosodes to remedies, that in this case Dysentery Co. might be useful and on this i~ was given. He was g~ad to hear from Dr. Hamil ton that this ease had responded to the suggested bowel nosode.

Cases No. 2 and 3 bring out another point tha t Morgan Co. is the outstanding skin nosode and thgs it may be indicated in all st0tges from infancy to old age. (No. 2 was aged 75 years, while No. 3 was only 7 mon ths old.)

He was grateful to Dr. Briggs for his very complimentary remarks and it was indeed news to learn tha t he had made such impression arid had influenced him in taking up this work on the bowel flora. He was very happy when Dr. Briggs joined in the work and at present they were ~o-operating in certain work, which is as yet incomplete but they hoped to publish details later. One result had been the r~ord ing of evidence by which it is possible to compare the findings of two individual workers, using the same laboratory Yeehnique, a point of great importance in assessing tl~e value of the work~ on ~h~ ~ a .

Dr. Briggs called attention to the sudden appearance of a I00 per cent. phase of non-lactose organisms in the stoolwhich went back to negative in three days. That is one of the points where it is essential tha t there should be some collaboration between clinician and bacteriologist. The explanation would probably be found by noting the remedies given before2~hand, observing the possibility of a latent period between the giving 6f a remedy and appearance of this non-lactose phase. Previous observations would suggest tha t there is a more or less definite latent period.

.~'~;~ erganiz~a~ ob~crv.r~tion sho~!d ~ oppn~unit, y of anawcrin 8 t, he question raised by Dr. Briggs.

He was grateful to Dr. Briggs for calling at tention to the fa~t that the more advanced workers are now considering " The Pathogenesis of the Para-colon bacillus "

He had expressed opinion ~o-day tha t he considered the B. Coli to be capable of pathogenesis , and had offered a working hypothesis based on observatioris.

Dr. ])IcCrae had indicategt a relationship between his emanometer drug grouping and tha t compiled from the observations on the b5wel flora. He was very interested to heat Dr. McCrae's observations " tha t B. Dysenteriae belonged to a class of organisms with a clinical association which was quite outs~nding, and probably much more eharaeteristacally acute than all the other bowel flora "

In this paper he had tried to make the point that the power of an organism to ferment a particular sugar was the prime importance and that some idea of virulence could be obtained from laboratory observations of the sugar reactions of the bowel flora.

Now if members would look at the tables of the reactions of the non- lactose organisms, copies of which they have, i t will be noted B. Dysenteriae unlike all the other members of the group, is unable to form gas, it can only form acid, and tha t he interpreted as rendering this organism capable of a more ac l l~ .pathngenesi~.


Clinical experience bears that out, as also Dr. McCrae',observations on the emanometer. He was grateful for this confirmation ~rf his work on the bowel flora.

Dr. Fraser Kerr's experience, illustraI~s one of the anomalies which face the disciples of Pasteur and Koch. What explanation cam they offer to explain such a case, where there is clinical evidence of a specific disease, but no laboratory evidence of the specific germ. According to the Koch postulates, "I~_ Fraser Kerr ~uM-not h~ve ha~l an a ~ <~f Chele~.

Dr. Julian raised several important points which he would t ry to answer as briefly as possible�9

The first question asks what control has been carried out in "normal " individuals to ascertain what changes take place in a person in "' ordinary health ". That he would answer 5y putting another question, where is one to find " normal " o r " healthy "persons ? Having put the question, however, he would at the same time say that a routine examination of presumably healthy persons would be a great advantage in assessing the changes found to occur in the unhealthy, and he and his colleagues on the research committee had considered how this control might be undertaken e.g. at a military barracks where the men were undergoing physical training for fitness.

His second question, is the more important. What is the significance of the appearance of these non-lactose organisms ; on what evidence did Dr. Paterson associate these with the power of pathogenesis ? To answer the question he (Dr. Paterson) would remind Dr. Julian of the reference, made as to his personal interpretation of the meaning of the word " pathogenesis " in the presentation of the paper. He azsoc/ated these non-lactose organisms with the presence of disease symptoms, he did not assume that the organism was the cause of the disease symptoms. In a previous paper " The Potentized Remedy and the Bowel Flora " he had stated his reasons for re-orientating his ideas about the relation of the germ to disease and he would favour the idea put forward by Dr. Julian, that " the patient is not ill because he has pathogenic organisms but the pathogenic organisms are there because he is ill '"

He had made it clear in his opening remarks about the bowel nosodes that the " p r o v i n g s " were built up by co-relating clinical symptoms with the presence of types of organisms. So far n o " proving " b y the administration of potentized vaccines to healthy individuals with a view of producing symptoms had been carried out.

Ha w4m{cl lik~ V0 see that dunv . . . . d huped m~mbers of ~ " p r~hrgs ~ ~ nc~c Dr. ~uli"-~'s point.

Until he had this evidence, Dr. Julian was reluctant to use the bowel nosodes, but surely he does not hesitate to use such a valuable nosode as T u b e r c u l i n u m , which, like many of the other generally used nosodes has its " pathogenesis " built up more from clinical observations on the sick person than by experiments on the healthy human. (Dr. Burnett did record the effects of 30c T u b e r c u l i n u m upon himself.) Clinical provings have usually preceded" and determined subsequent " provings on the healthy human ". He would suggest to Dr. Julian that he could take part in the clinical observations by using these bowel nosodes according to the evidence so far available, and he felt sure that Dr. �9 $ Julian would find these remedies valuable in the treatment of chronic diseases.

With reference to the B . r grouping, he would remind Dr. Julian that the classification was to be found in standard works of~acteriology, and all that he would require to do is to request his bacteriologist to return the findings according to that classification. The classification for B . Col i is accepted but there was difference of opinion as to the significance of this classification indeed as to, whether B . ~o l i had a n y " pathogenesis " a t all and that classification was therefore quite useless. There was no need to send specimens to Glasgow, if the physician wished to have a report on the type of B . C~oli present, but he would require to use the " working hypothesis " put forward by this


Glasgow bacteriologist, if he wished to t ry out clinical tests. He would then be in the position " to give " rather than " to suspend " his judgment as at present.

I ~ was very ~ ~ D~. ~ i a ~ :[or raising ~ m-a~hy import~nb aa~ a ~ x t i n g thi~ ~ for answer.

T~ [~)r ]~it.eh~U ~nd o~hers-~ho have-expressed-desire to have the lectures on '"Bowel _Nosodes " published, :he would just express his tl~anks for this appreciation of his work and wout~d inform them that he was hoping to have a publication in the near future, as soon as his duties to the Faculty and tl~c International League, not to mention the carrying on of a busy practice, would allow.

With regard to the question of dosage, he would like to know the particular ease in which he had recommended six doses of nosode.

As in any ot~her homceopathic case, one had to assess the dose on the type of eases and fia his lectures he had made a special effort to g~ve the student a working hypothesis on doses. I t wouldtake too long to go into all that now, aa~he v r m ~ - b v - i ~ e d ~u di~uus~ t im ~ r h :Dr. ~ t a * e r .

Regarding the nomenclature. What is Morgan Co., does it include Morgan bach, or is it a separate nosode ? The contraction " Co." is for Compound and has reference to the fact that all the bowel nosodes were made up from a number of the specific germ in each case, e.g. Morgan Co. is the potentized vaccine made up from some hundreds of Bacillus Morgan. All ~he bowel nosodes should really have the " Co." appended Dysentery Co., Proteus Co., Gaertner Co., etc,

Now as to the term " Bach " or " Paterson " this refers to laboratory olass.ification of the germ. "B. Morgan (Bach)" includes the sub-types B. Morgan (pure) (Paterson) and B. Morgan-Gaertner (Paterson) and it is suggested that these sub-types have individual pathogenesis and individual nosodes have been prepared from these and bear.the titles Morgan (pure) (Paterson) and Morgan- Gacrtner (Paterson). Note that the appendage " Co." has been dropped but should be understood as applicable.

Dr. Patrick had reminded them that the work on the bowel nosodes had given proof of the action of the potentized remedy.

" That the potentized remedy could alter the Flora of the Bowel " was a statement of great importance which so far had not been challenged. I t was, therefore, of immediate interest to report that the Faculty of Homceopathy, through their Research Committe%were incorporating stool examination in the routine work now going on in Drug Provings. He hoped that by this team work, some further evidence would be forthcoming.

out. " No growth " simply meant ~hat according to th~ standard technique and media employed in this partieular series of investigations, no colonies of organisms were visible within the time period of incubation. I t did not mean that there were no organisms in the intestinal canal of that patient or tl~at the person was unusually healthy., Indeed clinical observations in such cases often suggested that there was a symptom complex which called for a remedy- M ercurius.

He was interested in Dr. Brown's obse1:vations and details about the sugar consumption in this country, and if his thesis was sound, there should have been a reduction in the fignres for acute appendicitis during these war years. Was this the case ?

There was no doubt tha~ any article of diet which tended to change the intestinal content from alkalinity to acidity would alter ghe flora of the bowel but as the evidence, which he had quoted with regard taChe experiments carried out with the B. Acidophilus and Lactose, clearly showed, any change observed was of a temporary nature and there was a return tr normal as soon as the diet was wJthdraayiL.. II~w4m-~ mereCesg4ub~.exoexiraont~

T H E B O W E L F L O R A I N C H R O N I C D I S E A S E 2 5

In contrast it has been Shown that a change of bowel flora appeared after the giving of a potcaaey of a remedy, which coUld have no material effect~ ax~ that this effect lasted over a period long after the administratio~ ~f the remedy. The change must have been cause~bj/some vital change in the host, not just a

m ~ h ~ i n ~ canal. Dr. Mason asked about the relationship of Vitamin B to the non-lactose

fermenting organisms. He had not done any work on that but he could recall a particular case that of a doctor with disseminated sclerosis--who had sent stool specimens for examination and report. He had been very intrigued to find that this patient yielded a very high percentage of B. Morgan and that this non- lactose phase was observed to persist over a period of eighteen months and seemed to be unaffected by any remedy given during that period. This patient (a doctor) had been giving himself injections of a Vitamin B product over a long period, and one could only speculate as to whether this had caused the change and was responsible for the prolonged phase.

Dr. ~itsor~ ala~ ~ r e n c ~ ~ the question of-sugar and his observatiurrz on the effect of jam as a cause of acidity.

He very rightly wishes to pa~s from theory to practice ~nd would like to see a case ta~ken and the remedy or nosode worked out and then one could learn something of the symptomadology.

Had Dr. Wilson been nearer Glasgow and couid have paid a vizir to the Scottish Homoeopathie Hospital, he would have had this opportunity as it was routine work there ~o go round the beds with the members of the Medical Staff and discuss each case.

He was always delighted to discuss ~he clinical aspects of a case and to h~Ip in ~a~ line of the Bowel NosoSes_

He was grateful to Dr. Ross for giving evidence as to the beneficial action of the bowel nosodes, also for giving the warning that the nosodes must be given at the opportune time to get this action, and that disappointment in their use (or abuse) was often due to a complication due to multiplicity of previous remedies and the bowel nosode was only given as a last resort.

He wonders about the necessity for the sub-types, but he can find out for himself by using these sub-types and comparing his results. The nearer one got to the similar remedy the better the result, that was the case in all homceopathic treatment.

I t was also true that one could get results with what one may call" collateral therapy " - - the use of an allied remedy.

Dysentery Co. might act with some beneficial reaction where B. Proteus or B. Gaertner was present in the stool, being allied types of non-lactose fermenting organisms, but he was sure from his experience that a better result would follow from the similar nosode to the organism found.

He also, like Dr. McCrae, finds Dysentery Co. nosode to be something quite apart from the other nosodes.

Is-t-here any relationship of inC~tA~ml flor~ in diahetes, azks Dr. La~rence ? He could not answer that ~ perhaps Dr. Kennedy who was present and had carried out clinical observations at the London Hom~eopathic Hospital on One or two diabetic patients whose stools had been examined and reported on from Glasgow might have some observations to make on this. I t should be remembered what had already been said about the action of sugar in altering bowel flora and that a~y change noted might be due entirely to the sugar oont~r~ ~ the , ~ nrry ~ faetar, in tam patiea~

Dr. MeArthur Lees mentioned alternation between digestive and sk~ symptoms: That skin symptoms often appear after the giving of bowel nosodes is well, known to any who have used Morgan Co. in cases which presented digestive or asthmatic symptoms. I t is the right direction of cure according to Hahnemannian philosophy. Each of the nosodes has also its own peculiar m~ntals.


He had already answered the query about " rm growth " and Mercury but in answer tX) Dr. Lces's additional query, he could o~ly refer to the m~rke4 activn which Mercury had on the throat which might mce~ t~e point raise4 by ]~im.

The last speaker, Dr. Boyd, had very effectively given a summary of the points raised in this discussion, and for that he wished to thank him. There was only one other point which Dr. Boyd had offered, namely his opinion and experience of the autogcnous vaccine against that of the stock vaccine. He had found that the vaccine from the actual organism isolated from a patient had less effect than the compound (Co.) nosode made from a number of organisms taken from others. He was referring to a non-lactose organism appearing after a remedy and the action of the autogcnous vaccine in such a case.

He (Dr. Paterson) would support that point of view and his explanation would be that the appearance of organisms after the action of the remedy was evidence of a vital reaction on the part of the patient. The use of any bowel nosode aiter such a reaction must be given consideration.

An autogenous vaccine (nosodc) would be contra-indicated in such a case, and even the use of the stock vaccine also- it one had reason to believe that the " reaction " was in an ascending phase. I t was a working rule, which he adopted and advised others to follow, that if the percentage of non-lactose organisms was above 50 per cent. the nosode was contra-indicated. The smaller thepercentage of non:lactose organisms the greater the indication for the nosode. Here was a paradox for the followers of Pasteur-- the less obvious by the technique of the bacteriological laboratory, the greater the indication for the clinical use of vaccine or nosode prepared from a specific organism. There ~ was plenty of Opportunity of proving the therapeutic value of this working rule, be it paradox or not to the bacteriologist.

In conclusion Dr. Paterson thanked all the speakers and the audience for their interest and patient hearing of a long session.

the role of the bowel flora in chronic disease

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