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reversals," the mechanism of which is unknown-ahypothesis akin to that of McLeod,6 who has suggestedthat the different cultural types of Corynebacteriumdiphtherim may be cyclical mutations. An increase in theepidemic type-i meningococcus results from changes incarrier composition and is correlated with the occurrenceof meningitis ; but the persistence of a single type inindividuals exposed to other types suggests the operationof some general factor in the host. All agree that the

relatively high incidence of the disease in the army isdue largely to the influx of recruits ; but Aycock andMueller found no evidence that the carrier-rates differedgreatly between recruits, seasoned soldiers, and civilians.

This susceptibility of recruits to clinical attack isevident only during the first few months of service ; of3507 cases of meningitis, 78-6% occurred in men withless than six months’ service and 57-6% in men with lessthan three months’ service. It would therefore not beunreasonable to suppose that Fairbrother was right inattaching importance to fatigue as a contributory factorin attacks among recruits. Fortunately sulphadiazine(and other of the newer sulphonamides) is effective notonly in prevention and treatment but also in securingprompt termination of the carrier state. As the resultof trials, Aycock and Mueller suggest that the adminis-tration of 8 g. of sulphadiazine to recruits upon arrivalat the depot would ensure a refractory state throughoutthe period of greatest risk.

AMERICAN HOSPITALS

DESPITE a large Federal construction programme,the U.S.A. is still not within sight of achieving thenumber of hospital beds it needs. State plans show 7that at the start of 1950 the country had a total of

1,099,493 beds, of which 162,598 were rated as " non-

acceptable " ; to replace these and meet the full demanda further 867,833 beds were needed. The upper limitswithin which the States formulated their estimates were :for general-hospital beds 4-5-5-5 per 1000 populationfor mental-hospital beds 5 per 1000 population ; fortuberculosis beds 2-5 per average annual death in theState over the five-year period 1940-44 ; and for chronicdisease 2 beds per 1000 population. The wide dis-crepancies between different States are reflected in thefigures for tuberculosis. Whereas Minnesota, at the

top of the scale, had 2.96 "

acceptable " beds per annual

death, Alabama, at the bottom, had only 0-38 ; thenational average was 1-43, and in only six States was2-5 exceeded. (The estimates include beds in hospitalsunder construction.) These figures do not, of course,indicate the existing special need for more hospitalsin the less thickly populated parts.TISSUE CULTURE OF HUMAN ENDOMETRIUMTHE technique of tissue culture in artificial media has

been known for many years, and it is, therefore, surprisingthat it has not been used more extensively in physio-logical and pathological research. Randall and hisassociates 8 seem to be the first to have adopted thetechnique of Parker 9 and of Medawar 10 for the cultureof human endometrium in a fluid medium-a methodwhich permits simultaneous study of the effect of thetissue on the medium and of the medium on the tissue.Endometrium is a particularly suitable tissue for thistype of work ; it is easily obtained fresh and in quantityby curettage, and it undergoes certain well-definedmorphological and functional changes which are onlypartly understood and whose explanation would be ofdefinite clinical value.6. McLeod, J. W. J. Path. Bact. 1950, 62, 137. See Lancet, Dec. 2,

1950, p. 693.7. Cronin, J. W., Reed, L. S., Baney, A. M. Publ. Hlth Rep., Wash.

1950, 65, 1461.8. Randall, J. H., Stein, R. J., Stuermer, U. M. Amer. J. Obstet.

Gynec. 1950, 60, 711.9. Parker, R. C. Science, 1937, 85, 292.

10. Medawar, P. B. Quart. J. micr. Sci. 1948, 89, 187.

Randall and his colleagues have already obtainedsome striking results. Thus they found that, whereasproliferative endometrium required, for proper growth,nearly 80% oxygen and 5% carbon dioxide, secretoryendometrium survived quite well even under anaerobicconditions. The optimum pH corresponded with thesefindings : 7-3-7-6 for proliferative endometrium, and6-7-6.9 for secretory endometrium. Reduction of the

temperature greatly prolonged the survival-time of theexplanted tissues ; control cultures kept at 37°C beganto show evidence of degenerative changes after 10 days,but cultures kept at 4°-5°C were histologically normaleven after 35 days. On the other hand, at this Ipwtemperature no mitoses were seen in proliferative endo-metrium, whereas in cultures kept at 25° or 34°C theywere numerous. This work opens up a vista of possiblestudies-e.g., on the effects of hormones on the tissueand its products (which might, incidentally, offer a veryneat method of assaying progesterone) ,; the effects ofvitamins, amino-acids, and inorganic ions ; the changeswhich accompany menstruation ; and the developmentof inflammatory conditions.

SYNTHESIS OF COMPOUND F

COMPOUND F has been synthesised by research chemistsof Messrs. Merck & Co., New Jersey. This, says theNew York Tirnes (Dec. 29), was announced at the annualmeeting, in Cleveland, of the American Association forthe Advancement of Science. Like ’ Cortisone’ (Com-pound E), which was synthesised in the same laboratories,Compound F is made from desoxycholic acid ; the processis completed in 39 stages, compared with 37 for cortisone.Hitherto only small amounts of compound F have beenavailable for trial 1 ; but it is thought to have much thesame action as cortisone. The Merck chemists state that,given the necessary equipment, substantial amounts ofcompound F can be produced within a matter of months.

NEW YEAR HONOURS

OF eight members of our profession receiving knight-hoods,. two are fellows of the Royal Society. Dr. GordonHolmes has long had so great a name in neurology that aprefix seems almost irrelevant ; and the work on virusesdone in Professor Burnet’s institute in Melbourne is known

throughout the medical world as that of a mind whichcan kindle ideas as well as illuminate facts. Mr. KelsevFry, with his distinguished record in the Guy’s dentalschool and as dean of the faculty of dental surgery at theRoyal College of Surgeons, has aided the Royal AirForce and the Ministry of Health as consultant.Dr. Selwyn-Clarke, who is appointed K.B.E., is one of thefew doctors in the Colonial Service who have becomesenior administrators : during the war he had thedifficult post of director of medical services at Hong- "

Kong, and his recent efforts, as governor of the Seychelles,to improve the conditions of the people, have likewisecalled for courage. Also on the Colonial Office list areDr. F. A. Ibiam (honorary K.B.E.) and Dr. K. A. Abayomi,both of them members of the executive council of

Nigeria, and both Scottish graduates. In the RoyalVictorian Order, Dr. Daniel Davies and Dr. F. H. Tealeare promoted to knighthoods for personal services to theSovereign and his household. Dr. Davies’s skill as aclinician is based not only on large experience but onpatient investigations into the clinical aspects of the

pneumonias, anaemias, and dyspepsias ; while Dr. Teale,as former lecturer in bacteriology and head of the immu-notherapy department at University College Hospital, hasworked on problems of bacterial infection. The-list weprint on p. 47 contains also the names of many othermen and women who are already honoured in theirprofession but whose public recognition is none the lesswelcome to their colleagues.1. See Fourman, P., Bartter, F. C., Albright, F., Dempsey, E.,

Carroll, E., Alexander, J. J. clin. Invest. 1950, 29, 1462.