(3) A number of instances have been recorded in which the onset of tuberculosis followed the use of milk from tuberculous COWS. In some of these the relation of cause and effect is so close that Nocard has well said " they have almost the value of an experiment."

(4) That food containing bovine tubercle bacilli may and does produce tuberculosis in man seems already proven by finding in the intestinal tract (mesenteric glands) of children who have died of tuberculosis tubercle bacilli which have all the characteristics of the bovine germ, and which have an intense degree of virulence for cattle.

(5) The close relationship of the human and bovine tubercle bacilli has been shown by the recent experiments in immunization, in which it has been proven that injections of bacilli from human sources will protect animals against virulent bovine germs. This has been done by Trudeau, De Schweinitz, and Pearson and Gilliland in this country, and by Behring and Thomassen in Europe. WHAT HAS BEEN DONE IN THE UNITED STATES TOWARD THE SUPPRESSION OF TUBERCULOSIS.

Three States and four cities require the reporting of cases of tuberculosis; in five States and five cities report is optional; in one city it is under litigation.

Two States have general anti-spitting laws, while five States have local laws, and fourteen cities have their own laws. Twenty-two States and seven cities issue circulars and recommendations.

The United States Government has two sanatoria for persons in its employ; five States have five special institutions, and nine States have projected sanatoria. Two States have tent colonies on a small scale. Only three cities have special municipal hospitals for consumptives. There are forty-two private institutions in eleven States, some supported by private charity, some partially self-supporting, and some for pay patients only.

Twenty States and twelve cities have laws regarding bovine tuberculosis. Twenty States have done nothing in regard to human or bovine tuberculosis; six States have done something to combat tuberculosis in man only, and eight States have done something against bovine tuberculosis alone.1

1 These figures have been taken almost entirely from the valuable of paper Dr. S. A. Knopf, read before the American Medical Association at Saratoga, June, 1902. Since then considerable advance has been made.

Comparisons are said to be odious, but in the hope of stirring up our people in the United States, I quote the most recent statistics of what is being done in Germany, which may be taken as an index of the attitude of most of the countries of Europe toward the scourge of tuberculosis.

THE FIGHT AGAINST TUBERCULOSIS IN GERMANY.

According to the Imperial Health Office in Berlin, the deaths from tuberculosis are about one-tenth of those of all diseases. In 1899 the number of patients treated in hospitals in the empire was 226,000. According to the latest statistics there are at present 57 public sanatoriums for the tuberculous in Germany, of which 34 are located in Prussia, 6 in Bavaria, 2 in Saxony, t in Wurtemberg, I in Hessen, I in Sachsen-Weimar, I in Thuringia, 1 in Reichsland, 3 in Baden, 2 in Brunswick and 5 in the Hansa cities. Besides these there are 4 four institutions near the sea-namely, Nordeney, Wyk, Gross-Muritz, Zoppot. There are also 23 public sanatoriums nearly completed, among these being Buch, near Berlin. The city of Berlin has at the present time 3 public sanatoriums-namely, Malchow, Blankenfelde, Gutergotz. There are also 20 private German sanatoriums, and 1 in Davos (Switzerland). In the 78 sanatoriums for the tuberculous there are 7000 beds. If we calculate that each bed is used by four persons in the course of a year, we find that about 30,000 tuberculous patients annually enjoy the benefit of treatment in the sanatoriums. The efforts made in the German Empire to combat tuberculosis, both by direct regulations and by general preventive measures, are being actively carried on. In particular, the Imperial Government, the governments of the different States, the executive authorities, the national insurance institutions and the municipal governments are seriously and actively participating in this work. The result of these efforts, which have been now carried on for some years, is already noticeable in a decrease in the number of deaths from tuberculosis, which in the future will be still more marked (American Medicine, March 21, 1903).

ARTIFICIAL IMMUNITY AND SERUM-THERAPY.

For many years constant effort has been made to discover a serum or lymph for the specific treatment of tuberculosis, and several such substances have been announced from time to time. All of them

have proved disappointing, however, not excepting Koch's lymph or tuberculin, the discovery of which was hailed with delight and enthusiasm by physicians and consumptives alike in all parts of the world. Recently it has been demonstrated authoritatively that it is perfectly possible to produce artificial immunity against tuberculosis in animals by a process of vaccination, as such methods are now generally termed, and with this demonstration comes the wellfounded hope that we are within sight of the goal so much hoped for, the discovery of a specific serum for the cure and prevention of tuberculosis. Indeed, we have already the news that two wellknown bacteriologists have produced such a substance. While the details have not yet been made public, the names of these two men, Behring, of Germany, the discoverer of diphtheria antitoxin, and Marmorek, of the Pasteur Institute, in Paris, the discoverer of streptococcus antitoxin, are of such weight as to justify strong hope that they have achieved success. We may feel assured that marked progress has been made, to say the least.

I have not dwelt on the pathetic side of this question—the fearful loss of life and suffering entailed by a preventable disease. On this point I cannot do better than to quote a short editorial from a recent issue of American Medicine (March 28, 1903). While this deals with the city of New York, it is equally applicable to every city in the United States, the figures only needing modification.

THE TRAGEDY OF THE HOMELESS AND FRIENDLESS.

"In the year 1902, in the borough of Manhattan, there died of tuberculosis, chiefly in the various hospitals of the city, 1787 patients. Of these, 950 were 'not known at the addresses given; 456 gave no addresses; 275 gave the address of a lodginghouse, and 106 gave an address outside of the city. It must be remembered that these deaths constituted only about one-seventh of all the deaths that took place. Moreover, for every death there are, according to Dr. Farr, about two years of illness endured. When one thinks how much our happiness, even in health, depends upon home and love and friendship, and that in illness and death the blessedness of these things is vastly increased, and then when one realizes that there are so many thousands of the sick and dying in our cities utterly homeless and friendless, the pity of it all becomes indeed terrible. The tragedy of obviable disease and needless

death kindles our zeal to stop the spread of infection, to discover the means of preventing the suffering, and, when this is not possible, to surround the lonely sick and dying with the best medical skill, attention and kindness that is possible. The desolation of their appalling loneliness is often doubtless greater than that of their illness and oncoming death combined."

In a paper on mohawkite, domeykite and other copper arsenides of the Mohawk mine (Zeitsch. f. Krystall., etc., Vol. xxxiv, 1 Heft), I mentioned some attempts made by me to obtain domeykite in measurable crystals by the action of arsenic vapors upon metallic copper. One experiment gave crystals, although not measurable, but further trials failed at the time, evidently through my inability to maintain the proper temperature by means of an Erlenmeyer combustion furnace. The range between the temperature at which the crystals form and that at which the crystals melt is a very narrow one. On the other hand the eagerness with which the copper absorbs the arsenic causes heat, and hence the difficulty in adding just the right quantity of thermal energy from the outside. It occurred to me to try an electric current as a source of heat. The very first trial gave most promising results. The experiments were taken up in November, 1900, and continued until March, 1901. The adjoining figure illustrates the simple apparatus which proved itself adequate to all requirements.

In watching the rapid growth of the crystals the similarity of the phenomenon with the development of an egg occurred to me, and I applied the name "incubator" to the apparatus, than which no other could be more expressive.

The incubator consists of a piece of combustion tubing (T), closed at one end. The length is unimportant since only about three inches of it are in actual use. I have varied the diameter from three-eighths to three-fourths inch with no apparent difference in the action. The crystals do not grow any larger in a large tube than in a small one. Around the tube is wound a very thin platinum wire (W), beginning at the closed end. In order to keep the coils separated I laid three strips of thin asbestos paper (E) lengthwise upon the glass and then began winding. The first turn returns to the start, a twist is made, and thus a well-fixed start is secured

Fig 1

which will prevent the wire from slipping. The pitch of the thread will be governed by the maximum of heat desired. This will be variable with different metals and may be varied even for the same metal, as I have frequently done, the variation being between oneeighth and one-thirty-second of an inch. The last coil is secured in the same way as the first. Two inches of winding were mostly sufficient. Whenever the glass gets to full red heat the wire will fuse into it and will be broken in unwinding. To avoid this spoiling of the wire it would be the best thing to cover the whole glass surface with the asbestos sheet. But doing so would also prevent the observation of the phenomena occurring within. One might as well, or even preferably, use a porcelain tube. One would have to forego the great pleasure of seeing the so-called inanimate things