- Email: [email protected]
DETERGENT TREATMENT OF CONSTIPATION
128
ANNOTATIONS
Annotations _
AUTOMATION
that the cultured life of ancient slave labour, might be coming within reach again-with the slaves, of course, humanely displaced by machines. Intimations of automation (now in its early childhood) trail the clouds of glory nearer. The comic irony which dogs mankind will doubtless ensure that there is a catch, if not several catches, in it ; but in time, probably everything will be relatively splendid. Meanwhile those who survey the prospect with wide and shining eyes are mainly engineers. A push-button factory, doing the whole job under the care of a handful of men, most of them engaged in maintenance, has been described as " technically possible, economically sound and humanly desirable."1 P.E.P. give facts which suggest that the first of these claims is accurate, the second doubtful, and the third anybody’s guess.2 The term " automation " has been defined by R. K. Geiser at an American conference as "the accomplishment of a job by an integrated mechanism with a minimum of assistance of any kind." This might, of course, merely mean doing thejob oneself, but in industry it is taken to refer to the accomplishment of a job by means of various modern mechanical devices electronic, electromechanical, pneumatic, hydraulic, and others. Electronic devices in particular have a respectable future in this field, since they can be constructed IT has
long seemed
Greece, based
"
on
plan and control the operation of a machine tool with high precision, detect faults in a processed part, and by means of a closed-loop circuit (widely known as ’feed-back’) can communicate the error to the machine and adjust its operation so as to correct the fault ; they can integrate the work of individual machines ; the more complex of them can to
choose between alternative decisions or courses of action according to the instructions given them; finally, they extend the possibilities of remote control."
thus be used to reduce greatly the amount of They routine brainwork done in a factory, just as ordinary machines have reduced the amount of routine muscular work. P.E.P. mention some ways in which firms have already introduced the principle of automation. can
refinery built by the Esso Petroleum Fawley, six men on any one shift operate distillation units processing 51/2 million gallons of crude oil daily-thus meeting nearly a third of our inland daily consumption of oil products. At the catalytic cracking plant, eight men are needed in each shift. The new instruments which have made this possible have paid for themselves rapidly-those that control tank temperature in 6 months and the automatic apparatus for laboratory distillation in In the 1:40 million
Company
at
6 weeks. The Ford Motor
Company, in America, was a pioneer of automation, having installed the world’s first car assembly line in 1914. Automatic transfer machines now move parts from one machine to another for the next stage of the process (cylinder heads, for instance, are produced by what amounts The Austin Motor Company has to no-touch technique). adopted the same principles, and has gone further, transferring parts by overhead trolleys to the final assembly line, at the right time and in the right order. This unusual achievement in human affairs is the work of an electronic control unit, receiving its instruction from punched cards.
’
of their London employees, analyses daily the trend of bakery orders in Lyons teashops; and for a consideration gives sparetime help to outside bodies. At the Fawley refinery, the " computer Hec helps to select a production plan to meet the changing requirements of the market, and does all the mathematical work entailed in a mass-spectrometer analysis of refinery gases. Computer salesmen, however, like travellers in cement
docks, have at present to be content with only occasional As P.E.P. say, " it is easier to sell an instrument for a clearly defined and labour-saving purpose, like wage-calculation, than for a new and relatively success.
There is untried purpose like planning production." already, however, the air-line " reservisor " in New York, which, when a button is pressed in a ticketagency, correctly books or cancels passenger reservations at the La Guardia airport ; but even this is economic only because New York is such a busy centre for air travel. Enthusiasts for automation are vexed by the piecemeal manner in which many manufacturers are succumbing to its charms. This is an opportunity, they say, for working out the basic principles of factory and office organisation afresh. The manufacturers, however, are probably right to be cautious : for having installed an automatic office to deal with their wagebill, and built an automatic factory controlled by buttons, they might well find that their new wage-bill could be worked out by one little girl on a slate.
At
present,
create is the
help our
Will
as
P.E.P. remark, automation
seems
to
problems as it solves. Where, for instance, capital outlay to come from ? Would automation as
us
many
to balance
power
our overseas
resources
equal
payments
to the
or
probable
not ? Are demand ? make the
be flexible enough to necessary drastic changes, and make them quickly Will automation mean serious unemployment’? And what will be the effect on the community ?Some people are already attempting to answer these questions. The Institution of Production Engineers held a conference at Margate in June on The Automatic Factory: what does it mean ? The Department of Scientific and Industrial Research is collecting information and assessing trends, and its joint committee (with the Medical Research Council) on human relations in industry has sponsored a pilot research project at Cambridge, into " some human and social aspects of introducing automatic control techniques in industry." The National Physical Laboratory is looking into the technical possiclerical work at the Ministry of bility of Pensions and National Insurance-a revolutionary project. On the subject of unemployment P.E.P. are tentatively reassuring : our labour force will grow only from 23 million in 1954 to 24 million in 1979. A higher standard of living must depend on higher production, and thanks to automation this could be achieved with shorter working hours. Our passages to ancient Greece (with no return tickets for Erewhon) seem to be booked. It remains to be seen whether we use our greater leisure - when it comes-to equally good purpose.
management
"
"
mechanising
DETERGENT TREATMENT OF CONSTIPATION
Messrs. J. Lyons & Co. have " Leo," an electronic office which works out the weekly wage packets of more than 7000
PURGATIVES that are efficacious and safe, and themselves cause no troublesome symptoms, are singularly few. After twelve years’ observation Wilson and Dickinson/ of Ann Arbor, claim this combination of qualities for a wetting agent-dioetyl sodium sulphosuccinate (’Aerosol T ’)-which acts by promoting the penetration into hard faeces of water or mineral oil. Previous experimental work had yielded no evidence of toxicity 2 ; and Wilson and Dickinson have adminis-
1. Lilley, S. Discovery, April, 1955, p. 147. 2. Towards the Automatic Factory. Planning, 1955, 21, no. 380. Published by Political and Economic Planning, 16, Queen Anne’s Gate, London, S.W.1. 2s. 6d.
1. Wilson, J. L., Dickinson, D. G. J. Amer. med. Ass. 1955, 158, 261. 2. Benaglia, A. E., Robinson, E. J., Utley, E., Cleverdon, M. A. J. industr. Hyg. 1943, 25, 175.
Another prospect is the automatic office, where all calculations and manipulations of facts are made by instruments and machines.
129
ANNOTATIONS
tered the detergent in doses far exceeding those needed for purgation, without evoking toxic signs. Investigation of the effects on absorption of food gave equivocal results ; but it seemed clear that the detergent neither greatly aided nor grossly inhibited absorption. The Ann Arbor workers have administered dioctyl sodium sulphosuccinate in 1% aqueous solution to four types of patients : those with impacted faeces ; infants with hard lumpy faeces, often after anal fissure had developed ; infants with postoperative anal atresia ; and patients with poliomyelitis or other immobilising illness. The detergent has proved most dramatically successful in the first of these groups-and notably in children with megacolon. In a few of these cases where other measures had failed and symptoms of obstruction were appearing, administration of the detergent saved the patient from laparotomy. In patients with megacolon 2 ml. of a 1 % solution was given thrice daily by mouth, together with enemas of 1-2 oz. of mineral oil ; in less severe cases of constipation the detergent was effective in smaller doses, by itself. Wilson and Dickinson conclude that it can safely be administered repeatedly without loss of efficacy or risk to the patient. STAFFING THE TRANSFUSION SERVICE SEVERAL laboratories of the National Blood Transfusion Service are having serious difficulties in finding technical staff. There are two reasons : the prospects for promotion in blood-transfusion centres are not encouraging when compared with similar posts in hospital laboratories ; and the salaries are generally less attractive than those offered by commercial and industrial concerns and by other Government departments maintaining laboratories. There is no national policy for training and retaining laboratory technicians in the transfusion service. Promotion depends on the individual’s ability to pass the examinations of the Institute of Medical Laboratory Technology ; but unfortunately the work of a bloodtransfusion laboratory bears little relation to the syllabus for the institute’s examinations, with the result that technicians naturally transfer as soon as they can from these specialised units to hospital laboratories where the work is of wider scope and of more relevance to their examination questions. During August and September, school-leavers fill the vacancies for junior technical staff in medical laboratories throughout the country. Further vacancies during winter and spring are likely to be filled by applicants transferring from more specialised units, such as the blood-transfusion laboratories, which are in turn left with seriously depleted staff. For example, the Sheffield laboratory is at present struggling to maintain services with a technical staff of 17. Allowing for leave and sickness, this means that 15 pairs of hands are trying to do the work of a total establishment of 34. Moreover, some of those remaining on the staff are comparatively inexperienced. Standards of work have had to be lowered, and mistakes must be more likely when the staff is grossly overworked. Similar conditions exist at other centres. In view of the staff difficulties in the Sheffield region, the senior administrative medical officer of the regional hospital board has asked hospitals to limit the use of blood to urgent cases. Much more thought must be given to supplying the transfusion service with senior technical staff. Qualified associates and fellows of the institute are not anxious to enter this specialised field while there are good opportunities for extremely rapid promotion in general laboratories. If any should decide to enter the transfusion service it would be exceptional if much of their previous experience was appropriate to the work of a senior technician in that service, and many more months of training will be necessary. The most experienced and reliable workers at many of the
regional
transfusion laboratories
are
qualification and have been graded on age and experience " alone. There is no-one in sight at the moment to take their place. If a vital service is not to be dangerously cramped by recurrent staff difficulties, pay and promotion prospects must be improved. Yet, at a Whitley Council meeting last week, the management side apparently had no recommendations to m3lke concerning the salary of student and junior technicians.
without academic "
CANCER RESEARCH MANY occupational cancers are now detectable and preventable because the carcinogen that causes them has been identified. Similarly, if tobacco-smoking and air pollution prove to be direct causes of cancer, with their own particular carcinogens, it will be possible to curb the mounting death-rate from carcinoma of the lung. The annual report of the British Empire Cancer Campaign,
which appears this week, tells how examination of the products of cigarette-smoking is proceeding in six research centres, and inquiries into atmospheric pollution in four. Benzpyrene and other carcinogenic chemicals are being sought. Benzpyrene has been found as 100 parts per million of soot, but not all investigators have found it in tobacco tar. It is, however, uncertain whether benzpyrene itself is carcinogenic in man. Tests of benzpyrene and of tobacco tar are being made by I. Lasnitzki, using the method of organ culture in vitro on human foetal lung. Early stages of carcinoma of mouse prostate induced with methylcholanthrene were reproduced in this way. It is hoped that the same method will give information about the susceptibility of human lungs. The quest for curative cytotoxic agents is being pursued in many laboratories. The report refers to tests on grafted animal tumours with one of the newer synthetic chemicals. Unfortunately none of these substances discriminate sufficiently between tumour cells and all normal host cells : normal blood-forming cells are equally liable to damage ; and whereas tumour cells may become resistant to these drugs, normal blood-cells do not. Two naturally occurring enzymes, xanthine oxidase and ribonuclease, have been found by F. Bergel and his collaborators to restrain a variety of animal tumours. Intravenous ’Synkavit’ and X-irradiation combined with oxygen administration are being tested clinically by J. S. Mitchell and his collaborators in the treatment of bronchial carcinoma. F. S. Dainton and T. J. Hardwick suggest a possible reason for greater efficacy of X-irradiation when combined with the giving of oxygen. Efforts to discover an essential difference between normal and tumour cells include work on normal nucleic acids-an essential step in an attack on the abnormal. New comparisons are being made on the ability of hepatoma cells to produce albumin and on their content of trace elements. Although in some respects the results of biochemical investigations of hepatoma are not regarded as typical of cancer cells in genera1,1 these malignant cells and their normal homologues offer many advantages for comparisons of this kind. Morphological studies by electron microscopy, which have been finely illustrated and described by Howatson and Ham,2 are in accord with the biochemist’s conclusion that hepatoma and fcetal liver are similar metabolically and in enzyme activity. Early embryonic cells resembled neoplastic ones more closely than did normal adult cells. By means of phase and ultraviolet microscopy of- various living tumour cells and their normal counterparts, combined with the examination of fixed specimens, R. J. Ludford concludes that none of the pathological changes in tumour-cell nuclei are specific features peculiar to 1. Greenstein, J. P. Biochemistry of Cancer. New York, 1954. 2. Howatson, A. F., Ham, A. W. Cancer Res. 1955, 15, 62.
ANNOTATIONS
Annotations _
AUTOMATION
that the cultured life of ancient slave labour, might be coming within reach again-with the slaves, of course, humanely displaced by machines. Intimations of automation (now in its early childhood) trail the clouds of glory nearer. The comic irony which dogs mankind will doubtless ensure that there is a catch, if not several catches, in it ; but in time, probably everything will be relatively splendid. Meanwhile those who survey the prospect with wide and shining eyes are mainly engineers. A push-button factory, doing the whole job under the care of a handful of men, most of them engaged in maintenance, has been described as " technically possible, economically sound and humanly desirable."1 P.E.P. give facts which suggest that the first of these claims is accurate, the second doubtful, and the third anybody’s guess.2 The term " automation " has been defined by R. K. Geiser at an American conference as "the accomplishment of a job by an integrated mechanism with a minimum of assistance of any kind." This might, of course, merely mean doing thejob oneself, but in industry it is taken to refer to the accomplishment of a job by means of various modern mechanical devices electronic, electromechanical, pneumatic, hydraulic, and others. Electronic devices in particular have a respectable future in this field, since they can be constructed IT has
long seemed
Greece, based
"
on
plan and control the operation of a machine tool with high precision, detect faults in a processed part, and by means of a closed-loop circuit (widely known as ’feed-back’) can communicate the error to the machine and adjust its operation so as to correct the fault ; they can integrate the work of individual machines ; the more complex of them can to
choose between alternative decisions or courses of action according to the instructions given them; finally, they extend the possibilities of remote control."
thus be used to reduce greatly the amount of They routine brainwork done in a factory, just as ordinary machines have reduced the amount of routine muscular work. P.E.P. mention some ways in which firms have already introduced the principle of automation. can
refinery built by the Esso Petroleum Fawley, six men on any one shift operate distillation units processing 51/2 million gallons of crude oil daily-thus meeting nearly a third of our inland daily consumption of oil products. At the catalytic cracking plant, eight men are needed in each shift. The new instruments which have made this possible have paid for themselves rapidly-those that control tank temperature in 6 months and the automatic apparatus for laboratory distillation in In the 1:40 million
Company
at
6 weeks. The Ford Motor
Company, in America, was a pioneer of automation, having installed the world’s first car assembly line in 1914. Automatic transfer machines now move parts from one machine to another for the next stage of the process (cylinder heads, for instance, are produced by what amounts The Austin Motor Company has to no-touch technique). adopted the same principles, and has gone further, transferring parts by overhead trolleys to the final assembly line, at the right time and in the right order. This unusual achievement in human affairs is the work of an electronic control unit, receiving its instruction from punched cards.
’
of their London employees, analyses daily the trend of bakery orders in Lyons teashops; and for a consideration gives sparetime help to outside bodies. At the Fawley refinery, the " computer Hec helps to select a production plan to meet the changing requirements of the market, and does all the mathematical work entailed in a mass-spectrometer analysis of refinery gases. Computer salesmen, however, like travellers in cement
docks, have at present to be content with only occasional As P.E.P. say, " it is easier to sell an instrument for a clearly defined and labour-saving purpose, like wage-calculation, than for a new and relatively success.
There is untried purpose like planning production." already, however, the air-line " reservisor " in New York, which, when a button is pressed in a ticketagency, correctly books or cancels passenger reservations at the La Guardia airport ; but even this is economic only because New York is such a busy centre for air travel. Enthusiasts for automation are vexed by the piecemeal manner in which many manufacturers are succumbing to its charms. This is an opportunity, they say, for working out the basic principles of factory and office organisation afresh. The manufacturers, however, are probably right to be cautious : for having installed an automatic office to deal with their wagebill, and built an automatic factory controlled by buttons, they might well find that their new wage-bill could be worked out by one little girl on a slate.
At
present,
create is the
help our
Will
as
P.E.P. remark, automation
seems
to
problems as it solves. Where, for instance, capital outlay to come from ? Would automation as
us
many
to balance
power
our overseas
resources
equal
payments
to the
or
probable
not ? Are demand ? make the
be flexible enough to necessary drastic changes, and make them quickly Will automation mean serious unemployment’? And what will be the effect on the community ?Some people are already attempting to answer these questions. The Institution of Production Engineers held a conference at Margate in June on The Automatic Factory: what does it mean ? The Department of Scientific and Industrial Research is collecting information and assessing trends, and its joint committee (with the Medical Research Council) on human relations in industry has sponsored a pilot research project at Cambridge, into " some human and social aspects of introducing automatic control techniques in industry." The National Physical Laboratory is looking into the technical possiclerical work at the Ministry of bility of Pensions and National Insurance-a revolutionary project. On the subject of unemployment P.E.P. are tentatively reassuring : our labour force will grow only from 23 million in 1954 to 24 million in 1979. A higher standard of living must depend on higher production, and thanks to automation this could be achieved with shorter working hours. Our passages to ancient Greece (with no return tickets for Erewhon) seem to be booked. It remains to be seen whether we use our greater leisure - when it comes-to equally good purpose.
management
"
"
mechanising
DETERGENT TREATMENT OF CONSTIPATION
Messrs. J. Lyons & Co. have " Leo," an electronic office which works out the weekly wage packets of more than 7000
PURGATIVES that are efficacious and safe, and themselves cause no troublesome symptoms, are singularly few. After twelve years’ observation Wilson and Dickinson/ of Ann Arbor, claim this combination of qualities for a wetting agent-dioetyl sodium sulphosuccinate (’Aerosol T ’)-which acts by promoting the penetration into hard faeces of water or mineral oil. Previous experimental work had yielded no evidence of toxicity 2 ; and Wilson and Dickinson have adminis-
1. Lilley, S. Discovery, April, 1955, p. 147. 2. Towards the Automatic Factory. Planning, 1955, 21, no. 380. Published by Political and Economic Planning, 16, Queen Anne’s Gate, London, S.W.1. 2s. 6d.
1. Wilson, J. L., Dickinson, D. G. J. Amer. med. Ass. 1955, 158, 261. 2. Benaglia, A. E., Robinson, E. J., Utley, E., Cleverdon, M. A. J. industr. Hyg. 1943, 25, 175.
Another prospect is the automatic office, where all calculations and manipulations of facts are made by instruments and machines.
129
ANNOTATIONS
tered the detergent in doses far exceeding those needed for purgation, without evoking toxic signs. Investigation of the effects on absorption of food gave equivocal results ; but it seemed clear that the detergent neither greatly aided nor grossly inhibited absorption. The Ann Arbor workers have administered dioctyl sodium sulphosuccinate in 1% aqueous solution to four types of patients : those with impacted faeces ; infants with hard lumpy faeces, often after anal fissure had developed ; infants with postoperative anal atresia ; and patients with poliomyelitis or other immobilising illness. The detergent has proved most dramatically successful in the first of these groups-and notably in children with megacolon. In a few of these cases where other measures had failed and symptoms of obstruction were appearing, administration of the detergent saved the patient from laparotomy. In patients with megacolon 2 ml. of a 1 % solution was given thrice daily by mouth, together with enemas of 1-2 oz. of mineral oil ; in less severe cases of constipation the detergent was effective in smaller doses, by itself. Wilson and Dickinson conclude that it can safely be administered repeatedly without loss of efficacy or risk to the patient. STAFFING THE TRANSFUSION SERVICE SEVERAL laboratories of the National Blood Transfusion Service are having serious difficulties in finding technical staff. There are two reasons : the prospects for promotion in blood-transfusion centres are not encouraging when compared with similar posts in hospital laboratories ; and the salaries are generally less attractive than those offered by commercial and industrial concerns and by other Government departments maintaining laboratories. There is no national policy for training and retaining laboratory technicians in the transfusion service. Promotion depends on the individual’s ability to pass the examinations of the Institute of Medical Laboratory Technology ; but unfortunately the work of a bloodtransfusion laboratory bears little relation to the syllabus for the institute’s examinations, with the result that technicians naturally transfer as soon as they can from these specialised units to hospital laboratories where the work is of wider scope and of more relevance to their examination questions. During August and September, school-leavers fill the vacancies for junior technical staff in medical laboratories throughout the country. Further vacancies during winter and spring are likely to be filled by applicants transferring from more specialised units, such as the blood-transfusion laboratories, which are in turn left with seriously depleted staff. For example, the Sheffield laboratory is at present struggling to maintain services with a technical staff of 17. Allowing for leave and sickness, this means that 15 pairs of hands are trying to do the work of a total establishment of 34. Moreover, some of those remaining on the staff are comparatively inexperienced. Standards of work have had to be lowered, and mistakes must be more likely when the staff is grossly overworked. Similar conditions exist at other centres. In view of the staff difficulties in the Sheffield region, the senior administrative medical officer of the regional hospital board has asked hospitals to limit the use of blood to urgent cases. Much more thought must be given to supplying the transfusion service with senior technical staff. Qualified associates and fellows of the institute are not anxious to enter this specialised field while there are good opportunities for extremely rapid promotion in general laboratories. If any should decide to enter the transfusion service it would be exceptional if much of their previous experience was appropriate to the work of a senior technician in that service, and many more months of training will be necessary. The most experienced and reliable workers at many of the
regional
transfusion laboratories
are
qualification and have been graded on age and experience " alone. There is no-one in sight at the moment to take their place. If a vital service is not to be dangerously cramped by recurrent staff difficulties, pay and promotion prospects must be improved. Yet, at a Whitley Council meeting last week, the management side apparently had no recommendations to m3lke concerning the salary of student and junior technicians.
without academic "
CANCER RESEARCH MANY occupational cancers are now detectable and preventable because the carcinogen that causes them has been identified. Similarly, if tobacco-smoking and air pollution prove to be direct causes of cancer, with their own particular carcinogens, it will be possible to curb the mounting death-rate from carcinoma of the lung. The annual report of the British Empire Cancer Campaign,
which appears this week, tells how examination of the products of cigarette-smoking is proceeding in six research centres, and inquiries into atmospheric pollution in four. Benzpyrene and other carcinogenic chemicals are being sought. Benzpyrene has been found as 100 parts per million of soot, but not all investigators have found it in tobacco tar. It is, however, uncertain whether benzpyrene itself is carcinogenic in man. Tests of benzpyrene and of tobacco tar are being made by I. Lasnitzki, using the method of organ culture in vitro on human foetal lung. Early stages of carcinoma of mouse prostate induced with methylcholanthrene were reproduced in this way. It is hoped that the same method will give information about the susceptibility of human lungs. The quest for curative cytotoxic agents is being pursued in many laboratories. The report refers to tests on grafted animal tumours with one of the newer synthetic chemicals. Unfortunately none of these substances discriminate sufficiently between tumour cells and all normal host cells : normal blood-forming cells are equally liable to damage ; and whereas tumour cells may become resistant to these drugs, normal blood-cells do not. Two naturally occurring enzymes, xanthine oxidase and ribonuclease, have been found by F. Bergel and his collaborators to restrain a variety of animal tumours. Intravenous ’Synkavit’ and X-irradiation combined with oxygen administration are being tested clinically by J. S. Mitchell and his collaborators in the treatment of bronchial carcinoma. F. S. Dainton and T. J. Hardwick suggest a possible reason for greater efficacy of X-irradiation when combined with the giving of oxygen. Efforts to discover an essential difference between normal and tumour cells include work on normal nucleic acids-an essential step in an attack on the abnormal. New comparisons are being made on the ability of hepatoma cells to produce albumin and on their content of trace elements. Although in some respects the results of biochemical investigations of hepatoma are not regarded as typical of cancer cells in genera1,1 these malignant cells and their normal homologues offer many advantages for comparisons of this kind. Morphological studies by electron microscopy, which have been finely illustrated and described by Howatson and Ham,2 are in accord with the biochemist’s conclusion that hepatoma and fcetal liver are similar metabolically and in enzyme activity. Early embryonic cells resembled neoplastic ones more closely than did normal adult cells. By means of phase and ultraviolet microscopy of- various living tumour cells and their normal counterparts, combined with the examination of fixed specimens, R. J. Ludford concludes that none of the pathological changes in tumour-cell nuclei are specific features peculiar to 1. Greenstein, J. P. Biochemistry of Cancer. New York, 1954. 2. Howatson, A. F., Ham, A. W. Cancer Res. 1955, 15, 62.