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The Eradication of Bed-Bugs
1934.
PUBLIC HEALTH.
Nothing was said about wastage and nothing about cost. The expression " o r thereabouts" too has peculiar interest and importance since, as the conference takes care to stress in the report, " nutrition and dietetics, dealing as they do with physical and chemical changeg inside the body, most of which are imperfectly understood, cannot be considered exact sciences." The calorie is merely a convenient unit for measuring the energy-content of food and the energyoutput of the body. More important still, because people differ so very much in so many different ways, " it is not only impossible to define but also there does not in fact exist, any standard of food requirement which can be rigidly applied to all men alike." To provide authorities with a working basis on which to determine the needs of individual men and families, what is needed is a sliding scale of calorie needs. One of the most valuable results achieved by the conference, it may be claimed, was the settling of a scale : as follows : SLIDING
S C A L E OF
CALORIE REQUIREMENTS
P~R DAY. Individuals. Man : heavy work .. ,, moderate work .. ,, light work . . . . Woman : active work .. housework . . Boy: 14 to 18 . . . . Girl: 14 to 18 Child : 12 to 14 ,, 10 to 12 ,, 8 to 10 ,, 6to 8 ,, 3 to 6 ,, 2to 3 ,, lto 2
Calories Gross 3,400-4,000 3,000-3,400 2,600-3,000 2,800-3,000 2,600-2,800 3,000-3,400 2,800-3,000 2,800-3,000 2,300-2,800 2,000-2,300
1,700-2,000 1,400-1,700 1,100-1,400 900-1,100
In regard to this scale it is to be noted that there was agreement by the conference on this further point : that the all-round average requirements of the entire population or of large mixed groups of people at the present time is about 3,000 calories per day, a figure which can safely be employed for calculations of mass requirements, though in tile case of individuals and single families due regard should be paid to the sliding scale. In the case of proteins, the same difficulties exist so far as standards are concerned. The total daily needs per man unit is probably from 80 to 100 grammes (2~ to 3½ ounces). The exaet proportion that first-class protein should bear to the total has never been exactly deter-
279
mined. That growing children and expectant and nursing mothers require relatively large amounts, " much more indeed than would be arrived at by simple calculation based on their man-value equivalents," was one of the matters upon which there was complete unanimity. Another point on which there was entire agreement was that for children, milk is a most valuable food, being; in fact, the only naturally balanced food containing in readily available form not only first-class protein (18.7 grammes or ] ounce to the pint) but also minerals, vitamins, carbohydrate and fat. Finally, and not by any means least, the conference agreed in deploring the exaggerated importance attached to the alleged disagreement between the two committees and, taking advantage of the opportunity offered by the report, add that " there did not exist, nor does there exist now, any fundamental disagreement on matters of scientific fact between the two bodies." Apart from the fact that it so very satisfactorily clears away misunderstan6ings, as an addendum to the memorandum of the Ministry's Committee and the British Medical Association's report, this one has very real practical and scientific value. #
*
#
#
@
The Eradication of Bed.bugs. first and main recommendation in the T HE report of the Committee on the Eradication of Bed-Bugs,* for which there can be nothing but praise on account of its lucidity, thoroughness and completeness--as evidenced, for example, by the list of references--was that sanitary officers and health visitors should be provided with the fullest possible information with regard to the habits and so on of the bedbug, in order that they might be in a position to give suitable instruction and advice as to how to deal with the pests. This recommendation appearing sound to the Ministry of Health, a memorandum t has been prepared and circulated to local authorities. Whether or not the officers of local authorities are quite so illinformed as the committee supposed may be . . ~., . doubted : in most dlstrmts the bug problem is rather prominent, and it is not easy for sanitary *Ministry of Health Reports on Public Health and Medical Subjects, No. 72. H.1VL Stationery Office, 1934. Price Is. net. tMinistry of Health Memo, t80 Med. H,M. Stationery Office, 1934. Price 3d. net.
280
PUBLIC
inspectors and even health visitors to escape contact with it or frequent calls to advise, urge and compel the taking of action with a view to dealing with it. It is not always, of course, that success attends the efforts put forth, the bug herself apparently having an instinct, natural no doubt, for discovering harbourage and nesting-places in the most unlikely and unthought of positions. Conversation with sanitary officers ready and willing to draw upon their experiences very soon reveals that unexpectedness is not uncommonly a feature of bug infestation. Nevertheless, t h e memorandum of the Ministry deserves praise and must inevitably prove of real value, because of what it tells and on account of the suggestions it has to offer with regard to harbourages particularly, and the results of experiments and experience with various methods designed to prevent infestation and bring about extermination. The description of the appearance, habits, and life of the vermin is most heltfful, the illustrations showing various stages in the development of the bug being especially interesting. The notes under the headings, " Where to look for Bed-Bugs " arid " Sources of Infestation," are very complete, though the fact that the space behind the fire-place occasionally finds favour because it is quiet and warm, and that the backs of pictures are amongst the most commonly chosen of furniture haunts, might have been stressed. In the hints off prevention of infestation and methods, most of those that are best known and most widely practised are referred to, and the right emphasis is laid upon the necessity for maintaining vigilance and dealing with any vermin as they appear after " Spring-cleaning " has been carried out. The notes on insecticides and the use of these agents should prove helpful, particularly those relating to fumigation with hydrogen cyanide. The necessity for the exercise of care in connection with the use of the latter is very rightly emphasised. Very properly also a special note is included with regard to the precautions to be adopted in relation to the removal of tenants to new premises, since it is in this regard that the greatest amount of worry and trouble, and discouragement also, are caused to local authorities anxious to secure better housing and sanitary conditions, and to their officers concerned to assist the authorities and to contribute in every way possible t o improving and maintaining the health, comfort and convenience of the people.
HEALTH.
JUNE,
The Composition and Description of Food. T is not uncommonly the case where matters I .affecting food are involved that legislation along the lines suggested very quickly follows the appearance of the report of the departmental committee appointed to enquire into the particular matters. Probably, therefore, it may be anticipated that there will soon appear a bill to make such provision as the committee on the Composition and Description of Food have advised i n the report recently issued.* The fact that the investigations of the committee were suspended " as a measure Of economy," and the report has been considerably delayed, is a further reason for anticipating early legislative action, and encourages the hope that it may be so. The main question the committee was required to answer was as to whether or not it was necessary that the law relating to the composition and description of articles of food should be altered so as to enable definitions or standards to be prescribed, or declarations of composition to b e required for articles of food other than liquid milk. Their reply is definitely in the affirmative. As the evidence submitted on behalf of the Society of Medical Officers of Health pointed to a need for alteration of the law, it is gratifying to find that the committee have reported so unhesitatingly. So far as regards the procedure to be adopted in settling standards and definitions, the views of the Society have not been accepted. In this matter, in common with a number of other bodies, the Society came to the conclusion that something in the shape of a more or less permanent advisory committee, consisting in part at least of representatives of food manufacturers, should be set up. To this and other like suggestions the committee gave full consideration, but decided finally that having regard to the existence of the Foods Department of the Ministry, generally recognised as extremely efficient in the performance of its function of protecting the consumer, no special committee was necessary. It was recommended, however, that in all cases the power to fix standards and definitions should be exercised by means of an Order, a draft of which should be-published and ample time allowed to any persons interested to state their objections. eH.M. Stationery Office, 1934, Cmd. 4564. Price 3d. net.
PUBLIC HEALTH.
Nothing was said about wastage and nothing about cost. The expression " o r thereabouts" too has peculiar interest and importance since, as the conference takes care to stress in the report, " nutrition and dietetics, dealing as they do with physical and chemical changeg inside the body, most of which are imperfectly understood, cannot be considered exact sciences." The calorie is merely a convenient unit for measuring the energy-content of food and the energyoutput of the body. More important still, because people differ so very much in so many different ways, " it is not only impossible to define but also there does not in fact exist, any standard of food requirement which can be rigidly applied to all men alike." To provide authorities with a working basis on which to determine the needs of individual men and families, what is needed is a sliding scale of calorie needs. One of the most valuable results achieved by the conference, it may be claimed, was the settling of a scale : as follows : SLIDING
S C A L E OF
CALORIE REQUIREMENTS
P~R DAY. Individuals. Man : heavy work .. ,, moderate work .. ,, light work . . . . Woman : active work .. housework . . Boy: 14 to 18 . . . . Girl: 14 to 18 Child : 12 to 14 ,, 10 to 12 ,, 8 to 10 ,, 6to 8 ,, 3 to 6 ,, 2to 3 ,, lto 2
Calories Gross 3,400-4,000 3,000-3,400 2,600-3,000 2,800-3,000 2,600-2,800 3,000-3,400 2,800-3,000 2,800-3,000 2,300-2,800 2,000-2,300
1,700-2,000 1,400-1,700 1,100-1,400 900-1,100
In regard to this scale it is to be noted that there was agreement by the conference on this further point : that the all-round average requirements of the entire population or of large mixed groups of people at the present time is about 3,000 calories per day, a figure which can safely be employed for calculations of mass requirements, though in tile case of individuals and single families due regard should be paid to the sliding scale. In the case of proteins, the same difficulties exist so far as standards are concerned. The total daily needs per man unit is probably from 80 to 100 grammes (2~ to 3½ ounces). The exaet proportion that first-class protein should bear to the total has never been exactly deter-
279
mined. That growing children and expectant and nursing mothers require relatively large amounts, " much more indeed than would be arrived at by simple calculation based on their man-value equivalents," was one of the matters upon which there was complete unanimity. Another point on which there was entire agreement was that for children, milk is a most valuable food, being; in fact, the only naturally balanced food containing in readily available form not only first-class protein (18.7 grammes or ] ounce to the pint) but also minerals, vitamins, carbohydrate and fat. Finally, and not by any means least, the conference agreed in deploring the exaggerated importance attached to the alleged disagreement between the two committees and, taking advantage of the opportunity offered by the report, add that " there did not exist, nor does there exist now, any fundamental disagreement on matters of scientific fact between the two bodies." Apart from the fact that it so very satisfactorily clears away misunderstan6ings, as an addendum to the memorandum of the Ministry's Committee and the British Medical Association's report, this one has very real practical and scientific value. #
*
#
#
@
The Eradication of Bed.bugs. first and main recommendation in the T HE report of the Committee on the Eradication of Bed-Bugs,* for which there can be nothing but praise on account of its lucidity, thoroughness and completeness--as evidenced, for example, by the list of references--was that sanitary officers and health visitors should be provided with the fullest possible information with regard to the habits and so on of the bedbug, in order that they might be in a position to give suitable instruction and advice as to how to deal with the pests. This recommendation appearing sound to the Ministry of Health, a memorandum t has been prepared and circulated to local authorities. Whether or not the officers of local authorities are quite so illinformed as the committee supposed may be . . ~., . doubted : in most dlstrmts the bug problem is rather prominent, and it is not easy for sanitary *Ministry of Health Reports on Public Health and Medical Subjects, No. 72. H.1VL Stationery Office, 1934. Price Is. net. tMinistry of Health Memo, t80 Med. H,M. Stationery Office, 1934. Price 3d. net.
280
PUBLIC
inspectors and even health visitors to escape contact with it or frequent calls to advise, urge and compel the taking of action with a view to dealing with it. It is not always, of course, that success attends the efforts put forth, the bug herself apparently having an instinct, natural no doubt, for discovering harbourage and nesting-places in the most unlikely and unthought of positions. Conversation with sanitary officers ready and willing to draw upon their experiences very soon reveals that unexpectedness is not uncommonly a feature of bug infestation. Nevertheless, t h e memorandum of the Ministry deserves praise and must inevitably prove of real value, because of what it tells and on account of the suggestions it has to offer with regard to harbourages particularly, and the results of experiments and experience with various methods designed to prevent infestation and bring about extermination. The description of the appearance, habits, and life of the vermin is most heltfful, the illustrations showing various stages in the development of the bug being especially interesting. The notes under the headings, " Where to look for Bed-Bugs " arid " Sources of Infestation," are very complete, though the fact that the space behind the fire-place occasionally finds favour because it is quiet and warm, and that the backs of pictures are amongst the most commonly chosen of furniture haunts, might have been stressed. In the hints off prevention of infestation and methods, most of those that are best known and most widely practised are referred to, and the right emphasis is laid upon the necessity for maintaining vigilance and dealing with any vermin as they appear after " Spring-cleaning " has been carried out. The notes on insecticides and the use of these agents should prove helpful, particularly those relating to fumigation with hydrogen cyanide. The necessity for the exercise of care in connection with the use of the latter is very rightly emphasised. Very properly also a special note is included with regard to the precautions to be adopted in relation to the removal of tenants to new premises, since it is in this regard that the greatest amount of worry and trouble, and discouragement also, are caused to local authorities anxious to secure better housing and sanitary conditions, and to their officers concerned to assist the authorities and to contribute in every way possible t o improving and maintaining the health, comfort and convenience of the people.
HEALTH.
JUNE,
The Composition and Description of Food. T is not uncommonly the case where matters I .affecting food are involved that legislation along the lines suggested very quickly follows the appearance of the report of the departmental committee appointed to enquire into the particular matters. Probably, therefore, it may be anticipated that there will soon appear a bill to make such provision as the committee on the Composition and Description of Food have advised i n the report recently issued.* The fact that the investigations of the committee were suspended " as a measure Of economy," and the report has been considerably delayed, is a further reason for anticipating early legislative action, and encourages the hope that it may be so. The main question the committee was required to answer was as to whether or not it was necessary that the law relating to the composition and description of articles of food should be altered so as to enable definitions or standards to be prescribed, or declarations of composition to b e required for articles of food other than liquid milk. Their reply is definitely in the affirmative. As the evidence submitted on behalf of the Society of Medical Officers of Health pointed to a need for alteration of the law, it is gratifying to find that the committee have reported so unhesitatingly. So far as regards the procedure to be adopted in settling standards and definitions, the views of the Society have not been accepted. In this matter, in common with a number of other bodies, the Society came to the conclusion that something in the shape of a more or less permanent advisory committee, consisting in part at least of representatives of food manufacturers, should be set up. To this and other like suggestions the committee gave full consideration, but decided finally that having regard to the existence of the Foods Department of the Ministry, generally recognised as extremely efficient in the performance of its function of protecting the consumer, no special committee was necessary. It was recommended, however, that in all cases the power to fix standards and definitions should be exercised by means of an Order, a draft of which should be-published and ample time allowed to any persons interested to state their objections. eH.M. Stationery Office, 1934, Cmd. 4564. Price 3d. net.