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PENICILLIN IN EYE INFECTIONS
92 for the institution, and 53 were in favour of legal means of detention. The length of legal detention advocated
varied ;
a
large majority favoured
an
indeterminate
period and the bias isa towards long rather than short terms. The report’s leaning towards compulsion is unlikely to be regarded favourably in this country. Yet our great voluntary hospitals might consider the plea that they should act as the first line of attack on alcoholism. The emphasis of the report is on the inadequacy of hospital facilities for treatment, but it commends - the educational and preventive work being carried out by temperance and other social service societies. ’
MEDICAL
THE
OFFICERS OF HEALTH WHITE-PAPER
ON
THE
council of the Society of Medical Officers of
Health, having considered the Government’s proposals for a
the form of drops the penicillin must be instilled every half-hour for acute infections, and this in’itself is a handi. cap to its universal use. If kept at room temperature, the drops lose much of their effectiveness in 48 hours and they should therefore be kept in a refrigerator. On the eyelids penicillin ointment is useful and Keyes used 25% hydrous wool fat and 75% cold cream as a base, one gramme of ointment containing 500 units of peni. cillin. Neely and Cross describe in this issue a penicillin lamella, each lamella containing 100 units. The lamellae have the advantage that they do. not degenerate at room temperature and preserve their potency for a long time, being thus especially useful for Service con. ditions. For acute iritis due to the gonococcus there seems no doubt that penicillin given intramuscularly by injection or by drip is effective, and it is also recommended as an irrigation for the anterior chamber of the eye in severe infections and war wounds. Cashell2 irrigated the anterior chamber in 2 cases of perforating injury with good results. NEGOTIATIONS
OPEN
NEGOTIATIONS between the Government and the medical
profession on the proposals for a National Health Service opened on Friday of last week, when Mr. Henry Willink (Minister of Health) and Mr. J. Westwood (joint parliamends : ! mentary under-secretary for Scotland), met the Negotiatappointed by professional bodies. The (1) That the medical and health functions of various ing Committee committee has 31 members, 16 being appointed by the Government departments be brought within one central British Medical Association, 3 by the Royal College of Health Ministry with a Cabinet Minister as the responsible head. Physicians of London, 3 by the Royal College of Surgeons (2) That, pending the formation of suitable local-govern- .of England, 3 by the Scottish Royal Medical Corporament units, area hospital councils be established to advise tions, 2 by the Royal College of Obstetricians and Gynaethe hospital authorities and the Minister as to the distribution cologists, 2 by the Society of Medical Officers of Health, of hospitals in the areas, and that such additional hospital the Society of Apothecaries of London and and 1 each accommodation as may be required be provided and main- the MedicalbyWomen’s Federation. tained by existing hospital authorities, municipal or voluntary, ,
singly or jointly, as may be necessary, in accordance with the plan as approved by the Minister. (3) That as soon as possible the necessary steps be taken to resolve the chaos of’ local-government administration, special consideration being given to the needs of Greater London.
It is suggested that in any local-government area there should be a single authority for health purposes and that the extended health services should be administered, in the larger local-government areas required, by elected bodies responsible for the other services of local government. PENICILLIN
IN
EYE
INFECTIONS
OF the organisms commonly causing eye infections the most sensitive to penicillin are the hæmolytic streptococcus, the gonococcus, and some strains of staphylococcus. Streptococcus viridans and the pneumococcus are less sensitive, and staphylococci vary from extreme sensitivity to extreme resistance. It is now two years since penicillin was first used clinically as a local applica tion to the eye and to judge from reports so far published it seems doubtful if our expectations of its usefulness in external eye disease will be realised. All agree that it is now the treatment of choice in gonococcal
ophthalmia neonatorum, being an improvement on sulphapyridine for this condition, and it has also proved remarkably successful in clearing up chronic ulcerative blepharitis, hitherto a most disfiguring and resistant disease. Varied results have attended its use in catarrhal and mucopurulent conjunctivitis other than gonococcal, and in the treatment of corneal ulcer, and Keyes1 finds that there is not much to choose between penicillin and sulphathiazole for these infections. Penicillin has been used in strengths ranging from 250 to0,000 units per c.cm. of normal saline, the usual strength in this country being 500 Oxford units to the c.cm. If used in 1.
Keyes J. E. L. J. Amer. med. Ass. 1944, 126, 610.
THE President of the United States has awarded the of the Legion of Merit to MajorGeneral Sir ERNEST COWELL, FRCS, " for exceptionally meritorious conduct in the performance of outstanding services from September, 1942, to March, 1944," as director of medical services at Allied Headquarters in the Mediterranean. General Cowell was responsible for the medical services of the forces landing in North Africa, Sicily and Africa. He " welded together the medical services of the American and British forces and produced a highly successful organisation whiclrresulted in the saving of many lives and contributed to the wellbeing and comfort of the sick and wounded of both nations."
military decoration
,
Sir THOMAS
BARLOW, FRS, consulting physician to
University College Hospital and Children, Great Ormond Street, 12.
He
was
in his 100th year.
to the Hospital for Sick died in London on Jan. _
2. Cashell, G. T. W. Brit. med. J. 1944, i, 420.
RELIEF WORK.—The Minister of Health officers of local authorities who are anxious to volunteer for relief work abroad should be given the chance to do so, though he stresses that the needs of public health in our own country must not be overlooked. Volunteers for posts under UNRRA, or with the voluntary societies who are members of the Council of British Societies for Relief Abroad, should therefore obtain the consent of their local authority before making application through the appointments offices of the Ministry of Labour and National Service. This preliminary assent will not, however, bind the local authority to release the applicant, and the authority will be consulted again before the officer is actually engaged. The Minister has recognised relief work undertaken in accordance with these arrangements as war service for the purposes of the Local Government Staffs (War Service) Act 1939. VOLUNTEERS
FOR
(Circular 1/45) considers it right that medical
varied ;
a
large majority favoured
an
indeterminate
period and the bias isa towards long rather than short terms. The report’s leaning towards compulsion is unlikely to be regarded favourably in this country. Yet our great voluntary hospitals might consider the plea that they should act as the first line of attack on alcoholism. The emphasis of the report is on the inadequacy of hospital facilities for treatment, but it commends - the educational and preventive work being carried out by temperance and other social service societies. ’
MEDICAL
THE
OFFICERS OF HEALTH WHITE-PAPER
ON
THE
council of the Society of Medical Officers of
Health, having considered the Government’s proposals for a
the form of drops the penicillin must be instilled every half-hour for acute infections, and this in’itself is a handi. cap to its universal use. If kept at room temperature, the drops lose much of their effectiveness in 48 hours and they should therefore be kept in a refrigerator. On the eyelids penicillin ointment is useful and Keyes used 25% hydrous wool fat and 75% cold cream as a base, one gramme of ointment containing 500 units of peni. cillin. Neely and Cross describe in this issue a penicillin lamella, each lamella containing 100 units. The lamellae have the advantage that they do. not degenerate at room temperature and preserve their potency for a long time, being thus especially useful for Service con. ditions. For acute iritis due to the gonococcus there seems no doubt that penicillin given intramuscularly by injection or by drip is effective, and it is also recommended as an irrigation for the anterior chamber of the eye in severe infections and war wounds. Cashell2 irrigated the anterior chamber in 2 cases of perforating injury with good results. NEGOTIATIONS
OPEN
NEGOTIATIONS between the Government and the medical
profession on the proposals for a National Health Service opened on Friday of last week, when Mr. Henry Willink (Minister of Health) and Mr. J. Westwood (joint parliamends : ! mentary under-secretary for Scotland), met the Negotiatappointed by professional bodies. The (1) That the medical and health functions of various ing Committee committee has 31 members, 16 being appointed by the Government departments be brought within one central British Medical Association, 3 by the Royal College of Health Ministry with a Cabinet Minister as the responsible head. Physicians of London, 3 by the Royal College of Surgeons (2) That, pending the formation of suitable local-govern- .of England, 3 by the Scottish Royal Medical Corporament units, area hospital councils be established to advise tions, 2 by the Royal College of Obstetricians and Gynaethe hospital authorities and the Minister as to the distribution cologists, 2 by the Society of Medical Officers of Health, of hospitals in the areas, and that such additional hospital the Society of Apothecaries of London and and 1 each accommodation as may be required be provided and main- the MedicalbyWomen’s Federation. tained by existing hospital authorities, municipal or voluntary, ,
singly or jointly, as may be necessary, in accordance with the plan as approved by the Minister. (3) That as soon as possible the necessary steps be taken to resolve the chaos of’ local-government administration, special consideration being given to the needs of Greater London.
It is suggested that in any local-government area there should be a single authority for health purposes and that the extended health services should be administered, in the larger local-government areas required, by elected bodies responsible for the other services of local government. PENICILLIN
IN
EYE
INFECTIONS
OF the organisms commonly causing eye infections the most sensitive to penicillin are the hæmolytic streptococcus, the gonococcus, and some strains of staphylococcus. Streptococcus viridans and the pneumococcus are less sensitive, and staphylococci vary from extreme sensitivity to extreme resistance. It is now two years since penicillin was first used clinically as a local applica tion to the eye and to judge from reports so far published it seems doubtful if our expectations of its usefulness in external eye disease will be realised. All agree that it is now the treatment of choice in gonococcal
ophthalmia neonatorum, being an improvement on sulphapyridine for this condition, and it has also proved remarkably successful in clearing up chronic ulcerative blepharitis, hitherto a most disfiguring and resistant disease. Varied results have attended its use in catarrhal and mucopurulent conjunctivitis other than gonococcal, and in the treatment of corneal ulcer, and Keyes1 finds that there is not much to choose between penicillin and sulphathiazole for these infections. Penicillin has been used in strengths ranging from 250 to0,000 units per c.cm. of normal saline, the usual strength in this country being 500 Oxford units to the c.cm. If used in 1.
Keyes J. E. L. J. Amer. med. Ass. 1944, 126, 610.
THE President of the United States has awarded the of the Legion of Merit to MajorGeneral Sir ERNEST COWELL, FRCS, " for exceptionally meritorious conduct in the performance of outstanding services from September, 1942, to March, 1944," as director of medical services at Allied Headquarters in the Mediterranean. General Cowell was responsible for the medical services of the forces landing in North Africa, Sicily and Africa. He " welded together the medical services of the American and British forces and produced a highly successful organisation whiclrresulted in the saving of many lives and contributed to the wellbeing and comfort of the sick and wounded of both nations."
military decoration
,
Sir THOMAS
BARLOW, FRS, consulting physician to
University College Hospital and Children, Great Ormond Street, 12.
He
was
in his 100th year.
to the Hospital for Sick died in London on Jan. _
2. Cashell, G. T. W. Brit. med. J. 1944, i, 420.
RELIEF WORK.—The Minister of Health officers of local authorities who are anxious to volunteer for relief work abroad should be given the chance to do so, though he stresses that the needs of public health in our own country must not be overlooked. Volunteers for posts under UNRRA, or with the voluntary societies who are members of the Council of British Societies for Relief Abroad, should therefore obtain the consent of their local authority before making application through the appointments offices of the Ministry of Labour and National Service. This preliminary assent will not, however, bind the local authority to release the applicant, and the authority will be consulted again before the officer is actually engaged. The Minister has recognised relief work undertaken in accordance with these arrangements as war service for the purposes of the Local Government Staffs (War Service) Act 1939. VOLUNTEERS
FOR
(Circular 1/45) considers it right that medical