67

Naval AppointmentsThe Admiralty announces that the following have

received appointment as surgeon-lieutenants, R.N., forshort service :—

J. 0. Fielding, M.R.C.S., N. A. Freebairn, M.B. Glasg.,J. T. Hayward-Butt, M.R.C.S., D.A., J. E. Price, L.R.C.P.E.,and L. G. Topham, M.B. Leeds.

Paddington Medical SocietyA meeting of this society will be held at 9 P.M. on

Tuesday, Jan. 10, at the Great Western Royal Hotel,Paddington, W.2, when Colonel J. M. Weddel will speakon the surgical treatment of air-raid casualties. Medicalmembers of the A.R.P. staff of the Ministry of Healthwill take part in the discussion, and all medical prac-titioners are invited to attend the meeting.Deutsche Gesellschaft fur Kreislaufforschung

This society will hold its twelfth congress at BadNauheim on March 25 and 26 under the presidency ofProf. E. Edens (Diisseldorf). The principal subjects fordiscussion will be electrocardiography and cardiacinsufficiency. An address on experimental hypertensionwill also be delivered by Prof. E. V. Allen of the MayoClinic. Further information may be had from Prof.Eb. Koch, Kerckhoff Institut, Bad Nauheim, Germany.Nursing Services in an EmergencyThe members of the Central Emergency Committee

for the Nursing Profession, appointed by the Minister ofHealth to compile a register of nurses and nursingauxiliaries available for service in a national emergency,are Sir Malcolm Delevingne (chairman), Dame EllenMusson, R.R.C. (General Nursing Council), Sir ComynsBerkeley, F.R.C.O.G. (Central Midwives Board), MissD. S. Coode (College of Nursing), Dame Beryl Oliver,R.R.C. (British Red Cross Society), Lady Perrott, R.R.C.(Order of St. John), the Dowager Marchioness of Reading(Women’s Voluntary Services for Civil Defence), Dr. G. C.Anderson (British Medical Association), Sir FrederickMenzies, F.R.C.P. (London County Council), Mr. E. W.Cemlyn-Jones (County Councils Association), AldermanW. E. Wilford (Association of Municipal Corporations),

Dr. James Ferguson (Society of Medical Officers of Health),Mr. W. H. Harper (British Hospitals Association), MissB. M. Martin, R.R.C. (Admiralty), Miss C. M. Roy, R.R.C.(War Office), Miss E. M. Blair, R.R.C. (Air Ministry),Colonel A. W. Moore, M.B. (Ministry of Pensions), Mr.H. N. de Villiers (Ministry of Labour), Dr. N. W. Hammer(Home Office A.R.P. Department), and Miss Z. L. Puxley(Ministry of Health) who will also act as secretary of thecommitteeA similar committee is being set up by the Secretary

of State for Scotland under the chairmanship of Sir JohnJeffrey and the medical members will include : LadyRuth Balfour, Dr. A. S. M. Macgregor, Dr. W. G. Clark,Dr. J. D. Comrie, Colonel D. J. Mackintosh, Colonel G. H.Edington, Dr. N. W. Hammer, and Dr. J. M. Mackintosh.Pharmaceutical Society of Great BritainA meeting of this society will be held on Tuesday,

Jan. 10, at 17, Bloomsbury Square, London, W.C.1, whenProf. J. H. Gaddum will speak on recent discoveriesabout animal hormones.

Research in Physiotherapy Applications are invited in our advertisement columns

this week for a research fellowship in physiotherapy to beheld at the Middlesex Hospital under the direction of thehead of the department of physiotherapy, Dr. F. D.Howitt, and the professor of physiology, Prof. SamsonWright. The initial salary is £250, but more may beoffered to candidates with suitable qualifications.National Institute of Industrial PsychologyA public luncheon organised by the institute will be

held on Thursday, Jan. 19, at Princes Restaurant,Piccadilly, London, W.1, at 1.10 P.M., at which Dr. J. R.Rees, medical director of the Tavistock Clinic, will speakon the progress of medical psychology. A demonstrationof the institute’s psychological methods of vocationalguidance, to which guests are invited, will be held at theinstitute following the luncheon at 3 P.M. Tickets maybe had from the institute, Aldwych House, Aldwych,W.C.2, and guests should indicate whether they wishto attend the demonstration.

NOTES, COMMENTS, AND ABSTRACTSTHE TUBERCULIN REACTION AS A MEASURE

OF ANTI-TUBERCULOSIS ACTIVITIES

WHEN Naegeli, Burckhardt, Hamburger, and otherspublished, a generation ago, their disquieting findingson the high frequency of infections with tuberculosis,as indicated by tuberculin testing, the prophylacticimplications of their work were not at once clear.Now the tuberculin test has begun to be used inSweden as a measure of the efficacy of anti-tuberculosiswork in a given area. Dr. Nicolai Johannsen hasgiven an account of a ten-year study in Gothenburgof tuberculin reactions in an institution or " home "to which healthy children were admitted betweenthe ages of one and fifteen years (Nord. med. Tidskr.Oct. 15, 1938, p. 1629). From the beginning of 1928till the end of 1937 tuberculin tests were applied to3373 of these children who were first tested withtuberculin, rubbed into the skin over the sternum,and then if no reaction occurred with a second per-cutaneous test. If this also proved negative anintracutaneous injection of 0’1 c.cm. of a 1 in 100dilution of Merck’s diagnostic tuberculin, obtainedfrom both human and bovine strains, was given.As was to be expected, the frequency of the positivereactions rose gradually with the age of the childrentested. At the age of three only 10 per cent. gavepositive reactions. At the age of seven the percentageof positive reactors had risen to about 30, and atthe age of fourteen to fifteen to about 50. Thesefindings are in conformity with those of otherScandinavian observers in recent times, but what issingularly striking in Dr. Johannsen’s study is hiscomparison of the first with the last year of tuberculintesting. In 1928 as high a proportion as 28’2 percent. of all the children tested gave positive reactions;

ten years later this figure was reduced to 12’4 percent. During these ten years an intensive tubercu-losis dispensary campaign was conducted in Gothen-burg, and Dr. Johannsen suggests that this dramaticdecline in the frequency of positive tuberculinreactions in healthy children of all ages may well beattributable to the success of this campaign. A controlseries in another less progressive district would benecessary before the evidence could be regarded asconvincing. And even then if, as Heimbeck and otherssuspect, young adults in some cases tolerate a primaryinfection with tuberculosis less well than children,what is gained by putting off the evil day ? Whilemany such questions still await answers, Dr.Johannsen’s demonstration of a rapidly declininglatent tuberculosis-infection rate must be greetedwith satisfaction as probably indicating that thenumber of open cases of tuberculosis had been muchreduced in the community studied.

"A NEW CIRCULATORY STIMULANT"

WE lately called the attention of readers to asynthetic amine, isomeric with ephedrine, recentlystudied in Germany for its pressor effects and placedon the market there under the name of Veritol(Knoll). In citing the experience of a number ofGerman clinicians we remarked that Dr. Mamier,assistant in Prof. Frank’s children’s clinic at Mann-heim, had used veritol with success for broncho-pneumonia in children, giving it by mouth alternatelywith Cardiazol. We added that in his article Mamierwarned practitioners against the simultaneous use ofveritol and cardiazol. This statement we regret wasbased on a misreading of the German text. ActuallyMamier wrote : " Also the simultaneous use of thesetwo circulatory remedies would seem to be valuable."

68

We have reason to think that this opinion is not sharedby those who are working with these drugs in thiscountry, but it is proper for us to emphasise that theirdoubts are not confirmed by the Mannheim experience.PSYCHIATRY TAKES THE FIELD IN SPAINTHE politically moderate may see little difference

in the extremists on each side of them; and it is easyto recall the names of leaders who were once con-spicuous in the opposite camp. In the heat of thestruggle, however, it is but natural to describe theenemy as altogether different and debased, and inGeneral Franco’s Spain the psychiatrist has beenenlisted to give verisimilitude to this allegation.Writing in the Semana Médica Espanola for Oct. 8,1938 (p. 172) A. V. Nageraexpresses the opinion thata certain biopsychic typeis associated with a con-

stitutional predispositionto accept the views ofKarl Marx, and he claimsthat there are consequentlymany Marxist fanaticsamong persons. of lowintelligence and manyantisocial psychopathsamong Marxists. He holdsthat the cyclothymicextra vert tends to politicalopportunism, adaptinghimself to shifting circum-stances, whereas theschizothymic introverttends to sentimentalism,idealism, and fanaticism.He expected therefore tofind a schizothymic tem-perament in those com-

munists who had bornearms and a cyclothymictemperament in those whohad acted as agents andpropagandists. Thematerial which he studiedincluded (1) "inter-national "-i.e., SouthAmerican-prisoners ofwar in concentrationcamps ; (2) men andwomen arrested for Marxist political activities;(3) Basque separatists, in whom, he claims, is oftenseen the curious phenomenon of combined politicaland religious fanaticism, doubly curious because theyare fighting in alliance with the enemies of theirreligion; and (4) Catalonian separatists in whomMarxism is combined with anti-Spanish hatred.With E. C. Gargollo and A. del Rio he gives details(p. 177) of physique, temperament, intelligence,education, culture, economic status, political andreligious ideas and training, social personality,motives for enlisting, patriotic ideas, professional,social, and sexual failures, occupation, and sexuallife of 78 South American prisoners. The investigatorsdraw many uncomplimentary conclusions aboutthe mentality and habits of their enemies, but theycannot be considered impartial guides to the state ofmind of Republican Spain.

NEW PREPARATIONSDICHLORO - INDOPHENOL TABLETS B.D.H. are

intended to enable practitioners, with little equip-ment, to determine the amount of ascorbic acid(vitamin C) in urine. A low excretion of this substanceafter a test dose is held to suggest that the patient’stissues are " unsaturated " and that his diet mayhave been deficient in the vitamin ; similarly a lowexcretion on the ordinary diet suggests that the dietor its absorption is inadequate. A rapid method oftest and a more elaborate quantitative method canboth be carried out with these tablets, which areobtainable, with instructions for use, from the British

Drug Houses Ltd., Graham Street, City Road,London, N.1.EPANUTIN. - Sodium diphenyl hydantoinate

(Dilantin) is sold in this country by Parke, Davisand Co. (Beak Street, W.1) under the name Epanutin.It is said to have an anti-convulsant action inepilepsy but to have relatively little hypnotic effect.Clinical results obtained with it by Merritt andPutnam of Harvard were reviewed in our issue ofOct. 22 (p. 956), and letters on the use of the drugappeared on Nov. 5 and Dec. 31. The correspondenceis continued in our present issue.

NICOTINIC ACID TABLETS A. AND H. each contain50 mg. of nicotinic acid. A leading article on theuse of this substance in the prevention and treatment

of pellagra will be foundADAM STREET, ADELPHI, JANUARY, 1939

Until the east side of the street is rebuilt visitorsto Number Seven may enjoy an unexpected vista south-wards across the Thames, with Cleopatra’s Needle(brought to London in 1879 by Sir Erasmus Wilson,M.D.) on the cis-fluvian side and the Waterloo ShotTower (Watts 1789) on the other.

in THE LANCET of Dec. 24.They are made by Allen andHanburys Ltd., BethnalGreen, E.2.

Ciba Handbooks Nos. 2and 3, obtainable fromCIBA LTD. (40, SouthwarkStreet, S.E.l) in paper-covered and library edi-tions, review the use ofPercaine and of CibaHypnotics and Analgesics.No. 2, after setting outthe special advantages ofPercaine, gives precise par-ticulars of its applicationin clinical practice, includ-ing the induction of spinalanaesthesia by varioustechniques. No. 3 is devotedchiefly to the merits of Dialand its combinations.

Messrs. J. C. ENO(Pomeroy Street, S.E.14)announce that they are

now the exclusive suppliersof Stabilized CalciumAcetylsalicylate, formerlysold by Genatosan Ltd.as Stabilized CalciumAspirin.The Medical Diary and

Therapeutic Index for1939 prepared by Messrs. Bayer is issued in manydifferent languages, and this year contains even fullerinformation about the preparations and methodsdescribed, both old and new. The leather-coveredEnglish edition issued by BAYER PRODUCTS LTD.(Africa House, Kingsway, W.C.2) is well adapted tothe needs of practitioners in this country, andthough a page is provided for every day of the yearthe book remains thin because the diary itself isissued in four quarters, only one of which need beinserted at a time.

FoR DOG-LOVERS.—Among the three million dog-owners in this country there must be many doctorswho will appreciate " Who has a Dog ? " (Chapmanand Hall, pp. 187, 7s. 6d.), a book of short storiesabout dogs written by Sir Reginald St. Johnstone, adistinguished doctor-administrator, and admirablyillustrated by Mr. Frank Hart. Sir Reginald hasbred, shown, and owned dogs of many kinds ; heunderstands them all: and Mr. Hart knows whatthey look like.

ABUNDANT provision is now made for the welfareof the child, both before and after it reaches school age,but there is no class of the community which moreconstantly escapes medical care and supervision than themother of the working-class family. And there is no onewho merits more worthily that care and attention.-J. A. CHARLES. Ann. Rep. of M.O.H. for Newcastle-upon-Tyne for 1937.