- Email: [email protected]
RESEARCH IN BACTERIAL CHEMISTRY
1405
things are good, but it certainly did not find out that they were good nor is their incorporation into da.ily life due to its advocacy. What Mr. Huxley probably means is that, especially in recent times, deliberate scientific investigation has ena,bled many alterations to be made in the surface details of life. With this everyone will agree and a,lmost everyone will be grateful for better food, better houses, better health, and the generally easier and richer existence which has become available. We deprecate, however, his implication that " science " is all that is necessary for salvation ; it makes its substantial contribution to our comfort and convenience, but he claims too much for it ; good men a,re useful too. RESEARCH IN BACTERIAL CHEMISTRY
Medical Research Council announce the inauguration of new arrangements for further combined chemical and bacteriological investigations into the conditions which govern the life and multiplication of micro-organisms causing disease. These have been made possible by the generous cooperation of the Middlesex Hospital medical school, the trustees of the late Lord Leverhulme, and the Sir Halley Stewart Trust. Accommodation and facilities are being provided at the Middlesex Hospital in the BlandSutton institute of pathology and the adjoining Courtauld institute of biochemistry. The investigations will be directed by Dr. Paul Fildes, F.R.S., who has been appointed a member of the scientific staff of the Medical Research Council. The other workers are Mr. B. C. J. G. Knight, with a Halley Stewart research fellowship, and Dr. G. P. Gladstone and Dr. G. Maxwell Richardson, holding Leverhulme research fellowships. The arrangements took effect on June 1st, and the support given by the cooperating bodies is sufficient for an initial period of five years. THE
A
BEQUEST TO
A NON-EXISTENT HOSPITAL
IT is unfortunate that
people who mean to leave hospital should, in making their wills, sometimes use such an inexact description of the hospital as to defeat their generous object. A fresh case of this kind came to light last week on a summons before Mr. Justice Bennett. Thomas Stanley Forshaw, who died in 1930, left property (subject to a life interest) unconditionally to " the Middlesex Children’s Hospital, Middlesex-street, London, W." What did money to
a
in Middlesex no " Middlesex There was a Middlesex-street Children’s Hospital." in London, but not in " London, W.," and there was no hospital in Middlesex-street. Consequently, as the judge remarked, there was no institution which bore the name or the address to be found in the will as the institution to which Mr. Forshaw gave the property. The Middlesex Hospital in Mortimer-street was able to show that Mr. Forshaw had taken an interest in its work ; the evidence, it was suggested, pointed to the conclusion that Mr. Forshaw had the Middlesex Hospital in Mortimer-street in mind when he made the bequest. The judge, however, did not find the evidence conclusive. There remained a legal question to be decided-did the legacy fail and did the property pass to the next of kin as on an intestacy or would the court apply what is known as the cy-pres doctrine, This mysterious-looking law-French expression means that the court will try to get so near (si-p7°es) to the testator’s intentions as it can ; it will give an approximate interpretation to the language he has used. But courts are not prepared to apply the cy-pres doctrine unless satisfied that the testator meant to benefit a particular charitable he mean ?
There
was
purpose rather than a particular institution. Mr. Justice Bennett declared himself not so satisfied. He found himself without any clue to Mr. Forshaw’s intention apart from the words which named "The
Children’s
Middlesex
Hospital,
Middlesex-street,
As the address of a particular institution was so specifically set out in the bequest, the judge felt obliged to hold that the testator had an institution in mind and not a purpose. In the circumstances, the judge concluded, it was impossible to find the institution. The legacy therefore failed and the property went to the next of kin as if on an
London, W."
intestacy. THE USE AND ABUSE OF A SALT-FREE DIET
FOR many years the salt-free
regime
has been used
therapeutic measure particularly in disorders of the kidney. A series of communications from a score of continental physicians on the indications for and as a
this treatment appear in a recent issue of La T7ie Médicale.1 It is generally accepted that the use of salt-free diets arose from the work of Widal in France and Strauss in Germany. Widal found that in patients with oedematous nephritis salt administration increased and withdrawal of salt decreased the amount of oedema. In many ca,ses this relationship was found to be so definite that variations in the degree of oedema could be produced at will by altering the intake of common salt, and the treatment of oedema by a, salt-free diet achieved widespread and deserved popularity. Unfortunately this success in cases of dropsy led to the indiscriminate use of saltfree diets in other disorders. In chronic oedematous nephritis the value of a, salt-free diet in reducing oedema is scarcely disputed. Many ambulant cases of chronic nephritis with swollen legs and puffy faces can be kept free from these discomforts merely by restricting the intake of common salt. Often it is enough if no salt is used in the cooking or at table, but sometimes it is also necessary to recommend salt-free butter and bread. In cases of dropsy so severe that the patient isbedridden a salt-free diet usually removes some but not all of the cedema. Any amelioration of oedema is appreciated by the patient. In a prolonged, trying, and often hopeless illness it provides what a,ppea,rs to be tangible evidence of at least a partial recovery. In mild cases it allows the patient to undertake more bodily activity and in severe cases often relieves the mechanical discomfort due to stretching of the skin and subcutaneous tissues. Moreover, the complications of sepsis in oedematous limbs and of pulmonary cedema occur less frequently if the accumulation of large dropsical effusions is limited by a salt-free diet. While patients are usually more comfortable7 on a salt-free diet, however, it is doubtful whether this regime produces any durable improvement in their health, and it is therefore important to know whether any disadvantages are attached to its enforcement. In 1928 L. Blum observed in certain cases of nephritis a marked increase in blood-urea, previously normal or but moderately raised, when salt was withdrawn from the diet. It is scarcely surprising, therefore, that many physicians hesitate to recommend this diet to patients who already have a tendency to nitrogen retention in the blood. It seems, however, that, in chronic nephritis with oedema, nitrogen retention rarely in practice gives rise to the symptoms which are usually associated with a failure to excrete the products of nitrogen metabolism. A salt-free diet often causes loss of appetite and, it is said,
against
1
La Vie Médicale, April 25th, 1934.
*
things are good, but it certainly did not find out that they were good nor is their incorporation into da.ily life due to its advocacy. What Mr. Huxley probably means is that, especially in recent times, deliberate scientific investigation has ena,bled many alterations to be made in the surface details of life. With this everyone will agree and a,lmost everyone will be grateful for better food, better houses, better health, and the generally easier and richer existence which has become available. We deprecate, however, his implication that " science " is all that is necessary for salvation ; it makes its substantial contribution to our comfort and convenience, but he claims too much for it ; good men a,re useful too. RESEARCH IN BACTERIAL CHEMISTRY
Medical Research Council announce the inauguration of new arrangements for further combined chemical and bacteriological investigations into the conditions which govern the life and multiplication of micro-organisms causing disease. These have been made possible by the generous cooperation of the Middlesex Hospital medical school, the trustees of the late Lord Leverhulme, and the Sir Halley Stewart Trust. Accommodation and facilities are being provided at the Middlesex Hospital in the BlandSutton institute of pathology and the adjoining Courtauld institute of biochemistry. The investigations will be directed by Dr. Paul Fildes, F.R.S., who has been appointed a member of the scientific staff of the Medical Research Council. The other workers are Mr. B. C. J. G. Knight, with a Halley Stewart research fellowship, and Dr. G. P. Gladstone and Dr. G. Maxwell Richardson, holding Leverhulme research fellowships. The arrangements took effect on June 1st, and the support given by the cooperating bodies is sufficient for an initial period of five years. THE
A
BEQUEST TO
A NON-EXISTENT HOSPITAL
IT is unfortunate that
people who mean to leave hospital should, in making their wills, sometimes use such an inexact description of the hospital as to defeat their generous object. A fresh case of this kind came to light last week on a summons before Mr. Justice Bennett. Thomas Stanley Forshaw, who died in 1930, left property (subject to a life interest) unconditionally to " the Middlesex Children’s Hospital, Middlesex-street, London, W." What did money to
a
in Middlesex no " Middlesex There was a Middlesex-street Children’s Hospital." in London, but not in " London, W.," and there was no hospital in Middlesex-street. Consequently, as the judge remarked, there was no institution which bore the name or the address to be found in the will as the institution to which Mr. Forshaw gave the property. The Middlesex Hospital in Mortimer-street was able to show that Mr. Forshaw had taken an interest in its work ; the evidence, it was suggested, pointed to the conclusion that Mr. Forshaw had the Middlesex Hospital in Mortimer-street in mind when he made the bequest. The judge, however, did not find the evidence conclusive. There remained a legal question to be decided-did the legacy fail and did the property pass to the next of kin as on an intestacy or would the court apply what is known as the cy-pres doctrine, This mysterious-looking law-French expression means that the court will try to get so near (si-p7°es) to the testator’s intentions as it can ; it will give an approximate interpretation to the language he has used. But courts are not prepared to apply the cy-pres doctrine unless satisfied that the testator meant to benefit a particular charitable he mean ?
There
was
purpose rather than a particular institution. Mr. Justice Bennett declared himself not so satisfied. He found himself without any clue to Mr. Forshaw’s intention apart from the words which named "The
Children’s
Middlesex
Hospital,
Middlesex-street,
As the address of a particular institution was so specifically set out in the bequest, the judge felt obliged to hold that the testator had an institution in mind and not a purpose. In the circumstances, the judge concluded, it was impossible to find the institution. The legacy therefore failed and the property went to the next of kin as if on an
London, W."
intestacy. THE USE AND ABUSE OF A SALT-FREE DIET
FOR many years the salt-free
regime
has been used
therapeutic measure particularly in disorders of the kidney. A series of communications from a score of continental physicians on the indications for and as a
this treatment appear in a recent issue of La T7ie Médicale.1 It is generally accepted that the use of salt-free diets arose from the work of Widal in France and Strauss in Germany. Widal found that in patients with oedematous nephritis salt administration increased and withdrawal of salt decreased the amount of oedema. In many ca,ses this relationship was found to be so definite that variations in the degree of oedema could be produced at will by altering the intake of common salt, and the treatment of oedema by a, salt-free diet achieved widespread and deserved popularity. Unfortunately this success in cases of dropsy led to the indiscriminate use of saltfree diets in other disorders. In chronic oedematous nephritis the value of a, salt-free diet in reducing oedema is scarcely disputed. Many ambulant cases of chronic nephritis with swollen legs and puffy faces can be kept free from these discomforts merely by restricting the intake of common salt. Often it is enough if no salt is used in the cooking or at table, but sometimes it is also necessary to recommend salt-free butter and bread. In cases of dropsy so severe that the patient isbedridden a salt-free diet usually removes some but not all of the cedema. Any amelioration of oedema is appreciated by the patient. In a prolonged, trying, and often hopeless illness it provides what a,ppea,rs to be tangible evidence of at least a partial recovery. In mild cases it allows the patient to undertake more bodily activity and in severe cases often relieves the mechanical discomfort due to stretching of the skin and subcutaneous tissues. Moreover, the complications of sepsis in oedematous limbs and of pulmonary cedema occur less frequently if the accumulation of large dropsical effusions is limited by a salt-free diet. While patients are usually more comfortable7 on a salt-free diet, however, it is doubtful whether this regime produces any durable improvement in their health, and it is therefore important to know whether any disadvantages are attached to its enforcement. In 1928 L. Blum observed in certain cases of nephritis a marked increase in blood-urea, previously normal or but moderately raised, when salt was withdrawn from the diet. It is scarcely surprising, therefore, that many physicians hesitate to recommend this diet to patients who already have a tendency to nitrogen retention in the blood. It seems, however, that, in chronic nephritis with oedema, nitrogen retention rarely in practice gives rise to the symptoms which are usually associated with a failure to excrete the products of nitrogen metabolism. A salt-free diet often causes loss of appetite and, it is said,
against
1
La Vie Médicale, April 25th, 1934.
*