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THE PATHOLOGY AND TREATMENT OF TUBERCULOSIS.
THE PATHOLOGY AND TREATMENT OF TUBERCULOSIS.
523
satisfied the ash-limit of the Austrian Pharmacopoeia. An ex- contentions that they are due to the " high quality of amination under the microscope showed that five samples weresensitivity"of the organism against the toxins of tubergrossly adulterated, three of them containing an abundance of culosis. Dr. Hollós also states that patients in the latent almond shell; five others also showed evidence of contamina- stage of tuberculosis respond well to antituberculous treattion with foreign vegetable substances, and the authors draw ment. The patients under his care were without exception the conclusion that ’’ the quality of commercial powdered treated with Spengler’s serums-namely, the smaller progentian still leaves much to be desired. Intentional adul- portion of them with tuberculin and the larger proportion with teration with foreign vegetable powders still continues. the ’’tuberkulose Immun-Körper " (LK.). In THE LANCET Carelessly cleaned root is ground to powder, and a large of Sept. 16th, 1911 (page 838), we made some remarks proportion of the samples are deficient in water soluble on this " I. K." treatment for tuberculosis, and after a substances." The 11 samples of nux vomica examined gave criticism of the accounts which had been published claiming much more satisfactory results, and the 11 samples of very favourable results from the employment of the prepowdered ipecacuanha, with one exception, contained paration we asked our readers to receive the results of emsufficient total alkaloid to comply with the requirements ploying " 1. K.""with reserve for the present. After reading of the Committee of Reference in Pharmacy. The series Dr. Holl6s’s remarks our opinion is not changed, but we of investigations promises useful results, and if other should be interested to receive from our readers any personal drugs are found to be adulterated to the same extent as experience they may have had in treating patients with root valuable caution will be instilled. In another paper read at the same meeting the same authors demonstrated that the frequently repeated statement that black mustard seeds do not always contain sufficient myrosin to decompose all the sinigrin they contain, was incorrect. In two of the samples of black mustard seeds examined there was, in fact, sufficient of the enzyme to decompose a much larger quantity of the glucoside than the seeds themselves contain, while in all the samples there was a sufficiency of myrosin. It therefore follows that the practice of adding white mustard seeds, which contain an excess of the same or a similar enzyme, myrosin, is not necessary to complete the decomposition of the glucoside, although a mixture of the two kinds of seeds may be more palatable than the black seed alone. The third paper consisted of a preliminary report on examinations of asafœtida and oil of asafoetida which have been conducted by Mr. E. F. Harrison and Mr. P. A. W. Self. The authors describe in detail the process employed in investigating the oil, and, since there is good reason to believe that the virtues of asafoetida are chiefly due not merely to the essential oil but to the sulphur-containing constituents of the oil, they draw especial attention to the importance of an accurate determination of the amount of sulphur present. They showed that high percentage of sulphur in the oil goes with high specific gravity, high refractive index, and levorotation, while the lowest percentage of sulphur goes with the lowest specific gravity and refractive index, and dextrorotation. The authors were reluctant to suggest that the figures they obtained established any sort of standard or limit, although the samples were chosen to be as representative as possible; they are inclined to think, however, that when the amount of sulphur in the oil is not under 1- 5 per cent. of the real gum resin, there is a primâ tacie case for regarding the drug as pure. They are continuing their investigations in the hope that the accumulation of further data may lead to results of greater value.
powdered gentian
Dr. Spengler’s THE
serums. -
CANADIAN ROYAL COMMISSION ON TUBERCULOSIS.
WiTH the administration of sanatorium benefit under the National Insurance Act in view, the attention of statesmen, Insurance Commissioners, local authorities, and practitioners may be directed advantageously to the report of the Royal Commission on Tuberculosis for the Province of Quebec recently issued. The report presents the problem of the prevention and eradication of tuberculosis in clear, concise, and eminently practical fashion. For ready reference the arrangement of the report is excellent. The body of the report is prefaced by a short summary of six pages which contains the more important conclusions. Following this comes the detailed report with excerpts from the evidence. The Commission consisted of 14 members, and included Dr. E. P. Lachapelle (chairman), Professor J. G. Adami, Dr. Roddick, and Colonel Jeffrey Burland, the donor of the Royal Edward Institute. The general conclusions include an emphatic statement that tuberculosis is infectious and transmissible. The unavoidable confession is made that the mortality from tuberculosis is higher in the Province of Quebec than in the Province-It is Ontario and the adjacent United States. further pointed out that the death-rate from tuberculosis in the rural population equals that in the urban population,. who, theoretically, live under more unhealthy conditionsr that the mortality among women is considerably greater than among men ; and that the mortality among French Canadians is higher than among Anglo-Canadians. Attention is especially drawn to the spread of tuberculosis through contagion in families, in the collective life of schools, boarding schools, offices, and workshops-in short, through the influence of vitiated air in all places where people are gathered together. Means for combating tuberculosis are divided in the report broadly into : (1) Measures that can be carried out at once ;;: and (2) measures to be carried out gradually. Among measures which the Commissioners hold can be carried out THE PATHOLOGY AND TREATMENT OF at once are included stricter application of the laws conTUBERCULOSIS. tained in public health statutes, the teaching of hygiene in IN another column we publish a communication from our schools, popular education in relation to tuberculosis, the correspondent at Budapest with regard to the views held by medical inspection of schools and industrial establishments, Dr. Joseph Holl6s respecting certain points in the pathology the establishment of tuberculosis dispensaries in the principal and treatment of tuberculosis. The remarks on latent and centres, the erection of isolation hospitals for advanced cases masked tuberculosis will doubtless be received with a con- among the poor, the establishment of open-air schools for siderable amount of scepticism by practitioners in this certain groups of children, and legislative measures regarding country. Nevertheless we have th6ught it well to publish institution of farm colonies and holiday colonies, thethem, as they have received some attention from French the employment of children, the abuse of alcoholism, and the observers. Certain symptoms are detailed which Dr. Ho1l6s inspection of meat and milk. Among measures to be carried believes are indicative of latent tuberculosis, but similar out gradually may be noted the creation of sanatoriums, the symptoms occur in so many other conditions that much improvement of dwellings under existing statutes, and fresh hesitation will be experienced in accepting Dr. Holl6s’s legislation to promote the building of cheap, healthy
of
523
satisfied the ash-limit of the Austrian Pharmacopoeia. An ex- contentions that they are due to the " high quality of amination under the microscope showed that five samples weresensitivity"of the organism against the toxins of tubergrossly adulterated, three of them containing an abundance of culosis. Dr. Hollós also states that patients in the latent almond shell; five others also showed evidence of contamina- stage of tuberculosis respond well to antituberculous treattion with foreign vegetable substances, and the authors draw ment. The patients under his care were without exception the conclusion that ’’ the quality of commercial powdered treated with Spengler’s serums-namely, the smaller progentian still leaves much to be desired. Intentional adul- portion of them with tuberculin and the larger proportion with teration with foreign vegetable powders still continues. the ’’tuberkulose Immun-Körper " (LK.). In THE LANCET Carelessly cleaned root is ground to powder, and a large of Sept. 16th, 1911 (page 838), we made some remarks proportion of the samples are deficient in water soluble on this " I. K." treatment for tuberculosis, and after a substances." The 11 samples of nux vomica examined gave criticism of the accounts which had been published claiming much more satisfactory results, and the 11 samples of very favourable results from the employment of the prepowdered ipecacuanha, with one exception, contained paration we asked our readers to receive the results of emsufficient total alkaloid to comply with the requirements ploying " 1. K.""with reserve for the present. After reading of the Committee of Reference in Pharmacy. The series Dr. Holl6s’s remarks our opinion is not changed, but we of investigations promises useful results, and if other should be interested to receive from our readers any personal drugs are found to be adulterated to the same extent as experience they may have had in treating patients with root valuable caution will be instilled. In another paper read at the same meeting the same authors demonstrated that the frequently repeated statement that black mustard seeds do not always contain sufficient myrosin to decompose all the sinigrin they contain, was incorrect. In two of the samples of black mustard seeds examined there was, in fact, sufficient of the enzyme to decompose a much larger quantity of the glucoside than the seeds themselves contain, while in all the samples there was a sufficiency of myrosin. It therefore follows that the practice of adding white mustard seeds, which contain an excess of the same or a similar enzyme, myrosin, is not necessary to complete the decomposition of the glucoside, although a mixture of the two kinds of seeds may be more palatable than the black seed alone. The third paper consisted of a preliminary report on examinations of asafœtida and oil of asafoetida which have been conducted by Mr. E. F. Harrison and Mr. P. A. W. Self. The authors describe in detail the process employed in investigating the oil, and, since there is good reason to believe that the virtues of asafoetida are chiefly due not merely to the essential oil but to the sulphur-containing constituents of the oil, they draw especial attention to the importance of an accurate determination of the amount of sulphur present. They showed that high percentage of sulphur in the oil goes with high specific gravity, high refractive index, and levorotation, while the lowest percentage of sulphur goes with the lowest specific gravity and refractive index, and dextrorotation. The authors were reluctant to suggest that the figures they obtained established any sort of standard or limit, although the samples were chosen to be as representative as possible; they are inclined to think, however, that when the amount of sulphur in the oil is not under 1- 5 per cent. of the real gum resin, there is a primâ tacie case for regarding the drug as pure. They are continuing their investigations in the hope that the accumulation of further data may lead to results of greater value.
powdered gentian
Dr. Spengler’s THE
serums. -
CANADIAN ROYAL COMMISSION ON TUBERCULOSIS.
WiTH the administration of sanatorium benefit under the National Insurance Act in view, the attention of statesmen, Insurance Commissioners, local authorities, and practitioners may be directed advantageously to the report of the Royal Commission on Tuberculosis for the Province of Quebec recently issued. The report presents the problem of the prevention and eradication of tuberculosis in clear, concise, and eminently practical fashion. For ready reference the arrangement of the report is excellent. The body of the report is prefaced by a short summary of six pages which contains the more important conclusions. Following this comes the detailed report with excerpts from the evidence. The Commission consisted of 14 members, and included Dr. E. P. Lachapelle (chairman), Professor J. G. Adami, Dr. Roddick, and Colonel Jeffrey Burland, the donor of the Royal Edward Institute. The general conclusions include an emphatic statement that tuberculosis is infectious and transmissible. The unavoidable confession is made that the mortality from tuberculosis is higher in the Province of Quebec than in the Province-It is Ontario and the adjacent United States. further pointed out that the death-rate from tuberculosis in the rural population equals that in the urban population,. who, theoretically, live under more unhealthy conditionsr that the mortality among women is considerably greater than among men ; and that the mortality among French Canadians is higher than among Anglo-Canadians. Attention is especially drawn to the spread of tuberculosis through contagion in families, in the collective life of schools, boarding schools, offices, and workshops-in short, through the influence of vitiated air in all places where people are gathered together. Means for combating tuberculosis are divided in the report broadly into : (1) Measures that can be carried out at once ;;: and (2) measures to be carried out gradually. Among measures which the Commissioners hold can be carried out THE PATHOLOGY AND TREATMENT OF at once are included stricter application of the laws conTUBERCULOSIS. tained in public health statutes, the teaching of hygiene in IN another column we publish a communication from our schools, popular education in relation to tuberculosis, the correspondent at Budapest with regard to the views held by medical inspection of schools and industrial establishments, Dr. Joseph Holl6s respecting certain points in the pathology the establishment of tuberculosis dispensaries in the principal and treatment of tuberculosis. The remarks on latent and centres, the erection of isolation hospitals for advanced cases masked tuberculosis will doubtless be received with a con- among the poor, the establishment of open-air schools for siderable amount of scepticism by practitioners in this certain groups of children, and legislative measures regarding country. Nevertheless we have th6ught it well to publish institution of farm colonies and holiday colonies, thethem, as they have received some attention from French the employment of children, the abuse of alcoholism, and the observers. Certain symptoms are detailed which Dr. Ho1l6s inspection of meat and milk. Among measures to be carried believes are indicative of latent tuberculosis, but similar out gradually may be noted the creation of sanatoriums, the symptoms occur in so many other conditions that much improvement of dwellings under existing statutes, and fresh hesitation will be experienced in accepting Dr. Holl6s’s legislation to promote the building of cheap, healthy
of