985
haemoptysis (all cases giving a history of streaky sputum being ignored), and in the other 3 the physical signs were definite, the diagnosis in one case being confirmed by radiographic examination. Of the T.B. To the Editor of THE LATCE1. cases, tubercle bacilli were found at various positive SiR,—It is good news indeed to see the strong intervals after gassing. These periods are as follows :interest at last aroused by the pioneer work of the T.B. + Cases, after Gassing.-Within 1 year, 1 ; 2 years, late Dr. Sloan. As long ago as 1910 I used to send 3 ; 3 years, 1 ; 4 years, 1 ; 5 years, 2. In all these cases catch him him in or as he see to Glasgow, the sputum was repeatedly examined. patients through London, in order to have his unique Of the haemoptysis positive cases, the haemoptysis opinion on the value of ionisation in individual cases. was discovered at various intervals after gassing. of his therefore I had the advantage having personal These periods are as follows :instruction in his methods. Erosions he always conHcemoptysis + Cases, after Gassing.-Within 1 year, 2;. sidered curable. It is difficult to see how they fail to 2 years, 2. CHRONIC ENDOCERVICITIS AND ITS TREATMENT.
passed
respond to the means which cure the endocervicitis. It is reassuring to know that other gynaecologists are following his work at length ; for so many years now I had become resigned to the discouraging fact that it aroused no interest outside the circle of electrotherapeutists. For those who have not had experience in general practice or special gynaecology it is difficult to master the dexterity required in certain cases; hence one so welcomes the interest of the gynaecologists. I note that
one correspondent refers to the fact that zinc electrode becomes adherent to the mucous membrane. I think this must be a slip ; that he had intended to write copper. I am, Sir, yours faithfully, a
AGNES
SAVILL, M.D.
Devonshire-place, W., Oct. 27th, 1922.
To.the Editor of THE LANCET.
SIR,-I would like to thank Dr. Johnston Abraham for his
complimentary remarks upon my paper on the above subject contained in his letter in THE LANCET of Oct; 28th. Dr. Abraham raises the question of the diagnosis of gonorrhoeal endocervicitis-a question which is quite outside the scope of the paper. The point which I was anxious to focus attention upon was that chronic endocervicitis, non-gonorrhceal in origin, was also an infective process and as such ought to receive scientific treatment. For this purpose the more elaborate technique one usually adopts in order to isolate the gonococcus was not necessary. The method I adopted produced 92 per cent. of positive cultures, thus proving my point. " With regard to Dr. Abraham’s second point, the incomplete description of the ionic technique," I cannot agree that the zinc rod " becomes firmly held by the mucous membrane and often cannot be dislodged without causing bleeding." I have not experi- i enced this in any of my cases, and invariably remove the rod without reversing the current. This is one of the great advantages of using zinc over copper, as the latter usually sticks. I am, Sir, yours faithfully, JOHN WILLIAM BURNS.
It will be seen from these results that tuberculosis of the lungs is not an uncommon sequela of gassing. I am, Sir, yours faithfully, HAROLD VALLOW, Oct. 25th, 1922. Tuberculosis Officer, City of Bradford.
PRIMARY PHLEGMONOUS ENTERITIS. To the Editor of THE LANCET. SiR,,-Dr. Edmund Cautley’s suggestion that the case described in your issue of Oct. 21st under the above title should be regarded as one of Henoch’s purpura and that the patient would have recovered without operation is one which I am unable to accept. In making this suggestion Dr. Cautley evidently relies more on the clinical phenomena than on the pathological findings. But even on clinical grounds th& diagnosis of Henoch’s purpura does not meet the case. There was no history of a previous attack, no clinical evidence of any form of haemorrhagic extravasation, the rash was an erythema-not a purpura-and ther& was no suggestion of intestinal obstruction. On the contrary, the pyrexia suggested an acute inflammatory lesion and the joint symptoms were regarded as a manifestation of an alimentary toxaemia. The histological evidence, however, is of the greatest importance, and one can only conclude from the presence of a small-celled infiltration-widespread throughout the wall of the affected intestine-that the condition was, as described, a phlegmonous inflammation of the small intestine. In my opinion, if the operation had not been performed, the chances of the patient’s recovery would have been nil. I am, Sir, yours Manchester, Oct. 27th, 1922.
faithfully,
E. E. HUGHES.
THE PREPARATION OF VACCINES. To the Editor of THE LANCET. SiR,—In a paper entitled the Action of Vaccines which was published under my name in your issue of Oct. 7th, brief reference was made to new.methods which have been introduced for the preparation of vaccines with the object of reducing what is described Rodney-street, Liverpool, Oct. 30th, 1922. as the toxicity of vaccines. In your issue of Oct. 14th is published a letter from Dr. David Thomson in defence of his " detoxication process " which he claims THE LATER EFFECTS OF GAS POISONING. does not destroy the antigenic nature of the vaccine " To the Editor of THE LANCET. (the italics are mine). I should like to point out that SIR,-It is stated by Lieut.-Colonel T. E. Sandall, the quotation from my paper given verbatim in in your issue of Oct. 21st under the above heading, Dr. Thomson’s letter definitely gives my opinion that that "there is a popular impression that pulmonary " the actual effect of this procedure is to weaken tuberculosis is a frequent sequela of gas poisoning, but enormously the antigenic value of the vaccine." These I do not think this is borne out by the facts in this two sentences disclose an entirely different standpoint. As I have not access at the moment of writing to area at any rate." Colonel Sandall also states that " In only one case of the series, also, were there any physical Dr. Thomson’s papers I trust that my memory serves signs suggestive of pulmonary tuberculosis, and in me correctly in stating that Dr. Thomson’s conclusions this case the evidence was not conclusive." In this in this matter are based chiefly on observations on industrial area, population 291,100, the Local War complement deviation and agglutinin. I do not recall Pensions Committee referred all the gassed cases with any reference to carefully controlled comparative any suspicion of lung disease to the tuberculosis officer quantitative tests with a vaccine before and after as one of their medical referees, and in at least 15 of treatment by his process. More important still is the them tuberculosis of the lung developed. None of question of comparative protection tests on animals these cases was discharged with tuberculosis. Of with vaccine before and after treatment by his process. these 15 cases of pulmonary tuberculosis detected, Under these circumstances Dr. Thomson cannot fairly 8 had tubercle bacilli in the sputum and 7 had not. complain if his claim to have provided proof of his. Of the 7 T.B. negative cases, 4 had a definite history ofi contentions is not accepted. "
986
My views have been expressed in the above-mentioned paper and do not call for emphasis or repetition. Will Dr. Thomson state if he is able to furnish conclusive data, especially data of animal protection experiments with vaccine before and after treatment, in refutation of the statement that his detoxication process enormously weakens the antigenic value of the I am, Sir, yours faithfully, vaccine ? J. PRATT-JOHNSON. Florence. Oct. 24tb, 1922. THE IRISH ROYAL COLLEGES AND THE FREE STATE SENATE. To the Editor of THE LANCET. SiR,-In the final stages of the debate in which Dail Earann passed the constitution for the Free State, .a clause was added to the draft directing the President, when making nominations to the first Senate, to take the advice of certain professional and business organisations in Ireland. Among the bodies named are the Royal College of Physicians and the Royal College of Surgeons. It is generally assumed that each College will be permitted to recommend one or two persons for nomination to the Senate. The debate on this clause was marked by an attack on the Royal College of Physicians by a Deputy, who stated that the College was merely an appanage of Trinity College, and that favour was shown in elections and appointments to graduates of Trinity College as compared with other physicians. There does not seem to be any substance in the charge. On only one occasion during the past quarter of a century was a candidate for Fellowship rejected, and he was subsequently elected. On another occasion a candidate proposed withdrew before the date of election. One of these gentlemen happened to be a graduate of Trinity College, the other Of the Presidents who have held office was not. during the same period nearly half have been Fellows Of who have not been graduates of Trinity College. the three leading Honorary Fellows resident in Ireland two are distinguished medical men not of Trinity College.-I am, Sir, yours faithfully, ONE OF YOUR IRISH CORRESPONDENTS. Dublui, Oct. 30th, 1922.
Capt. II. D. Pickles relinquishes his commn. on account of ill-health and retains the rank of Capt. The undermentioned relinquish their commns. and retain their rank : Capts. G. S. Glass, F. C. Kempson, and T. J. P. Maunders. The undermentioned resign their commns. and retain their rank, except where otherwise stated : Lt.-Col. H. W. Thomson (with permission to wear the prescribed uniform); Maj. G. H. Fleming (granted the rank of Lt.-Col.); Capts. J. Taylor (granted the rank of Maj.), G. W. Rogers, R. F. Young, and .1. K. Rennie. General Hospitals : Lt.-Col. H. Collinson resigns his commn, and is granted the rank of Col., with permission to wear the prescribed uniform. Maj. (Bt. Lt.-Col.) J. H. Drysdale relinquishes his commn. and retains his rank. Supernumerary for Service with O.T.C. : Capt. I. W. Corkey resigns his commn. and retains his rank. TERBITORIAL ARMY RESERVE.
Capt. J. C. Bridge having attained the age limit is retired, and retains the rank of Capt. Sanitary Companies : Capt. A. S. R.eeves, from 2nd Lond. San. Co., to be Capt. -
ROYAL AIR FORCE. Lt. 11. S. C. Starkey is granted a permanent commission in the rank stated. (Since promoted.) Flight Lt. ’r. M. Walker is granted a short service commission, retaining his present substantive rank and seniority. Capt. B. F. Beatson is granted a temporary commission as a Flight Lt. whilst seconded for duty with the R.A.F.
Flight
Medical News. UNIVERSITY Gotch memorial
Radcliffe Pri-e, 1923This prize, which is
papers, embodying research in any branch of medical science. The prize is open to all graduates of the University who have proceeded, or are proceeding, to a medical degree in the University. Candidates, at the date of application, shall not be Radcliffe Fellows. Any graduate who was eligible during the years of the war will be eligible for the next ensuing award (1923). Candidates are required to send in their memoirs on or before Dec. lst, to the assistant registrar of the University, Clarendon Building, Broad-street, Oxford, from whom further particulars can be obtained. M. Emil Coue will lecture on the subject of Suggestion in the Examination Schools on Saturday, Nov. 25th, at 12 noon. The Faculty of Medicine has re-elected Sir Frederick Andrewes, F.R.S., to be a. member of the Board of Electors to the Professorship of Pathology.
Surg. Capt.
--
ROYAL ARMY MEDICAL CORPS. of Med. Servs. : Lt.-Col. and Bt. Col. (tempt. Col.) Sir M. H. G. Fell relinquishes his appt. at the War Office and retains his temp. rank whilst spec. emplù. Maj. T. H. Gibbon relinquishes the temp. rank of Lt.-Col. on ceasing to be empld. as Asst. Dir. of Pathology. Maj. W. K. Beaman is placed temp. on the half-pay list, on account of ill-health. T. A. Weston and Capt. K. L. Capt. and Bt.
Inspr.
Maj.
O’Sullivan retire, receiving a gratuity. Capt. J. L. R. Philip, late temp. Capt., R.A.M.C., on ceasing to be empld. with the Ind. Med. Serv., is granted the rank of
Capt. Temp. Capts. S.
P. Hyam and J. R. Kemp relinquish and retain the rank of Capt. Temp. Capt. P. Boyle relinquishes his commn. on ceasing to be empld. as a Dental Surg. and retains the rank of Capt.
their
commns.
TERRITORIAL ARMY.
C. B. Moss-Blundell, from San. Co., to be Capt. Lts. G. E. Lloyd and P. Lloyd-Williams to be Capts. The undermentioned having attained the age limit are retired and retain their rank, except where otherwise stated : Maj. W. Young ; Capts. W. T. Barrie (with permission to wear the prescribed uniform), E. P. Minett, J. Grant Johnston, W. Ritchie, T. P. Thomas, and R. Cross.
Capt.
of the value of
P,5 0, will be awarded by the Master and Fellows of University College upon the report of the examiners, for a memoir, or
The Services. ROYAL NAVAL MEDICAL SERVICE. A. Maclean is promoted to Hag rank to fill the vacancy caused by the retirement of Surg. Rear-Admiral Sir D. J. P. McNabb. Surg. Lt. S. R. Johnston to be Surg. Lt.-Comdr. E. J. Benson to he Surg. Lt. Temp. Surg. Lt. (D.) J. L. Lean transferred to Permt. List with original seniority.
OxFORD.—An award of the Francis prize will be made in the present term.
OF
UNIVERSITY
I
OF
LONDON.-Mr. H. J.
Waring
has
been elected Dean of the Faculty of Medicine for the period 1922-24. A course of eight lectures on Secretion and Internal Secretion will be given by Prof. Swale Vincent at Middlesex Hospital Medical School, Union-street, W. 1, atP.3t., on Mondays and Thursdays, Nov. 6th, 9th, 13th, 16th, 20th, 23rd, 27th, and 30th. Attendance at this course is recognised in connexion with the B.Sc. (Honours) degree in Physiology. Admission free without ticket.
UNIVERSITY OF MANCHESTER.-Mr. E. J. Sidebotham, who recently resigned his post as deputy director
the Public Health Laboratory, has been appointed Honorary Lecturer in Public Health. The following appointments have been made : Honorary Assistant Lecturer in Experimental Physiology, G. J. Langley, M.D., I3.S. Lord. ; Leech Fellowship, C. D. Hough, M.B., Ch.B. ; Entrance Scholarships in Medicine, Florence V. Stephen, B.Se., and N. S. Walls, M.Sc., Ph.D. MEDICAL GOLFING SOCIETY.-The autumn meeting was held at Littlestone on Oct. 21st and 22nd by permission of
of the Committee of that club and
was in every way a success. The results were as follows :Singles v. Bogey (cup presented by Mr. Ernest CIarke).H. D. Gillies, 1 up ; T. P. Kolesar and E. Grogono, each 2 down. Foursomes v. Bogey (cups presented by Mr. G. Dawson and Dr. Rolf Creasy).-L. W. Bathurst and E. Laming Evans, 4 down, after a tie with L. Bromley and F. D. Saner, and E. Grogono and L. Welpby. Challenge 0-?zp for best 18 holes medal round (presented by E. Canny Ryall).-J. Grace, 8 7-9 = 7 8 ; 2nd, Sir M. Rees. 83-1=79 ; 3id, E. Laming Evans, 89-9=80.