PROGRESS IN PATHOLOGY
VALUABLE. RESEARCH WORK. Walter and Eliza Hall Institute.
If the Hickson mission has done nothing
better than to bring to common knowledge how much human suffering can exist in a community comparatively small, and ap- parently living under excellent conditions, it will, nevertheless, have performed a vast public service. For tthough sunny skies and a high standard of living are inimical to disease, they cannot of themselves pre- vent it. And now the resignation of Dr. S. W. Patterson from his appointments at Melbourne University, including the care of the Walter and Eliza Hall Institute, will direct public attention more acutely to the work that is being performed- or perhaps created- so new is some of it to the popular conception. The science of pathology, with its ever-widening compre- hension of the manifestations of ailments is continually increasing its scope for the prevention of factors of illness.
The work to which Dr. Patterson has brought his trained intelligence may com- prehensively be considered under two head- ings, firstly, the general results of the latest English and Continental research, as applied to Australian conditions, especi- ally with regard to dysentery, typhoid, and pneumonia, involving treatments with serum and vaccine; secondly, the investi- gation of diseases more or less peculiar to Australia, particularly the strange growth of hydatids. How different are the stand- ards of health in Europe from those of Australia, are indicated in the discoveries of Naegli, in Zurich, Switzerland, who found that 99 per cent. of people in the com- munity showed signs of tubercle; 15 per cent, actively; in the remaining 84 the in- dications were old, healed, or latent. This circumstances has prompted similar in- quiries in Australia. Figures are not yet available for definite use, but it is known that the proportion of disease is consider- ably smaller.
An Australian Field.
In such fields of inquiry the work of the Walter and Eliza Hall Institute dominates Australia; its help is frequently solicited from Adelaide, Sydney, and Brisbane. The card system is used as carefully as in any business office more, it is followed up in after years; for instance, in the case of cancer, the treatment directed, and the re- sults obtained are carefully annotated, and subsequently further inquiry is made re- garding the ultimate fate of the patient. Here if an excellent replacement for the old "cut-and-come-again" methods of our medical fathers.
The basis of modern pathological work is essentially quantitative. It is felt that the presence or absence of certain mallet is not sufficient knowledge, and that an exact estimate of maleficent influence must he made. Thus a quantitative method is used for performing the Widal reaction. When a patient has typhoid fever, his blood will cause typhoid germs put with it to cease circulation, and huddle to- gether. If the blood agglutinates the typhoid germs, it may be found by diluting with saline solution how weak the patient's blood may be and still agglutinate thc germs. Thus is a measure obtained of the agglutinating power of the blood.
Nothing of this nature has more interest than the adoption of certain physiological tests. The amount of work that an organ diseased (or suspect) can do is tried. Patients who are diabetic are unable to make healthy use of sugars. For examina- tion, large quantities of sugar are given; the normal is tested by the abnormal.
Another method that has proved very successful consists in working out a theory of basal metabolism, comprising all the changes taking place during the absorp- tion of food, burning it up, and excreting the waste. This scheme is founded on- soldiers will remember it- the Haldane gas mask. A mask is fixed to the face. The patient breathes into a bag. The oxygen a patient uses during a quarter of an hour is measured, and how much waste carbon dioxide is put out to cor- respond with that oxygen. On an ac- cepted calculation of how much oxygen the average man or woman- as compared with his or her ''surface" exhausts- so can the results of the patient's tests be taken. This test is particularly useful in cases of thyroid gland trouble, in estimating the secretion of the gland. Diminished func- tion of the thyroid gland occurs in people apparently lethargic and dull, both 'physi- cally and mentally. These are put down to about half the normal basal metabolism.
Excitable people with goitre are 50 per
cent, above it.
Of the intense accuracy shown in ana- lytic work the histology-room gives ample evidence. Here abnormal growths that have been cut out are fixed in solution
so that they can neither diminish not change; soaked in paraffin three times separately for two hours, and set in a special cutting apparatus, and after this one or two cells are placed in a series of coloured "stains," according to profes- sional suspicion. Finally, they are placed under a microscope, showing exactly the amount of evil matter present.
The use of white mice for diagnosing pneumonia is an unfamiliar circum. Guinea pigs are susceptible to tubercule, rats to plague, white mice to pneumonia. A specimen of the patient's saliva is in- jected into a mouse, which is killed after six jours if the test shown positive re- sult, the germs being treated and utilised. This innovation has considerably reduced the percentage of deaths from pneumonia. The bottling and growing of germs is the mainspring of many new methods, includ- ing that known as complement fixation, embodying a knowledge of the principle that when red blood corpuscles are in- jected from a sheep into a rabbit the rabbit's blood learns to burst any sheep corpuscles that are brought into contact with it.
The Walter and Eliza Hall Institute is truly a home for magical knowledge, but Dr. Patterson's absence will greatly be