"A CURIOUS EPIDEMIC OF SORE-THROAT "

1377 with it, leaving the pad undisturbed for 24 hours. There is never any septic discharge. The pad is changed every 24 hours. For use as drops : at home the easiest way is to pour the oil from a warmed teaspoon, rather than use a dropper which is difficult One to keep clean, every three or four hours. remarkable point is the almost instant relief from pain. I hope that others will try this treatment, for even if unsuccessful it has the advantage of being harmless. I am, Sir, yours faithfully, EDGAR STEVENSON. Dec. 9th. Liverpool, FEVER HOSPITALS To the Editor of THE LANCET SIR,-In the annotation headed Fever Hospitals, Past and Future, which appears in your issue of Dec. 7th (p. 1308), there is a statement against which I desire to protest, to wit: " The bed spacing which is now the rule would even thirty years ago have seemed fantastically extravagant or divinely fortuitous." Forty years ago the medical superintendents of the fever hospitals of the Metropolitan Asylums Board recognised and insisted upon the necessity of as ample floor-space in the wards as is provided at the present time. As you were kind enough on a previous occasion to publish a letter from me on this subject (see THE LANCET, 1933, ii., 1448) I will not now trespass further on your space, except to say that I had the pleasure of listening to Dr. Harries’s admirable address and to the best of my recollection he did not use the words I have I am, Sir, yours faithfully, quoted. E. W. GOODALL. Hampstead, Dec. 9th. ** Dr. Harries was referring not to bed spacing in the open ward but to the recent provision of ample isolation accommodation and we regret the false impression given in our necessarily brief note. The words " divinely fortuitous " were not his. We take this opportunity of amending other statements in the annotation. After. remarking that the decline in the fatality-rate from diphtheria had reached the limit, Dr. Harries added that the disease is now preventable. Dr. Harries did not say that instruction in fevers is at present quite inadequate. What he did. say was that knowledge of clinical work of fever hospitals was based upon a limited number of attendances at a fever course which provided no opportunity for day-to-day observation of the patients. The phrase quoted in the annotation about the " apparatus and protocols of a scientific paper " was used specifically in relation to the unsatisfactory literature. of the vaccine therapy of whooping-cough. -ED. L. BOTULISM of THE LANCET

To the Editor your issue of

SiR,-In Sept. 28th, in collaboration with Dr. Jones-Davies, I reported a case of botulism. May I be permitted to add a few further details which have since been worked out Since our report the organism from the nut brawn has been isolated in pure state and a-toxin prepared from it in a similar manner to that which was prepared from the impure culture ; this pure toxin killed a guinea-pig within 24 hours in a dose of 0-001c.cm. Through the kindness of Mr. Dalling, of the Wellcome Physiological Research Laboratories, Beckenham, I was able to obtain monovalent botulism antitoxic sera of the three types A, B, and C. Protection experiments on guinea-pigs gave the following results. One cubic centimetre of type A antitoxin protected against 0-001, 0-01, and 0-1 c.cm. of the pure toxin but not against 1-0 c.cm. One cubic centimetre

of both

C antitoxin failed to protect c.cm. of pure toxin, though in the case of the smallest dose of toxin life was prolonged to six days by type B antitoxin and to 19 days by type C antitoxin. The organism is thus a clear-cut type A. The pure strain of the organism fermented with gas production : lactose, glucose, dulcite, and salicin. Fermentation of the last-named is said to be distinctive of type A strains. In glucose agar, however, the deep colonies were not of the compact, discoid nature said to occur with type A, but rather woolly like B or C strains. The finding of type A in this case is of interest in view of the fact that while the Loch Maree outbreak was due to a type A, Meyer and Dubowsky in their report, in the Journal of Infectious Diseases (1922), on an examination of soils and vegetables found type B present, but type A consistently absent in Europe.-I am, Sir, yours faithfully, C. RICKWORD LANE. Wimpole-street, W., Dec. 3rd.

type

B and

type

against 0’001, 0-01, 0,1, and 1.0

A TEST FOR CANCER

To the Editor

of THE

LANCET

few years ago Dr. J. Round designed a Bendien’s lines by the use of urine instead of blood. Dr. Round worked with a chemist, Mr. D. A. Ruddle. Dr. Round as director and Mr. Ruddle as chemist for tests and research are now working at a laboratory at No. 12, Park-crescent, W. 1. The findings here on cancer urines and suspected cases have been proved to be satisfactory clinically by a number of medical men and have usually confirmed other tests. It is often found preferable to use urine as any one can take a specimen of early morning urine. The patient also prefers this method to having blood taken from a vein. The undersigned can speak from personal experience of the advantages of the test, not only can malignancy be judged by flocculations at a certain degree of pH, but by the presence of other substances. Further, if the presence of malignancy is not indicated further tests can be made to aid diagnosis. In doubtful cases an additional test can be made from feces, as in malignancy the amount of zinc in faeces is decreased. Practitioners desiring to use the services of the laboratory should send 4 oz. of urine with a little chloroform added to Mr. D. A. Ruddle, 12, Park-crescent, W. 1. Fee :91Is. Research on the nature of cancer has been carried out and this could be extended if funds were available. The support of the profession is requested for what may lead to still more useful research. Those desiring further information should address Dr. J. Round, 67, New Cross-road, London, S.E. 14.

SIR,-A

test for

cancer on

We are, Sir,

faithfully,

yours

GEORGE BURFORD, R. M. LE HUNTE COOPER, W. GUYON RICHARDS,

JNO. ROUND, C. E. WHEELER, H. WYNNE THOMAS.

London, Dec. 6th. "A CURIOUS EPIDEMIC OF SORE-THROAT "

To the Editor of THE LANCET have been using in my practice diphtheria SiR,-I antitoxin (P., D. and Co.) in cases of severe tonsillitis and sore-throat with very gratifying results. The temperature generally falls to normal after two injections ; the patient feels more comfortable. I think that in the presence of slight throat signs and mild temperature, quite apart from the presence of diphtheroid bacilli, antitoxin will prove valuable. I am,

Sir,

yours

faithfully, BHAT, M.B., B.S.

S. R. Amraoti (C.P.), India, Nov. 15th.