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of religion. May not the answer be that an experiencedgeneral practitioner should lecture with the supportof a panel of gynaecologist, psychiatrist, and ministerof religion ? The apprenticeship of students to familydoctors (as recommended by the College of General

Practitioners) would provide excellent opportunitiesfor such teaching, though I am aware of the difficultiesin choosing doctors for this purpose. Nevertheless,I feel that a few systematic lectures to senior studentscould provide them with information not otherwise

easily obtained and would enable them at least to askquestions of their teachers about problems which,oreviouslv, they had not known to exist.

BERNARD SANDLER.

COMMON-ROOMS FOR PATIENTS

I. MIRVISH.

SIR,—In children’s hospitals, it is usual to have play-rooms near the wards, for the use of children not con-fined to bed. Could not the same principle be appliedwith advantage to adults iri general hospitals ?

I visualise two types of common-room for this purpose :a

’‘

quiet " one for elderly people and those recoveringfrom serious illnesses and operations ; and an " active "

room containing ping-pong table, occupational therapyapparatus, &c., for the less incapacitated.Instead of aimlessly wandering round the hospital in

their dressing-gowns, ambulant patients would be ableto enjoy the benefits of convalescence while still underhospital supervision.

I am sure many readers would be interested to knowwhat is being done about this problem in Great Britain.

HOSPITAL INFECTION

I. M. LIBRACH.Ilford Isolation Hospital,Chadwell Heath, Essex.

SIR,—As one working in an isolation hospital, I havefollowed the recent correspondence in your columns withgreat interest.

I must agree with much of what Dr. Marsh says in hisletter of May 4. As he so aptly states, hospital infectionis no new thing. After all, it was one of the major causesof death in hospital in the l9th century.Surely its control simply represents the application of

common epidemiological principles to special circum’-stances. In this regard the experience gained in theadministration of fever hospitals seems to have beenforgotten or ignored. This is not surprising, resulting asit does from the now commonly held views on hospitaladministration in general and on the future of fever

hospitals in particular.For years before the National Health Service was

formed, medical administration in fever hospitals wasconstantly grappling with the problem of cross-infection.The principles of barrier nursing and then cubicle nursingwere intensively practised in them. It was by their rigidapplication that so many different infections could betreated.

I have deliberately used the past tense, because thepresent-day accent on the purely clinical aspects of

hospital work has led and will lead to a new generationof doctors and nurses lacking any basic epidemiological

training or background. Although the contribution of thebacteriologists in hospital and laboratory cannot beignored, nevertheless much of our existing epidemiologicalknowledge was built up not by them but by medicalofficers of health in the field and medical administratorsin fever hospitals. That both should now be ignored iscertainly a sign of the times.

If, as seems likely, ultimate ofticial policy is to dis-pense with fever hospitals as such, then, I submit, themain training-ground in hospital epidemiology will belost. Nowadays many of these hospitals face gravenursing shortages. It would certainly be to their mutualadvantage if all nurses in general training were obliged

to do six months training in a fever hospital before theirS.R.N. examination, for surely one of the main factors inpreventing hospital infection is the nurse with sound

epidemiological knowledge.

1. Brit. med. J. 1955, i, 1426.2. Anderson, S. G. Lancet, 1954, ii, 1107.3. The Director’s Annual Report of the Walter and Eliza Hall

Institute, 1954-55 ; p. 23.4. Rustigian, R., Johnston, P., Reihart, H. Proc. Soc. exp. Biol.,

N.Y. 1955, 88, 8.5. Hull, R. N., Minner, J. R., Smith. J. W. Amer. J. Hyg. 1956,

63, 204.6. The Director’s Annual Report of the Walter and Eliza Hall

Institute, 1955-56 ; p. 21.7. Coons, A. H., Kaplan, M. H. J. exp. Med. 1950. 91, 1.8. Anderson, S. G. J. Immunol. 1949, 62, 29.

CLINICAL THERMOMETERS

HENRY TIDY.

SIR,—In his letter last week Dr. Widlake asks whythe so-called half-minute clinical thermometer requiresat least two minutes to record a correct reading. I haveasked this question for fifty years and do not know theanswer yet. I have not found it in any book which Ihave consulted. A few years ago I was told that themark " half-minute " was the manufacturers’ guaranteethat, if the thermometer is placed in warm water aboutblood heat, it would record the temperature correctly inthat time. I have asked various of my associates butnot one of them has heard this explanation or indeedany other. In a letter published two years ago I gavethis explanation and asked if it was correct. I had hopedthat some manufacturer would reply, but none did so.Surely it is time that this mystery, which has puzzledthe medical and nursing professions for many decades,was cleared up by those who must know the explanation.

ATTEMPTS TO PROPAGATE RUBELLA VIRUS INTISSUE-CULTURE

SIR,—A previous publication 2 reported the appearanceof lesions in monkey-kidney tissue-cultures inoculatedwith rubella throat washings. Similar lesions were absentor scarce in control cultures. The lesions did not appearin the presence of convalescent human serum.

Further passages of both inoculated and control culturesbecame contaminated with one or more agents derivedfrom kidney tissue or medium.3-5 The passages werediscontinued. Attempts were made to reproduce the virallesions in kidney cultures derived from monkeys whoseserum contained no neutralising antibody to the con-taminating agents. To the culture medium was added2% heated (56°C for 30 minutes) monkey serum con-taining such antibody. No specific lesions appeared andnonspecific lesions were not completely eliminated. s

Inoculated and control cultures of the latter series weretreated with convalescent rubella gamma-globulincoupled to fluorescein isocyanate, by a method similar tothat of Coons.7 Specific staining of inoculated, but notcontrol, cultures was demonstrated in some experiments,but could not be regularly reproduced. s

Supernatant from fifth-passage inoculated cultures

showing presumed viral lesions was sprayed into thenoses of eight human volunteers aged 9 to 27 years, withno history of rubella.3 This material represented a 10-10dilution of original throat washing ; the technique of

spraying has been described elsewhere.8 After incubationperiods of 19, 19, and 20 days respectively three volun-teers developed a mild and transient exanthema, lowfever (99°-100°F) and slight but definite enlargement ofpostauricular lymph-glands. The clinical picture wasconsistent with a diagnosis of very mild rubella, but wasnot sufficiently definite to allow a firm diagnosis to bemade.

Throughout this work there were occasional suggestionsthat rubella virus was multiplying in monkey-kidney