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susceptible than the amnion to virus present in garglings,is apparently less likely to induce phasic modifications.The change from " 0 " (original) to " D " (derived)phase has also been encountered with an influenza B strain,but apparently occurs less sharply than with illfiuenzaA. Other work with chick embryos has been directedtowards a study of factors concerned in susceptibility toinfection which would have a bearing on the problem ofisolating new viruses.

’

In addition to influenza and the common cold. atypicalpneumonia and psittacosis are being studied at the

institute, with special reference to penicillin. Other

subjects of investigation are gas-gangrene, scrub typhus,the effects of heat, and the estimation of carbon monoxide,all of which are important to the war effort in Australiaand elsewhere.

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POLIOMYELITIS IN MALTA

FROM June 1940 till late in 1942 the islands of Malta.,. GC,were bombarded from the air with the utmost ferocity.In the areas of concentrated attack large numbers ofpeople were obliged to huddle in tunnels and basements,and later in deep shelters hewn out of the rock ; and in thereception areas refugees filled schools, churches, and anyother places that could offer protection against theweather. Relief obtained from the building of shelterswas counterbalanced by the spreading destruction ofhomes. In the summer and autumn of 1.942 the life-lines became so precarious that the food-supply fell to adangerously low level. Relief came at last in mid-November. A few days after the people had returned totheir homes an epidemic of poliomyelitis broke out.Prof. H. J. Seddon and his co-workers’ can now tell the

story of this outbreak and discuss its epidemiology. Thefirst known cases occurred among civilians in Malta onNov. 15, and in Gozo on the 21st. The first Service casewas on the 27th. The epidemic reached its peak onDec. 20 (108 cases), and came to an end in the beginningof March, 1943. It is fortunate that Professor Seddon’sexperience of the Malta epidemic has already. beenapplied : he has gone to Mauritius to advise on measuresto deal with a corresponding epidemic of considerableseverity, now mercifully on the wane. In Malta therewere in all 426 civilian and 57 Service cases ; 82 % of thetotal occurred in children under five years of age. Of the01 adults affected only 4 were Maltese ; and a noteworthypoint is that no Maltese troops were affected, althoughthey were in close contact with their allies. In thecivilian list the mortality was just over 6%, but therewere 11 deaths among the 57 Service men.

Poliomyelitis was not a new visitation in Malta ; therewas a small outbreak in 1902, and between 1921 and 1942a few sporadic cases appeared nearly every year. Theislands are densely populated (Malta 2551 and Gozo1087 persons to the square mile), and in the special cir-oumstances overcrowding was rife in the autumn of 1942,although the worst period had passed. Nevertheless,there were only seven homes in which more than one,child was affected, and none with more than two cases.There was no overcrowding to speak of among the Servicemen. During the summer and autumn of 1942 the dailyadult civilian calorie value of food was never more than1500 and often less. In the more fertile Gozo, however,overcrowding was relatively low and food fairly plentiful ;but the incidence was about the same as in Malta. In

considering the mode of spread Seddon and his colleaguespoint out that the men in the Services did not enjoy thesame degree of immunity as the civilians and suggestthat this group had not acquired immunity to the strain- of virus responsible for the epidemic. There is no evid-ence that the infection was brought to the islands fromwithout. It was not possible to trace the geographicalmarch of the epidemic and there was no regular connexionbetween the date of onset in one town and its near neigh-1. Seddon, H. J., Agius, T., Bernstein, H. G. G., Tunbridge, R. E.

Quart. J. Med. 1945, 14, 1.

bour. The evidence of case-to-case infection was rareand uncertain. Studies were made of the possibilitiesof excremental spread, especially in view of the sanitarydifficulties and of the direct use of sewage on the land.The crime-sheets of water and food (especially milk) werecarefully analysed, but in vain ; and flies were non-suitedbecause of their scarcity at the time. As the outbreakoccurred more or less simultaneously in Malta and Gozo," one is forced to the conclusion that the disease was

taken from Malta by one or more carriers." But whyneed one postulate the carrier frem Malta to Gozo ’?The virus was no doubt widely dispersed through bothislands before the disease assumed the paralytic form, andmany, though by no means all, outbreaks have takenprecisely the same course, affecting in most instances onlyone member of a family. The virus is constantly with us,constantly infecting us, but only rarely getting through toattack the central nervous system. And the circum-stances in which it loses its temper, so to speak, and goresus to the marrow we simply do not know.

THE CRYING BABY

THE cry of the newborn baby has long been recog-nised as valuable in securing the initial expansion- ofthe lungs, and in the subsequent fortnight its repetitionsecures full inflation. But the cry is also a warningsignal, and Aldrich thinks there is a tendency to forgetthis in the teaching that to pick up a crying infant islikely to promote spoiling." The -young baby turnson his cry whenever " he is hungry, cold, wet, underthe influence of pain ; when he heats loud sounds orloses his equilibrium ; and probably when he feels theneed for fondling." The early compulsive cry maytherefore be classified with other disappearing reflexes,like the startle, tonic-neck, grasping, and swimmingreflexes, all of which go after a few months and persistonly with cerebral retardation. Thus a baby whoseearly reflex crying persists will come under suspicionas mentally retarded. (So also should the excessively"

good " baby who cries very little.) But Aldrich’s

point is that since the highest mortality-rate in lifeoccurs during the first two weeks anything which willthrow light on the best management of this period is

worthy of close study. He is worried by the " unre-sponsiveness and even indifference " shown to thefundamental physiological needs of babies which hasundoubtedly grown up in the professional groups caringfor them. He makes, in effect, yet another plea thatbabies need more mothering than the best institutionsgive them. The baby who is startled, hungry, or coldsatisfies his basic needs through the mediation of hiscry. He is not to know, as the adults around him know,that modern civilised conditions of life give him-morebasic security than his predecessors many centuries ago.Modern work among children is rightly putting thissense of security as the most important of all the child’srights. But the newborn still cries, being largely acreature functioning on a subcortical level. A close,study of crying in a newborn babies’ nursery might yieldinstructive results and give scientific support to themother’s instinctive response of gratifying the infant’smore pressing needs.

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TYPHUS IN GREAT BRITAINTYPHUS has been diagnosed in 8-10 cases in prisoners-

of-war returning to this country. There have so far beenno secondary cases, but practitioners are asked to considerthe possibility of typhus in any patient with pyrexia ofunknown origin who has been in contact with a repatriatedprisoner.

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ON Thursday, June 7, at 3 P-Nr,. at the University 1-itioti,"Leeds, Brigadier J. A. MACFARLANE, consulting surgeonto the Canadian Army Overseas, will deliver theMoynihanlecture for 1944. He is to speak on the managementand results of war wounds of the abdomen.

1. Aldrich, C. A. Proc. Mayo Clin. 1945, 20, 60.