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special branches such as neurosurgery and plasticsurgery. The case for the retention of services pro-ducing safe blood and blood-products on a large scaleis indeed overwhelming, and everyone welcomedthe statement of the late MINISTER OF HEALTH inthe House of Commons on June 14, that when thewar emergency was over this service would be con-tinued. The necessary changes in organisation arenow being considered in detail.

Annotations

NOBEL LAUREATES

THE Nobel prize in medicine has been awarded jointlyto Sir Alexander Fleming, FRS, professor of bacteriologyin the University of London at St. Mary’s Hospital, toSir Howard Florey, FRS, professor of pathology in theUniversity of Oxford, and to Mr. E. B. Chain, PH D,lecturer in chemical pathology in the University ofOxford, for their work on the discovery of penicillin andits healing effects. In making the award the KarolinskaInstitute of Stockholm acclaims Fleming as the discovererof penicillin, and Florey and Chain for exploiting thediscovery by further experiments.

FOR RESEARCH ON AGEING

IN 1939 a Club for Research on Ageing was foundedby a group of medical and scientific workers. Ageingis a process to which we are all subject from the cradleto the grave, but members of the club are interested

mainly in the later phases of the process. Activitieswere naturally limited during the war, but are nowreviving, and branches have been established in GreatBritain, the United States, France, and the Argentine.A branch is now being formed in Sweden and there aremembers in Denmark and Switzerland. The NuffieldFoundation has supported clinical research at the LCCTooting Bee Hospital, which receives elderly psychiatricpatients ; and in 1944 Lord Nuffield gave :f:3000 to estab-lish an experimental research unit on gerontology.This is housed at Oxford University, under the directionof Dr. V. Korenchevsky, who is also the honorarysecretary of the British branch.Membership is limited by the rules of the club to 80.

At present there are some 75 members, the executivecommittee of the British branch including, under thechairmanship of Sir Robert Robinson, FRS, Prof. G. R.Cameron, Prof. E. C. Dodds, FRS, Lady Robinson, andProf. M. J. Stewart. The American branch has heldannual conferences at which research has been planned ;a museum of senile tissues has been established, and theElgin Hospital has arranged clinical research on theeffects of vitamins on the old. A quarterly Journal ofGerontology has also been started under the editorshipof Dr. R. A. Moore, professor of pathology at Washington;the first number will appear at the beginning of 1946.

PENICILLIN IN AGAR

PooR yields from surface-cultures of Penicillium, notatum have led to a modification in the production

of "penicillin agar" for local therapy. Roberts and

Murphy originally used agar on which the mould hadgrown, but in their later method 2 they added agar topenicillin filtrate ; advantages of the newer method aregreater concentration of penicillin, greater ease in pre-paring a sterile and potent product, better keepingqualities, and freedom to adjust the agar concentrationat will. This " penicillin agar " gave encouragingresults in the treatment of localised infections, andO’Hanlon and MacClancy 3 reported favourably on its

1. Roberts, O., Murphy, D. Irish J. med. Sci. July 1944, p. 225.2. Roberts, O, Murphy, D., Jones, M. J. med. Ass. Eire, October

1944, p. 41.3. O’Hanlon, R. H., MacClancy, P. C. D. Ibid, October 1944, p. 43.

use in breast abscesses. In Eire, where penicillinsupplies are limited, this type of application is likely tobe widely adopted ; it is now made in Dublin 4 and issold under the name of ’Pen-Agar,’ made up with anIrish agar and with a penicillin-content of about 50 unitsper gramme.

In England another type of "

penagar " has beenused in a military hospital since April, 1944 ; its sponsorsclaim that its higher penicillin-content is well maintainedat refrigerator temperature and that it is more pleasantto use than creams and ointments containing penicillin.A recent report from this hospital to the War Office 6indicates that the therapeutic value of penagar may beinfluenced by the origin of the agar ; Japanese agar waspreferred to one made from British seaweed. Britishagar differs from Japanese in physical properties suchas the melting- and setting-points, and in the viscosityof the melted gel. For penagar the lower melting-pointof the British agar was a disadvantage that was overcomeby using a greater concentration of agar ; this in turnmade a firmer gel that was less easily manipulated fortherapeutic purposes. It was found that penicillindiffused less readily and deteriorated more rapidly inBritish agar than in Japanese. In the search for a slow-release vehicle, for which Japanese agar is unsuitable,advantage might be taken of the lower setting-pointand the reduced diffusion of penicillin through Britishagar. A 1 % concentration of this agar in water sets atabout 38° C, and warm, freshly-made penagar could beinoculated with a warmed syringe ; in practice such aninjection should be simpler than the inoculation of

penicillin in beeswax and peanut-oil.

ABOLITION OF RICKETS

IN the British Isles the incidence of rickets amongchildren below the age of six months is 2%, and amongthose in their first year 4%. Small as this figure is,rickets is preventable, so there is no reason why itshould occur at all. With this as a maxim, the BritishPaediatric Association have surveyed on practical linesour present knowledge of rickets ; and the Ministry ofHealth and the Department of Health for Scotland haveissued their report as a memorandum for the use ofmedical officers of health, health visitors, midwives, anddistrict nurses.

After defining rickets as a disorder of calcium and

phosphorus metabolism due to deficiency of vitamin D,the memorandum reviews the diagnostic value of

symptoms at different ages. Thus at the age of 3-4months craniotabes is valuable evidence ; at 6-7 monthsthe rickety rosary is the predominant sign; whileenlargement of the wrists and abnormalities of dentitiononly come into the picture later in the first year. Now-

adays ’ rickets usually heals during the second year oflife unless the nutritional defect is severe. Bowing ofthe legs, pot-belly due to muscular hypotonia, head-sweating, and nervous signs, are present only when thedisease is severe. The presence of mild rickets can beconfirmed radiologically by examination of the distalends of the forearm bones.The memorandum is usefully dogmatic about pro-

phylaxis :" To guard against dietary deficiencies, and because

breast feeding is no certain preventative of rickets, allinfants, however fed, should receive a supplement ofvitamin D. When it is realised that any rapidly growinginfant is, as it were, on the verge of developing rickets, theimportance of this becomes obvious."

The memorandum then suggests that, broadly speaking,500-800 international units daily of vitamin D shouldprevent rickets, and reminds readers that cod-liver oil

4. Irish Chemist and Druggist, January 1945 ; Lancet, 1945, ii, 383.5. Coles, R. B., Barker, A. N., Robertson, E. A., Cowan, S. T.

Lancet, 1945, i, 720.6. Report to Director of Pathology, War Office, AMD 7/R, 12/45.