The London School

1% manner, with arresting illustrations, the summary of the Bill and the present deficiencies.) The Bill is " T o provide for the general welfare by enabling the several States to make more adequate provision for the health of school children through the development of school health services for the prevention, diagnosis, and treatment of physical and mental defects and conditions." I n the speech of its introducer, Representative Howell, in the House of ::l~epresentatives, mention was made that approximately 30% o f the young men, from 18 to 37 years of age, inclusive, examined for military service in the recent war were rejected for physical or mental defects which made them unfit to serve their country. Many of the defects which disqualified millions of young men for military service could have been detected and corrected when the men were boys in school. These statements sound like an echo of the arguments used in the beginning of the century in this country when school medical services were being advocated! Yet it is strange to believe that at the present time, according to the introducer of the Bill, not even half of the school-age children and young people in the United States receive even a health examination, let alone corrective care, and that where examinations are given there is rarely any provision for follow-up remedial work. We note with interest also the speaker's remarks that the Bill " should not be confused with the large issue of providing health insurance for the whole population with which my Bill has nothing whatever to do." Prosit omen ! Bacteriological Grading of Ice-Cream The ice-cream season is again upon u s ; new regulations came into force on May 1st and it is right to review the position of the local authority in regard to the control of this commodity. For many years we have been concerned with the possibilities of infection from contaminated ice-cream. Outbreaks of disease have from time to time been traced to this source but few have received the publicity of the two epidemics recorded in 1946. Aberystwyth and Coatbridge both suffered, but there is no doubt that through their suffering there was born in the minds of, at least, a certain section of the population a healthy dislike of ice-cream of questionable purity. Medical offigers of health and sanitary inspectors have agitated for many years for more effective powers of control and some have been quite outspoken in asking for a comprehensive ice-cream legislation comparable to that by which milk supplies are controlled. T h e publications of Priestley and Dixon (1945), Cross (1948) and others have shown only too clearly how inadequate are a local authority's legal powers in this matter to-day. The greatest of a number of difficulties facing the officer of a local authority in his efforts to ensure the purity of ice-cream still hold good. These have been the complete absence of any bacteriological standard whatever, in both existing and proposed legislation, and the exemptions by which licensed premises and places of entertainment arc specifically excluded from the local authority's registration. Circular 183/46 has finally and pub.licly, discredited the bacterial count as a means of testing purity m ice-cream. Local authorities are advised to use it solely as a guide to the discovery of faulty methods, but the ice-cream manufacturer has been told authoritatively that the test is of no value : so what good is it as a guide ? This test has long been known to be inadequate, if only because a low count may not mean a safe ice-cream. But surely a high count can only mean faulty methods of manufacture, distribution and sale, and, pending the introduction of a more adequate test, need not have been so ruthlessly deposed, and ,a still useful lever of persuasion removed from the medical officer's scanty armoury. T h e most hopeful feature in the fight for clean and safe ice-cream to=day is the opinion of a large section of the trade itself. Regularly do the trade journals reiterate the need for some equitable standard, and it is good to hear* that there is * Report of a sub-committee appointed to enquire into tests for the bacteriological, grading of ice-cream, Monthly Bulletin of the Ministry of Health and Public Health Laboratory Service (March,

19¢7, p. 60).

I~UBL~C HEALTH, May, 1947 now reason to believe that the Methylene-blue Reduction Test may prove itself worthy of an extended trial by local authorities. It was inevitable that grading as envisaged in the Public Health Laboratory Service report was omitted from the recently published regulations, but we hope that such introduction may not be long delayed and that t h e " pass" standard set is adequately high. Nothing lower than milk standards should be considered, for it must not be forgotten that there will, after. May 1st, be relatively more " cold mix " ice-cream manufactured. T h e small manufacturer will not face the outlay involved in complying with the proposed heat treatment regulations, even if all the necessary equipment were available, which it is not, and many will revert to the " cold mix " method. Popular though the " cold mix " is with the small trader, the medical officer's long-standing objections to it have been endorsed by the Laboratory Service report which suggests it is more prone to contain coliform organisms generally, and faecal B , coli in particular, than the pasteurised mix.

Health History of a Rural District We commend to our readers Dr. Eric Ward's presidential address to the Southern Branch of the Society, printed elsewhere in this issue, in which he reviews the public health history of the rural district of Midhurst since 1878. This district's population has not shown much fluctuation since that year, so that interesting comparisons are possible of the incidence of disease in various periods. The sanitary history is also illuminating. As Dr. Ward points out, the district has enjoyed the services of M.O.s H. engaged whole-time in public health throughout the period. Yet it took 24 years of agitation by the first M.O.H. to secure a piped water supply for Midhurst town, and 20 years to get a sewerage scheme. The change of public attitude in such matters in recent years is significant. Such a review, which must have entailed considerable study of the annual reports and other records, is well worth while and affords interesting comparisons with such urban records as that by Dr. G. F. Buchan on his years in Willesden, and the Luton and Middlesbrough surveys of last year.

Lest We Forget Many members ~of the Metropolitan Branch who heard Dr. Waldron, of Greenwich, give his account of his war-time experiences in the British Liberation Army asked that it should be reproduced in this journal. We feel that no excuses need be made for devoting a few of the pages usually given to recording the war against disease to this account of one man's encounter with the " evil things " against which we fought from 1939-45. Dr. Waldron conveys most vividly the impression which the entry into Belsen Camp made upon him and which we suspect will never leave him. His story will strengthen our conviction that this depth of man's inhumanity to man must never be tolerated again.

The London School The annual report of the London School of Hygiene and Tropical Medicine for the academic year 1945-46 shows that great progress has been made in the return to full peace-time activity in teaching rand research. More than 60 students, nearly all from the Services, took part in the D.P.H. course, the majority of the staff returned from war duties and new appointments were made. T h e great handicap was still lack of space owing to slow progress in the repair of the considerable bomb damage suffered by the School. In the department of Public Health, Professor Mackintosh has introduced some interesting ideas into the D.P.H. course, such as formation of a " p u b l i c health committee" among the students to familiarise them with the procedure they will meet in their future careers, and historical study u n d e r Dr. McCracken of contemporary reports in the 1840-50 period. The field work is also well looked after by co-operation with St. Pancras, Tottenham, Stepney and Twickenham, whose M.O.H.s also do part part-time teaching in the School itself.