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since their hypothermia would protect them from thedangers of hypoxia without materially altering the radio-sensitivity of their tumours. Secondly, in people exposedto ionising irradiations the ill-effects could perhaps bedelayed by hypothermia, while bone-marrow infusionsor other therapy were being organised.

THE METRIC SYSTEM IN PRACTICE

SLOWLY we are feeling our way towards full applicationof the metric system. The ultimate replacement of theapothecaries’ by the metric system for all pharmaceuticalpurposes is likely to lead to the adoption of this system formeasuring inches, feet, and yards; for length and volumeshould be as inseparable in our minds as part and parcel,and how can this be so without the same language ofmeasurement ?

Yet the adoption of the metric system even in pharma-cology (which will become all but obligatory in 1963 whenthe British Pharmacopaeia will contain no other notation)is not devoid of difficulties. Two years ago one of our

university hospitals-the United Birmingham group-decided to anticipate the British Pharmacopaeia in thisrespect. The immediate problem for the standing pharma-ceutical committee was to equate the metric with the

imperial dosage system and to explain this conversion tostaff at all levels. For convenience close approximationswere adopted. Thus gr. 1/4, so familiar for morphine,became 15 mg.; and gr. 3, familiar for certain barbiturates,became 200 mg. Conversion tables for solids and fluidswere printed on two sides of a small indestructible cardconvenient in size for both the uniform frock and thewaistcoat pocket. No prescription was to be accepted bythe hospital pharmacies unless it was set out in the metricsystem. The changeover was achieved without oppositionor complaints-though to those of middle age it is not

always easy to think of a dose of morphine as 15 mg., eventhough 1 g. of sulphonamide causes no difficulty : we havebecome accustomed to our anomalies. The hospital staffhad to decide whether letters to general practitionersshould continue to be written in the imperial manner.Most decided to discard this here too; for to do otherwisewould be to connive at the dual system that they wereattempting to end and would destroy the faith of newgraduates.One consequence has been wholly advantageous: wards

are now being equipped with metric measuring-flasks andutensils, thus eliminating an arrangement that was both asource of error and an unwarranted burden on the nursingstaff, who previously had had to measure in ounces andpints and convert (without the aid of tables) to millilitresand litres in order to satisfy the demands of an up-to-dateconsultant. But habit dies hard: at least to one ward sisterthe bottle of intravenous fluid had always been and stillwas a pint bottle-why not, since so many around her stillspoke of giving a patient x pints of saline ? She thereforerecorded each bottle as 600 ml., not appreciating that eachnow contained 500 ml.

Unification requires that we shall speak and write interms of centimetres. This is perhaps rather more diffi-cult : " the last 50 cm. of the small intestine " has a strangering. Moreover it is hard enough to persuade a medicalstudent to procure any tape measure (the stethoscope,though far more expensive, is bought readily enoughbecause it is a status symbol); and tape measures gradedin centimetres, though made, are hard to come by.

CURRENT MEDICAL RESEARCH

WHILE he was demonstrating a particularly abstractinvention Edison was asked what possible value it couldhave. He countered, we are told, with the question:" What is the value of a newborn baby ? " The value ofmany of the projects sponsored by the Medical ResearchCouncil is apparent immediately; that of others (as withEdison’s baby) less immediately.Work on interferon comes into the first category; for

this substance, found in tissue-cultures after incubationwith an inactivated virus, inhibits, in wide-spectrumfashion, the growth of many other viruses. Earlyenthusiasm about the therapeutic value of such an agentwas tempered by the possibility that it might proveintrinsically toxic, antigenic, or much less effective in vivothan in vitro. These possibilities have now been investi.gated, with results which indicate that interferon mayhave important clinical applications.An examination of the plasma-kinins seems to belong

to the second group; for the function of these compounds,even in normal physiological processes, is still obscure.They are polypeptides formed from plasma by the actionof proteolytic enzymes such as trypsin. In contact withexposed nerve-endings they give rise to severe pain, andwhen injected intravenously cause a fall of blood-pressureby relaxing the peripheral vessels. They may possibly beresponsible for reactive hyperaemia, and for the increasedblood-supply to skeletal muscle during exercise. Moredefinite grounds exist for believing that they play a partin the vascular changes which persist for so long inburned skin. The kinins are widely distributed: the urine,sweat, and saliva of many animals have been shown tocontain them, and their presence in wasp-venom m-

doubtedly accounts for much of the pain and swellingresulting from a sting.The drivers of London’s double-decker omnibuses

have been found to be some three times more liable tosudden death from heart-failure than the conductors,Further work has been directed towards examining thehypothesis that such a difference was due to the two jobsattracting contrasting somatotypes. Age for age, driversare larger round the chest than conductors; but study ofother occupations suggests that the death-rate fromischaemic heart-disease is commonly higher amongsedentary workers. Radio and telegraph operatorshave a particularly high mortality, postmen a muchlower one.

Twelve such items in its programme are described atlength in the report of the Council to Parliament,Formerly this intriguing resume of current researchproblems was available only to those who purchased thefull report, the greater part of which was concernedwith administrative matters. Now, however, the articles I

dealing with these projects are published separatelyat a modest price. These accounts are so topical in nature,and so catholic in appeal, that they are certain to be widelyread.

l

The title of Dr. EDITH SUMMERSKILL has been gazetted as

BARONESS SUMMERSKILL, of Ken Wood, in the County of, London.

1. Current Medical Research: a reprint of the articles in the report of theMedical Research Council for 1958-59. H.M. Stationery Office, 1960.3s. 6d.