Created J.R. H[utchinson]. ‘Minute Sheet’, 3rd Aug. 1934.
3 Aug 1934
Description:

‘It seems to me that Colonel James’ argument is convincing. The position is –

1. The Horton laboratory has become a training centre for malariologists and has a world-wide reputation.

2. It is the only organisation in the world where malariatherapy, with the use of mosquitoes, enables research to be done on the clinical, therapeutic and epidemiological features of malaria contracted in the natural manner.

3. The action of the Ministry in establishing such a place has been warmly praised in Europe and America and distinguished foreigners have visited the laboratory to study the technical arrangements and the methods.

4. The work done could, as Sir Hubert Bond said in 1930, fairly be called national, one might say international. This opinion could be expressed more strongly now.

5. The routine work of the laboratory is of a highly specialised nature, much more highly specialised than was anticipated when the laboratory was established. Four speciees of malarial organisms are cultivated. This extension of the original and simpler procedure has been rendered necessary by the discovery that partial immunity is acquired by patients against the species used in the primary course of treatment.

6. A fifth species, obtained from monkeys, is being investigated. It can be successfully inoculated into man. The disease produced is mild and can be controlled with atebrin. Moreover, as the febrile attacks are 24 hourly, the course of treatment can be shortened. Further, anopheles maculipennis can act as the other host. This is a most important development and further investigation may have very valuable results.

7. The routine work of the laboratory began in April, 1925 and from then to the end of 1926, 300 patients were treated. In 1927 the number was 200 and in 1933, 272. The 272 patients were treated at 37 London and 52 provincial hospitals. The maximum number of patients treated at one place was 5. The majority of the 272 were in mental hospitals, but the voluntary hospitals represented were all over the country & included some in Scotland & Ireland.

8. It is possible that a special ward block of 50 beds will be established at a London hospital for the malarial treatment of neuro-syphilis and the promoters would no doubt look to the Ministry for a supply of the therapeutic material. It does not appear that the time has arrived when the production of this material should be in the hands of Local Authorities. Annexed are particulars of the requests in 1927 and in 1933, setting out the localities from which they came. I do not see how it is possible for any, other than one centrally situated laboratory, to serve these localities, even assuming that they were sufficiently skilled and experienced to be trusted to do so. Local authorities have fallen short in very much simpler matters as, for example, the collection of measles serum.

9. I note that the Whittingham Mental Hospital had to stop providing inoculation material because their strain had become too enhanced in virulence and I do not think it can be claimed that this form of therapy is entirely free from a public health risk. We have surrounded the users with regulations and safeguards. We should have to surround the laboratories with a much stricter code of rules and the multiplication of laboratories is strongly to be deprecated.

J.R.H. 3rd August, 1934.’