Rational Line Research Articles

The Advancement of Medical Research and Education Through the Department of Health, Education, and Welfare: Final Report of the Secretary's Consultants on Medical Research and Education.

Our country has not shown any recent signs of being wise and thoughtful in the long-term plans for the future. We have survived because we could react to the unexpected. So far we have made little serious attempt to bend the future to our desires or even to our needs. We are eternal improvisers. Such haphazard methods are nothing less than blueprints for disaster in a fast-paced world. To the end that we might proceed along more rational lines, Dr. Folsom, Secretary of the Department of Health, Education, and Welfare (what an incorrigibly hopeful paradox lies in his name), appointed a board of scrutiny to look into the crystal ball of the future as it gives glimmerings about the advancement of medical research and education. This is the future of medical research and education seen through the eyes of the National Institutes of Health. Dr. Bayne-Jones, who has had illustrious

The chemotherapy of poisoning by organophosphate anticholinesterases.

Oximes (with or without atropine as an adjunct) have recently been used successfully in the treatment of humans poisoned by organophosphate anticholinesterases. The discovery of the nature of the biochemical lesion in organophosphate poisoning has permitted the design of drugs to repair specifically this particular lesion. This paper reviews historically the researches which led to the development of pyridine-2-aldoxime methiodide (PAM) and its corresponding methanesulphonate (P2S), the two most successful oximes yet tried, and summarizes the theoretical background to their rational use. Organophosphates are lethal because they inactivate cholinesterase due to phosphorylation of the enzyme9s active centre. Consequently two rational lines of treatment are: ( a ) To find some compound which could be phosphorylated as rapidly as the enzyme and which, if introduced into the body, would protect the enzyme from inhibition by competing with it for the organophosphate, or ( b ) to find a compound which would restore the activity of the inhibited enzyme by dephosphorylating it. In both cases essentially the same type of compound is needed, namely, one with a high intrinsic reactivity with organophosphoryl compounds, in ( a ) with the inhibitor itself or in ( b ) with the phosphorylated enzyme. Types of compounds with either or both of these properties are o -dihydroxybenzene derivatives, metal chelates, hydroxylamine, hydroxamic acids, and oximes. Pyridine-2-aldoxime methiodide and methanesulphonate have been by far the most successful as reactivators and in the treatment of poisoned animals. A brief account is given of the range of compounds for which PAM has been shown to be a successful antidote in intact animals and of the ability of PAM to overcome the signs and symptoms of poisoning both in animals and in man. Possible lines of future investigations are indicated.

The New American Conservatism and European Conservatism

N CONTRAST to liberalism and socialism and a whole series of other subject matters of political theory, conservatism is not a clearly definable concept. Not only does it respond to the constant flux and change in society: this would be true also of other social movements and ideas. (Thus, modern liberalism has undergone all kinds of transformations and has demonstrated variable aspects of its basic creed, ever since John Locke and Adam Smith applied similar hopes and terms to different fields of human endeavor; and, of course, we are only too familiar with the various phases and emphases through which modern socialism has passed.) The special point with regard to conservatism is that it varies not only as to form or temper but also as to substance from one society to another. This is the major point to be demonstrated, and it denotes the futility of so many of our new American who try to prove their case by quoting endlessly from the British model of thought, incidentally without paying sufficient attention to the prudent qualities of flexible British action. Much of the standard criticism directed at modern conservatism, however, misses the point no less. A favorite objection of liberals precisely is that conservatism cannot be clearly defined, and that its pragmatic adjustments to given situations prove only that a Communist in Russia may be termed a with no less justification than a dyed-in-the-wool Republican in Vermont. After all, he, too, preserves a given order or adjusts to a given situation; and is this not all there is to conservatism? The liberal critic who argues thus proceeds along far too easy rational lines. Not only does the question arise as to whether the member of a movement which still is bent on world revolution and which plans to subvert most, if not all, of the established orders and values can be termed conservative without the most violent stretch of the imagination; but, with a particular view to purely Russian conditions, is it not true that the degree to which a Russian Communist may be considered conservative will obviously depend on his party's as well as his own attitude toward Russia's total history and her institutions of the past? Here we approach the heart of the problem. It does not matter, namely, how distasteful Czarist institutions are either to Communists (Russian Communists actually have either preserved or ultimately resuscitated a considerable number of these) or to Western conservatives. The main characteristic of political conservatives everywhere is their pride, their nostalgia, their sentiment with respect to their own nation's (or group's) history, and their determination to cherish, perpetuate, or ''conserve'' policies and institutions particularly identified with it. However, the policy of preservation need not be unanimous. Conservatives of the same country or locale may show wide-

Cancer of the thyroid.

SATISFACTORY treatment of cancer of the thyroid depends not upon static morphologic standards but on a dynamic concept based upon an understanding of the biologic characteristics of these tumors. The physician faced with the problem of thyroid malignancy needs the answers to questions regarding the functional and biologic potential rather than a microscopic description of dead tissue. Of itself, the histology of a tumor has no value unless it can be utilized to predict how the cells of the tumor will act. This concept of cancer as living tissue is particularly important in any study of thyroid cancer because of the biologic and histologic variability of the tumors, the protean manifestations of the disease, the endocrinologic aspects of many of the tumors and the availability of isotopic iodine for use in study and treatment. The present study consists in the evaluation of 190 cases with an established diagnosis of cancer of the thyroid which were admitted to the Massachusetts General Hospital from 1931 through 1951. The objective was the accumulation of information which would help to direct our therapy along rational lines, based on the biologic characteristics of the various types of tumors.

Rational Theory of Delta Formation

From the approach of the geological oceanographer, this paper attempts to develop rational lines of reasoning for hindcasting how nature disposed of sediments brought into a lake or ocean at a particular place and time. By assuming the ocean to be a currentless, tideless, wave-free basin, jet theory as developed by Tollmien and subsequent workers is utilized in determining the magnitude and interrelations of limnological and oceanographic phenomena observed off mouths of sediment-laden rivers. To do this, the basic theory of jets is modified by introducing a rotating fluid system and postulating a hydraulic head at the orifice. If a delta is defined as a sedimentary deposit built by jet flow into or within a permanent body of water, these modifications allow for the existence of three basic types of deltaic deposits, depending on the density contrast between entraining and entrained fluids. Examples of these different types of inflow are cited from the Mississippi Delta region. In the case of hyperpycnal inflow (inflow more dense), it is suggested that turbidity currents carrying coarse-grained material during glacial stages eroded the Mississippi Submarine Canyon and supplied the material for the submarine delta off the canyon's mouth. Homopycnal inflow (inflow equally dense), which gives rise to the deltaic deposit characterized by classical top-, fore-, and bottom-set beds, is described for the Lake Ponch rtrain, Louisiana, area when the Bonnet Carre Floodway is in operation and for crevasses in the Lower Mississippi River. Hypopycnal inflow (inflow less dense) is discussed in some detail, including such aspects as flocculation effects, lunate bar development at river mouths, development of distributaries and flank depressions, the seaward movement of river water upon leaving the river's mouths, and effects of the earth's rotation. Modifying effects of wind, waves, and tides on deltaic deposits are discussed briefly.

CONTRIBUTIONS TO PLASTIC SURGERY DURING 1944

The literature on plastic surgery for 1944 contains numerous contributions on surgical technic, some reports of important investigative work and a few articles dealing with the principles involved in planning reconstructive surgical procedures. Most important among the latter group is the article published by Ferris Smith in which he urges simplification of plastic procedures along rational lines. He emphasizes that many types of facial disfigurement can be repaired by multiple excision or by using flaps of facial skin from the vicinity of the defect rather than grafts of foreign skin from elsewhere on the body surface. When the loss of facial skin is so extensive that the condition cannot be corrected by sliding or rotating skin from the face or the neck into the defect, then only may foreign skin flaps or free grafts be used. This foreign skin forms a satisfactory functional covering and relieves the tension caused by

CARBUNCLE OF THE KIDNEY: A REPORT OF THREE CASES AND A REVIEW OF THE LITERATURE

SummaryThree successful cases of renal carbuncle (one bilateral) are reported, and a total series of eighty‐four cases are reviewed, eighty‐one case records being obtained from a perusal of the literature.The pathology of renal carbuncle is discussed in relation to that of other members of the metastatic staphylococcal group of renal lesion.The importance of the complete investigation of all cases of “perinephric abscess” is emphasized.On the basis of the results obtained in this series, a rational line of treatment for renal carbuncle is suggested.

A Marx for the Managers

T nHERE is a tendency to interpret modern history, and particularly twentieth century, in terms of an increasing bureaucratization. In whatever domain of thought question has arisen there have been able presentations of facts of centralization of industrial and administrative organization. But it is not only in statistical curves that such phenomena receive notice. They make up stuff of several philosophies of history. It is no accident that Max Weber is more and more frequently quoted for his thesis that historical drift may be seen as a bureaucratization of industrial societies, irrespective of their constitutional governments. It is this form of organization which is taken to be substance of history, more so as it is identified with a growing rationality of modern society. It is clear that application of occidental science is an indispensable element in development of large-scale and planned administrations. For Thorstein Veblen, as well as for Weber, advent of science is a phenomenon unique and central to Western civilization. Veblen focused more directly upon the sequence of accumulative technology and drew inferences directly from fact of its dominance. Apart from opaque line of technological rationality, social life is drift and habituation. The irrational institutions, particularly pecuniary ones, are in main only permissive; all they do is occasionally hinder spread of a mechanical rationality into all areas of life. It is men who nurse big machines, industrial population, who implement that which makes history. For Weber, impersonal rationality stands as a polar opposite to personal charisma, extraordinary gift of leaders. For Veblen, technology, widely construed, stands opposite irrational institutions. And for both, in whatever other respects they may differ, rational, technical pole of history will come through; it will increase to dominate social life of West. In this kind of philosophy of history, warfare and revolutions, crises and class struggles, are not central objects to be explained. They are

Food in War-time

An important article, “Food in War Time”, by Lord Horder in the Quarterly Review of January emphasizes the way in which food policy in war could be utilized to make a permanent contribution to national fitness, and the part which science has to play in pursuing this objective. Science, Lord Horder points out, supports a return to the diet that kept our fathers and forefathers fit, and assures us that in doing so we are on sound and rational lines. The memorial sent to the Prime Minister last May, of which Lord Horder was a signatory, urged that milk, potatoes, fresh vegetables, cereals, fats and sugar,

Toward Reichsreform—The Reichsgaue

Until recently, despite repeated intimations from official sources that a definitive Reichsreform was in preparation, little has actually been accomplished in the direction of reorganizing administrative areas in Germany. A few consolidations of territory have been effected, a Greater Hamburg created, and the Prussian provinces4 and districts (Bezirke) made units of intermediate national administration. But thus far the traditional forces of German separatism and the opposition of powerful local party bosses have prevented the redistricting of Germany along more rational economic and geographic lines.

Water Resources and their Administration

IN a succeeding article on “National Water Resources and the Need for a Comprehensive Survey”, Mr. R. B. Dunwoody takes a much sounder and more practical view of the matter, recalling the investigation of the Royal Commission (1906-1911) on Canals and Waterways, which showed “a striking absence of statistical information as to the flows of rivers and streams, and consequently of the water available in different parts of the country”. On the completion of the investigation, as secretary of the Commission, he submitted in 1911 to the President of the Local Government Board a scheme for a comprehensive survey of the water supplies of England and Wales. Considerable extracts are quoted from the memorandum, all indicating that it has much in common with the proposals for a survey now being urged on the Government. Mr. Clemesha Smith, in his article on “Regional Water Supplies”, presses the need for co-ordination. Amplifying the policy of the appointment in several parts of the country of regional advisory committees, he considers that committees in respect of suitable areas should be set up covering the whole of England and Wales. He outlines the functions of the two sets of bodies he proposes, as follows: (a) regional committees, consisting of representatives of authorities, charged with the duty of supplying water for domestic purposes, empowered to demand the necessary information and able to raise funds to enable them to check statistics and examine and put forward proposals relating to water supply; and (b) water commissions, the duties of which should include considering the tabulated statistics prepared by the regional committees and advising them on the schemes submitted and as to improvements, amalgamations and variations. Mr. Smith emphasises that if problems of water supply are to be solved on rational lines, the first step must be the accumulation of accurate information, and the second the examination and consideration of the facts by recognised authorities.

Artificial Increase on Rational Lines

Artificial Increase on Rational Lines

Treatment of Corneal Infections

In this communication the writer indicates a rational line of treatment for corneal infections (other than those from leprosy, syphilis and tuberculosis), that may be followed with safety, and with a minimum destruction of corneal tissue. Read before the Pacific Coast Oto-Ophthalmological Society, June 20, 1932. In this communication the writer indicates a rational line of treatment for corneal infections (other than those from leprosy, syphilis and tuberculosis), that may be followed with safety, and with a minimum destruction of corneal tissue. Read before the Pacific Coast Oto-Ophthalmological Society, June 20, 1932.

Medical treatment of goiter on rational lines, and the thermogenic system

Medical treatment of goiter on rational lines, and the thermogenic system

Les physiciens hollandais et la méthode expérmentale en France au XVIII e siècle

THE legacy of Newton and his contemporaries of the seventeenth century has often been described. This was the century, too, that saw science organised through its societies on rational lines that at the same time made possible international relationship and collaboration on a scale hitherto impossible. The excellent volume before us deals with the handling of this legacy by the continental physicists of the eighteenth century. It is perhaps insufficiently realised that international relationship has affected the progress of science almost as often as it has the progress of peoples; and the historian of science who is concerned with the development of the broader aspects of his subject is confronted with continual illustrations of this. The French Descartes lived his scientific life in Holland; Huyghens was a Dutch philosopher who worked in France and visited England; 'S Gravesande, of Leyden, was a member of the delegation of 1715 sent to England to congratulate George I. on his accession. Desaguliers was a Dutch philosopher who was educated in England. Here are but a few of the ingredients of international relationships in science. The eighteenth century was notable for the rise of the Dutch experimental school of physicists, and the story of the development of the experimental method in Holland, and of its influence on the mathematical methods of the French school, is dealt with by Prof. Brunet with a sympathy, a penetration, and an understanding that has resulted in a volume of unique value to all students of the history of science. Les physiciens hollandais et la méthode expérmentale en France au XVIIIe siècle. Prof. Pierre Brunet Par. Pp. ii + 153. (Paris: Albert Blanchard, 1926.) 14 francs.

The Future of Radiology

The practitioner of medical radiology is so submerged in his work that he scarcely realizes the amazing history of the specialty, its present relations to other fields of medicine, or its probable future. It may be of benefit to step aside for a moment and view radiology from without, detachedly and impersonally, seeking especially to discover its defects and to suggest measures of improvement. As for its history, suffice to say, as has often been pointed out, that within less than three decades, radiant energy has become a sixth sense in the diagnosis of disease and a powerful agent in its treatment. There is no need to exaggerate the value of radiology to medicine. Its rapid growth to the high place it has attained has been along the lines of least resistance, natural and undirected. That method of increment and refinement will, perhaps, also determine largely its future. Nevertheless, radiology has now matured sufficiently to develop a degree of self-consciousness and self-determination. It is timely, then, to take an inventory of our present status, of the conditions that surround us, and of those that are not beneficial in the art of medicine. Having thus taken stock, we shall be better prepared to direct the course of radiology along more rational lines, or at least to exercise some control of its destiny. After even the most casual survey, certain defects in the present system of applying the specialty are apparent. Among them are the eccentric status of radiology as a specialty, its unsatisfactory inter-relations with other branches of medicine, the faulty co-operation among radiologists and the incoordination of research. In continental Europe, radiology is merely a feature of clinical diagnosis and treatment. The leading radiologists there are also experienced clinicians, and the clinical and radiologic viewpoints are never dissociated. In America, radiology is both more strongly differentiated from and more thoroughly entangled with other branches of medicine. At first view its status seems quite anomalous. It is practiced as an independent specialty, and as an adjunct to other specialties or to general diagnosis. It is practiced with various degrees of proficiency by ripe scholars in medicine, by novices, technicians, nurses and office assistants. In view of these facts it is not surprising that, until recently, the American Medical Association has not deemed radiology worthy of separate recognition. Radiologists have consistently objected to the haphazard work of inadequately trained physicians and laymen. Their objections have often been misconstrued as arising from personal and pecuniary motives, but, as a sober matter of fact, the conscientious radiologist has thought more of his art than of himself. Knowing that its efficient application requires thorough training, he has felt strongly that incompetent workers tended to degrade radiology, and to impair its usefulness.

Regional Planning

Early attempts at city planning were very limited in scope, having been confined almost entirely to projects for civic centers, many of which w ere ambitious, but few, if any, ever were completed. Subsequently, plans were made for particular and restricted areas of cities most of t hem having been for new suburban realest at developments. ' In very few cases, even yet, have plans been made f or the more orderly development of towns or cities as a whole, including an effort to correct some of the obvious mistakes due to the haphazard growth of the older built-up portions, as well as those where development could still be direct ed along more rational lines, with better adaptation to topography.

Elementary Practical Mathematics

DURING the past ten or fifteen years a great deal of work has been done by mathematical teachers in wiping old scores off the slate and redeveloping their teaching on more sensible and rational lines. It is well known that this revolution owes its success largely to the indefatigable exertions of Prof. John Perry. We cordially agree with many of the remarks contained in the preface to the present book. It is impossible to quote the whole of the author's attacks on the old-fashioned drudgery in algebra which has disgusted many would-be mathematicians in the past, and made it quite impossible for the present reviewer ever to appreciate anything but applied mathematics. We can only quote the first few lines:— Elementary Practical Mathematics. With Numerous Exercises for the Use of Students, and especially of Mechanical and Electrical Engineering Students. By Prof. John Perry. Pp. xiv + 335. (London: Macmillan and Co., Ltd., 1913.) Price 6s.

Book Review A Practitioner's Handbook of Materia Medica and Therapeutics . Based upon Established Physiological Actions and the Indications in Small Doses. To which is added Some Pharmaceutical Data and the Most Important Therapeutic Developments of Sectarian Medicine as Explained along Rational Lines. By Thos. S. Blair, M.D. Philadelphia: The Medical Council. 1907.

Book Review A Practitioner's Handbook of Materia Medica and Therapeutics . Based upon Established Physiological Actions and the Indications in Small Doses. To which is added Some Pharmaceutical Data and the Most Important Therapeutic Developments of Sectarian Medicine as Explained along Rational Lines. By Thos. S. Blair, M.D. Philadelphia: The Medical Council. 1907.