440

should be carefully observed thereafter, and the drugimmediately stopped on the first appearance of any toxicmanifestation."

" Patients taking sulphonamides in therapeutic dosesought, when possible, to be seen by the doctor at leastonce a day " so that he may inquire into such earlytoxic symptoms as headache, nausea, vomiting, andmalaise, and such signs as cyanosis, rashes, jaundicedscleras, or pale mucous membranes. The temperaturemust be recorded, and the report gives valuable adviceon drug fever, as well as granulopenia and urinarycomplications-their recognition and avoidance. Theseand other ill effects, including rashes, may be attributableto hypersensitivity,3 and methods of desensitisation arebriefly considered. As a rule sensitisation is not apparentuntil the drug has been taken for about 8 days, andsulphonamide therapy should rarely be continued formore than 7 days. Use of these drugs over a long period,in small doses, may be permissible to prevent relapsesin so serious a disease as rheumatic fever, but theircontinuous administration over many months to themembers of a community-such as a factory-to protectthem from respiratory infections " is not at present tobe generally recommended." Where, on the other hand,an outbreak (e.g., cerebrospinal fever or bacillary dysen-tery) can be controlled by small doses given for onlya few days, chemoprophylaxis may be clearly justified.American experience in the prevention of gonorrhoeaand chancroid is quoted without comment.As for the future, " the spheres of sulphonamide and

penicillin treatment overlap to a large extent, butpenicillin is usually the more efficient remedy in condi-tions susceptible to both " and " when supplies permitit will replace sulphonamides more frequently. In afew infections penicillin has a therapeutic action andsulphonamides have none ; in others (e.g., bacillarydysentery) the sulphonamides are more efficient thanpenicillin." The relative advantages and indicationsare briefly explained in the report, which points out thatfor local application penicillin is superior because of" its efficacy against even large numbers of bacteria,"because nothing in inflammatory exudates antagonisesit, and because it is almost non-toxic to tissues.

POLIOMYELITIS IN EUROPE

A sERious outbreak of poliomyelitis which, began inBelgium at the end of May 4 appears to have reached itspeak during August. The total number of cases up to

Aug. 19 was estimated at 800-900 ; actually. 750 caseswere notified, but this figure is unreliable because at firstmany of the cases were not reported, while later manywere notified on a misdiagnosis. According to a revisedrecord by the Ministry of Health, a total of 554 knowncases was reported up to Sept. 1. Of these, 165 occurredin West Flanders, 106 in the Liege Province, and 101 inthe Brabant. In Western Flanders, where sporadic caseswere reported in May and June, the incidence increasedappreciably during the first fortnight of July, when thedisease appeared also in epidemic form in the province ofLiege at Verviers and in the Brussels area ; Antwerpwas affected in August.. The disease seems to be of a particularly severe andrapid type, bulbar paralysis being common and early ;the fatality-rate at first was given as 25%, and at themiddle of August it was 15%. All age-groups have beenattacked, and many people died within 48 hours of theonset, a few within 24 hours. Means of spread havebeen hard to trace, but the summer has been dryand flies abundant. During the last week of Augustthe disease was reported throughout the country, withnumbers of cases still high in the Brabant (Brussels) andWest Flanders. The infection was further spreading3. See Lancet, Sept. 22, p. 374.4. UNRRA : Bull. Communicable Diseases and Medical Notes.

Sept. 5, 1945, p. 42.

towards Holland into the Dutch Limbourg and intoGermany via Eupen and Malmedy. The Grand Duchyof Luxembourg, according to reports available up to the,end of August, had apparently escaped infection.We have no further news of the outbreak in Prague,

where about 100 cases had been reported by Sept. 8, andthereafter about 6 cases daily. Epidemics were also

reported in Sweden, Finland, and Denmark early inSeptember.

CHARLES SPEARMAN

Prof. C. E. Spearman, who died oil Sept. 17, was of thespiritual progeny of Galton. He applied mathematicalprocedures to psychological phenomena, and mouldedthe outcome of his analysis into a theory which hasgreatly influenced modern psychology. Nurtured inWundt’s laboratory, he valued accuracy of observationand tidiness of experiment far higher than speculativeingenuity, but he was bold in developing theory so thatit would be in keeping with his findings. His two notableworks on The Abilities of Man and The Nature of Intelli-gence gave him a permanent place in the history of psycho-logy-the subject which he himself brilliantly andcritically expounded in his last work Psychology down theAges. His studies of individual differences did not stopshort at measurement and discrimination, but led himto formulate a theory of mental structure which stillexercises great influence. The statistical method ofwhich he was a pioneer has now entered into its kingdomhere and in America.. Spearman was always anxious that the methods he haddeveloped should be applied in psychiatry. He urgedthis cogently in his Maudsley lecture to the RoyalMedico-Psychological Association ; but in spite of somecontributions made on these lines by pupils and collab-orators of his, the development of factorial analysis asan instrument of psychiatric research has followedlines somewhat different from those which he conceived.Nevertheless his indirect influence upon psychiatry hasbeen considerable.

A CHAIR OF ANATOMY

ON another page we announce the appointment ofMr. J. Z. Young, FRS, a zoologist, to the chair of anatomyat University College, London. " Tradition in this

department," writes a correspondent, " favours a broad

conception of the field of anatomy, which is thus likelyto be continued. Professor Young’s work before thewar on the nervous system of many species, and hisfruitful collaboration with clinical colleagues on theNerve Injuries Committee of the Medical ResearchCouncil during the war, suggests, further, that the

especial emphasis on neurological anatomy associatedwith the work of Elliott Smith and Woollard at UniversityCollege is to be maintained. Experience gleaned inunusual fields should enable him to bring fresh ideas tothe current reconsideration of preclinical training, andto the teaching of anatomy itself."

A NEW DIPLOMA

THE Society of Apothecaries of London has decided toinstitute a diploma in industrial health. Particularswill be found in our news columns.

ON Thursday, Oct. 11, at 5 PM, Sir HOWAIW FLOREY,FRS, will deliver the Lister lecture at the Royal Collegeof Surgeons of England, Lincoln’s Inn Fields, London,WC2. He will speak on the use of micro-organisms fortherapeutic purposes.

’

Sir WiLLiAM Douax.AS, KCB, permanent secretary ofthe Ministry of Supply since 1942, has now taken up hisduties as permanent secretary of the Ministry of Healthon the retirement of Sir John Maude, KCB.