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216 as it does after intravenous and intramuscular injection, but the peak level was less than 10% of that attained by parenteral -injection; only 16%’ of the penicillin given was recovered in the urine, whereas the recovery after intravenous or intramuscular injection was never less than 37%, and usually much more. The same workers observed in another in- vestigation ’17 in which excretion was slowed by dio- drast, and also in two patients with renal failure,15 that less penicillin was recovered from the urine when excretion was delayed, suggesting that there was slow destruction in the body. Similar observations were made in the dog by BBYBR et al 18 RAMMELKAMP and KEEPER also confirmed 15 that after rectal administra- tion a bacteriostatic level was not reached in the blood-serum. Recently another group of workers in the United States" have administered penicillin in large doses (100,000 units) to " normal " subjects by mouth, and demonstrated its ’excretion in the urine for some hours; from 8% to 33% was recovered. The simultaneous administration of sodium bicarbonate reduced the amount recovered, instead of increasing it as had been expected; but it is to be noted that penicillin is even more rapidly inactivated by alkali than by acid so that a check on the purity of the bicarbonate is highly desirable. Unfortunately this work is incomplete, since no study was made of the acidity of the gastric juice or of the penicillin levels reached in the blood-serum. Now on another page LITTLE and LUMB produce more data. Some of their findings, such as the high proportion of the drug excreted in the urine after oral administration, conflict with previous reports. Others, such as the use of egg albumin as a vehicle for oral administration, are new, and their scientific basis has yet to be elucidated. In view of the promise of easier and more comfortable therapy which these investigations hold out, they deserve repetition and expansion, using the most refined methods of assay available. But as long as the supply of penicillin falls far short of potential demand, as it does today, no-one will wish to intro- duce a new method of use without complete assurance that it is economical as well as effective. A MEDICAL PRINCIPAL IT is perhaps one sign of the Oxford medical renais- sance of the last twenty years that Somerville College should have broken with precedent by appointing a woman doctor to be its next principal. Dr. Janet Vaughan’s qualities and experience abundantly justify the innovation. She has a scholastic and literary back- ground as the daughter of the late William Vaughan, headmaster of Wellington and Rugby, and- grand- daughter of John Addington Symonds ; her investiga- tions at University College Hospital and the British Postgraduate Medical School brought her into the first rank of haematologists ; during the war she has adminis- tered a large blood-supply depot ; she is the first woman counsellor of the Royal College of Physicians, and serves on its committee on social and preventive medicine ; she is one of the seven trustees of the Numeld Founda- tion ; and her other public work includes membership of the Goodenough Committee, the Royal Commission on Equal Pay, and the small body of experts who have recently been in India advising the Bhore Committee about medical education. Forty-five years of age, she married in 1930 Mr. David Gourla,y, and they have two daughters. 17. Rammelkamp, C. H., Bradley, S. E. Ibid, 1943, 53, 30. 18. Beyer, K. H., et al. Science, 1944, 100, 107. 19. Free, A. H., Leonards, J. R., McCullagh, D. R., Biro, B. E. Ibid, 1944, 100, 431. Annotations DRUGS FOR MALARIA WRITING under this title on Nov. 18 last we remarked that " although malaria has always been of immense importance to the British Empire, we owe our escape from a dangerous position to the enterprise of the German chemical industry supplemented by American energy in applying the product to military purposes." All will agree that the Allies are indebted to,the German workers who invented mepacrine (’Atebrin’) before the main quinine-producing areas were taken by the Japanese ; but it has been pointed out that our comment does less than justice to the precautions taken by the British Government to build up a reserve stock of quinine, or to the success achieved by British manu- facturers in producing mepacrine. Since the war of 1914-18, when quinine supplies were secured only by delicate negotiation, the possibility of a shortage in war-time has, we are informed, been fully appreciated! by the authorities in this country. In 1938 arrange. ments were made to ensure that as much quinine as possible was held throughout the Empire: a considerable national reserve was purchased, and in addition at least two years’ supply was obtained and held by most of the Dominions and Colonies. The manufacture of synthetic antimalarials is a complex process, and mepacrine was not made completely in the United Kingdom on any large scale till 1941, when intermediate substances were no longer obtainable from France. Thenceforward, how- ever, progress was rapid. It was in, March, 1942, that the Japanese overran Java, which provided over 90% of the world’s supply of quinine, and by that time mepacrine production here was already considerable. Officers of the Ministry of Supply at once visited the USA to arrange a joint programme for further production, and this was fulfilled as successfully here as in America. In 1943 the output was 40 tons, and this amount was more than trebled in 1944, when at least 150 tons was produced. Each ton provides about 10 million tablets, and in 1943 over 395 million tablets made by three British firms were allocated to the Services, Dominions, Colonies, -and certain Allied and neutral countries. The 1944 pro- duction will satisfy demands approaching 1500 million tablets, and it is already evident that such demands will be exceeded and met in 1945. ’ WHAT DETERMINES POLIOMYELITIS EPIDEMICS? LABORATORY mice sometimes contract a virus disease, often called Theiler’s disease after its discoverer. This resembles poliomyelitis in man so closely that many have hoped to learn more of the human disease by study of its murine counterpart. A first exciting step was the discovery that Theiler’s virus is to be found in the faeces, and (less abundantly) in the intestinal walls, of almost every young mouse. Nevertheless, naturally’ occurring paralysis was extremely rare. This fitted in with the current tendency of students of human polio- myelitis to pay more attention to the intestine and less to the nose as a portal of entry. Poliomyelitis virus was recovered from stools more readily than from throat washings ; it was found in sewage ; it turned up in flies caught in the wild state. Theiler’s virus is often of low neurotropic tendency ; so suggestions were made that human poliomyelitis virus was, like it, ubiquitous, but not always sufficiently strongly neurotropic to be demonstrable by inoculation into monkeys. Why should a ubiquitous denizen of the intestines reveal its presence by causing epidemics of nervous disease ? Sven Gard 1 of Uppsala has made some obser- vations on the mouse disease which may afrord a clue. In his stock of mice, producing 6000 animals a year, Theiler’s virus was regularly present in the .stools of 1. Gard, S. Yale J. Biol. Med. 1944, 16, 467.
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