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elative values of which may still be disputed"... may depend "upon slight changes in the atom
groupings of the bacterial protein determining its reaction with a particular antibody"... and "we
know very little as yet about the stability of such atom groupings, and the extent to which they may
undergo spontaneous variation."
The Committee incidentally declare that "a widely air-borne distribution of the meningococcus "
involves "a hypothesis to which all its biological properties are strongly opposed" (p. 52). And yet
an ability on the part of something or other to pervade the atmosphere of living rooms, theatres, and
places of assembly—limited, it may be, but certainly exceeding that ordinarily associated with "causal
organisms,"—seems a sine qua non if outbreaks of influenza and catarrh are to receive explanation; and
these outbreaks, according to the testimony of both bacteriologists and epidemiologists, occur coincidently
with outbreaks of cerebro-spinal fever. Why not, then, it may be asked, allow that the "potentialities
of parasitism," to which the Advisory Committee allude, may be called into activity by this
same unknown agency, which would then be regarded as primarily concerned with the development of
these epidemic diseases? The manifestations of the influence in quest'on are then, in some subjects
accompanied by multiplication of epidemic strains of meningococcus and by cerebro-spinal fever, and
in other subjects by development only of harmless domestic strains of meningococcus with no
cerebro-spinal fever; but in these latter subjects there may, unfortunately be development of
epidemic strains of pneumococci or of streptococci, or of Pfeiffer's bacilli, with corresponding
pneumonia, tonsillitis or influenza. The Advisory Committee advise (p. 57) that "cerebro-spinal
fever is an epiphenomenon of the epidemic." The alternative view is that the unknown agency is
the original cause of the "influenza outbreak," which assumes various types, and the appearance of
the corresponding " epidemic strain '' in each case constitutes the epiphenomenon.
Anthrax.
During 1915 the following seven cases of human anthrax occurred in London (1) On the 19th
February, 1915, a man, G.K., aged 52, developed a boil on the back of the neck. He was removed
to the London Hospital and operated upon there, but died on the day following the operation. He
had been occupied in making rugs at his home from miscellaneous materials, mostly said to be derived
from the goat.
(2) On 23rd April, 1915, a skin porter employed at the Leather Market, Bermondsey, developed
a pimple on the cheek. He was removed to the Great Northern Central Hospital, the ulcer was excised
immediately, specific serum treatment was applied and the patient recovered.
(3) On the 26th June, 1915, J. M., aged 26 years, a tea-packer, developed a boil on the forehead.
He was admitted to the Royal Free Hospital, and recovered. The source of infection was not discovered.
(4) On 8th July, 1915, Mr. Luxmore Drew held an inquest on the body of a solicitor's clerk
(H. C.), living in Paddington, who died from anthrax at the West London Hospital; the disease began
in the neck. The man (aged 38) had had nothing to do with animals or hides, wool, or skins, but it was
stated at the inquest that his mother had bought him a new shaving brush at the shop of a local chemist
about a week before his death.
Dr. Elworthy, the pathologist to the hospital, verified the fact that the man had died of anthrax.
He also examined the shaving brush and found it to be infected with anthrax spores. His experiments
(see Lancet, 1st January, 1916) showed that anthrax spores may remain dormant in the hairs of brushes
throughout the process of manufacture, and thus the disease may appear after the distribution of the
manufactured articles. The brush was one of six obtained by a chemist in Paddington from a wholesale
firm in Finsbury on 11th May, 1915. It was the only one of the six sold by the chemist. The others
were examined by Dr. Elworthy and found to be infected with anthrax. Enquiries were then extended
into the earlier history of the brushes. The bristles were found to be largely composed of mixed hair
of Chinese origin, chiefly goat, horse, pig, and human hair. Before the war such consignments of hair
were usually sent to dealers in Switzerland, who transmitted them to Germany, where they were graded
and cut into lengths after being disinfected, and returned to Switzerland, from whence they were
exported to wholesale manufacturers in this country. After the outbreak of war, however, these hairs
were imported into this country direct from China, and, being labelled as " goats hair," escaped the
Home Office regulations with regard to disinfection.
It appears that a consignment of these hairs conveyed by a Japanese vessel was purchased
through certain brokers by a firm in London in September, 1914, who sent them to manufacturers in
the Midlands for making into shaving brushes. About 1,500 of these brushes were distributed to various
wholesale and retail vendors, both in this country and in the Colonies; amongst these was a firm which
supplied the local chemists with the brush used by H. C.
The matter wasreported to the Local Government Board,and it was arranged that that Board would
take steps to collect the brushes in the provinces, while the London County Council would deal with those
sold in London. The medical officers of the City Corporation and the metropolitan boroughs in which
the brushes had been distributed were informed, and where the brushes were unsold they were collected
and dealt with, but a number had already been disposed of to casual customers and could not be traced.
(5) In the course of enquiries another case of human anthrax was discovered in Deptford, in
July, and it was found that the patient, who was a hawker, had obtained a shaving brush from a shop
receiving its supply from the suspected consignment. Dr. Elworthy examined the brush used, and
found it to be infected with anthrax. It was also ascertained that three other cases had occurred outside
London, one at Bristol, another at Southall, and a third at Coventry (see Lancet, 29th January, 1916),
and in all three instances the infected persons had bought shaving brushes shortly before contracting
Cases of
Anthrax
caused by
infected
shaving
brushes.