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Some aspects of nutrition
PUBLIC H E A L T H grid for the drainage of waste water a large opening 6 in. in diameter, closed with a cap of solid metal, of which the waste-water grid forms the centre; and (2) instead of a trap it sits on a metal receiver in shape something like an inverted pear, the core of which is the plunger which closes an outlet and renders it water-tight. The container is of cast iron with the interior glazed or enamelled to prevent rusting. At the top of the plunger is a movable column (which can be taken out and cleaned) which acts as a gauge determining the areas of the material allowed to pass into the container; in other works, a kind of selector. Overflow is prevented by the stem of the plunger being hollow, with perforations at the top through which surplus water drains away. The outlet is closed by the heavy end of the plunger, which is cone-shaped and has a rubber seating to render it water-tight. The housewife removes the metal cap or grid in the sink and deposits the refuse through the opening into the metal container. When the container is full she lifts the plunger and releases the contents, which are then washed through the outlet and over the trap into the gravitation pipe or chute. The trap is of the ordinary type with a water seal of 2 in. and a connection for an anti-syphon pipe on the distal arm. The gravitation pipe is of cast iron, 6 in. diameter, and runs from top to bottom of the building, just as a soil pipe does, without bend or angle. The top is open and projects beyond the roof so as to ensure ventilation. Opposite the inlet from each kitchen sink is an eye which can be removed for inspection in case of stoppage. In the Quarry Hill flats the gravitation pipe can be fitted into an angle inside the building; while o u t of sight, it is nevertheless readily accessible. The sectional area seems to be ample to receive the contents of as many as eight sinks. The solid and liquid wastes from the sinks proceed through the gravitation pipes to a large underground collection chamber outside the building. These chambers are constructed of reinforced concrete and are both air-tight and water-tight; they have a connection both with the sewer and with the disposal station, and are controlled partly by natural, and partly by mechanical forces. Contents consist of liquid and solid matter, the latter being gross and heavy sinks to the bottom, while the former accumulates until it reaches the overflow to the sewer, along which it proceeds without further treatment. The water is merely a vehicle and is not intended to be a solvent. The remaining water and solid residue in the chamber is carried by suction to the receiving tanks at the disposal station through a strongly made metal pipe of 8 in. diameter. At the disposal station liquid and solid matter together are lifted by means of compressed air through plunger pipes which extend to the bottom of the tanks into a single pipe through which they are forced up into specially fed tanks and then dropped into two hydro extractors. There the surplus water is removed by centrifugal action and sent to the sewer, while the residue falls into incinerators of special design and is consumed, leaving nothing but clinker and ash. These are removed and tipped. The heat generated by the burning of the residue is used to heat water for the adjoining laundry. 238
AUGUST When once a housewife grasps the principle of selecting rubbish and learns to operate and control the disposal at the sink end of the system breakdowns are few, but education is necessary to eliminate mistakes and ensure satisfactory results. Rubbish which is too big to pass over the gauge is collected separately and bins are periodically removed by the cleansing department. The system is designed to deal with more than the average daily amount of refuse from a dwelling, which is assumed to be three gallons of liquid and solid. The capacity of the reception chambers has been fixed at five times this amount, which gives a margin big enough to allow of storage for some days. In Leeds the system serves 938 flats on the Quarry Hill Estate and will eventually serve 2,500. As to cost, one may compare the Garchey system with the one real alternative, the chute system, over which it has advantages that cannot be expressed in £ s. d., e.g., the elimination of noise and dust and the greater degree of tidiness when refuse is not exposed to the elements. A comparative statement of the costs of the two systems shows that the capital expenditure for the Garchey system is £25 8s. per dwelling, and for the chute system £14; the maintenance expenditure is £2 6s. 5d. per annum for the Garchey system, and £1 1%. ld. for the chute system, which means that the difference between the running costs is about 1½d. per week. The system is clean, wholesome, and if properly used, free from offence. With education and a certain amount of supervision the human element can be trained to play its part and use the system to the be.st advantage.
SOME ASPECTS OF NUTRITION* By V. H. ]V[oTTRAM,M.A.,
Professor of Physiology in the University of London. The politicians of the world have apparently waked up to the importance of nutrition and the necessity of the " marriage of agriculture and nutrition." This interest in nutrition has been fostered by the League of Nations and many reports on the food situation from all parts of the world, totalitarian as well as democratic, have been submitted to the League. It has become apparent that no country really feeds its inhabitants satisfactorily, but some countries are better fed than others. The small democratic countries are, generally speaking, the best fed; next came the large industrial countries; and lowest on the scale are the oriental countries such as China, India and Japan. Children of oriental origin when translated to a country where the standard of living is high respond by increased stature and weight--a fair proof that their home diet is insufficient. That a new outlook has been adopted in this country is clear from the Ministry of Food's action in reducing the cost of milk to the pregnant and nursing mother and the child under five irrespective of class to 2d. a pint and allowing free milk to those cases where the * Abstract of a paper read to the Welsh Branch, Society of Medical Officers of Health, June 21st, 1940.
1940 family income is less than 40s. per week for two people+ 6s. for every child. T h i s new outlook is welcome. Most children do not get enough calcium when actively growing; it is known that the bones of the children of the hospital class are osteoporotic; a deprivation of calcium (see Friend--" The Public Schoolboy ") increases by three times the liability to fracture of the bones. The simplest way of supplying calcium is by giving milk. From a survey made of the diets of a large number of pregnant women, it has been demonstrated that very few in this country take enough calcium to cover their needs and those of the foetus. It was shown in Oslo by the Toveruds that an intake of 1.6 grammes of calcium is necessary to cover those needs. As 1 litre of milk (1 pint = 0.567 litre) contained 1.2 grammes of calcium, it is clear that a pregnant woman is likely to cover her needs for calcium only if she takes 1½ pints or more of milk per day. The only other good and convenient sources of calcium are cheese and the fat fish. Green vegetables are sometimes recommended but their content of calcium is low while that of wholemeal bread is almost negligible. Consequently the nutritionist welcomes the intention of the Government to increase the milk intake of pregnant and nursing women and of young children and hopes that their intention will be implemented. In the artificial feeding of babies, a new food had been introduced which consists of equal parts of dried milk and dried soya bean powder. This food, according to Dr. Helen Mackay, who presumably suggested its composition to the manufacturers, is much cheaper than ordinary dried milk and has a better effect in combating nutritional anaemia in the bottle-fed baby. In all respects it is practically equivalent to a dried milk fortified with iron. We have been driven in this country by logic to the desirability of feeding necessitous children. It is probable that we shall be driven to giving the necessitous child the foods at his school dinner which are most likely to be lacking in the home diet, i . e . , the " protective foods." It was from considerations such as these that the " Oslo breakfast " arose, which consisted of wholemeal bread, cheese, butter, milk and a raw carrot plus an orange or half an apple. The " Oslo breakfast " has been adopted experimentally in this country in Stepney and Glossop and called a " Health dinner." The results has been very satisfactory, one noticeable effect (apart from increased rate of growth and high spirits) being a cosmetic one : the children's skins have improved remarkably. The method of Dr. Milligan, of Glossop, of introducing " protective foods " is to give " sandwiches of wholemeal bread and butter mixed with yeast powder and fillings selected from cheese, egg and meat, lettuce, watercress, mustard and cress and tomato." Milk is also given. These meals are convenient ways of introducing all the inorganic substances and the vitamins together with first-class proteins into the diet in an acceptable form. It is a question whether the conventional dinner of a joint and two vegetables plus a pudding for necessitous children should not be scrapped and a " health dinner" given in its place. It will be remembered that in an experiment on t h e " free choice "
PUBLIC H E A L T H of foods by babies in the U.S.A., the results were highly successful if the choice w e r e l i m i t e d t o t h e p r o t e c t i v e foods. The seprotective foods are dairy foods, greengroceries, fat fish, liver, and whole cereals. Now the difficulty is to persuade the people to change their diet habits and adopt the " protective foods." Pamphlets, lectures and school education are not enough. The personal contact is essential. Such personal contact could be made by health visitors, maternity and child welfare workers, district nurses and even sanitary inspectors. I would suggest that every municipality of any size should have attached to its public health services a trained dietician whose task it should be not only to supervise the diets in hospitals, but to educate in dietetics those who come into contact with the people in their homes. There remains the economic difficulty in providing a satisfactory diet. It is not much use teaching people what they should eat if they have not the means to buy it. There is an antagonism apparently between guns and butter. It is highly probable that the peoples of the world will never be rightly fed until they have democracy and peace.
N I G H T O V E R EUROPE* The mounting catastrophe in Europe and its effect on universities and laboratories in every country there --whether involved in the war or not--have necessitated modifications in the work of the Rockefeller Foundation. When the war broke out on September 3rd, 1939, the Foundation had 110 running appropriations in Europe, distributed in 2 2 different countries, and involving a total sum in excess of $4,000,000. A substantial part of these appropriations was for research in various scientific fields. Nearly $2,000,000 of the total was for work in Great Britain; approximately $750,000 was allocated to Switzerland; $330,000 each to France and Sweden; and the balance in smaller amounts ranging down to $3,500 in Finland. In a number of instances work supported by these appropriations is being continued on a level that has been but little affected by the war. For example, Heilbron's research in organic chemistry to which the Foundation is contributing at Imperial College, London, is still going forward. Niels Bohr's work in biophysics at Copenhagen and Svedberg's studies with the supercentrifuge at Uppsala are also only indirectly disturbed. The Tavistock Clinic in London, where the Foundation is financing research in psychosomatic medicine is proceeding, thus far at least, without serious interruption. Similarly, work in the general field of neurology, under grants from the Foundation is being carried on at the Universities of Brussels, Leiden, Lund, Oslo and Oxford. Moreover, in spite of many unfortunate exceptions, there seems to be at least some effort in influential circles in Europe to insulate important scientific research work from the shock of war and to allow the laboratory men to continue with their tasks. In this *Extract (pp. 10-17) from The Rockefeller Foundation Review for 1939. By Raymond B. Fosdick, President of the Foundation. 1940. New York.
239
AUGUST When once a housewife grasps the principle of selecting rubbish and learns to operate and control the disposal at the sink end of the system breakdowns are few, but education is necessary to eliminate mistakes and ensure satisfactory results. Rubbish which is too big to pass over the gauge is collected separately and bins are periodically removed by the cleansing department. The system is designed to deal with more than the average daily amount of refuse from a dwelling, which is assumed to be three gallons of liquid and solid. The capacity of the reception chambers has been fixed at five times this amount, which gives a margin big enough to allow of storage for some days. In Leeds the system serves 938 flats on the Quarry Hill Estate and will eventually serve 2,500. As to cost, one may compare the Garchey system with the one real alternative, the chute system, over which it has advantages that cannot be expressed in £ s. d., e.g., the elimination of noise and dust and the greater degree of tidiness when refuse is not exposed to the elements. A comparative statement of the costs of the two systems shows that the capital expenditure for the Garchey system is £25 8s. per dwelling, and for the chute system £14; the maintenance expenditure is £2 6s. 5d. per annum for the Garchey system, and £1 1%. ld. for the chute system, which means that the difference between the running costs is about 1½d. per week. The system is clean, wholesome, and if properly used, free from offence. With education and a certain amount of supervision the human element can be trained to play its part and use the system to the be.st advantage.
SOME ASPECTS OF NUTRITION* By V. H. ]V[oTTRAM,M.A.,
Professor of Physiology in the University of London. The politicians of the world have apparently waked up to the importance of nutrition and the necessity of the " marriage of agriculture and nutrition." This interest in nutrition has been fostered by the League of Nations and many reports on the food situation from all parts of the world, totalitarian as well as democratic, have been submitted to the League. It has become apparent that no country really feeds its inhabitants satisfactorily, but some countries are better fed than others. The small democratic countries are, generally speaking, the best fed; next came the large industrial countries; and lowest on the scale are the oriental countries such as China, India and Japan. Children of oriental origin when translated to a country where the standard of living is high respond by increased stature and weight--a fair proof that their home diet is insufficient. That a new outlook has been adopted in this country is clear from the Ministry of Food's action in reducing the cost of milk to the pregnant and nursing mother and the child under five irrespective of class to 2d. a pint and allowing free milk to those cases where the * Abstract of a paper read to the Welsh Branch, Society of Medical Officers of Health, June 21st, 1940.
1940 family income is less than 40s. per week for two people+ 6s. for every child. T h i s new outlook is welcome. Most children do not get enough calcium when actively growing; it is known that the bones of the children of the hospital class are osteoporotic; a deprivation of calcium (see Friend--" The Public Schoolboy ") increases by three times the liability to fracture of the bones. The simplest way of supplying calcium is by giving milk. From a survey made of the diets of a large number of pregnant women, it has been demonstrated that very few in this country take enough calcium to cover their needs and those of the foetus. It was shown in Oslo by the Toveruds that an intake of 1.6 grammes of calcium is necessary to cover those needs. As 1 litre of milk (1 pint = 0.567 litre) contained 1.2 grammes of calcium, it is clear that a pregnant woman is likely to cover her needs for calcium only if she takes 1½ pints or more of milk per day. The only other good and convenient sources of calcium are cheese and the fat fish. Green vegetables are sometimes recommended but their content of calcium is low while that of wholemeal bread is almost negligible. Consequently the nutritionist welcomes the intention of the Government to increase the milk intake of pregnant and nursing women and of young children and hopes that their intention will be implemented. In the artificial feeding of babies, a new food had been introduced which consists of equal parts of dried milk and dried soya bean powder. This food, according to Dr. Helen Mackay, who presumably suggested its composition to the manufacturers, is much cheaper than ordinary dried milk and has a better effect in combating nutritional anaemia in the bottle-fed baby. In all respects it is practically equivalent to a dried milk fortified with iron. We have been driven in this country by logic to the desirability of feeding necessitous children. It is probable that we shall be driven to giving the necessitous child the foods at his school dinner which are most likely to be lacking in the home diet, i . e . , the " protective foods." It was from considerations such as these that the " Oslo breakfast " arose, which consisted of wholemeal bread, cheese, butter, milk and a raw carrot plus an orange or half an apple. The " Oslo breakfast " has been adopted experimentally in this country in Stepney and Glossop and called a " Health dinner." The results has been very satisfactory, one noticeable effect (apart from increased rate of growth and high spirits) being a cosmetic one : the children's skins have improved remarkably. The method of Dr. Milligan, of Glossop, of introducing " protective foods " is to give " sandwiches of wholemeal bread and butter mixed with yeast powder and fillings selected from cheese, egg and meat, lettuce, watercress, mustard and cress and tomato." Milk is also given. These meals are convenient ways of introducing all the inorganic substances and the vitamins together with first-class proteins into the diet in an acceptable form. It is a question whether the conventional dinner of a joint and two vegetables plus a pudding for necessitous children should not be scrapped and a " health dinner" given in its place. It will be remembered that in an experiment on t h e " free choice "
PUBLIC H E A L T H of foods by babies in the U.S.A., the results were highly successful if the choice w e r e l i m i t e d t o t h e p r o t e c t i v e foods. The seprotective foods are dairy foods, greengroceries, fat fish, liver, and whole cereals. Now the difficulty is to persuade the people to change their diet habits and adopt the " protective foods." Pamphlets, lectures and school education are not enough. The personal contact is essential. Such personal contact could be made by health visitors, maternity and child welfare workers, district nurses and even sanitary inspectors. I would suggest that every municipality of any size should have attached to its public health services a trained dietician whose task it should be not only to supervise the diets in hospitals, but to educate in dietetics those who come into contact with the people in their homes. There remains the economic difficulty in providing a satisfactory diet. It is not much use teaching people what they should eat if they have not the means to buy it. There is an antagonism apparently between guns and butter. It is highly probable that the peoples of the world will never be rightly fed until they have democracy and peace.
N I G H T O V E R EUROPE* The mounting catastrophe in Europe and its effect on universities and laboratories in every country there --whether involved in the war or not--have necessitated modifications in the work of the Rockefeller Foundation. When the war broke out on September 3rd, 1939, the Foundation had 110 running appropriations in Europe, distributed in 2 2 different countries, and involving a total sum in excess of $4,000,000. A substantial part of these appropriations was for research in various scientific fields. Nearly $2,000,000 of the total was for work in Great Britain; approximately $750,000 was allocated to Switzerland; $330,000 each to France and Sweden; and the balance in smaller amounts ranging down to $3,500 in Finland. In a number of instances work supported by these appropriations is being continued on a level that has been but little affected by the war. For example, Heilbron's research in organic chemistry to which the Foundation is contributing at Imperial College, London, is still going forward. Niels Bohr's work in biophysics at Copenhagen and Svedberg's studies with the supercentrifuge at Uppsala are also only indirectly disturbed. The Tavistock Clinic in London, where the Foundation is financing research in psychosomatic medicine is proceeding, thus far at least, without serious interruption. Similarly, work in the general field of neurology, under grants from the Foundation is being carried on at the Universities of Brussels, Leiden, Lund, Oslo and Oxford. Moreover, in spite of many unfortunate exceptions, there seems to be at least some effort in influential circles in Europe to insulate important scientific research work from the shock of war and to allow the laboratory men to continue with their tasks. In this *Extract (pp. 10-17) from The Rockefeller Foundation Review for 1939. By Raymond B. Fosdick, President of the Foundation. 1940. New York.
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