- Email: [email protected]
THE MISTAKES OF ASSISTANTS.
THE LIFE-CYCLE OF THE ORGANISM OF SYPHILIS.
1178 many other
equally dangerous poisons
impunity by the"patent Chicago,
Oct.
medicine I am,
"
can
be used with
manufacturer.
Sir, yours faithfully, ARTHUR J. CRAMP.
11th, 1912.
"MENTALLY EXCEPTIONAL" CHILDREN. To the Editor of THE LANCET. SIR,-It is quite clear that the class of children alluded
to
last week in an annotation under this heading, and described by Dr. Ziehen as psychopathic, if not saved for construotive work, are destined to become destructive forces in the - environment in which they are situated. It seems to be his object to evolve methods of education and to provide special institutions for their care and supervision, in order that this human wastage may be avoided. In America it has been suggested by the National Association for the Study and Education of Exceptional Children that the waste products or by-products of our social organisation, and among them may be counted the exceptional child, may possibly prove as commercially valuable to the State as many former waste products of industry are now found to be under improved processes of manufacture. This sounds to me rather speculative optimism, although as an incentive to action the view has its value. The great difficulty here, as in America, is to devise some reasonable system of grading such children in classes, for it is clear that the expense of giving each an individual education would be impracticable on the grounds of expense. I am, Sir, yours faithfully, ERIC PRITCHARD. Oct. 2lst, 1912.
be obtained. Some five of these sections I presented to Mr. E. H. Ross, whose brother is kind enough to admit that " they do show some "splodges." that Mr. H. C. Ross says there is no coil in the human parasite," but I have seen it in many instances both in living and in Giemsa stained specimens, and before I saw Mr. E. H. Ross’s paper I was familiar with the development of spirochastss from a coil from the writings of Danilewsky and Schaudinn, and I acknowledged my indebtedness to that paper out of courtesy, as Mr. E. H. Ross was working at the same subject, and, moreover, on material which I had unreservedly placed at his disposal. It was owing to Doflein’s and Kohler’s article in the Handbuch der Pathogenen Mikroorganismen," Band VII. 1, S. 88 and 89, under the heading " Gattung Leucocytozoon Danilewsky," that I ventured to suggest the name leucocytozoon for the analogous syphilitic parasite. And I cannot see that Mr. H. C. Ross has shown that the suggestion is "surely erroneous." In conclusion, I may add that on Oct. 17th I showed at the Dermatological Section of the Royal Society of Medicine 12 slides illustrating some of the phases I have described, at which meeting critics could have been present. I am sorry to trouble you with this lengthy letter, but I felt that Mr. H. C. Ross’s thinly veiled attack on my good faith in the matter called for an immediate reply. I am. Sir. vours faithfullv. J. E. R. MCDONAGH. Wimpole-street, W., Oct. 19th, 1912.
To the Editor of THE LANCET. to THE LANCET last week I wanted to letter SIR,—In my maintain that, since an undoubted parasite has been found in the cells of syphilitics, and since with the jelly method there is now a means of tracing its life-history in a way similar to that adopted for the homologous parasites of guinea-pigs and earthworms, it would be particularly harmful if, at this stage, we indulge in deductions, speculations, or names, based on incomplete evidence. I believe that this will be considered to be the right attitude to select.
THE LIFE-CYCLE OF THE ORGANISM OF SYPHILIS. To the Editor if THE LANCET. SiR,-May I be allowed to controvert some of the stateT Sir faithfully ments made by Mr. H. C. Ross in THE LANCET of Oct. 19th? H. C. Ross. The John Howard McFadden Researches, The facts are as follows. In January of this year I was London, S.W., Oct. 21st, 1912. the clinical and observations menprompted by pathological tioned in my article to inquire into the life-history of the - organism of syphilis, as I felt convinced that the spiroTHE MISTAKES OF ASSISTANTS. climta pallida alone could not account for all the phenoTo the Editor of THE LANCET. mena. The lymphatic gland suggested itself to me as the most likely place for the other phases to occur, SIR,-Professor Waller again alludes to my suggestion that and I accordingly looked for and found them there. On the slight corrections to which he refers may have been made .Sept. 7th Mr. E. H. Ross came to the Lock Hospual for some by an assistant. In my experience this is just the sort of syphilitic material, when he was informed by my house thing that an assistant would do ; many, like myself, who surgeon, Mr. Moolgavkar, that I had been working at this desire minute accuracy have to suffer for the mistakes of subject for some months. Consequently, he came to see me others, in spite of every effort to prevent them. I will give at the hospital on Sept. 14th, when I informed him that I two recent instances. In the final proof of a paper of mine had found certain bodies in sections of lymphatic glands, for the Journal of Physiology Loewe was spelt correctly, but but I did not mention that I had also found them in vivo in the Jozcrnal of Physiology it appeared Loewi, the correcand in fixed films. On Sept. 18th I took two sections of tion having been made in seven places by the proof-reader. glands, one before, the other after, the administration The next instance is more remarkable. In the minutes of of "606," to the Lister Institute, and showed him the evidence taken before the Departmental Committee on I was then shown a speci- Sight Tests, in reply to question 492, "Has your way of bodies that I had found. men by the jelly method from a lymphatic gland which exhibiting the colour any advantage over Sir William lie had received from me that day, the other half of which Abney’s apparatus?"Isaid,"The method he has adopted I had investigated the same morning. I saw nothing more is not the same as he recommended previously. I do not than I had already seen, and I was not shown the complete know the methods that he now uses, except from the reports cycle of the parasite of the guinea-pig or of the earthworm, I have seen. But they seem to me to be very similar to as Mr. H. C. Ross asserts. Following on this came Sir mine, showing spectral lights of varied intensity. They are Ronald Ross’s announcement in the British llledical Journal , not the methods reconmended by the Royal Society Comof Sept. 28th that his brother, Mr. E. H. Ross, had mittee. Their method was to pick out the neutral point, found bodies in syphilis "not in the mononuclear leuco- and the trichromic has not got a neutral point. In fact, I cytes of the blood, but in large mononuclear cells squeezed took three cases of colour-blindness to Sir William Abney, from local lymphatics." I was not anxious to publish and he passed them all." This is given correctly on page 26. This reply is quoted in a question in Sir W. Abney’s my observations until I had had the opportunity of ascertaining the action of 606"on- what I took to be the evidence on page 58 of the Report as follows :" The method spores, but this announcement appearing so soon after Mr. I he has adopted is not the same as was recommended E. H. Ross began his work, and after his examination of the previously. I do not know the methods that he does use, first lymphatic gland I had supplied him with, left me no except from the reports I have seen. But they seem to me option. It is not clear why Mr. E. H. Ross did not to be very similar to mine, showing spectral lights and announce his own discovery, or why he left the attack on shutters inside. They are not the methods reported by the my article to another brother. My deductions were not Royal Society Committee. Their method was to pick out solely drawn from sections, as I had seen the bodies both the neutral point, and the trichromic has not got a neutral alive stained by the borax methylene blue method and in point. In fact, I took three cases of colour-blindness to films stained with Giemsa, but I was especially glad to find Sir William Abney and he passed them all." them in sections, as in this way permanent specimens could The portions which differ in the erroneous version are in am
"
vnnre
THE MEDICAL PROFESSION AND THE NATIONAL INSURANCE ACT. It will be noticed that the second version eliminates I wished to make. I am, Sir, yours faithfully, F. W. EDRIDGE-GREEN. The Institute of Physiology, University College,
italics.
nearly all the special points
Gower-street, W., Oct. 18th, 1912.
secretary, British Red Cross Society, 9, Victoria-street, Westminster, London, S.W., or to Messrs. Coutts and Company, 440, Strand, London, W.C., will be and sent either to the
gratefully acknowledged. I am, Sir, your obedient servant,
ROTHSCHILD, Chairman of the Council British Red Cross
THE ACETONE-WRIGHT METHOD OF LEUCOCYTE COUNTING. To the Editor of THE LANCET. SIR,-In the very hot weather we have here May to August inclusive the acetone-Wright solution which I described in THE LANCETcompletely failed to work. Another method which is not affected by heat, is rather easier for the inexpert to handle, and gives almost equally good results, is as follows :-Prepare a 2/3 saturated solution of Wright’s stain in methyl alcohol free from sediment by adding 5 c.c. of methyl alcohol to 10 c.c. of filtered saturated solution. Store in a tall narrow bottle to allow any possible sediment to sink and leave perfectly clear fluid above. Prepare also some 0.1per cent. sodium chloride solution, filtered. For use add 1 part of the alcoholic solution to The alcoholic 3 parts of the saline and use at once. solution stains films quite successfully and is less apt to deposit a precipitate on them than the stronger solution commonly used. Further experience has convinced me of the great value and accuracy of these methods, provided that the cautions laid down in my previous communications are I am, Sir, yours faithfully, observed. R. A. P. HILL. Union Medical College, Peking, China, Sept. 30th, 1912.
from
BRITISH RED CROSS BALKAN FUND. To the Editor of THE LANCET. SIR,-The generosity of the British nation in alleviating the distress of the sick and wounded of foreign armies engaged in war has been repeatedly proved in the past. It is difficult to bring home to the public of this country the appalling suffering involved in a winter war in the Balkans. Communications are difficult, the cold is intense, and even rudimentary transport is a matter of extreme difficulty. Moreover, the fighting in this particular war is likely to be of a specially bitter and severe character, while, on the other hand, the medical organisation available is quite inadequate to cope with large numbers of wounded. In order to mitigate, in some measure, the terrible suffering entailed by such a winter campaign, the British Red Cross Society is preparing to despatch expeditions to the belligerent countries. In accordance with the provision of the Geneva Convention the sanction of the Foreign Office for these expeditions has been obtained, and offers of help have been gratefully welcomed by representatives in England of the various countries concerned. The invested funds of this society are only applicable to A special fund, wars in which British troops are engaged. therefore, is necessary in order to render assistance to foreign belligerents, and it is for this fund that the British Red Cross Society now appeals for subscriptions. The money contributed will be administered by specially appointed committees of the society. Among those who have consented to serve on these committees are Georgiana Countess of Dudley, R.R.C., the Marchioness of Lansdowne, C.I., the Marchioness of Londonderry, the Duchess of Montrose, LL.D., the Lady Wantage, R.R.C., Colonel Sir George Beatson, K.C.B., Sir Anthony A. Bowlby, C.M.G., Mr. James Cantlie, F.R.C.S., Sir Benjamin Franklin, K.C.I.E., Surgeon-General Sir Alfred Keogh, K.C.B., Mr. A. K. Loyd, K.C., Mr. George Henry Makins, C.B., Mr. J. Danvers Power, M.V.0., Mr. Edward A. Ridsdale, the Hon. N. Charles Rothschild, The Hon. Arthur Stanley, M.V.0., M.P., and Sir Frederick
Treves, Bart.,
G.C.0.C.B
The services of the society will be rendered impartially to all the combatants concerned, but it is, of course, open to .any subscriber to ear-mark a donation for the special assistance of one or other of the belligerent parties, and any instruction to that effect will be strictly observed. Subscriptions marked "British Red Cross Balkan Fund," 1
THE LANCET, Jan. 6th,
1912,
p.
20,
1179
and Feb.
10th, p. 389.
9, Victoria-street, London, S.W.. Oct.16th.1912.
Society.
EMETINE SALTS IN THE TREATMENT OF DYSENTERY. To the Editor of THE LANCET. SIR,-In THE LANCET for Oct. 19th Lieutenant-Colonel L. Rogers states that his treatment of dysentery with emetine salts is new. If he will refer to p. 269 of the Indian Medical Gazette for September, 1891, he will find that I used emetine with good results. No distinction was made between cases due to amcebas and those due to bacilli. I am, Sir, yours faithfully, J. H. TULL WALSH, Lieutenant-Colonel I.M.S. (retired). St. Faith’s, Norfolk, Oct. 23rd, 1912.
THE MEDICAL PROFESSION AND THE NATIONAL INSURANCE ACT. To the Editor of THE LANCET. SIR,-With all due deference I must contend that the ’ ° fallacies" Mr. Harford finds in my arguments more properly belong to his own. I I M.D."in the letter I criticised stated that in his opinion the need for medical services owing to sanitary advancement in the future would be diminished, as a matter of fact. This may or may not be the case. Mr. Harford appears to think that in reality there will be no such diminution, and that the average amount of medical work will remain the same. Perhaps he is right, but whether right or not it is a fallacy of the most pronounced kind to imagine that his arguments on this matter are in any way relevant to mine. With regard to the remarks on my representative responsibility, it is to be regretted that he is again rather wide of the mark. My letter was not in any sense written in my capacity as a member of the body to which he refers. If it will afford him any satisfaction I can assure him that it is exceedingly doubtful whether the State Sickness Insurance Committee would endorse all the views expressed in my letter. They only happen to be my own, and were not put forward in any representative character at all ; but I am not surprised at his confusing representative and individual opinions in this manner. He is not the only member of the profession at the present time subject to the same confusion. As I consistently opposed both the schemes Mr. Harford refers to, as is generally known in my own division, it will be a good illustration of the fallacy of supposing that a member of a representative body necessarily incurs any individual responsibility for its action, or can be accurately described as one of the "authors " of the same. I do not question the bona fides of Mr. Harford in the attitude he has thought fit to take up. When gentlemen like himself and Dr. Mills circularise the whole medical profession on the lines laid down in their recent pamphlet, it must be admitted that they are strongly impressed by the present situation. But I must be permitted to say that Mr. Harford’s remarks as to the likelihood of a rupture in the unity of the profession and the danger of its disunion come with an ill grace from one who has chosen to follow his own individual opinion in preference to that of his profession, which, if not unanimous, has been given with a solidarity hitherto unknown in its annals. If the profession remains united, even to the extent it has appeared to be, since the introduction of this mischievous Act, it is probable that it will gain its ends. If the causes that Mr. Harford suggests are sufficient to break it up, then it must be confessed that it is incapable of that union without which no independent profession can expect to protect its legitimate interests. In the latter case a heavy responsibility rests on those men who, like Mr. Harford, have deliberately flouted the opinion of their profession. The coming Representative Meeting may decide a good many
1178 many other
equally dangerous poisons
impunity by the"patent Chicago,
Oct.
medicine I am,
"
can
be used with
manufacturer.
Sir, yours faithfully, ARTHUR J. CRAMP.
11th, 1912.
"MENTALLY EXCEPTIONAL" CHILDREN. To the Editor of THE LANCET. SIR,-It is quite clear that the class of children alluded
to
last week in an annotation under this heading, and described by Dr. Ziehen as psychopathic, if not saved for construotive work, are destined to become destructive forces in the - environment in which they are situated. It seems to be his object to evolve methods of education and to provide special institutions for their care and supervision, in order that this human wastage may be avoided. In America it has been suggested by the National Association for the Study and Education of Exceptional Children that the waste products or by-products of our social organisation, and among them may be counted the exceptional child, may possibly prove as commercially valuable to the State as many former waste products of industry are now found to be under improved processes of manufacture. This sounds to me rather speculative optimism, although as an incentive to action the view has its value. The great difficulty here, as in America, is to devise some reasonable system of grading such children in classes, for it is clear that the expense of giving each an individual education would be impracticable on the grounds of expense. I am, Sir, yours faithfully, ERIC PRITCHARD. Oct. 2lst, 1912.
be obtained. Some five of these sections I presented to Mr. E. H. Ross, whose brother is kind enough to admit that " they do show some "splodges." that Mr. H. C. Ross says there is no coil in the human parasite," but I have seen it in many instances both in living and in Giemsa stained specimens, and before I saw Mr. E. H. Ross’s paper I was familiar with the development of spirochastss from a coil from the writings of Danilewsky and Schaudinn, and I acknowledged my indebtedness to that paper out of courtesy, as Mr. E. H. Ross was working at the same subject, and, moreover, on material which I had unreservedly placed at his disposal. It was owing to Doflein’s and Kohler’s article in the Handbuch der Pathogenen Mikroorganismen," Band VII. 1, S. 88 and 89, under the heading " Gattung Leucocytozoon Danilewsky," that I ventured to suggest the name leucocytozoon for the analogous syphilitic parasite. And I cannot see that Mr. H. C. Ross has shown that the suggestion is "surely erroneous." In conclusion, I may add that on Oct. 17th I showed at the Dermatological Section of the Royal Society of Medicine 12 slides illustrating some of the phases I have described, at which meeting critics could have been present. I am sorry to trouble you with this lengthy letter, but I felt that Mr. H. C. Ross’s thinly veiled attack on my good faith in the matter called for an immediate reply. I am. Sir. vours faithfullv. J. E. R. MCDONAGH. Wimpole-street, W., Oct. 19th, 1912.
To the Editor of THE LANCET. to THE LANCET last week I wanted to letter SIR,—In my maintain that, since an undoubted parasite has been found in the cells of syphilitics, and since with the jelly method there is now a means of tracing its life-history in a way similar to that adopted for the homologous parasites of guinea-pigs and earthworms, it would be particularly harmful if, at this stage, we indulge in deductions, speculations, or names, based on incomplete evidence. I believe that this will be considered to be the right attitude to select.
THE LIFE-CYCLE OF THE ORGANISM OF SYPHILIS. To the Editor if THE LANCET. SiR,-May I be allowed to controvert some of the stateT Sir faithfully ments made by Mr. H. C. Ross in THE LANCET of Oct. 19th? H. C. Ross. The John Howard McFadden Researches, The facts are as follows. In January of this year I was London, S.W., Oct. 21st, 1912. the clinical and observations menprompted by pathological tioned in my article to inquire into the life-history of the - organism of syphilis, as I felt convinced that the spiroTHE MISTAKES OF ASSISTANTS. climta pallida alone could not account for all the phenoTo the Editor of THE LANCET. mena. The lymphatic gland suggested itself to me as the most likely place for the other phases to occur, SIR,-Professor Waller again alludes to my suggestion that and I accordingly looked for and found them there. On the slight corrections to which he refers may have been made .Sept. 7th Mr. E. H. Ross came to the Lock Hospual for some by an assistant. In my experience this is just the sort of syphilitic material, when he was informed by my house thing that an assistant would do ; many, like myself, who surgeon, Mr. Moolgavkar, that I had been working at this desire minute accuracy have to suffer for the mistakes of subject for some months. Consequently, he came to see me others, in spite of every effort to prevent them. I will give at the hospital on Sept. 14th, when I informed him that I two recent instances. In the final proof of a paper of mine had found certain bodies in sections of lymphatic glands, for the Journal of Physiology Loewe was spelt correctly, but but I did not mention that I had also found them in vivo in the Jozcrnal of Physiology it appeared Loewi, the correcand in fixed films. On Sept. 18th I took two sections of tion having been made in seven places by the proof-reader. glands, one before, the other after, the administration The next instance is more remarkable. In the minutes of of "606," to the Lister Institute, and showed him the evidence taken before the Departmental Committee on I was then shown a speci- Sight Tests, in reply to question 492, "Has your way of bodies that I had found. men by the jelly method from a lymphatic gland which exhibiting the colour any advantage over Sir William lie had received from me that day, the other half of which Abney’s apparatus?"Isaid,"The method he has adopted I had investigated the same morning. I saw nothing more is not the same as he recommended previously. I do not than I had already seen, and I was not shown the complete know the methods that he now uses, except from the reports cycle of the parasite of the guinea-pig or of the earthworm, I have seen. But they seem to me to be very similar to as Mr. H. C. Ross asserts. Following on this came Sir mine, showing spectral lights of varied intensity. They are Ronald Ross’s announcement in the British llledical Journal , not the methods reconmended by the Royal Society Comof Sept. 28th that his brother, Mr. E. H. Ross, had mittee. Their method was to pick out the neutral point, found bodies in syphilis "not in the mononuclear leuco- and the trichromic has not got a neutral point. In fact, I cytes of the blood, but in large mononuclear cells squeezed took three cases of colour-blindness to Sir William Abney, from local lymphatics." I was not anxious to publish and he passed them all." This is given correctly on page 26. This reply is quoted in a question in Sir W. Abney’s my observations until I had had the opportunity of ascertaining the action of 606"on- what I took to be the evidence on page 58 of the Report as follows :" The method spores, but this announcement appearing so soon after Mr. I he has adopted is not the same as was recommended E. H. Ross began his work, and after his examination of the previously. I do not know the methods that he does use, first lymphatic gland I had supplied him with, left me no except from the reports I have seen. But they seem to me option. It is not clear why Mr. E. H. Ross did not to be very similar to mine, showing spectral lights and announce his own discovery, or why he left the attack on shutters inside. They are not the methods reported by the my article to another brother. My deductions were not Royal Society Committee. Their method was to pick out solely drawn from sections, as I had seen the bodies both the neutral point, and the trichromic has not got a neutral alive stained by the borax methylene blue method and in point. In fact, I took three cases of colour-blindness to films stained with Giemsa, but I was especially glad to find Sir William Abney and he passed them all." them in sections, as in this way permanent specimens could The portions which differ in the erroneous version are in am
"
vnnre
THE MEDICAL PROFESSION AND THE NATIONAL INSURANCE ACT. It will be noticed that the second version eliminates I wished to make. I am, Sir, yours faithfully, F. W. EDRIDGE-GREEN. The Institute of Physiology, University College,
italics.
nearly all the special points
Gower-street, W., Oct. 18th, 1912.
secretary, British Red Cross Society, 9, Victoria-street, Westminster, London, S.W., or to Messrs. Coutts and Company, 440, Strand, London, W.C., will be and sent either to the
gratefully acknowledged. I am, Sir, your obedient servant,
ROTHSCHILD, Chairman of the Council British Red Cross
THE ACETONE-WRIGHT METHOD OF LEUCOCYTE COUNTING. To the Editor of THE LANCET. SIR,-In the very hot weather we have here May to August inclusive the acetone-Wright solution which I described in THE LANCETcompletely failed to work. Another method which is not affected by heat, is rather easier for the inexpert to handle, and gives almost equally good results, is as follows :-Prepare a 2/3 saturated solution of Wright’s stain in methyl alcohol free from sediment by adding 5 c.c. of methyl alcohol to 10 c.c. of filtered saturated solution. Store in a tall narrow bottle to allow any possible sediment to sink and leave perfectly clear fluid above. Prepare also some 0.1per cent. sodium chloride solution, filtered. For use add 1 part of the alcoholic solution to The alcoholic 3 parts of the saline and use at once. solution stains films quite successfully and is less apt to deposit a precipitate on them than the stronger solution commonly used. Further experience has convinced me of the great value and accuracy of these methods, provided that the cautions laid down in my previous communications are I am, Sir, yours faithfully, observed. R. A. P. HILL. Union Medical College, Peking, China, Sept. 30th, 1912.
from
BRITISH RED CROSS BALKAN FUND. To the Editor of THE LANCET. SIR,-The generosity of the British nation in alleviating the distress of the sick and wounded of foreign armies engaged in war has been repeatedly proved in the past. It is difficult to bring home to the public of this country the appalling suffering involved in a winter war in the Balkans. Communications are difficult, the cold is intense, and even rudimentary transport is a matter of extreme difficulty. Moreover, the fighting in this particular war is likely to be of a specially bitter and severe character, while, on the other hand, the medical organisation available is quite inadequate to cope with large numbers of wounded. In order to mitigate, in some measure, the terrible suffering entailed by such a winter campaign, the British Red Cross Society is preparing to despatch expeditions to the belligerent countries. In accordance with the provision of the Geneva Convention the sanction of the Foreign Office for these expeditions has been obtained, and offers of help have been gratefully welcomed by representatives in England of the various countries concerned. The invested funds of this society are only applicable to A special fund, wars in which British troops are engaged. therefore, is necessary in order to render assistance to foreign belligerents, and it is for this fund that the British Red Cross Society now appeals for subscriptions. The money contributed will be administered by specially appointed committees of the society. Among those who have consented to serve on these committees are Georgiana Countess of Dudley, R.R.C., the Marchioness of Lansdowne, C.I., the Marchioness of Londonderry, the Duchess of Montrose, LL.D., the Lady Wantage, R.R.C., Colonel Sir George Beatson, K.C.B., Sir Anthony A. Bowlby, C.M.G., Mr. James Cantlie, F.R.C.S., Sir Benjamin Franklin, K.C.I.E., Surgeon-General Sir Alfred Keogh, K.C.B., Mr. A. K. Loyd, K.C., Mr. George Henry Makins, C.B., Mr. J. Danvers Power, M.V.0., Mr. Edward A. Ridsdale, the Hon. N. Charles Rothschild, The Hon. Arthur Stanley, M.V.0., M.P., and Sir Frederick
Treves, Bart.,
G.C.0.C.B
The services of the society will be rendered impartially to all the combatants concerned, but it is, of course, open to .any subscriber to ear-mark a donation for the special assistance of one or other of the belligerent parties, and any instruction to that effect will be strictly observed. Subscriptions marked "British Red Cross Balkan Fund," 1
THE LANCET, Jan. 6th,
1912,
p.
20,
1179
and Feb.
10th, p. 389.
9, Victoria-street, London, S.W.. Oct.16th.1912.
Society.
EMETINE SALTS IN THE TREATMENT OF DYSENTERY. To the Editor of THE LANCET. SIR,-In THE LANCET for Oct. 19th Lieutenant-Colonel L. Rogers states that his treatment of dysentery with emetine salts is new. If he will refer to p. 269 of the Indian Medical Gazette for September, 1891, he will find that I used emetine with good results. No distinction was made between cases due to amcebas and those due to bacilli. I am, Sir, yours faithfully, J. H. TULL WALSH, Lieutenant-Colonel I.M.S. (retired). St. Faith’s, Norfolk, Oct. 23rd, 1912.
THE MEDICAL PROFESSION AND THE NATIONAL INSURANCE ACT. To the Editor of THE LANCET. SIR,-With all due deference I must contend that the ’ ° fallacies" Mr. Harford finds in my arguments more properly belong to his own. I I M.D."in the letter I criticised stated that in his opinion the need for medical services owing to sanitary advancement in the future would be diminished, as a matter of fact. This may or may not be the case. Mr. Harford appears to think that in reality there will be no such diminution, and that the average amount of medical work will remain the same. Perhaps he is right, but whether right or not it is a fallacy of the most pronounced kind to imagine that his arguments on this matter are in any way relevant to mine. With regard to the remarks on my representative responsibility, it is to be regretted that he is again rather wide of the mark. My letter was not in any sense written in my capacity as a member of the body to which he refers. If it will afford him any satisfaction I can assure him that it is exceedingly doubtful whether the State Sickness Insurance Committee would endorse all the views expressed in my letter. They only happen to be my own, and were not put forward in any representative character at all ; but I am not surprised at his confusing representative and individual opinions in this manner. He is not the only member of the profession at the present time subject to the same confusion. As I consistently opposed both the schemes Mr. Harford refers to, as is generally known in my own division, it will be a good illustration of the fallacy of supposing that a member of a representative body necessarily incurs any individual responsibility for its action, or can be accurately described as one of the "authors " of the same. I do not question the bona fides of Mr. Harford in the attitude he has thought fit to take up. When gentlemen like himself and Dr. Mills circularise the whole medical profession on the lines laid down in their recent pamphlet, it must be admitted that they are strongly impressed by the present situation. But I must be permitted to say that Mr. Harford’s remarks as to the likelihood of a rupture in the unity of the profession and the danger of its disunion come with an ill grace from one who has chosen to follow his own individual opinion in preference to that of his profession, which, if not unanimous, has been given with a solidarity hitherto unknown in its annals. If the profession remains united, even to the extent it has appeared to be, since the introduction of this mischievous Act, it is probable that it will gain its ends. If the causes that Mr. Harford suggests are sufficient to break it up, then it must be confessed that it is incapable of that union without which no independent profession can expect to protect its legitimate interests. In the latter case a heavy responsibility rests on those men who, like Mr. Harford, have deliberately flouted the opinion of their profession. The coming Representative Meeting may decide a good many