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Notes and News

EFFECTS OF MASS B.C.G. VACCINATION

MEASURING the effects of mass B.c.G. vaccination by thesubsequent tuberculosis mortality involves long delay. Thistime-lag, Dr. T. Godde-Dahl suggests, might be overcomeby studying the earliest manifestations of infection withtuberculosis. In Norway both erythema nodosum and

pleurisy are notifiable ; and since 1941 their incidence hasdeclined remarkably, as the following figures show :

Erythema nodosum Pleurisy1941 .... 1374 .... 29891942 .... 1416 .... 26871943 .... 1155 .... 22031944 .... 1192 .... 22931945 .... 1073 .... 21081946 .... 1147 .... 19911947 .... 859 .... 17081948 .... 634 .... 1247

It will be seen that the fall in numbers was greatest in thelast two years, during which, for the first time, mass B.c.G.vaccination was carried out (about 35,000 vaccinations in1947, and about 135,000 in 1948). There are, of course,various other factors for which credit can be claimed ; duringthe past decade there have been large advances in the

campaign against tuberculosis, and since 1943 mass radio-

graphy has played an important part. The invidious taskof apportioning marks between all the factors capable ofreducing morbidity and mortality would tax the ingenuityof any statistician, and Dr. Gedde-Dahl is not prepared torush in where purists would not tread. But he has a

suggestion to make : let tuberculosis notifications be accom-panied by a statement that the person concerned has, or hasnot, been vaccinated with B.C.G. In countries where massvaccination with B.O.G. is extensively practised, this planmight well yield valuable information.

ADDITIONS TO THE POISONS LIST

THE following changes are to be made in the poisons listand rules :

D. F. P. (di-isopropyl ftuorophosphonate) will be added to part iof the poisons list and included in the first and seventh schedules tothe poisons rules. The special labelling requirements prescribed bythe seventh schedule will apply to eyedrops as well as to injectionsolutions.

Deca-, hexa-, penta-, &c., methonium iodide will be added to part Iof the poisons list and included in the first and fourth schedules tothe poisons rules. They will be listed as

" polymethylene bis-trimethyl ammonium salts."

Anti-histamine drugs will be added to part I of the poisons list andincluded in the first and fourth schedules to the poisons rules.Exemption will be provided for preparations intended for externalapplication only.

Synthetic drugs.-The following drugs to which part III of theDangerous Drugs Act, 1920, is shortly to be applied will beadded to part I of the poisons list and included in the first scheduleto the poisons rules :

Alphaprodine (a-4-propionoxy-4-phenyl-1: 3-dimethyl-t-piperi-dine) its salts ;

Betaprodine (-4-proplonoxy-4-phenyl-l : 3-dimethyl-4-piperi-dine) its salts ;

Hydroxypethidine (ethyl-4-m-hydroxyphenyl-l-methylpiperidine-4-carboxylate) its salts ;

Isoamidone (6-dimethylamino-4 : 4-diphenyl-5-mothylhexan-3-one) its salts ;

Ketobemidone (I-propionyl-I-m-hydrogyphenyl-1-methylpiperi-dine) its salts ;

Methadol (6-dimethylamino-4 : 4-diphenylheptan-3-ol) its salts;Methadyl acetate (6-dimethylamino-4 : 4-diphenyl-S-heptyl

acetate) its salts.

Part m of the Dangerous Drugs Act, 1920, will also be applied tophenadoxone, a poison at present included in part I of the poisonslist and in the first and fourth schedules to the poisons rules underthe description " 6-morpholino-4 : 4-diphenylheptan-3-one ; itssalts." The name phenadoxone and the present description will beadopted in part i of the poisons list and the first schedule to thepoisons rules. The reference in the fourth schedule will be deletedas no poison in that schedule is also subject to control under theDangerous Drugs law.The British and American conventional form will be adopted in

the Dangerous Drugs law for amidone, a poison included in part Iof the poisons list and the first schedule to the poisons rules." Amidone (dl-2-dimethylamino-l : 4-diphenylheptan-3 -one) itssalts " will accordingly be deleted from part i of the poisons list andthe first schedule to the poisons rules and replaced by " Amidone(6-dimethylamino-4 : 4-diphenylheptan-3-one) its salts."

Rules 7 and 12 of the poisons rules will be amended to legalisethe supply in ampoules of an additional quantity of a poison suffi-cient to permit the withdrawal and administration of the quantityordered and the amount prescribed.

1. Nord. Med. March 10, p. 444

NUFFIELD TRUST IN NORTHERN IRELAND

THE first meeting took place recently in Belfast of theNorthern Ireland committee of the Nuffield Provincial Hos-pitals Trust. In 1942 the Northern Ireland Regional HospitalsCouncil was constituted under the chairmanship of Mr. D.Lindsay Keir (now Sir David Lindsay Keir). This councilwas formed under the aegis of the Nuffield Provincial HospitalsTrust, and it will be remembered mainly for its " Survey ofthe Hospitals Services of Northern Ireland," published in1945, and for its " Plan for the Hospital Services for NorthernIreland," published in 1946. With the passing of the HealthServices Act (Northern Ireland), 1948, it was believed that thecouncil had fulfilled its main purpose. It was felt, however,that there was a place for an independent voluntary body,fully representative of all the health and social services ; andaccordingly the council’s final act was to draw up a newconstitution, providing for the formation of a committee tobe known as the Northern Ireland committee of the NuffieldProvincial Hospitals Trust.Under its constitution this committee has for its aims:

(a) to assist the coordination on an area basis of hospitalservices ; (b) to initiate and promote research which aims atthe raising of the standard of hospital services throughout thearea ; and (c) to advise on any proposals which serve theforegoing purposes. Further, its functions are to advise andcooperate with the statutory and other bodies on such mattersas may seem conducive to the improvement of the hospital,ancillary, or auxiliary services within the area, and also toinitiate, promote, and encourage, whether independently orin consultation with appropriate bodies, research on thecausation, prevention, and treatment of disease, and for theimprovement of the hospital, ancillary, and auxiliary services.It aims to achieve in every possible way the raising of thestandard of service to the patient throughout the area.

" IN PRAISE OF NURSES" 1

NURSES have always deserved a poet to sing their praises,and it is pleasant that they should have found such a dis.tinguished one as Mr. John Masefield. In a set of verseshe declares his appreciation, especially, of the five who latelynursed him in sickness :

" All honour Doctors ; let me honour those- Who tend the patient when the doctor goes."

He wrote at that enchanted stage of recovery when everyone of the five seemed more than human, more than thekind young woman his wits knew her to be ; and this is

surely the right moment to praise nurses for the essentialquality of their art. To each other they may be sensible,jolly, hard-working, flippant, talkative, or a dozen other

things that go with youth, hearty appetites, and simpletastes ; but to the sick man they have something to giveof which they are themselves unaware until they fall sickand experience it-, a nourishing tenderness springing fromtheir own strongest and most lasting instinct. It was this

quality which another poet had in mind when he wrote :" When pain and anguish wring the browA ministering angel thou."

-lines now so hackneyed that they can hardly be readwithout a smile. Mr. Masefield, less romantic and moredirect about it, writes of them

" Cleansing the foul, and smiling through the piqueOf nerves unstrung..."

He ends with a gratitude and simplicity which we must allshare on his behalf :

" I thank and bless you : that I write at allIs, by itself, your work’s memorial."

University of CambridgeAt a congregation to be held on June 8 the honorary degree

of sc.D. will be conferred on Dr. William S. Middleton, deanof the medical school of the University of Wisconsin.

University of BirminghamOn May 15, 16, 17, and 18, at 4 P.M., Prof. Herbert M.

Evans, director of the institute of experimental biology.University of California, will deliver the William Witheringlectures at the anatomy theatre of the medical school. He isto speak on the Internal Secretions of the Anterior Lobe of thePituitary Body.

1. London : Heinemann. 1950. 1s.