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streptomycin as a therapeutic agent. Here the combined use of
intramuscular and aerosol inhalation treatment appears to be
promising. They stress the importance of dosage and technique
in the administration of streptomycin.
Although the results so far reported have been promising,
it is recognised that much remains to be learned concerning the
mechanism of action of streptomycin. Whilst in certain cases it
has been a life-saving device in others it has proved of little value.
The location and age of the lesion rather than its extent or
character, appear to be significant. Fresh, acute miliary disseminations
may resolve completely and tuberculous meningitis
may show prolonged remissions although resistant forms with
fatal results can and do occur. In recent acute exudative lung
lesions results may be good. In chronic fibro-caseous lesions there
may be little if any response.
It is to be hoped that, apart from the small quantity of
streptomycin available in this country for experimental purposes,
a larger supply as in several other countries, will be available for
more general use.
Some Personal Experiences of the Prophylactic Inoculation
against Tuberculosis in Scandinavia.
I found the enthusiasm for B.C.G. in Norway, Sweden and
Denmark widespread, and most people were convinced of its efficacy
as a valuable adjunct in the control of tuberculosis, although
several public-health experts emphasised that vaccination should
in no way interfere with established anti-tuberculosis measures.
I was struck, too, with the little control work done on B.C.G. in
any of the three countries, and while I can understand and
appreciate the difficulties encountered in this connection, I hope
that in this country We shall have an opportunity for remedying
this defect in order to produce reliable statistical evidence of the
value of immunisation. Such control work as I saw—admittedly
the figures were comparatively small—was convincing; but I am
of the opinion that "only the most carefully compiled figures in
significant quantity will satisfy the statisticians."
Although we rightly look to chemotherapy for striking results
in the future, I think it is true that in this country a somewhat
neglected field of preventive medicine has been protection against
tuberculosis by active immunisation in tuberculin-negative