- Email: [email protected]
PITUITARY EXTRACT IN OBSTETRICS
47 undernourished individuals can make adjustments by restricting their diet and taking light work, while their apathetic bowels, once vigorous, lose the power to make effective protest. Professor Wells and Mr. MacPhee, by focussing attention on the afferent loop, have made a substantial contribution. It is to be hoped that the conception of " neurotic attacks" 1will now cease to bedevil the serious and growing problem of the post-gastrectomy
syndrome.
that whole posterior pituitary extract (the preparation mentioned was ’Pituitrin ’) is still being used in domiciliary obstetric practice. We firmly believe that whole posterior pituitary extract should not be used in obstetrics since it contains not only the oxytocic but also the toxic vasopressor factor. Admittedly the purified oxytocic fraction (injectio oxytocini, B.P.) contains some vasopressor substance, but its vasopressin content per unit activity is not more than 1/20 of whole extract (injectio pituitarii posterioris, B.P.) ;hence the latter is much more toxic. Vasopressin constricts the coronary vessels and produces impairment of the action of the heart. In a woman who has already lost blood this may produce shock or even .
death. Obstetric Unit, University College Hospital Medical School. Department of Pharmacology, University College, London, W.C.1.
W. C. W. NIXON. H. O. SCHILD.
BUTAZOLIDINE
SiR,-To the reports of toxic effects following the
administration of butazolidine I would like to add two observations which I have not seen described in publications in this country. They seem noteworthy among others I have include the usual digestive, cutaneous, purpuric, and haematuric incidents, and threeI cannot cases of jaundice, apparently obstructive. at present give their proportional incidence, as they have occurred in three hospitals and in private practice. One patient went into left ventricular failure complicatmentioned ing generalised cedema. This complication was by Stephens et al.3 and Steinbrocker et al.4 Another patient had characteristic oedema with extensive patches of cedematous erythema on limbs and trunk, progressing to peeling of the face and limbs and maculate purpura on the trunk, after taking one tablet only. There was no evidence that this patient had had the drug before. I may add that I am taking the drug myself with much relief of the pain of my rheumatoid arthritis. W. A. BOURNE. Hove, Sussex.
seen, which
SUFFERING FROM PERNICIOUS ANÆMIA
SIR,—Patients with pernicious anaemia, suffer
more
at the hands of doctors than the failure to reassure
them mentioned
by Dr. Todd (Dec. 20). Recently an applicant for entry to the teaching profession was medically examined and found physically fit in all respects. She gave a history of pernicious anaemia, successfully treated ; was
"
Public Health Deaths During the Fog THERE were 4703 deaths registered in Greater London in the week ended Dec. 13 when, during the first half of -
A. J. GLAZEBROOK. Harrogate. PITUITARY EXTRACT IN OBSTETRICS SIR,—The report of the Emergency Obstetrical Service in the Manchester area2 is disturbing since it reveals
and this
If I had to be ill I should rather have " pernicious " anaemia than " benign " tertian malaria or a " benign adenoma. Would it not be better to give up the adjective " pernicious " and talk about addisonian anaemia, as many already do ?’? Giggleswick, D. P. LAMBERT. Settle, Yorks.
entered
on
the official form
as a
minor
condition
likely to interfere with the performance of her duties, Her application for entry to two teachers’ training colleges has been rejected on medical grounds, because of pernicious anaemia. Had she not told the examining doctor about her ansemia it would not have been diagnosed clinically ; so she is being penalised for giving an honest history, and her whole career is jeopardised unfairly. What remedy has she ? not
1. Any Questions. Brit. med. J. 1952, ii, 1006. 2. Lancet, 1952, ii, 746. 3. Stephens, C. A. L. jun., Yeoman, E. E., Holbrook, W. P. Hill, D. F., Goodin, W. L. J. Amer. med. Ass. 1952, 150, 1084. 4. Steinbrocker, O., Berkowitz, S., Eholich, M., Elkind, M., Carp, S.
Ibid, p. 1087.
the week, smoke-laden fog covered most of the area.! The figures for the preceding two weeks were 1902 and 2062, and deaths in the corresponding week of 1951 were less than a third of this year’s total. Deaths from influenza and pneumonia, increased from 89 in the week ended Dec. 6 to 380 in the week of the fog ; and many more deaths from respiratory or cardiac disease were referred to coroners than in normal weeks. First reports on the chemical content of the fog indicate that there was more sulphur dioxide and carbon in it than usual. The Ministry of Health suggests that " these increases are for the present better regarded as a measure of fuel consumption, principally coal, rather than as an index of ’atmospheric vitriol.’ " The Ministry says that an analysis of the information given on the death certificates is being made, pathologists’ reports are being examined, and further investigation of the constituents of the fog and srnoke is in hand. No conclusions can be reached until this work is completed.
Saving Fuel in Hospitals The Northern Ireland Hospitals Authority, examining the reasons for the rising cost of the hospital and specialist services, has been paying particular attention to means of reducing fuel consumption- in its hospitals. The authority’s report for the year ended March 31, 1952, says that an engineer and a stoker-demonstrator have been visiting some of the hospitals in Northern Ireland to test the fuel-burning plant, and to make recommendaIt is estimated from tions for improving efficiency. their reports that expenditure on fuel in the general hospitals visited (1740 beds in all) can be cut from £29.3 per bed per annum to £23.6—an annual saving of £9900. The changes needed to save this sum are being made wherever possible. All the hospitals in Northern Ireland will eventually be dealt with.
Appointments BOOTH, R. W., M.R.C.S. : appointed factory doctor, Cinderford district, Gloucester.. BRENTNALL, T. D., M.R.C.S. : appointed factory doctor, Oakham district, Rutland. LOVE, S. H. S., M.B. Belf., D._. : consultant in anaesthetics, hospitals of Belfast H.M.C.
MILLAR, J. H. D., M.D. Belf., --NI.R.C.1. : part-time consultant neurologist, Royal Victoria and Claremont Street Hospital, Belfast.
O’RioRDAtf, J. P.,
M.B.
Dubl.,
D.P.H. :
port M.o., Dublin.
Colonial Medical Service :
BEDELL, F. E., L.M.S.S.A. : district M.O., Windward Islands. EASMON, C. 0., F.R.C.S. : surgical specialist. Gold Coast. GORROD, C’. E., M.B. Aberd., D.P.H.: M.O.H., Federation of Malaya. HALL, C. L., B.M. Oxfd : senior M.O., Tanganyika. JOHNSTON, H. M., M.B., M.P.H. : senior M.O.H., Jamaica. LUNKING, F., M.B. : M.O., Federation of Malaya. MCDONALD, W. H. B., M.B. Lond., D.T.M. & H. : senior M.O., Sduth Pacific Health Service.
MCGREGOR, ALAN, M.B. Durh. : senior M.O., Tanganyika. MAXWELL, R. BV. D., M.B., D.P.H. : deputy director of medical services. South Pacific Health Service. MURCOTT, E. H., M.D. Edin., D.r’.H. : deputy director of medical services, Xvasaland. REECE. _ A., M.D. : M.O. (grade A), Trinidad. NYrcER, J. R. C.. M.B. Lond., D.O.M.S., D.T.M. R H. : specialist (ophthalmology). Gold Coast. SUTHERLAND, E. S., L.R.C.P.E., D.P.H.: senior M.O.H., Jamaica. SWI8TER..,;KI, K. P., MED. DIP. Lwow : anaesthetist, Barbados General Hospital, Barbados. North East Metropolitan Regional Hospital Board : Dow, J. R., M.R.C.P., D.ar.R.D. : consultant radiologist, Hackney Hospital. HAMILTON, MARGARET, M.B. Leeds, D.A.-: part-time consultant ansesthetist. Eastern Hospital. MORGAN, J. A. L’., -Nf.R.c.p. : consultant pathologist, Hackney Hospital. 1. See Lancet, 1952, ii, 1222. ,
-
’
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syndrome.
that whole posterior pituitary extract (the preparation mentioned was ’Pituitrin ’) is still being used in domiciliary obstetric practice. We firmly believe that whole posterior pituitary extract should not be used in obstetrics since it contains not only the oxytocic but also the toxic vasopressor factor. Admittedly the purified oxytocic fraction (injectio oxytocini, B.P.) contains some vasopressor substance, but its vasopressin content per unit activity is not more than 1/20 of whole extract (injectio pituitarii posterioris, B.P.) ;hence the latter is much more toxic. Vasopressin constricts the coronary vessels and produces impairment of the action of the heart. In a woman who has already lost blood this may produce shock or even .
death. Obstetric Unit, University College Hospital Medical School. Department of Pharmacology, University College, London, W.C.1.
W. C. W. NIXON. H. O. SCHILD.
BUTAZOLIDINE
SiR,-To the reports of toxic effects following the
administration of butazolidine I would like to add two observations which I have not seen described in publications in this country. They seem noteworthy among others I have include the usual digestive, cutaneous, purpuric, and haematuric incidents, and threeI cannot cases of jaundice, apparently obstructive. at present give their proportional incidence, as they have occurred in three hospitals and in private practice. One patient went into left ventricular failure complicatmentioned ing generalised cedema. This complication was by Stephens et al.3 and Steinbrocker et al.4 Another patient had characteristic oedema with extensive patches of cedematous erythema on limbs and trunk, progressing to peeling of the face and limbs and maculate purpura on the trunk, after taking one tablet only. There was no evidence that this patient had had the drug before. I may add that I am taking the drug myself with much relief of the pain of my rheumatoid arthritis. W. A. BOURNE. Hove, Sussex.
seen, which
SUFFERING FROM PERNICIOUS ANÆMIA
SIR,—Patients with pernicious anaemia, suffer
more
at the hands of doctors than the failure to reassure
them mentioned
by Dr. Todd (Dec. 20). Recently an applicant for entry to the teaching profession was medically examined and found physically fit in all respects. She gave a history of pernicious anaemia, successfully treated ; was
"
Public Health Deaths During the Fog THERE were 4703 deaths registered in Greater London in the week ended Dec. 13 when, during the first half of -
A. J. GLAZEBROOK. Harrogate. PITUITARY EXTRACT IN OBSTETRICS SIR,—The report of the Emergency Obstetrical Service in the Manchester area2 is disturbing since it reveals
and this
If I had to be ill I should rather have " pernicious " anaemia than " benign " tertian malaria or a " benign adenoma. Would it not be better to give up the adjective " pernicious " and talk about addisonian anaemia, as many already do ?’? Giggleswick, D. P. LAMBERT. Settle, Yorks.
entered
on
the official form
as a
minor
condition
likely to interfere with the performance of her duties, Her application for entry to two teachers’ training colleges has been rejected on medical grounds, because of pernicious anaemia. Had she not told the examining doctor about her ansemia it would not have been diagnosed clinically ; so she is being penalised for giving an honest history, and her whole career is jeopardised unfairly. What remedy has she ? not
1. Any Questions. Brit. med. J. 1952, ii, 1006. 2. Lancet, 1952, ii, 746. 3. Stephens, C. A. L. jun., Yeoman, E. E., Holbrook, W. P. Hill, D. F., Goodin, W. L. J. Amer. med. Ass. 1952, 150, 1084. 4. Steinbrocker, O., Berkowitz, S., Eholich, M., Elkind, M., Carp, S.
Ibid, p. 1087.
the week, smoke-laden fog covered most of the area.! The figures for the preceding two weeks were 1902 and 2062, and deaths in the corresponding week of 1951 were less than a third of this year’s total. Deaths from influenza and pneumonia, increased from 89 in the week ended Dec. 6 to 380 in the week of the fog ; and many more deaths from respiratory or cardiac disease were referred to coroners than in normal weeks. First reports on the chemical content of the fog indicate that there was more sulphur dioxide and carbon in it than usual. The Ministry of Health suggests that " these increases are for the present better regarded as a measure of fuel consumption, principally coal, rather than as an index of ’atmospheric vitriol.’ " The Ministry says that an analysis of the information given on the death certificates is being made, pathologists’ reports are being examined, and further investigation of the constituents of the fog and srnoke is in hand. No conclusions can be reached until this work is completed.
Saving Fuel in Hospitals The Northern Ireland Hospitals Authority, examining the reasons for the rising cost of the hospital and specialist services, has been paying particular attention to means of reducing fuel consumption- in its hospitals. The authority’s report for the year ended March 31, 1952, says that an engineer and a stoker-demonstrator have been visiting some of the hospitals in Northern Ireland to test the fuel-burning plant, and to make recommendaIt is estimated from tions for improving efficiency. their reports that expenditure on fuel in the general hospitals visited (1740 beds in all) can be cut from £29.3 per bed per annum to £23.6—an annual saving of £9900. The changes needed to save this sum are being made wherever possible. All the hospitals in Northern Ireland will eventually be dealt with.
Appointments BOOTH, R. W., M.R.C.S. : appointed factory doctor, Cinderford district, Gloucester.. BRENTNALL, T. D., M.R.C.S. : appointed factory doctor, Oakham district, Rutland. LOVE, S. H. S., M.B. Belf., D._. : consultant in anaesthetics, hospitals of Belfast H.M.C.
MILLAR, J. H. D., M.D. Belf., --NI.R.C.1. : part-time consultant neurologist, Royal Victoria and Claremont Street Hospital, Belfast.
O’RioRDAtf, J. P.,
M.B.
Dubl.,
D.P.H. :
port M.o., Dublin.
Colonial Medical Service :
BEDELL, F. E., L.M.S.S.A. : district M.O., Windward Islands. EASMON, C. 0., F.R.C.S. : surgical specialist. Gold Coast. GORROD, C’. E., M.B. Aberd., D.P.H.: M.O.H., Federation of Malaya. HALL, C. L., B.M. Oxfd : senior M.O., Tanganyika. JOHNSTON, H. M., M.B., M.P.H. : senior M.O.H., Jamaica. LUNKING, F., M.B. : M.O., Federation of Malaya. MCDONALD, W. H. B., M.B. Lond., D.T.M. & H. : senior M.O., Sduth Pacific Health Service.
MCGREGOR, ALAN, M.B. Durh. : senior M.O., Tanganyika. MAXWELL, R. BV. D., M.B., D.P.H. : deputy director of medical services. South Pacific Health Service. MURCOTT, E. H., M.D. Edin., D.r’.H. : deputy director of medical services, Xvasaland. REECE. _ A., M.D. : M.O. (grade A), Trinidad. NYrcER, J. R. C.. M.B. Lond., D.O.M.S., D.T.M. R H. : specialist (ophthalmology). Gold Coast. SUTHERLAND, E. S., L.R.C.P.E., D.P.H.: senior M.O.H., Jamaica. SWI8TER..,;KI, K. P., MED. DIP. Lwow : anaesthetist, Barbados General Hospital, Barbados. North East Metropolitan Regional Hospital Board : Dow, J. R., M.R.C.P., D.ar.R.D. : consultant radiologist, Hackney Hospital. HAMILTON, MARGARET, M.B. Leeds, D.A.-: part-time consultant ansesthetist. Eastern Hospital. MORGAN, J. A. L’., -Nf.R.c.p. : consultant pathologist, Hackney Hospital. 1. See Lancet, 1952, ii, 1222. ,
-
’
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