References

It is well to recall at the beginning of this brief outline of the dangers of antibiotic therapy that infectious disease has existed since man's earnest history and that his survival despite pandemics and epidemics is proof of his own in-herent resistance to infection. Further, the mortality from epidemics varies at different periods of history: for example, the mortality from the pandemic of tuberculosis was falling for a very long rime in Europe and North America before the advent of antituberculosis chemotherapy preci-pitated the decline. Moreover, there is a natural biological variation in the virulence of infecting micro-organisms, and the prevention of many infections by vaccines, antitoxins, antisera and public health measures had achieved notable successes before the antibiotic era began. There cannot be a single branch of medicine today upon which the antibiotics do not have their repercussions, but some difficult and perplexing problems have followed in the wake of these great discoveries. The most obvious and pressing of these is the development of bacterial resistance, which is discussed in detail elsewhere in this number of the Bulletin.1 Antibiotic therapy of necessity disturbs the patient's delicate biological balance in nature and is apt to create a bacterial vacuum which, as nature abhors a vacuum, must be filled by other micro-organisms not infrequently more dangerous than the originals; this is especially true of the so-called "hospital staphylococcus". Cross-infection in hospital wards by this organism already presents a ver