2
1121 are still some severe septicaemias that defy all attempts at exact diagnosis. And it might be profitable to find out whether V. fetus infection takes any part in the causation of that 25% of all abortions which are said to be unexplained. MEDICAL PATENTS AMONG doctors the habit is to share knowledge freely : what is learnt by one is made known to all. Desire to preserve this open communication and to avoid harmful monopolies underlies the precept that no medical man should take out a patent in respect of a medical invention. In abstract this isa sound, and even a noble, idea ; but in the context of a warmly competitive world market it has proved increasingly detrimental to those whom it is meant to protect-the public. Accordingly, in their annual report 1 the council of the British Medical Associa- tion recommend that, subject to certain conditions, a doctor should be allowed to patent an invention. Patentable discoveries derive from the work not of clinicians but of research-workers, who nowadays are associated with chemists, physicists, engineers, and others. A special committee which the council appointed, with Dr. Robert Forbes as chairman, notes that " there immediately arises the possibility of a moral obligation upon the non-medical specialist to avoid patenting where formerly he would have patented, and it may be incumbent upon the medical profession to make con- cessions in departing from the custom that formerly prevailed." There are further, and perhaps weightier, arguments for a change of attitude. Where an invention is not protected by a patent, a manufacturer would normally refuse to handle it, lest others took the oppor- tunity of profiting freely by his development of the discovery. More important still, observance of the no-patenting rule may tell hard on the whole country, particularly where a " central " patent is vacated : the British consumer now pays royalties to American firms for penicillin manufactured in this country. Some years ago the British Medical Association pro- posed that doctors should be enabled to dedicate patents to the public. There are precedents for such usage. The Dicks patented their scarlet-fever toxin and antitoxin, but delegated their rights to a special committee. The patent for Sir Frederick Banting’s process for preparing insulin was taken out in the name of the University of Toronto, but the British rights were vested in the Medical Research Council. The way to delegation in the public interest has now been opened by the Development of Inventions Act, 1948, under which the National Research Development Corporation was set up as an independent body to which medical patents might be assigned. As regards reward to the inventor, none would be paid by the Corporation to anyone who is another man’s servant -for instance, a Crown servant, who in any event would be precluded by his contract from deriving any benefit from his invention (though he might receive an award from the Departmental Awards Committee). The relationship between the corporation and a sole worker not employed by an organisation who wished to assign a patent and claim an award would be one of buyer and seller ; but, says the B.M.A. report, "in the case of a medical man the Corporation would not take any action that would conflict with a policy laid down by the profession as a whole." When the association’s Representative Body meets next month it will be asked to approve the conclusion that " in the opinion of the Association there is no longer any objection to the patenting of inventions for which members of the medical profession are responsible, provided such patents are assigned to the National Development Corporation with a view to their administration in the best interests of the Dublic as a whftjf " This Hfma a raH).:) enl"tinn. 1. Brit. med. J. suppl. June 10, p. 276. THE THYROID AND LACTATION THE lactation-stimulating (galactopoietic) effect of thyroid-active preparations seems to have been first suggested in 1896 by an experiment of Hertoghe,l who increased the milk yield of a cow by feeding it dried thyroid gland. This effect of dried thyroid was later independently rediscovered -and extended to thyroxine by Graham,2 and soon the results of Folley and White 3 in lactating cows clearly demon- strated the considerable galactopoiesis produced by injections of crystalline thyroxine. Interest in the possible applications of this discovery in dairy farming remained lukewarm for some years, mainly because of the belief that the effectiveness of thyroxine by mouth was so low that it would be uneconomic to give it to milking cows except by injection, which would obviously be impracticable. And dried thyroid gland, though fully active by mouth in cows, was not plentiful or cheap enough to be a practical alternative. At the beginning of the late war, however, Ludwig and von Mutzen- becher 4 discovered that a thyroid-active protein effective by mouth could be prepared by the iodination of casein. Improved methods of cheap large-scale production were soon devised, so that extensive researches could be begun on the various uses of this artificial thyroid-active protein in agriculture, mainly for increasing the milk yield of cattle, but to a less extent for stimulating egg- production in hens and accelerating growth in young pigs. 5 Lately the wheel has come full circle, bringing synthetic thyroxine back into the picture. A new synthesis of l-thyroxine has been worked out 6 which seems capable of large-scale development so as to supply the synthetic hormone in considerable amounts at relatively low cost. Following this, Bailey, Bartlett, and Folley have shown that l-thyroxine by mouth is a good deal more active in stimulating lactation in milking cows than has hitherto been believed. The optimum oral dose of the synthetic hormone for this purpose (about ten times that by the subcutaneous route) is such that, in view of its relatively low cost of production by the new method, it is likely to be at least as cheap to use as iodocasein, and in practice it has some important advantages. Thus, the crystalline l-thyroxine is virtually tasteless, whereas iodocasein preparations are often so unpalatable that a significant proportion of cows will refuse to eat rations containing them. Perhaps its most valuable feature is that, being a pure crystalline substance, it does not need to be standardised by bio-assay, a trouble- some and unsatisfactory procedure which has proved difficult from the very outset of the experiments with iodocasein in this country. Provided the long-term experiments now in progress under the auspices of the Agricultural Research Council show that the repeated administration of thyroid preparations in successive lactations does no harm to the health or reproductive abilities of the cattle, synthetic thyroxine is likely to be chosen for general use. The thyroid treatment of hypogalactia in women also dates back to Hertoghe, but the modern clinical investi- gations can be said to have started with the work of Robinsoii,8 who reported successful though variable results in hypogalactia by feeding either dried thyroid 1. Hertoghe, E. Bull. Acad. Méd. Belg. 1896, ser. 4, 10, 381. See Robertson, J. D. Lancet, 1946, i, 978. 2. Graham, W. R. jun. J. Nutrit. 1934, 7, 407 ; Biochem. J. 1934, 28, 1368. 3. Folley, S. J., White, P. Proc. roy. Soc. B. 1936, 120, 346. 4. Ludwig, V., von Mutzenbecher, P. Hoppe-Seyl. Z. 1939, 258, 195. 5. See Reineke, E. P. Vit. & Horm. 1946, 4, 207. Young, F. G. Brit. med. Bull. 1947, 5, 155. 6. Chalmers, J. R., Dickson, G. T., Elks, J., Hems, B. A. J. chem. Soc. 1949, p. 3424. 7. Bailey, G. L., Bartlett, S., Folley, S. J. Nature, Lond. 1949, 163, 800. 8. Robinson, M. Lancet, 1947, ii, 385.
