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POTENTIATION OF STREPTOMYCIN
31
blindly, mucosa
has enabled them to, obtain sufficient gastric for detailed histological study in 55 out of 83
attempts ; though somewhat inconvenienced, the patients
apparently unharmed. In one of the cases described gastric biopsy showed haemosiderin in the parietal and chief cells of the stomach ; liver biopsy showed changes typical of haemochromatosis ; and skin biopsy a little haemosiderin in the sweat glands. In another case biopsy revealed atrophic gastritis associated with perwere
nicious anaemia ; and of two further cases one was found to have chronic atrophic gastritis with a normal blood picture, and the other chronic gastritis whose nature
is unspecified.
On whether findings of this order justify the means of obtaining them, opinion will differ ; but most would agrae that the procedure should be confined to centres carrying out organised research into changes in the gastric mucosa. HEATING OF HOUSES
problems of housing have held the imagination of people for nearly a generation. At the end of the first world war the shortage of houses became acute, THE
our
’
and one Administration after another made its contribution to the building programme. From 1930 onwards the attention of the Government was directed in turn to slum clearance and to the relief of overcrowding ; and considerable progress was made before the return of war cut short this great social effort. During the whole of the inter-war period earnest attempts were made to meet the demand for houses of low cost, but relatively little thought was given to the kind of home that ought to be provided. Comfort and amenity took a subordinate place in planning, with the result that traditional designs, offering open hearths as the sole means of space heating, were almost universal. Few attempts were made to apply scientific methods in assessing the efficiency, or in calculating the relative , costs, of different types and combinations of heating appliances. Recently the Building Research Station, working under the general direction of the Department of Scientific and Industrial Reseatch, has succeeded in supplying authoritative data on which estimates of efficiency and economy in warming small homes can be based. A team of workers led by Mr. Richard Eve has now begun to publish 1 the results of a thorough investigation carried out in a group of trial houses at Abbots Langley. The houses were unoccupied at the time of the preliminary study, but the staff used the various appliances in such a way as to reproduce the ordinary conditions of life for a family of father, mother, and two children. They examined three main types of space heating : the " partial," with a fire in the living-room and no heating arrangements in the bedrooms ; the " two-, stage," with limited background heating in two or more bedrooms, and provision for " topping-up " with gas or electric fires as required ; and the full central heating up to 65°F in every room. Under the experimental conditions each house was expected to provide for 250 gallons of water at 140°F per week ; with warmth at 65° in the living-room for eight hours a day, and 600 in the kitchen. The bedrooms were warmed to the same extent, so far as the heating appliances allowed. In carefully controlled observations it was found that the space heating actually obtained improved from the partial to the whole house heating ; and that there was no great difference between the two-stage and central heating in efficiency, except that the latter maintained better levels in really cold weather. The main point, however, was that full central heating was substantially cheaper in maintenance than the other types, while giving at the same time much greater uniformity in 1. J. R. Inst. Brit. Arch. November, 1948.
In capital costs full central heating was to install, but owing to its efficient and economical use of fuel the extra initial expense would be balanced in about twenty years. These elaborate studies have at last brought the problems of space heating under scientific measurement, and the results of continued research will be watched with interest, because hitherto we have had to content ourselves with opinion based on guesswork. space more
warming. expensive
-
POTENTIATION OF STREPTOMYCIN IODIDES have long been known to cause tubercle bacilli, previously absent, to appear in the sputum of patients with pulmonary tuberculosis ; and for many years they have also been used to promote the solution and absorption of fibrocaseous lesions in the lungs of the tuberculous. These facts have led Woody and Avery1 to test the combined action of potassium iodide and streptomycin against established tuberculosis in guineapigs. After excluding any possible effect of potassium iodide on the antibiotic action of streptomycin, they injected the two drugs into guineapigs inoculated with a suspension of tubercle bacilli (H37RV). The controls were inoculated guineapigs receiving either no treatment at all, or potassium iodide alone, or streptomycin alone. All the animals On gross examinawere killed at the end of four weeks. tion the untreated guineapigs and those treated with potassium iodide showed heavy tuberculous infection of all viscera, and the streptomycin guineapigs showed some spread to the organs ; but in those treated with potassium iodide as well as streptomycin the organs were entirely free from infection. A survival experiment gave comparable findings, the mortality-rate after fifteen weeks being lowest in the animals that had both streptomycin and potassium iodide. This observation is of considerable interest. If it could be shown clinically that the two drugs, when given together, are more effective than streptomycin alone it should be possible to reduce the dose of streptomycin for the treatment of tuberculosis, and so diminish the undesirable side-effects. At present the daily effective dose of streptomycin is supposed to be 2 g. ; but evidence is already accumulating that it may be as small as 1 g. If the dose could be cut still further the side-effects might be negligible ; and in countries, such as Britain, where streptomycin is scarce more patients could have the benefit of it. SPECIALISTS AWARDS COMMITTEE THE Minister of Health and the Secretary of State for Scotland, acting on the recommendations of the Spens Committee, have appointed a committee of 14 members to advise " which specialists engaged in the National Health Service should receive awards for professional distinction, having regard to the desirability that 4% of the number eligible should receive the highest award, 10% the second award, and 20% the third award." The members are : Lord Moran, P.R.C.P. (chairman), Sir Horace Hamilton (vice-chairman), Mr. V. Zachary Cope, F.R.C.S., Prof. G. B. Fleming, F.R.C.P., Sir Gordon Gordon-Taylor, F.R.C.s., Mr. J. M. Graham, F.R.C.S.E., Sir David Henderson, F.R.c.P., Sir Edward Mellanby, F.R.C.P., F.R.S., Mr. J. F. Mountford, Sir Harry Platt, F.R.C.S., Prof. A. L. Robinson, F.R.C.O.G., Dr. J. H. Sheldon, Sir Lionel Whitby, F.R.c.p., Mr. J. M. Wyatt, F.R.C.O.G., Mr. T. B. Williamson, of the Ministry of Health, is secretary. Eleven members of the committee have been nominated by the Royal Colleges and the Scottish Royal Corporations, one by the Medical Research Council, and one by the universities’ committee of vice-chancellors and
principals. 1. Woody,
E., Avery,
R. C.
Science, 1948, 108, 501.
blindly, mucosa
has enabled them to, obtain sufficient gastric for detailed histological study in 55 out of 83
attempts ; though somewhat inconvenienced, the patients
apparently unharmed. In one of the cases described gastric biopsy showed haemosiderin in the parietal and chief cells of the stomach ; liver biopsy showed changes typical of haemochromatosis ; and skin biopsy a little haemosiderin in the sweat glands. In another case biopsy revealed atrophic gastritis associated with perwere
nicious anaemia ; and of two further cases one was found to have chronic atrophic gastritis with a normal blood picture, and the other chronic gastritis whose nature
is unspecified.
On whether findings of this order justify the means of obtaining them, opinion will differ ; but most would agrae that the procedure should be confined to centres carrying out organised research into changes in the gastric mucosa. HEATING OF HOUSES
problems of housing have held the imagination of people for nearly a generation. At the end of the first world war the shortage of houses became acute, THE
our
’
and one Administration after another made its contribution to the building programme. From 1930 onwards the attention of the Government was directed in turn to slum clearance and to the relief of overcrowding ; and considerable progress was made before the return of war cut short this great social effort. During the whole of the inter-war period earnest attempts were made to meet the demand for houses of low cost, but relatively little thought was given to the kind of home that ought to be provided. Comfort and amenity took a subordinate place in planning, with the result that traditional designs, offering open hearths as the sole means of space heating, were almost universal. Few attempts were made to apply scientific methods in assessing the efficiency, or in calculating the relative , costs, of different types and combinations of heating appliances. Recently the Building Research Station, working under the general direction of the Department of Scientific and Industrial Reseatch, has succeeded in supplying authoritative data on which estimates of efficiency and economy in warming small homes can be based. A team of workers led by Mr. Richard Eve has now begun to publish 1 the results of a thorough investigation carried out in a group of trial houses at Abbots Langley. The houses were unoccupied at the time of the preliminary study, but the staff used the various appliances in such a way as to reproduce the ordinary conditions of life for a family of father, mother, and two children. They examined three main types of space heating : the " partial," with a fire in the living-room and no heating arrangements in the bedrooms ; the " two-, stage," with limited background heating in two or more bedrooms, and provision for " topping-up " with gas or electric fires as required ; and the full central heating up to 65°F in every room. Under the experimental conditions each house was expected to provide for 250 gallons of water at 140°F per week ; with warmth at 65° in the living-room for eight hours a day, and 600 in the kitchen. The bedrooms were warmed to the same extent, so far as the heating appliances allowed. In carefully controlled observations it was found that the space heating actually obtained improved from the partial to the whole house heating ; and that there was no great difference between the two-stage and central heating in efficiency, except that the latter maintained better levels in really cold weather. The main point, however, was that full central heating was substantially cheaper in maintenance than the other types, while giving at the same time much greater uniformity in 1. J. R. Inst. Brit. Arch. November, 1948.
In capital costs full central heating was to install, but owing to its efficient and economical use of fuel the extra initial expense would be balanced in about twenty years. These elaborate studies have at last brought the problems of space heating under scientific measurement, and the results of continued research will be watched with interest, because hitherto we have had to content ourselves with opinion based on guesswork. space more
warming. expensive
-
POTENTIATION OF STREPTOMYCIN IODIDES have long been known to cause tubercle bacilli, previously absent, to appear in the sputum of patients with pulmonary tuberculosis ; and for many years they have also been used to promote the solution and absorption of fibrocaseous lesions in the lungs of the tuberculous. These facts have led Woody and Avery1 to test the combined action of potassium iodide and streptomycin against established tuberculosis in guineapigs. After excluding any possible effect of potassium iodide on the antibiotic action of streptomycin, they injected the two drugs into guineapigs inoculated with a suspension of tubercle bacilli (H37RV). The controls were inoculated guineapigs receiving either no treatment at all, or potassium iodide alone, or streptomycin alone. All the animals On gross examinawere killed at the end of four weeks. tion the untreated guineapigs and those treated with potassium iodide showed heavy tuberculous infection of all viscera, and the streptomycin guineapigs showed some spread to the organs ; but in those treated with potassium iodide as well as streptomycin the organs were entirely free from infection. A survival experiment gave comparable findings, the mortality-rate after fifteen weeks being lowest in the animals that had both streptomycin and potassium iodide. This observation is of considerable interest. If it could be shown clinically that the two drugs, when given together, are more effective than streptomycin alone it should be possible to reduce the dose of streptomycin for the treatment of tuberculosis, and so diminish the undesirable side-effects. At present the daily effective dose of streptomycin is supposed to be 2 g. ; but evidence is already accumulating that it may be as small as 1 g. If the dose could be cut still further the side-effects might be negligible ; and in countries, such as Britain, where streptomycin is scarce more patients could have the benefit of it. SPECIALISTS AWARDS COMMITTEE THE Minister of Health and the Secretary of State for Scotland, acting on the recommendations of the Spens Committee, have appointed a committee of 14 members to advise " which specialists engaged in the National Health Service should receive awards for professional distinction, having regard to the desirability that 4% of the number eligible should receive the highest award, 10% the second award, and 20% the third award." The members are : Lord Moran, P.R.C.P. (chairman), Sir Horace Hamilton (vice-chairman), Mr. V. Zachary Cope, F.R.C.S., Prof. G. B. Fleming, F.R.C.P., Sir Gordon Gordon-Taylor, F.R.C.s., Mr. J. M. Graham, F.R.C.S.E., Sir David Henderson, F.R.c.P., Sir Edward Mellanby, F.R.C.P., F.R.S., Mr. J. F. Mountford, Sir Harry Platt, F.R.C.S., Prof. A. L. Robinson, F.R.C.O.G., Dr. J. H. Sheldon, Sir Lionel Whitby, F.R.c.p., Mr. J. M. Wyatt, F.R.C.O.G., Mr. T. B. Williamson, of the Ministry of Health, is secretary. Eleven members of the committee have been nominated by the Royal Colleges and the Scottish Royal Corporations, one by the Medical Research Council, and one by the universities’ committee of vice-chancellors and
principals. 1. Woody,
E., Avery,
R. C.
Science, 1948, 108, 501.