Page:EB1922 - Volume 30.djvu/496

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BILHARZIOSIS—BIRDWOOD, SIR W. R.

ence and assisted the Secretary for India at the Imperial War Cabinet. The Maharaja's public speeches attracted marked attention, and were collected under the title of India's Imperial Partnership. His warm sympathy with Indian aspirations of self-government within the Empire made the greater impression on public opinion because of the notable moral and material progressiveness and efficiency of his administration in Bikaner, and his constitutional reforms. He was selected to represent the Indian states at the Peace Conference and the Imperial Cabinet meetings in connexion therewith, and at Versailles on June 28 1919 he affixed the first Indian signature to a great inter- national treaty. Keenly concerned to uphold the rights and dig- nities of the ruling princes, he formulated their views with force and skill, and his was the dominant personal influence in securing the constitution, under royal proclamation, of the Chamber of Princes in 1921 as a deliberative, consultative and advisory body. His appointment as chancellor, carrying the presidency of the small standing committee, was indicative of the intellectual ascendancy he had acquired in the deliberations of the rulers. He had made himself well known as a sportsman, and in 1920 the " record " tigress (9 ft. 7 in.) fell to his gun. A major-general of the British army, his honours included the grand crosses of the Victorian and the two Indian Orders, the knighthood of the Bath, the honorary doctorate in laws of Oxford, Cambridge and Edinburgh and the freedom of London, Edinburgh, Manchester and Bristol. His permanent local salute was raised from 17 to 19 guns. (F. H. BR.)


BILHARZIOSIS (see 3.932). The complete elucidation of the cause, mode of transmission, prevention and cure of this disease (Schisostoma haematobium) was one of the triumphs of medical progress during the decade 1910-20. In 1913-4, in his annual report on Egypt, Lord Kitchener said: " It is high time that some steps should be taken to prevent the continuity of infection which has been going on so long in this country." At that time Egypt was a hot-bed of the disease, and so were many areas of South Africa. Indeed some 625 British soldiers were infected during the Boer War of 1899-1902, and of these in 1914 no fewer than 359 were still on the sick-list.

Early in the World War, when British troops were dispatched to Egypt, Sir Alfred Keogh, director-general of the A. M.S., sent a mission there to investigate bilharziosis. At the head of it was Lt.-Col. R. T. Leiper, helminthologist to the London School of Tropical Medicine. Leiper's object was to discover the intermediate host of the parasite which is the cause of this disease. The parasite itself had already been discovered, as early as 1852, and was called after its discoverer T. Bilharz, a Gefman. There was, moreover, some reason to suppose that a portion of its life-history was passed in the body of a fresh- water mollusc, this being a usual cycle among trematode worms (see 27.240). Leiper adopted the simple measure of engaging a large number of native boys and paying them to collect all the molluscs they could find. The boys brought in large quantities, and the research workers set themselves to examine them. Within a very short period the parasite of bilharziosis was found in the body of one variety, a water-snail which inhabits canals and pools and is thus found " at spots daily frequented, such as the praying ground at the embankment crossing, in front of the cafes, and at the bend of the canal daily used for washing." The next step was to discover whether animals could be infected experimentally. Leiper observed that rats and mice and other vermin were notably scarce in the regions infested by the snails. A professional rat-catcher was employed but he failed to secure any animals. On June 13 1915 the first positive result was obtained when a rat was experimentally infected. Various experiments were now undertaken to determine the mode of infection of human beings. It was found that both drinking and bathing are dangerous for the free-swimming parasites. " Cercariae, " after they have been born from the body of the water-snail, are so provided that they are able to pierce the human skin and so enter the body. Happily they live only 36 hours after birth in the pools, dying thereafter unless they find a suitable host.

The life-history of the parasite is therefore a double one. It lives in the bodies of men from which it is passed to water where it enters the water-snail's body. From this after six weeks it is hatched in the free-swimming form and then re-enters the bodies of men. The snail is safe until six weeks from its first infection have elapsed. It retains its powers of dissemination over con- siderable periods. The following conclusions were formulated :

1. Transient collections of water are quite safe after recent con- tamination.

2. All permanent collections of water such as the Nile canals, marshes and birkehs (pools) are potentially dangerous, depending on the presence of the essential intermediary host, the snail.

3. The removal of infected persons from a given area would have no effect, at least for some months, in reducing the liability to infection, as the intermediate hosts discharge infective agents for a prolonged period.

4. Infected troops cannot reinfect themselves or spread the disease directly to others. They could convey the disease to those parts of the world where a local mollusc could efficiently act as carrier.

5. Infection usually takes place both by the mouth and through the skin. Recently contaminated moist earth or water is not in- fective.

6. Infection in towns is acquired from unfiltered water, which is still supplied even in Cairo, in addition to filtered water, and is delivered by a separate system of pipes.

7. The eradication can be effected without the cooperation of infected individuals by destroying the molluscan intermediaries.

The irrigation work in Egypt being in the hands of the Government, it is possible to have the pools in which the snails breed drained and dealt with. Along such lines, at least, lie the preventive measures which will in course of time be instituted. Through Leiper's work, therefore, this disease may be regarded as much less of a menace than it has ever been formerly.

The great success which attended this work caused other investigators to turn their attention to the disease and to begin the search for a cure. Many remedies had, of course, been tried, but none of these could be guaranteed to eliminate the parasites and so to end the mischief. It occurred to Dr. J. B. Christopherson to apply to this disease the method of using antimony tartrate which had been employed with success in the treatment of the Indian disease kala-azar. This consists in giving the antimony by injection into a vein. Christopherson soon found that his idea was to be relied on and that the effect far exceeded his hopes. The parasites and their ova were killed off and the patients became entirely free of the disease. This work has now passed beyond the stage of experiment, and Christopherson's treatment is universally acknowledged to be a complete cure of bilharziosis.

Thus this formidable disease has been conquered. Its means of transmission are known. Its prevention is only a matter of time. Its cure is a matter of certainty. (R. M. Wi.)


BINYON, LAURENCE (1869- ), English poet (see 3.952), produced after 1910 a book on Botticelli (1913); a catalogue of Japanese woodcuts in the British Museum (1917); The Art of Asia (1915); English Poetry in Relation to Painting and other Arts (1918); For Dauntless France (1918) and Court Painters of the Great Mogul (1920); as well as certain collections of poems, Auguries (1913) and The Four Years (1919), the last of which gathered together his fine war poems, which had previously appeared in several smaller collections. In 1920 his play Sakun- tala was performed in London.


BIRDWOOD, SIR GEORGE CHRISTOPHER MOLESWORTH (1832-1917), Anglo-Indian writer (see 3.979), died at Ealing June 28 1917.


BIRDWOOD, SIR WILLIAM RIDDELL, BART. (1865- ), British general, was born Sept. 13 1865. He joined the 12th Lancers in 1885 and was in the following year transferred to the Indian staff corps, joining the cavalry. He served in the Hazara expedition of 1891 and the Isazai expedition of 1892, and in the 1897-8 frontier war. He was sent to South Africa in 1899 and served on the staff there during the whole of the war, the close of which found him a brevet lieutenant-colonel. He was afterwards closely associated for several years with Lord Kitchener in India, acting as his military secretary. In