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Medical Research in War
PUBLIC HEALTH, August, 1948
224 tioners. This includes a medical library, doctors' common foorn, staff common room, dining room and staff lavatories. A suite comprising a bed-sitting room and private bathroom has been incorporated for the use of a duty doctor at the Health Centre. This accommodation has been planned with serving facilities from the kitchen, to which the caretaker has direct access from his flat, for the preparation of occasional meals. A flat of two bedrooms, living room and the usual service rooms has been provided for the caretaker, having a private entrance. Construction.--In considering the use of prefabricated units, first thought has been given to its suitability for hygienic planning, construction and internal finishes. Impervious washable floors and wall finishes are a practicable proposition in the type of construction selected, with windows giving a full standard of ventilation and sunlight. T h e fact that this system is suitable for erection by semi-skilled and unskilled labour will assist in the balance of skilled labour for essential works. T h e external wall panels are of cavity construction, incorporating high durability and insulating value. Roof lights will be incorporated to give adequate lighting to central service corridors. This method of construction will provide a well-planned Health Centre, capable of a maximum of architectural treatment, both in grouping and external design. [The proposed plan, which is reproduced herewith, has been adopted by Birmingham City Council and submitted to the Ministry of Health for approval. It will be recalled that in Birmingham the School Health Service is separately administered under the Education Committee, so that provision for this service does not appear among the local autl~ority services to be included in this Health Centre. We are indebted to Dr. H. P. Newsholme, M.O.H., and Mr. Goldfinch for permission to publish the general plan and perspective drawing of the Centre.--Editor, PUBLIC HEALTH.]
On nutrition the M.R.C. advised the Ministry of Food. and it is fairly plain that the results of feeding the population during the blockade have been a triumph for those who have been working in nutritional research for the past 30 years. Notable action introduced on the advice of the M.R.C. was the fortification of margarine and bread and the raising of the extraction of flour to 85%. T h e report says that the changes in the nature of the dietary and the more equitable distribution of foods have probably contributed largely ir~ the continued fall in the maternity and infant mortality rates and the still-birth rate. T h e y think other facts, e.g., the large diminution of rheumatic fever deaths, may also be related to nutritional factors and continue " If unhappily there should be a reversal of feeding policy and a return to the faults of our pre-war dietary, it will no doubt be possible to confirm with more certainty what effects the changed nutritional qualities of the diet have had on the public health." T h e other sections of the report which will particularly interest the public health service are those dealing with research into the physiological problems of the services, which covered such diverse questions as those involved in high altitude flying and deep sea diving, the design of clothing for airmen, men set'ring in the Arctic and tropics, ventilation of warships for tropical service and the training and acclimatization of their crews, and designs of aircraft, guns and armoured vehicles in particular relation to human capabilities or needs. All this drives home the lesson that the work of the physiologist on the human factor applies to all matters where human effort is needed in the civilian as wei1 as in the military field. This, of course, is realised and is continuing in the Industrial Health Research Board of the M.R.C. who added to their knowledge especially during the great activity of the post-Dunkirk period. T h e work of the Board on psychology of industrial health continues and may be of great value in the future success of British industry. Altogether this is a fascinating report and one which should go alongside the Ministry of Health's war years' report as a notable contribution to the history of that time.
CORRESPONDENCE " CAVALCADEOF PUBLIC HEALTH " To the Editor of PUBLIC HEALTH SIR--Your kindly critic, in commenting on the " Cavalcade of Public Health," which was incorporated in our Annual Report, gives me more personal credit than I deserve. I was happy to he enrolled as a member of a student team under the direction of Dr. Ian McCracken. T h e teamwork was great fun and I am glad to know that it produced such an impression of dramatic unity. Yours faithfully, J. M. MACKINTOSH. London School of Hygiene and Tropical Medicine, Keppel Street, London, W.C.1. July lOth, 1948.
BOOK REVIEWS Medical Research in War. Report of the Medical Research Council for the years 1939-45. Cmd. 7335. (Pp. 455. Price 7s, 6d. net.) London : H.M. Stationery Office. 1948. This is a most interesting record of t h e brilliant work carried out by the Medical Research Council during the war years. , Indeed, one feels after reading it how much credit for the attainment of victory in the struggle should go to the scientific workers whose contributions are described in this volume. The main efforts of the M.R.C. in the war were directed to (1) the maintenance of health, covering work on the control of infective disease and on nutrition ; (2) restoration of the wounded and sick, covering work on the sulphonamides, penicillin, control o f cross infection in hospitals and in blood transfusion; (3) factors in human efficiency, covering research on service personnel and the human factor in industry ; and (4) post-war reconstruction, covering industrial health and more recent work on infective disease, notably the common cold and epidemic influenza. T h e magnitude of the M.R.C.'s war organisation is indicated by the list of 1:1o less than 81 committees or sub-committees, each of which was devoted to some specific field or individual problem. U n d e r the heading " T h e maintenance of health," the control of infective disease was mainly based on the organisation of the Emergency Public Health Laboratory Service which is now continued in a permanent form by the N.H.S. Act. Another important committee was that on Tuberculosis in War-time which carried out a nation-wide s u r v e y of non-pulmonary tuberculosis to find out whether the rise in the death rate from that disease in the early part of the war was caused by the bovine or human type of bacillus. T h e general finding was that the raw milk supply of the country appeared to be almost as heavily contaminated with bovine tubercle bacilli now as it was 20 years ago. T h e other work bearing on tuberculosis Was the well-known discovery by Wells, of Oxford, on the possible use of the vole nmrine type of bacillus as an immunising vaccine. T h e other notable achievements and control of disease were the production of paludrine for malaria control and the application of D D T and of new insect repellents in dealing with malarial mosquitoes.
A History of State Medicine in England. By Sir Arthur S, MacNalty, K.C.B., M.A., M.D., F.R.C.P., F.R.C.S., D.e.m (Pp. 83. Price 12s. 6d.) L o n d o n : T h e Royal Institute of Public Health and Hygiene 1948. This book incorporates the FitzPatrick Lectures of the Royal College of Physicians for the years 1946-47 which have been previously published in the journal of the Royal Institute and which we reviewed in the May issue of PUBLIC HEALTH,page 141. W e suggested at that time that if the book were republished in one volume it should be added to the reference library of public health departments, and a re-reading confirms that advice. The publication o f this history of the period from 1837 to i919 is particularly appropriate in the year of the centenary of the first Public Health Act. Handbook of Communicable Diseases for the Use of Medical Officers 0[ Seh001S. Issued by the Medical Officers of Schools Association. l l t h Edition. (Pp. 71. Price 5s.) L o n d o n : J. & A. Churchill, Ltd. 1948. T h e history of this handbook (formerly known as " A Code of Rules ") now goes back 62 years. T h e Committee of the Medical Officers of Schools Association which d/'afted this l l t h edition consisted of the medical officers of three public schools and of Drs. W. H. Bradley, of the Ministry of Health, J. A. H. Brincker (formerly P.M.O., L.C.C.), A. H. Gale, of the Ministries of Health and Education, and Maurice Mitman, of the River Fever Hospital, L.C.C. Credit for the bulk of the work in issuing it is given to Dr. C. M. Billington, Medical Officer of Haileybury and I.S.C. and Honorary Secretary of the Association. T h e Committee have given full weight in this edition to the booklet " The Control of Communicable Diseases," prepared by the American Public Health Association in consultation with the British Ministry of Health and have adopted the format of that book in presenting each disease with the addition of a new item " Return to School." T h e handbook therefore recognises the changes in the virulence and infectivity of certain diseases within recent years and should give a reliable guidance to all responsible for the health of residential schools, it is reeognised that a further edition will be called for and the Association ask that any suggestions or fresh knowledge should be communicated to the Honorary Secretary of the Association at 11, Chandos Street, London, W.I. The Child's Hearing for Speech. By MARY D. SHERIDAN,M.A., M.D., D.C.H., L.R.A.M. (Pp. 120. Price 10s. 6d.) London : Methuen & Co. 1948. Dr. Mary Sheridan has been well known to colleagues in the Society for many years as an active member of the School Health Service Group. T h e great interest of this book is that the material is the result of so-called routine work in the course of Dr. Sheridan's duties as an assistant school medical officer in Manchester, although she was able to collect some other material in the neighbouring borough of Salford and she also reviewed the speech of several hundred children in the L.C.C. area and in Cornwall. She acknowledges too
224 tioners. This includes a medical library, doctors' common foorn, staff common room, dining room and staff lavatories. A suite comprising a bed-sitting room and private bathroom has been incorporated for the use of a duty doctor at the Health Centre. This accommodation has been planned with serving facilities from the kitchen, to which the caretaker has direct access from his flat, for the preparation of occasional meals. A flat of two bedrooms, living room and the usual service rooms has been provided for the caretaker, having a private entrance. Construction.--In considering the use of prefabricated units, first thought has been given to its suitability for hygienic planning, construction and internal finishes. Impervious washable floors and wall finishes are a practicable proposition in the type of construction selected, with windows giving a full standard of ventilation and sunlight. T h e fact that this system is suitable for erection by semi-skilled and unskilled labour will assist in the balance of skilled labour for essential works. T h e external wall panels are of cavity construction, incorporating high durability and insulating value. Roof lights will be incorporated to give adequate lighting to central service corridors. This method of construction will provide a well-planned Health Centre, capable of a maximum of architectural treatment, both in grouping and external design. [The proposed plan, which is reproduced herewith, has been adopted by Birmingham City Council and submitted to the Ministry of Health for approval. It will be recalled that in Birmingham the School Health Service is separately administered under the Education Committee, so that provision for this service does not appear among the local autl~ority services to be included in this Health Centre. We are indebted to Dr. H. P. Newsholme, M.O.H., and Mr. Goldfinch for permission to publish the general plan and perspective drawing of the Centre.--Editor, PUBLIC HEALTH.]
On nutrition the M.R.C. advised the Ministry of Food. and it is fairly plain that the results of feeding the population during the blockade have been a triumph for those who have been working in nutritional research for the past 30 years. Notable action introduced on the advice of the M.R.C. was the fortification of margarine and bread and the raising of the extraction of flour to 85%. T h e report says that the changes in the nature of the dietary and the more equitable distribution of foods have probably contributed largely ir~ the continued fall in the maternity and infant mortality rates and the still-birth rate. T h e y think other facts, e.g., the large diminution of rheumatic fever deaths, may also be related to nutritional factors and continue " If unhappily there should be a reversal of feeding policy and a return to the faults of our pre-war dietary, it will no doubt be possible to confirm with more certainty what effects the changed nutritional qualities of the diet have had on the public health." T h e other sections of the report which will particularly interest the public health service are those dealing with research into the physiological problems of the services, which covered such diverse questions as those involved in high altitude flying and deep sea diving, the design of clothing for airmen, men set'ring in the Arctic and tropics, ventilation of warships for tropical service and the training and acclimatization of their crews, and designs of aircraft, guns and armoured vehicles in particular relation to human capabilities or needs. All this drives home the lesson that the work of the physiologist on the human factor applies to all matters where human effort is needed in the civilian as wei1 as in the military field. This, of course, is realised and is continuing in the Industrial Health Research Board of the M.R.C. who added to their knowledge especially during the great activity of the post-Dunkirk period. T h e work of the Board on psychology of industrial health continues and may be of great value in the future success of British industry. Altogether this is a fascinating report and one which should go alongside the Ministry of Health's war years' report as a notable contribution to the history of that time.
CORRESPONDENCE " CAVALCADEOF PUBLIC HEALTH " To the Editor of PUBLIC HEALTH SIR--Your kindly critic, in commenting on the " Cavalcade of Public Health," which was incorporated in our Annual Report, gives me more personal credit than I deserve. I was happy to he enrolled as a member of a student team under the direction of Dr. Ian McCracken. T h e teamwork was great fun and I am glad to know that it produced such an impression of dramatic unity. Yours faithfully, J. M. MACKINTOSH. London School of Hygiene and Tropical Medicine, Keppel Street, London, W.C.1. July lOth, 1948.
BOOK REVIEWS Medical Research in War. Report of the Medical Research Council for the years 1939-45. Cmd. 7335. (Pp. 455. Price 7s, 6d. net.) London : H.M. Stationery Office. 1948. This is a most interesting record of t h e brilliant work carried out by the Medical Research Council during the war years. , Indeed, one feels after reading it how much credit for the attainment of victory in the struggle should go to the scientific workers whose contributions are described in this volume. The main efforts of the M.R.C. in the war were directed to (1) the maintenance of health, covering work on the control of infective disease and on nutrition ; (2) restoration of the wounded and sick, covering work on the sulphonamides, penicillin, control o f cross infection in hospitals and in blood transfusion; (3) factors in human efficiency, covering research on service personnel and the human factor in industry ; and (4) post-war reconstruction, covering industrial health and more recent work on infective disease, notably the common cold and epidemic influenza. T h e magnitude of the M.R.C.'s war organisation is indicated by the list of 1:1o less than 81 committees or sub-committees, each of which was devoted to some specific field or individual problem. U n d e r the heading " T h e maintenance of health," the control of infective disease was mainly based on the organisation of the Emergency Public Health Laboratory Service which is now continued in a permanent form by the N.H.S. Act. Another important committee was that on Tuberculosis in War-time which carried out a nation-wide s u r v e y of non-pulmonary tuberculosis to find out whether the rise in the death rate from that disease in the early part of the war was caused by the bovine or human type of bacillus. T h e general finding was that the raw milk supply of the country appeared to be almost as heavily contaminated with bovine tubercle bacilli now as it was 20 years ago. T h e other work bearing on tuberculosis Was the well-known discovery by Wells, of Oxford, on the possible use of the vole nmrine type of bacillus as an immunising vaccine. T h e other notable achievements and control of disease were the production of paludrine for malaria control and the application of D D T and of new insect repellents in dealing with malarial mosquitoes.
A History of State Medicine in England. By Sir Arthur S, MacNalty, K.C.B., M.A., M.D., F.R.C.P., F.R.C.S., D.e.m (Pp. 83. Price 12s. 6d.) L o n d o n : T h e Royal Institute of Public Health and Hygiene 1948. This book incorporates the FitzPatrick Lectures of the Royal College of Physicians for the years 1946-47 which have been previously published in the journal of the Royal Institute and which we reviewed in the May issue of PUBLIC HEALTH,page 141. W e suggested at that time that if the book were republished in one volume it should be added to the reference library of public health departments, and a re-reading confirms that advice. The publication o f this history of the period from 1837 to i919 is particularly appropriate in the year of the centenary of the first Public Health Act. Handbook of Communicable Diseases for the Use of Medical Officers 0[ Seh001S. Issued by the Medical Officers of Schools Association. l l t h Edition. (Pp. 71. Price 5s.) L o n d o n : J. & A. Churchill, Ltd. 1948. T h e history of this handbook (formerly known as " A Code of Rules ") now goes back 62 years. T h e Committee of the Medical Officers of Schools Association which d/'afted this l l t h edition consisted of the medical officers of three public schools and of Drs. W. H. Bradley, of the Ministry of Health, J. A. H. Brincker (formerly P.M.O., L.C.C.), A. H. Gale, of the Ministries of Health and Education, and Maurice Mitman, of the River Fever Hospital, L.C.C. Credit for the bulk of the work in issuing it is given to Dr. C. M. Billington, Medical Officer of Haileybury and I.S.C. and Honorary Secretary of the Association. T h e Committee have given full weight in this edition to the booklet " The Control of Communicable Diseases," prepared by the American Public Health Association in consultation with the British Ministry of Health and have adopted the format of that book in presenting each disease with the addition of a new item " Return to School." T h e handbook therefore recognises the changes in the virulence and infectivity of certain diseases within recent years and should give a reliable guidance to all responsible for the health of residential schools, it is reeognised that a further edition will be called for and the Association ask that any suggestions or fresh knowledge should be communicated to the Honorary Secretary of the Association at 11, Chandos Street, London, W.I. The Child's Hearing for Speech. By MARY D. SHERIDAN,M.A., M.D., D.C.H., L.R.A.M. (Pp. 120. Price 10s. 6d.) London : Methuen & Co. 1948. Dr. Mary Sheridan has been well known to colleagues in the Society for many years as an active member of the School Health Service Group. T h e great interest of this book is that the material is the result of so-called routine work in the course of Dr. Sheridan's duties as an assistant school medical officer in Manchester, although she was able to collect some other material in the neighbouring borough of Salford and she also reviewed the speech of several hundred children in the L.C.C. area and in Cornwall. She acknowledges too