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Report of the Medical Research Council for the Year 1937–1938
I76
THE
BRITISH
JOURNAL
OF TUBERCULOSIS
Report of the Medical Research Council for the Tear I937-~938. H.M. Stationery Office, i939.
London:
Price 3s. 6d. net.
This Report always makes interesting reading and covers the whole range of medicine. Work has continued during the last year in such diverse fields as .parasitology, bed-bug infestation, hormones, tropical diseases, cancer, varus diseases, chemical transmission of nervous effects, chemot h e r a p y , pulmonary diseases, and numerous other subjects. In the field of pulmonary diseases various advances have been made from different angles. In Scotland, the incidence of bovine pulmonary tuberculosis has been under survey. It was found that 4"7 per cent. of town cases and 9" I per cent. of country cases of h u m a n pulmonary tuberculosis yielded the bovine strain of tubercle bacillus in the sputum. Over 200 cases of pulmonary tuberculosis due to the bovine strain have now been recorded in Great Britain, and further work will doubtless increase this n u m b e r considerably. T h e condition is far commoner in Scotland than in England. At Guy's Hospital, Dr. Poulton and his co-workers have extended clinical observations and treatment of respiratory diseases by allowing patients to breathe dried air given in a tent. Analysis has also been made of temperature and humidity curves throughout the country at different centres, in relation to the hypothesis that atmospheric dryness m a y be the important factor in the open-air and mountain treatment of tuberculosis. The observation that voles are susceptible to tuberculosis promised to open a wide field for investigation. The further reports now suggest that the myco-bacterium responsible for the disease in voles is indeed a tubercle bacillus of a hitherto undescribed strain. It has been shown that the vole is more susceptible to the bovine than to the h u m a n or avian strain, but what we would like to know now is the pathogenicity of the vole strain for cattle, particularly in view of the widespread distribution of the vole. Chronic pulmonary disease among coal-miners has also engaged attention. In recent years it has become apparent that coal-miners are subject to chronic pulmonary disease of a disabling nature which does not come within the accepted definition of silicosis. A condition occurs which clinically resembles silicosis, but is radiologically different from it. In this condition nodulation is absent, but there is instead a variety o f ot cr shadows, the significance of which, in relation to the occurrence and progress of disability, is not clearly understood. The scientific problem is one of great difficulty and research of this kind is necessarily slow, but there is every reason to hope that interesting new information will be yielded when all the evidence now carefully collected is available for review. Another condition under investigation is cancer of the lung, particularly the relation of dust to its ~etiology. It seems probable that the action of organic carcinogens in modern road-dust must be reinforced by some properties of the mineral basis; and the chemical examination of various mineral dusts which have been associated with a high incidence of lung cancer in man suggests an association of silica and iron oxide as a common feature of their composition. Other dusts, such as nickel dust, and samples from the Joachimstal mines, are still under examination.
THE
BRITISH
JOURNAL
OF TUBERCULOSIS
Report of the Medical Research Council for the Tear I937-~938. H.M. Stationery Office, i939.
London:
Price 3s. 6d. net.
This Report always makes interesting reading and covers the whole range of medicine. Work has continued during the last year in such diverse fields as .parasitology, bed-bug infestation, hormones, tropical diseases, cancer, varus diseases, chemical transmission of nervous effects, chemot h e r a p y , pulmonary diseases, and numerous other subjects. In the field of pulmonary diseases various advances have been made from different angles. In Scotland, the incidence of bovine pulmonary tuberculosis has been under survey. It was found that 4"7 per cent. of town cases and 9" I per cent. of country cases of h u m a n pulmonary tuberculosis yielded the bovine strain of tubercle bacillus in the sputum. Over 200 cases of pulmonary tuberculosis due to the bovine strain have now been recorded in Great Britain, and further work will doubtless increase this n u m b e r considerably. T h e condition is far commoner in Scotland than in England. At Guy's Hospital, Dr. Poulton and his co-workers have extended clinical observations and treatment of respiratory diseases by allowing patients to breathe dried air given in a tent. Analysis has also been made of temperature and humidity curves throughout the country at different centres, in relation to the hypothesis that atmospheric dryness m a y be the important factor in the open-air and mountain treatment of tuberculosis. The observation that voles are susceptible to tuberculosis promised to open a wide field for investigation. The further reports now suggest that the myco-bacterium responsible for the disease in voles is indeed a tubercle bacillus of a hitherto undescribed strain. It has been shown that the vole is more susceptible to the bovine than to the h u m a n or avian strain, but what we would like to know now is the pathogenicity of the vole strain for cattle, particularly in view of the widespread distribution of the vole. Chronic pulmonary disease among coal-miners has also engaged attention. In recent years it has become apparent that coal-miners are subject to chronic pulmonary disease of a disabling nature which does not come within the accepted definition of silicosis. A condition occurs which clinically resembles silicosis, but is radiologically different from it. In this condition nodulation is absent, but there is instead a variety o f ot cr shadows, the significance of which, in relation to the occurrence and progress of disability, is not clearly understood. The scientific problem is one of great difficulty and research of this kind is necessarily slow, but there is every reason to hope that interesting new information will be yielded when all the evidence now carefully collected is available for review. Another condition under investigation is cancer of the lung, particularly the relation of dust to its ~etiology. It seems probable that the action of organic carcinogens in modern road-dust must be reinforced by some properties of the mineral basis; and the chemical examination of various mineral dusts which have been associated with a high incidence of lung cancer in man suggests an association of silica and iron oxide as a common feature of their composition. Other dusts, such as nickel dust, and samples from the Joachimstal mines, are still under examination.