To reach, to excel, to conquer, is the dream of man; and if he is strong and perseverant enough to trace his own path step by step, wise but unafraid of Nature's ire, he may finally reach the goal, tired, but victorious.

titude of children were breaking into quiet laughter; every billow burst into snowy foam that was, in turn, dissolved by oncoming billows. The Dora streamed away like the irresistible desire of the vagrant, toward the far off valleys that we do not know, laughing perpetually in its perpetual adventure. We ascended the hill which leads to Santa Colomba, and, higher up, to the upland valleys of Comboe; before entering among the trees, we lingered to look down upon the valley; now the Dora appeared to be a tiny ribbon, with reflexes of diamonds in the sun; the few white steeples of the chapels scattered here and there in the valley, pointed toward the sky, like the image of the purest thoughts of men, hoping and expecting the blessings of a just God; the numerous patches of the carefully cultivated soil changed at every instant under dazzling light or heavy clouds that, all of a sudden, changed the golden fields of corn into dead, brown spots, or transformed the dark green of the vineyards into living emerald. Climbing on, we reached the first houses of the mountaineers. Since it was Sunday, the women, all dressed in black,-those stern dresses of middle-age fashion, with corsage and huge sleeves trimmed with precious handmade lace, sat on the balconies surrounding

their houses; the young girls blushed, as usual, with downcast eyes and hands clasped like nuns, and the older women and the few men stared in admiration at the beautiful foreigner, walking beside me.

"We easily reached Santa Colomba, the sanctuary of pure water, so precious, so chaste and so humble; we followed the water-falls, which rebound in fine spray among the rich vegetation; and while, as a relief to the heat of the day, we let ourselves feel their refreshing sprinkling, we discovered near the edge of the water a bird's nest, all full of a trembling, piping crowd of little bodies, so helpless in their naked tininess. The bitter absinth showed its pale green leaves, wild roses were opening their bosoms to gorgeous. butterflies, and strawberries of a bloody red appeared in big clusters among the grass. Always following the alluring voice of the water, climbing and climbing, we reached that summit which, all around, is enclosed, almost as by a fortress of huge spruces, firs and pines. Here we saw the first fragrant violets, gazing like baby's eyes at the first vibration of the morning light. It was now like going through a thousand rooms of an enchanted palace; the trees were so thick, so dark and majestic, that they suggested a compact wall without end. We passed from one recess of the palace to another, and every recess had its peculiar wonders; big fields literally covered by large, tall daisies, obeying, maybe, the superior orders of the caressing breeze, bowed their smiling faces before us; in other spots the violet wedded the forget-menot in the suavest combination of soft purple and pale blue. New fields appeared strewn with nigritella, the strange flower so exquisite in its perfume, so bright in its red-purple color, so mystic in its roots-those two entangled roots so much like human hands, a white, clasping a black, just as in the ensign of St. Francis of Assisi! And we had garlands of lavender clematis with delicate leaves, rich bunches of blue aquilegia, numberless stems of

azure polygala, star-like blossoms of rosy dianthus, flesh-like petals of geranium argenteum, golden chains of cytisus, frail and matchless stalks of Paradise lilies, nosegays of anemone sulphurea, countless varieties of sempervivums, robust of leaf and hardy in manycolored flowers, bluish thistle-like eryngiums, purple asters, creeping campanulas.

"We met an infinite variety of orchids,-tiny voracious mouths of yellow-brown or greenblack, queer entanglements of tentacles, claws, wings, eyes-strange shapes, white and polished as bare human bones, now stained with a bloody flower at the top, now bearing white corollas, matchless and royal as lilies, or bunches of grapes, each one disclosing a little throat, red, purple or black; snaky disorders of shoots, like Medusa's heads, and everywhere among the orchids, the attempt at a gesture, sometimes imploring, sometimes despairing; little tongues bearing a liquid black like a poison, burning petals commingled in a single flame; where do they borrow that mysterious poison, whence comes the strange blood with which they burn? And in virtue of what miracle are they so vivacious in their gesture, so rich in their expression, so alluring in their charm? Green orchids like stars of emerald, enclosed, in the treacherous velvet of their petals, most beautiful insects. How they tantalize the human mind, through their unknown and miraculous powers of attraction, not defenseless in their tininess, not exhausted in their whiteness, capable of defense and offense, of fight and destruction, enclosing in themselves secrets of beauty and force, the courage of evil, the consciousness of a personality which develops itself among all dangers and feeds itself upon all kinds of prey! And all this gorgeous, multiform family was greeting us, bowing before us, telling us through its different and penetrating fragrances how much it had worked under the soil during the long seven months of winter, how it had yearned to meet the sun, how joyous it And all this gorgeous, multiform family, was

Spring, queen of the heights, passes in her journey near the homes of men; climbs toward the peaks, where, fighting against the frost. meets the autumn and becomes one with it; always climbing, is made prisoner by the eternal snows and buried until the advent of Easter calls her to resurrection.

The edelweiss reveals to the mind ready to catch, beyond the symbol, the hidden meaning of thingsthat in the Alps the snow has its flower star-like, as many other flowers of the lowland are, but unique in its color as well as in its substance.

how eager every little soul was to commingle with all the others, through the messages of the wind, of the insects, of the bees and butterflies!

"But the sun became hotter; bees, flies, mosquitoes, began to swarm around us; the sky grew darker and darker, and suddenly a violent rain poured down. It was good to breathe the smell of the moist earth, while above the protecting trees, the wind, borrowing its voice from the ocean, sang its melodious lullabies.

"The jingling of the cow-bells directed us out of the enchanted forest and we ran toward the house of Nino, the royal gamekeeper. We reached it in a pitiful condition, but, since there was a bright fire waiting for us, we were able to dry our clothes and rest; Nino's children, blond and white as angels, smiled and stared at us with wondering faces; Nino led us to the hut where he makes cheese and offered us some milk, fragrant as the violets the cows like so well. Shortly after we left the house and the forest, we were on the top of the Signale Sismunda.

"The mountain showed now a magnificent sight; the gentiana verna stared at us with eyes of such a deep Antwerp blue that the azure spots appearing among the clouds seemed colorless in comparison; and down on the steep

slopes of the mountain, big bunches of crimson rhododendrons, of variegated pink mountain laurels, emerged among the gorgeous carpets of androsaces. At times, as by enchantment, the veil of the clouds was rent open, disclosing an unsuspected giant, with its glaciers shining under the sun in the blue mists surrounding it. Large spots of yellow primulas and blue gentianas mingled in happy combinations at the foot of a near-by mountain, all green with pines; the cattle browsed and chewed the cud, accompanying every languid movement by the jingling of their bells; down, as far as the eye could reach, new valleys and new mountains, on, on, in serried succession, while higher above us a huge stripe of snow marked the path of a recent avalanche and, just near the snow, as first conqueror, immense purple stripes of viola calcarata were already in bloom. Everywhere in the valley speaks the affirmation of Nature's unfolding in a resurrection of beauty, fragrance and color; everywhere around the valley rise the stern peaks, some dazzling with ice, others freshly delivered of the snow, but, not yet touched by the alltransforming enchantment of spring, still harsh and dark. So the two forms of Nature are manifest; on one side the stern countenance of necessity and justice, on the other, the blissful, caressing, regenerating smile of grace and mercy, both hiding sources of beauty that no human eye shall ever see, that shall not need human help to bring them into life, to bloom and pass away. How small a man looks on the top of a mountain, or seen from the top in the valley below!-as tiny, but, alas, not so radiant as the tiniest of flowers! Were the life of man as rich in storms as are those pastures, and were he able to climb above the bitterness of his human experience, entrusting himself with unfailing faith to the power of resurrection enclosed in a sunbeam, his soul, mayhap, would flourish as they do, purified and strengthened by the same destroying power of lightning, by the same whitening needles of ice: for stormless days are rare in the realm of peaks! The scarcely perceptible cloud, appearing on a mountain among the rosy mists of dawn, becomes, in a few hours, the unchained fury that makes mountains tremble as

if attacked by a force monster bent on rending them asunder.

"The jingling of the cow-bells, like a mystic voice, the only voice in that silence, recalled us to the necessity of return. So, rapidly descending by the natural bridges of stones across the torrents, breathing in deeply the surrounding perfumes, taking short cuts, tired, but exhilarated, softened by the remembrance of half-forgotten songs which the falling water, inseparable companion, brought back to our hearts, we reached the town, while, clear and brilliant in the darkness of the sky, the stars smiled in the peacefulness of night."

Jean listened eagerly; there was something new in his brother's voice; there was more vivacity and clearness than usual in his expressions; never had his ideas sounded so lofty and profound as now. Were his eyes opening to beauty and consciousness with the blooming of his years? Or, rather, had his thoughts and feelings been refined by his contact with the lovely stranger? He could feel, through his brother, the fragrance of her exquisite personality, full of charms, desires, ambitions, a delicate but proud flower, anxious for the conquest of untrodden heights, a rare source of pure gladness, mysterious in her reserve and strangely beautiful.

Evening after evening Jean drank at the source of a dream, seeing with the eyes of his spirit many things that the eyes of his body had never been able to perceive, going farther and farther in a realm of joy and promise and hope: until, one evening, Julius kept silent; for his voice had lost the soothing and enticing sounds which had charmed the sadness of his brother; his thoughts were sunk in darkness, and no more color, or ray, or fragrance, could be perceived through them.

The beautiful stranger had left. Like the spirit of Spring she had passed away, unconscious of the hopes awakened, of the longings nourished; unmindful, because queen of the heights, of the dwellers of the valley; ignoring the yearning of those human beings whose desires have been crushed forever, whose eyes have been blinded by the revenge, of a conquered peak.

I am myopic.

motion.

BRIGHAM NORTON.

Our ignorance of what goes on between the tissues and tubercle bacilli once the latter attach themselves to the animal body and there gain a foothold far surpasses what we know. Hidden from our eyes, defying our powers of observation, leading astray our scientific logic, a series, perhaps a jumble, of mutual and antagonistic reactions, adaptations and conflicts undoubtedly prepares the scene of what then becomes visible to us as the anatomic and functional effects of tuberculous infection. As to the real nature of these reactions speculation has always outrun proof. Some of the speculation has stuck fairly close to observed or demonstrable phenomena, and has been relatively sound, but much of it has been little short of fantastic.

We really know only one fact upon which a scientific system of belief in any domain of tuberculosis may be based. This fact is that the presence of the tubercle bacillus in tissues initiates all manifestations that we have come to bring under the concept of tuberculosis. This is not to say that the story of a tuberculosis is wholly or even mostly the story of a germ. It is to say exactly what it says,-with the corollary that wherever there is no tubercle bacillus there can be no tubercle with its consequent tuberculosis. No matter how numerous the bacilli may be, if tubercle and disease are to result it is absolutely necessary that the tissues do their share and play their part in the process. This fact is all-important; and is so evident that, were it not for the reason that so much speculation fails to take it into consideration, the writer would owe the reader an apology for stating it.

But there are several other well authenticated facts that must be taken into account whenever fundamental matters like infection and resistance are under discussion. To urderstand only slightly these latter phases of tuberculosis we must have some comprehension of the more deep-seated effects of infection on the animal body, and here we find that the last two decades have yielded us information which, though incomplete, is probably fundamental, and which, when more fully developed and elaborated, may be determining in our conceptions of tuberculosis both as a mere infection and as a disease.

Any consideration of the essential nature and mechanism (and, therefore, manifestations) of the variegated infectious process that we call tuberculosis,-a process of ebb and flow, of "ups and downs," of halting and direct progressions, of fulminations and concealments, once the necessity of the presence of the tubercle bacillus is taken for granted, must start from and be based upon two scientific propositions, which in their simplest terms may be stated as follows:

1. The animal body reacts to a first infection by tubercle bacilli in a certain definite manner. 2. If an animal is already tuberculous, in other words, if tubercle is already present, then the body reacts to re-infection,-to any further localization of bacilli,-in a manner that is different from the first. Under the influence of the first infection a change has taken place in the tissues of the host so that their behavior to renewed infection represents an altogether new and acquired capacity.

It is these two propositions that I wish to

go into more fully, and to draw from them whatever implications may be germane to the matter of resistance to tuberculosis and may in consequence be applicable to any scientific ideas that it is permitted us to entertain in regard to infection and its effects.

THE HEALTHY, NON-TUBERCULOUS ANIMAL REACTS TO A FIRST INFECTION IN A CERTAIN, DEFINITE MANNER

To determine the earlier sequence of events as these unfold themselves from day to day after tuberculous infection first takes place, we must make our observations on the animal of experiment. It is at once obvious that we cannot perform the volitional experiment of infection on the human being. If, therefore, we should make our studies on a person who is known to be infected, the occasion would be rare when we would be certain that we had to do with a first infection and we would practically never be able to tell how long a period had elapsed between infection and the appearance of any phenomena that might become manifest. But we can inoculate susceptible animals in any one of several ways and thus have the factors of time, dosage and the point of first localization of bacilli, which are so important to correct interpretation of results, always under "control."

We may take an animal that has never been in contact with tubercle bacilli and is, therefore, without tubercle. Into such an animal we may introduce living tubercle bacilli,either under the skin, or into the abdominal cavity or into a vein. We may apply small or large doses of bacilli; yet no matter how the infection is performed and no matter how small or large the dose, a striking and significant fact comes to light. This is, that for a comparatively long time the animal does not exhibit the least symptom of illness. We can inject enormous numbers of living bacilli by way of a vein directly into the blood-stream without causing the animal the least discomfort thereby. The guinea pig contentedly runs away from the field of operation, its coat remains smooth and sleek and it eats its food as usual. A day, a week, two weeks, go by; and during all this time the little animal lives its life with all the appearance and activity of normal health. Only toward the end of the first month after infection do we notice that the animal is losing muscle-tone or is becoming thin or is eating less.

This simple experiment at once teaches us that the immediate effects of a first infection with tubercle bacilli do not bring about illness in the infected individual. It also suggests that there is nothing essentially or specifically poisonous in the bacilli themselves, for, if there were, we should expect an early intoxication of the animal. And since symptoms develop so late and so gradually it also indicates that as a result of first infection the anatomic changes or reaction upon which may depend the functional disturbances (and therefore symptoms) also develop very slowly.

An absence of early symptoms is therefore the first phenomenon that follows primary infection. To detect the more immediate behavior of the animal body to the localization of tubercle bacilli we must resort to observation of anatomic changes.

The general nature of the characteristic anatomic reaction to tubercle bacilli has already been disclosed.* It is the response of living tissues to irritation which eventuates in the production of a new formation, the tubercle. This tubercle undoubtedly plays a protective rôle, imperfect though it may be. With greater or less competence it encysts and walls off foreign bodies-in this case, living tubercle bacilli -and to some extent limits their sphere of influence. Fundamentally therefore such reaction of tissues to form tubercle represents a foreign-body reaction, although, because living tubercle bacilli are self-propagating and can maintain themselves and multiply in tissue, the bacillary tubercle presents certain features that are not to be met with in the tubercle that is the response to non-living or inert foreign bodies.

In further support of this view we have something more besides certain resemblances that specific (bacillary) tubercles bear to ordinary foreign-body tubercles in several of their elements and phases of development. A phenomenon of the first significance is that, up to a certain point, tissues react to dead tubercle bacilli exactly like they react to living bacilli.

These changes to dead bacilli, surprising as they seemed at the time, were thoroughly investigated by Prudden and Hodenpyl of New York in 1891. Their work, "Studies on the Action of Dead Bacteria in the Living Body," was in every respect a notable contribution. It abounds in significant phrases which at the time were barely more than hints and speculations but which later work has in some instances amply justified. Moreover, it includes the records of a very complete series of wellplanned experiments, and shows that the authors made their observations which what was almost prevision. Though now almost thirty years old, Prudden and Hodenpyl's pamphlet can still be closely read with profit by any student of tuberculosis.

Its opening paragraphs are illuminating as conveying the ordinary point of view of the time in relation to infectious diseases. Early in the work there is a sentence or two that expresses an idea which some of us even today are now and then misled into conceiving as new. "We are just beginning," so runs the argument, "fairly to realize that the disease (that is, any infectious disease) is not an entity, a thing imparted by the invading germ to the body, but that it is the result of the reaction of the body cells in the presence of the germs; that the body-cell factor is just as important and just as much in need of study as is the germ-cell factor. . . . The germ side of

* See August, 1919, Essay.