VACCINES AND THE COMMON COLD.

834 in the later months of foetal life. The second and rarer type is non-pigmented. in which all choroidal and retinal structures have been completely destroyed and replaced by scar tissue with generally some ectasia of the sclera. This may be due to a chovoidal infection in the earlier months of feetal life when the tissues are less formed and less resistant to attack. A third type is still rarer in which the tmacular coloboma is associated with abnormality of blood-vessels. A case has been recorded in which a persistent hyaloid vessel emerged from a, macular coloboma. Miss Mann points out that by no possibility could a hyaloid artery enter the eyeball at the macula instead of at the disc, and her ingenious explanation is that at a very early period of fœtal life—before the end of the third month—an inflammatory process beginning in the macular region caused an adhesion of an adjatcnt branch of the hyaloid artery and that a perforation of the optic cup at the weak spot allowed )a ciliary vessel to communicate with this so that it retained its patency long after all other remains of fn-tal structures had disappeared. Such studies as these have a practical importance, for if it can be shown that certain congenital conditions are infective in origin and not developmental, we are at once able to exclude any relation to an innate hereditary defect in these

particular

cases.

_____

VACCINES AND THE COMMON COLD. IN the current number of the Journal of Hygiene Fergus R. Ferguson. (vol. xxvi., No. 1) is It paper A. F. C. Davey, and W. W. C. Topley, describing an attempt to discover whether there is any value in prophylactic inoculation against the common cold. A population conTheir results were significant. sisting of students of the university and members of the departmental staffs was inoculated during October and November, and the subsequent incidence and severity of colds amongst them was recorded for the period ending on the last day of the following May. The mixed vaccine employed was of a type which has been widely used in this countrv and contained eight different organisms or groups of organisms ; three immunising doses were given at weekly intervals. The experiment was as adequately controlled as it possibly could be, as might be expected in work emanating from the Department of Bacteriology and Preventive Medicine of Manchester The population examined numbered University. 286. of which 138 were immunised and 148 served as controls. Every precaution was taken to ensure that this division was a fair one. For example, a certain number of the population desired to be immunised, whilst others wanted to serve as controls, and it was necessary to guard against the inoculated population containing an undue proportion of individuals who would be influenced in favour of the treatment because they suffered from colds. The relevant facts concerning the fate of the inoculated and the uninoculated are briefly as follows : 138 inoculated persons at risk suffered from 203 colds, giving a mean number of colds per person of 1-47 ; 148 uninoculated persons suffered from 168 colds, or 1-14 per person. As regards the severity of the infections, the mean duration of the colds in days was 13-0 arnong the inoculated and 10-7 among the uninoculated, and the percentage of colds associated with fever was 25-1 among the inoculated as compared with 19-0 among the controls. The only possible conclusion is that prophylactic vaccination with the stock vaccine used is valueless, but the investigators are doubtful whether the evidence justifies the conclusion that the inoculations actually did harm. These results are in general agreement with those obtained in two experiments carried out in America in 1921, and constitute a body of evidence which it is difficult to ignore. Influenced by the results of antityphoid inoculations even those who can see little reason to look for good results from therapeutic inoculations have been prepared to accept the value of prophylactic vaccination against colds as well as against many other diseases. But the evidence in

by

their

favour has largely been based on uninstructed and Prof. and his colleages point out that the reports of individual patients are worthless as evidence of efficient prophyla they find themselves in agreement with E. O. fordan and W. B. Sharp,1 who investigated the problem conelusions and remarked that ’Satisfied differ widely from those of controlled statistics. Although the difficulties of adequately controllim methods of treatment in the severer diseases are obvious,the minor maiadies are susceptible to a more rigid investigation, and it is to be hoped this type of Dr. A. I. Simey experiment will be extended. suggested not long agoa combined test-effort on the part of medical officers of public schools.

Topley

lay opinion,

"

DEATHS

FROM

DISEASE

patient

IN THE

CROWN

COLONIES. in the Ilouse of Commons. the Colonial Seeretary supplied a statistical table. singularly complete. setting out the number of deaths attributed t" certain specified, diseases which occurred irr Crown Colonies during the years 1923-25. From this table it is clear that black water feverstill remains a most pott’nt form of death in the Central African Colonies. especially amongs the European population. and the largest number in a single year (23 in 1925) are recorded frmn the Uganda Protectorate. while Tanganyika Territory holds the second place in the East. and on the West Coast Nigeria heads the list with a total number of 31 deaths in three years. This most deaded of tropical fevers hardly features as a cause )f death in the other protectorates (of which 39 are cited). save in the case of Malaya. Palestine, and British Guiana. Yellow fever accounted for 19 deaths on the Gold Coast during the period under review, and for 15 in Nigeria, Fortunately it is unknown elsewhere. save in British Honduras where it accounted for one fatality in 1924. Small-pox is recorded as the cause of death in 66 cases in Kenya irr 1925, and or numerous others both in East and West Africa, though the returns are obviously far from complete: but no variola fatalities are recorded from the Unfederated Malay States, from British Guiana. or from the West Indies. Epidemic encephalit is has been noted in Kenya (two in 1924), Malta (20 deaths), and the Straits Settlements (2). Epidemic cerehro-spina! fever is the most deadly and widespread according to these returns; thus fatal cases are recorded in all the 39 protectorates and colonies on the list. On the Gold Coast 408 fatalities are recorded, frum Uganda 367, from Ceylon 312. Though less prevalent than in West Africa, it is a potent cause of death in the West Indies. Itis instructive to note that fatal cases of anterior poliomyelitis are recorded sparingly From Central Africa, the Malay States and though the aggregate number from this cause issmall (a total of 45 in three years). These are some of thf be made from figures which deductions which must have taken much time and trouble to collect and compile. Those who wish to follow the trend of fatal disease in some of the most important parts f the British Commonwealth should turn to the figures as given in Hansard of April 6tli.

Fiji.

may

MISUNDERSTANDING OF PANEL PRESCRIBING. THE regulation and supervision of preseribing in insurance practice appear still to be misunderstood in A correspondent who is given prominent some areas. place in a responsible Edinburgh journal makes the absurd statement that the total cost of the drug-: which a panel doctor may give his patient in a full year must not exceed the sum of Is. 1 (M. perperson And he adds, by way of illustration, that on his list. 12 doctors were called upon to pay sums varying from £5 to 50 for giving their patients medicines of a 2

1 Jour. Inf. Dis., xxviii., 337. THE LANCET, 1925, ii., 1053.