MUSTARD-GAS LESIONS OF THE EYE

805 MUSTARD-GAS LESIONS OF THE EYE SiB,—An instruction E.M.S. 1.252 (revised) on the treatment of mustard-gas lesions of the eye has been widely distributed to the officers, consultants and hospitals of the E.M.S. It came before the medical board of Moorfields Eye Hospital " for your information." The board felt that several points in it required comment. 1. The use of Albucid solution is advised at first-aid posts and at hospitals in cases in which the eyes have been affected by gas vapour or gas splashing. It must be pointed out that the use of sulphanilamide preparations is not directed against gas contamination but only against subsequent infection of the conjunctiva and that opinion as to its efficiency in this latter respect is far from being generally favourable. 2. No mention is made in the instruction of the very diverse lesions which may be produced by gas, most of them slight and very few of them serious. 3. No indication is given of the treatment necessary when the cornea is definitely involved, and, while water is advised for irrigation of the eye at an incident and at first-aid posts, no advice is given as to the lotion to be used for the irrigations recommended at hospitals. It would appear that this instruction is not in fact the "result of further experience " and should be withdrawn and replaced by a carefully considered and detailed note based on actual experience obtained in the last war and on substantiated experimental evidence. F. A. JULER, Royal London Ophthalmic MAURICE WHITING. Hospital. BLACKCURRANT PREPARATIONS FOR CHILDREN SiR,-For the past six months vitamin C has been supplied to the infants attending the Erith child-welfare clinics in the form of blackcurrant puree. This puree was supplied in 8-oz. tins. Each ounce was guaranteed to contain between 400 and 600 units of vitamin C (20-30 mg. of ascorbic acid) ; it is approximately twice as strong as orange juice, which, however, varies greatly in its vitamin content. The puree was used in three large weekly clinics, in which attendances averaged 80 per session. Very few children refused it, and of all those seen less than 10 disliked it or seemed at all upset by it. In my experience a larger proportion of children refuse orange juice. The puree was first given cautiously to children over nine months, and later to younger infants. Finally, it was used as a routine measure for all infants from the age of two months upwards, starting with a few drops three times a day in water, and working up gradually to a dosage of half a teaspoon three times a day. To lessen the time during which the vitamin was exposed to the air mothers were advised to share tins with their neighbours. The puree was used in larger doses with rapid effect on one case of acute scurvy and three of latent scurvy. My object in writing this letter is to record that the puree is tolerated and liked by quite small infants, and that therefore the preparation of black-currant juice for them, as you suggest in your annotation of June 7, does not seem to be necessary. CÉCILE ASHER. Finchley.

UNITED

STATES

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AMERICA

MILK-BORNE EPIDEMICS

IN his address to the Ohio State University medical school Dr. James E. Perkins, director of the division of communicable diseases, New York state department of health, related the sum of epidemic disease known to have been milk-borne in the state, exclusive of New York city, in 1917-40. There were 4. outbreaks of bacillary dysentery involving 311 cases ; 5 of diphtheria with 123 cases ; 25 of scarlet fever with 1466 cases ; 30 of septic sore throat with 5138 cases ; and 75 of typhoid and paratyphoid fever with 1203 cases. In 136 out of these 139 outbreaks the milk-supply was frankly raw. Of the 3 remaining outbreaks 2 were due to milk contaminated after pasteurisation and in the third instance, although the milk had been labelled " pasteurised," the evidence clearlv indicated it actually had not been so

treated. The only possible reason for failure to pasteurise milk, said Dr. Perkins, is the excessive cost of treating small supplies. Even that reason is rapidly disappearing. An apparatus is now on the market which w:ll pasteurise economically 48 quarts at a time. CONSCRIPTION OF MEDICAL STUDENTS

In

of the acknowledged need for maintaining the doctors no exception is made in favour of medical students in the terms of the Selective Service Act, and Congress has refused to amend the act to provide exemptions. Various medical bodies have passed resolutions opposing the calling up of medical students and the army has arranged that students graduating this year shall be allowed to take their year of internship before being mobilised. The unwillingness of Congress to amend the law arises from the desire to leave to the local draft boards all decision as to who shall be excused. A Gallup poll shows that 87% of the population favour allowing medical students to finish their course. This suggests that in most cases the local draft boards will take favourable action.

spite supply of

MEDICAL CARE FOR THE UNFIT

Concern is expressed in many quarters that the large number of men found unfit for active service should be rehabilitated if possible by appropriate medical care. Colonel Kopetzky, who besides being director of the medical division of the Selective Service Administration of the New York city area is also the new president of the Medical Society of the state of New York, has proposed that men with remediable physical defects should be taken into the army and promptly referred to hospitals for curative therapy. The American Medical Association has proposed a system which it calls " prehabilitation," under which men will voluntarily submit themselves for examination and if necessary corrective treatment before they are examined for the draft. The recognition by the profession that there is a large number of remediable defects which have not been remedied must have an effect on the distribution of medical care, though it is not yet clear what that effect will be. All the reformers naturally see an opportunity to promote their particular panaceas and the advocates of compulsory health insurance are by no means silent.

Parliament Civil Defence IT was pointed out in the House of Commons last week that civil defence is no longer sticking paper on windows and carrying gas-masks but embraces the whole life of the nation under the blitz. We have passed the stage of improvisation, and Lord STRABOLGI in the Lords, and Mr. KENNETH LINDSAY in the Commons, urged the establishment of a ministry of civil defence to take over functions now shared by half a dozen departments, and ensure the living and working conditions of the civil population against air-attack. The Prime Minister, who had turned the Local Defence Volunteers into the Home Guard, and communal feeding into British Restaurants, could now turn the remnants of 6 Government departments, 12 commissioners, 315 large local authorities, 1200 smaller authorities, and 3,000,000 men and women into a civilian army under a minister of civil defence. Mr. Lindsay also pleaded for a simplification of the machinery of the Ministry of Health in all the reception areas of the country. Dr. HADEN GuEST thought the scope of the proposed ministry should be operational rather than administrative. He suggested the appointment of a small committee of the House to be charged with the swift preparation of a plan. He did not want to displace local government, but he wished to build a steel frame of civil-defence services within it. From the Government side the proposal for a separate ministry of civil defence met with uncompromising opposition. Mr. HERBERT MoRRisoN, home secretary and minister of home security, thought that coordination of the kind suggested would lead to chaos. Could he, for instance, cut the hospitals and medical administration of the Ministry of Health in two ? There was still an ’