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the serological laboratory of the university clinic fornervous diseases. The state of his health prevented hisaccepting appointments offered to him in Venezuelaand Bolivia.

Wolff-Eisner regarded it as his life’s work to provethat Pfeiffer’s discoveries on lytic immunity and theendotoxins apply not only to typhus and cholera, butalso to many other diseases in men and animals--especially tuberculosis. His H andbuch der experi-nzentelleyc Serumtherapie was published in 1910. He wasthe friend of Ehrlich and Calmette, and his relationshipwith the latter was unclouded by their rival claimsfor priority in the discovery of the cutaneous andconjunctival reaction for tuberculosis.

In the memorial printed at his death a colleaguestresses as his outstanding quality-" seine unbestechlicheWahrheitsliebe, ein absolutes Gefuhl fur Recht, das ihnzwang, überall dort in die Schranken zu treten, wo erglaubte dass Recht bebeugt wurde, auch wenn er sich... selbst sehr oft damit geschadet hat."

Public Health

Insurance against Industrial Diseases

EARLY last year a committee was set up by Mr. JamesGriffiths, Minister of National Insurance, with instructionsto advise on the principles which should govern theselection of diseases insurable under the NationalInsurance (Industrial Injuries) Act, 1946. In its report 1the committee expresses the opinion that the tests whichthe Samuel Committee of 1906 recommended for applica-tion before a disease was scheduled are no longer appro-priate. The present committee recognises, that for adisease to be selected for insurance, particular cases mustnormally be attributable with reasonable certainty to thenature of employment. Subject to this overriding test,the primary consideration should be whether the diseaseis specific to an occupation, or, if not specific, whetherthe occupation causes special exposure to risk of thedisease ; incidence alone is not a conclusive test of risk.A condition which can be treated as an accidental injuryshould not be selected for insurance as a disease, unlessit can be more suitably dealt with in this way. Thecommittee also recommends the appointment of a smallstanding committee to investigate proposals for addingto the list of selected diseases, to review periodically theexisting list, and to suggest subjects for research.

Diphtheria in Scotland

The capacity of inoculation to protect against diph-theria and to reduce fatality is well known. There is,however, less evidence of the difference in the charac-teristics of the illness in the inoculated and the uninocu-lated ; and in Scotland a subcommittee of the Departmentof Health’s scientific advisory committee has undertakenan investigation 2 to fill the gap. -

The subcommittee, under the chairmanship of Prof.J. W. McNee, investigated the records of 4272 of the9340 cases admitted to hospital in 1942. Of these4272 cases 58-5% were in females, and over the age of15 almost 75 % were in females-a finding attributedto this sex’s greater attachment to the home and closercontact with children.Of the 3187 cases in which the type of organism

. was recorded 2219 (69-6%) were of the gravis type.Altogether 1746 (40-9%) of the patients developed somecomplication ; and the incidence of toxic complicationswas appreciably higher in patients under the age of 10.The over-all fatality-rate was 2 -97 %—a low rate inview of the preponderance of gravis infections. Overhalf the deaths were in patients with circulatory com-plications. In uncomplicated cases the fatality-rate was0-75%. With tonsillar diphtheria gravis infection wassix times more fatal than intermedius and mitis, whereas

1. Ministry of National Insurance: Report of the Committeeon Industrial Diseases. Cmd. 7557. H.M. Stationery Office. 4d.

2. Department of Health for Scotland. Diphtheria: Report bythe Infectious Diseases Subcommittee of the Scientific AdvisoryCommittee. H.M. Stationery Office. Pp. 31. 6d.

with pharyngeal and multiple sites gravis infectionwas only twice as fatal.

’ ’

Counting all the 1023 with a history of inoculation as" inoculated," the fatality-rate in the inoculated was0-68%, while in the uninoculated it was 3-69%. Withregard to the incidence of complications, the inoculatedfared little better than the uninoculated. Of all inoculatedcases, 2-16% developed nervous complications, 7-2%circulatory complications, and 0-3% a combination ofthese two ; for the uninoculated the comparable figuresare 4-05%, 4-8%, and 0-77%. However, in inoculatedpatients there were significantly fewer toxic complica-tions than in the uninoculated of the same age-groups.In the inoculated who developed nervous complicationsthere were no deaths, while in the inoculated withcirculatory complications the fatality-rate was 6-4%;for the uninoculated the fatality-rates were respectively5-26% and 27-88%. Compared with the uninoculated,the inoculated had a significantly higher proportion ofgravis infection (suggesting a less solid immunity thanagainst intermedius and miti ). They* also had a

significantly higher proportion of tonsillar infections andsignificantly less pharyngeal and multiple infections.On admission toxaemia was significantly less.

Poliomyelitis in British Zone of GermanyThe peak of the poliomyelitis outbreak in the British

zone of Germany was reached between Sept. 18 and 25with 267 cases and 34 deaths. Totals for the month ofSeptember were 937 cases and 67 deaths. A Britishfilm on early diagnosis and treatment, completed earlierthis year, has been shown,

" dubbed " in German, beforelarge medical audiences in Berlin and Hamburg.

Notification of Infectious Diseases

ENGLAND AND WALES

In qualifying the measures of child care as mostlyarbitrary, I refer to the fact that only a very few of thesemeasures, outside the actual chemical composition of the foodof children, are actually based on the welfare of the infant.They are instituted for all sorts of extraneous reasons:

facilitating a normal social life for the mother by rigid adher-ence to a feeding schedule ; making matters easier for thenursing personnel in the obstetrical hospitals by advisingagainst nursing and for bottle-feeding infants ; segregatingnewborn infants in a separate room without contact withtheir mothers, for the purpose of making the control ofinfections easier; and many others. The strangeness ofthese measures will strike you immediately if you try toapply them.to the grownup."-Dr. RENE A. Srrrz, Medicinein the Postwar World. New York and London, 1948 ; p. 38.