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Services Hygiene Group
49
PUBLIC H E A L T H , December, 1949
BOOK REVIEWS Canning Practice and Control.
By OSMAN JONES, F.R.I.C. 3rd ed. (pp. 322 + xii. Fig. 121. Price 36s.). L o n d o n : C h a p m a n & Hall, 1949. This is the t h i r d edition of t h e Well k n o w n work b y O s m a n J o n e s and T . W. Jones. T h e size is t h e s a m e as t h e second edition b u t eliminations have enabled n e w e r d e v e l o p m e n t s to be discussed, s u c h as new tin erosion p r o b l e m s a n d v i t a m i n assays. Its essential value is in its very clear exposition of t h e principles of c a n n i n g a n d in the full details of t h e m e t h o d s u s e d in t h e laboratory to control the varied stages in c a n n i n g practice. Canning in t h e last 50 years h a s gradually p a s s e d f r o m rule of thumb m e t h o d s to p r o c e d u r e s b a s e d u p o n exact scientific k n o w ledge a n d their application. All t h e s e m e t h o d s are well b r o u g h t out in this valuable book. O f t h e m a n y stages in c a n n i n g t h e m o s t important is t h e h e a t t r e a t m e n t k n o w n as " P r o c e s s i n g . " O r i g i n ally, this was very m u c h b a s e d o n practical experience a n d t h e m a n y food poisoning o u t b r e a k s f r o m t h e p r o d u c t s s h o w e d u p its inefficiency and unreliability. G r a d u a l l y this h a s all b e e n replaced b y .accurate methods b a s e d u p o n two g r o u p s of s t u d i e s - - h e a t p e n e t r a t i o n rates and the factors w h i c h influence t h e m a n d t h e t h e r m a l d e a t h p o i n t s of bacteria. B o t h are complicated, particularly t h e second, for t h e pH and other factors in t h e foods m a r k e d l y influence t h e s e t h e r m a l death ranges. F r o m t h e s e studies reliable safety t i m e s a n d t e m p e r a tures of h e a t i n g have b e e n evolved for all p r o d u c t s . It is this scientific work w h i c h h a s m a d e c a n n e d foods safer f r o m t h e risk of conveying food poisoning t h a n f r e s h foods. T h e major part of t h e book is devoted to m e t h o d s of control in the laboratory and, while s o m e e l e m e n t a r y m e t h o d s are described, readily obtainable f r o m o t h e r sources, m a n y specially apply to canning control. T h e book will be f o u n d invaluable to all workers c o n c e r n e d w i t h laboratory control of c a n n i n g practice. It also can be read with profit by medical officers of h e a l t h a n d o t h e r s w h o w i s h to u n d e r stand t h e principles w h i c h underlie s o u n d c a n n i n g as carried o u t to-day. T h e n u m e r o u s illustrations a d d to t h e value of t h e book, while the exposition of t h e a u t h o r s is particularly clear a n d very few errors have b e e n noted. Public Health Engineering--Vol. I. By EARLE B. PHELPS a n d collaborating authors. (Pp. 655. Illustrated. Price 45s.). L o n d o n : C h a p m a n & Hall, Ltd., 1948. T h i s v o l u m e is w r i t t e n p r i m a r i l y for A m e r i c a n engineers in order to t e a c h - - i n t h e light of p r e s e n t - d a y knowledge of s a n i t a t i o n - - w h a t to design a n d why. It is, as its title implies, " Public H e a l t h for E n g i n e e r s . " A t t h e s a m e time, it m i g h t also be described as " E n g i n e e r i n g for Medical Officers of H e a l t h . " A l t h o u g h certain sections of the book are n o t very applicable to conditions in t h e U n i t e d K i n g d o m , yet t h e r e m a i n d e r of t h e book is so lucid t h a t it s h o u l d find a place on t h e book shelves of a p r o gressive medical officer, a n d to be called into u s e particularly w h e n the advance of public sanitation is no longer h a m p e r e d b y e c o n o m i e s and austerity, b u t c a n be carried o u t in A m e r i c a n style. A Psychiatrist Looks at Tuberculosis. By ERtC WITTKOWER, M.D. W i t h an i n t r o d u c t i o n by J o h n R i c k m a n . (Pp. 144.). L o n d o n : National Association for the P r e v e n t i o n of T u b e r c u l o s i s , 1949. Despite the e n o r m o u s n u m b e r of c o n t r i b u t i o n s to t h e literature of tuberculosis, only t h e coastline of this disease h a s b e e n m a p p e d out a n d a great part of the " interior " still r e m a i n s largely u n e x plored territory. T h e i m p o r t a n c e of t h e psychological aspects of a disease always yield valuable material, a n d t h e N . A . P . T . is therefore to be c o n g r a t u l a t e d o n c o m m i s s i o n i n g Dr. Eric W i t t k o w e r specifically to investigate this p r o b l e m . T h e p r o d u c t of two a n d a half years' work in a n u m b e r of sanatoria a n d chest clinics is n o w p r e s e n t e d in this slim v o l u m e . P e r h a p s the o u t s t a n d i n g c o m p l i m e n t t h a t c a n be paid to this w o r k is t h e authenticity a n d realism o b s e r v e d in each p a t i e n t ' s self-portrait which e m e r g e s in t h e course of interview w i t h t h e analyst. M o r e over, the a u t h o r is to be congratulated on t h e p i t h i n e s s a n d brevity of the narrative w h i c h at t i m e s reads as racily as a D a m o n R u n y a n short story. L u c i d i t y a n d an absence of technical j a r g o n e m e r g e as the dual qualities so rarely to be o b s e r v e d in t h e writings of medical colleagues. Yet this m o n o g r a p h h a s its defects. As one t u r n s t h e pages one is only too painfully aware of t h e lack of definition of t e r m s t h a t has c o n t r i b u t e d so m u c h to t h e e m p i r i c i s m of psychiatry. I n discussing the b e h a v i o u r of patients a n d their reaction to their s y m p t o m s and diagnosis, Dr. W i t t k o w e r h a s classified s o m e of t h e s e reactions as being of " m i l d " a n d o t h e r s of " severe c o n c e r n . " B u t precisely what connotation t h e a u t h o r attaches to either of these g r o u p s is a matter for conjecture by t h e reader. T h i s is especially i m p o r t a n t , for if t h e reader is to be g u i d e d by t h e subjective a n d p e r h a p s arbitrary decisions of t h e a u t h o r as to t h e category in w h i c h t h e b o r d e r line case s h o u l d be included, little scientific reliance can be placed on the findings. Again, in tl~e c h a p t e r on t h e " P r e - m o r b i d
Personality of t h e T u b e r c u l o u s , " Dr. W i t t k o w e r breaks u p his cases into a n u m b e r of differing types, v i z . , o v e r - d e p e n d e n t , leaning, asserters of i n d e p e n d e n c e , rebellious, self-drivers, conflict harassed, etc. T h i s is interesting, b u t it w o u l d be even m o r e interesting, a n d certainly m u c h m o r e valuable, if we k n e w h o w t h e p r o p o r t i o n of each of t h e s e g r o u p s c o m p a r e d with a control g r o u p of c o r r e s p o n d ing age, sex, social level, occupation a n d family history. I n other words, this v o l u m e s h o u l d be t h e solution to s o m e of t h e p r o b l e m s w h i c h h a v e c o n f r o n t e d m o s t phthisiologists at one t i m e or a n o t h e r - v i z . , is t h e r e a h i g h e r percentage of dependent personalities a m o n g t h e t u b e r c u l o u s t h a n a m o n g a control g r o u p in t h e n o r m a l p o p u l a tion, or a f u r t h e r g r o u p suffering f r o m chronic h e a r t disease, a n d are t h e s e differences b e t w e e n t h e g r o u p s significant or otherwise ? W e are sadly afraid that D r . W i t t k o w e r h a s n o t a n s w e r e d a n u m b e r of t h e s e questions to our satisfaction. D e s p i t e t h e s e imperfections, this m o s t readable a n d s t i m u l a t i n g v o l u m e does r e p r e s e n t a n h o n e s t a t t e m p t to find a n explanation for m a n y of t h e p e r p l e x i n g psychological p a t t e r n s one e n c o u n t e r s in s t u d y i n g tuberculosis. T h e second edition will profit by a little m o r e devotion to t h e statistical, rather t h a n t h e psychiatric m e t h o d of analysis of data.
OBITUARY ALFRED ERNEST REMMETT WEAVER, M.D. (B'HAM.), D.P.H.. W e regret to record the d e a t h after a short illness, on N o v e m b e r 15th, of Dr. A. E. R e m m e t t Weaver, formerly medical 0triter of h e a l t h of the u r b a n district of Weston-super-Mare. W e are indebted to Dr. Cyril B a n k s for the following t r i b u t e : H e was born 76 years ago in B i r m i n g h a m a n d educated at K i n g Edward's School. W h i l e a c t i n g as secretary to Mr. Priestley S m i t h , the oculist, h e studied science at evening classes a n d later h i m s e l f t a u g h t c h e m i s t r y at various n i g h t schools in order to p a y his way as a medical student. H e g r a d u a t e d in medicine from B i r m i n g h a m University in 1904 a n d b e c a m e M.D. in 1906. A f t e r h o l d i n g h o u s e a p p o i n t m e n t s at t h e Q u e e n ' s Hospital, Birm i n g h a m , he was for a time in general practice at Cradley H e a t h , d u r i n g w h i c h period he s t u d i e d for, a n d obtained, t h e D.P.H. in 1908. T u r n i n g to public h e a l t h as a career, he was for a t i m e School Medical Officer of H e a l t h a n d A s s i s t a n t M.O.H. at Coventry u n d e r the late Dr. E. H. Snell. Later, as M.O.H. for Abertillery, he did some very good work, b u t was perhaps geographically rather badly placed for g a i n i n g t h e rapid promotion w h i c h his knowledge a n d experience warranted. He moved to Yeovil as M.O.H. a n d in 1919 joined Dr. (later Sir William) Savage as d e p u t y C o u n t y M.O.H. for Somerset, residing at Weston-super-Mare. T h e proposed removal of the c o u n t y offices to T a u n t o n did not suit h i m a n d he accepted t h e position of Medical Officer qf H e a l t h for W e s t o n super-Mare when it b e c a m e v a c a n t in 1929, a n d c o n t i n u e d in ~his post until his retirement in 1941. H e was greatly respected in t h e town, was a p r o m i n e n t m e m b e r of the Rotary Club a n d also took part in m u c h social a n d religious work in t h e district. He was twice married b u t h a d no children. He was a m a n of wide r e a d i n g a n d great knowledge, with a generous and friendly nature. He was a Fellow of t h e Society f r o m 1930. Services H y g i e n e Group NOTICE A m e e t i n g of the Group will be held in the H a s t i n g s Hall~ B.M.A. House, Tavistock Square, London, W.C.1, on Friday~ D e c e m b e r 16th, 1949, at 5.30 p.m., when A i r C o m m o d o r e J. M. Kilpatrick, O.B.E., will deliver his presidential address entitled " P u b l i c H e a l t h in Relation to Aviation." T h e following p r o g r a m m e h a s been a r r a n g e d for 1 9 5 0 : J a n u a r y 2 7 t h - - A n n u a l Dinner. F e b r u a r y - - . - - A Lecture on " T h e Medical Aspects of A t o m i c Radiation." M a r c h --.---Visit to Millbank. April 14th (?)--Visit to Port of London. M a y 2 0 t h ~ V i s i t to Cow a n d Gate Factory, W i n c a n t o n . J u n e - - . - - J o i n t m e e t i n g with Association of Industrial Medical. Officers. F u r t h e r dates a n d particulars will be a n n o u n c e d later. G. M. FRIZELLE, Hon. Secretary.
L o n d o n School of H y g i e n e a n d Tropical Medicine, Keppel Street, Gower Street, London, W.C.I.
PUBLIC H E A L T H , December, 1949
BOOK REVIEWS Canning Practice and Control.
By OSMAN JONES, F.R.I.C. 3rd ed. (pp. 322 + xii. Fig. 121. Price 36s.). L o n d o n : C h a p m a n & Hall, 1949. This is the t h i r d edition of t h e Well k n o w n work b y O s m a n J o n e s and T . W. Jones. T h e size is t h e s a m e as t h e second edition b u t eliminations have enabled n e w e r d e v e l o p m e n t s to be discussed, s u c h as new tin erosion p r o b l e m s a n d v i t a m i n assays. Its essential value is in its very clear exposition of t h e principles of c a n n i n g a n d in the full details of t h e m e t h o d s u s e d in t h e laboratory to control the varied stages in c a n n i n g practice. Canning in t h e last 50 years h a s gradually p a s s e d f r o m rule of thumb m e t h o d s to p r o c e d u r e s b a s e d u p o n exact scientific k n o w ledge a n d their application. All t h e s e m e t h o d s are well b r o u g h t out in this valuable book. O f t h e m a n y stages in c a n n i n g t h e m o s t important is t h e h e a t t r e a t m e n t k n o w n as " P r o c e s s i n g . " O r i g i n ally, this was very m u c h b a s e d o n practical experience a n d t h e m a n y food poisoning o u t b r e a k s f r o m t h e p r o d u c t s s h o w e d u p its inefficiency and unreliability. G r a d u a l l y this h a s all b e e n replaced b y .accurate methods b a s e d u p o n two g r o u p s of s t u d i e s - - h e a t p e n e t r a t i o n rates and the factors w h i c h influence t h e m a n d t h e t h e r m a l d e a t h p o i n t s of bacteria. B o t h are complicated, particularly t h e second, for t h e pH and other factors in t h e foods m a r k e d l y influence t h e s e t h e r m a l death ranges. F r o m t h e s e studies reliable safety t i m e s a n d t e m p e r a tures of h e a t i n g have b e e n evolved for all p r o d u c t s . It is this scientific work w h i c h h a s m a d e c a n n e d foods safer f r o m t h e risk of conveying food poisoning t h a n f r e s h foods. T h e major part of t h e book is devoted to m e t h o d s of control in the laboratory and, while s o m e e l e m e n t a r y m e t h o d s are described, readily obtainable f r o m o t h e r sources, m a n y specially apply to canning control. T h e book will be f o u n d invaluable to all workers c o n c e r n e d w i t h laboratory control of c a n n i n g practice. It also can be read with profit by medical officers of h e a l t h a n d o t h e r s w h o w i s h to u n d e r stand t h e principles w h i c h underlie s o u n d c a n n i n g as carried o u t to-day. T h e n u m e r o u s illustrations a d d to t h e value of t h e book, while the exposition of t h e a u t h o r s is particularly clear a n d very few errors have b e e n noted. Public Health Engineering--Vol. I. By EARLE B. PHELPS a n d collaborating authors. (Pp. 655. Illustrated. Price 45s.). L o n d o n : C h a p m a n & Hall, Ltd., 1948. T h i s v o l u m e is w r i t t e n p r i m a r i l y for A m e r i c a n engineers in order to t e a c h - - i n t h e light of p r e s e n t - d a y knowledge of s a n i t a t i o n - - w h a t to design a n d why. It is, as its title implies, " Public H e a l t h for E n g i n e e r s . " A t t h e s a m e time, it m i g h t also be described as " E n g i n e e r i n g for Medical Officers of H e a l t h . " A l t h o u g h certain sections of the book are n o t very applicable to conditions in t h e U n i t e d K i n g d o m , yet t h e r e m a i n d e r of t h e book is so lucid t h a t it s h o u l d find a place on t h e book shelves of a p r o gressive medical officer, a n d to be called into u s e particularly w h e n the advance of public sanitation is no longer h a m p e r e d b y e c o n o m i e s and austerity, b u t c a n be carried o u t in A m e r i c a n style. A Psychiatrist Looks at Tuberculosis. By ERtC WITTKOWER, M.D. W i t h an i n t r o d u c t i o n by J o h n R i c k m a n . (Pp. 144.). L o n d o n : National Association for the P r e v e n t i o n of T u b e r c u l o s i s , 1949. Despite the e n o r m o u s n u m b e r of c o n t r i b u t i o n s to t h e literature of tuberculosis, only t h e coastline of this disease h a s b e e n m a p p e d out a n d a great part of the " interior " still r e m a i n s largely u n e x plored territory. T h e i m p o r t a n c e of t h e psychological aspects of a disease always yield valuable material, a n d t h e N . A . P . T . is therefore to be c o n g r a t u l a t e d o n c o m m i s s i o n i n g Dr. Eric W i t t k o w e r specifically to investigate this p r o b l e m . T h e p r o d u c t of two a n d a half years' work in a n u m b e r of sanatoria a n d chest clinics is n o w p r e s e n t e d in this slim v o l u m e . P e r h a p s the o u t s t a n d i n g c o m p l i m e n t t h a t c a n be paid to this w o r k is t h e authenticity a n d realism o b s e r v e d in each p a t i e n t ' s self-portrait which e m e r g e s in t h e course of interview w i t h t h e analyst. M o r e over, the a u t h o r is to be congratulated on t h e p i t h i n e s s a n d brevity of the narrative w h i c h at t i m e s reads as racily as a D a m o n R u n y a n short story. L u c i d i t y a n d an absence of technical j a r g o n e m e r g e as the dual qualities so rarely to be o b s e r v e d in t h e writings of medical colleagues. Yet this m o n o g r a p h h a s its defects. As one t u r n s t h e pages one is only too painfully aware of t h e lack of definition of t e r m s t h a t has c o n t r i b u t e d so m u c h to t h e e m p i r i c i s m of psychiatry. I n discussing the b e h a v i o u r of patients a n d their reaction to their s y m p t o m s and diagnosis, Dr. W i t t k o w e r h a s classified s o m e of t h e s e reactions as being of " m i l d " a n d o t h e r s of " severe c o n c e r n . " B u t precisely what connotation t h e a u t h o r attaches to either of these g r o u p s is a matter for conjecture by t h e reader. T h i s is especially i m p o r t a n t , for if t h e reader is to be g u i d e d by t h e subjective a n d p e r h a p s arbitrary decisions of t h e a u t h o r as to t h e category in w h i c h t h e b o r d e r line case s h o u l d be included, little scientific reliance can be placed on the findings. Again, in tl~e c h a p t e r on t h e " P r e - m o r b i d
Personality of t h e T u b e r c u l o u s , " Dr. W i t t k o w e r breaks u p his cases into a n u m b e r of differing types, v i z . , o v e r - d e p e n d e n t , leaning, asserters of i n d e p e n d e n c e , rebellious, self-drivers, conflict harassed, etc. T h i s is interesting, b u t it w o u l d be even m o r e interesting, a n d certainly m u c h m o r e valuable, if we k n e w h o w t h e p r o p o r t i o n of each of t h e s e g r o u p s c o m p a r e d with a control g r o u p of c o r r e s p o n d ing age, sex, social level, occupation a n d family history. I n other words, this v o l u m e s h o u l d be t h e solution to s o m e of t h e p r o b l e m s w h i c h h a v e c o n f r o n t e d m o s t phthisiologists at one t i m e or a n o t h e r - v i z . , is t h e r e a h i g h e r percentage of dependent personalities a m o n g t h e t u b e r c u l o u s t h a n a m o n g a control g r o u p in t h e n o r m a l p o p u l a tion, or a f u r t h e r g r o u p suffering f r o m chronic h e a r t disease, a n d are t h e s e differences b e t w e e n t h e g r o u p s significant or otherwise ? W e are sadly afraid that D r . W i t t k o w e r h a s n o t a n s w e r e d a n u m b e r of t h e s e questions to our satisfaction. D e s p i t e t h e s e imperfections, this m o s t readable a n d s t i m u l a t i n g v o l u m e does r e p r e s e n t a n h o n e s t a t t e m p t to find a n explanation for m a n y of t h e p e r p l e x i n g psychological p a t t e r n s one e n c o u n t e r s in s t u d y i n g tuberculosis. T h e second edition will profit by a little m o r e devotion to t h e statistical, rather t h a n t h e psychiatric m e t h o d of analysis of data.
OBITUARY ALFRED ERNEST REMMETT WEAVER, M.D. (B'HAM.), D.P.H.. W e regret to record the d e a t h after a short illness, on N o v e m b e r 15th, of Dr. A. E. R e m m e t t Weaver, formerly medical 0triter of h e a l t h of the u r b a n district of Weston-super-Mare. W e are indebted to Dr. Cyril B a n k s for the following t r i b u t e : H e was born 76 years ago in B i r m i n g h a m a n d educated at K i n g Edward's School. W h i l e a c t i n g as secretary to Mr. Priestley S m i t h , the oculist, h e studied science at evening classes a n d later h i m s e l f t a u g h t c h e m i s t r y at various n i g h t schools in order to p a y his way as a medical student. H e g r a d u a t e d in medicine from B i r m i n g h a m University in 1904 a n d b e c a m e M.D. in 1906. A f t e r h o l d i n g h o u s e a p p o i n t m e n t s at t h e Q u e e n ' s Hospital, Birm i n g h a m , he was for a time in general practice at Cradley H e a t h , d u r i n g w h i c h period he s t u d i e d for, a n d obtained, t h e D.P.H. in 1908. T u r n i n g to public h e a l t h as a career, he was for a t i m e School Medical Officer of H e a l t h a n d A s s i s t a n t M.O.H. at Coventry u n d e r the late Dr. E. H. Snell. Later, as M.O.H. for Abertillery, he did some very good work, b u t was perhaps geographically rather badly placed for g a i n i n g t h e rapid promotion w h i c h his knowledge a n d experience warranted. He moved to Yeovil as M.O.H. a n d in 1919 joined Dr. (later Sir William) Savage as d e p u t y C o u n t y M.O.H. for Somerset, residing at Weston-super-Mare. T h e proposed removal of the c o u n t y offices to T a u n t o n did not suit h i m a n d he accepted t h e position of Medical Officer qf H e a l t h for W e s t o n super-Mare when it b e c a m e v a c a n t in 1929, a n d c o n t i n u e d in ~his post until his retirement in 1941. H e was greatly respected in t h e town, was a p r o m i n e n t m e m b e r of the Rotary Club a n d also took part in m u c h social a n d religious work in t h e district. He was twice married b u t h a d no children. He was a m a n of wide r e a d i n g a n d great knowledge, with a generous and friendly nature. He was a Fellow of t h e Society f r o m 1930. Services H y g i e n e Group NOTICE A m e e t i n g of the Group will be held in the H a s t i n g s Hall~ B.M.A. House, Tavistock Square, London, W.C.1, on Friday~ D e c e m b e r 16th, 1949, at 5.30 p.m., when A i r C o m m o d o r e J. M. Kilpatrick, O.B.E., will deliver his presidential address entitled " P u b l i c H e a l t h in Relation to Aviation." T h e following p r o g r a m m e h a s been a r r a n g e d for 1 9 5 0 : J a n u a r y 2 7 t h - - A n n u a l Dinner. F e b r u a r y - - . - - A Lecture on " T h e Medical Aspects of A t o m i c Radiation." M a r c h --.---Visit to Millbank. April 14th (?)--Visit to Port of London. M a y 2 0 t h ~ V i s i t to Cow a n d Gate Factory, W i n c a n t o n . J u n e - - . - - J o i n t m e e t i n g with Association of Industrial Medical. Officers. F u r t h e r dates a n d particulars will be a n n o u n c e d later. G. M. FRIZELLE, Hon. Secretary.
L o n d o n School of H y g i e n e a n d Tropical Medicine, Keppel Street, Gower Street, London, W.C.I.