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Special Articles.BRITISH EMPIRE EXHIBITION,

WEMBLEY.

TROPICAL HEALTH SECTION.IT may not be generally known that in the Hygiene

Section of the British Empire Exhibition as manyas 27 different diseases are the subject of specialeducational propaganda. The section is housed inthe Government pavilion and occupies one of thebest positions in the exhibition. A small book,descriptive of this section, has been published witha view to bringing home to the public the greatadvances made in this field and to emphasise theimperial significance of tropical diseases.

The Tropical Health Comrra-ittee.-W ith Sir HumphryRolleston as chairman and Sir W. B. Leishman asdeputy chairman, this Committee is composed as

follows : Major E. E. Austen, Dr. Andrew Balfour,Sir P. W. Bassett-Smith, Dr. J. E. Butler, Sir R.Havelock Charles, Dr. J. B. Christopherson, Lieut.-Col. W. W. Clemesha, Dr. S. H. Daukes, Mr. G. C.Dudgeon, Dr. N. Bishop Harman, Mr. Guy A. K. IMarshall, D.Sc., Dr. H. B. G. Newham, Prof. R. INewstead, F.R.S., Capt. J. Ramsbottom, Surg.-Com-mander T. B. Shaw, Dr. H. S. Stannus, and Prof.J. W. W. Stephens. Illustrations and specimens havebeen provided by individual contributors and by theNatural History Section of the British Museum, bythe Liverpool School of Tropical Medicine, the RoyalArmy Medical College, the Royal Naval College, theWellcome Bureau of Scientific Research, and theImperial Bureau of Emtomology and Mycology.

Guiding Principles of the Exhibition.The Tropical Health Section is intended to give a

bird’s-eye view of the various diseases dealt with-how they are caused and prevented. It is essen-

tially an exhibition for the layman, but no attempthas been made to soften the picture which is presentedin all its naked truth for the benefit of the adminis-trative layman who has to deal with the problemsarising from these diseases. The Tropical HealthSection is in four parts. There is a jungle scenedevised to emphasise the material benefits to bederived from well-regulated preventive measures,and the differences between 50 years ago and to-dayare contrasted in two well-planned tableaux. Thesecond part, or Disease Section, deals with 27 diseases,and one portion is devoted exclusively to that largegroup, the diseases in which are spread by bitinginsects. Each disease is briefly described with thehelp of pictures, photographs, models, and specimens,and there is a short introductory account of itshistory and the means at present available for fightingit. There are also specimens and models of theinsects which play a part in disseminating thesediseases. This portion includes such diseases as Imalaria and yellow fever. Another group of diseases Iare those essentially due to intestinal infections, such <as typhoid fever. Food-deficiency diseases are repre- 1sented by scurvy and beri-beri, and considerable I

space is devoted to skin diseases, yaws, and leprosy.In the third section, devoted to hygiene, a uniformilluminated device is employed to provide statisticalinformation at a glance. The fourth section deals with iplant diseases. g

Tropical Diseases.Sleeping Sickness, -41ala?-ia, Blackwater’ and a

Yellow Fever.-Special attention is called to photo-graphs of natives suffering from sleeping sickness, Sthe characteristic somnolence, emaciation, and puffi- tness of the face being well shown. Wax models vand specimens of the tsetse-fly and its developmental a

stages, and photographs depicting its haunts and t

breeding-grounds are shown. It is pointed out that ga well-organised campaign against the tsetse-fly s smay practically stamp out the disease, as has been d

proved in the Island of Principe. The malariaexhibit is remarkably complete ; a central exhibitshows by means of models and actual’ specimens thestages and processes of breeding, and there are

models of the parasite in the human and mosquitostages. There are several illuminated devices demon-strating the value of preventive measures. Therelation of blackwater fever to malaria is brieflydiscussed, and a short account is given of the genesisand course of yellow fever. A model is shown ofthe " tiger mosquito " responsible for this disease,and an interesting account is given of how smallfish may be employed to eat the larvae in the breedingplaces of this mosquito. A pictorial account isgiven of the recent successful campaign in Guayaquilagainst this mosquito.Dengue Fever, Filariasas, Guinea-worm Disease,

and Relapsing Fever.-The relation of dengue feverto mosquitoes is pointed out, and in the exhibitdevoted to filariasis there is a specimen of elephan-tiasis of the leg showing the gross deformity resulting

from this disease. There is also a wax model of" Calabar swelling" caused by the West African

I " loa loa" worm. The life-history of the guinea-worm is also pictorially described, and there is a

model of the ulcer produced by the female worm.There are also specimens of the water flea in whichthe embryos of this worm develop. The variousspirochaetes responsible for relapsing fever, syphilis,and other diseases are demonstrated, and their modeof propagation explained.

Plague, Saitdfly Fever, Rocky Jlountaaia Fever,Oriental Sore, and Trachorna.-There are photographsand paintings of plague patients and pathologicalspecimens illustrating three varieties of this disease.There is much in this exhibit of historical interest,and the leaden crosses, which were buried withplague corpses, are shown. The costume worn byphysicians attending plague patients, and certaininstruments for opening the buboes, are includedamong the exhibits, which also show ancient picturesof incidents connected with plague. There are

original paintings showing the development of thesand-fly, and this particular exhibit gives a good ideaof the detailed work required to investigate a diseasecaused by an insect hardly large enough to be visibleto the naked eye. The exhibits of Rocky Mountainfever and ’’ Oriental sore " are an eloquent tributeto the efficiency of research, and it is pointed outhow recent advances in treatment as wcll as preven-tion have made the outlook for these diseases muchmore hopeful. There are excellent paintings empha-sising the seriousness of trachoma, and justifyingthe elaborate efforts made to keep this disease outof the British Isles by the Alien Acts.

Dysentery, Typhoid and Paratyphoid Fevers, Cholera,Hookworm Disease, and Bilharziasis.-There are someexcellent pathological specimens showing liver abscessfollowing amcebic dysentery, and special attention isdirected to the decline in the typhoid and para-typhoid fevers by an illuminated statistical devicecontrasting the incidence of these diseases in theSouth African campaign and the late war. Anexhibit of the method of preparing vaccines showsshe meticulous care taken to guarantee purity andaccuracy of dosage. In connexion with the typhoidroup of fevers there are sundry exhibits drawingattention to the possible dangers of eating shell-fish, fattened " in polluted water, and of eating uncookedvegetables, such as watercress, contaminated by;ewage. With reference to the mortality from;holera, it is interesting to note the illuminated;tatistical device showing the efficiency of intra-venous injections of saline solution as advocated by5ir Leonard Rogers. There are also paintings illus-rating the causation of cholera.. The methods byvhich the hookworm attaches itself to the intestinesre illustrated, and there are large wax models ofhe heads of the two species of hookworm which:ive most trouble. The exhibit of bilharziasistresses the value of preventive measures; thisisease has recently been located in Portugal.

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Scurvy, Ber-i-beri, Pellagra, and Tropical Skindiseases, including Leprosy.-’1’he relation of scurvyto diet is driven home by an exhibition of samplesor models of various anti-scorbutic foodstuffs. Thereis a specimen of a dilated heart from a case of severeberi-beri to teach the lesson that acute heart failureis one of the chief dangers of this disease. A sampleof the diet consumed by a ship’s crew suffering fromberi-beri is shown. The existence of pellagra in ourmidst is drawn attention to by paintings of patientsobserved in English asylums. Various rare skindiseases in the tropics are demonstrated by photo-graphs, and the problem of leprosy is dealt with bypaintings, photographs, and illuminated statisticsshowing the effects of preventive measures.Sunstroke.-There are various exhibits showing

the means best suited to the protection of the headand spine by helmets, spine pads, and other con-trivances, and there is a small model of a double-roofed tent. There is also a rough model ofthe improvised bath-house used in emergencieswith success for the treatment of heatstroke inMesopotamia.

fflodel of a Tea Garden.The central exhibit contains a model of a manager’s

bungalow built in two storeys, the upper beingcarefully screened with mosquito gauze, and con-

taining five rooms in the form of a cross which givesthe maximum amount of outside wall, and catchesevery breath of wind. A house of this kind shouldbe healthy in almost any country, however malarious.The latrines are connected with the main block bya masonry path devised to prevent hookwormdisease. The banks of the stream which runs through ’,’the garden are riveted with brick to prevent mosquito Ibreeding, and there is an arrangement for oil to dripinto the water to render it less attractive to themosquito.PilgrimWles, J.11arine Quarantine, Vaccination, Oriental

Sanitary Appliances, and Chlorination of TVate)’.Pictures are shown illustrating the sanitary prob-

lems associated with pilgrimages and festivals, anduseful hints are given as to the sanitary arrange-ments necessary for such a situation. In the MarineQuarantine exhibit there are shown models of porthealth officers’ boats especially prepared for isolatinga patient with yellow fever from the local mosquitoes.The method of preparing vaccine lymph from calvesis demonstrated, and it is shown how much moretroublesome this process is in hot than in coldcountries. Dr. Allan Green’s apparatus for purify-ing calf lymph with chloroform is also demonstrated.The sanitary fittings usually found in Europeanhouses not being always to the likings of the

conservative Oriental, English manufacturers havedesigned special fittings to closets, urinals, &c., forthe needs of India, China, and the Far East ; thesefittings are said to be much superior from a sanitarypoint of view to anything which can be manufacturedin the countries for which they are intended. Appa-ratus for the chlorination of water is also displayed.The keynote of the Tropical Health Section is hopeful

realism ; its realism must be almost painful to somelaymen, but there can be no doubt as to the hopeful-ness of the outlook, of the prospect that in the nearfuture many of the Empire’s territories will cease todeserve the title " The White Man’s Grave."

NEW CORONER FOR SOUTH LONDON.-To fill thevacancy caused by the death of Mr. G. P. Wyatt, theLondon County Council has appointed Surgeon-CommanderA. D. Cowburn, M.R.C.S., D.P.H., L.R.C.P., Barrister-atLaw, to be coroner for the Southern District of the Countyof London. The inclusive salary attaching to the office is981 18s. per annum, but it is probable that the Duchy ofLancaster will appoint Commander Cowburn to the vacantfranchise district of Clapham at a salary of ;t:59 8s. a year,making the combined salary ;t:1041 6s. a year. A conditionof the appointment is that the occupant shall " devote hiswhole time to the duties of his office, not practise anyprofession or hold any other public appointment, andresign on attaining the age of 70 years."

THE TUBERCULOSIS SOCIETY :MEETING AT CAMBRIDGE.

(Concluded from p. 818.)’FOLLOWING the papers reported in our last issue

which were read at the Cambridge meeting of thisSociety, Dr. A. Stanley Griffith gave a communicationon

Lupus.Dr. Griffith’s paper dealt with atypical tuberclebacilli in natural tuberculosis with special referenceto those occurring in lupus. Since Cobbett firstisolated an atypical strain of tubercle bacillus froma case of lupus, the bacteriology of lupus has beeninvestigated by Dr. Griffith. Dr. Griffith’s workwas carried out in the Field Laboratories, Milton,and he paid a tribute to Sir G. Sims Woodhead’sencouraging support. In the first series of 20 cases oflupus there were only three strains conforming todefinite types, the remainder did not conform exactlyeither to the human or to the bovine type as far astheir virulence to experimental animals was concerned.Culturally, the strains could be classified as bovineor human. The main objects of subsequent investiga-tions were (1) to search for atypical strains in othervarieties of human and animal tuberculosis, (2) to seekdirect evidence of modification of strains in skinlesions, and (3) to ascertain if, by examining a largenumber of cases of lupus, the finding of the highproportion of atypical strains in the first series couldbe confirmed. The observations of Dr. A. Eastwoodand Dr. F. Griffith between 1911 and 1916 wereincorporated with those of Dr. A. S. Griffith. In thehuman subject atypical strains were found at firstonly in lupus, but in the later investigations atypicalstrains were obtained also from other varieties ofhuman tuberculosis. Strains with modified virulenceresembling those from lupus were, however, veryuncommon and occurred only in about 0-6 per cent.of the cases. The avian tubercle bacillus was notfound in the human being. In animals atypicaltubercle bacilli were not of frequent occurrence.

Of 132 cases of tuberculosis in the pig, 94 were dueto the bovine type, 31 to the avian, four to the humantype, and in three cases the infection was due tomore than one type of tubercle bacillus ; only threeof the porcine strains were atypical. In the six casesin which tuberculosis in the horse was investigated,.the type was invariably bovine, although in three ofthese cases the characters of the bacilli were not inevery respect strictly those of the bovine type.Up to date 140 cases of lupus have been investigated,

the tubercle bacilli being classified according to theirbehaviour on culture and their virulence to rabbits,guinea-pigs, and certain other experimental animals.Two main groups, each with a subgroup, were dis-tinguished. Of the 71 cases showing typical bovinecharacteristics on culture, 22 were characteristicallyvirulent to all the species of experimental animalstested. Of the 66 cases showing typical humancharacteristics on culture, 19 showed standard viru-lence to experimental animals. There were alsothree cases in which the strains were atypical incultural characteristics. It was noticed that therewere no clinical features distinguishing cases of

lupus according as the infection was of the bovineor human type. With regard to the question," Do ’the atypical lupus tubercle bacilli acquiretheir special characteristics during residence in thecutaneous tissues ? " Dr. Griffith stated that allthe evidence goes to show that lupus is producedoriginally by tubercle bacilli of normal virulence,and that their virulence becomes modified in thecourse of the disease. The evidence in support ofthis view is direct and indirect. With regard to theformer, re-examinations were made of 24 cases of

lupus, the characters of the strains in one and the

1 In the report last week of Dr. Matson’s remarks onAmerican tuberculosis work the death-rate in 1910 of 202 ardin 1922 of 94&middot;2 should, of course, have been given as per 100,000.