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found that the infectivity of their nucleic-acid

preparation was unstable, and- was abolished bytreatment with ribonuclease. It is possible that someof the infectivity of the reconstituted virus preparedby FRAENKEL-CoNRAT may have been due to thenucleic acid present, the protein acting mainly as astabilising factor ; further experiments will be

required to settle this point.We have become familiar with the fact that pure

preparations of desoxyribonucleic acid can, undercertain conditions, transform pneumococci and otherorganisms into the serological variety of organismfrom which the nucleic acid was derived. Now comesthe idea that a ribonucleic acid alone can induce aninfected cell to produce intact virus particles. Moreand more problems in biology seem to be gravitatingtowards the chemistry of the nucleic acids.

The Indian VillageIF today we seem to hear less about the theory of

preventive medicine, this is partly because, in so manyparts of the world, theory has passed into practice.Under the auspices of the United Nations, of govern-ments, of philanthropic foundations, and of privateagencies, schemes which a few years ago would haveseemed visionary have brought together teams ofmedical and other experts for joint action againstpoverty and disease.Of such schemes, one of the most interesting is the

Indian Community Development Project, described byMr.-T. SwAMINATHAN, of the Indian Civil Service, atthe Conference on Regional Planning and Develop-ment held in London last September. This project,started in 1952 under the Indian government’s firstfive-year plan, is intended eventually to raise thestandards of living of a population of no fewer than310 million, most of whom have hitherto existed atsubsistence level. Naturally its achievement musttake many years, but the progress already made showswith what energy and foresight the Indian leaders aretackling some of their problems. In this they owemuch to Mahatma GANDHI; and it is because he sawclearly the limitations of welfare schemes imposedfrom above that the I.C.D.P. is primarily a movementto enlist the cooperation of the people in their ownbetterment : the government, through its central

agencies, supplies the means, but the momentum isto be supplied by the villagers, working through theirvillage organisations. During the British tenure ofIndia the peasants got the benefit of sound systemsof justice and taxation, and a skeletal rural medicalservice, but otherwise no great effort had been madefor their social advancement : indeed, the policy was,on the whole, to tamper with rural institutions as

little as possible. Only now, therefore, is the villagepopulation (83% of the total) beginning really toemerge from the two or three millennia during whichits intricate customs and beliefs seem to have changedvery little. So far new ideas have not made muchimpact, though bicycles, cinemas, sewing-machines,and alarm clocks have been fully accepted by thosefew who have means to enjoy them. But the govern-ment of free India, activated by GANDHI, the threatof Communism, and universal franchise, has set towork to narrow the great gulf between itself andthe overwhelming majority of its citizens.

The programme began in 1952 with 55 "

projectareas " each consisting of 500 villages with a totalpopulation of about 200,000. These areas are dividedinto " development blocks

" which cover about 100

villages and are themselves divided into " circles "containing 5-10 villages. In each village there is adevelopment council through which the villagersthemselves operate the projects and seek the specialisedhelp and advice they require. Projects are plannedin agriculture, communications, - education, health,cottage industries and subsidiary employment,housing, and social welfare : the health projects centremainly upon the protection of water-supply, properdisposal of human and animal wastes, the control ofepidemic diseases, and the provision of midwiferyand medical services. Such work demands complexadministrative machinery, but the Indian schemediffers from many others in that this machineryrevolves round the all-important " village-levelworker," who, with the individual village councils,is responsible for each circle. This vital man has to

cope with the forces of reaction as represented inalmost every village by the big landowner, the money-lender, the priest, and even the council of elders, allof whom fear that the influx of new ideas and equip-ment may reduce their power and prestige. (Perhapsno other institution anywhere is more truly con-

servative than the Indian Hindu village, where one-self, one’s children, and one’s children’s childrenforever, are destined to follow the narrow caste rules-working, marrying, and conforming in all respects, onpain of social excommunication.) With the villagers’confidence and cooperation, the village-level workercan do great things : without them he does nothingexcept deepen the villagers’ inherent suspicion of4

government " and all its representatives. Henceone of the question-marks behind this great effort iswhether enough of the " right " men will be preparedto forsake the bright lights of the big city for themud hut and humble fare of the village. Medicalworkers, too, have always proved hard to attract tothe countryside.Though the project is too big for detailed descrip-

tion, some idea of the scale is given by the factthat on the medical side alone the personnel require-ments of the first five-year plan are 620 doctors, 2480midwives, and 620 each of health visitors and sanitaryinspectors-figures which, it is hoped, will be trebledin the second five-year plan. The problems meetingthese medical workers are great, for it is no medicalvacuum into which they move, and they inevitablycome into competition with the local " veds " or

practitioners of the Ayurvedic system (which has givenus rauwolfia among other things), to be found in mostvillages. Their task is not made lighter by the (tomost Western eyes) misguided government supportto schools of Ayurvedic and homoeopathic medicine.To the average Indian, Western medicine (known as"

allopathic ") is but one alternative of a number, tobe considered if the " ved,"

"

hakim," or " homoeo-

path " fail to cure the condition quickly, with theirvery much cheaper medicines. Public-health measures,also, are not made easier in circumstances wheresuccessful opposition can be made to B.c.G. on thegrounds that it means " Birth Control General."Though the I.C.D.P. is primarily financed by the

Indian government, the people’s contribution is

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considerable, amounting, in terms of money, labour,and materials, to a value about half of what is spentby the government. Important assistance has alsobeen given by the United States government and theFord Foundation, amounting to a quarter of the totalcost. Since its inception the main scheme has beensupplemented by a preparatory one which, at the

expense of restricting objectives, will provide someof the benefits for a greater number of people.For doctors, however, a noteworthy feature of the

project is its comprehensiveness, which exceeds thatof community development programmes in othercountries. Speaking at the conference, Dr. JOHN B.GRANT, of the Rockefeller Foundation, who is now

professor of public health and medical care at theUniversity of Puerto Rico, outlined principles for thedevelopment of backward areas.The success of an attempt to eliminate poverty, disease,

or ignorance depends, he said, on how far it is undertakenas part of " multi-purpose community development,"and the project must be within the framework of anational plan for industry as well as welfare. Theprogramme must be based on practical economics-e.g.,on whether the number of doctors the country can affordis one per 1000 of the population, or one per 10,000, andwhether the number of hospital beds is four per 1000 oronly one per 1000. Each level of government-national,State, and district-requires, in Dr. GRANT’S view, adevelopment organisation with coordinating and planningfunctions, designed to act as a catalyst, not as an

executive agency. The success of technical assistancedepends on the degree to which it can mobilise voluntaryself-help, and this in turn depends on the extent to whichconsciousness of local needs is generated in the com-munity through its village councils. The unit of organisa-tion for community development must., he believes, betechnically self-contained, providing its own services,supplies, and supervision: empirically it has been foundthat the population it serves should not be less than200,000 or more than 500,000, and its area should coincidewith that of a previously existing administrative unit ofgovernment, with which it can be integrated. No lessimportant are the steps that must be taken to ensure localinitiation of the plan according to the determined needs,and it is similarly essential to provide for continuousrepresentation from the village level to the highest organsof the State. Finally, a development programme mustprovide for the training of personnel and for independentassessment and criticism of the project as a whole.

Concluding his survey, Dr. GRANT said that, by itsadherence to essential precepts, the present plan seemsto have placed India well in advance of other countrieswhich have undertaken community development.But though the technique of village development,

as he said, has been carefully studied and manyschemes have been successful, it remains to be seenhow such techniques will bear fruit on the historicsoil of India. The difficulties are immense, and it isnot surprising that one can find, dotted about India,defunct small-scale schemes, with and without

Evangelical backgrounds. The Indian village has aremarkable capacity for absorbing (quite amiably)outside endeavour, and for having absolutely nothingto show for it ten years later. Continuity of policy andadequate funds will thus be essential if the presentproject is to succeed and if India is to show howdemocratic methods can be applied in a field too oftenthe preserve of the authoritarian theorist. A five-

year plan is a beginning ; but what are five yearsamong so many hundreds ? If the slip-back to oldhabits is to be avoided, the government must beprepared to extend the work in each block for a

second, third, and even fourth five-year period. Atpresent its exact intentions are not clear, but it

evidently expects to cover the entire country with itscommunity development programme during thesecond five-year plan (1956-57 to 1960-61).1 This is aformidable task indeed, and it remains to be seenwhat will be the effects of the changing attitude ofIndia towards American aid, and of the presentinternal unrest. Certainly the financial burden willfall heavily on a country as poor as India, and we ofthe West ought to be prepared individually andnationally to do what we can to help. For this vastand well-conceived experiment must not be allowed tofail for want of aid that we are able to offer.

Annotations

TUBERCULOSIS IN THE TROPICS

THE waning of tuberculosis in Britain and othercountries well supplied with hospital and other resourcesis not yet evident in less favoured areas ; and there isno certainty that the methods which are proving effectivehere will be equally effective in different cultural, environ-mental, epidemiological, and nutritional conditions.Even the causal bacillus may not be the one we know.As Dr. M. G. Candau, director-general of W.H.O.,remarks in his latest annual report 2: " There is increas-

ing evidence that mycobacteria isolated from patientsin tropical areas may differ, in type and in other

particulars, from those which are defined at presentas tubercle bacilli." Chemotherapy, without admissionto hospital, may help to control tuberculosis in landswhere the disease is rife ; but we are not yet certainthat it will, and meanwhile its use with imperfect super-vision may be actually increasing the load of infectionin communities by prolonging the lives of patients withoutrendering them non-infective, and by promoting thespread of drug-resistant organisms.An important step to solve these problems has now

been taken by W.H.O. in conjunction with the MedicalResearch Council and the Indian Council for MedicalResearch. An international research unit, selected bythe M.R.C., is to conduct a five-year survey in Madras.In the first stage, which may take two years or more,a group of patients treated by various drug regimeswithout being admitted to hospital will be studied forsputum conversion and compared with a reference groupadmitted to hospital. If this stage goes well a secondstage--probably an investigation of the communityeffects of widespread domiciliary chemotherapy-willbe considered.Not the least important aspect of this venture may

be the opportunity to train counterpart personnel witha view to establishing permanent cadres in clinical andbacteriological research. The two vacancies on the unitannounced in our advertisement columns this weekcomprise one for a bacteriologist, and one for a chestphysician who will undertake some postgraduate teaching.The unit’s task will be difficult ; but it should proverewarding.

1. The Second Five Year Plan, Draft Plan Frame, Mahalanobis, P.C.March 17, 1955. Indian Statistical Institute, Calcutta, 35.

2. The Work of W.H.O., 1955. Annual report of the director-general to the World Health Assembly and to the United.Nations. H.M. Stationery Office. Pp. 241. 10s.

3. Millar, It. A., Stephenson, R. P. Brit. J. Pharmacol. 1956, 11, 27.

NEW ANALGESICS

IN their continuous search for new analgesics withfewer side-effects than those drugs in common use,

pharmacologists commonly investigate the effect ofvariations in the basic molecule of one of the establishedanalgesics. Thus, Millar and Stephenson 3 have recently