616 MEDICAL RESEARCH COUNCIL-NLTFFIELD FOUNDATION

patients and 48% of the patients maintained ondesoxycorticosterone acetate had a lymphocytosis ;but the " average " figures given for these groupsshow that the 40% level has only just been exceededand most of the counts would hardly be regarded asabnormal. Others have had similarly unconvincingresults.The severest criticism has fallen on that part of the

theory which connects the dissolution of lymphocyteswith the release of globulin antibodies. Li andREINHARDT 5 gave adrenocorticotrophin to rats andfound that the plasma globulin actually decreased,but the albumin increased ; GJESSING and CHANUTIN 6

report similar findings ; HOUGHTON et al.,7 using catsand rabbits, were also unable to confirm DOUGHERTYand WHITE’S findings. Again, it has been notedthat increased serum globulin is not found in humandiseases associated with lymphatic hyperplasia;NrTSxE and COHEN,8 for example, found no significantalteration in serum proteins in 12 - patients withlymphatic leukaemia. FAGRAEUS 9 denies that lympho-cytes have anything to do with antibody formationand points out that the changes in lymphocytes brought5. Li, C. H., Reinhardt, W. V. J. biol. Chem. 1947, 167, 487.6. Gjessing, E. C., Chanutin, A. Ibid, 169, 657.7. Houghton, J. S., Thatcher, J. S., Hiles, C. J. Lab. clin. Med.

1947, 32, 1410.8. Nitske, B. A., Cohen, P. P. Blood, 1947, 2, 363.9. Fagraeus, A. Acta med. scand. 1948, 130, suppl. 204.

about by adrenocortical hormones occur in less than12 hours, whereas most antibody formation takes

place 48 hours after appropriate stimulation. It is theplasma cells, she says, that are important for antibodyformation, and there is good evidence now thatplasma cells are derived directly from reticulo-endothelium and are not - modified lymphocytes.FAGRAEUS carried out in-vitro experiments withisolated fragments of rabbit spleen ; she found thatthere was always more antibody in red pulp than inwhite pulp containing splenic follicles (malpighianbodies), and that the capacity of the red pulp to formantibodies varied with the number of plasma cells,especially immature types that were present.The idea that the dissolution of lymphocytes caused

by adrenal cortical hormones is concerned withglobulin production in general and antibody releasein particular must therefore be regarded as " notproven." This is a pity because we- have so littlefirm information on the function of the lymphocyte.But such contradictions should remind us to bear inmind the possible fallacy of assuming that changesbrought about by artificial and considerable changesof hormone concentrations represent the normalmechanism of control ; we are in fact faced with theold difficulty of deciding whether observed changesare physiological or toxicological.

Annotations

’MEDICAL RESEARCH COUNCIL

Viscount Addison, M.D., has joined the MedicalResearch Council as chairman in succession to LordBalfour of Burleigh. Others whose appointments to thecouncil were announced this week are : Sir GeorgeSchuster, who succeeds Sir William Goodenough as

treasurer; Sir Frederic Bartlett, F.R.S., professor of

experimental psychology in the University.of Cambridge ;Sir Howard Florey, M.D., F.R.S., professor of pathologyin the University of Oxford : and Mr. Geoffrey Jefferson,F.R.c.s., F.R.s., professor of neurosurgery in the Universityof Manchester. The other members of the council are :

Group-Captain C. A. B. Wilcock, M.P., Prof. P. A.

Buxton, M.R.C.S., F.R.S., Prof. Sir Alexander Fleming,F.R.C.P., F.R.S., Prof. C. A. Lovatt Evans, F.R.C.P., r.R.S.,Prof. R. A. Peters, M.D.; F.R.S., Prof. J. H. Gaddum,M.R.C.S., F.R.S., Prof. H. P. Himsworth, F.R.c.P., andSir Edward Mellanby, F.R.C.P., F.R.s. (secretary).

NUFFIELD FOUNDATION

Two of the objects of the Nuffield Foundation are wellknown to doctors. These are " the advancement ofhealth " and " the care and comfort of the aged poor."But there is a further aim-namely, " the advancementof social well-being " ; and under this broad canopy thethird report records new grants for work on such widelydiffering topics as agricultural policy and the develop-ment of the reflecting microscope. In the field of thesocial sciences support is promised for a study of grouprelations and an investigation into the social factors oftown-planning.

"

Town-planning in the past," the report observes, " hastaken account of sanitary needs, natural features, andaesthetic considerations, and has reached the concept of the, master plan’ ; but knowledge of the social and economictrends which should provide the real basis for continuedplanned development consists mainly in wisdom acquiredafter the event."

1. Report of the Trustees for the Year ending March 31, 1948.Issued from the foundation’s offices, 12-13, MecklenburghSquare, London, W.C.1.

The foundation is also supporting a study of the middleclasses, with special reference to their recruitment-anintricate system of which little is known. Recruitment ofanother sort is to be examined by Prof. Aubrey Lewisat London University’s Institute of Psychiatry. ProfessorLewis is undertaking a long-term study of universitycandidates-accepted and rejected-with the aim of

determining : (1) to what extent the existing andfamiliar practice of selection agrees with the results ofpsychological procedures ; (2) whether, in those accepted,academic or psychological assessment agrees better withthe students’ examination results and later performance ;and (3) what happens to those rejected, and how far theirsubsequent success or failure could have been predictedfrom the results of the psychological tests.

Medical research is being aided by two new grants.One is for the establishment of a haematological unit atOxford, and the other is for a survey of the health anddevelopment of children born in one week of March, 1945,who at that time were observed in a study of maternityservices organised by a joint committee of the RoyalCollege of Obstetricians and Gynaecologists, the Popula-tion Investigation Committee, and the Institute of ChildHealth of London University. One of the most valuablefunctions which the foundation has undertaken is the

encouragement, by fellowships and other awards, of theexchange of students, both senior and junior, within theEmpire. The Dominion medical travelling fellowships areto be continued, with slight modifications, for a furtherseven years ; and within the Dominions committees areto be set up to advise on local requirements. The founda-tion has also been instrumental in procuring, for doctors inoutlying parts of the African colonies, the stimulus ofperiodic visits by consultants from Britain.2The major part of the obligation to the welfare of the

old is now discharged through the National Corporationfor the Care of Old People, established last year jointlywith the Lord Mayor of London’s Air Raid Distress Fund.For income the foundation relies mainly on the capitalfund of 910 million presented by Lord Nuffield, but asthe scope of its work grows it can put to good -use any

2. See Lancet, 1948, i, 431.

617

additions to the auxiliary fund ; and the report recordsa gift of £450,000 by Captain Oliver Bird for rheumatismor other medical research. In the trustees’ introductorywords :

" The welcomed increase of State support for learningand research does not lessen the need for voluntary enter-prise : neither does it decrease the importance of alternativesources of support if the principle-fundamental to a freeand democratic society-is to be upheld that there shouldbe room for more than one opinion and for more than onemeans of putting that opinion to the test.’

"

MEDICAL FILMS

THE three medical film meetings held on Oct. 8, 9,and 11 by the Scientific Film Association 1 in conjunctionwith the International Scientific Film Congress in Londonmade it clear that too many recent productions are

comparable to unrevised laboratory notebooks and notto prepared lectures or articles. On Oct. 8 there was areasonably good film from Australia showing neuro-

logical sequelse of starvation ; this was followed by aDanish one on the clinical examination of syphilitics ;then by a Belgian film which was difficult to follow

visually, and by an American film on the toxic effects ofstreptomycin which wasted time on introductorysequences and on demonstrating nystagmus whichwas not there. Dr. Margaret Fries’s film on the psycho-logical implications of observations of behaviour duringthe (paediatric) clinic visit showed what a wonderful

subject this is for a teaching film, but did not quiteovercome the difficulties it presents. Mr. E. GwynneEvans’s film on the behaviour of the orofacial muscula-ture in children opened up new and more intelligentdiagnostic and therapeutic approaches to the problemsof " adenoidal" and mouth-breathing children. Twoother films illustrating cases of chorea and Friedrich’sataxia, were approved for their brevity and directness ;for the omission of unnecessary introductory shots anddistracting furnishings in the backgrounds, and because(nearly) everything in the commentary was illustratedin the films. The absence of choreic movements duringsleep, a fact that clinicians have usually to take on trust,was well demonstrated, and the shots of the child afterrecovery gave the viewers an interest in her as a personas well as a case. This admirable new venture bythe Wellcome Medical Museum should certainly be

expanded.Next day Mr. R. McV. Weston spoke on cinemicro-

graphy and showed four examples. The first was anexcellent twenty-year-old Canti film of cells in tissueculture ; the other films showed a progressive improve-ment culminating in the film of osteoclasts made byMr. Weston in collaboration with Dr. Norman Hancox,of Liverpool University. The evident possibilities ofthis skilled technique should be exploited for largeraudiences. Teachers of biology and physiology wouldwelcome a fifteen-minute film on the behaviour of livingcells in normal blood.The lesson of the first day’s meeting- was that badly

photographed and badly edited films cannot tell a storywell, but the moral to be drawn from the discussion onthe second day was that good photographic techniqueis not enough. The American Medical Associationcentenary film, The Medical Motion Picture, was followedby a recently finished British film, Subtotal Hysterectomy,shown as a text for discussion. The lighting and colourwere first-class, but the case was an unfortunate choice forthe tumour was so large that it was difficult to see theother organs ; only once was any detail of surgicaltechnique shown, and possible difficulties were not

emphasised. The criticism that this operation is or

should be rarely done led to the expression of a widelyheld view-that the potential audience is too smallto justify the making of postgraduate surgical films,1. Programme and detailed list of films can be obtained from the

association at 34, Soho Square, London, W.1.

in view of the urgent need for improving the teaching ofstudents and nurses. The meeting ended with thefilm Introduction to Acute -Inflammation, made byDr. Beckett, Dr. Hansell, and Dr. Moller when they werestudents at the Westminster Hospital. This film uses

diagrams, colour, and microscopy, and is a goodinstrument for teaching.The last meeting opened with an American film on

peptic ulcer, fcfllowed by a short cartoon film by Giles,Cautionary Tales abo-ut Sepsi8. Mr. E. Fife Clark, publicrelations officer to the Ministry of Health, outlined pastand present films from his ministry and discussed thepart the film can play in health education. Miss Ma-vis

Englefield of the Queen’s Institute of District Nursing,introducing the U.S. Navy film, Bathing the Bed Patient,made a plea for simple nursing training films for motherswho like to look after their sick and would like to do itbetter. Dr. Stanford spoke on the value of short films,and several of these were shown-on the foramen ovale,a Dutch film on D.D.T. poisoning, an English film onthe Aschheim-Zondek test, another showing a case ofSturge Weber syndrome (ending with the child sittingon Dr. Parkes Weber’s knee), and one telling nurses howto put on a mask. Dr. Bloemensthal, of Holland,introduced a film he has made on the development ofthe peritoneum—an ideal subject for animation.The meeting brought out once again the value of

polished technique, to ensure that the audience’s interestis in the content of the film,2 and the importance of havinga clear idea of what the film is to say and to whataudience. It is good to hear that the S.F.A. are arrangingthat some, at least, of the films seen will be available inthis country.

THE NAMES OF BACTERIATHE complexities of bacteriological classification can

only be guessed at by the student who has to follow histextbooks, or by the clinician who must grasp the gistof laboratory reports; but the present multiplicity ofauthoritative nomenclatures is a trial for both of them.On one side of the Atlantic we have the radicalism of

Bergey’s Manual3 (reviewed on p. 612), which has nothesitated to lay hands even on such an old enemy asStaphylococcus aureus ; moreover its sixty contributors,like their predecessors, seem to have ignored much of thework done outside the American continent. On the otherside the Medical Research Council follows a more

conservative path in the new list of species 4 maintainedin the National Collection of Type Cultures at Elstree, /Herts. In general the- List follows the familiar nomen-clature of Topley and Wilson,5 so that Salmonella typhihas not suffered a sea change, a, la Bergey, into S. typhosa.On points of detail, medical bacteriologists may express

surprise and regret that neither publication recognisesthe species Bacillus mesentericus and B. vulgatus; inthe past the name mesentericus has been given to differentorganisms, but most strains are now regarded as eitherB. p1tmilus or B. subtilis. B. anthracis retains itsidentity in spite of Nathan Smith’s 6 view that it is a

pathogenic variety of B. cereus. Synonymy is commonin the genus Clostridium ; the List prefers welchii tothe Manual’s perfringens, though neither is valid if theBacteriological Code is strictly followed. Bacterium isused in the Manual as the generic name for gram-positiveand gram-negative non-sporing rods of uncertain taxo-nomic position ; in the List it is used in italics forcoliforms (Escherichia and Aerobacter of the Manual)and related intestinal organisms, and in roman type2. Izod, A. C. Place of the Film in Medical Education. London,

1946; p. 12.3. Breed, R. S., Murray, E. G. D., Hitchens, A. P. Bergey’s

Manual of Determinative Bacteriology. Baltimore, 1948.4. List of Species Maintained in the National Collection of Type

Cultures. Med. Res. Coun. Memo. no. 21. London: H.M.Stationery Office. 1948. Pp. 17. 9d.

5. Topley and Wilson’s Principles of Bacteriology and Immunity.Revised by G. S. Wilson and A. A. Miles. London, 1946.

6. Smith, N. R., Gordon, R. E., Clark, F. E. U.S. Dept. Agric.Misc. Publ. no. 559. Washington, 1946.