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CONTROL OF RATS AND MICE
201 Professor Alstead rightly emphasises the importance of of man, but he is very ready to sacrifice the body, which he regards as clumsy and erratic in contrast to the human mind and its activities. He makes the challenging statement that the vehicle for the spirit of man could
preserving the soul
equally well have been the simple amceba rather than the appallingly complex organism of the mammal," and he finds it hard to believe that it would matter in the slightest. To my way of thinking the moral and spiritual development of man, which represents the present stage in the evolutionary process, would ’have been impossible without the development of the human brain through the activity of which man’s humanity and spiritual qualities are manifest. How can these higher qualities have been developed or made manifest at the evolutionary level of the amoeba ? In his pentateuch, Back to Methu.selccli, Shaw has envisaged the final stage of human evolution as a disembodied spirit. But to be disembodied implies having been embodied, and the body of man, be it ever so frail and subject to suffering and disease, is in my opinion the only medium through which the divine work of evolution
can
be continued and fulfilled
on
the
spiritual plane. C. BEAVEN.
Hounslow, Middlesex.
EMERGENCY BED SERVICE
SIR,—Early this month the Emergency Bed Service incited some senior member of the medical profession to visit the operatiom room to see the service at work in times of stress. The visitors were surprised at the amount of work in hand, and it was suggested that it would be profitable for all hospital admission officers to visit Fielden House on or before their appointment, and thus to acquire a more vivid impression of the vohme of emergency cases, for which admission is required in London, than they could by dealing only with cases in their own
hospitals.
The committee think this suggestion excellent, and are very glad to invite all those in the Greater London area to whom urgent cases are offered, and who have the responsibilityfor admission or otherwise, to visit the service and study its work. An by telephone (Hop 7181) would be a great help to those in charge.
appointment
Fielden House 28. London Bridge Street, S.E.1.
G. F. ABERCROMBIE Chairman, Emergency Bed Service.
CONTROL OF RATS AND MICE
SIR,—I quote from your annotation
of Dec. 18
on
this
subject : ‘’Today, the main strong poisons of choice are zinc phosphide, arsenic, and antu (alphanaphthylthiourea)-all after prebaiting-but antu is unsuitable for use against R. rattus. The Oxford workers are properly sceptical of the value of ’1080’ (sodium monofluoroaeetate) despite the enthusiasm with which it
was
first received in the U.S.A....
seem to me somewhat sweeping and not in accord with our own conclusions they certainly on the use of rat poisons in the Port of London where, as a result of extensive field experience and investigation, rat poisons such as barium carbonate, red squill, arsenious oxide, and antu have been abandoned in favour of zinc phosphide and, more recently, the anticoagulant’ Warfarin’ and the poison sodium monofluoroacetate (popularly known as 1080). Field trials are now in progress with another water-soluble rodenticide which promises to be a further useful addition to the range of rodenticides. There is ample evidence in this country to prove the usefulness of these new rodenticides in selected operations - zinc phosphide with a variety of solid bait bases, warfarin with both a variety of solid bait bases and as a water solution and 1080 as a water solution or as a soak for solid bait bases. While only zinc phosphide and warfarin are in general use throughout the country, all three have been proved and have been regularly used in the Port of London for several years. 1080 can be dangerous if the correct methods of disare
are
Medical Officer of Health, Port of London.
OPERATIONS ON THE HEART
SIR,—I read with interest your leader of Dec. 25 and find
myself in agreement with much
of what Dr. Cort
wrote in his letter last week.
Our paper1 was concerned only with metabolic disturbances observed after mitral valvotomy. Administration of saline after operation is indicated only if the patient is sodium-depleted. This was occasionally observed in those with mitral stenosis who had been free of cedema but had nevertheless been treated with a low-salt diet and mercurial diuretics in preparation for operation. After valvotomy there is an exudate from the wound and pleural cavity of fluid rich in sodium. If the body-sodium content has been considerably reduced preoperatively, and this secondary loss after operation is large and uncorrected, true sodium depletion may develop. In such exceptional circumstances, but in them alone, hypertonic saline produces a rapid and lasting improvement in both the clinical and biochemical state of the patient. The fall in serum-sodium concentration regularly observed during the first week after operation is not usually associated with a loss of sodium from the body and is certainly not an indication for giving additional saline. This fall is transient and is due at least in part to water retention. I do not wish to encroach on your space to discuss the wider aspects of hyponatraemia in cardiac patients apart from operation on the heart valves, and should only like to endorse Dr. Cort’s remarks regarding hypertonic saline. In patients with persistent hyponatræmia the body-sodium content measured by isotope dilution methods is commonly greatly increased in spite of the low serum concentration. The administration of saline simply aggravates the condition by leading to further retention of water in excess of sodium. Sheffield. G. M. M. WILSON. MASKED EPILEPSY
"
These conclusions
pensing and adequate safety precautions
but no difficulty whatever has been experienced by trained operators working in the Port of London. It has proved in their hands to be a highly valuable, efficient, and readily acceptable rodenticide capable of a decisive kill overnight. By its use it is also possible to secure an appreciable saving in man-hours, an advantage of paramount importance in port conditions where prompt action is essential. It is by the selective use of zinc phosphide, warfarin, and 1080 that the Port of London is kept remarkably free from rodent infestation. J. GREENWOOD WILSON
not
applied,
SIR,—Ithink it might fairly be said in criticism of Dr. Wallis’s paper (Jan. 8) that he provides a very good example of the tendency described in his own quotation from Tom Jones : " Every physician almost hath his favourite disease, to which he ascribes all the victories obtained over human nature ..." *
It is true, of course, that epilepsy is common, and that sensory or, less commonly, motor manifestations may occur alone, but other recurrent disturbances of function in childhood are very much commoner. For a large group of these disorders in which various combinations of pallor, vomiting, headache, abdominal pain, and pyrexia make up the picture, many of us use the provisional diagnostic term periodic syndrome, which is convenient if only because it replaces
unsatisfactory ones such as cyclical vomiting, abdominal migraino, vasovagal attacks, and acidosis." These recurrent episodes vary from the simple bilious attack to bizarre symptom-complexes which are diagnostic puzzles, and of which some lie in the borderland of epilepsy, classically described by Gowers. This, I suggest, is as far as we can really go at present. "
" Masked 1.
epilepsy "
is
surely just
as
unsatisfactory
Wilson, G. M., Edelman, I. S., Brooks, L., Myrden, J. A., D. E., Moore, F. D. Circulation, 1954, 9, 199.
as
Harken,
preserving the soul
equally well have been the simple amceba rather than the appallingly complex organism of the mammal," and he finds it hard to believe that it would matter in the slightest. To my way of thinking the moral and spiritual development of man, which represents the present stage in the evolutionary process, would ’have been impossible without the development of the human brain through the activity of which man’s humanity and spiritual qualities are manifest. How can these higher qualities have been developed or made manifest at the evolutionary level of the amoeba ? In his pentateuch, Back to Methu.selccli, Shaw has envisaged the final stage of human evolution as a disembodied spirit. But to be disembodied implies having been embodied, and the body of man, be it ever so frail and subject to suffering and disease, is in my opinion the only medium through which the divine work of evolution
can
be continued and fulfilled
on
the
spiritual plane. C. BEAVEN.
Hounslow, Middlesex.
EMERGENCY BED SERVICE
SIR,—Early this month the Emergency Bed Service incited some senior member of the medical profession to visit the operatiom room to see the service at work in times of stress. The visitors were surprised at the amount of work in hand, and it was suggested that it would be profitable for all hospital admission officers to visit Fielden House on or before their appointment, and thus to acquire a more vivid impression of the vohme of emergency cases, for which admission is required in London, than they could by dealing only with cases in their own
hospitals.
The committee think this suggestion excellent, and are very glad to invite all those in the Greater London area to whom urgent cases are offered, and who have the responsibilityfor admission or otherwise, to visit the service and study its work. An by telephone (Hop 7181) would be a great help to those in charge.
appointment
Fielden House 28. London Bridge Street, S.E.1.
G. F. ABERCROMBIE Chairman, Emergency Bed Service.
CONTROL OF RATS AND MICE
SIR,—I quote from your annotation
of Dec. 18
on
this
subject : ‘’Today, the main strong poisons of choice are zinc phosphide, arsenic, and antu (alphanaphthylthiourea)-all after prebaiting-but antu is unsuitable for use against R. rattus. The Oxford workers are properly sceptical of the value of ’1080’ (sodium monofluoroaeetate) despite the enthusiasm with which it
was
first received in the U.S.A....
seem to me somewhat sweeping and not in accord with our own conclusions they certainly on the use of rat poisons in the Port of London where, as a result of extensive field experience and investigation, rat poisons such as barium carbonate, red squill, arsenious oxide, and antu have been abandoned in favour of zinc phosphide and, more recently, the anticoagulant’ Warfarin’ and the poison sodium monofluoroacetate (popularly known as 1080). Field trials are now in progress with another water-soluble rodenticide which promises to be a further useful addition to the range of rodenticides. There is ample evidence in this country to prove the usefulness of these new rodenticides in selected operations - zinc phosphide with a variety of solid bait bases, warfarin with both a variety of solid bait bases and as a water solution and 1080 as a water solution or as a soak for solid bait bases. While only zinc phosphide and warfarin are in general use throughout the country, all three have been proved and have been regularly used in the Port of London for several years. 1080 can be dangerous if the correct methods of disare
are
Medical Officer of Health, Port of London.
OPERATIONS ON THE HEART
SIR,—I read with interest your leader of Dec. 25 and find
myself in agreement with much
of what Dr. Cort
wrote in his letter last week.
Our paper1 was concerned only with metabolic disturbances observed after mitral valvotomy. Administration of saline after operation is indicated only if the patient is sodium-depleted. This was occasionally observed in those with mitral stenosis who had been free of cedema but had nevertheless been treated with a low-salt diet and mercurial diuretics in preparation for operation. After valvotomy there is an exudate from the wound and pleural cavity of fluid rich in sodium. If the body-sodium content has been considerably reduced preoperatively, and this secondary loss after operation is large and uncorrected, true sodium depletion may develop. In such exceptional circumstances, but in them alone, hypertonic saline produces a rapid and lasting improvement in both the clinical and biochemical state of the patient. The fall in serum-sodium concentration regularly observed during the first week after operation is not usually associated with a loss of sodium from the body and is certainly not an indication for giving additional saline. This fall is transient and is due at least in part to water retention. I do not wish to encroach on your space to discuss the wider aspects of hyponatraemia in cardiac patients apart from operation on the heart valves, and should only like to endorse Dr. Cort’s remarks regarding hypertonic saline. In patients with persistent hyponatræmia the body-sodium content measured by isotope dilution methods is commonly greatly increased in spite of the low serum concentration. The administration of saline simply aggravates the condition by leading to further retention of water in excess of sodium. Sheffield. G. M. M. WILSON. MASKED EPILEPSY
"
These conclusions
pensing and adequate safety precautions
but no difficulty whatever has been experienced by trained operators working in the Port of London. It has proved in their hands to be a highly valuable, efficient, and readily acceptable rodenticide capable of a decisive kill overnight. By its use it is also possible to secure an appreciable saving in man-hours, an advantage of paramount importance in port conditions where prompt action is essential. It is by the selective use of zinc phosphide, warfarin, and 1080 that the Port of London is kept remarkably free from rodent infestation. J. GREENWOOD WILSON
not
applied,
SIR,—Ithink it might fairly be said in criticism of Dr. Wallis’s paper (Jan. 8) that he provides a very good example of the tendency described in his own quotation from Tom Jones : " Every physician almost hath his favourite disease, to which he ascribes all the victories obtained over human nature ..." *
It is true, of course, that epilepsy is common, and that sensory or, less commonly, motor manifestations may occur alone, but other recurrent disturbances of function in childhood are very much commoner. For a large group of these disorders in which various combinations of pallor, vomiting, headache, abdominal pain, and pyrexia make up the picture, many of us use the provisional diagnostic term periodic syndrome, which is convenient if only because it replaces
unsatisfactory ones such as cyclical vomiting, abdominal migraino, vasovagal attacks, and acidosis." These recurrent episodes vary from the simple bilious attack to bizarre symptom-complexes which are diagnostic puzzles, and of which some lie in the borderland of epilepsy, classically described by Gowers. This, I suggest, is as far as we can really go at present. "
" Masked 1.
epilepsy "
is
surely just
as
unsatisfactory
Wilson, G. M., Edelman, I. S., Brooks, L., Myrden, J. A., D. E., Moore, F. D. Circulation, 1954, 9, 199.
as
Harken,