THE HUMAN ELEMENT IN EXPLORATION

1152

Tercentenary

of John Graunt

a London haberdasher, JOHN GRAUNT, his Natural and Political Observations upon published Bills of Mortality, and so became the founder of demography and medical statistics. With the most rudimentary of materials he undertook the statistical study of sex and age in relation to mortality, defined the loss of child life, compared mortality in town and country, and devised the first life table. His scrutiny of the data for error and ambiguity, his way of dealing with fashions in diagnosis, and his search for the reality behind the figures would have satisfied the highest standards of today. GRAUNT became one of the first fellows of the Royal Society; and, on Nov. 15-16, the society held discussions to mark the tercentenary of the appearance of his work. There were three main themes: health, genetics, and demography. Dr. B. BENJAMIN, of the General Register Office, described how official statistics changed with the current health problems. Mortality-rates, for example, were introduced as an instrument of public education in the fight to prevent infectious disease; in 1911, when problems of poverty were predominant, the notion of social class was introduced into the returns; and with the reduction of postneonatal mortality the concept of perinatal mortality had been evolved. Today the study of populations whose succeeding generations live longer and longer again calls for some new methodology. Prof. J. N. MORRIS suggested that infant-mortality rates for each social class-which are still far from uniformwould provide a yardstick of the quality and effectiveness of our social services in the coming years. The figures for delinquency and other maladjustment in adolescence were still rising. With the greater crowding of young people from the bulge ", the rise might well be accelerated. MORRIS presented evidence that the three " modern epidemics " of middle-aged men might be reaching saturation point. Mortality from lung cancer among men under 60 was now stationary; the incidence of doctors with ischaemic heart-disease did not seem to be rising any more; and the figures for duodenal ulcer (mortality, perforation, cold surgery, sick absence) suggested that the condition had actually become less common in the course of the 1950s-although whether the incidence of the disease was less, or only its severity, was not yet clear. We must be prepared, however, for rapid biological change in parallel with the present pace of social change. GRAUNT was interested in mental as well as physical illness and calculated the odds against any man " at this present well in his Wits " dying in a mental hospital within seven years. Ever since, the perennial question has been asked: Is mental disorder on the increase?" According to Sir AUBREY LEWIS, the provisional answer was no, although there were now four times as many mongol children alive as thirty years ago because of the fall in the death-rate. The number of live-born offspring provides a measure of biological fertility. But Prof. L. S. PENROSE pointed out that more valuable figures-if they could be come by-would be for the total number of ova fertilised, and

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proportion which failed to reproduce or had impaired reproductive power because of their genetical the

constitution. Known lethal genes or chromosomal errors might account for 3% of all zygote deaths, and viable genetical abnormality, leading to sterility or reduced fertility, could account for some 5% of reproductive failure. The association between genetic defect and parental age was an example of the interaction of social and hereditary factors which should be bringing together natural and social scientists. As was fitting, the discussions closed with a consideration of world population problems. Prof. R. FREEDMAN, from Michigan, showed how closely family size was related to other aspects of social structure and culture. He advocated promotion of interdependence of village communities in a wider society, and a concerted attack on illiteracy as the most promising way of achieving this. Prof. F. W. NOTESTEIN, of the Population Council, New York, pleaded for tact and patience in approaching developing countries about population problems. He did not believe that there were any quick solutions and was categorically opposed to the idea of giving economic " aid with population-control strings attached; the decisions involved were personal and could probably best be influenced through education and maternity and child welfare. There was need for more physiological research on reproduction and for the spread of demographic studies to the developing countries themselves. For a hundred and fifty years the Royal Society has held aloof from the social sciences. Demography would have fresh cause to be grateful to JOHN GRAUNT if his tercentenary marked the end of this isolation. "

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Annotations THE HUMAN ELEMENT IN EXPLORATION

THE man who explores is not readily understood by him who stays at home. Sir Vivian Fuchs, in a Rickman Godlee lecture delivered in London on Nov. 12, undertook to explain him and the process of his incorporation into an expeditionary team. The professional life of the explorer is longer than that of many a sportsman. The man in his 20’s certainly has the advantages of physical fitness and strength, but he may become bored if repetitive activity has to be continued for a long time; the older man, of 30 or 35, may do better as he will have learnt patience. The man ’over 35 has experience which compensates for any decline in his physical capabilities. This is particularly true if he has to lead. The leader who is too young must always be his making competence plain to all the members of his and this can be a strain. On the other hand, the team, young man can look forward to improving with time. The explorer should be sufficiently motivated-not only to begin his work but to complete it efficiently. Here, perhaps, lies the distinction between a traveller and an explorer. The former visits places which are new to him, mainly for his own education and interest. But the latter penetrates areas new to him and to mankind; and he records and publishes his work, which today embraces

1153 are past when over the land in consisted travelling merely exploration has The leader Morale needs cultivation. it. and mapping to in his and the to engender team, community spirit a sense of and man in each inculcate loyalty personal responsibility for the expedition’s success. If he has had a hand in choosing his men he will find this easier than if he has been sent out to meet the group for the first time in the field. But, either way, he will be dealing with a group of individuals. He must beware of the egotist (who is nothing more than selfish) and of the lazy man who produces sophisticated apologies for doing nothing; and in each member of his team he should encourage that most necessary characteristic of the explorer-his curiosity. Another important quality is imagination and the ability to interpret the unknown. The man with exotic but impracticable ideas is dangerous, valuable though he may be in an established laboratory. In strange territory, a man must be in tune with Nature and able to assess the factors which may be working against him. There are several ways of uniting a party. Common hatred of the leader is one-but not one to be recommended. Someone to act as a good-natured butt is often a useful safety valve; but if the leg-pulling falls on a man who cannot cope with it, the leader must quickly see that the man does not suffer. When things are going almost too well, a wise leader will temper high spirits with caution and maintain a reasonably even keel; then, if the situation takes a bad turn, he is ready to counteract any undue depression among his more volatile followers. Especially on isolated expeditions, men tend to become very petty and to complain that they are never told anything-a well-recognised symptom in all administrations. One good solution is to hold frequent roundtable conferences where every man’s comment is invited: he who says nothing will then have no excuse for complaint Human physiology and psychology are very later. The important factor on a relevant to exploration. successful expedition is not the limit of endurance but the level of human efficiency. The way men react in isolation may reveal their true patterns of behaviour and provide a useful opportunity for research: the problem is how to take advantage of this opportunity and introduce a psychologist into a closely knit group without disturbing the cohesion. A possible solution would be for a doctor serving in, say, the Antarctic, to return to Britain, qualify in psychology, and then go back to the Antarcticnominally, at least, as a doctor rather than a psychologist. Such a man, by virtue of the experience of his first trip, would be better able to distinguish normal from abnormal behaviour. Whatever patterns are revealed, findings in one national group cannot be applied automatically to another. But from all experience, said Sir Vivian, the British temperament did seem to be well suited to expeditions.

almost every scientific discipline. The days

CLASSIFICATION AND NOMENCLATURE OF MYCOBACTERIA

INTEREST in the taxonomy of mycobacteria has revived with the recognition that disease resembling tuberculosis, and weak but widely distributed sensitisation to tuberculin, may be produced by mycobacteria other than tubercle bacilli. These so-called anonymous, unclassified, or atypical strains need to be classified and named if they are to be better understood. At the same time, the tubercle bacillus itself has come under scrutiny. Tubercle bacilli are normally defined according to the characteristic

produce in certain animal species. Difficulty arises, however, from the occurrence of attenuated virulence-occasionally idiopathic, but often induced by chemotherapy. In practice, it has become necessary to regard as tubercle bacilli not only mycobacteria of the appropriate pathogenicity but attenuated strains which share certain cultural, biochemical, and immunological properties; and new definitions are needed to take these properties into account. In Britain, attenuation of virulence is not particularly frequent and mainly accompanies resistance to isoniazid; but in India at least, attenuated strains are quite common and most are drugsensitive.1 This is worth remembering in cases of tuberculosis in immigrants. The old division of tubercle infections they

bacilli into varieties is also out of date: what have been called the human, bovine, murine, and avian types can be accepted as the species Mycobacterium tuberculosis, Myco. bovis, Myco. microti, and Myco. avium respectively, but the so-called cold-blooded type has not been similarly established as an entity. The anonymous mycobacteria are troublesome to classify. Runyon’s2 four groups, defined by pigmentation and rate of growth, are generally accepted but far from satisfactory. The criteria are difficult to apply to some strains, and some quite dissimilar organisms are brought together in his groups 11 and iv. Collins3 now proposes a similar four-group classification based on sensitivity to thiosemicarbazone, growth at 44°C, and capacity to grow in a simple synthetic medium. These criteria are more objective and reproducible than Runyon’s, but homogeneity is not improved-nor will it be by any scheme which forces such diverse organisms into so few categories. The first step to a solution is to separate off the casual strains-the commensal, transient, or contaminating mycobacteria which have no pathological significance. These are chiefly eugonic -scotochromogens and psychrophiles whose classification is not of medical interest. Marks and Richards,4 in the light of their experience in Britain, have divided the remaining potentially pathogenic strains into seven groups:

Myco. kansasii, which corresponds to Runyon’s group I, is the most important organism causing mycobacterial pseudotuberculosis in Britain. Myco. scrofulaceum, as a scotochromogen, forms part of Runyon’s group II and is often found in cervical adenitis, although not the only anonymous mycobacterium responsible; it occasionally infects other sites besides. Group 3 has not previously been recognised as an entity and has therefore created difficulties in earlier schemes of classification. Group 4 corresponds to the " Battey bacillus " of America and to part of Runyon’s group III. Bacilli in group 5 do not seem to have previously been distinguished from those in group 4. Group 6 includes part at least of Runyon’s group Iv and probably incorporates Myco. fortuitum. And group 7 is somewhat artificial, being limited to certain strains isolated from patients with pneumoconiosis; but its members play a pathological role in these patients if seldom in any others. 1.

Mitchison, D. A., Wallace, J. G., Bhatia, A. L., Selkon, J. B., Sabbiah, T. V., Lancaster, M. C. Tubercle, Lond. 1960, 41, 1.

2. 3. 4.

Runyon, E. H. Med. Clin. N. Amer. 1959, 43, 273. Collins, C. H. Tubercle, Lond. 1962, 43, 292. Marks, J., Richards, M. Mon. Bull. Minist. Hlth Lab. Serv. 1962, 21, 200.