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Annotations.11 Ne quid nimis."

SYMBIOSIS.

THE problem of symbiosis is one of the manyinteresting bacteriological questions which haveassumed a position of importance during the lastfew years. Indirectly, if not directly, the subjecthas been raised in our columns on more than oneoccasion recently in dealing with war time diseasessuch as gas gangrene, with its mixed anaerobic flora,and typhus fever; while the two communicationson influenza and diphtheria, one by Dr. EvelynConstable, which appeared in our pages last week,and the other by Mr. Robert Nairn, on page 635 ofthe present issue, raise the same question indifferent form. The fact that widely differingspecies of bacteria can flourish together on an agaror gelatin plate or in fluid media has, of course,been obvious since the very early days of bacteri-ology, but the precise conditions of symbiotic exist-ence still remain obscure. Indeed, the name itselfprobably covers a number of different phases ofbacterial growth. Should it be confined to a condi-tion in which the growth of one organism isessential to the growth of another ? Or shouldthe term symbiosis refer to all conditions of livingtogether, both conditions which are mutuallyhelpful and conditions antagonistic ? Is it a

"harmonious living together with a minimal dis-turbance to the host," as Adami believes it to bein the case of the metazoan parasites, or is it acondition which tends to the production of moreserious disease ?During the early years of bacteriological research

we were busily engaged in obtaining pure cultures,in studying morphological differences for the pur-poses of classification-in short, we were workingout the problem of the identity of disease whichSir William Jenner put before medicine in hispapers on fevers. Of late years the study ofbacteriology has taken on a new aspect. We spendour days in the laboratory at the present time ininvestigating toxins and analysing the biochemicalproperties of our cultures, and these subjectsare leading us back again to symbiosis. Several

interesting facts have emerged from this lineof research. Coley has shown that the strepto-coccus is more active when combined with B.

prodigio8u8 and has made practical use of thefact in his fluid. According to Neisser and

others, Pfeiffer’s influenza bacillus flourishesbest under symbiotic conditions, and the influenza,vaccine now in use is frequently a vaccine ofmixed cultures. In the case of the acid-fast bacilli,again, Twort has succeeded in growing Johne’sbacillus by combining with his culture media thedead bodies of timothy-grass bacilli. The under-

lying principle of this method of cultivation opensup large possibilities, and we shall be interested tosee the results of the application of this methodnot only to the glOwth of organisms such as

B. leprae, which have hitherto presented such greatdifficulties in cultivation, but also to the productionof bacterial antigens.

It would be pure speculation at this stage toenter upon the discussion of the connexion betweensymbiosis and pleomorphism, involution forms,spore formation, and the accidental association oforganisms. The part symbiosis plays in diseases ofthe skin, of the external genitals, of the mouth,

and of the intestines-indeed, of all regions "wherea mixed bacterial flora is the rule-still awaits

investigation and solution.

A STUDY IN PROPAGANDA.

A GOOD deal of publicity has lately been givenin this country to the subject of venereal disease,and there are indications of similar activity acrossthe Channel. As an example of the methods

employed there we may instance Les Confidencesd’un Tréponème pâle,l in which Dr. Maurice Boigeyadopts the artifice of stating his case through themouth (if we may be permitted the expression) ofthe organism associated with syphilis, which ispersonified as a monster gloating over its powers ofevil. If a scheme of propaganda is justified by itseffectiveness the book before us may claim a con-siderable measure of success, for it is calculated tohold the attention of the lay reader, and under amask of frivolity there may be detected an earnestintent to cope with a social peril. In the main thevolume is made up of accounts of illustrativecases treated from historical and psychologicalstandpoints, though it is marred by a certainextravagance of statement which detracts from itsvalue as evidence. Thus selections from what pur-ports to be the journal of a painter lead up tothe proposition that the syphilitic virus " givesrise to the obsessions whence issue realism,pornography, symbolism, cubism, and diabolism."One need not take too seriously the suggestion thatthe turmoil of the war years may be traced ulti-mately to the fact that Friedrich Nietzsche was thevictim of congenital infection, and while some

psychiatrists may chuckle over the treponeme’sclaim to have "created the sect of psycho-analysts,"it is not likely to receive wide acceptance. As

regards questions of prophylaxis and treatment theauthor has little that is novel to say, but it wouldappear that he attaches no great importance to theemployment of calomel ointment. Although hisattitude towards his subject is unfamiliar toBritish minds, his book may afford useful hints tomedical officers of health and others engaged in thework of protecting the public.

DYSENTERY IN GERMANY IN 1918.

BACILLARY dysentery was epidemic during theyear 1917 in many parts of Germany, and especiallyin Prussia. Among the towns that suffered mostwere Berlin, Essen, Leipsic, and Dusseldorf. Withthe advent of winter the prevalence subsided, butit did not cease entirely, for cases and deaths con-tinued to be reported every week during the wintermonths as well as during the spring and summer of1918. The recrudescence of 1918 became evidentearly in August, and from that time up to the endof October, a period of three months, 20,648 caseswere officially reported in Prussia alone, of which2157, or a little over 10 per cent., died. In thisepidemic the infection extended to the eastern aswell as the western districts of Germany andaffected both the military and civil populations.Among the German towns outside Prussia thatsuffered most severely in 1918 were Hamburg,Hesse, and Stuttgart. During the autumn of 1918the disease was also epidemic in Austria-Hungary,affecting chiefly the cities of Vienna and Budapestand in a less degree Prague and Lemberg.By some German authorities the outbreaks of

1 Payot et Cie, Paris.