Medical News

SALVARSAN SILVER JUBILEE

On 10th December, 1935, a special meeting was held in the auditorium of the All-India Institute of Hygiene and Public Health to celebrate the twenty-fifth anni-

versary of the first introduction of salvarsan into

therapeutics. The room was well filled and the gathering was a

representative one. Dr. A. C. Brocke, d.sc., opened the proceedings in the following words:? Ladies and Gentlemen, On behalf of the Scientific Department of Bayer-

Meister Lucius, the organizers of this meeting at which this distinguished gathering of medical men anil scientists have come together to celebrate the silver jubilee of the discovery of salvarsan and to do honour to its inventor Paul Ehrlich, I have the great honour to welcome you here to-day. We have been particularly fortunate in having as our

speakers to-day such distinguished scientists as

Brevet-Colonel R. N. Chopra, c.i.e., k.h.p., m.a., m.d., m.r.c.p., i.M.S., and Lieutenant-Colonel K. K. Chatter- Ji, f.r.c.s.i., i.t.f. It would be incongruous if I were to introduce either of these speakers as both are already so well known to you all and their research work has gained them a reputation not only in this country but in the medical world at large. I feel that this is a good opportunity for thanking, on behalf of the medical and chemical research workers of our scientific department of which I am the humble representative in Calcutta, not only the two speakers but the many other workers in Calcutta for their co-operation with us in the search for new drugs to use in our fight against disease. The laboratories in Elberfeld and Frankfurt can work out and prepare drugs and test them on animals just as Ehrlich did 25 years ago, but they are dependent on those workers in the field with a scientific outlook to give the necessary clinical trials under carefully- controlled conditions before they can issue them for use to the general medical profession. The disease which Paul Ehrlich was fighting is an

universal one and therefore he could carry out the initial trials in our own country. However to continue his research it was necessary to look to workers in this country for guidance in certain aspects, such as in the suitable dosage to be recommended to doctors whose patients are mainly Indians who will not stand the full doses recommended for Europeans, and in such matters as the keeping properties of arsenicals in the Indian climate, but for a number of other drugs we are

dependent almost entirely on the research work and clinical trials by workers in this and other tropical countries. It has been the tradition in our laboratories to work in the closest collaboration with scientists in this country and all over the world. We hope the Department '

Bayer' has been of some assistance to

you, but I can assure you that your co-operation has been invaluable to us and on behalf of the research workers in our laboratories at Home and my colleagues here, I once more want to express our sincerest thanks for your active help in furthering the science of chemo- therapy, the foundations of which were laid by that great man in whose honour we are gathered here to-day. Lieutenant-Colonel Chatterji proposed that Colonel

Chopra should be chairman of the meeting, and took the opportunity of congratulating him on the recent honours conferred on him?his admission as a member of the Royal College of Physicians of London, and his appointment as King's Honorary Physician.

_Colonel Chopra took the chair and after thanking Lieutenant-Colonel Chatterji and all those present, he delivered an address on Paul Ehrlich and his work, as follows:?

The preparation and application of organic arsenicaig in medicine, for which Paul Ehrlich was primarily responsible, were doubtless the result of a long and persistent search for substances which have specific action against disease. The advent of these compounds into the realm of medicine marked a new era in the

history of rational development of therapeutics and the modern science of chemotherapy. At once, it opened up a new vista, pregnant with infinite possi- bilities, towards the one goal of medical science, viz, the amelioration of human suffering. Not only was this a definite step forward in the path of medical research, but it was a new departure, indeed a new acquisition to the armamentarium in our struggle against disease. The diseases which exacted a heavy toll of human lives, that ravaged towns and villages, and told adversely upon the culture and civilization of bygone ages, and which were in consequence looked upon as visitations from Heaven, due to sins of man, are no longer looked upon with awe and dismay, but with the spirit of

triumph and victory on account of this work. These monumental contributions of Ehrlich rightly deserve a

foremost place in the history of the fight of man against disease. Paul Ehrlich was born in March 1854 in Silesia in

Germany where the art of dyeing flourished as an old handicraft. He was, therefore, familiar from his boy- hood with dyes and a story is told that when attending the microscopical courses as a young student in

Strasburg, his teacher Professor Waldaryer found, to his surprise, Ehrlich's place in the laboratory covered by a patchwork of stains of many colours, and asked him what he was doing. The answer was ' I am staining', whereon the teacher could only reply

' Well go on by all means '. In his early life as a medical student Ehrlich was

very much impressed with Heubel's work on lead poisoning. This work probably first gave him the basis for the idea that chemical agents have great influence up.on living bodies in general and that

' the ways and means by which the drugs are distributed in the body must be of greatest importance' in therapeutics. This idea combined with the knowledge that in technical processes certain dyes were fixed by certain fibres gave a strong impulse to his research work in later years and led him into a series of studies upon the selective effect of various synthetic dyes on the blood and tissue cells. The results of such studies no doubt further led him to the conclusion that chemical substances might be produced which would unite with and destroy parasitic agents of disease without in any way injuring the cells of the host. It is this study of the selective affinity of chemical agents for parasites that led him to pronounce his famous theory

'

Corpora non agunt nist fixata' which means ' bodies do not act unless fixed'? a theory that still lies at the basis of modern chemo-

therapy. The development of the science of immunology with

its discovery of natural and acquired antibodies, specially the discovery of the protective and curative action of the diphtheria antitoxin, strengthened Ehrlich's hope of finding out chemical agents capable of destroying parasites causing disease. Regarding the antibodies his idea was that '

they had no affinity at

44 THE INDIAN MEDICAL GAZETTE [Jan., 1936

all for substances of the body, but they rush exclu-

sively at the parasites. Therefore in this case organo- tropy is reduced to zero, parasitotropy is absolute and the antibodies represent magic bullets which seek their unerring aim

Researches with dyes.?In 1887 acetanilide (anti- febrin) and certain other substances were synthesized from coal tar and the use of these substances in medi- cine as antipyretics and analgesics still further stimulated him. Ehrlich began his work with the appli- cation of synthetic dyes to those bacterial infections that could be produced in laboratory animals like mice, guinea-pigs, rabbits, etc.; the line of study being the investigation into the manner in which immunity to such diseases could be increased in mice. Unfortunately his work with bacteria mot with little success. He

had, however, an infinite reservoir of patience and after a lengthy period of failures, which lasted till 1901, lie at last came across Laveran's work on the production of trypanosomiasis experimentally in mice and rats. From that time onward Ehrlich and his co-worker Shiga directed their attention towards the trypanosome infection in laboratory animals. These parasites were then known to be responsible for causing sleeping sick- ness in the natives of Africa and to produce a disease in horses known as mal de Caderas. The incidence of death due to infection with these parasites in mice was one hundred per cent. Ehrlich and Shiga tried a large number of synthetic dyes on such infected animals, but the results were uniformly unsuccessful till at last they hit upon a dye known as henzo-purpurin. This dye was however without any effect, but by the introduction of a '

sulpho-group ' into this they were able to synthe-

size a new compound that gave hopeful results in a few cases. This '

changed' dye was termed trypan red, but it was later found that the failures with it were perhaps more numerous than the successes, and that the efficacy of the drug was therefore doubtful. But the perseverance and zeal of Ehrlich were

unbounded. Success and failure were looked upon by him equally with enthusiasm so long as they were

instrumental in gaining experience. In the words of

Tennyson, to him ' all experience is an arch wherethro'

gleamed that untravell'd world' and failures in partic- ular instead of throwing him into despair goaded him all the more '

to follow knowledge like a sinking star beyond the utmost bound of human thought'. Preparation of organic arsenicals.?Ehrlich's next line

of attack consisted in the study of various pentavalent organic arsenicals on trypanosomes in vitro and he found that these compounds were all inert. In 1905, however, Thomas published the results of experiments showing that atoxyl had a curative action on laboratory animals infected with trypanosomes. Koch about the same time obtained encouraging results in the mass

treatment of sleeping sickness with atoxyl among the natives of Africa. He found that, although atox3d was .not a certain cure for this disease, it often produced considerable improvement. The number of failures could not, however, be overlooked. Besides this the untoward effects produced by this drug, particularly the loss of sight among those who received treatment with it, were of serious significance. Contrary to the find- ings of its discoverer, Beauchamp, atoxyl was found to be ' para-amino-phenyl arsenic acid' containing penta- valent arsenic within it, and the activity of this com- pound, although it contained pentavalent arsenic, was regarded by Ehrlich as being due to the reduction of arsenic to the trivalent state within the body. With this theory as his basis, he started work on the study of trivalent organic arsenical compounds. Ehrlich's first attempt was to

'

change' pentavalent arsenic in

atoxyl to the trivalent form. This led to the prepara- tion of many compounds and the search for suitable

compounds went on incessantly in Ehrlich's laboratory. He himself and his assistants prepared one compound after another with atoxyl as the starting point and

tested each compound on animals infectcd with

trypanosomes. In this way this laborious process of

preparation and testing continued and over COO different

compounds were duly examined. Most of these were found to be ineffective, only one or two among them

giving promising results. It was observed that although some of these compounds could cure trypanosomiasis, they unfortunately produced in some animals fatal

haemolysis, jaundice and other toxic effects. In the

case of one drug it was found that it killed the para- sites, but it damaged the nervous system of the animals to such an extent that the animals used to dance

' not

for a minute or an hour due to their liberation from the clutches of the dreadful disease but for the rest

of their livesAfter studies extending over many

years with derivatives of atoxyl a compound, para-

arseno-phenyl-glycine, was produced in which two

arsenic atoms were linked by a double bond and each

coupled to the benzene nucleus by a single linkage. This compound was in fact the precursor of the arseno- benzene compounds which were later found by him to be very effective. At last after a prolonged search he was in 1910 rewarded by the production of the 606th

compound which was '

dihydroxy-diamino-arseno- benzol-dihydrochlorideThis compound had a most

potent effect on the trypanosome in infected animals

without at the same time injuring the host and the news of the great, discovery soon spread throughout the scientific world.

Action of arsenicals on spirochetes.?In the meantime the organism responsible for producing syphilis had been discovered by Schaudinn in 1906, who named it '

spirochwta pallida' and brought out the fact that it was closely related to trypanosomes. Indeed he went so far as to say that

'

spirochetes may sometimes turn into trypanosomesWhen Ehrlich came across this work the importance of the destructive action of his arsenical preparations on trypanosomes and; their chemotherapeutic possibilities became apparent to him and he was led to announce

'

Quod non sanat jcrrum sanat arsenicus; quod non sanat arsenicus sanat ignis' which means ' what iron does not cure arsenic cures; what arsenic does not cure fire cures'. Ehrlich's work received a fresh impulse when Paul Uhlenhuth in 1907 demonstrated the striking effect of atoxyl in fowl spirochetosis, an action which was confirmed in colla- boration with E. Hoffmann in experimental syphilis in monkeys. This strong conviction of his on the efficacy of arsenical preparations has, to a very great extent, come true as recent researches clearly point out. It was therefore very natural for him to try his com-

pound no. 606 in this disease also. He justified this attempt of his by saying

' If the pale spirochete is a cousin of the trypanosome of the mal de Caderas then 606 ought to hit that spirochete What kills trypanosomes should kill their cousins'. In this way Ehrlich and his co-worker Hata first tried this drug on a rabbit infected with spirochetes and that rabbit was the first living being completely cured of the disease. This, however, is the short history of a long research requiring years of patience, and perseverance amidst failures and anxieties and culminating in the discovery of

' Ehrlich 606 '. It will be seen, therefore, that the drug '

Ehrlich 606' was primarily discovered to fight trypanosomes and it was later found to be useful in the treatment of syphilis. The action of this compound against two of the most dreadful diseases impressed the scientific world and the drug was examined by both chemists and pharmacologists alike who confirmed Ehrlich's claims. This compound is said to have a dibenzol or arsenobenzene nucleus coupled together by two tri- valent atoms of arsenic. The nucleus itself is of no

therapeutic value and is of interest only because it is the parent substance of salvarsan. By a multiplicity of changes, syntheses and experiments attempts were made to determine which atoms or groups of atoms and what grouping in the molecule increased its affinity for the parasites and reduced its toxicity to the cells of the host. It was found that substitutions in the NIT group may cause profound differences in iVn effect of tho compounds, sometimes an increase and sometimes a decrease in the therapeutic effect.

Jan., 1936J MEDICAL NEWS 45

Preparation of ncosalvarsan.?On the 20th of Septem- ber 1910 when Ehrlich's discovery was officially made known to the world, his friend Neisser remarked that

naturally the first discovery cannot be expected to be perfect in every respect, but that it was hoped that the preparation 006 would be followed by a still better preparation 607 or 608. Neisser, however, was too

optimistic when he expected that the next two prepara- tions were going to solve the question. Years of further patient and laborious work were required until the preparation 914 or neosalvarsan (which is a

condensation product of salvarsan and sodium formal- dehyde sulpho-oxylate) was discovered. This com-

pound is sodium 3 : 3 diamino-4 : 4 dihydroxy-arseno- benzene-methylene-sulphinate and it is derived by the introduction of the methylene sulphinic group into one of the two amino-groups. This new compound satisfied many of the requirements demanded from such drugs, viz, decreased toxicity, and has a neutral reaction. The fact that it is nearly 2.5 times less toxic than salvarsan and the ease in manipulation has increased its popu- larity although its keeping powers are not so great; its solution oxidizes readily on shaking and its toxicity and therapeutic efficiency are also apt to vary in differ- ent samples (Dale and White). In fact, its precise structural composition is still uncertain; Ehrlich merely described it by stating that it was obtained from arsephenamine by the action of formaldehyde sulpho- oxylate. Nevertheless it was a distinct improvement on the former compound and is at present being used extensively bjr medical men throughout the world. Attempts have been made and are still being made to find out a stable variety of this compound that will prove to be even more satisfactory from a therapeutic point of view and less toxic. Of all these the silver sodium compound of salvarsan or neosalvarsan has a

high chemotherapeutic index but therapeutically it is no more effective. All other compounds of this nature that, have been obtained up to now have however no special advantage over neosalvarsan.

Arsenical preparations in therapeutics.?The far-

reaching effects of Ehrlich's work cannot be overestimated. Although admittedly the therapin magna sterilisans that was expected to follow on the heels of 606 has not matured, the development of the science of chemotherapy, of which salvarsan was the first striking success, has placed within the reach of the physician many potent remedies against disease. To the physician in the tropics, Ehrlich's .researches have directly or indirectly given many specifics for diseases, such as kala-azar, trypanosomiasis, syphilis, yaws, etc., which were considered incurable. Other diseases such as rat-bite fever and relapsing fever which produced much incapacity can now be cured with a few injections of arsenobenzene compounds.

Ehrlich's work on the organic arsenicals has been carried further by other workers. Not only were further possibilities of the trivalent compounds explored, but a comprehensive study of the pentavalent compounds was pursued with gratifying results. In this way another compound, tryparsamide (sodium-n-phenyl-glycina- mide-p-arsonate), was discovered at the Rockefeller Institute, New York, which is useful in the later stages of trypanosomiasis and syphilis when the parasites have penetrated into the central nervous system. Fourneau and his colleagues at the Pasteur Institute, Paris, produced a series of compounds of which Fourneau 270 (sodium-4 acetyl amino-2-hydroxyl- phenyl-arsonate) and Stovarsol (sodium-3-acetyl- amino-4-oxypheny-arsonate) are well known. These compounds are of particular interest since not only did they throw light on the relationship between chemical constitution and parasitic action, but led to the produc- tion of certain compounds which are effective when administered by the oral route. Although these partic- ular compounds had a limited degree of success in curing syphilis and trypanosomiasis, they opened up for the physician fresh possibilities in oral therapy. The result has been rediscovery of the compound carbarsone (4-carbamino phenyl arsonic acid) which

.was originally prepared by Ehrlich and which was

discarded by him because it did not have any marked trypanocidal properties. This compound in doses of 0.025 gm. twice daily for 10 to 15 days cures a large percentage of cases of chronic amcebiasis which were not touched by emetine and its derivatives. The introduc- tion of carbarsone into tropical therapeutics marks a

definite advance in the treatment of this widespread disease.

Ehrlich's basic work on dyes, although it gave him

disappointing results, has been responsible for the production of such powerful drugs as Bayer 205 which has proved effective in the treatment and prophylaxis of trypanosomiasis and Yatren 500 which is an effective remedy against amoebic and bacillary dysentery. The preparation of powerful antimalarial remedies such as plasmochin and atebrin by Professor Schulemann of Bayer-Meister Lucius and his co-workers, which has changed our whole outlook of this world-wide disease, followed indirectly upon Ehrlich's work. The series of organic compounds, of antimony we

also owe to his researches, because it was working on the lines of Ehrlich's work with the preparation of organic arsenicals that Professor Schmidt, at that time working with Von Hay don's firm, produced the anti- monial compounds which led eventually to the prepara- tion of urea-stibamine and neostibosan which are

effective against leishmaniasis, and antimosan and foudain which are effective against the dreaded schistosomiasis.

Organic arsenicals themselves have been tried in the treatment of widely different diseases and, although they have not produced uniformly successful results, further studies may lead to the production of com-

pounds having a specific action against disease. For instance experiments on bacterial infections show that

arsphenamine compounds when injected into animals confer upon the blood bactericidal properties that are retained therein for a considerable time. The serum of patients after injection of arsenicals exerts a bacteri- cidal effect upon staphylococci and hsemolytic streptococci. Further work in this connection may lead to interesting and important developments. In helminthic diseases although the arsenicals do not

produce uniformly successful results, a few intravenous

injections may often give relief against trichinosis and filarial infections. Such is a brief account of Ehrlich's researches and

their achievements in the domain of medical science. It will not be too much to say that so far as protozoal diseases are concerned the effects have been remarkable and further progress is expected. Hosts of workers are following in Ehrlich's footsteps and chemotherapeutic research is making rapid strides. The discovery of salvarsan is not only a pioneer work but a distinct landmark in rational development of therapeutics. The preparation of this single compound has given chemo- therapy a solid foundation on which it now stands. It has supplied the practitioner with missiles with which he can wage war against parasites which produce disease and suffering in man and animals. It has raised chemistry at once from being a science necessary for human comfort to one that can save mankind from its microscopic enemies.

Lieutenant-Colonel Chatterji then addressed the meeting:?In my student days I used to hear of Paul Ehrlich, of him as a man and his wonderful contribu- tions to the science of medicine. Reading about a

person is one thing but seeing him is something very different and I have always been addicted to indulge in the curiosity of seeing the person I had read about, and I wondered then whether I would ever be able to meet this great man. For once, luck was in my favour, and I found it possible to go abroad to see things and to learn what I could from seeing. In 1908, I found myself in the august presence of Paul Ehrlich. It

was at a meeting of medical men and Ehrlich turned up there most unexpectedly; let me be frank and admit that his advent was an inspiration to me. A little man, rather thin with a genial face and even more genial

46 THE INDIAN MEDICAL GAZETTE [Jan., 1936

smile; there was an air of sadness in his features which may be explained by the virulent criticisms levelled against him bjr other scientists. His eyes were remark-

able; they were bright with an intensity of life which seemed to glow from them. I think he told me that, he never despairs and that no one should ever despair. Like an expectant mother he was looking forward to a

successful issue of his investigations. With Brahma- nical instinct I wished for blessings for his success.

That success came, success always comes to the deserving, like Paul Ehrlich. A weary traveller, he travelled the paths of research, working and achieving and giving the results of his achievements away for the advancement of science; such gifts are like mile- stones of silent mementoes of his scientific work which led to amelioration of human suffering. This day, 25 years ago, Paul Ehrlich addressed a

meeting of scientists and members of the medical profession at Frankfurt and made the momentous announcement that ' 606' had achieved what he had hoped it would achieve. He christened it 1

salvarsan' and rightly so. It is truly salvation (sanskrit equiva- lent, paritran) because it not only meant salvation of

the_ individual sufferer, but it has brought salvation to nations all over the world from the ravages of a disease which cripples, maims, incapacitates and invalidates through the destructive propensities of its causal parasite, pretty to look at, delicate in its movements but endowed with powers of invasion of every structure of the human ho^t. More than that, it can lie fast and latent in the most intricate parts of the human body and has the unique capacity of transmitting itself from one human generation to another. This familial transmission seems to be its birthright and environ- mental protection its latent safeguard. From time immemorial weapons have been devised for the destruc- tion of Treponema pallidum but it was left to Ehrlich to find in ' 606' the most formidable among them, thanks to his genius, undaunted courage and perseverance. Paul Ehrlich was instinctively an investigator,

originator of ideas and a philosopher; a man of great imagination, imagination which was creative and

productive. There is no finality in research and Ehrlich knew that. I believe he was contemplating a voyage East and West, to the tropical regions to make a further study of the disease for the cure of which he had discovered

'

606', but the cruel war interposed and his work was interrupted. He might have got some

information from his understudy, Hata, and from the

Hamburg Institute of Tropical Hygiene. How I wish he had come to India, because the more I see, the more I appreciate the vagaries in the manifestations of the disease tainted with tropical infections and during my last sojourn to the West I wandered about in search of facts in relation to this disease influenced by tropical conditions. I collected some and presented them to

research departments here for investigation and study. But this, the most killing of_ diseases rendered even

more killing by tropical infections, did not seem to be included in the departmental nomenclature of diseases. There seems to be an apathy towards this and sooner it is shaken off the better it is, for this and other tropi- cal and subtropical countries. It would be difficult to find a Paul Ehrlich again, but lesser Ehrlichs may be found who could pick up the thread where he left it and work for the solution of this great problem. This is neither the place nor the time for entering

into the posology and therapeusis of '606', but I shall just tell you a few things that trouble me. The mani- festations of this disease are most varied. It is a great mimic and to be misled is not difficult. Then the toxicity of the drug in some cases and its inaccessibility to the parasite in arsenic-resistant cases are further puzzles. Familial and third generation transmissions, their vague, indefinite and uncertain manifestations are difficult problems. Ehrlich has brought salvarsan as a

rare gift to the medical profession; it is a good and powerful weapon, but let us not forget that in fighting a formidable and subtle enemy like the treponema,

while ' 606' may make the frontal attack, _

we have

other weapons like mercury, bismuth and iodine for

rear and flank attacks and the much condemned air

bombing. We may use these simultaneously or alter-

natively as surprise attacks. The eradication of the infection is indeed a difficult problem. Ehrlich is not

here to make further gifts to solve these problems, but whoever does will bring paritran to our land.

Gentlemen, in treating a patient to cure him of this disease, begin in the beginning and go on till you think you have come to the end of treatment but do not

stop lost you may have to begin over again. Dr. Brocke then spoke again:? The addresses of two so distinguished workers have

given us very vivid impressions on the great scientist's career and I feel that this is the occasion to present to the speakers two replicas of the memorial tablet erected in Paul Ehrlich's study in the Georg Speyer- Haus and State Institute for Experimental Therapy in Frankfurt. I feel greatly honoured that I am allowed to do so and that I am to convey the sincerest greetings of the research workers of Bayer at Home whose names?like Dr. Schulemann, Dr. Hoerlein and Dr. H. Schmidt?are not entirely unknown to you. The memorial tablet in Paul Ehrlich's study bears

the Latin inscription CHEMOTHERAPEUTICS POSTULATUM PRIMUM UT PROFICIATUR. PRIMO PROXIMUM ITT NIL NOCEATUS (For a

chemotherapeutic it is the first postulate that it should cure but the very next one that it should not do any harm), a principle which has always been and we hope will be the guide of research work all over the world as a living heritage of Ehrlich's work. He presented the two medallions. A very excellent cinematograph

'

talking' film describing and illustrating the history, the symptomato- logy, and the treatment and cure of syphilis was

shown. Colonel Chopra then closed the meeting by thanking

Dr. Brocke and the scientific department of Bayers for organizing the meeting and for the replica medallions that he had presented to Lieutenant-Colonel Chatterji and himself.

EXTRACTS FROM THE MINUTES OF THE BENGAL COUNCIL OF MEDICAL REGISTRA- TION HELD ON THE 18TII FEBRUARY, 1935* 1. The remarks offered by the authorities of the

undermentioned medical schools on the Inspection Committee's observations recorded on inspection were referred to the Committee for consideration:?

(0 Ronaldshay Medical School, Burdwan. (ii) National Medical Institute, Calcutta. (m) Bankura Sammilani Medical School, Bankura. 2. It was reported that nomination papers were

issued to the members of the Council for the election of a representative of the Council on the Bengal Nursing Council and as a single candidate Dr. Bidhan Chandra Ray, m.d., m.r.c.p., f.r.c.s., was nominated for this election he was reported as elected. The action taken by the office was approved.

3. Government resolution announcing the appoint- ment on the Bengal Sanitary Board of Dr. Taraknath Majumdar, l.m.s., d.t.m., d.p.h., f.c.s., and Dr. Abdul Majed, m.b., d.t.m., d.p.h., representatives of the Bengal Council of Medical Registration and the State Medical Faculty of Bengal, was recorded.

4. Report on the inspection of the Campbell Medi- cal School was adopted.

5. Report on the inspection of the Jackson Medical School, Jalpaiguri, was considered and adopted and it was decided that the authorities of the school should be asked to stop admissions and that the question of its disaffiliation be considered by the Council at their

* Forwarded for publication under letter dated 15th November, 1935.

Jan., 1936J MEDICAL NEWS 47

next meeting and that Government be informed of the decision taken.

6. Government letter authorizing the entry of the title 'Fellow of the State Medical Faculty' in the

Register of Registered Practitioners as an additional qualification was recorded.

7. The consideration of the report on the revision of the appendix to the Annual Medical List was

postponed. 8. Government notification announcing the accept-

ance of the recommendation of the Council that the

M.B., B.S. degree granted by the Andhra University be recognized as registrable under section 18 of the

Bengal Medical Act, 1914; was. recorded. 9. It was decided that the qualification D.B.

(London) be entered as an additional qualification against the name of Dr. Ganapati Panja, m.b., in thf

Register of Registered Practitioners. 10. The consideration of the application of Dr. M. R.

Treu, m.d. (Cologne University), for registration of his name under the Bengal Medical Act, 1914, was post- poned for the next meeting.

11. Government notification announcing the election of Dr. Bidhan Chandra Ray, md., m.r.c.p., F.R.C.S., under clause (c) of section 4 of the Bengal Medical Act, 1914, was recorded. ^ 12. On an application from the Registrar, Andhra

University, it was decided that a report be made to the local Government under section 18 of the Bengal Medical Act, 1914, recommending that the L.M.S. diploma granted by the University be recognized as

registrable in Bengal. . 13. On an application from the Registrar, Univer-

sity of Rangoon, it was decided that a report be made to the local Government under section 18 of the Bengal Medical Act, 1914, recommending that the L.M.S. diploma granted by the University be recognized as

registrable in Bengal. 14. An application from the Principal, Ludhiana

Medical School, praying for recognition of the school as an institution eligible to train and send up candidates for the Licentiateship Examinations of the State Medi- cal Faculty of Bengal up to the Intermediate standard was refused as there was already a Medical Faculty in the Punjab.

15. It was decided that the Dacca Medical School and the Lytton Medical School, Mymensingh, should be critically inspected during the next 6 months.

16. The consideration of the returns submitted by the recognized medical schools was postponed for the next meeting.

17. With regard to the publication of the Annual Medical List it was decided that it should henceforth be corrected up to the date it goes to press.

18. With regard to an application from the authorities of the Medical Bulletin, Bombay, it was decided that copies of such proceedings and resolutions as are intended for the medical press may be supplied for publication in the Bulletin.

19. The undermentioned gentlemen were re-

appointed members of the Penal and Ethical Cases Committee for the year 1935:? Lieutenant-Colonel T. C. Boyd, d.p.h., f.r.c.s., i.m.s.

Dr. J. N. Moitra, m.b. Sir K. N. Das, Kt., c.i.e., M.D., F.C.O.G. Dr. P. Chatterjee, m.b., f.r.c.s. Dr. A. D. Mukherjee, l.m.f. 20. Considered two reports of the Penal and Ethical

Cases Committee. 21. Dr. J. C. Chatterjee, l.m.s., was re-appointed a

member of the Managing Committee of the Provident Fund of the Office.

22. Dr. K. S. Ray, m.a., b.sc., m.b., ch.B., was

appointed a member of the Inspection Committee vice Dr. Mrigendralal Mitra, m.d., f.r.c.s., deceased.

23. With regard to an application from Mrs. Kusum- kumari Majumdar, l.m.p., l.m., praying that her M.D. (Berne) qualification be entered against her name in the Register of Registered Practitioners as an addi- tional qualification it was decided that particulars

regarding this degree should be obtained from the University.

24. Entry under section 21 of the Bengal Medical Act, 1914, of the qualification D.T.M. & H. (England) against the name of Dr. Francis John Copeland, m.b., ch.B., was approved.

25. The raising of the fee for registration of an

additional qualification from Rs. 5 to Rs. 25 and the price of the Annual Medical List from Rs. 3 to Rs. 5 per copy was agreed upon.

26. The following motion of Dr. Amulyadhan Mukherjee, l.m.f., was referred to the Inspection Committee:?

' This Council is definitely of opinion that in institu- tions recognized by this Council each subject excepting Medical Jurisprudence and Hygiene must be taught by separate teachers as is done in the Medical Institutions of Calcutta and Dacca

TROPICAL DISEASES BULLETIN

Tropical Diseases Bulletin. Vol. 32. Supplement. Nov., 1935. 280 pp.

' Medical and Sanitary Reports from British Colonies, Protectorates and Dependencies for the Year 1933' summarized by H. Harold Scott , M.D., f.r.c.p., d.p.h., etc., Director of the Bureau of Hygiene and Tropical Diseases. [Price 7/6.] This fifth annual issue of the ' Medical and Sanitary

Reports from British Colonies, Protectorates and

Dependencies for 1933' contains an account of the activities of 55 medical services within the British Colonial Empire. The reports record the progress made in health work during the year in the face of the difficulties of controlling disease among backward popu- lations under unfavourable economic conditions. The main lesson that comes out of a study of the sum- maries is that in the tropics, as at Home, real improve- ment in health among the population is bound up with improvement in agriculture, housing, and education and the raising of the general standard of living, and to

bring this about wise and informed administration at the head and harmonious co-operation between the different government departments are essential. The medical departments are shown by their reports to be

making their contribution towards the general economic advancement of the native communities in the British colonies by providing medical facilities for curing disease, by prosecuting research into the causes of disease and methods of diagnosis and prevention, by developing health services such as maternity and child- welfare work, school hygiene, and general sanitation, and by arranging for the training of natives as dis- pensary assistants, sanitary inspectors, nurses, and mid- wives and in some colonies as doctors, to take their proper share in caring for the health of their own

people. The usual table of vital statistics for British Colonies,

Protectorates and Dependencies during 1933 which is appended brings out the lack of reliable data from many parts of the Colonial Empire and the need for a much improved system for the collection of vital statistics in certain British colonies.

INDIAN MEDICAL COUNCIL In pursuance of the proviso to sub-section (2) of

the Indian Medical Council Act, 1933 (XXVII of 1933), the Governor-General in Council is pleased to nominate Major-General Sir Frank Powell Connor, Kt., d.s.o., F.R.C.S., D.T.M. & H. (Eng.), L.R.C.P. (Lond.), K.H.S., I.M.S., Officiating Director-General, Indian Medical Service, as the President of the Medical Council of India, with effect from the afternoon of the 29th October, 1935, vice Major-General C. A. Sprawson resigned. Colonel H. C. Buckley, mjj, f.r.c.s. (Edin.), i.m.s.,

Inspector-General of Civil Hospitals, United Provinces, has been nominated by the Government of the United Provinces under clause (a) of sub-section (1) of section 3 of the Indian Medical Council Act, 1933 (XXVII of 1933), as a member of the Medical Council of India vice Lieutenant-Colonel H. Stott, i.m.s.,

resigned.