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work-than the more placid long-distance man. Thevalue of glucose and alcohol is chiefly psychological.Alcohol in moderate amounts with meals may help toward off staleness. Though the first to suggest thatglucose should be taken immediately before races, henow believes that its effect is due principally to thepleasant sweet taste.

Physiological research in the twelve years since thelast Games has strengthened the hypothesis that inthe production of energy carbohydrate, fat, and proteinfinally follow a common path ; it is now virtually certainthat these three main energy foods are partly or whollyinterconvertible. Thus it seems that the athlete in

training will do well to follow his own likes and dis-likes in satisfying his appetite he will get the carbo-hydrate and proteins he requires. *He need take novitamin pills or glucose tablets, and he should drinkfreely-not necessarily avoiding alcohol with meals,provided that the amount is moderate.

COST OF CONVALESCENCE

As things stand at the moment, some patients haveto pay for convalescent treatment while others get itfree. There are three categories of convalescent homes :(1) a relatively small number transferred to the NationalHealth Service ; (2) a few that successfully appealedagainst such transfer and were " disclaimed " ; and

(3) a relatively large number remaining outside the service,which the Ministry of Health classes as " holiday homes."Though the regional boards are required to pay for

patients in transferred and disclaimed homes, theyhave no power to pay for patients in holiday homes;and the methods of supporting hospital patients in this

last and largest group still seem to be uncertain. Thelocal authorities, it is true, have powers under section 28of the Act to pay for aftercare, and this is sometimestaken to include convalescence ; but the idea is new,and though the authorities generally agree to it, it

may be some time before any payments are actuallymade. Meanwhile, King Edward’s Hospital Fund Emer-gency Bed Service, which has agreed to provide, onrequest, information about vacancies in convalescenthomes, finds that a curious situation is developing. Allhomes are fully booked, but the transferred and dis-claimed homes have long waiting-lists, while waiting-lists for the holiday homes are much shorter. It is

clearly only a matter of time before patients in holidayhomes ask : " Why am I paying, here, when Mrs. So-and-so was sent to a convalescent home for nothing

"

The regional boards are trying to arrange that thelocal authorities should meet the cost for patients sentto holiday homes ; but this will take a little time toestablish, and will oblige patients to answer questionsabout their income. Some of the teaching hospitals arethemselves paying for convalescent treatment in holidayhomes, and this lead might possibly be followed by otherhospitals until something more satisfactory is arranged.The principles of prevention and reablement upheld bythe Act are contravened if some patients are charged fora reasonable and necessary period of recuperation whileothers are not.

STREPTOMYCIN SUPPLIES

FOR the past year the Emergency Bed Service (E.B.S.)in London has acted as an admission bureau for casesof tuberculous meningitis and miliary tuberculosisrequiring streptomycin. This arrangement has workedwell, and for some months the E.B.S. was able to finda bed for every case found to be suitable for streptomycintreatment. Unfortunately, however, since the numberof beds set aside in the selected hospitals for the officialtrial of streptomycin was limited, and because of thelong course of treatment necessary, in April of this yearthe cases in the hands of the E.B.S. began to accumulate

- -which is highly undesirable in a disease where earlytreatment is essential. In the annual report of the

King’s Fund Sir Harold Wernher, chairman of theE.B.S. committee, says that during April 45 cases wereawaiting admission, with little chance of finding a bedin time for treatment to be valuable. Lately this figurehas fallen slightly to about 35-mostly children. It was

generally understood that lack of dollars prevented anymore streptomycin being imported, and that home

production was unlikely to contribute significantly toour needs until the autumn. It was therefore a pleasantsurprise when the Minister of Health, in reply to Parlia-mentary questions on July 14, made the followingannouncement :

Streptomycin is not in short supply because of its cost indollars at all. Production on quite a large scale over herehas begun. Already, together with purchases still being madefrom the U.S.A., it is enough to cover all medical needs forwhich the use of the drug is so far reliably indicated-andshortly it should do so without any need for purchasingabroad. I am advised as to the purposes just mentioned bythe Medical Research Council. There is still some limitationof suitably staffed beds and therefore some waiting-lists,but-now that I am in a position to do so, since 5th July-I am asking all regional hospital boards to arrange additionalfacilities wherever they can.

Immediately afterwards an official announcement wasmade that -any hospital needing streptomycin for a

patient with tuberculous meningitis or miliary tubercu-losis would be able to obtain it by applying to the SuppliesDivision of the Ministry of Health. As a result theE.B.S. accumulation vanished overnight.

WORLD HEALTH ASSEMBLY

IN the weeks since its opening on June 241 the WorldHealth Assembly-at Geneva has made slow but generallysatisfactory progress, most of the work being done inthe various committees. On the motion of Sir WilsonJameson, for the United Kingdom, the United Statesdelegation were admitted to full membership despite the

. reservations made by Congress in ratification. A moreserious difficulty arose on July 10 when vigorous protestswere made against the general committee’s nominationsof a "slate" of 18 members for the executive board.-to be accepted or rejected as a whole. The committee,had evidently found it difficult to reconcile such factorsas the claims of the Great Powers, the fact that only8 countries in the American continent have so farratified (compared with 24 in Europe), and the desireof the Russian group to be well represented. Thecommittee’s nominations, which were ultimately endorsedby the assembly on July 14 by 39 votes to 10, distributeseats as follows : United States, Mexico, Brazil; SouthAfrica ; Egypt, Iran ; India, Ceylon ; China, Australia ;Norway, Netherlands, United Kingdom, France, U.S.S.R.,Byelorussia, Poland, Yugoslavia. Despite grave doubtson various sides, the assembly has adopted a proposalthat five regional offices should be established as soonas a majority of the countries proposed for each regiondecide that they want to have one. Thus the Alexandriabureau is likely to be recognised as the regional centrefor the Near East, while the " Middle East " will probablyhave an office in Mysore. African and Far Easternregions, and the integration of the Pan-American SanitaryBureau as the regional office for the Western Hemi-sphere, may take more time, and the financial aspect ofregionalisation has yet to be squarely faced.As already recorded, the assembly has chosen Geneva

as the permanent seat of the World Health Organisation.Next year’s meeting of the assembly is to be held ill

Europe, and Dr. Melville Mackenzie last week conveyeda warm invitation from the British Government to makeLondon the meeting-place.

1. Lancet, July 3, p. 17.