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THE WORLD’S FOODFROM OUR SPECIAL CORRESPONDENT

THE meetings of the Food and Agricultural Organisa-tion of the United Nations in Washington from May 20to 27 have resulted in the formation of an InternationalEmergency Food Council of very wide scope. This new

body has now been formally inaugurated with Mr. JohnStrachey, the Minister of Food, representing GreatBritain.The long preparation given to the proposals of the

conference led to such a large measure of agreementbetween the representatives of the different nations thatonly minor divergences, such as on the size of com-mittees, finally emerged. This preliminary work, whichcovered the whole world, was divided among threecommittees. Committee I was concerned with a surveyof the world food situation as a whole. Their report onthe food situation in 1946-47 was the first attemptmade to forecast the state of the world’s larder so farahead as fifteen months. The committee’s appraisal,based on reliable sources of information, made possiblea rational approach to world food problems. There willbe similar surveys at regular intervals as part of theinformation and intelligence service of the new Inter-national Emergency Food Council. The surveys willfill a big gap in the field of economic intelligence, thoughUNRRA, the Combined Food Board, the CombinedWorking Party (London), and the Emergency EconomicCommittee for Europe have published reports on variousaspects of their work, and some governments havereported on countries other than their own.The first world survey was prepared by a group of

experts attached to the staff of F.A.O. and working inclose collaboration with various governments which hadthe information at their disposal. Committee I pointedout that to run a world food information service success-

fully it is necessary to have current information cableddirect from workers in the field all over the world. Thefield information must then be analysed at F.A.O. head-quarters. To attempt analysis at a lower level causesdelay and prevents the information being up to date.

It is on the basis of the work of this committee thatthe world food information service of F.A.O. will befounded. While the world food emergency exists thisservice will keep the International Emergency Food Councilsupplied with the intelligence data required for its work.

FOOD OUTPUT

Committee II was concerned with the measures

required to maintain or augment the world output offood in 1947 and 1948. The committee reported that,assuming " average " weather, 1947-48 would certainlybe’a lean year. Given this average weather there will

probably be about the same quantities of food availablefor export from the exporting countries, and there issome prospect of an improvement in production- inEurope and the East. But to set against this there willbe a strong tendency to increase consumption in variouscountries, and, where circumstances appear to makeit possible, to discontinue rationing. The committeeconsider that the world will need larger crops in 1947than in 1948 in order (a) to close the gap which threatensto be as large in 1947-48 as in the previous year, and ifpossible raise nutritional levels ; (b) to rebuild foodstocks ; and (c) to begin the replenishment of livestock.For all of these reasons the committee foresee a

continuance of shortage in 1947-48 and urge that everyeffort should be made to increase production, especiallyof cereals and foods of high calorie value. This meansin effect a greater emphasis on the production of wheatand rice, but in some areas it means an increase in

potatoes and sugar beet.’

. Decisions taken now on the supply of fertilisers, seeds,agricultural machinery, and cropping plans affect food-

supply for consumption up to 1948. The committeereport that as regards fertilisers the outlook for 1945-46is better than it was last year when UNRRA, for instance,could get only 50% of its demands met in the countriesin which it was operating. But much greater suppliesare needed during the next few months, particularlyof nitrogen ; this means an increased output in Germanyand Japan and the reopening of some nitrogen plants inthe U.S.A. Many countries are still short of seeds, andin some countries seeds have been used for food. Agri-cultural machinery (particularly tractors) is also scarce.

Crop planning is probably quite as important as otherfactors-for example, the committee note the remarkablyhigh proportion of crop land in north-western Europeand call for more wheat, potatoes, and sugar beet. Butin crop planning the possibility of future surpluses is

playing a part. Farmers in exporting countries fear thatany present extension of wheat planting will lead todifficulty when the era of surpluses arrives. Also farmersin other countries are anxious to avoid reductions inlivestock and there are problems in this connexion inHolland and Denmark. These fears can only be allayedby some form of long-term guarantee to farmers thattheir position will not be worsened. The committee donot say it, but it is clearly in the interest of all countriesto overcome these difficulties ; the penalty of failure isa continuance of the period of restriction and whilethat persists world recovery on a large scale is alsorestricted.

ADMINISTRATION

To committee III was confided the task of drawingup proposals for the future organisation of F.A.O., andit was from committee III that there came the proposals,which were adopted, to set up an International Emer-gency Food Council whose functions shall be :

" To consider, investigate, inquire into, and formulateplans with regard to any question in respect of which themember governments have, or may have, a common concernrelating to the supply and distribution, in or to any partof the world, of foods, agricultural material from which foodsare derived, and equipment and non-food materials ancillaryto the production of such foods and agricultural materials,and to make recommendations to the member governmentsin respect of any such question."These recommendations will deal with the international

distribution of food, feeding-stuffs, and fertilisers, and" in principle " the entire food resources of the membergovernments will be " matters on which the fullestinformation will be interchanged." Here is international

cooperation of a new kind. The work of the new councilwill include or take over the present functions of theCombined Food Board on which at present only theU.K., U.S.A., and Canada are represented. In future allthe subscribing governments will be represented. As

long as UNRRA exists-that is, up to the end of 1946in Europe and to the spring of 1947 in the East-theclosest cooperation will be maintained with UNRRA;its functions will be taken over when it ceases to have an

independent existence.The secretary of the Emergency Food Council is to be

nominated by F.A.O., and the secretariat will as faras possible be chosen from F.A.O.The representatives of governments present at the

plenary conference on May 27, when the setting up ofthe International Emergency Food Council was agreed,took on themselves a solemn obligation. And they weremen and women of ministerial or ambassadorial rank.They agreed (1) to give full cooperation for the purposesof the council, (2) to ensure the prompt supply of informa-tion regarding supplies and their dispatch and utilisation,and (3) to endeavour to implement all the recommenda-tions which had been accepted, seeking special nationalaction when necessary.The F.A.O. is in future to report on its proceedings

to the Economic and Social Council of the United Nations

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and it will enter into relations with the InternationalHealth Organisation which will be set up after meetingswhich are now taking place at Hunter College, in NewYork, the temporary H.Q. of the United Nations.As soon as this week’s meeting of the F.A.O. has

validated the setting up of the International EmergencyFood Council the organisation will come into existence.Then there will for the first time be a body of worldauthority, made up of representatives of governmentssupported by an expert secretariat, to confront the

greatest food shortage which has ever faced mankind,and from that authority the world expects that help willcome.

TO GUARD AGAINST FAMINE

A MEDICAL conference called by the health divisionof UNRRA at its European Regional Office on May 25 *made the following recommendations on how the victimsof famine in a European community should be treated.The treatment of starving patients requires an adequate

supply of spray-dried skimmed-milk powder,. dried eggs,prepared cereals, glucose (preferably fortified with vita-mins), fats, fruit juices, and flavouring agents. Apartfrom the lack of calories, shortage of protein is likelyto be the most serious consideration and every effortshould therefore be made to increase supplies of protein-rich products such as prepared yeast, soya, dried liverpowder, protein hydrolysate for administration bymouth, and dried slaughter-house plasma. Such productswould be a useful supplement to the diet of the starving,and, in an emergency, could be used in partial sub-stitution for dried milk and eggs. To hasten recovery,prevent relapses, and avoid overcrowding the hos-pitals, starving patients should receive a diet supplyingat least 3000 calories daily. Hospitals dealing with severecases of starvation should keep supplies of dried plasmafor intravenous therapy, in normal or double concentra-tion.

It is unlikely that there will be any serious incidenceof florid vitamin-deficiency diseases (maize-eating com-munities excepted). In general, supplies of vitaminsshould be for oral use only and in amounts for prophy-laxis rather than for treatment. The greater part of thevitamin requirements would best be met by the provisionof natural, rather than synthetic, sources of vitamins-e.g., yeast or liver extract, fish-liver oils, and fruitjuices. -

If the supply of milk for children failed, rickets andvitamin-A deficiency would become a serious problem,so stocks- of cod-liver oil should be on hand. Since theadministration of a single large dose of vitamin D hasgreat advantages in the prevention of rickets, adequatesupplies of concentrated vitamin D in oil would beuseful.

Sulphonamides would be needed for the treatment ofdiarrhoea and the intercurrent infections which are

particularly liable to attack starving people. Penicillinwould also be needed for intercurrent infections.

ADMINISTRATIVE MEASURES

In general, supplies of milk in post-war Europe havebeen sufficient at least to provide for the essential needsof young children ; but there has been very little foradults and the older children. This, combined with thehigh phytic-acid content of the long-extraction breadgrains at present in use throughout Europe, makes thediets of adults and older children particularly deficientin available calcium. Calcium carbonate should thereforebe added to the bread. The general diet is also deficientin available iron, and in many parts of Europe anaemiais apparently prevalent. Efforts should therefore bemade to provide additional iron, in medicinal doses, j

especially for pregnant women and those employed in 4

factories. Facilities for communal feeding in factories, I

schools, and elsewhere should be used to the utmost, (

even if the factories and schools are closed. 1

* Those present included : Dr. C. N. Leach, Prof. H. P. Himsworth,Mr. M. Pyke, PH.D., Dr. Janet Vaughan, Miss Harriette Chick,D.se., Miss Margaret Hume, Dr. J. F. Loutit, Dr. 1. A. Anderson,and Dr. D. A. Smith ; for UNRRA, Dr. N. M. Goodman (Directorof Health, European Regional Office),-Dr. J. Cottrell, Dr. A. P.Meiklejohn, Dr. H. S. Collins, Dr. B. H. Smith, and Miss JeanRitchie.

Rationing systems in post-war Europe have on thewhole provided fairly adequate rations for young children,but older children, who should be growing rapidly, haveoften had to subsist for long periods on insufficientdiets. For this reason, older children and adolescentsmay require special consideration in a famine.

It is obviously desirable to maintain adequate food-supplies for children of all ages, but if a gross reductionin the official rations was inevitable it might becomenecessary to give first priority to workers in essentialcommunity services.To lessen the effect of shortage of calories in the diet,

every effort should be made to ensure sufficient heatingin living and working quarters during the winter. Intowns, the evacuation of non-essential population-children and non-working adults-to rural areas, or evento other countries, should be encouraged.- If famine developed in a European city the firstpeople affected would probably be those living alone,the elderly, the occupants of institutions, and thosewithout regular employment. It is important to provide" flying squads " to search out these people and bringthem for treatment. Provision should also be made forspecial and regular medical inspections of orphanages,convents, old people’s homes, mental hospitals, and gaols.

Next, ambulant cases of hunger oedema would beginto appear in increasing numbers, not serious enoughto go to hospital, but requiring supervision and specialtreatment at clinics. A considerable increase in out-patient clinic facilities will be needed to deal withthem, including " ambulatoria " attached to soup-kitchens and other places where people congregate.Large numbers of hospital cases need not be expectedat the outset, but in the worst eventuality it may becomenecessary to provide extra hospital space in schools andelsewhere. -

Doctors, nurses, health visitors, and others would beneeded to staff these " flying squads," " ambulatoria.,"and inspecting teams. Consideration would have to begiven to the best way of recruiting and equipping thisemergency staff from the local population, UNRRA,military, and voluntary relief organisations.

PSYCHICAL SEIZURESDR. WILDER PENFIELD’S ADDRESS

Dr. WILDER PBNFiBLD. F.R.S., director of the Neuro-logical Institute, Montreal, delivered a lecture on

psychical seizures at Oxford on June 14. He first des-cribed the mechanism of focal epileptic attacks ; seizuresresult, he said, from intense spontaneous neural activity," which may spread across the grey matter like a prairiefire." There is a powerful discharge from the cellsinvolved until they are exhausted. The interictal stage,ictal exaltation, and postictal fatigue can be defined bythe electroencephalogram. Clinical attacks should beclassified according to the point of original discharge,which may be established either by the mode of onsetor bv the character of minor attacks. It is often said thatattacks may start in a variety of ways in the same patient,but this is rarely so. During an attack the sensory andmotor functions of the affected parts are completelyparalysed ; and postictal paralysis may be equallycomplete. Dr. Penfield quoted the case of a young womansubject to local discharges in Broca’s area; duringthe attacks she was fully conscious and aware of herdisability, which she sought to conceal by occupyingherself with something that did not necessitate speech.Psychomotor seizures may be classified as (1) visual,

(2) sensory, (3) jacksonian, (4) conscious contraversive,(5) autonomic, (6) olfactory, (7) auditory, (8) vertiginous,(9) with illusion of perception, and (10) unconscious:ontraversive. Seizures originating in the temporal lobenay begin with silence, and be followed by turning tome side and an illusion of perception. The attack mayitop here, or go on. Objects may seem to come closer>r to recede ; sounds may seem distant or unusuallyoud ; or present experience may be interpreted as old.Jsually there is a sense of remoteness, the patient feel-ng as if he were an onlooker. These attacks, whichnay end with convulsions, can be reproduced by elec-rical stimulation. They are the "dreamy state" "

lescribed by Hughlings Jackson ; but this term wasised, by him to include also hallucinations.