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years, and the latter figure is exactly the same as the’ge at death in 445 cases among laymen seen in consultingpractice by White and his colleagues.6 So if we find ourattention wandering to our chances of sudden deathwe may hang the following quotation from Levine’sarticle as a text on our consulting-room wall : ‘‘ The life eof a physician i8 not conduoive to coronary artery (lisease."

DIABETIC DIARRHŒA

RECENT work 6 7 has suggested that the neuropathyof diabetes mellitus involves not only the peripheralnerves but also the central and autonomic nervous

systems.’ Sheridan and Bailey 8 cite the diarrhoea ofdiabetes as a possible manifestation of such a n’euro-pathy. The striking feature of this diarrhoea, which wasobserved in 40 patients, is its nocturnal incidence ;- patients had anything up to eight stools at night, some-times with incontinence during sleep, but no troubleduring’the day. In each case the stools were watery, andthere was nothing to suggest pancreatic deficiency.Another feature of the condition is the tendency to

spontaneous remissions.The age of patients in this series ranged from 20 to 79

years, with an average of 42 ; and the average durationof diabetes was 9 years. In every case there was evidencethat the diabetes had been incompletely controlledbefore the onset of diarrhoea. Of 29 patients in whomgastric analysis was performed, complete achlorhydriawas found in 14. Of the 28 patients to-whom a bariumenema was given, 6 showed spasticity of the colon. The

blood-picture was essentially normal. An interestingfinding was a total protein above 100 mg. in 6 of the18 patients whose cerebrospinal fluid was examined.Diabetic retinitis was found in a third of the 33 patientssubmitted to ophthalmic examination. It is these lasttwo findings, in conjunction with the presence, beforethe onset of diarrhoea, of diabetic neuritis in more thanhalf the patients, that suggest the neuropathic origin.Sheridan and Bailey postulate that the diarrhoea maybe due to disturbance of the sympathetic innervationof the colon. Apart from treatment of the diabetes, themost effective therapy was found to be crude liverextract, which controlled the diarrhoea in 26 out of28 patients ; this was given in doses of 2-4 c.cm. intra-muscularly every day for 4-6 days, followed by weeklyinjections. While the tendency to spontaneous remissionsmakes it difficult to assess the effect of any form of treat-ment, this response supports the hypothesis that thecondition may be part and parcel of a neuropathy. Butit would be instructive to learn whether folic acid is

equally effective.

HEALTH BY TELEVISION, THERE are many ways of spreading health information.The Bureau of Health Education in the United Statesis exploring a new one by organising a series of " tele-casts " on such topics as the evolution of the stethoscope,the medical uses of X-rays, the basal metabolic rate,blood examinations, contagious disease precautionsin the home, and methods of administering drugs. Withthe -return -of television to this country on the eve ofV-day, June 8 next, it will be open to us to considerthe value of this method, though there is little hope ofits reaching any great number of the public for sometime, owing to the cost of sets and the limited range ofreception.

Television- can distribute practical instruction witha clarity and precision that are unattainable by thespoken word alone ; and the addition of vision mayserve to sustain interest in topics which hold no great5. White, P. D., Bland, E. F., Miskall, E. W. J. Amer. med. Ass.

1943, 123, 801.6. Rundles, R. W. Medicine, 1945, 24, 111.7. Rudy, A., Epstein, S. H. J. clin. Endocrin. 1945, 5, 92.8. Sheridan, E. P., Bailey, C. C. J. Amer. med. Ass. 1946, 130, 632.

appeal on the radio. Information must be directed- mainly at those who are ignorant and/or uninterestedin questions of health ; and the criteria in the selectionof subjects should thus be simplicity, usefulness, -andinterest, though an occasional boost could be given toa series by concentrating on interest to the detriment ofutility. The first demonstration in the American series,on the nutritional values of foods, is one particularlysuited to this medium. First-aid, infant welfare, and,of course, physical training are other -possible subjectsthat come to mind. But the value of television willbe not so much in systematic education as in the stimula-tion of interest, that is, in propaganda by example :a demonstration of bathing the baby will have fulfilledits purpose if it attracts fresh comers to the infant-welfarecentre. ’

"

The day is long past when the doctor sought, or wasgranted, a veil of mystery in which to invest his calling.But this does not absolve the profession from its dutyof’protesting against the irresponsible presentation ofmedical subjects to an unselected audience of -laymen:For example, the American series includes a blood-

pressure demonstration. Will this not encourageneurotics to purchase their own- sphygmomanometersor to plague their doctors for readings Knowledge bythe layman of isolated medical facts will always beencompassed by danger. The B.B.C. has shown anadmirable restraint in its selection of medical broad-casts, and it will no doubt exercise still greater care inexploiting the new medium.

BETTER WHEAT

WITH the prospect of a world shortage of wheatcontinuing for some years we must not only grow asmuch wheat as possible in this country but must growwheat of the highest possible quality. The conferenceon the post-war loaf last year 1 reported that home-grown wheat was usually, though not always, poorerin nutrients than imported Canadian wheat. Thisview was not supported in the report by actual figures,but Mr. T. Moran, D.se., of the Ministry of Food CerealsResearch Station, has now supplied more precise dataon this important point.2 The following figures for

protein and the three accessory nutrients for whicha minimum requirement was recommended by theconference -were obtained on nos. -1 and 2 Manitobawheats imported in the summer of 1943 and an averageof 32 samples, covering 19 varieties, of wheat- grownin different parts of England in 1943.

’

’Zunitobu EnglislaProtein (%) ...... 13-62 .. 8-89Vitamin BI (i.u. per g.) .. 1-18 ... 0-96Nicotinic acid ([.Lg. per g.) .. 55-0 .. 48-0Iron (ing. per 100 g.) .... 3-81 ...3-05- -

The differences throughout are striking, and well sub-stantiate the conference statement. Dr. Morannotes, however, that the view that English wheats areregularly lower in B, content than Manitoba wheatsrests on results from an insufficient number of successiveharvests and-requires further investigation. Nevertheless,he- points out that though in general there is no -signi-ficant correlation between protein content and BI contentof different varieties in the same season, there does

appear to -be such a correlation between the averageBI content and the average protein content of the Englishcrop from one year to another, and the protein contentof home-grown wheats is commonly appreciably lowerthan that of imported.

’ ,

Bound up with the apparently genuine lower nutri-tional value of home-grown wheats is the well-knownpoorer bread-making quality of English flour. It isclear therefore that the conference was well justified1. Cmd. 6701. H.M. Stationery Office, 1945.2. Moran. T., Jones, C. R. Nature, Lond. May 18, 1946, p. 643.

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in recommending research to determine which varietiesof English wheat " will produce flour (a) of good bread-making quality, and (b) containing the maximumproportion of the desired nutrients without appreciableloss of yield on average soils." They further recommendedthat our farmers should be encouraged to use suchvarieties. This selection of the best varieties is a sound

preliminary measure, but research should be carriedfurther than that. Sir Rowland Biffen showed manyyears ago how, by controlled breeding, to combine

quality and yield in wheat with resistance to disease.A research programme on wheat-breeding should bedrawn up to produce new varieties of wheat suitablefor our soils and climate which will combine the twofactors of bread-making quality and high nutrient content.The work would have to be done at several coordinatedcentres, such as Rothamsted, the National Institute ofAgricultural Botany, and the Cereals Research Station.It would take many -years to bring the research tosuccessful fruition ; but the investigation should beundertaken, and its inception should not be delayed ifwheat-growing is to remain a corner-stone of agriculturalpolicy in this country.

EMPIRE MEETING

THE Empire Scientific Conference arranged by theRoyal Society is to be opened by the King on June 17in London, but some of the later meetings will be held inCambridge and Oxford. Among the subjects on theagenda are the aetiology and control of infectious andtransmissible diseases, particularly those which are insect-borne (Cambridge, June 28) ; physiological and psycho-logical factors affecting human life and work under

tropical conditions and in industry (Oxford, July 1) ;and the science of nutrition (Oxford, July 3). General

subjects include methods of improving the interchangeof scientists throughout the Empire ; scientific organisa-tion ; measures to secure greater uniformity in physicalstandards of measurement and the use of units, terms,and symbols ; a scientific information service (forscientists) ; and Empire cooperation with internationalorganisations.The topic that may rouse the greatest public interest

is the dissemination of scientific news to the publicgenerally, which will be discussed in London on thelast day of the conference, July 8. Many have felt forsome time that the public’s desire for accurate informa-tion of scientific progress should be met by the establish-ment of a scientific news agency.

200 YEARS OLD

THE Middlesex Hospital’s bicentenary celebrationslast week were a happy mixture of the formal and thefriendly. On three afternoons the president and thechairman of the hospital received guests at tea in theboard-room before a lecture. On Monday Sir RobertRobinson, P.R.S., spoke on Chemistry and Medicine,contrasting the biologist’s tendency to more and moredetailed analysis with the chemist’s attempts at moreand more complex synthesis. On Wednesday SirEdward Mellanby, F.R.s., introduced by Sir AlfredWebb-Johnson, r.R.c.s., considered -the Future of theMedical Sciences ; and on Thursday, Sir Lionel Whitby,in an address on The Middlesex and Medicine, broughtsome of the great dead to life. On this occasion ColonelJ. J. Astor, as chairman of the board, read a messagefrom Prof. Elliott C. Cutler conveying affectionate

greetings from the Harvard Medical School, and his ownreply looking forward to ever-increasing cooperationwith the United States. Since all Earl of Northumber-land was chosen as president of the hospital 200 yearsago his successors have always been presidents of thehospital and the new Duke, in thanking Sir LionelWhitby for his address, was able to add his tribute tomedicine as one fresh from the battlefield.

On Saturday afternoon and evening between two andthree thousand subscribers, helpers, and friends of thehospital attended an exhibition of its work. The exhibitsincluded the synthesis of stilboestrol, models of micro-organisms 50,000 times their natural size, the electro-

encephalograph, and films. Short services of thanks-

giving were held in the chapel.

FUNCTIONS OF THE G.M.C.

A COMMITTEE of the General Medical Council has beenpreparing a draft Bill for consolidating and amending theMedical Acts. Sir Herbert Eason, the president, told thecouncil on Tuesday that the pressure on parliamentarytime makes it unlikely that a comprehensive Bill of thiskind could be introduced " within any period which cannow be foreseen." Accordingly the committee has pre-pared the draft of a short Bill including only those pro-visions for amendment which it deems urgent. Therecommendations, said the president, involve not onlythe constitution of the council but their powers"; andit is significant that in a previous passage he recalledproposals to the Ministry of Health in 1943 and to thePrivy Council in 1944

" that legislation should empowerthe council to form and maintain a register of specialists,and to make regulations for prescribing the manner inwhich applications for admission to the register should bemade." .

KEEPING QUALITIES OF PENICILLIN

THERE is some confusion about the loss of potency inpenicillin during storage. Its stability varies widelyaccording to the preparation being used. Solutionsfor injection should be used within 48 hours of prepara-tion and even so should be kept at a temperature notexceeding 40° F during this period. Aqueous prepara-tions such as creams must be stored in a refrigerator,but when taken out will remain effective for about aweek if kept in a cool place. Penicillin in the powderform in which it is usually supplied in bulk can be storedfor a year in cool dry conditions, such as a dry cellar, ifthe temperature does not exceed 60° F. Anhydrous pre-parations, such as lozenges and ointments with a greasybase, may be kept in the same way. Thus the doctor whohas no refrigerator can keep a supply of penicillin powderin rubber-capped vials or ampoules for injection, oint-ments for local application, and lozenges for treatingmouth and throat infections.

THE NEW WELLCOME CHAIR

THE University of London has accepted an offer fromthe trustees of the estate of the late Sir Henry Wellcomeof a capital sum of 74,000 for the endowment of the chairof pharmacology at the College of the PharmaceuticalSociety, now occupied by Dr. G. A. H. Buttle, whichwill henceforth be called the Wellcome chair. Since itsfoundation in 1936 the department of pharmacologyat the college has made important contributions toresearch and teaching.

ABOUT 2000 people are expected to attend the RoyalSanitary Institute’s health congress at Blackpool on June 3-7.Among the subjects to be discussed are the social pathologyof rheumatic fever, the future place of the special hospital,the care of children away from their parents, the future ofpaediatrics, the care of the aged in health and sickness, andhousing and slum clearance.

Dr. Adrianus Pijper and Miss Freda Troup have compileda life of the late Dr. J. MacD. Troup, of Pretoria (see lancet,1945, ii, 514), for private circulation. The biography, whichis entitled Pfay.sicia,n and Friend, is being published by sub-scription at 30s. a copy. After expenses have been met theprofits will be divided between the South African MedicalBenevolent Fund and King’s College Hospital, of whichDr. Troup was a student and a governor. Those wantingcopies are asked to write as soon as possible to the authors; atBox 5783, Johannesburg, South Africa.