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HOME NURSING OF PREMATURE BABIES
908 the records of
some of the experiments performed, I away with the conviction that one can gather everlasting converts to every crude suggestion. May I
came
quote three extracts.:
Trauma of the sciatic nerve sometimes produces trophic ulcers of the hind extremities and sometimes papillomatosis of’the mucous membrane of the mouth." " As a matter of fact who would have believed, even
recently, that it is possible to blind a dog by acting upon the sciatic nerve, or to kill an animal through the pulp cavity, of the tooth, producing intestinal haemorrhage by ’ means of one drop of formalin, two or three months after, not only the formalin, but the tooth itself had been removed." Two dogs are pictured with gangrenous ulcers on the hind extremities, after section of the sciatic nerve and injection of a drop of pus in the centrifugal end (with subsequent extraction of the cerebrospinal fluid)." Sir, when truth jostles fiction, those who try to part them oft buffet one another, be it with tongue or pen. There was a worthy biblical injunction in your last issue : "-A soft answer turneth away wrath." SOL. M. COHEN. . London, W.1. "
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HOSPITAL BIOCHEMISTS I be to comment on a recent in your columns ?P The post advertised was that of a.hospital biochemist, and the salary offered was (a) for a medical graduate with experience in biochemistry £1500 per annum subject to possible increase under the new scales, or (b) for a science graduate £750-1000 according to age and experience. If the larger salary were being paid to a fully trained chemist (at least to M.sc. standard) who also possessed a medical degree, this letter would not have been written. However, according to the advertisement this need not be the case. I may be wrong, but I consider that to carry out his duties a hospital biochemist should be first and foremost an efficient and fully qualified chemist. If he is, also medically qualified, so much the better ; but I am at a loss to understand why a medical graduate with - a limited knowledge of chemistry is worth at least £500 per annum more than a chemist with a limited PH.D. medicine.
SIR,—May advertisement
permitted
knowledge of
TESTING ANALGESICS SIR,—The work on quantitative evaluation of analgesics both in this country and in the United States has revealed great variations in pain-threshold values, even in the same individual under identical experimental conditions. Two factors are worth noting as having a limiting value upon the interpretation of the action of analgesics : one is neurophysiological and the other
pharmacological. : Relief of pain may mean a reduction of (a) peripheral reception (nerve-endings), (b) neural transmission (including the spinothalamic tracts), (c) central pain perception. Analgesic action is fairly clear-cut when it results from the elimination of pain reception and from interference with neural transmission, but when it comes to central pain perception we are dealing with a composite cerebral entity.. Its component parts-the thalamus, the hypothalamus, and the cortical somæsthetic area-play their various roles in the formation of psychic, somatic, and autonomic reactions. The interrelationship of these cerebral components makes for interdependence of the
reactions.
There is no evidence that analgesics of the phenanthrene derivatives, the barbiturates, the anaesthetic gases, the antihistaminics, procaine, and so on, have all got a central, global, uniform, and therefore comparable action.On the contrary there is some evidence that these widely differing drugs have to a degree a preponderantly selective action-viz., cortical or diencephalic. Apart from pain-threshold-raising influence, there are the degree of involvement of the autonomic system, different degrees of respiratory depression, different ways of losing consciousness or producing lethargy and sleep. Thus the site of action of these numerous drugs is unlikely to be either identical or total within the brain. With these reservations the term " analgesic " is useful clinically, but less so for the purpose of precise estimation of their action. BERNARD KENTON. London Hospital. CONTRACEPTION IN GERMANY SIR,—I regret that my letter of Sept. 11 contained an error of dictation, when I said that contraception was forbidden in the British and American" zones." I should have said British and American " sectors " of Berlin. I am also informed by the public-health division of the Military Government that " there are no -restrictions whatsoever." The position, however, is still obscure because the Himmler police ordinance forbidding contraception has never been officially repealed, although the Hitler laws in general have been annulled. Confusion arises, therefore, as to the exact legal position. I understand from various sources that in actual practice, since the reduction of the censorship, the Himmler laws. have been disregarded, although not repealed. Nevertheless the fact remains that, for whatever reason, contraceptives, certainly up till September, were ahnost unobtainable under Allied rule in Berlin. According to my information, contraceptives sent throughthe post (unless in considerable bulk) are now unlikely to be stopped. BERNARD SANDLER. Urmston, Lanes. A REGISTRARS’ GROUP
SIR,—A Registrars’ Group has been -formed in the Liverpool region to discuss conditions of service under the National Health scheme. We would be interested to hear if such groups have been formed in other regions as we consider that interchange of ideas dn this subject would be of great value. Ingleside, Hightown, near Liverpool. W. H. R. COOK. C. S. McKENDRICK. Ashley, Reservoir Road, Prenton, ---
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-
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Birkenhead. , HOME NURSING OF PREMATURE
BABIES
interested in Dr. Miller’s article of Oct. 30 SIR,—I on home nursing of premature babies in Newcastle-onTyne. He expresses the hope that the experience of others will be recorded. The accompanying table gives the figures of premature babies born and nursed at home, in comparison with those born and nursed in a hospital, maternity home, or nursing-home in the West Riding (1945-47) and in Warwickshire (1943-44),’ in comparison with the figures for Newcastle. C. FRASER BROCKINGTON County Medical Officer, West Riding of Yorkshire was
,
Wakefield. 1.
Brockington, C. F. Arch. Dis. Lond. 1945, 58, 101.
Childh. 1944, 19, 93 ;
Publ, Hlth,
some of the experiments performed, I away with the conviction that one can gather everlasting converts to every crude suggestion. May I
came
quote three extracts.:
Trauma of the sciatic nerve sometimes produces trophic ulcers of the hind extremities and sometimes papillomatosis of’the mucous membrane of the mouth." " As a matter of fact who would have believed, even
recently, that it is possible to blind a dog by acting upon the sciatic nerve, or to kill an animal through the pulp cavity, of the tooth, producing intestinal haemorrhage by ’ means of one drop of formalin, two or three months after, not only the formalin, but the tooth itself had been removed." Two dogs are pictured with gangrenous ulcers on the hind extremities, after section of the sciatic nerve and injection of a drop of pus in the centrifugal end (with subsequent extraction of the cerebrospinal fluid)." Sir, when truth jostles fiction, those who try to part them oft buffet one another, be it with tongue or pen. There was a worthy biblical injunction in your last issue : "-A soft answer turneth away wrath." SOL. M. COHEN. . London, W.1. "
---
HOSPITAL BIOCHEMISTS I be to comment on a recent in your columns ?P The post advertised was that of a.hospital biochemist, and the salary offered was (a) for a medical graduate with experience in biochemistry £1500 per annum subject to possible increase under the new scales, or (b) for a science graduate £750-1000 according to age and experience. If the larger salary were being paid to a fully trained chemist (at least to M.sc. standard) who also possessed a medical degree, this letter would not have been written. However, according to the advertisement this need not be the case. I may be wrong, but I consider that to carry out his duties a hospital biochemist should be first and foremost an efficient and fully qualified chemist. If he is, also medically qualified, so much the better ; but I am at a loss to understand why a medical graduate with - a limited knowledge of chemistry is worth at least £500 per annum more than a chemist with a limited PH.D. medicine.
SIR,—May advertisement
permitted
knowledge of
TESTING ANALGESICS SIR,—The work on quantitative evaluation of analgesics both in this country and in the United States has revealed great variations in pain-threshold values, even in the same individual under identical experimental conditions. Two factors are worth noting as having a limiting value upon the interpretation of the action of analgesics : one is neurophysiological and the other
pharmacological. : Relief of pain may mean a reduction of (a) peripheral reception (nerve-endings), (b) neural transmission (including the spinothalamic tracts), (c) central pain perception. Analgesic action is fairly clear-cut when it results from the elimination of pain reception and from interference with neural transmission, but when it comes to central pain perception we are dealing with a composite cerebral entity.. Its component parts-the thalamus, the hypothalamus, and the cortical somæsthetic area-play their various roles in the formation of psychic, somatic, and autonomic reactions. The interrelationship of these cerebral components makes for interdependence of the
reactions.
There is no evidence that analgesics of the phenanthrene derivatives, the barbiturates, the anaesthetic gases, the antihistaminics, procaine, and so on, have all got a central, global, uniform, and therefore comparable action.On the contrary there is some evidence that these widely differing drugs have to a degree a preponderantly selective action-viz., cortical or diencephalic. Apart from pain-threshold-raising influence, there are the degree of involvement of the autonomic system, different degrees of respiratory depression, different ways of losing consciousness or producing lethargy and sleep. Thus the site of action of these numerous drugs is unlikely to be either identical or total within the brain. With these reservations the term " analgesic " is useful clinically, but less so for the purpose of precise estimation of their action. BERNARD KENTON. London Hospital. CONTRACEPTION IN GERMANY SIR,—I regret that my letter of Sept. 11 contained an error of dictation, when I said that contraception was forbidden in the British and American" zones." I should have said British and American " sectors " of Berlin. I am also informed by the public-health division of the Military Government that " there are no -restrictions whatsoever." The position, however, is still obscure because the Himmler police ordinance forbidding contraception has never been officially repealed, although the Hitler laws in general have been annulled. Confusion arises, therefore, as to the exact legal position. I understand from various sources that in actual practice, since the reduction of the censorship, the Himmler laws. have been disregarded, although not repealed. Nevertheless the fact remains that, for whatever reason, contraceptives, certainly up till September, were ahnost unobtainable under Allied rule in Berlin. According to my information, contraceptives sent throughthe post (unless in considerable bulk) are now unlikely to be stopped. BERNARD SANDLER. Urmston, Lanes. A REGISTRARS’ GROUP
SIR,—A Registrars’ Group has been -formed in the Liverpool region to discuss conditions of service under the National Health scheme. We would be interested to hear if such groups have been formed in other regions as we consider that interchange of ideas dn this subject would be of great value. Ingleside, Hightown, near Liverpool. W. H. R. COOK. C. S. McKENDRICK. Ashley, Reservoir Road, Prenton, ---
--
-
-
Birkenhead. , HOME NURSING OF PREMATURE
BABIES
interested in Dr. Miller’s article of Oct. 30 SIR,—I on home nursing of premature babies in Newcastle-onTyne. He expresses the hope that the experience of others will be recorded. The accompanying table gives the figures of premature babies born and nursed at home, in comparison with those born and nursed in a hospital, maternity home, or nursing-home in the West Riding (1945-47) and in Warwickshire (1943-44),’ in comparison with the figures for Newcastle. C. FRASER BROCKINGTON County Medical Officer, West Riding of Yorkshire was
,
Wakefield. 1.
Brockington, C. F. Arch. Dis. Lond. 1945, 58, 101.
Childh. 1944, 19, 93 ;
Publ, Hlth,