NATIONAL HEALTH INSURANCE. FIRST ANNUAL REPORT OF THE MEDICAL RESEARCH COMMITTEE, 1914–1915. Presented to both Houses of Parliament by Command of His Majesty. LONDON; PRINTED UNDER THE AUTHORITY OF HIS MAJESTY’S STATIONERY OFFICE By HARRISON and SONS, 45–47, St Martin’s Lane, W.C., Printers in Ordinary To His Majesty To be purchased, either directly or through any Bookseller, from WYMAN and SONS, Limited, 29, Breams Buildings, Fetter Lane, E.C., and 28, Abingdon Street, S.W., and 54, St Mary Street, Cardiff; or H.M. stationery OFFICE (Scottish Branch), 23 Forth Street, Edinburgh ; or E.PONSONBY, Limited, 116, Grafton Street, Dublin ; or from the Agencies in the British Colonies and Dependencies, the United States of America and other Foreign Countries of T. FISHER UNWIN, Limited, London, W.C. [Cd. 8101] Price Threepence. NATIONAL HEALTH INSURANCE, MEDICAL RESEARCH COMMITTEE. The following publications relating to the work of the Medical Research Committee can be purchased, either directly or through any bookseller, from Wyman & Sons, Ltd., 29, Breams Buildings, Fetter Lane, E.C., 28, Abingdon Street, S.W., and 54, St. Mary Street, Cardiff; or H.M. Stationery Office (Scottish Branch), 23, Forth Street, Edinburgh; or E. Ponsonby, Ltd., 116, Grafton Street, Dublin; or from the Agencies in the British Colonies and Dependencies, the United States of America and other Foreign Countries of T. Fisher Unwin, Ltd., London, W.C. National Health Insurance (Medical Research Fund) Regulations, 1914. [S.R. & O., 1914, No. 418.] Price 1d., post free 1½d. Interim Report on the Work in connection with the War undertaken by the Medical Research Committee. [Cd. 7922.] Price 1d., post free 1½d. First Report of the Special Investigation Committee upon the Incidence of Phthisis in relation to Occupations.—The Boot and Shoe Trade, Price 3d., post free 4d. First Annual Report, of the Medical Research Committee, 1914–1915. [Cd. 8101.] Price 3d., post free 4d. NATIONAL HEALTH INSURANCE. FIRST ANNUAL REPORT OF THE MEDICAL RESEARCH COMMITTEE, 1914–1915. Presented to both Houses of Parliament by Command of His Majesty. LONDON; PRINTED UNDER THE AUTHORITY OF HIS MAJESTY’S STATIONERY OFFICE By HARRISON and SONS, 45–47, St Martin’s Lane, W.C., Printers in Ordinary To His Majesty To be purchased, either directly or through any Bookseller, from WYMAN and SONS, Limited, 29, Breams Buildings, Fetter Lane, E.C., and 28, Abingdon Street, S.W., and 54, St Mary Street, Cardiff; or H.M. stationery OFFICE (Scottish Branch), 23 Forth Street, Edinburgh ; or E.PONSONBY, Limited, 116, Grafton Street, Dublin ; or from the Agencies in the British Colonies and Dependencies, the United States of America and other Foreign Countries of T. FISHER UNWIN, Limited, London, W.C. [Cd. 8101] Price Threepence. (ii) Medical Research Committee, (National Health Insurance.) The Right Hon. Lord Moulton of Bank, K.C.B, L.L.D, F.R.S. (Chairman). Christopher Addison, Esq., M.D., M.P. Major Waldorf Astor, M.P. (Treasurer) Professor Sir T. Clifford Allbutt, K.C.B., M.D., F.R.S. C. J. Bond, Esq., F.R.C.S Professor William Bulloch, M.D., F.R.S. Professor MATTHEW HAY, M.D., LL.D. Professor F.G. HOPKINS, D.Sc, F.R.S Colonel Sir WILLIAM LEISHMAN, C.B., F.R.S W. M. FLETCHER, Esq., M.D. Sc.D., F.R.S (Secretary) (b 1788) 2500/90 11/15 II & S Gp 5. 1 CONTENTS I.—INTRODUCTION page The Medical Research Fund ... ... ... ... ... ... ... 3 The Administration of the Fund ... ... ... ... ... ... 4 The Medical Research Committee and Schemes of Research ... ... ... ... 5 Establishment of a Central Research Institute ... ... ... ... ... 8 Proposals from the Governing Body of the Lister Institute for Amalgamation ... ... 9 The Preparation of Research Schemes ... ... ... ... ... ... 12 II.—THE CENTRAL RESEARCH INSTITUTE AND ITS DEPARTMENTS The Mount VernonBuilding, Hampstead ... ... ... ... ... ... 14 Department of Bacteriology ... ... ... ... ... ... ... 15 Department of Bio-Chemistry and Pharmacology ... ... ... ... ... 17 Department of Applied Physiology ... ... ... ... ... ... 19 Statistical Department ... ... ... ... ... ... ... 20 Library ... ... ... ... ... ... ... ... 22 Committee and Secretarial Offices ... ... ... ... ... ... 23 III.—GENERAL SCHEMES FOR RESEARCH Tuberculosis ... ... ... ... ... ... ... ... 23 Special Bacteriological Problems ... ... ... ... ... ... 23 Presence of the Bacillus in the Blood, Much’s granules, etc. ... ... ... 24 Pathology of Infection in Tuberculosis ... ... ... ... ... 24 The Value of Tuberculin Treatment ... ... ... ... ... ... 24 Immunity Problems ... ... ... ... ... ... ... 24 Radiography in the Diagnosis of Tuberculosis ... ... ... ... ... 24 Effects of non-specific Treatment ... ... ... ... ... ... 24 The incidence of Phthisis in relation to particular occupations ... ... ... 25 Rickets ... ... ... ... ... ... ... ... ... 25 Deficiency factors in diet ... ... ... ... ... ... 25 Relation of fat metabolism to Rickets ... ... ... ... ... 26 Analysis of general metabolism in Rickets ... ... ... ... ... 26 Determination of growth factors with special references to Rickets ... ... 26 The Hygienic Relations of Milk ... ... ... ... ... 26 Methods of Sterilisation ... ... ... ... ... ... 27 Contamination of Milk ... ... ... ... ... ... ... 27 The cellular elements of Milk ... ... ... ... ... ... 27 Rheumatic Infections ... ... ... ... ... ... ... 27 Diseases of the Nervous System ... ... ... ... ... ... 28 Thyroid Secretion ... ... ... ... ... ... ... ... 28 Chronic (Rheumatoid) Arthritis ... ... ... ... ... ... 28 Dust Inhalation and Pulmonary Disease ... ... ... ... ... ... 28 (b 1783) A 2 2 page Oral Sepsis ... ... ... ... ... ... ... ... ... 29 Diabetes ... ... ... ... ... ... ... ... ... 29 Anaphylaxis ... ... ... ... ... ... ... ... 29 Diseases of the heart ... ... ... ... ... ... ... ... 30 General Pathological Research ... ... ... ... ... ... ... 30 IV.—WORK IN CONNECTION WITH THE WAR The Central Research Institute and its Departments. ... ... ... ... 31 Pathological Work at Military Hospitals ... ... ... ... ... ... 32 General Hospitals (Territorial Force) ... ... ... ... ... .. 33 Other Military Hospitals ... ... ... ... ... ... 34 Special Enquiries ... ... ... ... ... ... ... ... 36 Antiseptics ... ... ... ... ... ... ... 36 Typhoid and Paratyphoid Infections ... ... ... ... ... ... 37 Cholera Expedition to Galicia ... ... ... ... ... ... 38 Bilharzia Expedition to Cairo ... ... ... ... ... ... 38 Cerebro-Spinal Fever ... ... ... ... ... ... ... 40 Chemical Factors in Bacterial Growth ... ... ... ... ... 41 Neurological Enquiries ... ... ... ... ... ... ... 42 Testing of Salvarsan Preparations ... ... ... ... ... 42 Acute Neprhitis ... ... ... ... ... ... ... 44 Dysentery ... ... ... ... ... ... ... ... 44 Industrial Fatigue and the Health of Munition Workers ... ... ... 44 Disorders of the Soldier’s Heart ... ... ... ... ... ... 44 Gunshot Wounds of the Chest ... ... ... ... ... ... 45 Classification of Anaerobic Organisms ... ... ... ... ... 45 Measles in Military Camps ... ... ... ... ... ... 46 Skin-Grafting of Wounds ... ... ... ... ... ... 46 X-Ray Work at Military Hospitals ... ... ... ... ... ... 46 Miscellaneous Enquiries ... ... ... ... ... ... ... 46 Medical History of the War ... ... ... ... ... ... 47 V.—CONCLUSION Conclusion ... ... ... ... ... ... ... ... ... 47 APPENDIX Medical Research Fund Regulations, 1914, showing the membership of the Medical Research Committee and the Advisory Council for Research 49 NATIONAL HEALTH INSURANCE. FIRST ANNUAL REPORT OF THE MEDICAL RESEARCH COMMITTEE, 1914–1915. St. Stephen’s House, Westminster, S.W. 18th October, 1915. To the Chairman of the National Health Insurance Joint Committee. Sir, The Medical Research Committee beg leave to submit the following report upon their work during the year ending the 1st October, 1915. In presenting for the first time a Report upon a completed year, of work, the Committee think it may be found desirable for the sake of historical completeness that an account should be given here in the first place of the circumstances in which the Medical Research Committee received their constitution and approached the task of forming schemes for the effective use of the Medical Research Fund. I.— INTRODUCTION. The Medical Research Fund. The Medical Research Fund consists of an annual sum calculated at the rate of one penny in respect of each insured person in the United Kingdom, payable out of mon- eys provided by Parliament, which has been retained for the purposes of Research in accordance with the proviso to Section I6 (2) (b) of the National Insurance Act, 1911. For the year 1914, the sum thus available amounted to about £55,000 ; in normal circumstances it may be expected to increase slightly in each successive year in accor- dance with the natural growth of the population and the increase in the number of insured persons. The Fund for the year 1915, however, will show a diminution owing to the enlistment of insured persons in H.M. Forces. (b 1783) A 3 4 Regulations made by the Treasury assigned to the National Insurance Joint Committee the duty of making Regulations as to the manner in which the Fund should be applied for Research, and the Joint Committee in due course made provisional Regulations on the 20th August, 1913, and substantive Regulations on the 21st March, 1914. It is these Regulations (see Appendix, page 49) which now govern the administration of the Medical Research Fund. The Administration of the Fund. The following account of the administrative system adopted in these