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Award for gallantry in civil defence
1941 (1) Patients showing malaise or indefinite pyrexia without apparent cause are given sulphapyridine by mouth in appropriate doses and kept under close observation. (2) Patients with earlier manifestations of the infection receive in addition convalescent poliomyelitis serum. Initially, 2 grammes of sulphapyridine by mouth and 20 c.cm. of convalescent serum intra.muscularly are given, and 1 gramme of sulphapyridine is repeated four-hourly until the temperature settles unless there are serious contraindications. Occasionally the serum is repeated once or twice. (3) Patients presenting acute symptoms, where paralysis is impending or has already developed, receive initially 2 or 3 grammes of sulphapyridine soluble in physiological saline intravenously at the earliest moment possible, together with 20 c.cm. of convalescent serum intramuscularly. The sulphapyridine soluble is repeated four-hourly until 8 to 10 grammes have been given. A second dose of 20 c.cm. of the serum is administered eight to ten hours after the first. Next day sulphapyridine soluble and serum are repeated; in the more severe cases further injections are given o11 the third day, but usually they are not required. Modification for children is made according to age. Since this procedure has been adopted we have had 11o serious extension of paralysis in any case, nor" have there been any deaths; such reactions as occurred were negligible.
Award for Gallantry in Civil Defenee The award of the George Medal to Dr. Laura Bateman, Medical Officer, Brook Hospital, Shooter's Hill, is announced in a Supplement to the London Gazette dated June 13th. The announcement reads as follows: " When the Brook Hospital was bombed two maids were imprisoned by debris, Dr. Bateman quickly relieved the suffering of the first maid, but the other was buried under girders and masonry. Dr. Bateman volunteered to crawl under the wreckage and administer an anaesthetic. A porter held her, suspended by her ankles, while she reached the casualty and successfully carried out the injection. A slight subsidence might have resulted in her being trapped and fatally crushed. The danger was very apparent, but this did not deter Dr. Bateman from carrying out a gallant and difficult action." The Minister of Health (Circ. 2407) calls the attention of authorities to the desirability on nutritional grounds of making available to patients and staffs of hospitals within the Emergency Hospital Scheme, and to inmates and staffs of any other residential Institutions under the control of local authorities, bread made of national wheatmeal flour. This flour contains the greater part of the germ of the wheat, with some of the finer bran, but excludes the coarser bran. It thus contains not only most of the vitamin B~ but also most of the remainder of the vitamin B complex, as well as valuable mineral elements which are removed in producing white flour.
PUBLIC HEALTH CORRESPONDENCE DIPHTHERIAIMMUNISATION To the Editor o[ PUBLIC HEALTH SIR,--I have to thank you for your comments (PUBLIC HEALTH, July, 1941, p. 175) on my recent article in the Medical Officer. There are one or two small comments arising out of those remarks which seem worth while. In the first place, is not the Emergency Hospital Laboratory Service a child of the Ministry of Health, and is it a fact that the father advises two injections of A.P.T. of 0'2 c.cm. and 0"5 c.cm., while the rebellious child (to wit, the E.H.L.S.) specifically advises the dosage o.f 0'1 and 0"3 c.cm. of A.P.T.? Is it a case of the right hand not knowing what the left is doing, or is the policy of the Ministry really to countenance the smaller dosage and are the responsible officials hiding behind the petticoats of the E.M.S.? The whole thing savours a little of Dr. Jekyll and Mr. Hyde. The other important point is based on the famous quotation: " T h e evil that men do lives after them. The good is oft interred with their bones." I may be accused of undue anxiety about the ultimate effect on the community of imperfection in the immunisation of individual cases. But in this respect I beg to point out that the failures are shouted from the housetops locally, while all the sound but unknown work which has protected numerous other children passes unrecognised because it is unseen, and because it could never be proved that any of the children concerned would have contracted diphtheria. In the field of diphtheria prophylaxis I object to being classed with the scientists. I imagine that I have been in more intimate contact with more parents than most people in the country in the course of my work, and I know, from peace-time experience, that if we want our clinics to advertise themselves failure must be kept as low as possible. Britons are probably the most thoughtful people on earth when it comes to sizing up the value of anything they are asked to do for their own good. The more we can convince them of the worth of what we are doing, the sooner shall we have the demand for universal immunisation, as opposed to the war-time receptivity of guidance which you so rightly mention is prevalent at the present time. I am hard at work assessing the degree of enormity of the failure of the Ministry (or ought we to say Emergency Hospital Laboratory Service) campaign for the immunisation of our child population. When the facts collected are sufficient, they will be published. In the meantime,, it has reached my ears that some people have thought that something was wrong with Schick toxin because it gave such strongly positive readings after adopting the Jekyll and Hyde dosage of 0"l and 0"3 c.cm. of a certain brand of A.P.T. Would anyone like to say anything about that? Or may I perhaps be right in saying that the Ministry is leading the Nation right up the garden.--I am, etc., GuY BOUSFIELD. London, S.E.5. ]uly 22nd, 1941. 215
Award for Gallantry in Civil Defenee The award of the George Medal to Dr. Laura Bateman, Medical Officer, Brook Hospital, Shooter's Hill, is announced in a Supplement to the London Gazette dated June 13th. The announcement reads as follows: " When the Brook Hospital was bombed two maids were imprisoned by debris, Dr. Bateman quickly relieved the suffering of the first maid, but the other was buried under girders and masonry. Dr. Bateman volunteered to crawl under the wreckage and administer an anaesthetic. A porter held her, suspended by her ankles, while she reached the casualty and successfully carried out the injection. A slight subsidence might have resulted in her being trapped and fatally crushed. The danger was very apparent, but this did not deter Dr. Bateman from carrying out a gallant and difficult action." The Minister of Health (Circ. 2407) calls the attention of authorities to the desirability on nutritional grounds of making available to patients and staffs of hospitals within the Emergency Hospital Scheme, and to inmates and staffs of any other residential Institutions under the control of local authorities, bread made of national wheatmeal flour. This flour contains the greater part of the germ of the wheat, with some of the finer bran, but excludes the coarser bran. It thus contains not only most of the vitamin B~ but also most of the remainder of the vitamin B complex, as well as valuable mineral elements which are removed in producing white flour.
PUBLIC HEALTH CORRESPONDENCE DIPHTHERIAIMMUNISATION To the Editor o[ PUBLIC HEALTH SIR,--I have to thank you for your comments (PUBLIC HEALTH, July, 1941, p. 175) on my recent article in the Medical Officer. There are one or two small comments arising out of those remarks which seem worth while. In the first place, is not the Emergency Hospital Laboratory Service a child of the Ministry of Health, and is it a fact that the father advises two injections of A.P.T. of 0'2 c.cm. and 0"5 c.cm., while the rebellious child (to wit, the E.H.L.S.) specifically advises the dosage o.f 0'1 and 0"3 c.cm. of A.P.T.? Is it a case of the right hand not knowing what the left is doing, or is the policy of the Ministry really to countenance the smaller dosage and are the responsible officials hiding behind the petticoats of the E.M.S.? The whole thing savours a little of Dr. Jekyll and Mr. Hyde. The other important point is based on the famous quotation: " T h e evil that men do lives after them. The good is oft interred with their bones." I may be accused of undue anxiety about the ultimate effect on the community of imperfection in the immunisation of individual cases. But in this respect I beg to point out that the failures are shouted from the housetops locally, while all the sound but unknown work which has protected numerous other children passes unrecognised because it is unseen, and because it could never be proved that any of the children concerned would have contracted diphtheria. In the field of diphtheria prophylaxis I object to being classed with the scientists. I imagine that I have been in more intimate contact with more parents than most people in the country in the course of my work, and I know, from peace-time experience, that if we want our clinics to advertise themselves failure must be kept as low as possible. Britons are probably the most thoughtful people on earth when it comes to sizing up the value of anything they are asked to do for their own good. The more we can convince them of the worth of what we are doing, the sooner shall we have the demand for universal immunisation, as opposed to the war-time receptivity of guidance which you so rightly mention is prevalent at the present time. I am hard at work assessing the degree of enormity of the failure of the Ministry (or ought we to say Emergency Hospital Laboratory Service) campaign for the immunisation of our child population. When the facts collected are sufficient, they will be published. In the meantime,, it has reached my ears that some people have thought that something was wrong with Schick toxin because it gave such strongly positive readings after adopting the Jekyll and Hyde dosage of 0"l and 0"3 c.cm. of a certain brand of A.P.T. Would anyone like to say anything about that? Or may I perhaps be right in saying that the Ministry is leading the Nation right up the garden.--I am, etc., GuY BOUSFIELD. London, S.E.5. ]uly 22nd, 1941. 215