Friday evening by Dr. J. H. L. Cumpston, D.P.H., under the auspices of the
committee of the Western Australian Museum and Art Gallery. The subject
was most interestingly presented, and gave the audience a most informative
insight into the progress of medical research during the last 30 years.

Dr. Cumpston commenced by inviting the audience to join with him in
admiration and wonder at the marvellous progress in medical science that
the last few years had witnessed. Continuing, he said :—In instituting a
comparison between things as they now are and things as they have been,
there is no occasion to refer to such things as mandrake, frog’s blood,
powdered lizards, and all the disgusting armamentarium of the physician of
the dark Middle Ages, nor is it necessary to remind you of cupping,
purging, leeching, bloodletting, and the other irrational practices that
were used indiscriminately by medical men of even later days. I need only
quote from a lecture to which I listened 10 years ago. The
lecturer—surgery was the subject—said, “Fifteen years ago in these wards
hospital gangrene was rampant, and it was considered an achievement if an
operation wound healed without suppurating.” That state of affairs existed
25 years ago, and to-day one occasionally hears a surgeon say, “I regret
to have to tell you that the wound suppurated,” while

“Hospital Gangrene” Is Unknown.

What was the recognised condition 25 years ago now is a matter for
reproach. In the text-books of 10 years ago there still remained in use
the term “laudable pus.” Think of what that means. The dirty discharge
from an infected wound described by leading surgeons as “praiseworthy,”
while to-day the surgeon spends a sleepless night if the suspicion if pus
occurs in a wound. What was meant, of course, was that type of discharge
referred to as “laudable” indicated that the wound would ultimately heal
and the patient get well. Thirty years ago no surgeon would, except in the
most extreme circumstances, operate on the abdomen or the brain, because
the wounds were sure to become infected and the patient sure to die. Now
such operations are performed daily and many lives saved. Only 12 years
ago diphtheria and croup were most deadly. The spectacle of a child, its
throat choked with membrane, fighting for breath, and dying after hours of
suffering, worn out with the combined effects of the disease, poison, and
the unavailing struggle for enough breath to carry on its life—this was
only too common a sight. To-day we have in our hands a remedy which

Robs Diphtheria of All Its Terror

and enables us to save many hundreds of children every year. The story of
the last 30 years of medical work is fascinating beyond words, and an hour
will not he wasted if it is spent in reviewing some of the most
interesting features of the revolution in thought which has taken place—a
revolution of which the keynote is not war and death, but peace and life.
When one reviews the position as it was 30 years ago, one cannot help
feeling that the whole medical world was in a state of suspense, waiting
almost with bated breath for someone to open the door of that chamber in
which lay the secret of

Many Unexplained Mysteries.

Whether the hour made the man, or the man proclaimed the hour is of little
moment ; the great fact remains that the door of that chamber was unlocked
by a single hand—that of him whom the whole English world now reverences
as Lord Lister. But after all, what was it that that he first proved? It
was very simple, and the wonder is not that he discovered it, but that it
was not recognised long before. It was that when a wound inflames and
suppurates it does so because the instruments used, the hands of the
surgeon, and the dressings applied were not clean. In other words, dirt,
containing germs, was present somewhere within the field of operation.
This seems to us now an elementary fact so ridiculously simple as to lead
to wonder why it was never before recognised, but the results of Lister’s
discovery and teaching have been incalculable. It has become possible to
operate on the brain, the lungs, all the abdominal organs, and even the
heart itself, with the knowledge that in almost every case the patient
will recover ; it is now possible for women to go through the period of
childbirth without “milk fevers” (once considered to be normal) or any of
the ghastly “blood-poisonings” of the lying-in period once so common.
About the same time that Lister was giving his message to the scientific
world there was working quietly in Paris

Another Genius

whose work was destined to play an equally important part. All tourists
who visit Paris take the earliest opportunity of travelling across the
river to the Hotel des Invalides, there to see one of the most sumptuous
and magnificent mausoleums in Europe. In a massive block of glittering red
porphyry lies buried Napoleon—the man who was responsible for more deaths
than any other man of modern centuries. There is one other tomb in Paris
worthy to be compared with that of Napoleon, and to this go all medical
men as surely and as devotedly as the Mohammedan to Mecca. In this tomb of
black marble lies buried the man who with Lister has been the means of
saving more lives than any other man throughout all time—Louis Pasteur.

What Lister and Pasteur Did.

What was it that these two men did? Why does the world count them so
honourable? It was because they discarded completely the cloaks of
tradition, broke their way through the bewildering meshes of humbug and
sought the reason for all things, asking restlessly and persistently of
all phenomena in season and out of season the question “why.” And this is
what they discovered. That no part of Nature stands alone, that the nature
is one complete scheme and the explanation of one part is to be found only
by the study of all the other parts, that man is not a self-contained
being but is affected and played upon by innumerable factors involving the
most widely divided parts of the scheme of nature ; that disease in Nature
is frequently merely one set of organisms living at the expense of others;
that members of the vegetable kingdom become diseased because they are
invaded by other and inferior members of that kingdom, that members of the
animal kingdom  are preyed upon by members of both animal and vegetable
kingdoms, and that what is known as disease in nature is often the result
of one type of organism obtaining its nourishment from and at the expense
of the organisms to which it attaches itself, and further that these
diseased conditions may be spread from one animal or vegetable to another
by the medium of other animals, e.g., bees may carry disease from flower
to flower, so that the whole kingdom of nature is a closely interwoven
mass where

All Things Are Fighting Against Each Other.

for their existence. In short, that disease in man is produced by minute
vegetable cells, by larger vegetable organisms, by fungi, by minute animal
cells, and even by comparatively large animals. That seems a very simple
thing to have discovered, but it was never realised before, and has since
been found to explain almost every problem in disease of animals and
plants, and many things hitherto obscure became plain under the light of
this simple truth. The picture shows a number of small knobs such as are
frequently seen on small bushes in the scrub. If these are cut open a
number of small worms will be found inside. This is an instance of a worm
producing a disease—a tumour, in fact—on a plant. Another condition common
enough on the leaves of small eucalypts and acacias in the bush in this
country is the scale. These scales, if examined with a microscope, are
seen to be formed by myriads of minute organisms of different types.

This ceaseless warfare throughout Nature of cue form of living organism
against another—the struggle for existence, as it is called—had no sooner
been recognised than it was turned to useful account. From apparent chaos
and confusion man’s intelligence has produced a certain system and order,
playing off one variety of organism or parasite against another, in such a
way as to produce desired and useful results. A separate branch of
science—economic entomology—has arisen, which concerns itself with
annihilating the parasites which infest and destroy our edible fruits and
plants by attacking them with other parasites.

Let us now consider some of the diseases which have been elucidated by the
discovery of these minute disease-producing plants or vegetable cells. The
first disease which

Pasteur Elucidated,

after realising that the source of any disease was to be looked for in any
part of the animal or vegetable kingdom, was the silkworm disease, which
was causing great havoc and pecuniary loss in the South of France. This
disease he showed to be due to a minute parasite which invaded the body of
the silkworm and rapidly caused its death. The next disease which Pasteur
elucidated was anthrax. This caused a heavy mortality amongst sheep in
France, and it arose from time to time in different places in most
mysterious ways. It could not be understood why a flock of sheep should
suddenly be invaded by this disease when there was no other case within
some hundreds of miles. There was also a disease known as “woolsorters’
disease,” in which the hands, arms, and faces of workers among wool became
attacked with a severe ulceration, the effects of which were so great that
the patients often died. The same disease was found to break out from time
to time among men who had handled mohair, camels’ hair, horses’ hair from
China and Persia. Frequently as soon as the bales of such hair were opened
the men became attacked. It was Pasteur’s work that demonstrated that all
these conditions were produced by the same organism—a microscopic
vegetable cell, the anthrax bacillus. This organism has the power of
forming spores, i.e., when the food supply is insufficient or the
environment of the organism is not favourable to the life of the bacillus
it forms itself into small spherical masses and surrounds itself with an
extremely hard and resistant coat. This fact explains why it is that the
disease breaks out in remote parts and why men working with goods packed
in China contract the disease in England. These spores live for many
months, and as soon as they find themselves in a suitable environment they
develop into an active form and again produce the disease. Pasteur proved
the important fact that a disease in man which was not previously
understood was the result of accidental infection with the virus of a
disease of sheep and other animals.

Although Lister showed that inflammation, abscess formation, and
suppuration were the result of the infection of a wound with foreign forms
of life, he did not at once describe the organisms in detail. Pasteur was
once at a meeting of the Royal Society of Medicine of France, where the
subject under discussion was

Puerperal Fever.

All the members supported various theories of spontaneous generation of
inflammation except Pasteur, who, rising in the meeting, spoke to this
effect :—“What rubbish you talk! It is nonsense to speak of spontaneous
generation of puerperal fever ! A woman can no more suffer from puerperal
fever by herself than she can produce children by herself. The cause of
puerperal fever is a microbe introduced with the dirt on the hands of the
midwives and the hands of yourselves—members of this Society.” One member
laughingly said, “That’s all very well, but what is this microbe like? Who
has ever seen it?” Pasteur replied, “I have. It’s like this,” and he drew
it on a blackboard. What he drew is now known as a streptococcus, which
together with the staphylococcus produce almost all the inflammation and
abscesses the world suffers from. These organisms are to be found
everywhere throughout Nature in the sweepings of the streets, the water we
drink, the food we eat, and the clothes we wear. Before they can do any
damage, however, a person must be in a condition of lowered resistance,
there must be some wound through which they may enter the body, and they
must be in sufficient numbers to overcome the body’s resisting powers.

In 881 it was announced that the organism which caused

Typhoid Fever

had been discovered. This organism is a short rod-shaped bacillus
possessed of a very large number of flagella (limbs, in other words), by
means of which it propels itself through any fluid in which it may be. The
discovery of this organism has made an immense difference in the way in
which the disease is regarded. It is now possible to examine carefully and
ascertain whether the bacilli are present in any substance supposed to
have produced typhoid fever and investigate the various ways in which it
may be spread. Among other ways it has been found that typhoid fever
organisms are conveyed from privies and collections of excreta to milk and
other food exposed on tables in dining-rooms or kitchens by the ordinary
house-fly, and also that a frequent source of infection is by oysters,
mussels, and shellfish which are laid down in beds at the outfall of sewers.

Tetanus, or lockjaw, as it used to be called, has been shown to be caused
by a bacillus which exists in the form of spores and is found almost
invariably in horse manure. The reason for this association with horse
manure is not very clear, but the fact has been abundantly proved.

It is difficult to find any single discovery that has created such a
sensation and been productive of such far-reaching results as that of

The Bacillus of Tuberculosis,

announced by Koch in 1882. Up till the time of that announcement there had
been the vaguest uncertainty and the wildest speculation about tubercular
diseases, but the discovery of the organism that caused the disease and
the description of the methods by which it could be recognised
crystallised at once the whole matter and made definite knowledge and
rational action possible. Perhaps the most important result of Koch’s
discovery was the finding that many of the diseases of cattle and pigs,
the nature of which was previously very obscure, were caused by the same
organism as that which produced tuberculosis in man, and that eating the
flesh of diseased cattle or pigs or drinking milk from such cattle can and
does produce tuberculosis in man. This is not the place to deal with
Koch’s subsequent announcement in 1901 that the organisms of human and
bovine tuberculosis are different and not interchangeable. It will be
sufficient to say that the work of the British Royal Commission has proved
beyond question that tubercular meat and milk can produce tuberculosis in
man.

In such a review of recent discoveries as the present one it is difficult
to refrain from using expressions of admiration and wonder, and with each
fresh phase of the subject one is tempted to use superlatives. Perhaps,
however, the portion of medical work where we would be justified in using
expressions beyond the ordinary restrained forms of speech is that of

Research Work on Plague.

Medical research work can point to nothing more brilliant than the
demonstration of the fact that bubonic plague is primarily a disease of
rats, and man becomes affected in a secondary way by the agency of fleas.
It is to be counted as an achievement that not only have rats and fleas
been shown to be practically the only agents in the spread, but the
particular rat and the particular flea have been identified and the
innocent criminals, if one may so describe them, are those which have been
shown on the screen. One is tempted to dwell on this subject and refer to
the many interesting developments in this particular field of work. The
careful and brilliant work of Captain W. Glen Liston, of the Indian
Medical Service, who with such simple materials as two small cages of flea-
proof woven-wire and two rats and some sheets of “tanglefoot” demonstrated
conclusively the role played by fleas in the transmission of bubonic
plague. Even more fascinating is the ancient history of this disease, a
study of which reveals the fact that the part played by rats was well
recognised. Let me just draw your attention to two out of the many facts
now known to us. It is accepted now that the legend of the “Pied Piper of
Hamelin” rendered familiar to us all by Browning refers to plague. You
will remember how first the rats and then the young children were
destroyed by the Piper. The other instance is the familiar one of the
taking of

The Ark of the Covenant

by the Philistines, recorded in the first book of Samuel, the 4th, 5th,
and 6th chapters. You will remember that after the Ark of the Covenant had
been taken by the Philistines a great plague fell on them, and “the hand
of the Lord was heavy upon them of Ashdod and He destroyed them, and smote
them with emerods. Then said they, ‘What shall be the trespass offering
which we shall return to Him?’ And the priests and diviners answered,
‘Five golden emerods and five golden mice.’ The Philistines returned the
ark to the Israelites and the section of the Israelites who received it
were the men of Beth-Shemesh.” You will remember that the men of Beth-
Shemesh were “smitten” because “they had looked into the Ark of the Lord,”
and there were smitten fifty thousand three score and ten men. It is only
necessary to remind you that the Hebrew word “emerod” is the equivalent of
our modern word “bubo,” i.e., an enlarged gland, and that part of the
covering of the Ark of the Covenant was badgers’ skins, and that in Hebrew
the same word stood for rats and mice for you to at once realise that the
Philistines had a notion of the part played by rats in the dissemination
of plague. It is obvious that the badgers’ skins formed an ideal place in
which the fleas could hide during the journey from the Philistines to the
Beth-Shemites.

Martyrs to Research.

Before leaving this subject I might draw your attention to a melancholy
notice which appeared in the medical journals a month ago. Those of us
whose lot in life it is to engage in medical research work realise that
the handling of plague germs is one of the most dangerous parts of our
work. Dr. Parkinson, a brilliant young graduate of Sydney University, went
to London and took up work at the Lister Institute, deliberately choosing
the bacteriology of plague as his first field of work. He contracted the
infection and died. Not long ago Dr. Allan Macfadyen, of London, while
working with the organisms of typhoid fever, contracted the disease and
died after a painful illness. For many years—one might accurately say
centuries—the West Indies was regarded with horror by travellers of all
nations because of

Yellow Fever.

The Panama Canal was begun by a French syndicate, but it was found
necessary to abandon the undertaking because of the enormous loss of life
and the consequent expense involved. The loss of life was due almost
entirely to yellow fever and malaria. The United States Government has
begun and half completed the task, and the loss of life from these two
diseases has been small. The patient work and persevering investigation
which have made this possible constitute as fascinating a chapter in the
progress of science as any of the discoveries of electricity or radium.
For many years it was thought that malaria and yellow fever were due to
the exhalations, “miasms” as they were called, from swampy and marshy
ground, and many theories were current as to the way in which these damp
vapours acted. There were never wanting, however, men who were not
satisfied with this somewhat indefinite idea and who sought for something
more tangible. One of these, a Frenchman, Laveran by name, was the first
to show that the cause of malaria was a minute parasite which made its
home in the blood corpuscles. This parasite was always found to be present
cases of malaria, but for a long time there was no explanation of how it
got there. It was reserved for an Englishman—Ross—to show that it was

Transmitted by Mosquitoes,

and by a particular variety of mosquito only. Among many characteristics
of this variety of mosquito is one which makes it recognisable by anybody
who sees it—its position when biting, i.e., its body and head are in one
straight line, as distinct from other varieties, which have the proboscis
at right angles to the body when biting. The French have a mot which is
very familiar, “Cherchez la femme toujours. “ However applicable it may be
to the routine matters of life it is certainly true in relation to
mosquitoes—it is only the female mosquito which bites, and on the head of
that sex, therefore, mast be laid the blame of all malaria and yellow
fever. Yellow fever has now been definitely shown to be conveyed by
mosquitoes, and mosquitoes only. The actual organism that causes the
disease has been proved to be so small that it is beyond the magnifying
powers, great as they are, of our present microscopes to reveal it. The
mosquito which is responsible for this disease is a different one from the
malaria mosquito with somewhat different habits. Both varieties, by the
way, are to be found in Perth. How do we know that mosquitoes convey the
infection? I would like to take you through the steps that led up to the
conclusive demonstration of this fact, but I can only now refer to two of
the most striking examples of the readiness of the medical profession to
expose themselves to any danger to prove the truth of any theory the
substantiation of which will benefit mankind at large. Two English medical
men lived for some months in that part of the Campagna, near Rome, known
to be the most badly infected with malaria. They exposed themselves to all
the other suggested sources of malaria, but did not allow themselves to be
bitten by mosquitoes. For such time as they were not so bitten they did
not develop malaria. They then returned to England taking with them some
mosquitoes from the district, and after their return to England allowed
themselves to he bitten by these mosquitoes and they at once developed
malaria, one of them becoming seriously ill.

Self Sacrifice.

For some time the American surgeons working at Havana had thought it
likely that mosquitoes conveyed yellow fever. It was necessary to prove
this. Drs. Reed and Laxear [sic] and some privates in the American Army
volunteered to allow themselves to be bitten by mosquitoes which were
known to have bitten yellow fever patients. They all developed the
disease, and as a result Dr. Lazear—a most brilliant medical man—died
within a few days. I referred just now to Drs. Parkinson and Macfadyen,
who died from plague and typhoid respectively, and have now spoken of Dr.
Lazear, who died from yellow fever. A host of others could be named who
have contracted diseases and recovered. Dr. Dean, under whom I had the
privilege of working at the Lister Institute, in London, was patiently
investigating one of the most difficult problems in connection with
typhoid fever when I left London. Soon afterwards I received word that he
had narrowly escaped death as a result of infection contracted from some
of the material with which he was working. Throughout his whole illness he
kept one of his assistants busy taking his blood and other specimens in
order that such a good opportunity might not be lost. There can be
imagined no greater heroism than that shown by these men. They knew the
danger, and deliberately making preparations against their possible death
they calmly faced lingering illness and death

For the Sake of Humanity at Large.

There is no Victoria Cross for these men, there is not even a Royal Human
Society’s medal, there is merely the knowledge that they are doing what
the conceive to be a duty. Theirs is heroism of the best kind. I cannot
refrain from bringing forward another example. As you know, sleeping
sickness is now ravaging the whole of Central and Western Africa. The
disease is an extremely protracted one. Full use of the mental faculties
is enjoyed for a long while after the nature of the disease has become
undoubted, then a gradually increasing lethargy ensues, tailing off into
continuous sleep or unconsciousness, which lasts day and night until death
ends all suffering. Dr. Tulloch went to West Africa to investigate this
disease and most unfortunately became himself a victim, but not before he
had succeeded in demonstrating the organism which was the cause. He
returned to England, and after months of illness, throughout a[ll] of
which he knew that his disease was incurable, he ultimately died.

The Sleeping Sickness.

The cause of this a minute organism which is found in the blood and in the
fluid which is present in the spi[nal] canal and is called a tdypanosome.
The disease is conveyed from man to man [by] a biting fly—the Glossina
palpalis—wh[ich] bites first on infected person and subsequently a healthy
person, and so [per]petuates the malady. All round shores [the] of the
Mediterranean there [?] for many years the disease now known as

Mediterranean or Malta Fever.

This disease was an infectious fever which, by its invasion of the navy
and army, led to much illness and death. Its cause for years was quite
obscure until Colonel Sir David Bruce—a member of the Royal Army Medical
Corps—discovered that the minute germ which caused the disease was to be
found in the goats’ milk which was freely supplied to the troops. A
careful examination of the goats in Malta, where this discovery was made,
revealed the fact that about 90 per cent. of the goats were suffering
front the disease, and that this was the sole cause of the fever which so
seriously affected the human population of Malta. The use of goats’ milk
was prohibited, and from that time onwards fever practically ceased to
exist. I can now only refer briefly to two other diseases in which

The Agency of Lower Animals

is manifest. Kala-Azar is a disease which chiefly affects North-Eastern
India and severely attacks the native population. It has been shown to be
conveyed from one to the other by bed-bugs. Relapsing fever—a severe and
prolonged fever which has been known for many centuries, has recently been
shown to be due to a minute corkscrew organism—a spirillium as it is
called—which inhabits the blood stream. The disease has now been shown to
be due to the agency of the body louse, which, feeding on an infected and
then on a healthy person, easily conveys the organism.

My theme to-night has been the unity and indivisibility of Nature. On this
central idea I have endeavoured to fasten your attention. I have tried to
show you how the explanation of one natural phenomenon is to be looked for
in some other perhaps infinitely remote part of the scheme of Nature. If
we desire an explanation of why beer is formed from malt we look for the
yeast, why vinegar from sugar, another yeast, why honeycomb is badly
formed we look for the moth, why trees have unsightly knobs we look for
the worm inside, why silkworms die we look for the bacteria, why lambs
cough we inspect the lungs for parasitic worms, why apples rot we look for
the parasite, and so on throughout the whole realm of Nature. I have
pointed out that sheep, horsehair, house flies, various kinds of
shellfish, cattle, pigs, rats, fleas, mosquitoes, goats, biting flies, bed-
bugs, and body lice all play their part in the dissemination of human
disease. This by no means exhausts the list, for no mention has been made
of hydatid disease conveyed by dogs, and many other less familiar
examples. I think, however, enough has been said to illustrate the main
argument. The wonderful feature about it is that all this was entirely
unsuspected thirty years ago. I had intended to speak of other branches of
medicine and surgery where equally

Marvellous Progress has been Made,

but the field was found to be too wide. If there be any who might be
inclined to ask “Has there been any practical result fro [sic] mall [sic]
this?” such may be easily answered. On entering the Pasteur Institute two
things at once attract attention—a bibulous and somewhat overfed concierge
whose gracious permission is necessary before one can enter, and a statue
on the left of the entrance. The statue represents a youth strangling a
mad dog with a whiplash. The story is a pretty one. A young girl was being
attacked by a mad dog, and the youth ran to her rescue. He was severely
bitten, but succeeded in strangling the dog. The unromantic concierge is
the hero of this romantic story, and was the first case of hydrophobia
cured by Pasteur’s remarkable discovery. Since that time hydrophobia has
had no terror. The table shown sets out the results of medical research on
three diseases. The figures speak for themselves:—
Malta Fever (the Garrison at Malta.)—1904, 320 cases; 1905, 643 cases;
*1906, 161cases; 1907, 11 cases; 1908, 2 cases.

Diphtheria.—Case mortality—1894, 45.1 per cent.; 1898, 1.94 per cent.

Yellow Fever. —Havana—1900-1, 308 cases, 74 deaths; 1901-2, 8 cases, 2
deaths.

*June, 1906, goats’ milk prohibited.

As a result of the realisation of the unity of Nature the whole system of
medical treatment has been profoundly modified. The fluxes, purges, and
leeches of the middle ages are unknown, and the whole problem of the
treatment of disease has now become a

Study of Nature’s Methods

and an attempt—often brilliantly successful—to imitate Nature’s own of
working. I need not remind you of the treatment of bacterial diseases by
the deliberate injection of the bacteria themselves suitably modified, or
of the use of antitoxins in imitation of the body processes, or of the
prevention of malaria by destroying mosquitoes—all these are familiar
enough. Man has begun the gigantic task of reducing to order the chaotic
warfare of organism against organism that is ceaselessly occurring through
Nature, and though some have laid down their lives in the work, yet the
results have been unspeakably successful.

I have shown on the screen three photographs of medical men, and would
call your attention to the fact that one is [En]glish, one French, and one
German. [The] present English Minister for Foreign [?] stated the other
day that during [?] administration several important [?]congresses had
been held, [?]thout exception they had all been [?] to the treatment and
prevention [?]  [?]se. It is unnecessary to labour  [?] [?]ect of my
subject.

[?] [?]tify the title of this lecture it [?] claimed that if it is right
to [?] the destruction of more than [?] by tearing down the pillars of [?]
of Gaza then it is not too [?] the word “romance” when [?] salvation of
millions of [?] [?]aring down of the pillars [?] of Tradition and
Supersti[on].