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Institute of Medical Research, is reflected in the growthof grants-in-aid by Parliament for current expenditurefrom £415,000 in 1946-47, to B618,000 in 1947-48,and £770,000 in 1948-49. To the nation this is a bargainprice.

VACCINES AGAIN

IN the heyday of vaccines there was much debateabout the best method of rendering the bacteria harm-less without impairing their powers to stimulate antibodyformation. Heat, phenol, and other bactericidal agentsall had their advocates. That we hear less of all this thanwe did is due, no doubt, to experience, which has shownthat vaccine therapy is less effective than some hadclaimed and that vaccine prophylaxis is applicable torelatively few of the ailments which plague us.

Felix’s 1 successful substitution of alcohol for heat as akilling agent in making a prophylactic against entericfever, and Grasset’s 2 introduction of endotoxoid vaccinefor the same purpose, both indicate that this subjectstill deserves inquiry ; and a recent paper by Pattison 3suggests a line of approach which has not, as far as weknow, been followed before. He wished to immunisemice against a streptococcus of group B, the group whichincludes the organisms mostly responsible for bovinemastitis. Having first shown. that the strain he wasemploying was sensitive to penicillin, he injected a

lethal dose intraperitoneally ; and he followed this withinjections of penicillin in aqueous solution at intervals of1/2, 2, and 6 hours. Later the three doses were replacedby a single one of procaine-penicillin half an hour afterthe injection of the organisms. With each method theinjection of organisms, repeated two or three times,protected the animal against a further lethal dose ofstreptococci given a few days later.The basic idea is so obvious that we are not surprised

that no-one has previously called attention to it. Thereis much more that we would like to know-how longsuch immunity lasts ; how it compares quantitativelywith the immunity produced by the same dose of organ-isms killed by heat and other methods ; and what happensif the bacteriostatic effect of penicillin wanes, to allow aresurrection of the viable organisms. But the methodis of special interest because the time has come, webelieve, when the arguments for vaccine therapy mightusefully be re-examined in the light of newer knowledge.

THE INDEX-CATALOGUE

FOR seventy years the Index-Catalogue of the ArmyMedical Library at Washington has been an indispensabletool for medical research all over the world. It is the keyto the work of our predecessors, buried in the ever-growing stack of periodical literature. This work is

ignored at peril. Pasteur’s revival of Jenner’s workafter three-quarters of a century ; Banting’s culminationof earlier attacks on the secret of diabetes ; Florey’senlargement of Fleming’s discovery of penicillin, whichhad been anticipated by Lister-all these illustrate theinescapable chain of discovery.When John Shaw Billings built up the Army Medical

Library in the ’70s, he saw that an index to journalliterature was as essential as a catalogue of his books.He accepted the " decided preference " of a great majorityof American physicians against the convenience oflibrarians, and combined the two. He foresaw thathis Index-Catalogue would be of general usefulness : " ananalysis, by subjects, of so large a collection of medicalperiodicals," Billings wrote in his first preface, " is,necessarily, useful in St. Petersburg, for example, as well asin Washington, its measure of utility in any localitybeing the extent of the collections of medical periodicalliterature therein." In Britain, certainly, good use hasbeen made of it, for the United States government has

1. Felix, A. Brit. med. J. 1941, i, 391. 2. Grasset, E. C.R. Soc. Biol. Paris, 1931, 106, 810. 3. Pattison, I. H. J. Path. Bact. 1949, 31, 337.

presented the successive volumes widely. We have cometo assume, indeed, that the Index-Catalogue is compre-hensive and infallible, and are surprised when Americancritics point out that- it is neither. The truth no doubtis that a machine devised seventy years ago deserves over-haul ; and, observing with admiration the active resur-gence of the Army Medical Library from comparativequiescence in the lean ’30s, we have looked forward tothe projected correlation of the Index-Catalogue with theQuarterly Cumulative Index ltledicus. The Index-Cataloguehas served, not altogether regularly, as, a twenty-yearcumulation of the Index Medicus, cutting the labour ofsearch from forty volumes to one. We knew that theAmericans, who are past masters of documentary method,could make it a comprehensive cumulation, easy to use.But now a rumour comes that the Index-Catalogue is tobe ended.

’

Billings offered his first volume as a proof that " aidand sympathy " received from many physicians both inAmerica and Europe had not been wasted. We mustthank his successors for a payment which has far surpassedthis debt, and a,ssure them that if the Index-Catalogueceases to exist, it will have to be invented again.

ANTI-HISTAMINE DRUGS AND THE TUBERCULIN

REACTION

THERE is ample evidence to showthat the anti-histaminedrugs can partially or completely inhibit the develop-ment of histamine weals, allergic weals, and passivetransfer weals. Elias and McGavick,l for example,found that the preliminary administration of ’ Benadryl’by mouth diminished both the weals and the erythemaproduced by subsequent histamine skin tests. Thequestion therefore arises whether these drugs will inter-fere with tuberculin tests. In tuberculous guineapigsBoquet 2 could not detect any such inhibitory effect.Sarber, on the other hand, says that adequate doses ofbenadryl can reduce both the skin reaction andthe incidence of necrosis in guineapigs injected withtuberculin.The point has now been investigated by Friedman-

and Silverman 3 in children aged 5-11 ’years who wereknown to be positive reactors to tuberculin. Injectionsof 1 in 100,000 (0001 mg.) old tuberculin produceddefinite positive reactions in 48 children.- Several daylater 43 of these children were given Pyribenzamine’ indoses of 60 mg. daily for two days and then the tuberculintest was repeated. After the test the pyribenzamine wascontinued in the same dosage for a further two days.As controls, the remaining 5 children in the groupwere not given pyribenzamine but were re-tested withtuberculin at the same time. Finally, still later, 10 of thechildren were re-tested with the same dose of tuberculinafter receiving 240 mg. of pyribenzamine daily. In allcases the tuberculin reactions obtained were about thesame as in the initial tests. Criep and his colleagues 4in Pittsburgh have tested human adults and tuberculousguineapigs with pyribenzamine and have reached thesame conclusion. Various brands of tuberculin andboth oral and intradermal routes of administration ofthe anti-histaminic drug were used without affectingtuberculin sensitivity. The numbers are, of course

small, but the findings suggest that the previousadministration of anti-histamine drugs will not affectthe results of -a tuberculin test.

THE death is reported from Melbourne of Dr. L. S.LATHAM, president of the Royal Australasian Collegeof Physicians, and a former deputy chancellor of theUniversity bf Melbourne.1. Elias, H., McGavick, H. Proc. Soc. exp. Biol., N.Y. 1946.

61, 133.2. Boquet, A. Ann. Inst. Pasteur, 1943, 69, 55.3. Friedman, E., Silverman, I. Amer. Rev. Tuberc. 1949, 60, 354.4. Criep, L. H., Levine, M. I., Aaron, T. H. Ibid, 59, 701.