1418 THE PHYSICAL BASIS OF STUFFINESS.-AGAINST RHEUMATISM

This could have no influence upon its nutritive

utility for children, since the need of children for theseminerals is less than that of calves, judging by thelower content of calcium and phosphorus in humanmilk. On the other hand, if the diminution werereally substantial it would presumably affect the

growing calf, and the fact that it did not do so-which surprised the investigators-makes it clearthat this objection to pasteurisation of milk for grow-ing children has no force behind it. Nor, in fact,have any of the other objections, and it is more thantime that the medical profession, realising the import-ance of milk-borne infection, ranged itself solidlybehind the demand for a safer supply.

E. L. EHLERS

THE three diseases with which the name of Prof.. Ehlers is most closely associated are syphilis, leprosy,and scabies. He was president of the Danish Associa-tion for Combating Venereal Disease and also forseven years president of the International Unionagainst Venereal Disease. His interest in leprosyhelped to make him a great traveller, and he did muchto lighten the lot of the leper in many parts of theworld, from Iceland to the West Indies. In 1897he was the organiser of the first International LeprosyConference, in Berlin ; and. from 1900 to 1914 hewas the chief editor of an international publicationon leprosy. His most important contribution toscabies was its ambulant treatment. A welcomevisitor in many countries, it was particularly in Francethat he was known and appreciated. He died onMay 6th at the age of 74.

THE PHYSICAL BASIS OF STUFFINESS

RECENT fluctuations from arctic to equatorialclimatic conditions should stimulate interest inmethods now available for the control of indoor

temperature and humidity. The subject was dis-cussed at the Royal Society of Medicine on May 28th(see p. 1401) when special consideration was given tothe requirements of ships in the Royal Navy and infactories. In this country, where extreme condi-tions are rare, regulation of humidity is not usuallyemployed in factories as it is in the United States,attention being concentrated on ventilation, tempera-ture, and the extraction of dust. In a recent article 1

C. P. Yaglou of Boston considers the physical andphysiological principles of air conditioning andcollects a number of interesting observations. Althoughthe percentage of CO in the air may be used as aconvenient guide to atmospheric purity this gas doesnot in itself produce discomfort in the concentrationsordinarily met with in stuffy rooms ; imponderableamounts of organic matter appear to be far moreeffective in this respect; this observation has thesupport of experiments on the isolated frog’s heartin which it was found that the weakening action ofexpired air was greater with old and sick personsthan with the young and healthy. Dr. Yaglouconsiders that the preference which still exists forwindow ventilation may be due to the monotonyof the air movements produced by mechanical

systems of ventilation which are found to be lessstimulating than oscillating gusts of air comingthrough an open window. Dr. Bedford’s new book 2

on ventilation contains a chapter on air conditioning1 J. Amer. med. Ass. May 15th, 1937, p.1708

2 Modern Methods and Principles of Ventilation and Heating.By T. Bedford, D.Sc., Ph.D., Investigator to the MedicalResearch Council’s Industrial Health Research Board. London :H. K. Lewis and Co. 1937. Pp. 85. 4s. 6d.

in which a clear account may be found of the apparatusused for filtering, warming or cooling, humidifyingor dryirig atmospheric air. Dr. Bedford also notes theimportance of organic matter in producing a disagree-ably stuffy atmosphere ; he quotes a table compiledby Dr. Yaglou from which it appears that the numberof cubic feet per minute required by a group of peopleis inversely proportional to the frequency with whichthey take baths. Thus school-children of the poorerclass require 38 cubic feet per min. each as comparedwith only 18 for children in a higher social grade.

AGAINST RHEUMATISM

REMARKING that most services are promotedby the force of public opinion, Capt. G. S. Elliston,M.P., at the Margate Congress last month, saidthat first among the conditions now needing attentionis chronic rheumatism. No steps, he said, commen-surate with its importance have yet been taken;and he was right. Since he spoke, the welcome newshas come of a gift of 10,000 guineas by Mr. AlexanderMaclean to the Empire Rheumatism Council tofinance a rheumatism research unit, together with apromise of a further JE2500 from the same source.The Council was constituted last November, whenLord Horder, as president, urged the need for a

comprehensive research campaign for which the helpof prominent citizens throughout the British Empirewould be sought. In congratulating the Council onthe success already achieved we take the oppor-tunity of mentioning a modest appeal made sometime ago for another and related enterprise. TheInternational League against Rheumatism has donemuch to inspire the present interest in rheumaticdiseases: besides maintaining a quarterly journal,an information bureau, and a library it has heldfive large congresses in European capitals, in whichthe medical profession and the governments con-

cerned have shown great interest. The sixth congressis to be in England next year; and it is somewhat

unpleasant to reflect that the English nationalrheumatism committees have hitherto not been in a

position to give any financial support to the League’swork, which has been supported, throughout thedepression, chiefly by the smaller countries and,in emergency, by the honorary secretary. The

League is likely to receive adequate support hence-forward, but having missed the aid that might havebeen expected from this country it has barely struggledthrough the years of difficulty and must be restoredto security. If any of our readers have rheumaticpatients who happen to retain some faith in thevalue of international cooperation the appeal mightfittingly be passed on to them. Of the 1000 asked for,about a fifth has been secured and the situation isone in which a small sum may do substantial good,since it will make possible the continuance of workthat was formerly, and will again be, financed byregular national contributions. Cheques should bemade payable, and sent, to Barclays Bank Ltd.,54, Lombard-street, London, E.C.3.

EPIDEMIOLOGY OF THE BASQUE CAMP

THE arrival of 4000 refugee children from Bilbaoconfronts us with an old but ever-fascinating problem.Should the " herd at risk " be kept concentrated orscattered ? In this particular case, should the Basquechildren be split up into units of not less than 50 or soand moved into the various homes prepared for themin different parts of the country ; or should they, onhealth grounds, remain in their original camp at

Eastleigh If the children were experimental herds

1419EPIDEMIOLOGY OF THE BASQUE CAMP

of mice, it would seem better that they should bekept together, provided no new additions were madeto the herd, rather than that they should have thechance of infecting other " herds " all over the country.But the children are not mice; and though theirhealth record so far is good their camp was designedfor a considerably smaller population and, as theHouse of Commons was told last Monday, it is highlydesirable that the number of children there shouldbe reduced as speedily as possible. The objectionraised is that they would be going to homes andinstitutions some of which already contain healthychildren and have no special medical arrangementsin operation, such as have been made at the camp.Again, in theory, the argument seems to be chieflyin favour of delaying dispersal. But what are theactual dangers to be feared The children were allmedically examined before embarkation and thosewho took responsibility for the examination, Dr.Richard Ellis and Dr. Audrey Russell, give good reasonfor thinking that the risk of importing trachomais by no means as serious as has been suggested.Two cases of diphtheria and three of measles havearisen among the 4000 children, but have been suit-ably isolated. And finally, there have been six casesof typhoid fever. All of these, however, haveappeared within the incubation period since leavingSpain, and presumably there is little likelihood ofinfection occurring after arrival in England. Hencewe are not considering the dispersal of an unhealthy" herd " as in the poliomyelitis outbreaks of 1926and 1932 1 but of a healthy one. The visitors tothe Bournemouth, Poole, and Christchurch district,who scattered back to their homes during the 1936milk epidemic, for example, presented a much greaterrisk to the country. At Eastleigh each child is tohave three full medical examinations before leavingthe camp.The Ministry of Health, though it has no direct

responsibility, has been asked for its advice and hasbeen in direct touch with the camp authorities throughits medical officers. Its advice is, apparently aftersome hesitation, to allow evacuation of children goingdirect to empty homes and institutions where they willnot be in contact with other children-provided thatthe medical officer of health of the district is preparedto accept them. The remainder are being inoculatedagainst typhoid and will be evacuated when immune.This advice we regard as sound. Medical officersof health are not likely to grudge any extra troublethe present policy may entail, nor will they wantto put unnecessary obstacles in the way of colleagueswho have done and are doing a fine piece of humani-tarian work.

THE Inter-Departmental Committee appointed inApril, 1936, to inquire into the restoration of workingcapacity in persons injured by accidents has made aninterim report (H.M. Stat. Office, 4d.). The objectto be aimed at is the covering of the country witha network of " fracture services " attached to existinghospitals, whether voluntary or controlled by thelocal government authorities. A

" model " scheme hasbeen prepared by the committee, capable of adapta-tion to the varying circumstances and needs ofdifferent localities and areas. The maximum sizeof a fracture clinic compatible with an efficientunified control is put at one capable of dealing with3000 to 3500 cases a year, of which about one-thirdwould, on a general average, need in-patient treat-ment, involving the provision of, say, 40 beds. The

1 See Lancet, 1926, 2, 1070 ; 1932, 2, 903, et seq.

needs of rural areas would be met by linking themup with a fracture clinic at some convenient centre towhich cases could be transferred. The committeeoffers its assistance in any difficulties presented bythe application of such a scheme to local circum-stances. Sir Malcolm Delevingne has presided overthe committee, whose medical members are MissMuriel Bywaters, Mr. W. A. Cochrane, Dr. T. Ferguson,Prof. E. W. Hey Groves, Dr. J. F. E. Prideaux,Mr. H. S. Souttar, and Mr. A. C. T. Woodward.

THE inquiry into the physical, psychological, andgenetic aspects of mental deficiency carried on

in the research department of the Royal EasternCounties’ Institution at Colchester has receivedvaluable aid from the trustees of the RockefellerFoundation. Hitherto the research department,under Dr. Lionel Penrose, has been financed by theMedical Research Council, the Darwin Trust, andby the Institution itself. Recently also a generousdonation of S2200 was made by the Hon. AlexandrinaPeckover towards the cost of a new laboratory andresearch offices provided by the Institution. Nowthe trustees of the Rockefeller Foundation have

opened the way to further developments by makinga grant at the rate of 600 per annum for five yearsto provide additional research workers and a non-recurrent grant of 700 towards the cost of laboratoryequipment.

Sir THOMAS NEILL, who died last week at the ageof 81 years, was one of the three insurance com-missioners appointed by Mr. Lloyd George when theAct of 1911 came into force. He had had much todo with framing the scheme itself from his longexperience with the Pearl Assurance Company, andafter serving as commissioner he became chairmanof the National Amalgamated Approved Society.This post he held until his retirement last year, com-bining it with many other important executive offices.His judgment was sound, and in conference his

opinion was influential and decisive. He had a

slight stutter, but there was nothing hesitatingabout his mind, which worked like a well-oiledmachine. His decisions, which were nearly alwaysright, were quickly made and tenaciously held;though keen and firm in business he was one of thekindest-hearted of men, as his staff well knew. Hefound difficulty in passing street collectors on flagdays, and on Queen Alexandra’s day he wouldarrive at his office richly decked with roses. Hewill long be regretted by those who worked withhim.

’

AN account of the memorial to the late Sir WalterMorley Fletcher, printed for the trustees of thememorial fund at the University Press, Oxford, hasbeen issued to all the subscribers to the fund. It isembellished by two illustrations, one of which showsMiss Dora Clarke’s posthumous portrait bust ofWalter Fletcher, photographed from the clay model,the other a corner of the library of the NationalInstitute for Medical Research with the finishedbronze in position.

LEwEs VICTORIA HOSPITAL. -This institution,whose accommodation has lately been doubled, needsan increased income of about f400 yearly if the workis to go on successfully. A nurses’ hostel has been builtand the hospital extensions proved more complicatedand expensive than had been expected. Private wardshad to be closed last year because of the work and theincome of the hospital suffered in consequence.