The catarrhal state.

It was during the measles epidemic of the autumn of 1951 to the spring of 1952 that I blundered-for there is no other more suitable word to describe my shameful and unscientific empiricism-on a useful treatment to control the catarrhal state. Frequent upper respiratory tract infections, otorrhoea, sinusitis and tonsillitis became the accepted accompaniment of convalescence from measles in this working-class practice. Quite a number of adults were known to have quiescent tuberculosis and I was anxious that children debilitated by measles should not inadvertently become infected by neighbours as they played in other houses. So it became a routine to use the jelly test for tuberculin sensitivity during the 6 months after recovery in any children who appeared to be unduly debilitated, prone to frequent colds and catarrh, or who suffered multiple attacks of upper respiratory tract infection of one kind or another. I found quite a number of positive reactors, although on looking round I could never trace the source. Nor could I detect any physical signs of a primary focus by clinical or radiological examinations. Nevertheless, I decided to try the effect of rimifon on these children who were underweight, full of catarrh, wouldn't eat, had no energy and who were also positive reactors to the jelly test. To my surprise and delight they appeared to make very satisfactory progress and their mothers would come again and again for the " vitamin tablets ". As long as the treatment continued the catarrh was controlled, nocturnal nasal obstruction disappeared and there were no further infections of the throat or ears. If the tablets were discontinued the catarrhal state would soon relapse. In some cases treatment was used continuously or with intervals of abstinence for periods ofa year or two with satisfactory results. As soon as I was convinced ofthe usefulness of rimifon, I decided to use it on all cases of catarrh and upper respiratory tract infections regardless of the result of the jelly test and it became evident that this test was not connected with the efficacy of rimifon. As I developed this therapy, I included para-aminosalicylic acid and its less unpleasant tasting derivatives