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to a line of investigation which has at least as much tojustify it as have those based on the theories of virusinfection, primary demyelinisation, sensitisation to

demyelinating substances, and introduction of organicand inorganic toxins. It is nevertheless disappointingthat there are no therapeutic results to support thethesis, although it must be borne in mind that theassessment of therapy in disseminated sclerosis isprobably more difficult than in any other disease.

SHARING ST. DUNSTAN’S

AMERICAN soldiers in Britain who may be temporarilyor permanently blinded are to be sent to St. Dunstan’sfor a few weeks while waiting to go home, and at thelunch given by St. Dunstan’s to senior officers of theAmerican and Canadian army medical services Sir IanFraser announced that the first American guest, anupper turret gunner who was blinded during enemyaction, is already in residence. In his report on theassociation’s work Sir Ian compared the eye casualtiesof the two wars. Two-thirds of those blinded in action

during the last war were wounded by high-explosiveshells and hand-grenades. In nearly all the eyes werepenetrated by metal fragments. The remaining thirdwere the result of bullet wounds. In -this war more havebeen blinded by concussion changes in the eye, causingcollapse or irreparable damage through haemorrhage.With less damage to sinuses surgery had become moreplastic in character. The tendency of modern weapons,including aerial bombs, was to increase the high explosiveand decrease the metal until it was merely a container.Much of the metal being non-ferrous, the electro-magnethad become less important.

Of the 288 Service and civil defence casualties knownto St. Dunstan’s, 88 had recovered some useful sight.Of the others, 100 were in training or had been trained atSt. Dunstan’s in England, 30 were prisoners of war, 30were in South Africa or India, and Sir Ian estimated therewould be 40 more from recent fighting in Africa. St.Dunstan’s now had units in Cairo, India, and SouthAfrica.

Brigadier Paul Hawley, chief surgeon of the US Armyin the European theatre of operations, said that St.Dunstan’s training would help the blinded Americansoldier to return to his family walking with confidenceand facing the world with courage. He foreshadowedthat accommodation at American hospitals in this

country might soon, in emergencies, be available forEnglish casualties.

A CONTRIBUTION TO EPIDEMIOLOGICAL METHOD 1"

Epidemiology is something more than the total of itsestablished facts. It includes their orderly arrangement intochains of inference which extend more or less beyond thebounds of direct observation. Such of those chains as are welland truly laid guide investigation to the facts of the future ;those that are ill made fetter progress."These words were written by the late Wade HamptonFrost, professor of epidemiology at the Johns Hopkinsschool of hygiene, and no-one better exemplified theirmeaning than their author, whose influence as a leaderof epidemiological progress and as teacher of his subjecthas rather tardily become appreciated in America. Herehis name and work have been known only to the few,but the circle will be enlarged by this publication, with

. help from the Commonwealth Fund, of twenty of hispapers, with biographical notes. The first group of

papers are studies on epidemics of typhoid fever, milk-borne tonsillitis, and poliomyelitis. Each shows thesame painstaking collection and marshalling of evidencewhich denotes the born epidemiologist; written more

1. Papers of Wade Hampton Frost, MD. Editor : Kenneth F.Maxcy, MD. London: Humphrey Milford, Oxford UniversityPress. Pp. 628. 16s. 6d.

than 30 years ago, they can be read with profit today byanyone interested in epdemiological methods. The nextsection deals with studies on water-supplies and streampollution, an urgent problem at the time in America,but now of less general interest. Then come five paperson influenza, the common cold and minor respiratoryinfections in which Frost developed the use of the familyunit as the basis for measuring the tendency of diseasesto spread in the immediate environment of a recognisedcase-a concept originated by Chapin. In the samesection are two papers on infection and immunity todiphtheria in relation to artificial immunisation andcarrier prevalence, studies of considerable interest to usnow in Great Britain. In the fourth section, Frostexpresses his broad philosophy of epidemiologicalprinciples and public health practice, and pays tribute toJohn Snow, of cholera fame, who by logical inferencefrom observed facts gave the germ theory of infectionscientific status before it was bacteriologically established.In the last 10 years of his life Frost was particularlyinterested in the epidemiology of tuberculosis ; becauseof the chronicity of the infection, he had to develop anew technique entailing studies in longitudinal sectioninstead-as with the acute infections-in cross-section.He used a modified form of life-table analysis applied tofamily groups. The early results of such studies arereported here in two papers but the more mature workis to be found in the publications of his pupils. The lastpaper, on control of tuberculosis, is the distilled wisdomof a man who had thought much about the problem.As he says, the two conditions-which most favour tuber-culosis are intimate exposure and poverty ; but he adds" the tubercle bacillus is losing ground, and the eventualeradication of tuberculosis requires only that the presentbalance against it be maintained." Epidemiology hasbeen too much neglected in -this country ; here is avolume which should be a real stimulus to those engagedin its teaching and practice.

Sir JOHN LEDINGHAM, FRS, is to retire on March 31from the post of director of the Lister Institute ofPreventive Medicine, which he has held since 1930.His successor will be Dr. A. N. DRURY, FRS, Huddersfieldlecturer in special pathology in the University of

Cambridge, and a member of the scientific staff of theMedical Research Council.

Dr. E. R. A. MEREWETHER will become senior medicalinspector of factories in succession to Dr. J. C. BRIDGEwho retired at the end of the year.

CONTROL OF TUBERCULOSIS.—The Minister of Health’s

promised circular to local authorities on the development ofthe tuberculosis service has now been issued (No. 2741), andminiature radiography units are to be offered to the followingauthorities: Essex, Lancs, London, Middlesex, Northants,Staffs, Surrey, Birmingham, Bristol, Leeds, Liverpool,Manchester, Newcastle-on-Tyne, Norwich, Nottingham,Portsmouth and Sheffield. The first sets should be readyearly in 1943 and it is hoped that delivery will be completedduring the year. Arrangements for training the necessarystaff are being made and the Minister is anxious that themethods of examination by miniature radiography should bestandardised throughout the country. He also undertakesto allocate additional beds for tuberculosis and to helpsanatoriums in securing nursing and domestic staff. Par-ticulars of the scheme for relieving patients of financialanxiety for themselves and their dependants will soon beavailable and the general principles have already been workedout. Assistance, usually in the form of maintenance allow-ances, is to be made available for everyone with a dependantwho loses income through giving up his occupation while beingtreated for pulmonary tuberculosis. Reasonable obligations,such as rent insurance policies, hire purchase of furniture,education of children, will be taken into account. Theseallowances will be reimbursed to local authorities by theMinistry.