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685 TRIALS OF WHOOPING-COUGH VACCINES IN conjunction with the medical officers of health of Manchester, Tottenham, and Wembley, the Medical Research Council are initiating field trials to assess the protective value of pertussis vaccines. In these three .areas, parents of children aged 6-12 months have been invited to help by enrolling their children for inoculation within the next few months. The volunteer children are to be divided into two groups, one group receiving pertussis vaccine and the other group-the controlsDetails of the investigation an anticatarrhal vaccine. .are so arranged that no-one engaged in the day-to-day work of inoculation and subsequent follow-up will know which vaccine any particular child has received. The children are to be visited every month by specially appointed health visitors, who will take specimens for bacteriological examination from any child with a suspicious cough, and arrange for one of the doctors taking part in the trial to visit the child and make a clinical diagnosis. The results will be assessed at the end of two years. In the propaganda to parents-mainly by pamphlets and personal visits by health visitors-all the details The- enrolment of children has so are fully explained. far been encouraging. All general practitioners in the areas concerned have had a letter telling them about the investigation, and they have been asked to report any suspicious coughs in children included in the trial. The doctor will then be told immediately if whooping-cough is diagnosed by the special investigators. In the first place American vaccines, as prepared for Professor Sauer, of Evanston, and Dr. Pearl Kendrick, - of Grand Rapids, both of whom have claimed success with prophylactic vaccination, are to be used. The American vaccines have been chosen for trial because previous results obtained ’in controlled trials with a British vaccine had proved disappointing. If these prove satisfactory, further trials will be made with new British vaccines. ANÆSTHESIA
ON Oct. 30 the Princess Royal unveiled at the Royal College of Surgeons a memorial with the following
inscription : This tablet was erected in the Royal College of Surgeons of England by the Association of Anaesthetists of Great Britain and Ireland to mark the centenary of the first operation under Anaesthesia in this country and to keep the memory of four British pioneers whose names will be held in honour from generation to .generation HENRY HILL HICKMAN JAMES YOUNG SIMPSON JOHN SNOW JOSEPH THOMAS CLOVER
In his speech on this occasion Dr. A. D. Marston; president of the association, pointed out that two of the pioneers thus commemorated were members of the college, while one was a follow and he announced that a medal _; named after John Snow is to be awarded from time to time for signal service to the specialty. As recorded on p. 702, Dr. Marston presided next day at a centenary dinner held in Lincoln’s Inn. The main events and personalities of the story of ansesthesia were again reviewed in a fascinating address, delivered after a reception at the Royal Society of
Medicine on Nov. 1, by Dr. Stanley Rowbotham, president of the section of anaesthetics. It was surprising, he said, how long man suffered pain without making purposive efforts to relieve it ; how long he had the means at hand but did not use them ; and how long their use, once discovered, was opposed. Beginning with Sir in 1799 who Humphry Davy, stopped toothache with nitrous oxide and suggested that this gas might " probably be used with advantage " in surgical operations, he spoke of the experiments begun in 1824 by Hickman, the first man to conceive of an anesthetic state, and passed from
the observations and practice of Faraday, Long, Clarke, and Wells to those of Morton, who by his enterprise and determination made anaesthesia an accomplished fact. Having shown a portrait of the first child delivered under an anaesthetic, who was of course baptised Anaesthesia, Dr. Rowbotham noted how the popularity of ether, chloroform, and nitrous oxide waxed and waned as new methods of giving them were devised. In 1884 local anaesthesia was introduced on the Continent, and it is still largely in use there because of the comparative scarcity of specialist anaesthetists. (Sir Gordon Gordon-Taylor expressed the opinion that surgery is not going to advance much further in European countries without an advance in their methods of anaesthesia.) Then came intraspinal, endotracheal, and intravenous techniques, basal narcosis, and curare. The Society of Anaesthetists, parent of the R.S.M. section of anaesthetics, was founded in 1893, the first society in the world for the special discussion of the subject. The Association of Anaesthetists dates from 932 ; the diploma in anaesthetics, which Dr. Rowbotham thinks has done more than anything else to raise the standard of anaesthetic practice, from 1935 ; and the Nuffield chair at Oxford, creating a great centre for teaching and research, from 1937. Contrasting the operating-theatre of 100 years ago with that of today, he was astonished at the difference already made in the removal of pain. What other branch of medicine could claim such progress in a centur "May the next hundred years be as prolific in its gifts to mankind." TOO WIDE A GAP
suggestion on Oct. 26 that, in an experimental training school for nurses, a medical dean of nursing might be appointed has proved unwelcome both to Miss Houghton (p. 693) and to the Nursing Times (Nov. 2, p. 836). The dismay which this proposal, made in full sympathy with nursing interests, has evoked is some measure of the gap now dividing the two main professions responsible for the welfare of the patient. Perhaps it will reassure our nursing colleagues if we add that in OUR
medical schools we should like to see a senior member of the nursing staff appointed to ensure that medical students get enough instruction in the principles of nursing, that they watch all major nursing measures carried out by experts, and that no young doctor enters general practice (as many do at present) grossly ignorant of one side of the care of the sick. We must not be afraid to learn from one another : it has long been the great pride of medicine and nursing that knowledge is freely shared. THE BASIC SALARY
ON Monday the House of Commons, by 303 votes to 128, declined to say that remuneration of general practitioners in the National Health Service should normally be by capitation fees alone. Much was made of the advantages of a basic salary. But there would also be great advantages in reserving such a salary, as the House of Lords suggested, for circumstances in which it is clearly required. By accepting this arrangement the Government could have gone far to secure the willing participation of practitioners in the service. Happily the Minister’s words, as reported on p. 697, allow us to hope that this question will be reconsidered in the coming negotiations. Sir EDWARD THORNTON, late secretary for public health and chief medical officer for the Union of South Africa, has died at Pretoria. A former D.G.M.s. of the Union’s Defence Forces, he later held the appointment of director-general of rehabilitation training. He was 68 years of age.
ON Oct. 30 the Princess Royal unveiled at the Royal College of Surgeons a memorial with the following
inscription : This tablet was erected in the Royal College of Surgeons of England by the Association of Anaesthetists of Great Britain and Ireland to mark the centenary of the first operation under Anaesthesia in this country and to keep the memory of four British pioneers whose names will be held in honour from generation to .generation HENRY HILL HICKMAN JAMES YOUNG SIMPSON JOHN SNOW JOSEPH THOMAS CLOVER
In his speech on this occasion Dr. A. D. Marston; president of the association, pointed out that two of the pioneers thus commemorated were members of the college, while one was a follow and he announced that a medal _; named after John Snow is to be awarded from time to time for signal service to the specialty. As recorded on p. 702, Dr. Marston presided next day at a centenary dinner held in Lincoln’s Inn. The main events and personalities of the story of ansesthesia were again reviewed in a fascinating address, delivered after a reception at the Royal Society of
Medicine on Nov. 1, by Dr. Stanley Rowbotham, president of the section of anaesthetics. It was surprising, he said, how long man suffered pain without making purposive efforts to relieve it ; how long he had the means at hand but did not use them ; and how long their use, once discovered, was opposed. Beginning with Sir in 1799 who Humphry Davy, stopped toothache with nitrous oxide and suggested that this gas might " probably be used with advantage " in surgical operations, he spoke of the experiments begun in 1824 by Hickman, the first man to conceive of an anesthetic state, and passed from
the observations and practice of Faraday, Long, Clarke, and Wells to those of Morton, who by his enterprise and determination made anaesthesia an accomplished fact. Having shown a portrait of the first child delivered under an anaesthetic, who was of course baptised Anaesthesia, Dr. Rowbotham noted how the popularity of ether, chloroform, and nitrous oxide waxed and waned as new methods of giving them were devised. In 1884 local anaesthesia was introduced on the Continent, and it is still largely in use there because of the comparative scarcity of specialist anaesthetists. (Sir Gordon Gordon-Taylor expressed the opinion that surgery is not going to advance much further in European countries without an advance in their methods of anaesthesia.) Then came intraspinal, endotracheal, and intravenous techniques, basal narcosis, and curare. The Society of Anaesthetists, parent of the R.S.M. section of anaesthetics, was founded in 1893, the first society in the world for the special discussion of the subject. The Association of Anaesthetists dates from 932 ; the diploma in anaesthetics, which Dr. Rowbotham thinks has done more than anything else to raise the standard of anaesthetic practice, from 1935 ; and the Nuffield chair at Oxford, creating a great centre for teaching and research, from 1937. Contrasting the operating-theatre of 100 years ago with that of today, he was astonished at the difference already made in the removal of pain. What other branch of medicine could claim such progress in a centur "May the next hundred years be as prolific in its gifts to mankind." TOO WIDE A GAP
suggestion on Oct. 26 that, in an experimental training school for nurses, a medical dean of nursing might be appointed has proved unwelcome both to Miss Houghton (p. 693) and to the Nursing Times (Nov. 2, p. 836). The dismay which this proposal, made in full sympathy with nursing interests, has evoked is some measure of the gap now dividing the two main professions responsible for the welfare of the patient. Perhaps it will reassure our nursing colleagues if we add that in OUR
medical schools we should like to see a senior member of the nursing staff appointed to ensure that medical students get enough instruction in the principles of nursing, that they watch all major nursing measures carried out by experts, and that no young doctor enters general practice (as many do at present) grossly ignorant of one side of the care of the sick. We must not be afraid to learn from one another : it has long been the great pride of medicine and nursing that knowledge is freely shared. THE BASIC SALARY
ON Monday the House of Commons, by 303 votes to 128, declined to say that remuneration of general practitioners in the National Health Service should normally be by capitation fees alone. Much was made of the advantages of a basic salary. But there would also be great advantages in reserving such a salary, as the House of Lords suggested, for circumstances in which it is clearly required. By accepting this arrangement the Government could have gone far to secure the willing participation of practitioners in the service. Happily the Minister’s words, as reported on p. 697, allow us to hope that this question will be reconsidered in the coming negotiations. Sir EDWARD THORNTON, late secretary for public health and chief medical officer for the Union of South Africa, has died at Pretoria. A former D.G.M.s. of the Union’s Defence Forces, he later held the appointment of director-general of rehabilitation training. He was 68 years of age.