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Pasteurization
August 1948
TUBERCLE
Information was also obtained regarding mass-radlography investigations which had been carried out h~ Schleswig-I-Io!steln and Hamburg, both inside the British Zone. The findings do not suggest the existence of any formidable prevalence of tuberculosis, although the classification of the films did not accord closely with that adopted in this country. One extremely Nvourable factor at work in Germany is the adequacy of available institutional accommodation. It was found to vary fi'om 3.4 beds per death in Schleswig-Holstein to I. 9 in Nordrheln-Westfalen and to average at ~,~ beds per death tbr the whole British Zone, which may be compared with 1.3 beds pet' death in England artd Wales. In this way the isolation ofiidb,cdous cases must help in preventing the spread of the disease. But art off-setting factor is the great overcrowding and inferior living conditions in Germany today. The position in the city of Berlin is far less llwourable than in the rest of Germany. A shat'p rise occurred between I9,t,4 and I945, which seems to haw: steadied in t946 and to have comraenccd to decline in ~947, In this city only 0, 7 beds'per annual tuberculosis death are provided in institutions. '['he following figures are of interest: .....
189
VACCINATION PAR LE B.C.G, PAR SCARIFICATIONS CUTANEES. (B.C.G, Vaccination by Cutaneous Scarification.) By L. Negro and J, Bretey, fi'om the Pasteur Institute. Pp. I o7. Paris, Masson et Cie. ~947. This authoritative monograph by collaborators and followers of Calmette and Guerin teemselves has a preface by Professor Marfan who as long ago as i886 propounded his 'law': 'If adults bearing the scars of scrofula are examined, practically none (slightly more than I per cent) of' those whose adenitis was completely healed L~y 15 years of age will be found to have developed active pulmonary tuberculosis. Conversely, if one examines patients with active pulmonary tuberculosis very few (under I per cent) are found to bear scrofulous scars which had healed by the age of 15 ycars.' The introduction points out that two and a llalF million people in France have been vaecinamd with B.C.G. by mouth, subcutaneously o1' intradennally since Igor. It is also maintained that there is a general relationship between tuberculin sensitivity and resistance to tuberculosis~though as Lyle Cummings (~948) points out, this is not necessarily always so, and as Bluhm has shown, the degree of sensitization may be affected by continuing contact with a source of infection, or amy w~ry with the stage or type of a tuberculous lesion. The authors feeI that while it is dlNcult to t:ul,osm (ALL FoRMs) 1,].u~ ioo,ooo PoPuI,A'rlON doubt that B.C,G, vaccination can play an IN BERLIN AND ]'~I,SEWIIERI'.. important r61e in the prevention of tuberculosis, 1938 t 946 it is important to have available a technique Berlin . . . . . 82 Berlin . . . . ,06o which is simple and safe and yet gives, without Hamburg ,, 66 Hamburg .. 85 complications, a rapid and lasting protection. The work is divided into two parts. The first Deutsches Reich 6_- British Zone .. 7~ describes the experimental work of the authors London .. 7~ and their predecessors, leading to the developGlasgow .. t32 ment of the intradermal methods of vaccination. The second describes the clinical study which Various useful suggestions are made for covers the work, mainly of others, on the relations improving the reporting of tuberculosis deaths of allergy and resistance after B.C.G. vaccinand notifications, so that the position in the ation by various methods in man, and the future may be more accurately watched. This effects thereof. little report is an excellent example of good The techniqueof human vacdnation by sca@ation work done while using unsatisfactory material; is then described. All that is required is a vaccineupon it we would congratulate the authors. style and a recently prepared ampoule of B.C.G. containing 75 mgm. per rail, The ampoule is well shaken before opening, The site preferred P A S T E U R I Z A T I O N . By Harry Hill. Second by the authors is the dorsum of the foot, beEdition. H, K, Lewis. Pages viii and ~96. cause the outer aspect of the arm is so often Ill. 73, Price 2~s. used for tuberculin testing. The skin is cleansed This is a comprehensive account of the tech- with ether and a few drops of the suspension are nique of pasteurization with details and placed on the skin ~ to 3 cm. apart, Two or illustrations of the ptant requ[rcd. There are three scratches are made through each drop: in also chapters showing the need for pasteurization newborn infants 4 scratches 0- 5 cm. long with replies to the criticisms which have been through ~ drops, in school clfildren 6 scratches I cm. long through 3 drops and in adults 6 to levelled at the process.
TUBERCLE
Information was also obtained regarding mass-radlography investigations which had been carried out h~ Schleswig-I-Io!steln and Hamburg, both inside the British Zone. The findings do not suggest the existence of any formidable prevalence of tuberculosis, although the classification of the films did not accord closely with that adopted in this country. One extremely Nvourable factor at work in Germany is the adequacy of available institutional accommodation. It was found to vary fi'om 3.4 beds per death in Schleswig-Holstein to I. 9 in Nordrheln-Westfalen and to average at ~,~ beds per death tbr the whole British Zone, which may be compared with 1.3 beds pet' death in England artd Wales. In this way the isolation ofiidb,cdous cases must help in preventing the spread of the disease. But art off-setting factor is the great overcrowding and inferior living conditions in Germany today. The position in the city of Berlin is far less llwourable than in the rest of Germany. A shat'p rise occurred between I9,t,4 and I945, which seems to haw: steadied in t946 and to have comraenccd to decline in ~947, In this city only 0, 7 beds'per annual tuberculosis death are provided in institutions. '['he following figures are of interest: .....
189
VACCINATION PAR LE B.C.G, PAR SCARIFICATIONS CUTANEES. (B.C.G, Vaccination by Cutaneous Scarification.) By L. Negro and J, Bretey, fi'om the Pasteur Institute. Pp. I o7. Paris, Masson et Cie. ~947. This authoritative monograph by collaborators and followers of Calmette and Guerin teemselves has a preface by Professor Marfan who as long ago as i886 propounded his 'law': 'If adults bearing the scars of scrofula are examined, practically none (slightly more than I per cent) of' those whose adenitis was completely healed L~y 15 years of age will be found to have developed active pulmonary tuberculosis. Conversely, if one examines patients with active pulmonary tuberculosis very few (under I per cent) are found to bear scrofulous scars which had healed by the age of 15 ycars.' The introduction points out that two and a llalF million people in France have been vaecinamd with B.C.G. by mouth, subcutaneously o1' intradennally since Igor. It is also maintained that there is a general relationship between tuberculin sensitivity and resistance to tuberculosis~though as Lyle Cummings (~948) points out, this is not necessarily always so, and as Bluhm has shown, the degree of sensitization may be affected by continuing contact with a source of infection, or amy w~ry with the stage or type of a tuberculous lesion. The authors feeI that while it is dlNcult to t:ul,osm (ALL FoRMs) 1,].u~ ioo,ooo PoPuI,A'rlON doubt that B.C,G, vaccination can play an IN BERLIN AND ]'~I,SEWIIERI'.. important r61e in the prevention of tuberculosis, 1938 t 946 it is important to have available a technique Berlin . . . . . 82 Berlin . . . . ,06o which is simple and safe and yet gives, without Hamburg ,, 66 Hamburg .. 85 complications, a rapid and lasting protection. The work is divided into two parts. The first Deutsches Reich 6_- British Zone .. 7~ describes the experimental work of the authors London .. 7~ and their predecessors, leading to the developGlasgow .. t32 ment of the intradermal methods of vaccination. The second describes the clinical study which Various useful suggestions are made for covers the work, mainly of others, on the relations improving the reporting of tuberculosis deaths of allergy and resistance after B.C.G. vaccinand notifications, so that the position in the ation by various methods in man, and the future may be more accurately watched. This effects thereof. little report is an excellent example of good The techniqueof human vacdnation by sca@ation work done while using unsatisfactory material; is then described. All that is required is a vaccineupon it we would congratulate the authors. style and a recently prepared ampoule of B.C.G. containing 75 mgm. per rail, The ampoule is well shaken before opening, The site preferred P A S T E U R I Z A T I O N . By Harry Hill. Second by the authors is the dorsum of the foot, beEdition. H, K, Lewis. Pages viii and ~96. cause the outer aspect of the arm is so often Ill. 73, Price 2~s. used for tuberculin testing. The skin is cleansed This is a comprehensive account of the tech- with ether and a few drops of the suspension are nique of pasteurization with details and placed on the skin ~ to 3 cm. apart, Two or illustrations of the ptant requ[rcd. There are three scratches are made through each drop: in also chapters showing the need for pasteurization newborn infants 4 scratches 0- 5 cm. long with replies to the criticisms which have been through ~ drops, in school clfildren 6 scratches I cm. long through 3 drops and in adults 6 to levelled at the process.