893

highly eestrogenic 4 : 4’-dihydroxystilbene. Thus, byadministering 4 : 4’-dihydrogy-&agr;&bgr;-diethylstilbene (thatis, stilbcestrol), we are getting under the guard of thebody mechanism and giving it a compound againstwhich it has not developed an adequate defence.

AIR-RAID SHELTERS

A LARGE number of occupancy tests in A.R.P.shelters for factory workers have been carried out bythe staff of Messrs. J. and E. Hall of Dartford, withthe assistance of medical and scientific advisers. Twokinds of shelter were used, each capable of holding50 seated people, one being of steel, completely belowground level, and the other of pre-cast concrete, onlypartly buried. The objects of the tests were to deter-mine the length of time before discomfort began whenall exits were completely closed; to determine thechanges in the temperature and humidity in thesecircumstances; and in general to note any data ofinterest and any methods of improving the comfortof the occupants. Apart from tests in the entirelyclosed shelters, the steel shelter was tested with anair-filtration plant in operation; with the exits ajar(as they would be during a raid were no gas used) ;and with added oxygen and soda lime. The typesof shelter differed in two rather unexpected ways.The completely limed steel chamber is more comfort-able because the surface temperature of the walls isgoverned by the temperature of the surrounding earth.The walls therefore absorb heat and keep the dry-bulbtemperature within comfortable limits, and moreoverprovide a cold surface on which expired moisture canbe condensed. On the other hand the walls of theconcrete shelter seem to have absorbed carbon dioxide,for the concentration after two and a half hours’occupation was only 60 per cent. of the theoreticalvalue. This, in the absence of any means of addingoxygen or subtracting carbon dioxide, might delay toan appreciable extent the onset of symptoms ofcarbon-dioxide poisoning. The investigation broughtno fresh facts to light, but it was none the less wellworth the labour. It demonstrated practically thatshelters can be constructed which can be fully occupied,though completely sealed, for two hours withoutdamage to the occupants, or indefinitely if the doorscan be left ajar, if filtration plant is fitted, or ifadequate amounts of oxygen are provided at hourlyintervals and soda lime is continuously exposed. The

report, published by Messrs. H. K. Lewis at 2s., bringstogether in a simple way much information valuableto builders of shelters and is a timely warning to thecareless that for long occupation some form of ventila-tion or of oxygen-enrichment is a necessity.

POLIOMYELITIS VIRUS IN SEWAGE

THE virus of poliomyelitis has on several occasionsbeen isolated by the treatment of human fœces withvolatile antiseptics, and Professor Kling in Swedenhas lately recovered from drinking-water a virus whichappears identical with that of the disease.1 Now Paul,Trask and Culotta have for the first time isolated thevirus from sewage-at Charleston, South Carolina,where there was an epidemic of poliomyelitis fromMay to July this year. Samples of sewage from thepart of the town where most of the cases had arisenvere inoculated intraperitoneally into six monkeys.Two of the monkeys died of peritonitis and two of aninfection of the abdominal wall ; but the remaining twodeveloped poliomyelitis, and from one of them thevirus was successfully transferred to another monkey.Passage was not attempted in the other case becausethe monkey died on the third day of the disease.1. See Lancet, Sept. 20, 1939, p. 753.2. Paul, J. R.. Trask, J. D., and Culotta, C. S., Science, Sept. 15,

1939, p. 258.

HÆMATURIA WITH M. & B. 693

IN our correspondence columns Dr. G. A. H. Buttlecalls attention to the rarity of heematuria duringtreatment with M. & B. 693 in the cases reported fromtemperate climates as compared with the highincidence met with by Backhouse in New Guinea.In their account of 100 cases of pneumonia treatedwith this drug (now becoming a classic) Evans andGaisford saw no haamaturia, and in their paper on280 pneumonia patients treated in South Africa,Agranat, Dreosti and Ordman’ do not mention thiscomplication at all. Romcke and Vogt’ met withtransitory haamaturia in only 2 of their 342 collectedpneumonia cases treated in Norway. On the otherhand, Robertson described a brisk hasmaturia. in aboy with pneumococcal meningitis treated at Hamp-shire County Hospital, and McCann of Belfast foundred cells in the urine on routine microscopicalexamination in 29 of 65 men with gonorrhoeatreated with the drug. Backhouse’s findings were

more definite: in 109 New Guinea natives he reportsgross bleeding in 5 and red cells in 8 more; in 11 ofthese the haematuria was accompanied by pain andin most the urine was scanty. Gross bleeding withcolicky pain has also been reported in Peiping bySnapper et al. and in the United States.The explanation 01 the bleeding seems clear.

M. & B. 693 is excreted partly as the free base andpartly in the inactive acetylated form, and thehaematuria arises from the trauma of crystals of theacetyl derivative, which is relatively insoluble in anacid medium. The quantity acetylated in the rabbitis high, and it is easy to recover from the rabbit’surine considerable amounts of the crystalline acetylcompound if it is allowed to stand in an ice chestfor some time. In human beings, however, the pro-portion acetylated varies greatly in different subjects,but when it is large, mechanical irritation of thekidney is always a possibility, particularly in febrilestates where the urine is concentrated and acid. Back-house was able to demonstrate crystals of M. & B. 693derivatives in the urine of his cases, and Snapper andothers have described actual renal calculi of the sameconstitution. Buttle suggests that the climate of NewGuinea would tend to lead to a low output of highlyconcentrated urine. The complication is not a seriousone, for the bleeding has usually been transitory, butits occurrence does emphasise the necessity for givingample fluids and for reducing the acidity of the urineas far as possible when M. & B. 693 is being given,more particularly in hot climates.

Dr. W. ALLEN DALEY has been appointed medicalofficer of health for London in succession to SirFrederick Menzies who is retiring on Nov. 2.

Dr. BEDFORD FENWICK, senior consulting gynaecolo-gist to the Hospital for Women, Soho, and sometimeeditor of the British Gynœcological Journal, died inLondon on Oct. 14 in his 85th year.We also regret to announce the death on Sunday of

Mr. A. T. PITTS, who did much to enhance the prestigeof dentistry in this country. He was well known alikeas dental surgeon to the Middlesex Hospital, teacherat the Royal Dental Hospital and scientific editor ofthe British Dental Journal. He was aged 58.

1. Backhouse, T. C., Lancet, Sept. 30, 1939. p. 736.2. Evans, G. M., and Gaisford, W. F., Ibid, 1938, 2, 14.3. Agrauat, A. L., Dreosti, A. O., and Ordman, D., Ibid, Feb. 11,

1939, p. 309.4. Römcke, O., and Vogt, M.D., Ibid, Oct. 7, 1939, p. 778.5. Robertson, K., Ibid, 1938. 2, 728.6. McCann, J. S., Ibid. July 8, 1939, p. 100.7. Snapper, I. et al., Clin. med. J. July, 1939, p. 1.