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THE COMMON COLD
822 that the Mecca
pilgrimage had again been free from disease and decided to defer for further epidemic consideration the request of the Egyptian delegate to revise the pilgrimage clauses of the 1926 convention. Discussions were also held on the surveillance of air passengers, the so-called " immunity reaction " to smallpox vaccination, and the great value of dried lymph in hot countries. Noteworthy among the general contributions were papers on tuberculosis in Denmark and France, by Prof. Th. Madsen and Dr. E. Aujaleu ; on an epidemic of smallpox in Arras, by Prof. A. Lemierre ; and on the control of transmissible diseases in the British colonies during the war, by Dr. W. H. Kauntze. Finally the finance commission reviewed the financial position of the Office, which seems to have met its obligations adequately during the war years despite the lapse of contributions. Indeed the health and vigour generally shown by this prospective corpse proved quite remarkable. THE COMMON
COLD
THE study of several important human diseases has been hampered because the infectioncannot be transmitted to laboratory animals or because its effect on animals is quite different from its effects on man. This is true especially of viruses. The discovery that influenza could be transmitted to ferretswas a big step forward, and the story of the ferret, nearly 200th in the chain of infection, which gave a man influenza by sneezing in his face has passed into the history of bacteriology. Unhappily the only animal so far found to contract the common cold is the chimpanzee, which is unsuitable for tests on a large scale. For the new investigation which begins in July volunteers will therefore be used. The work will be done by a common-cold research unit established by the Medical Research Council and the Ministry of Health at the Harvard Hospital, near Salisbury, which was built and equipped in 1941 and was given to the Ministry by Harvard University and the American Red Cross for research into communicable diseases. Volunteers from the universities, who will be isolated in pairs, -will have their noses sprayed with material to test for the presence of the virus. Organised observations of this kind have been going on for many years2 and it is high time that whatever outstanding questions they_ can answer were answered definitely. Conclusive experiments necessitate rigorous quarantine, but every effort will be made to mitigate the irksomeness of isolation, and there will be no lack of volunteers for any serious attempt at investigating one of the major afflictions of these islands. The unit will make new efforts to find a susceptible animal " or, better still, some other laboratory technique which will permit a scientific approach to the problem." ",
PREDIGESTED PROTEIN
importance of enough protein in the diet, both maintaining health and for speeding recovery from disease, has been emphasised by the present world shortage of food. In the care of sick infants paediatricians have long been faced with the dilemma of choosing THE
for
between the risks of food intolerance and those of starva-
tion, while physicians responsible for older patients the dangers of former " light " diets, .which were often insufficient to keep the body in nitrogen balance. Predigested protein is now increasingly used to provide easily assimilable nourishment for those who cannot tolerate ordinary food : after hydrolysis most of the protein is reduced to amino-acids which are soluble
now -,recognise
in water. The main objection to these products is their bitter taste, which is unpalatable to all humans, other than premature or very young babies. There are, how1. Smith, W., Andrewes, C. H., Laidlaw, P. P. Lancet, 1933, ii, 66. 2. E.g., Dochez, A. R., Mills, K. C., Kneeland, Y. Ibid, 1931, ii, 547.
disguising this flavour, and these may be _improve. material has usually been the casein of cows’
ever, ways of
expected
to
The raw milk or raw beef, but Dormer1 in South Africa announces a proposal to prepare protein digests on a large scale from whale flesh, a substance not at present used for human consumption. Concentrates are made up in two forms, both of which are reported to be stable ; the first is a water-soluble syrup or powder containing mostly amino-acids, and the second an insoluble powder containing amino-acids, polypeptides, and peptones. It is said that the products can be processed without difficulty on shore or at sea, and that the cost of production will probably be a quarter that of concentrates from other sources. Chemical analysis is proceeding, and successful clinical trials have already been made. Protein biscuits might, it is suggested, be issued to school-children in areas where the diet is deficient ; and the concentrate, which lends itself to easy transportation and protracted storage, might be kept in depots throughout the world as a reserve against times of war and famine. THE
DOCTOR’S
DISEASE ?
THE Registrar-General’s Decennial Supplement for 1931 was largely responsible for the widespread belief that doctors are more liable to coronary thrombosis than any other section of the community ; the death-rate from coronary disease and angina pectoris among 25,000 physicians and surgeons was found to be 3-68 times the average for all occupations. In 1941, Willius, a distinguished American cardiologist,2 expressed the view that the cardiac death-rate among physicians today is appalling." This Anglo-American shroud of gloom was rudely rent by Hope Gosse,3 who not only indicated anomalies in both the Registrar-General’s returns and the American figures but also produced new figures of his own contradicting the claim that doctors were particularly liable to coronary thrombosis. He pointed out that during the period covered by the Registrar-General’s returns the diagnosis of coronary thrombosis was not yet in general use in this country, the condition probably often being certified as myocardial degeneration. A fairer comparison, he maintained, was to take the total of deaths due to " heart diseases," which showed, that physicians and surgeons had a mortality 1-38 times that of the average for the community. Vrillius’s figures were based on those deaths, reported in the Journal of the A’/nerican Jledical Association, in which the cause of death was stated. Since this was not stated in all cases, the statistical value of the figures was doubtful. As part of an analysis of morbidity and mortality among 8884 medical men between the ages of thirty and sixty-five, Hope Gosse found that among 100 consecutive deaths only 27 were due to cardiovascular causes. He summed up the position in Great Britain as being that I doctor in 4 dies before he reaches the age of sixty-five ; 1 in 40 dies from coronary thrombosis : and less than 1 in 10 up to sixty-five years of age dies from cardiovascular and cerebrovascular degeneration, including coronary thrombosis. This comforting conclusion is now supported by American workers.4 Working on the principle that, if the age at death from a particular disease is distinctly lower in one occupational group than in the general population the occupation must play a part in the aetiology of the disease, they have compared the average age at death from coronary-artery disease among doctors and among the general population. In two different series (215 and 253 cases) of doctors dying 6f coronaryartery disease the average age at death was 66-0 and-65°8 ’
’
1. Dormer, B. A. Report to the Red Cross Society, Natal, on an Experiment with Predigested Protein. 2. Willius, F. A. Proc. Mayo Clin. 1941, 16, 714. 3. Gosse, A. H. Brit. med. J. 1942, ii, 567. 4. Levine, S. A., Hindle, J. A. New Engl. J. Med. 1945, 233, 657.
pilgrimage had again been free from disease and decided to defer for further epidemic consideration the request of the Egyptian delegate to revise the pilgrimage clauses of the 1926 convention. Discussions were also held on the surveillance of air passengers, the so-called " immunity reaction " to smallpox vaccination, and the great value of dried lymph in hot countries. Noteworthy among the general contributions were papers on tuberculosis in Denmark and France, by Prof. Th. Madsen and Dr. E. Aujaleu ; on an epidemic of smallpox in Arras, by Prof. A. Lemierre ; and on the control of transmissible diseases in the British colonies during the war, by Dr. W. H. Kauntze. Finally the finance commission reviewed the financial position of the Office, which seems to have met its obligations adequately during the war years despite the lapse of contributions. Indeed the health and vigour generally shown by this prospective corpse proved quite remarkable. THE COMMON
COLD
THE study of several important human diseases has been hampered because the infectioncannot be transmitted to laboratory animals or because its effect on animals is quite different from its effects on man. This is true especially of viruses. The discovery that influenza could be transmitted to ferretswas a big step forward, and the story of the ferret, nearly 200th in the chain of infection, which gave a man influenza by sneezing in his face has passed into the history of bacteriology. Unhappily the only animal so far found to contract the common cold is the chimpanzee, which is unsuitable for tests on a large scale. For the new investigation which begins in July volunteers will therefore be used. The work will be done by a common-cold research unit established by the Medical Research Council and the Ministry of Health at the Harvard Hospital, near Salisbury, which was built and equipped in 1941 and was given to the Ministry by Harvard University and the American Red Cross for research into communicable diseases. Volunteers from the universities, who will be isolated in pairs, -will have their noses sprayed with material to test for the presence of the virus. Organised observations of this kind have been going on for many years2 and it is high time that whatever outstanding questions they_ can answer were answered definitely. Conclusive experiments necessitate rigorous quarantine, but every effort will be made to mitigate the irksomeness of isolation, and there will be no lack of volunteers for any serious attempt at investigating one of the major afflictions of these islands. The unit will make new efforts to find a susceptible animal " or, better still, some other laboratory technique which will permit a scientific approach to the problem." ",
PREDIGESTED PROTEIN
importance of enough protein in the diet, both maintaining health and for speeding recovery from disease, has been emphasised by the present world shortage of food. In the care of sick infants paediatricians have long been faced with the dilemma of choosing THE
for
between the risks of food intolerance and those of starva-
tion, while physicians responsible for older patients the dangers of former " light " diets, .which were often insufficient to keep the body in nitrogen balance. Predigested protein is now increasingly used to provide easily assimilable nourishment for those who cannot tolerate ordinary food : after hydrolysis most of the protein is reduced to amino-acids which are soluble
now -,recognise
in water. The main objection to these products is their bitter taste, which is unpalatable to all humans, other than premature or very young babies. There are, how1. Smith, W., Andrewes, C. H., Laidlaw, P. P. Lancet, 1933, ii, 66. 2. E.g., Dochez, A. R., Mills, K. C., Kneeland, Y. Ibid, 1931, ii, 547.
disguising this flavour, and these may be _improve. material has usually been the casein of cows’
ever, ways of
expected
to
The raw milk or raw beef, but Dormer1 in South Africa announces a proposal to prepare protein digests on a large scale from whale flesh, a substance not at present used for human consumption. Concentrates are made up in two forms, both of which are reported to be stable ; the first is a water-soluble syrup or powder containing mostly amino-acids, and the second an insoluble powder containing amino-acids, polypeptides, and peptones. It is said that the products can be processed without difficulty on shore or at sea, and that the cost of production will probably be a quarter that of concentrates from other sources. Chemical analysis is proceeding, and successful clinical trials have already been made. Protein biscuits might, it is suggested, be issued to school-children in areas where the diet is deficient ; and the concentrate, which lends itself to easy transportation and protracted storage, might be kept in depots throughout the world as a reserve against times of war and famine. THE
DOCTOR’S
DISEASE ?
THE Registrar-General’s Decennial Supplement for 1931 was largely responsible for the widespread belief that doctors are more liable to coronary thrombosis than any other section of the community ; the death-rate from coronary disease and angina pectoris among 25,000 physicians and surgeons was found to be 3-68 times the average for all occupations. In 1941, Willius, a distinguished American cardiologist,2 expressed the view that the cardiac death-rate among physicians today is appalling." This Anglo-American shroud of gloom was rudely rent by Hope Gosse,3 who not only indicated anomalies in both the Registrar-General’s returns and the American figures but also produced new figures of his own contradicting the claim that doctors were particularly liable to coronary thrombosis. He pointed out that during the period covered by the Registrar-General’s returns the diagnosis of coronary thrombosis was not yet in general use in this country, the condition probably often being certified as myocardial degeneration. A fairer comparison, he maintained, was to take the total of deaths due to " heart diseases," which showed, that physicians and surgeons had a mortality 1-38 times that of the average for the community. Vrillius’s figures were based on those deaths, reported in the Journal of the A’/nerican Jledical Association, in which the cause of death was stated. Since this was not stated in all cases, the statistical value of the figures was doubtful. As part of an analysis of morbidity and mortality among 8884 medical men between the ages of thirty and sixty-five, Hope Gosse found that among 100 consecutive deaths only 27 were due to cardiovascular causes. He summed up the position in Great Britain as being that I doctor in 4 dies before he reaches the age of sixty-five ; 1 in 40 dies from coronary thrombosis : and less than 1 in 10 up to sixty-five years of age dies from cardiovascular and cerebrovascular degeneration, including coronary thrombosis. This comforting conclusion is now supported by American workers.4 Working on the principle that, if the age at death from a particular disease is distinctly lower in one occupational group than in the general population the occupation must play a part in the aetiology of the disease, they have compared the average age at death from coronary-artery disease among doctors and among the general population. In two different series (215 and 253 cases) of doctors dying 6f coronaryartery disease the average age at death was 66-0 and-65°8 ’
’
1. Dormer, B. A. Report to the Red Cross Society, Natal, on an Experiment with Predigested Protein. 2. Willius, F. A. Proc. Mayo Clin. 1941, 16, 714. 3. Gosse, A. H. Brit. med. J. 1942, ii, 567. 4. Levine, S. A., Hindle, J. A. New Engl. J. Med. 1945, 233, 657.