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A large part of India’s health campaign, in James’swords, consists of " encouraging the will to be healthy, andspreading the knowledge of the meaning of health " ;and wide circulation of his booklet will certainly helpthis aim. Nevertheless a health service, no matterhow complete, cannot by itself solve India’s health

problem. Until there is a substantial rise in the standardof living people will continue to die of starvation and ofthe diseases attendant on malnutrition ; the nutritionaland dietary surveys by members of the Servants ofIndia Society 2 emphasise this fact. These studies includeaccounts of famine conditions in Malabar, Madras, andKanara, and contain many valuable family dietarysurveys, which illustrate vividly the shortcomings of thetypical Indian diet and the poverty of the Indian peasant.The curses of inadequate price control and of ineffectiveadministrative measures are here translated into termsof mouthfuls of rice and morsels of meat and fish. The

great volume of facts revealed by these painstakingstudies underline the need for rigid control of the priceand distribution of all foodstuffs, and not only the basiccereals. Stress is also laid on the need for irrigationand subsidies to encourage food-production. ForIndia, at present, food is the best -medicine.

COLDS AND CONSTITUTIONNEWS of the reopening of the laboratory’s offensive

against the common cold reawakens interest in the othermeans of studying civilised man’s most persistent enemy.With so much clinical and epidemiological material onevery hand, there is little excuse for any failure to extractall possible information from observations in the field.Yet opinion is still divided even on so simple a topicas whether some people catch colds more frequently thanothers.A group of workers at Boston

3 endeavour to answerthis query. Under the rather formidable title of Stabilityof Resistance to the Common Cold, they analyse theincidence of upper respiratory infections during four

years among the boys at the Phillips Exeter Academy.Previous work at the Harvard School of Public Health 4had suggested that the frequency of colds in individualswas not, as deduced by Gafafer and Doull,5 explicableby the operation of the laws of chance, and the ExeterAcademy study provides fresh evidence that each personhas a relatively constant incidence ; the number of coldseach year seemed to be characteristic for the individual,and slightly increased as the investigation progressedfrom 1935 to 1939. Sargent and his associates deducethat some factor such as the constitution must play asignificant part in determining the incidence of a diseasewhich appears to be thus correlated with the individualhost, but the value of their study is somewhat lessenedby the inclusion of all cases of coryza, pharyngitis,laryngitis, bronchitis, tonsillitis, and even pneumoniaunder the heading of common colds, even though 95%of all cases were diagnosed as

"

nasopharyngitis." It isprobable that epidemic influenza, for instance, was there-by included, and it would surely have been fairer to haveused for such a mixture a term such as A.R.D. (acute

respiratory disease), as adopted by the United StatesArmy. 6 .

The thesis that constitution affects the incidence of anacute infection is not new, and has been applied by severalauthors to poliomyelitis.7 8 Constitutional factors which2. Food Control and Nutrition Surveys in Malabar and S. Kanara.

Inadequate Diets, Deaths and Diseases, and a Food Plan forMadras. Studies by members of the Servants of India Society.Madras: Servindia Kerala Relief Centre. Pp. 300 and 83.Rupees 4 and 1.

3. Sargent, F., II, Lombard, O. M., Sargent, V. W. Amer. J. Hyg.January, 1947, p. 29.

4. Wilson, E. B., Worcester, J. Science, 1944, 99, 468.5. Gafafer, W. M., Doull, J. A. Amer. J. Hyg. 1933, 18, 712.6. Commission on Acute Respiratory Diseases. Amer. J. publ.

Hlth, 1946, 36, 439.7. Draper, G., Dupertuis, C. W. J. clin. Invest. 1939, 18, 87.8. Aycock, W. L. Amer. J. publ. Hlth, 1937, 27, 575.

determine the incidence of disease could, of course, begenetic, as suggested by Webster’s work on the inbreedingof mice,9 or might depend on individual influences suchas the hormones. Mention of hormones in connexionwith the common cold reminds one of some remarkableand unexplained facts recorded by the School EpidemicsCommittee of the Medical Research Council.l0 Boston

boys may develop colds by numbers, but the M.R.C.report suggests that British schoolgirls suffer from coldsthree or four times as frequently as their male coevals-though boys and girls suffer equally from influenza.,

VITAL STATISTICS AND THE M.O.H.

IN discussing innovations in the methods of nationalvital statistics at the meeting of the Society of MedicalOfficers of Health on Feb. 20, Dr. Percy Stocks, medicalofficer to the Registrar-General’s Office, described a

morbidity survey of E.M.S. hospital patient?. The

hospital records were sampled and the main features ofeach of the 1 in 5 cases selected were transferred topunched cards. The populations exposed to risk couldnot be enumerated, but proportional rates based on thenon-seasonal diseases gave some indication of the ebband flow of serious illness, and some useful specificinvestigations were made on motor-cycle injuries andtransfusion hepatitis. This experience will be valuableas a basis for a complete and accurate scheme of recordingthe clinical material in the National Health Service

hospitals. A more novel kind of morbidity -samplinginquiry is being condu,cted by the governmental agencyknown as Social Survey. Here a statistically repre-sentative sample of the population numbering 2500 isselected each month. Each person is questioned abouthis health in the previous three months by a, field worker.The refusal-rate is negligible, and Dr. Stocks was confidentabout the general accuracy of the results. When com-bined with the fuller notifications of infectious diseasenow in hand, the sample survey has much to commendit as an epidemiological tool for the M.o.H.

Mr. Louis Moss, director of Social Survey, said thatthe picture of the cross-section of the adult populationgiven by the sample agrees with that obtained fromthe more usual national statistics, and the incidenceof serious illness in the sample corresponds with estimatesbased on E.M.S. surveys. However, validation studiesinvolving a clinical examination of a sample of thoseinterviewed are under way. Later speakers, while

appreciating the limitations and difficulties of morbiditysurveys, agreed on their potential value to the M.O.H.,when, freed by the new Act from other responsibilities,he can concentrate on the environmental aspects ofsickness as well as death.

WHITE PENICILLIN

FROM the beginning of this year- a " white " penicillin

free from the impurities that gave the drug its yellowcolour has been obtainable. White penicillin is sold atthe price which yellow penicillin used to cost, while theless pure product is reduced to three-quarters of its

original price-the lowest charge for penicillin anywherein the world. The unitage of this white penicillin rangesfrom 1200 to over 1600 units per mg., but there can be no

guarantee that brands of the same unit age will be equallyeffective therapeutically unless we know what propor-tions of the different penicillins the preparations contain.Thus white penicillin may contain from 10% to 30% ofpenicillin iv, which, from American evidence, is quicklyinactivated by the human tissues and therefore of littletherapeutic value. However, two of the principalproducers claim tha,t their products contain at least 90%of penicillin n, which is known to be active in vivo aswell as in vitro against a wide range of bacteria,. One of

9. Webster, L. T. Medicine, Baltimore, 1946, 25, 77.10. Spec. Rep. Ser. med. Res. Coun., Lond. 1938, no. 227.