Some nutritional parameters in the ecology of infectious disease.

Professor Bell, Ladies and Gentlemen : The great pleasure I had anticipated in responding to the invitation of The British Nutrition Society and the University of London to address this audience has been dimmed by the passing from among us, just days past, of Mr Alfred Bacharach. The American Institute of Nutrition extends its sympathy to its sister society on the loss of one of its distinguished members and as one of the members of the American Institute of Nutrition I would wish to dedicate this address as a memorial to my departed friend. There is considerable relevance in my doing this, for it was Alfred Bacharach, more than 20 years ago, who was the first to discern the hope that lay in the beginnings of the work which I will try to summarize here. I regret, more than I can say, that he is not among us this afternoon. There is a special appropriateness that I should cross the Atlantic to come to London to lay this work before you, for like all human enterprises this one, too, has a history; and the history of this inquiry into the relationship of nutrition to resistance and susceptibility to infectious disease had its beginning here in London, in the studies of Professor W. W. C . Topley, Director of the London School of Hygiene and Tropical Medicine. These studies, which gave rise to what came to be known as experimental epidemiology, and which are known to you all, had their inception when Professor Topley (1919), in his Goulstonian Lecture, declared that the time was then ripe to inquire, by means of laboratory experiment, concerning the general biological basis of epidemic infectious disease. When Professor Topley spoke, the medical world was still reeling from the great influenza pandemic of 191819. And reel it might, for while preening itself in the hubris generated by the golden age of bacteriology, medical knowledge had suffered an humiliating and deflating experience in the eyes of laymen all over the world. The influenza pandemic had come without warning, exacted its terrible toll, and now, just as mysteriously had waned, all the while men of medicine stood bewildered, speaking, if they spoke at all, in a babble of theory and conflicting ideas. Pandemic influenza was a shocking challenge to medicine. As Professor Toynbee warns us, a societal challenge calls forth a response, or paralyses a culture. The challenge of pandemic influenza called forth two responses: one was the investigation of the disease itself, which led to the discovery of the virus, unknown in 1918-19, and to studies on vaccines, etc., all of which goes on right down to the present day; but the second response, in the mind of Professor Topley, was a different one and which started, really, a train of thought