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DRUGS FOR INDIA
1151 of the Medical Research Council and the works of the British Aluminium Co., Ltd., at Kinlochleven and Lochaber were chosen for the investigation of this problem. Certain of the men at these works are exposed to a considerable amount of alumina dust of a very fine order, and at the same time to fumes containing traces of fluorine which is generated in the decomposition of cryolite. Some of these men were subjected to a clinical and radiological examination, designed first towards ascertaining whether there is evidence of lung damage following exposure to alumina dust, and secondly, whether there is evidence of any pathological effects resulting from the absorption of fluorine. The number of cases examined was 49, among whom the period of exposure varied from 5 to 39 years. No evidence of pneumoconiosis or other lung disease arising from the dust was discovered and there was no indication that any system or organ was adversely affected by it. The outcome of the inquiry so far justifies the conclusion that alumina does not produce lung disease under the conditions met with and is therefore infinitely to be preferred to powdered flint for the bedding of china biscuit ware in saggers. As to fluorine, no lesion arising from this gas was discovered, but the suggestion is made that a biochemical investigation of the body tissues for fluorine and other gases produced in the furnace-room should be made. We shall watch with interest the results of the application of the new process. DRUGS FOR INDIA
THE extent to which the practice of drug adulteration exists in India was revealed in the report of the Drugs Inquiry Committee. Internal legislation alone can put a stop to it, and this is the prerogative of the provincial governments. The central legislature can only regulate imports, and the Import of Drugs Bill, recently introduced in the Assembly and referred to a select committee, is limited in its scope and will not when it becomes law put a stop to adulteration in the country itself. It can ensure that the drugs which are landed at Indian ports conform to certain standards, but it cannot ensure that the drugs will be of the same standard when they reach the It may be hoped, however, that the consumer. example which the central legislature is setting will be followed in the provinces, and it may well be that through the influence of the press which, for a long time, has been enlightening the public in this matter of sophistication, the provincial governments will be induced to follow the lead of the central government. Be that as it may, the Bill to regulate imports, which is based upon the recommendations of the Inquiry Committee, will serve a useful purpose even if it does no more than stop the entry of inferior goods. It can be readily understood that some exporters to a country where there are no standards of purity may be less careful about the quality of the drugs shipped to that destination than they are when the goods are exported to countries where drug laws are rigidly enforced. This is no reflection on British drug firms which trade with India for it must be remembered that the ports of India are open wide to all comers, and that a considerable proportion of imports are received from the Far East and elsewhere. The standards which the Bill seeks to set up are, in the cases of drugs and medicines, those of the B.P., the B.P.C., and the Extra Pharmaeopceia published by direction of the Council of the Pharmaceutical Society of Great Britain. In the case of vaccines, sera and other biological products the standards are those
proposed by the Permanent Commission on Biological Standardisation of the League of Nations or those prescribed by the B.P. The powers which the Bill seeks to confer on the central government are not confined to the regulation of staple products but extend to proprietary medicines ; there are no standards for such articles but they will fall into the misbranded " category if the container " bears a statement or device relating to the drug or ingre"
dients therein which is false or calculated to mislead." A year ago a central biochemical standardisation laboratory was established at Calcutta, this being in accordance with the recommendations of the Inquiry Committee. The laboratory is an essential part of the scheme which is now being planned. THE MEDICAL USES OF RADIUM
THE activities during 1936 in the experimental laboratories and the clinical research centres coöperating in the special investigation of the effects of radiation are summarised in a green book issued by the Medical Research Council. The subject of radiosensitiveness is receiving much attention ; this is, of course, of the utmost importance to the clinician who has to consider suitable treatments for tumours which may vary widely in their response. The work of Mr. F. G. Spear, D.Sc., and Dr. A. Glucksmann at the Strangeways Research Laboratory has shown that it is possible to discriminate between the effects of radiation, of chilling, and of fasting on mitotic division in tadpoles, and that radiation in the doses used is only effective in producing degeneration when mitosis is either active or approaching a state of activity. The occurrence of degenerate cells has also been studied quantitatively in this laboratory, and the results support the theory that the effect of gamma rays on cells about to divide makes them unfitted for the ordeal of mitosis. Mr. D. E. Lea, Ph.D., in collaboration with the Low Temperature Research Station, has investigated the action of gamma rays on bacteria and concludes that large doses of radiation have in addition to their lethal action the property of inhibiting division without hindering the increase of volume of the individual organism. He has also demonstrated an interesting difference in the reaction of certain organisms to beta radiation though their reaction to gamma radiation is very similar. Dr. J. C. Mottram of the Mount Vernon Hospital and the Radium Institute has attempted to relate radio-resistance to anaerobiosis. Basing his argument on observation of the effect of radiation on the deep lying cells of tar cancers in mice, he suggests that the better the blood-supply the more sensitive the cell. He believes that periods of rapid growth, which can be found by measuring the tumour, are associated with an increased blood-supply and that radiation during these periods is more effective. Certain cases of advanced but slowly evolving cancer in the human subject have been treated by radiation given only during the times of growth, 500 r being given each time radiation is applied, and it is said that a number of tumours have been made to disappear locally. The influence of abundant mitotic division has also been studied and it seems that there must be some difficulty in distinguishing between the two effects with tumours treated in vivo. The statement that tumours composed of small cell masses should be more sensitive than those with large cell masses is open to question, since certain 1 Medical Uses of Radium. Summary of Reports from Research Centres for 1936. Medical Research Council, Special Report Series No. 226. London: H.M. Stationery Office. 1s. 1937. Pp. 41.
THE extent to which the practice of drug adulteration exists in India was revealed in the report of the Drugs Inquiry Committee. Internal legislation alone can put a stop to it, and this is the prerogative of the provincial governments. The central legislature can only regulate imports, and the Import of Drugs Bill, recently introduced in the Assembly and referred to a select committee, is limited in its scope and will not when it becomes law put a stop to adulteration in the country itself. It can ensure that the drugs which are landed at Indian ports conform to certain standards, but it cannot ensure that the drugs will be of the same standard when they reach the It may be hoped, however, that the consumer. example which the central legislature is setting will be followed in the provinces, and it may well be that through the influence of the press which, for a long time, has been enlightening the public in this matter of sophistication, the provincial governments will be induced to follow the lead of the central government. Be that as it may, the Bill to regulate imports, which is based upon the recommendations of the Inquiry Committee, will serve a useful purpose even if it does no more than stop the entry of inferior goods. It can be readily understood that some exporters to a country where there are no standards of purity may be less careful about the quality of the drugs shipped to that destination than they are when the goods are exported to countries where drug laws are rigidly enforced. This is no reflection on British drug firms which trade with India for it must be remembered that the ports of India are open wide to all comers, and that a considerable proportion of imports are received from the Far East and elsewhere. The standards which the Bill seeks to set up are, in the cases of drugs and medicines, those of the B.P., the B.P.C., and the Extra Pharmaeopceia published by direction of the Council of the Pharmaceutical Society of Great Britain. In the case of vaccines, sera and other biological products the standards are those
proposed by the Permanent Commission on Biological Standardisation of the League of Nations or those prescribed by the B.P. The powers which the Bill seeks to confer on the central government are not confined to the regulation of staple products but extend to proprietary medicines ; there are no standards for such articles but they will fall into the misbranded " category if the container " bears a statement or device relating to the drug or ingre"
dients therein which is false or calculated to mislead." A year ago a central biochemical standardisation laboratory was established at Calcutta, this being in accordance with the recommendations of the Inquiry Committee. The laboratory is an essential part of the scheme which is now being planned. THE MEDICAL USES OF RADIUM
THE activities during 1936 in the experimental laboratories and the clinical research centres coöperating in the special investigation of the effects of radiation are summarised in a green book issued by the Medical Research Council. The subject of radiosensitiveness is receiving much attention ; this is, of course, of the utmost importance to the clinician who has to consider suitable treatments for tumours which may vary widely in their response. The work of Mr. F. G. Spear, D.Sc., and Dr. A. Glucksmann at the Strangeways Research Laboratory has shown that it is possible to discriminate between the effects of radiation, of chilling, and of fasting on mitotic division in tadpoles, and that radiation in the doses used is only effective in producing degeneration when mitosis is either active or approaching a state of activity. The occurrence of degenerate cells has also been studied quantitatively in this laboratory, and the results support the theory that the effect of gamma rays on cells about to divide makes them unfitted for the ordeal of mitosis. Mr. D. E. Lea, Ph.D., in collaboration with the Low Temperature Research Station, has investigated the action of gamma rays on bacteria and concludes that large doses of radiation have in addition to their lethal action the property of inhibiting division without hindering the increase of volume of the individual organism. He has also demonstrated an interesting difference in the reaction of certain organisms to beta radiation though their reaction to gamma radiation is very similar. Dr. J. C. Mottram of the Mount Vernon Hospital and the Radium Institute has attempted to relate radio-resistance to anaerobiosis. Basing his argument on observation of the effect of radiation on the deep lying cells of tar cancers in mice, he suggests that the better the blood-supply the more sensitive the cell. He believes that periods of rapid growth, which can be found by measuring the tumour, are associated with an increased blood-supply and that radiation during these periods is more effective. Certain cases of advanced but slowly evolving cancer in the human subject have been treated by radiation given only during the times of growth, 500 r being given each time radiation is applied, and it is said that a number of tumours have been made to disappear locally. The influence of abundant mitotic division has also been studied and it seems that there must be some difficulty in distinguishing between the two effects with tumours treated in vivo. The statement that tumours composed of small cell masses should be more sensitive than those with large cell masses is open to question, since certain 1 Medical Uses of Radium. Summary of Reports from Research Centres for 1936. Medical Research Council, Special Report Series No. 226. London: H.M. Stationery Office. 1s. 1937. Pp. 41.