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year 1941,’ thore would be a reduction or cessation of benefitunless the accrued arrears were discharged at the full healthand pensions rate by the seamen ; and whether, as the positionhad already arisen in the case of seamen rescued from the4MMM*&, he would.ensure that such men were not called uponto make substantial payments to clear arrears in the circum-stances.-Mr. MACDoNALD replied : I am aware that the

existing law does not make satisfactory provision for maintain-ing the National Health Insurance and contributory pensionsrights of civilian prisoners of war and I hope to have an earlyopportunity of introducing the necessary amending legislation.

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Our Reinforced LoafIn reply to a question the Parliamentary Secretary to the

Ministry said that the total cost of fortifying white flour withvitamin B1 could not be stated, but it is not expected toexceed one-tenth of a penny per quartern white loaf.

In reply to a further question he added that wholemealbread made from a 100% extraction flour contains about28 units of vitamin B1 per oz., but that bread made from sucha flour is not fully digested. Bread made from flour of 85%extraction, which it has been decided to adopt as the minimumfor a wholemeal flour, would contain about 20 units of vitaminB1 per oz. It was proposed to add vitamin B1 to white flourin sufficient quantity to raise the vitamin B1 content of whitebread also to 20 units per oz.

Foreign Firms and PatentsSir ERNEST GRAHAM-LITTLE asked the Minister of Economic

Warfare whether he had investigated the possibility of therebeing any direct or indirect financial relationship between theHoffman-La Roche Company of Basle, parent company ofRoche Products Ltd., and the German concerns of BayerProducts or I.G., and whether he had satisfied himself thatnone of the payments made to Roche Products Ltd. for

synthetic vitamins B1 would pass into the possession of

Germany through Switzerland.-Dr. DALTON replied:This matter has been carefully investigated ; but I havefound no evidence that any of the payments made to RocheProducts Ltd. will pass to Germany through Switzerland.

Sir ERNEST GRAHAM-LiTTLE asked the ParliamentarySecretary to the Ministry of Food on what licence from theGerman I.G. patents for the manufacture of vitamin B1 theGovernment is now relying for the right to manufacture thisproduct ; and why, in view of the war, any such licence was I

required to operate a German patent.-Mr. HARCOURTJOHNSTONE replied : The Government have not undertakenthe manufacture of vitamin Bl, but will for the present obtainsupplies from a firm of chemical manufacturers which had theright to use patents Nos. 471, 416 and 475, 595 coveringinventions made by the German company, I.G. Farbenindus-trie. Bayer Products Ltd. of Africa House, Kingsway, are theregistered proprietors of both patents in this country.

InfluenzaIn reply to Sir FRANCIS FREMANTLE Mr. MACDoNALD said:

There is no evidence at present of any general epidemic ofinfluenza. In 126 major cities and towns of England andWales during the four weeks ending Jan. 13, 1939-40, therewere respectively 27, 45, 94 and 158 deaths from influepza.The comparable figures for 1940-41 were 30, 40, 53 and 74.

Physical Training in LondonIn reply to a question the President of the Board of Trade

stated conditions in London during the last five months havealmost wholly precluded the continuance of evening activities.Nevertheless, good use has been made of the week-ends totrain leaders and maintain recreative activities for youngpeople, and a successful experiment has been made in centralLondon in lunch-time keep-fit classes for girls and women.Some 300 classes, including keep-fit classes, are being held bythe local authority in public shelters, and the provision ofdormitory shelter is being facilitated in boys’ and girls’ clubs,so that the work of the clubs may continue during the evening,or an existing public shelter may be partially or whollyallocated for the same purpose. One of the three newrecreation centres planned by the authority for opening lastSeptember has been opened. The meetings of the LondonYouth Committee and the Borough Youth Committees, likethose of other committees of the London County Council, havebeen suspended by the council, but emergency arrangementswere made to deal with urgent matters. These arrangementshave, among other things, enabled over 60 applications forgrant to be submitted to the board, and the board had madegrants in respect of over 50 of these applications.

Accidents in FactoriesThe Minister of Labour announced that accidents reported

under the Factories Act were in 1940 1384 fatal and 231,000non-fatal, and in 1939, 1104 fatal and 192,371 non-fatal. Thefigures for 1940 are provisional and subject to correction.

Public Health

Health in Northern IrelandTHE annual report of the Registrar-General for

Northern Ireland for 1939 shows that the customarypeace-time progress in declining mortality-rates was wellmaintained in that year. The population is slightlyincreasing and is estimated as 1,295,000. The crudedeath-rate of 13-6 per 1000 was the lowest recorded sinceNorthern Ireland became a separate administrative unit.Standardisation to allow for the changing age and sexcomposition of the population gives a figure which hasdeclined steadily over the previous five years and is lessthan the level of 1926 by nearly 20 per cent. The infant-mortality rate also touched its lowest point but at 70 per1000 live births is hig]4 in comparison with the figure of50 in England and Wales. There is a considerabledifference in this respect between the urban and ruraldistricts of Northern Ireland with rates respectively of80 and 58. The most striking component of thisdifference is, the detailed tables show, mortality attri-buted to diarrhoeal diseases. In 1934-39 these causesof death were consistently 3-4 times as important in theurban as in the rural communities, and such a differencemight well be an object of special inquiry.

The downward trend of the tuberculosis death-ratecontinued unchecked to a low record level, but itsimportance is still apparent in the observation thattuberculous diseases were responsible for very nearly halthe total mortality at ages 15-25 and rather more thara third at 25-35. The death-rate from pneumoniashowed a decline from 0-80 per 1000 in 1938 to 0-62 in1939, and as influenza was probably present to a greaterdegree in the latter year (judging from its mortality)modern methods of treatment may well be the cause.Similarly considerable improvement is apparent in therate of mortality in pregnancy and childbirth. In 1935-362-2 deaths per 1000 births were attributed to puerperaland post-abortive sepsis, in 1937-38 there were only 1-2and in 1939 as few as 0-8. No corresponding improve-ment is shown by other puerperal diseases. Deaths fromviolence were responsible for 3-4% of all deaths andmotor vehicles yearly supply about a fifth of them.

From the Annual ReportsNORWICH

Dr. V. F. Soothill reports that the population ofNorwich has fallen to 121,700. For 1939 the Registrar-General furnishes two figures of population, one for thecalculation of the birth-rate, the other for the death-rate.This is usual in war-time when many adult males are onservice, the deaths of whom are not accredited to thedistricts, and, in the present war, evacuation andreception have disturbed normality. The figure forcalculating the death-rate is below that for the birth-rateexcept in some reception areas: The -higher numbergives the nearer approach to the true population figure.Before the industrial revolution, Bristol and Norwichwere the only towns in England outside London with anyconsiderable population. Their populations have in-creased actually since the eighteenth, century, butrelatively have fallen greatly. They retain the honourof being the only towns which are counties by historical

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right, though for administrative purposes they have noadvantage over the other county boroughs.

In 1939 Norwich had the low infantile-mortality rateof 27-77. Many districts in 1939 registered totalinfantile-mortality rates below the neonatal rates offormer years, so we must be making some progress in thereduction of neonatal deaths which had stubbornlyresisted our endeavours. The year was exceptional andwe have no hope that its low rates will be repeated untilpeace has been restored, but the fact that they have beenattained tells us that neonatal death is not " incurable."The birth-rate was 13-29 and the adjusted death-rate11 52. The crude death-rate was 12-53, so the popula-tion is not falling from natural decrease. There were

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two maternal deaths, one from sepsis and one other,giving a total maternal mortality of 1.24 per 1000 livobirths. Vaccination is in a very poor way in Norwich,for only 15,6% of the infants born were successfullyvaccinated in 1939, and 78.3% of the parents wereconscientious objectors. Four new cases of ringwormwere found in the school-children, three of which werein one family. The first discovered was a boy recentlyreturned from India who was presumed to have beencured, but he infected a brother and a sister. In the

past, histories comparable with this were abundant, butof recent years have been so rare that when they occurthey are worth recording.

Infectious Disease in England and WalesWEEK ENDED JAN. 4

VoCttMos.—The following cases of infectious diseasewere notified during the week ; smallpox, 0 ; scarletfever, 1335 ; whooping-cough, 2783 ; diphtheria, 1396 ;enteric fever, 18 ; measles (excluding rubella), 17,816 ;pneumonia (primary or influenzal), 1297 ; puerperalpyrexia, 122; cerebrospinal fever, 229 ; poliomyelitis, 9 ;polio-encephalitis,l; encephalitis lethargica, 2; dysentery,68 ; ophthalmia neonatorum, 62. No case of cholera,plague or typhus fever was notified during the week.The number of civilian and service sick in the Infectious Hospitals

of the London County Council on Jan. 10 was 2279, including :scarletfever,319; diphtheria, 315 ; measles, 884 ; whooping-cough,119 ; enteritis, 32 ; chicken-pox, 221 ; erysipelas, 48 ; mumps, 27 ;poliomyelitis, 1 ; dysentery, 11 ; cerebrospinal fever, 47 ; puerperalsepsis, 6 ; enteric fevers, 6 ; german measles, 2 ; other diseases(non-infectious), 127 ; not yet diagnosed, 84.Deaths.-In 126 great towns there was no death from

smallpox or enteric fever, 3 (0) from scarlet fever, 27 (2)from whooping-cough, 21 (5) from measles, 54 (2) fromdiphtheria, 34 (4) from diarrhoea and enteritis under 2years, and 53 (8) from influenza. The figures in paren-theses are those for London itself.

Fatal cases of diphtheria were scattered over 24 great towns,Liverpool reporting 12 deaths and no other town more than 4.There were 14 deaths from whooping-cough at Birmingham.The number of stillbirths notified during the week was204 (corresponding to a rate of 41 per thousand totalbirths), including 16 in London.

BACTERICIDAL AEROSOLSDr. C. C. Twort writes : There were some errors in my

letter of Jan. 11 (p. 61). In the list of five desirablecharacteristics of a germicidal aerosol the fourth and fifthshould read " it should preferably possess high persist-ence," and " it should preferably be non-inflammable."Then in the paragraph on smokes on page 61 the passagebeginning at line 5 should be amended to read " Theiroutstanding feature is that they are much more bacteri-cidal in the air to the flora of the saliva than they are tobroth emulsions of the several laboratory culturestested, and when equal parts of water and sterile salivawere used as an emulsifying medium the sensitivitiyof the contained bacteria to the germicide was increased,instead of being decreased as it was with hypochlorite,82 or ultraviolet light. The average results when usingvarious concentrations for varying contact times indic-.

ated that smokes were ten times as lethal and 1%hypochlorite solutions were a tenth as lethal to the floraof the saliva compared with the lethal effectiveness onbroth emulsions of stock laboratory cultures." Onpage 62, last paragraph, I should have advocated balsa-mic smokes, rather than the burning of balsamic candles.In the legend to the table it should have been made clearthat the Corynebacterium xerosis is not our standard testorganism and was only used in certain of the experimentswith smokes and S2, more especially those with very highdilutions of the latter. Elsewhere the organism usedwas the " F coccus," a saprophytic, white, gram-positivemicrococcus.

PYLUMBRIN is a stable sterile 35% aqueous solution ofthe diethanolamine salt of 3 : 5 di-iodo-4-pyridone-N-acetic acid which Messrs. Boots are manufacturing intheir Nottingham laboratories and are supplying in

ampoules of 3 c.cm. and 20 c.cm. for excretion pyelo-graphy. It may be given either by intravenous injectionor subcutaneously if a suitable vein cannot be found.Clinical trial has shown that it is well tolerated and givesgood contrast shadows.

Obituary

CHARLES THURSTAN HOLLAND

CH.M., LL.D. LPOOL, F.R.C.S.

Mr. Thurstan Holland who died on Jan. 16 at the ageof 78 was one of the small group of Liverpool pioneerswho introduced radiology into this country.Born at Bridgwater in 1863, the son of Alderman W. T.

Holland, he was educated privately and at UniversityCollege Hospital. He qualifiedM.R.C.S. in 1888 and the sameyear set up in practice inLiverpool. He was already anexpert amateur photographer

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-he was also an expertmountaineer and in his Alpinestudies these two hobbies werehappily combined. But nowhis photography assumed anew importance. At this timeOliver Lodge held the uni-versity chair of physics andHolland was helping RobertJones, and he has describedhow these contacts startedhim on what was to becomehis life’s work. Towards the Haines

end of 1895 Rontgen dis-covered that an electric charge passing through a vacuumproduced a ray much more penetrating than ordinarylight. Sir Robert heard of the discovery through aprivate letter before any reference had been made to it inan English paper. Sensing immediately the value of thediscovery as applied to his own work he ordered anapparatus and placed it in Holland’s hands. Later hewrote " The first X ray in our country was, I think, takenby Dr. Holland and myself with a little tube, and wewere able to develop a photograph of a small bulletwhich was embedded in a boy’s wrist." At first the newdiscovery was used mostly on limb fractures and foreignbodies, but the scope of the work widened when in thesame. year the Royal Southern Hospital asked Hollandto set up one of the first radiology departments of thecountry. To begin with he used his own apparatuswhich was erected in a semi-underground room placedunder the stairs leading up to the wards. In 1904Holland left to organise the new radiology departmentat the Liverpool Royal Infirmary. His work here wasinterrupted by the war, when as consulting radiologistto the Western Command he spent busy years organisinga radiology service from Pembroke to Carlisle. He alsosat on the War Office committee on radiology. But inthe midst of this administrative work he found time todevise and perfect his new technique for localisingbullets.The war had given an impetus to the development of

radiology and in 1920 he was appointed lecturer inradiology in the University of Liverpool, and two yearslater he was granted the degree of Ch.M. in recognitionof his services in organising the new diploma in thatsubject. In 1928 as a member of twenty years’ standinghe was elected to the fellowship of the Royal College ofSurgeons. He had twice been president of the RontgenSociety, and in 1929 he served as president of the BritishInstitute of Radiology, with which it had been incor-porated. In 1924 Holland delivered the SilvanusThompson lecture and the following year he presidedover the first International Congress of Radiology whenit met in London. He was also a fellow of the AmericanCollege of Radiology.

Holland was blunt and downright, and if you did notknow him well he could be withering, for he had thehonesty as well as the kindness of a big-hearted man.After his illness in 1931 he aged a good deal and as hisintimate friends died he became very lonely. But hestill retained his sense of humour if rather grimmer thanbefore and he enjoyed watching cricket at Aigburththough he could not flay enough the modern dullcounty games. He was a great man with a fine zest forlife.He married Lilian Fergusson who died in 1924 and he

is survived by one son.