572 SCOTLAND.-UNITED STATES OF AMERICA

SCOTLAND

SYNTHETIC HORMONE ANALOGUES

Prof. E. C. Dodds began his Cameron prize lecture inEdinburgh on the biological significance of the synthetichormone analogues by surveying therapeutic methods ofthe past. From Galen’s time until sixty years ago, hesaid, drugs had been derived from compounds occurringnaturally in plants. After the rise of organic chemistrysalicylic acid was synthesised ; and later came thesynthesis of acetylsalicylic acid, a compound not foundin nature, and its introduction into the treatment ofdisease. Schafer and Oliver’s discovery of a therapeuticagent in the adrenal glands and Murray’s successfultreatment of a case of myxoedema focused attention onthe endocrine glands. Allen and Doisy’s experimentswith an alcoholic ovarian extract marked the commence-ment of the researches in which Professor Dodds had beenparticularly interested. For long the task of separatingthe active principle from the ovarian extract seemedinsuperable. The discovery by Aschheim and Zondekthat an oestrogenic substance was excreted in the urineduring pregnancy led up to the isolation of pure oestro-genic substances by three separate workers, Marrian,Doisy, and Butenandt. The chemical structures ofthese substances varied and it was not clear whetherthe oestrogenic property was a specific action. Carcino-genic hydrocarbons were also found to be oestrogenic.The only common factor among these chemical sub-stances was the phenanthrene nucleus, and it was thoughtthat this was necessary to oestrogenic activity. Furtherexperiments were carried out with unrelated compoundsand one of these-p-hydroxy-propenyl benzene (anol)-was found to possess cestrogenic activity, which was,however, less than that of the oestrone isolated frompregnancy urine. Dimerides of anol were then investi-gated and it was during these experiments that threecompounds were found which not only had oestrogenicactivitv but were at least three times as active as

naturally occurring oestrone ; these were stilboestrol,hexoestrol, and a hexadiene. Although their physio-logical properties were similar to oestrone they werechemically unrelated to it. Clinically they were moreuseful as they were effective when given by mouth,more potent, and cheaper. They could be used in thetreatment of symptoms arising in association with themenopause, failure of lactation, and certain forms ofinfantilism. The only untoward side-effect reportedafter their administration was nausea which was centralin origin and appeared to be related to the nausea

experienced in the early months of pregnancy ; itoccurred in only 1-2% of cases. The synthetic compoundswhich were most active pharmacologically-Prontosil,Salvarsan, and stilbcestrol-had a chemical relationshipin the presence of two benzene rings linked in variousways. This linkage might be the fundamental factor intheir pharmacological activity.

COMBINED RESEARCH IN NEUROLOGY AND PSYCHIATRY

At a recent meeting of the Edinburgh Universitycourt it was announced that the Rockefeller Foundationhad made a grant to the university for the year 1940-1941 of 24500 for the furtherance of combined researchin neurology, neurosurgery and psychiatry. This fund,together with other moneys which are available, will bedirected by Mr. Norman Dott and Prof. D. K. Hendersonwho are collaborating to set up a combined neurologicaland psychiatric organisation. The neurology andneurosurgery unit under the direction of Mr. Dott hasrecently taken charge of a portion of Bangour E.M.S.hospital. The accommodation built in the RoyalInfirmary a few years ago with the help of funds givenby Sir Alexander Grant will now be used largely as aneurological diagnostic centre in close touch with BangouIwhere nearly all the operative work will be concentrated,A large team will include psychiatrists, neurologists,neurosurgeons, a worker in electroencephalography andthe staffs of the usual ancillary services. Clinicalmaterial will be drawn from ordinary civil practice, air-raid casualties, and the wounded of the forces, so that theopportunities for coordinated research and therapeuti(work should be excellent.

REGIONAL HOSPITAL PLANNING

Following Lord Nuffield’s recent gift to provincialhospitals, representatives of voluntary hospitals from allparts of Scotland met in Glasgow to confer with membersof the Nuffield Trust about the coordination of regionalhospital schemes. Mr. S. P. Richardson, of the BritishHospitals Association and the provincial hospitalsregionalisation committee of the trust, said that thefirst aim was to promote the coordination of healthservices of all kinds, to eliminate all unnecessary services,and to see that services were adequate for the needs ofthe population throughout the district. The trust hadno intention of interfering with the internal managementof any hospital but they wished all voluntary andmunicipal hospitals in Scotland to be represented on theregional council so that their views might be pooled. Thetrustees were convinced that any step which wouldmean that not only voluntary hospitals but municipalhospitals were to come under one vast state organisationwould be most detrimental to the public health servicesof the country. Alderman W. Hyde, secretary of theNuffield Provincial Trust, said that the trustees haddecided not to make donations or grants to individualhospitals. Scotland was already represented on thecentral medical council of the trust by Sir John Fraserand Professor Mackintosh, who had been invited to helpto form a Scottish medical advisory committee ; a

nucleus of personnel had already been suggested. Thetrust proposed to place at the disposal of this committeesuch money as was necessary to finance the initialorganisation. There would be direct contact betweenthe Scottish and the English medical committees.

SCOTLAND’S FIRST WOMAN PROFESSORDr. Margaret Fairlie was formally installed in the

chair of midwifery and gy naecology in the University ofSt. Andrews at a graduation ceremony last week.Principal Sir James Irvine said that the use of the word"

daughter " under circumstances where hitherto onehad always been compelled to use " son " called atten-tion to the fact that this was the first occasion whena woman had been admitted to a professorial chair in aScottish university. To play the part of pioneer wasno novel experience for the university which was thefirst in Scotland to open its doors to women students,but it was no desire for novelty that led to Dr. Fairlie’selection. She had won the position by merit, by hersympathy and skill, and her zeal in imparting herknowledge to others.

UNITED STATES OF AMERICA

CIVIL SUIT AGAINST TYPHOID CARRIER

IN New York state people who are proved to be carriersof typhoid bacilli are registered and are thereupon placedunder certain restrictions, so long as the carrier statepersists. Last December one of these registered carrierswas convicted of handling food in violation of the statelaw and was fined$25. A civil suit has now beenbrought against this carrier by an electrical engineer whoasks$53,500 damages for the death of his wife fromtyphoid fever, contracted, it is alleged, through theillegal action of the carrier in preparing food.

SULPHATHIAZOLE

The present status of sulphathiazole in the treatmentof infections was discussed at a recent meeting of thethird district branch of the Medical Society of the stateof New York by Dr. Charles H. Rammelkamp, assistantin medicine at the Boston University school of medicine.Sulphathiazole is more readily absorbed and morerapidly excreted than sulphapyridine. It diffusesreadily into the pleural and ascitic fluids but irregularlyinto the spinal fluid, and therefore has not been used incases of meningitis. In animals sulphathiazole is foundto be only half as toxic as sulphapyridine and sulpha-methylthiazole. In man it causes nausea and vomitingless often (a third to half as often as sulphapyridine) andwhen they occur the symptoms are less severe. Haema-turia is less but drug rashes are more common. In the