VIRUSES IN HEALTH AND DISEASE C. H. ANDREWES, M.D., F.R.C.P., F.R.S.* Ofthe legion ofbacterial species in man's external and internal environment , only comparatively few ever cause disease. This is something familiar to all. Most of the bacteria in question are saprophytes or harmless commensals. Some in invertebrates may be symbiotes, often living in specialized organs; ifthey are eliminated, the host may die. Many ofthem have an intracellular habitat. Viruses differ from most bacteria in that they cannot multiply except within cells. They can, therefore, hardly be imagined to function as saprophytes or commensals. They are essentially parasites and can exist within a healthy animal only if their parasitism has come so completely under control that they can do no harm which we can detect. It is accepted by most people that, on a long-term basis, violence ofreaction between host and parasite benefits neither and that evolution tends toward a state of mutual tolerance. It is the purpose of this essay to consider whether, despite their obligate parasitism, there may not be, in fact, far more harmless viruses in animals and plants than pathogenic ones. As the great bulk ofan iceberg is under water, so the vast majority ofviruses may be submerged , too. Until lately, all the viruses we knew ofhad been discovered as a result of research directed to revealing the causes of disease. It is still true that all the viruses we know have come to light because ofthe work ofanimal and plant pathologists. No longer, however, do we believe that all the viruses we unearth in our researches are the ones we are looking for. Too many people have found "incidental" viruses which have led them astray. I. Terminology The subject of latency of virus infections has been confused because different workers have used the words "latent," "inapparent," "masked," * The National Institute for Medical Research, Mill Hill, London, N.W. 7. 211 and so forth in different senses. A symposium (i) was held in Madison, Wisconsin, in September, 1957, to clarify ideas in this fieldand, more especially , to establish uniform meanings ofkey words. There was good agreement concerning the suggestions which follow. Inapparent infections embrace all infections whose signs and symptoms are not overt. It was recognized that many workers, particularly in human medicine, would continue to use "subclinical" as an alternative to "inapparent ." Latent infections are inapparent infections which are chronic, with some measure ofequilibrium established between host and parasite. The term "latent virus" is undesirable; if the adjective is used to qualify both "virus" and "infection," it will inevitably be used in different senses. "Masked" and "masking" have been used in so many different ways that continued use ofthe terms should not be encouraged. Instead, occult virus can describe virus which cannot be recognized by direct tests and the cause ofwhose elusiveness is at present not known; specific terms can describe the cause when it has been elucidated. Meanwhile, we can call a virus occult when it fails to be revealed in a host because it is either qualitatively altered, present in minute quantity, or mixed with antibody or inhibitor —and we do not know which explanation applies. "Moderate" was suggested , at the cellular level, to describe a virus which, in aparticular system, infects a cell without killing it or preventing its multiplication; in contrast, cytocidal describes a virus lethal for a cell. The words would roughly correspond to "temperate" and "virulent" phages. Other terms that were discussed are not relevant to the subject ofthis essay. II. The Story of Virus III The writer had the advantage ofbeing concerned with one ofthe first "incidental" animal viruses to be discovered. Like many another virus in later years, it was brought to light by workers using the technique of making serial passages of organ suspensions inoculated into the same species. Rivers and Tillett (2) were trying to transmit chicken pox to rabbits. They inoculated varicella material into rabbit testes and after a few days removed these and injected suspensions ofthe ground-up organs into testes of other rabbits. After a few such "blind passages," they obtained a filterable agent which produced acute orchitis and fever, transmissible in series. Histological study...