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be a conflictless and suffering-free childhood. In Britain

today parents have become acutely conscious of familytensions, and are often so guilt-ridden about them thatthey are discouraged in their task- of rearing a family,and look round for someone else to do it for them. Butthe idea that there exists an expert method, with aguaranteed result, seems to me a most dangerous assump-tion, because of the suggestion that goes with it-thatother methods are wrong.Many parents will continue to bring up many children

in all sorts of different ways. Indeed it is difficult to seehow any kind of communal upbringing, however benevo-lent, could provide the excitement and the tension, theups and the downs, which are inseparable from ordinaryfamily life. The quality of love, which is essential in goodparents, begins with love of the pair for each other, andwith love of the idea of having children-not in order tojustify a marriage, or even to cement its bonds, but aspart of the job as a whole. Children who are the naturaloutcome of love will be loved as much when they are badas when they are good (or even a little more).The tenderness felt towards young children, so well

revealed in the 18th-century analogy of the nursery ofyoung trees, will allow a baby to enjoy its body peacefullyin relation to its mother’s body and so come to learn theright use of tenderness at a later stage. The older childwho fights his parents is engaged in a wholly humanactivity, in which he explores a great range of humanemotion in miniature. He cannot be trained to behavewithout a quiet place in which to pursue this rehearsalof the real stuff to come. Indeed, what he experiences isthe real stuff, but he is not expected to stand or fall bythe results, as he will have to do later in his life.

I am indebted to Mr. L. M. Payne of the library of theRoyal College of Physicians for his help in referring me to anumber of rare and early books in the possession of the college.

BIBLIOGRAPHY

Buchan, W. (1794) Domestic Medicine, London.Chavasse, P. H. (1898) Advice to a Mother. 15th ed. Edited by

George Carpenter, M.D.Combe, A. (1844) Management of Infancy. Edinburgh.Gosse, E. (1907) Father and Son. London.Hastings, J. (1910) Encyclopædia of Religion and Ethics. Vol. III;

p. 545.McArdle, D. (1951) Children in Europe. London.Phayre, T. (16th century) The Regiment of Lyfe with the Booke of

Chyldren.Smith, H. (1792) Letters to Married Women on Nursing and the

Management of Children. London.Tytler, H. W. (1797) Translation of Paedotrophia from the Latin

of Sammarthamus 1584.

MEDICAL RESEARCH COUNCIL

THE council’s report for 1952-53,1 like its predecessors,gives a clear and succinct account of the year’s activities.This is preceded by a modest reminder :

" Any account of achievements in medical research isbound to be misleading unless the reader bears in mind thatvirtually every conspicuous advance depends on a mass ofunspectacular work, all of which has -been indispensable tothe final result. To appraise fairly the significance of thecontributions which different individuals and branches ofscience make to the general progress of medicine one mustremember that all are not equally well placed to make thosefinal contributions which attract public attention."

Ascent of EverestM.R.C. workers contributed much to the planning

of the successful Everest expedition ; and Dr. L. G. C. E.Pugh, of the council’s staff in the division of human

physiology at the National Institute for Medical Research,was an active member of the expedition, during whichhe collected many data on physiological changes at

high altitude.Cell -Iletabolisni.

In November, 1953, the Nobel prize for physiologyand medicine for that year was awarded jointly to Prof.

1. Report of the Medical Research Council for the Year 1952-53.H.M. Stationery Office. Pp. 269.

H. A. Krebs, F.R.S., director of the council’s CellMetabolism Research Unit, and Prof. F. Lipmann, ofHarvard. The award to Professor Krebs was madefor his work on the citric-acid cycle.

In this cycle a three-carbon substance, pyruvic acid,produced in the fermentation reaction, reacts with a four-carbon substance, oxalacetic acid, already present in the cell,to form the six-carbon tricarboxylic acid, citric acid, one

carbon atom being given off as carbon dioxide. By a complexseries of reactions the citric acid loses two further carbonatoms as carbon dioxide and is turned into succinic acid.then fumaric acid, and finally is reconverted to the originaloxalacetic acid. Thus the process cari be repeated indefinitely,and the net result of each operation of the cycle is that thethree-carbon acid arising from the fermentation of the sugaris converted by a series of distinct oxidative steps into threemolecules of carbon dioxide.

Later work has shown that the tricarboxylic cycle isconcerned not only in the metabolism of sugars but alsoin that of fatty acids and, in addition, in the synthesisand degradation of many of the building-stones of

proteins. The work of Professor Krebs and others hasthrown light on the way in which vitamins affectmetabolic reactions.

Peripheral-nerve InjuriesThe task of the council’s Peripheral Nerve Injuries

Committee, set up in 1940, has now been completed.Since 1940 great strides have been made in the under-standing and treatment of such injuries, including theintroduction of autogenous grafting for the repair of

gross lesions, and proof that early secondary suture ispreferable to primary repair. An analysis of the long-term results of nerve suture showed that failure wasusually due to one or more of three factors : (1) longdelay between infliction of the wound and repair ofthe nerve ; (2) injury involving a considerable lengthof the nerve ; and (3) injury to the nerve -in a part ofthe limb near the body.Influenza

After a preliminary trial in 1951-52 to select the bestvaccines against influenza, a larger field investigationwas made in the winter of 1952-53, when an influenza-Aepidemic was expected. Over 12,000 volunteers wereincluded in the trial ; and of these half received virusvaccine made from the strains thought to be most

suitable, while the other half received a mixed bacterialvaccine such as had been recommended in the past for pro-tection against the disease. When the epidemic appeared,influenza attacked 4.9% of the group who had receivedold-type vaccine, compared with 3.0% of those giventhe newer virus vaccine. This is equivalent to a reductionin incidence of 40%-a result which, in the words ofthe report,

" is not as good as could be wished but whichprovides definite evidence of a protective action by thenew vaccine and is sufficiently encouraging to justifyefforts to improve it."

ADMINISTRATION

During the year the following new groups of workerswere formed : the Betatron Research Group at theChristie Hospital and Holt Radium Institute, Man-chester ; the Radiological Protection Service (MedicalResearch Council and Ministry of Health) ; and the,

Group for Research in Infantile Malnutrition in Uganda.At the Central Public Health Laboratory, Colindale.the Air Hygiene Laboratory was set up. At the endof the year the council’s establishments consistedof the National Institute for Medical Research, 3bresearch units (in some cases with other titles), 11 researchgroups, the Antibiotics Research Station, the Labora-tory Animals Bureau, and the Medical Research CouncilLaboratories, Gambia. Some members of the staff areattached individually to other institutions. The councilalso continues to provide for a very substantial part of theresearch activities of the Institute of Cancer Researchat the Royal Cancer Hospital, London.