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SCIENCE AND CANNING
137 was a primary symptom in only 7 per cent. of cases, whereas nearly a quarter complained of cough and 11-8 per cent. of all cases developed bronchopneumonia, 40 per cent. of them dying. Minchin goes so far as to recommend that, in tropical countries, all bronchopneumonias should be investi-
constipation
typhoid fever. In this series none of the patients had epistaxis, rose spots were difficult to see on the Indian skin, and enlargement of the spleen was rare. Where malaria and kala-azar are rampant, splenomegaly is of little diagnostic value. The prognostic significance of initial symptoms was equivocal, with the exception of diarrhœa, which was associated with a fatality-rate twice the average. When this symptom developed in hospital the prognosis was bad, 40 per cent. dying. No support was forthcoming for the view of Lantin3 that a positive blood-culture indicates a worse prognosis. The diagnostic value of blood-culture in every case of typhoid fever, no matter how late, was emphasised by the finding of positive results in 11 per cent. of cases after the fifteenth day of the disease. A review such as this is of particular value in war, when a lowering of the standards of the disposal of excreta and of the preparation of food and drink may result in an increased prevalence of ingestive diseases. gated
A
as
possible
cases
of
NEW DRUG FOR STAPHYLOCOCCAL INFECTIONS.
WE have lately commented in these columnson the good results being reported from the treatment of generalised staphylococcal infection with sulphathe search goes on for more pyridine, but effective and less toxic sulphonamide compounds. A preparation in which a thiazol radical replaced one of the amido groups in sulphanilamide was found to be effective against certain experimental coccal infections, and now Herrell and Brownpresent a preliminary report on the use of a methylated derivative of this compound, " sulphanfethylthiazol," in staphylococcal infections. Both in the test-tube and in experimentally infected mice this drug gave better results than either sulphanilamide or sulphapyridine, and was apparently non-toxic to normal human subjects. An opportunity arose to test it therapeutically in a woman who developed staphylococcal septicaemia after a gallThis patient had been treated bladder operation. earlier with sulphapyridine which caused severe nausea and vomiting, and she refused to take it again. She was therefore given 2 g. of sulphamethylthiazol, followed by another 2 g. four hours later and after that 1 g. four-hourly for the next six days. Within twentyfour hours the patient was much improved, and the temperature gradually fell to normal four days after treatment was begun. There were no toxic effects apart from a mild erythematous rash. Meanwhile older remedies are not without their protagonists. Baker and Shandsgive a useful review of the results obtained in acute osteomyelitis with staphylococcus antitoxin, and report their own findings in a series of 65 such cases with positive blood-culture. Of 30 cases which did not receive antitoxin 70 per cent. died compared with a fatality-rate of 25-7 per cent. among 35 treated patients. If the degree of bacteraemia is a justifiable criterion, there was a higher proportion of severely ill patients among the treated than among the untreated cases. Baker and Shand recommend big doses--40,000 to 60,000 units-of antitoxin intravenously, the total amount to depend on the Schilling
inevitably
3. Lantin, P. T., Amer. J. med. Sci. 1933, 185, 768. 4. Lancet, 1939, 2, 1076. 5. Proc. Mayo Clin. 1939, 14, 753. 6. J. Amer. med. Ass. 1939, 113, 2119.
count of the polymorphonuclear cells or the antitoxin content of the patient’s blood. Staphylococcus toxoid may be given during the recovery stage. Immediate and adequate surgical drainage was carried out on all cases. It is evident that encouraging results may be
obtained either with drug alone or with antitoxin alone, but so far no-one has recorded a series of cases treated with both drug and antitoxin. It will be interesting to see what this combination can do in a type of infection where in the past the betting has been on the staphylococcus. SCIENCE AND CANNING
IN
article
on research in canning in the trade of the Times for January, Mr. F. Hirst, director of the University of Bristol fruit and vegetable preservation research station, points out that the preservation of canned foods has now been placed on a satisfactory basis, because the fundamental principles of " processing" (the technical term for the heat treatment given) have both been established and put into practice. On the technical side stationary retorts with controls liable to human fallibilities are being replaced by pressure cookers worked automatically, and these are now available not only for fruit but for non-acid products, such as vegetables, meat and fish, which require much higher temperatures. Tin poisoning from canned foods is not a health hazard, but the action of the acid contents on the tin container is a commercial problem, for the interaction of acid and tin gives rise to the production of hydrogen which bulges the tin and is responsible for one variety of " blown " tin. Such tins in the trade are known as " hydrogen swells," and while the contents are harmless the tin is unsaleable. This problem is being dealt with mainly along two lines. One is by a study of the composition of the steel base and the preparation of a plate less susceptible to corrosion. The other is by looking for a feasible way of reducing or eliminating contact between the container and its contents. Early investigations with lacquer-coated containers were not altogether satisfactory, but more recently the lacquer coating has been applied after the can has been made up, and in this way the trouble can largely be eliminated and the tin dissolved is Research has also reduced to negligible amounts. played an important part in improving the quality of the foods canned. Particularly as regards fruit and vegetables the strains used for canning, the exact age when canned and the type of preliminary treatment are all of importance in giving a satisfactory product. The application of scientific study to food preparation is a feature of modern life, and although this has not always been to the benefit of the consumer the canning industry and its customers have undoubtedly gained from the association. -
an
supplement
Sir ARTHUR MACNaLTY’s report on the health of the school-child appears this week (H.M. Stationery Office, ls. 3d.). Economy has dictated some curtailment of the usual chapters on special subjects, but it is satisfactory to learn that the average heights and weights of school-children throughout the country are being maintained, and that the standard of nutrition has remained constant for the last three years, although minor degrees of defect are now being more faithfully reported. This report deals with the year 1938 when the school medical service was already distracted by rumours of war, and arrangements for evacuation threw ’an unprecedented strain on the service. The partial rehearsal of the September crisis proved the value of the scheme as a whole.
constipation
typhoid fever. In this series none of the patients had epistaxis, rose spots were difficult to see on the Indian skin, and enlargement of the spleen was rare. Where malaria and kala-azar are rampant, splenomegaly is of little diagnostic value. The prognostic significance of initial symptoms was equivocal, with the exception of diarrhœa, which was associated with a fatality-rate twice the average. When this symptom developed in hospital the prognosis was bad, 40 per cent. dying. No support was forthcoming for the view of Lantin3 that a positive blood-culture indicates a worse prognosis. The diagnostic value of blood-culture in every case of typhoid fever, no matter how late, was emphasised by the finding of positive results in 11 per cent. of cases after the fifteenth day of the disease. A review such as this is of particular value in war, when a lowering of the standards of the disposal of excreta and of the preparation of food and drink may result in an increased prevalence of ingestive diseases. gated
A
as
possible
cases
of
NEW DRUG FOR STAPHYLOCOCCAL INFECTIONS.
WE have lately commented in these columnson the good results being reported from the treatment of generalised staphylococcal infection with sulphathe search goes on for more pyridine, but effective and less toxic sulphonamide compounds. A preparation in which a thiazol radical replaced one of the amido groups in sulphanilamide was found to be effective against certain experimental coccal infections, and now Herrell and Brownpresent a preliminary report on the use of a methylated derivative of this compound, " sulphanfethylthiazol," in staphylococcal infections. Both in the test-tube and in experimentally infected mice this drug gave better results than either sulphanilamide or sulphapyridine, and was apparently non-toxic to normal human subjects. An opportunity arose to test it therapeutically in a woman who developed staphylococcal septicaemia after a gallThis patient had been treated bladder operation. earlier with sulphapyridine which caused severe nausea and vomiting, and she refused to take it again. She was therefore given 2 g. of sulphamethylthiazol, followed by another 2 g. four hours later and after that 1 g. four-hourly for the next six days. Within twentyfour hours the patient was much improved, and the temperature gradually fell to normal four days after treatment was begun. There were no toxic effects apart from a mild erythematous rash. Meanwhile older remedies are not without their protagonists. Baker and Shandsgive a useful review of the results obtained in acute osteomyelitis with staphylococcus antitoxin, and report their own findings in a series of 65 such cases with positive blood-culture. Of 30 cases which did not receive antitoxin 70 per cent. died compared with a fatality-rate of 25-7 per cent. among 35 treated patients. If the degree of bacteraemia is a justifiable criterion, there was a higher proportion of severely ill patients among the treated than among the untreated cases. Baker and Shand recommend big doses--40,000 to 60,000 units-of antitoxin intravenously, the total amount to depend on the Schilling
inevitably
3. Lantin, P. T., Amer. J. med. Sci. 1933, 185, 768. 4. Lancet, 1939, 2, 1076. 5. Proc. Mayo Clin. 1939, 14, 753. 6. J. Amer. med. Ass. 1939, 113, 2119.
count of the polymorphonuclear cells or the antitoxin content of the patient’s blood. Staphylococcus toxoid may be given during the recovery stage. Immediate and adequate surgical drainage was carried out on all cases. It is evident that encouraging results may be
obtained either with drug alone or with antitoxin alone, but so far no-one has recorded a series of cases treated with both drug and antitoxin. It will be interesting to see what this combination can do in a type of infection where in the past the betting has been on the staphylococcus. SCIENCE AND CANNING
IN
article
on research in canning in the trade of the Times for January, Mr. F. Hirst, director of the University of Bristol fruit and vegetable preservation research station, points out that the preservation of canned foods has now been placed on a satisfactory basis, because the fundamental principles of " processing" (the technical term for the heat treatment given) have both been established and put into practice. On the technical side stationary retorts with controls liable to human fallibilities are being replaced by pressure cookers worked automatically, and these are now available not only for fruit but for non-acid products, such as vegetables, meat and fish, which require much higher temperatures. Tin poisoning from canned foods is not a health hazard, but the action of the acid contents on the tin container is a commercial problem, for the interaction of acid and tin gives rise to the production of hydrogen which bulges the tin and is responsible for one variety of " blown " tin. Such tins in the trade are known as " hydrogen swells," and while the contents are harmless the tin is unsaleable. This problem is being dealt with mainly along two lines. One is by a study of the composition of the steel base and the preparation of a plate less susceptible to corrosion. The other is by looking for a feasible way of reducing or eliminating contact between the container and its contents. Early investigations with lacquer-coated containers were not altogether satisfactory, but more recently the lacquer coating has been applied after the can has been made up, and in this way the trouble can largely be eliminated and the tin dissolved is Research has also reduced to negligible amounts. played an important part in improving the quality of the foods canned. Particularly as regards fruit and vegetables the strains used for canning, the exact age when canned and the type of preliminary treatment are all of importance in giving a satisfactory product. The application of scientific study to food preparation is a feature of modern life, and although this has not always been to the benefit of the consumer the canning industry and its customers have undoubtedly gained from the association. -
an
supplement
Sir ARTHUR MACNaLTY’s report on the health of the school-child appears this week (H.M. Stationery Office, ls. 3d.). Economy has dictated some curtailment of the usual chapters on special subjects, but it is satisfactory to learn that the average heights and weights of school-children throughout the country are being maintained, and that the standard of nutrition has remained constant for the last three years, although minor degrees of defect are now being more faithfully reported. This report deals with the year 1938 when the school medical service was already distracted by rumours of war, and arrangements for evacuation threw ’an unprecedented strain on the service. The partial rehearsal of the September crisis proved the value of the scheme as a whole.