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CHOOSING THE STUDENT
549 catch its moles, and it may quite same line in choosing its doctor."
safely be
left to take the .
(Prefatorynote, dated April 12,1882, to Horae Subsecivae). The circumstances now are different, but Dr. John Brown’s contention that both doctor and patient should be free, the one to exercise his gifts and the other to choose his doctor, still holds good. Whatever freedoms may be sacrificed, both by doctor and patient, in accepting the national medical service, let -us not sacrifice these. THOMAS H. WHITE. Tanganyika Territory.
.
CLOSED PLASTER SIR,—In the Spanish Civil War I held a responsible position in the Medical Corps of the Republican Army, and I should like to point out to Colonel Cutler that the reason why we used the closed plaster method was not because we were short of Thomas splints, as he suggests in his article. The closed plaster method owes its success to Dr. Trueta, who convinced the Consultant Army Surgeon that the method he was using with great success on civilian casualties could also be applied to the army. In December, 1937, a year and five months from the commencement of the war, Dr. Trueta’s method was organised on a large scale and used by the military. The Medical Corps of the Republican Army organised first-class assistance for the wounded, and some of the Spanish methods have been emulatedin this present war -for instance, the blood-transfusion service and the use of forward surgical units. The Russians particularly took a great interest in our methods, and re-discovered the closed plaster technique after its use in the Spanish War. As Colonel Cutler mentions, they were already aware of this method, which had been practised by Pirogov, but I think I am right in stating that the Russians did not use this technique in the Great War (1914) ; after its success in Spain it was used in the Russo-Finnish War, and referred to in the medical reports as the " Spanish or Barcelona method." F. DURAN-JORDA. Ancoats Hospital, Manchester. EXPERIMENTAL TRACHOMA SIR,—The statement in your annotation of June 17 (p. 794) that macaques are quite unreliable for trachoma research requires elaboration. If we can trust reports M. rhesus is probably the most reliable animal we have and has largely been used by Julianelle and others, but only 50% of the animals are susceptible and this necessitates their use in large numbers if negative results are to be significant. You suggest that my statement that, because of the of spontaneous folliculosis in the grfvet, prevalence " all previous experiments in which grivets have been used must be regarded as invalid " is unnecessarily drastic if reasonable precautions have been observed. Can we be too drastic in our demands upon experimental work,? I think not. In any case, of the previous workers with grivets only F. H. Stewart (in the report of this laboratory for 1933, p. 142) urges the need for precautions. His rules may be summarised thus :
(1) No animal is regarded positive for trachoma unless follicles
the 20th to 30th day and cover the whole conjunctiva of the upper fornix ; (2) Animals with follicles to be avoided for experiments; (3) All animals to be tested by non-trachomatous inoculation before use for trachoma experiments. None of these precautions is sufficient. My experience shows that a grivet without spontaneous follicles may develop a crop covering the whole upper fornix at any time. If this occurred between the 20th and 30th days after inoculation it would completely falsify a trachoma experiment. Stewart’s third rule is rather strangely put forward on the very page following a list of 69 experiments showing that spontaneous folliculosis is not produced by non-trachomatous inoculation. In view of these, the precaution seems pointless. In my experience, folliculosis seems unrelated to trauma -and I do not
appear about
,
.
,
consider in none
Stewart’s third precaution satisfactory.
Thus,
of the
previous experiments on grivets have satisfactory precautions been taken and therefore they are
indeed invalid.
cautions
nothing
It is hard to see what other precould be taken against this disease since is known of its aetiology.
Your statement that " the grey baboon (P. hamadryas) a perfect experimental animal for trachoma " I have, alas, found untrue. Since publication of my paper on the grivet I have had opportunity to make a study of a small group - of young P. hamadryas (the results will shortly appear elsewhere), which shows that this animal is just as susceptible to spontaneous folliculosis as the grivet and therefore just as unreliable. You give an interesting hypothesis to explain the absence of inclusions in trachomatous monkeys but I cannot find any published work which supports this. A’similar but shorter statement is made by Stewart (Brit. J. Ophthal. 1939, 23, 373) but also without experimental details or references. The matter has a great importance for some experiments of my own and I should be grateful for any references to published work ’ or details of any observations. JOHN BLAND, Memorial Ophthalmic Laboratory, Giza, Cairo. Pathologist.
is
CHOOSING THE
STUDENT
SIR,—Miss Heim and Miss Tirripany have drawn
attention to discrepancies in our article on examination results and an intelligence test (Lancet, Aug. 26, p. 294). We regret that in the final draft when two tables were condensed into one to save space, a column of figures was incorrectly substituted. Table I, ,third column, which gives the distribution of scores obtained in 1942, when unlimited time was allowed for the performance of the test, should read : -
Distribution % 53 27 13 6 1
Score 54-60 49-53 44-48 37-43 28-36
......
......
..........
..........
..........
We apologise for this mistake, and hope that anyone interested in the original article will apply the necessary correction. The remaining figures have all been carefully rechecked, and do not require alteration, and our
conclusions remain unchanged.
!V
U. G. EDHOLM.
Q. H. GIBSON.
Queen’s University, Belfast.
TROPIC OR TROPHIC ?
SIR,—In your issue of Sept. 30, Dr. Meyer argues in favour of the word gonadotropic and against gonadotrophic. The fact is that both are wrong. The pituitary hormone neither turns towards the gonads nor does it nourish them ; it stimulates them, and should therefore be described as gonadokinetic. Similarly we should speak of the thyrokinetic hormone and so on. But I expect it is too late to point that out now. RAYMOND GREENE. Whitchurch, Bucks. INFECTIOUS DISEASE IN ENGLAND AND WALES WEEK ENDED
OCT.
7
Notifications. The following cases of infectiousdisease
notified during the week : smallpox, 0 ; scarlet fever, 1932 ; whooping-cough, 860 ; diphtheria, 509 ; paratyphoid, 7 ; typhoid, 7 ; measles (excluding rubella), 2492 ; pneumonia (primary or influenzal), 628 ; puerperal pyrexia, 166 ; cerebrospinal fever, 24 ; poliomyelitis, 19 ; polio-encephalitis, 0 ; encephalitis lethar- ’ gica; 1 ; dysentery, 390 ; ophthalmia neonatorum, 58. No case of cholera, plague or typhus fever was notified were
during
the week.
The number of civilian and service sick in the Infectious Hospitals of the London County Council on Oct. 4 was 707. During the previous week the following cases were admitted: scarlet fever, 36 ; diphtheria, 12 ; measles, 12; whooping-cough, 18.
Deaths.—In 126 great towns there were no deaths from scarlet fever, 1 (0) from an enteric fever, 3 (0) from measles, 6 (0) from whooping-cough, 10 (1) from diphtheria, 59 (6) from diarrhoea and enteritis under The figures in two years, and 19 (3) from influenza. parentheses are those for London itself. In the case of enteric fever. 25 deaths from diarrhoea in Glasgow.
Northampton reported the fatal same
week there
were
The number of stillbirthls notified during the week was 212 (corresponding to a rate of 31 per thousand total births), including 18 in London.
safely be
left to take the .
(Prefatorynote, dated April 12,1882, to Horae Subsecivae). The circumstances now are different, but Dr. John Brown’s contention that both doctor and patient should be free, the one to exercise his gifts and the other to choose his doctor, still holds good. Whatever freedoms may be sacrificed, both by doctor and patient, in accepting the national medical service, let -us not sacrifice these. THOMAS H. WHITE. Tanganyika Territory.
.
CLOSED PLASTER SIR,—In the Spanish Civil War I held a responsible position in the Medical Corps of the Republican Army, and I should like to point out to Colonel Cutler that the reason why we used the closed plaster method was not because we were short of Thomas splints, as he suggests in his article. The closed plaster method owes its success to Dr. Trueta, who convinced the Consultant Army Surgeon that the method he was using with great success on civilian casualties could also be applied to the army. In December, 1937, a year and five months from the commencement of the war, Dr. Trueta’s method was organised on a large scale and used by the military. The Medical Corps of the Republican Army organised first-class assistance for the wounded, and some of the Spanish methods have been emulatedin this present war -for instance, the blood-transfusion service and the use of forward surgical units. The Russians particularly took a great interest in our methods, and re-discovered the closed plaster technique after its use in the Spanish War. As Colonel Cutler mentions, they were already aware of this method, which had been practised by Pirogov, but I think I am right in stating that the Russians did not use this technique in the Great War (1914) ; after its success in Spain it was used in the Russo-Finnish War, and referred to in the medical reports as the " Spanish or Barcelona method." F. DURAN-JORDA. Ancoats Hospital, Manchester. EXPERIMENTAL TRACHOMA SIR,—The statement in your annotation of June 17 (p. 794) that macaques are quite unreliable for trachoma research requires elaboration. If we can trust reports M. rhesus is probably the most reliable animal we have and has largely been used by Julianelle and others, but only 50% of the animals are susceptible and this necessitates their use in large numbers if negative results are to be significant. You suggest that my statement that, because of the of spontaneous folliculosis in the grfvet, prevalence " all previous experiments in which grivets have been used must be regarded as invalid " is unnecessarily drastic if reasonable precautions have been observed. Can we be too drastic in our demands upon experimental work,? I think not. In any case, of the previous workers with grivets only F. H. Stewart (in the report of this laboratory for 1933, p. 142) urges the need for precautions. His rules may be summarised thus :
(1) No animal is regarded positive for trachoma unless follicles
the 20th to 30th day and cover the whole conjunctiva of the upper fornix ; (2) Animals with follicles to be avoided for experiments; (3) All animals to be tested by non-trachomatous inoculation before use for trachoma experiments. None of these precautions is sufficient. My experience shows that a grivet without spontaneous follicles may develop a crop covering the whole upper fornix at any time. If this occurred between the 20th and 30th days after inoculation it would completely falsify a trachoma experiment. Stewart’s third rule is rather strangely put forward on the very page following a list of 69 experiments showing that spontaneous folliculosis is not produced by non-trachomatous inoculation. In view of these, the precaution seems pointless. In my experience, folliculosis seems unrelated to trauma -and I do not
appear about
,
.
,
consider in none
Stewart’s third precaution satisfactory.
Thus,
of the
previous experiments on grivets have satisfactory precautions been taken and therefore they are
indeed invalid.
cautions
nothing
It is hard to see what other precould be taken against this disease since is known of its aetiology.
Your statement that " the grey baboon (P. hamadryas) a perfect experimental animal for trachoma " I have, alas, found untrue. Since publication of my paper on the grivet I have had opportunity to make a study of a small group - of young P. hamadryas (the results will shortly appear elsewhere), which shows that this animal is just as susceptible to spontaneous folliculosis as the grivet and therefore just as unreliable. You give an interesting hypothesis to explain the absence of inclusions in trachomatous monkeys but I cannot find any published work which supports this. A’similar but shorter statement is made by Stewart (Brit. J. Ophthal. 1939, 23, 373) but also without experimental details or references. The matter has a great importance for some experiments of my own and I should be grateful for any references to published work ’ or details of any observations. JOHN BLAND, Memorial Ophthalmic Laboratory, Giza, Cairo. Pathologist.
is
CHOOSING THE
STUDENT
SIR,—Miss Heim and Miss Tirripany have drawn
attention to discrepancies in our article on examination results and an intelligence test (Lancet, Aug. 26, p. 294). We regret that in the final draft when two tables were condensed into one to save space, a column of figures was incorrectly substituted. Table I, ,third column, which gives the distribution of scores obtained in 1942, when unlimited time was allowed for the performance of the test, should read : -
Distribution % 53 27 13 6 1
Score 54-60 49-53 44-48 37-43 28-36
......
......
..........
..........
..........
We apologise for this mistake, and hope that anyone interested in the original article will apply the necessary correction. The remaining figures have all been carefully rechecked, and do not require alteration, and our
conclusions remain unchanged.
!V
U. G. EDHOLM.
Q. H. GIBSON.
Queen’s University, Belfast.
TROPIC OR TROPHIC ?
SIR,—In your issue of Sept. 30, Dr. Meyer argues in favour of the word gonadotropic and against gonadotrophic. The fact is that both are wrong. The pituitary hormone neither turns towards the gonads nor does it nourish them ; it stimulates them, and should therefore be described as gonadokinetic. Similarly we should speak of the thyrokinetic hormone and so on. But I expect it is too late to point that out now. RAYMOND GREENE. Whitchurch, Bucks. INFECTIOUS DISEASE IN ENGLAND AND WALES WEEK ENDED
OCT.
7
Notifications. The following cases of infectiousdisease
notified during the week : smallpox, 0 ; scarlet fever, 1932 ; whooping-cough, 860 ; diphtheria, 509 ; paratyphoid, 7 ; typhoid, 7 ; measles (excluding rubella), 2492 ; pneumonia (primary or influenzal), 628 ; puerperal pyrexia, 166 ; cerebrospinal fever, 24 ; poliomyelitis, 19 ; polio-encephalitis, 0 ; encephalitis lethar- ’ gica; 1 ; dysentery, 390 ; ophthalmia neonatorum, 58. No case of cholera, plague or typhus fever was notified were
during
the week.
The number of civilian and service sick in the Infectious Hospitals of the London County Council on Oct. 4 was 707. During the previous week the following cases were admitted: scarlet fever, 36 ; diphtheria, 12 ; measles, 12; whooping-cough, 18.
Deaths.—In 126 great towns there were no deaths from scarlet fever, 1 (0) from an enteric fever, 3 (0) from measles, 6 (0) from whooping-cough, 10 (1) from diphtheria, 59 (6) from diarrhoea and enteritis under The figures in two years, and 19 (3) from influenza. parentheses are those for London itself. In the case of enteric fever. 25 deaths from diarrhoea in Glasgow.
Northampton reported the fatal same
week there
were
The number of stillbirthls notified during the week was 212 (corresponding to a rate of 31 per thousand total births), including 18 in London.