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by the use of marginal-punched cards each investigatorcan make the literature more easily available to himself.The photographs were taken by Mr. R. F. Carter.

REFERENCES

Casey, R. S., Perry, T. W. (1951) Punched Cards : Their Appli-cation to Science and Industry. New York.

Dorland, W. A. N. (1951) American Illustrated Medical Dictionary.Philadelphia.

Lawson, M. G. (1948) Amer. Archivist, 11, 143.McGaw, H. F. (1952) Marginal Punched Cards in College and

Research Libraries. Washington, D.C.Medical Research Council (1944) Spec. Rep. Ser. med Res. Coun.

Lond. no. 248.Rogers, F. B., Adams, S. (1950) Texes Rep. Biol. Med. 8, 271.Shaw, J. A., Fisher, E. (1946) Science, 104, 180.Smith, J. M. (1953) Treatment Index for Use with Marginal Punched

Cards. Mimeographed.

HOSPITALS AND THE PRESSA CONFERENCE of doctors and press organisations,

held under the auspices of the British Medical Associa-tion with Dr. H. Guy Dain as chairman, has agreedon the recommended procedure by hospitals for therelease of news about the condition of patients. Therecommendations are as follows :Sickness Cases

1. No information should be divulged to the press withoutthe consent of the patient, beyond the admission on inquirythat the person concerned is a patient. Where, however,even this statement would be deleterious to the patient’sinterests, his presence in the hospital should not be disclosedwithout his consent. For example, in certain special hospitals,such as mental hospitals and sanatoria, where the mereadmission of the patient implies the nature of the diagnosis,no information should be given to the press without the

patient’s consent.2. In the case of well-known people (and subject always

to the patient’s consent) a brief indication of progress may begiven, in terms authorised by the doctor in charge.

3. In the circumstances referred to under 1 and 2, where thepatient is too ill to give his consent, or is a minor, the consentof the nearest competent relative may be accepted.

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Accident Cases4. (a) Individual cases.-The press should be given, on

inquiry only, and at the time of the inquiry or as soon aspossible afterwards, the name and address of the patientand a general indication of his condition. The patient’srelatives should normally be informed before any statementis given to the press ; but if it has not been possible to do so,this should be made clear to the press. Further informationshould be given only with the patient’s consent.

(b) Mult’iple cases.-In accidents involving a number ofpeople (for example, a railway or air accident) all reasonablesteps should be taken to inform relatives of the injuredbefore the publication of names, bearing in mind the. necessityof early publication to dispel the anxiety of the next-of-kinof all other persons who were, or might have been, involvedin the accident. Further information should be given onlywith the patient’s consent.

5. Hospitals admitting accident cases should maintaina casualty book by reference to which inquiries may beanswered.General .

6. All hospitals should ensure that a sufficiently senior andresponsible officer of the hospital is at all times available,whether in person or by telephone, to answer press inquiries,and should nominate an officer or officers for this purpose.

7. When dealing with press representatives who call at

hospitals and are unknown to them, such hospital officersare advised to ask to see evidence of accreditation in theform of a document issued by the press representative’snewspaper, news agency, or photographic news agency, or amembership card of the Institute of Journalists or the NationalUnion of Journalists.

8. Cooperation between hospitals and the press must

depend on mutual confidence and good personal relations.Difficulties and misunderstandings should be taken up betweenthe hospitals or board concerned and the local press.These recommendations are to go for ratification to the

bodies represented at the conference ; and the Ministryof Health is expected to consult hospital authorities.The conference also approved an explanatorymemorandum.

Public Health

Chemicals in Food

A JOINT conference of the Food and AgricultureOrganisation and the World Health Organisation washeld recently in Geneva, under the chairmanship ofDr. Norman Wright, to explore what action could betaken by the two organisations on the internationallevel in the matter of chemical additives in food. Allmember countries were invited to this technical explora-tory conference : 12 countries sent delegates, and 1 anobserver ; and 4 scientific groups were also represented.The conference decided that international action on

food additives was necessary because : (1) the potentialhealth hazards were world-wide ; (2) both the less-developed and the highly developed countries were

exposed to these hazards, especially the latter, for theyused a greater variety of additives ; (3) the size of theproblem made it impossible for a single country to under-take all the investigations needed ; (4) apart from healthaspects, food additives affected international trade andthe free movement of foods ; (5) many countries werecurrently reviewing their legislation on food additives ;(6) laboratory facilities for work on food additives wereinadequate in most countries and international coöpera-tion was needed to put them to their most effective use.The first step should be to recommend uniform methodsfor evaluating the safety of food additives, and toformulate general principles governing their use. Inaddition, F.A.O. and W.H.O. should collect and dissem-inate information on pertinent legislation and on thevarious properties and effects of individual food additives.Finally, the two organisations should assist in thecoordination of investigations, to prevent overlappingand duplication of research.

Of the classes of additives now in use, the con-

ference recommended that priority should be given tothe work concerning food colours, preservatives, andemulsifiers.

The situation has become much more complex since thesynthesis of the so-called " coal-tar " colours. Over 2000of these synthetic dyes have been prepared, but, fortunately,only about 80 are currently permitted in foods. There is atpresent no internationally agreed list for either natural or

synthetic colours, although attempts have been made toobtain international acceptance, in Europe, of a list of 7

synthetic and 5 natural colours. The conference urged earlyconsideration for this question.

Preservatives, including both antimicrobial agents and anti-oxidants, are of special value in limiting wastage and deteriora-tion in food-supplies. They are of special importance for thestorage and orderly disposal of surplus commodities. Finally,they are particularly valuable in tropical areas, where storagepresents special problems. As antimicrobial agents are moreextensively used, especially in hot climates, they should begiven higher priority.

A Survey of TuberculosisA seven-week campaign of mass X-ray examination

and tuberculin-testing was carried out in an industrialarea of Northumberland in May and June this year.Blyth, with a population of just under 35,000, wasselected as suitable for the survey because both its size andits nature as a comparatively isolated industrial town.A total of 20,900 people were examined by three mass-radiography units. This represented 60 % of the censuspopulation over the age of 5 years, together with 1739people working but not resident in Blyth.About 1 in every 25 volunteers were recalled for large films.

Among these, 40 cases of active tuberculosis were discovered-a rate of 1-9 per 1000 examined. As is usual, other

important abnormalities were found, and some of these weredealt with by direct reference to the general practitioner orschool medical officer and the chest clinic. A guarantee wasmade that every case requiring hospital admission would beoffered an immediate vacancy.Of the Blyth cases, 8 were potential sources of infection,

and only 5 had symptoms that would have probably resultedin their diagnosis apart from the survey. Further examination

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of contacts of active cases resulted in 2 additional casesbeing found, and the possibility of finding further cases hasnot yet been fully ruled out.

An interesting feature of this survey was the use ofthe tuberculin test by Heaf’s multiple-puncture method.There was surprisingly little opposition from the public,and no less than 95 % of those examined were tested.The tuberculin test was carried out by school medicalofficers in the schools, assisted by health visitors, whothemselves carried out the testing of the public with thehelp of members of the St. John Ambulance Brigade.The postal method of reading, as previously tried ina small pilot survey, was used as the only practicablemethod of reading these tests, and a control of a10 % random sample was read twenty-four to forty-eighthours later by the health visitors. This check showed noserious error in postal reading; 2 % were incorrectlyrecorded positive and 3 % were incorrectly recorded nega-tive. Used in this way, the value of the tuberculin testis not yet fully clear, but there can be little doubt thatthe results relating to a 60 % sample of the communityis of value in the search for further evidence of tuberculousinfection in the borough.The radiography units were concentrated on their proper

work of mass radiography only ; the large films were alltaken in the chest clinic. Throughout the survey, one staticunit was situated in a hall near the market square and twomobile units moved around the town according to need.Where possible they operated in public halls, but when thiswas impracticable a marquee was used. The survey beganin the schools, which were covered in the first week, and

- achieved a rate of 88%. This had the advantage of bringing- the survey to the notice of the majority of the population.

Later the units worked in the shipyard, the collieries, and thelight industries.From the administrative standpoint, no difficulty was

experienced in the apportionment of the cost above the normalexpenditure of the X-ray units ; this was shared about equallybetween the regional hospital board and the local authority.Most of the extra clerical work was done by volunteers. Asin the pioneer Salford survey of 1953, the medical officers ofhealth, chest physicians, school medical officers, health visitors,and clerks in the public-health department and mass-

radiography teams all worked as a single unit and illustratedthe close cooperation that can and should exist between theregional board and the local authorities.

Well supported by the press and the public, the Blythsurvey was a model of how mass radiography can beused effectively and economically.

PoliomyelitisUncorrected notifications of poliomyelitis in England

and Wales in the week ended Oct. 15 (41st week) showeda slight increase. The figures were (40th week in paren-theses) : paralytic 189 (186), non-paralytic 177 (164),total 366 (350). The total uncorrected notifications in the41st week during the past six years were (percentageof paralytic cases in parentheses) : 1950, 308 (72-4%) ;1951, 94 (57-4%); 1952, 109 (84-4%); 1953, 124(63-7%); 1954, 71 (70-4%); 1955, 366 (51-6 %). Sofar this year the proportion of non-paralytic cases inEngland and Wales has been approximately 46-3%of the total. The figures for the whole of the precedingfour years were: 1951, 41-5 % ; 1952, 29-8%; 1953,34-6%; 1954, 32.8%.

Third Quarter in England and WalesThe Registrar-General 1 announces provisional figures

for the quarter ended Sept. 30, 1955. Live birthsnumbered 166,584 (a rate of 14-9 per 1000 population) ;in the corresponding quarter of 1954 the rate was 15-0.There were 101,647 deaths registered-9-1 per 1000population, compared with 9-3 per 1000 in the thirdquarter of 1954. The infant-mortality rate was 21-6 per1000 related live births, compared with 21-0 last year.There were 3897 stillbirths, or 22-9 per 1000 total births,compared with a rate of 23-1 in the September quarterlast year.

1. The Registrar-General’s Return for the week ended Oct. 15, 1955.H.M. Stationery Office, Pp. 20. 1s.

In England NowA Running Commentary by Peripatetic CorrespondentsTHIS season of ducks for dinner is a time of rather

mixed feelings. Barely four months have passed sincePorter Fred rang up to say that a carton of day-oldducklings had come off the 7.32 ; undoing the box onthe kitchen table, and the cold little webs wriggling overthe children’s fingers in a mutual squealing match ofexcitement ; the snuggling acceptance of twelve balls offluff beneath the dignity of a broody hen. The blossomon the apple tree was already set for sauce.High summer saw prodigious growth. Those little

yellow shovels scooped up crumbly meal with all theefficiency of open-cast mining. Their foster-motherclucked with frustration at the water edge ; her bastardbrood upended’in derision. One was curiously flattenedby the feeding bucket, and one just went by night torat or weasel. The other ten survived for human pleasures.The drought was overcome by a self-appointed rostersystem in the horse trough, an inconvenience more thancompensated by long hours of basking in .the sun-

drenched grass, one leg extended, beak tucked neatlyover back. How I have often envied such torticollisfor taking forty winks in car or cinema.But even the nicest of ducks have their debit side.

I wish Aylesburys were a little more constipated; theback-door steps are treacherous. I wish they did nottake it upon themselves to sound reveille for the restof the dawn chorus, or at least do it less raucously. I wishthey would go to bed at sundown instead of causing meto stumble through the nettles to shoo them in andshut them in safe from foxes. The design of their under-carriages seems hopelessly inefficient for taxiing atpresent-day speeds: a small wheel on the sternum isthe obvious modification for the next marks.Squadron manoeuvres also need working up. Pro-

gression in line astern is not only monotonous but out-moded since Farnborough. The sudden removal of theleader to the oven caused a degree of disorganisationquite out of proportion to the accepted principles of

delegation, save for the smirk on the beak of Tail-EndCharlie. Subsequent candidates for execution were

picked haphazardly from the hut at night, but the sur-vivors continue to honour their memory by maintainingblank files in the procession--a mute rebuke to Nemesis.The last two shall go together to minimise psychic

trauma. A bumper-size packet of frozen peas and the bestof the cooking apples shall adorn their passing. When wehave eaten our way through ten luscious ducklingsanother summer will be officially over, and we shall bein good trim to turn our thoughts to turkeys.

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In one of your recent issues I noted that a hospitalin the Midlands requested that their new R.M.o. shouldhold the M.R.C.P. (London). I am now awaiting anadvertisement which stipulates that the new registrarat this or that hospital should have the school-leavingcertificate (Oxford and Cambridge Joint Board),B.A. (Oxfd), B.M. (Guy’s Hospital trained), and, of course,M.R.C.P. (London)-not to mention a full knowledge ofthe report of the Royal Commission on Monopolies.

* * *

I am an octogenarian, as my mother was before me-my father would have been one had he lived long enough.I know all about octogenarians, I realise their immensevalue, and am happily conscious that everywhere inEngland now, this is fully recognised.But octogenarians were not always held in such high

esteem. Not many years ago they were thought to bepoor old people, who sat all day before the fire in largearmchairs, wrapped in shawls and wearing caps. Theold men wore smoking caps, rather the shape of thoseworn by Montenegrins, made of cloth and embroidered ingreen and red. As a child these caps greatly worried me.Why, I wondered, were they called smoking-caps, formany old gentlemen never smoked, they thought itrather a wicked habit. I supposed in my childish waythat as most of them were bald they were worn to keeptheir heads hot, in fact smoking hot, and, of course, asa mark of distinction. This idea was somewhat confirmed