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2512. Galactose and the blind eye
342
NATURAL PRODUCTS
the light of their reported findings, the authors of this paper recommend that the neonatal
use of HC in maternity hospitals should continue, the skin being subsequently rinsed with water as a precautionary measure, but they consider that use of HC in the home and extended use in hospital should be avoided. There is considered to be little scientific basis for the use of HC in cosmetics, toothpastes, mouthwashes or vaginal deodorants (see following abstract) since Staphylococcus aureus is rarely found in either mouth or vagina.
2511. But no support for vaginal deodorants
Gowdy, J. M. (1972). Feminine deodorant sprays. New EngL J. Med. 287, 203. Adverse skin reactions may occasionally be caused by a variety of commonly-used ingredients of cosmetics and toiletries, including ethanol (Cited in F.C.T. 1970, 8, 438), isopropyl myristate (ibid 1970, 8, 239), fluorocarbons such as dichlorodifluoromethane (ibid 1966, 4, 467), perfumes (ibid 1970, 8, 240), talc (ibid 1967, 5, 590) and hexachlorophene (HC) (Gump, J. Soc. cosmet. Chem. 1969, 20, 173). All these ingredients are frequently used in vaginal deodorants, which up to May 1972 had been the subject of 28 reports of injury received by the FDA. Reactions included burning, rash (ranging from simple itching to a herpetiform reaction), vaginal discharge, urinary infection, abdominal cramping (in one case with threatened abortion), recurrent rash in the absence of further contact with the product, and balanitis in the male partner. Some patients recovered after ceasing to use the sprays, but in most cases therapy with systemic steroids was required; the average recovery time was 30 days but in nine cases it was greater than this. The reactions could not be attributed to any single cause. HC, typically used at 0.1 ~ in such formulations, was the principal suspect, since evaporation of the propellant can raise its concentration on the skin to as high as 95 ~o and it is known to be irritant above 5 ~o (Gump, loc. cit.). However, some reactions occurred with HC-free products, and there was no correlation between the HC concentration and the incipience of reactions. Nor was there a correlation with the concentration of alcohol, which can also irritate mucous membranes, although there was some indication of a connexion between a high perfume content and the number of reactions. Pressure from propellants was thought to be an important factor in urethral reactions, and their cooling or even freezing effect on the skin may have caused local damage. A similar report of adverse reactions to vaginal deodorants was published earlier (Kaye, J. Am. reed. Ass. 1970, 212, 2121), and there have been other reports in the lay press. [In view of the possibility of adverse effects, the need for such products must be seriously questioned, particularly in view of the ready availability of soap and water.]
NATURAL PRODUCTS 2512. Galactose and the blind eye
Keiding, S. & Mellemgaard, L. (1972). Dose dependence of galactose cataract in the rat. Acta ophthal. 50, 174.
NATURAL PRODUCTS
343
Galactose-induced cataract formation appears to be linked to an accumulation of this sugar, or its 1-phosphate derivative, in the lens of the eye (Cited in F.C.T. 1964, 2, 76). The current work was undertaken to establish whether there was a quantitative relation between galactose intake and the extent of cataract formation. Female rats were fed varying amounts of galactose in the diet, and the rate and extent of subcortical, and later nuclear, cataract formation were found to be directly proportional to the galactose concentration in the diet and also to the blood levels of the sugar. Thus, when galactose made up 15 % of the dietary calories, only cortical cataracts developed. Nuclear cataract was associated with diets in which galactose accounted for 20 % or more of the calories and took at least 45 days to develop, compared with the minimum of 4 days required for the development of cortical cataract. After the test diets had been fed for about 1 wk, there was a marked fall in the ATP concentration in the lens. Levels of ADP and AMP remained constant, so it was clear that the ATP change was not merely a relative decrease due to water accumulation. These results are compatible with the view that cataract formation can result from the overloading of the pathway for galactose metabolism (ibid 197 I, 9, 602) and the consequent accumulation of the sugar in the plasma. 2513. The heady effects of red wine Trethewie, E. R. & Khaled, Laila (1972). Wine and migrainous neuralgia. Br. med. J. 3, 290. High levels of tyramine and histamine often occur in foodstuffs such as wine, beer and cheese (Cited in F.C.T. 1964, 2, 761 ; ibid 1965, 3, 508) and may lead to severe reactions in patients also receiving monoamine oxidase inhibitors. Even in the absence of such drugs, it has long been recognized that these foods may provoke migraine attacks in susceptible individuals, and in one case, ripe cheese containing 850 ppm histamine was held responsible for flushing, headache, palpitations and hypotension (ibid 1968, 6, 812). The authors cited above described an Australian who had suffered severe attacks of migrainous neuralgia at least once a month for many years, principally in response to strong beer and red wine, but who was symptom-free for 18 months after avoiding these beverages and also cheese, chocolate and oranges. Fortunately he was able to drink white wine with impunity. Analysis of the red Australian wine that provoked such attacks showed it to contain no detectable tyramine and only 2-3 ppm histamine, but many other unidentified amines were present. The white wine, on the other hand, contained no histamine but large quantities of bradykinin and the presumed kinin SRS. In some migraine sufferers the mechanism of tyramine conjugation has been found to be defective (Youdim et al. Nature, Lond. 1971,230, 127) and in the present case it would appear that deficient conjugation of amines other than tyramine or histamine may have been responsible for the attacks.
2514. There's poison in them there herbs Schoental, R. (1972). Herbal medicines to avoid. Nature, Lond. 238, 106. In spite of the undoubted hazard of some modern synthetic drugs, that associated with traditional herbal remedies may be even greater. Nitrosamines present in self-administered
NATURAL PRODUCTS
the light of their reported findings, the authors of this paper recommend that the neonatal
use of HC in maternity hospitals should continue, the skin being subsequently rinsed with water as a precautionary measure, but they consider that use of HC in the home and extended use in hospital should be avoided. There is considered to be little scientific basis for the use of HC in cosmetics, toothpastes, mouthwashes or vaginal deodorants (see following abstract) since Staphylococcus aureus is rarely found in either mouth or vagina.
2511. But no support for vaginal deodorants
Gowdy, J. M. (1972). Feminine deodorant sprays. New EngL J. Med. 287, 203. Adverse skin reactions may occasionally be caused by a variety of commonly-used ingredients of cosmetics and toiletries, including ethanol (Cited in F.C.T. 1970, 8, 438), isopropyl myristate (ibid 1970, 8, 239), fluorocarbons such as dichlorodifluoromethane (ibid 1966, 4, 467), perfumes (ibid 1970, 8, 240), talc (ibid 1967, 5, 590) and hexachlorophene (HC) (Gump, J. Soc. cosmet. Chem. 1969, 20, 173). All these ingredients are frequently used in vaginal deodorants, which up to May 1972 had been the subject of 28 reports of injury received by the FDA. Reactions included burning, rash (ranging from simple itching to a herpetiform reaction), vaginal discharge, urinary infection, abdominal cramping (in one case with threatened abortion), recurrent rash in the absence of further contact with the product, and balanitis in the male partner. Some patients recovered after ceasing to use the sprays, but in most cases therapy with systemic steroids was required; the average recovery time was 30 days but in nine cases it was greater than this. The reactions could not be attributed to any single cause. HC, typically used at 0.1 ~ in such formulations, was the principal suspect, since evaporation of the propellant can raise its concentration on the skin to as high as 95 ~o and it is known to be irritant above 5 ~o (Gump, loc. cit.). However, some reactions occurred with HC-free products, and there was no correlation between the HC concentration and the incipience of reactions. Nor was there a correlation with the concentration of alcohol, which can also irritate mucous membranes, although there was some indication of a connexion between a high perfume content and the number of reactions. Pressure from propellants was thought to be an important factor in urethral reactions, and their cooling or even freezing effect on the skin may have caused local damage. A similar report of adverse reactions to vaginal deodorants was published earlier (Kaye, J. Am. reed. Ass. 1970, 212, 2121), and there have been other reports in the lay press. [In view of the possibility of adverse effects, the need for such products must be seriously questioned, particularly in view of the ready availability of soap and water.]
NATURAL PRODUCTS 2512. Galactose and the blind eye
Keiding, S. & Mellemgaard, L. (1972). Dose dependence of galactose cataract in the rat. Acta ophthal. 50, 174.
NATURAL PRODUCTS
343
Galactose-induced cataract formation appears to be linked to an accumulation of this sugar, or its 1-phosphate derivative, in the lens of the eye (Cited in F.C.T. 1964, 2, 76). The current work was undertaken to establish whether there was a quantitative relation between galactose intake and the extent of cataract formation. Female rats were fed varying amounts of galactose in the diet, and the rate and extent of subcortical, and later nuclear, cataract formation were found to be directly proportional to the galactose concentration in the diet and also to the blood levels of the sugar. Thus, when galactose made up 15 % of the dietary calories, only cortical cataracts developed. Nuclear cataract was associated with diets in which galactose accounted for 20 % or more of the calories and took at least 45 days to develop, compared with the minimum of 4 days required for the development of cortical cataract. After the test diets had been fed for about 1 wk, there was a marked fall in the ATP concentration in the lens. Levels of ADP and AMP remained constant, so it was clear that the ATP change was not merely a relative decrease due to water accumulation. These results are compatible with the view that cataract formation can result from the overloading of the pathway for galactose metabolism (ibid 197 I, 9, 602) and the consequent accumulation of the sugar in the plasma. 2513. The heady effects of red wine Trethewie, E. R. & Khaled, Laila (1972). Wine and migrainous neuralgia. Br. med. J. 3, 290. High levels of tyramine and histamine often occur in foodstuffs such as wine, beer and cheese (Cited in F.C.T. 1964, 2, 761 ; ibid 1965, 3, 508) and may lead to severe reactions in patients also receiving monoamine oxidase inhibitors. Even in the absence of such drugs, it has long been recognized that these foods may provoke migraine attacks in susceptible individuals, and in one case, ripe cheese containing 850 ppm histamine was held responsible for flushing, headache, palpitations and hypotension (ibid 1968, 6, 812). The authors cited above described an Australian who had suffered severe attacks of migrainous neuralgia at least once a month for many years, principally in response to strong beer and red wine, but who was symptom-free for 18 months after avoiding these beverages and also cheese, chocolate and oranges. Fortunately he was able to drink white wine with impunity. Analysis of the red Australian wine that provoked such attacks showed it to contain no detectable tyramine and only 2-3 ppm histamine, but many other unidentified amines were present. The white wine, on the other hand, contained no histamine but large quantities of bradykinin and the presumed kinin SRS. In some migraine sufferers the mechanism of tyramine conjugation has been found to be defective (Youdim et al. Nature, Lond. 1971,230, 127) and in the present case it would appear that deficient conjugation of amines other than tyramine or histamine may have been responsible for the attacks.
2514. There's poison in them there herbs Schoental, R. (1972). Herbal medicines to avoid. Nature, Lond. 238, 106. In spite of the undoubted hazard of some modern synthetic drugs, that associated with traditional herbal remedies may be even greater. Nitrosamines present in self-administered