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A PIONEER OF ACTINOTHERAPY
440 may have gained, since male hormone is also indicated in the management of benign enlargement of the prostate on the view that the condition results from the prolonged activity of oestrogens. It is idle, however, to speculate, in the present state of knowledge, on these various issues. One thing only is plain. Several hypotheses regarding the 2etiology of enlarged prostate have implied that male hormone would be of use in the treatment of the condition. Information about the chemistry and biology of male hormone compounds has also multiplied rapidly in the past year. It is time, therefore, that male hormone was given a fair and adequate clinical trial im those conditions which experimental work suggests may benefit from its use.
prophylaxis, when adequately attested, may the real solution of the problem if the public, provide as the result of education, agrees to the necessity. Vaccine
A PIONEER OF ACTINOTHERAPY
A MEMORIAL to Albert Jesionek in the Niinchener medizinische Wochenschrift of Jan. 31st is a worthy tribute to the work and personality of an outstanding dermatologist of modern times. In this country he will be remembered chiefly for the remarkable results. he obtained in all forms of cutaneous tuberculosis by purely " natural" means-viz.,diet and sunlightat- his Lupusheilstatte at Giessen. In this achievement his clinic was probably unique, for his energies were concentrated on the dermatoses; neithernor articular cases, as in many other pulmonary " WHOOPING-COUGH AND THE PUBLIC biological" institutes, shared the available space and facilities. Jesionek was a long way ahead of his. IN spite of unanimous medical opinion and thetime in formulating his problems and visualising them evidence of statistics to the contrary, the public He was no slave to this or as biological. of most countries continues to regard whooping- broadly that type of diet, lamp, or local application, and he cough as a disease of little account. Dr. F. Barbary, was rarely seen at medical congresses with some new of Nice, in a communication1 to the Paris Academy of cure or prevention. He preferred the quiet of Medicine, deplores the indifference shown in the gospel of his now famous institute at Giessen, rural districts of France. Evidently an optimist atmosphere and consistently refused the offer of larger and more then, he is disappointed now, seeing that since he drew important spheres of scientific activity. He will be attention to the matter ten years ago nothing has remembered with Finsen, Rollier, and the other been done. Dr. Barbary alludes to the well-known for his services to actinotherapy and the pioneers fact that the actual numbers of cases and deaths management of cutaneous tuberculosis. from whooping-cough far exceed those known to the sanitary authorities. From personal inquiry ASPIRATION FOR MAMMARY ABSCESS he found that, although very few cases had been DISSATISFIED with the results of incision and notified voluntarily, several hundreds of children drainage in a carefully controlled series of 42 caseshad been attacked by the disease in the district of abscess of the breast, Mr. R. J. V. Battle and he surveyed and of these many had died from Mr. G. N. Bailey resorted to aspiration and lavage pneumonia or broncho-pneumonia, the true cause of the abscess cavity.l As irrigating fluid they used of which, namely whooping-cough, had not been at first " bouillons vaccins," and later Dakin’s. revealed on the certificate. Dr. Barbary advocates solution, and they report results from aspiration the education of the public by means of addresses and which compare favourably with those of incision. handbills. In his view, it is essential to explode To their recommendation of aspiration as a routine the legend of the efficacity " du fameux changement treatment there are the very exceptions-notably d’air," since removal of the child results not in the large abscess that results from neglect of a small, amelioration of the attack but in the spread of localised one, and the diffuse cellulitic type of infection infection to a fresh locality. He deprecates, too, which shows localisation and severe constitupoor the practice of permitting children suffering from the tional reaction from the start. The combination disease to play with others in the street. At intervals, of a virulent infection with a poor physical condition games are interrupted while the sufferer, during a probably accounts for the incidence of this type of paroxysm, sprays his playmates with infection. breast infection. In general, Battle and Bailey It should be impressed upon the public that a few believe that the cause of breast abscess is engorgeminutes’ contact with an infective child are sufficient ment followed by infection of the stagnant secretion for the transmission of a disease which, far from being by organisms present in the ducts or gaining access trivial, may result in fatal complications. Dr. Barbary to them by way of the nipple. Cracks of the nipple declares for compulsory notification in order that increase the liability to infection in so far as pain specific measures may be taken for the detection of leads to curtailment of suckling and hence to engorge-suspects and the protection of contacts. Early ment. Aspiration is most successful when infection diagnosis is facilitated by the cough-plate method remains localised, but watch must always be kept for and should be followed by isolation. For the contacts multiple infection. Where the suppurative process Dr. Barbary advocates either passive immunisation is of the cellulitic type it is better to incise and explore by means of convalescent serum or active immunisa- with the finger until all pockets have been opened into tion by means of vaccines. one main cavity. Before starting aspiration, the The problem of the control of whooping-cough baby is taken off the affected breast, which is emptied in rural France presents the same features in urban by a pump. Battle and Bailey use a 25 c.cm. syringe England. It is true that in the large cities a com- and a needle of 2-5 mm., and they have two or three mencement towards its solution has been made by of such needles in readiness. They prefer a syringe hospitalisation upon a fairly large scale ; at the with a Luer fitting instead of the Record, which is. present time, for example, not far short of 700 too narrow in calibre. The breast surface is cleansed children suffering from whooping-cough are in the with ether, and a point with definite fluctuation, wards of the infectious diseases hospitals of the or, in patients seen before this is present, a point of London County Council. Since, however, as is the maximum tenderness, is selected. Novocain (2 per case in measles, patients are removed to hospital cent.) is injected through the tissues down to the only when the phase of maximum infectivity has abscess cavity. The wide-bore needle is inserted, passed, hospitalisation is mainly a curative measure. the pus aspirated, and an equal quantity injected 1 Bull. Acad. de Méd. de Paris, 1936, cxv., 192.
1 Brit. Jour. Surg., January, 1936, p. 640.
prophylaxis, when adequately attested, may the real solution of the problem if the public, provide as the result of education, agrees to the necessity. Vaccine
A PIONEER OF ACTINOTHERAPY
A MEMORIAL to Albert Jesionek in the Niinchener medizinische Wochenschrift of Jan. 31st is a worthy tribute to the work and personality of an outstanding dermatologist of modern times. In this country he will be remembered chiefly for the remarkable results. he obtained in all forms of cutaneous tuberculosis by purely " natural" means-viz.,diet and sunlightat- his Lupusheilstatte at Giessen. In this achievement his clinic was probably unique, for his energies were concentrated on the dermatoses; neithernor articular cases, as in many other pulmonary " WHOOPING-COUGH AND THE PUBLIC biological" institutes, shared the available space and facilities. Jesionek was a long way ahead of his. IN spite of unanimous medical opinion and thetime in formulating his problems and visualising them evidence of statistics to the contrary, the public He was no slave to this or as biological. of most countries continues to regard whooping- broadly that type of diet, lamp, or local application, and he cough as a disease of little account. Dr. F. Barbary, was rarely seen at medical congresses with some new of Nice, in a communication1 to the Paris Academy of cure or prevention. He preferred the quiet of Medicine, deplores the indifference shown in the gospel of his now famous institute at Giessen, rural districts of France. Evidently an optimist atmosphere and consistently refused the offer of larger and more then, he is disappointed now, seeing that since he drew important spheres of scientific activity. He will be attention to the matter ten years ago nothing has remembered with Finsen, Rollier, and the other been done. Dr. Barbary alludes to the well-known for his services to actinotherapy and the pioneers fact that the actual numbers of cases and deaths management of cutaneous tuberculosis. from whooping-cough far exceed those known to the sanitary authorities. From personal inquiry ASPIRATION FOR MAMMARY ABSCESS he found that, although very few cases had been DISSATISFIED with the results of incision and notified voluntarily, several hundreds of children drainage in a carefully controlled series of 42 caseshad been attacked by the disease in the district of abscess of the breast, Mr. R. J. V. Battle and he surveyed and of these many had died from Mr. G. N. Bailey resorted to aspiration and lavage pneumonia or broncho-pneumonia, the true cause of the abscess cavity.l As irrigating fluid they used of which, namely whooping-cough, had not been at first " bouillons vaccins," and later Dakin’s. revealed on the certificate. Dr. Barbary advocates solution, and they report results from aspiration the education of the public by means of addresses and which compare favourably with those of incision. handbills. In his view, it is essential to explode To their recommendation of aspiration as a routine the legend of the efficacity " du fameux changement treatment there are the very exceptions-notably d’air," since removal of the child results not in the large abscess that results from neglect of a small, amelioration of the attack but in the spread of localised one, and the diffuse cellulitic type of infection infection to a fresh locality. He deprecates, too, which shows localisation and severe constitupoor the practice of permitting children suffering from the tional reaction from the start. The combination disease to play with others in the street. At intervals, of a virulent infection with a poor physical condition games are interrupted while the sufferer, during a probably accounts for the incidence of this type of paroxysm, sprays his playmates with infection. breast infection. In general, Battle and Bailey It should be impressed upon the public that a few believe that the cause of breast abscess is engorgeminutes’ contact with an infective child are sufficient ment followed by infection of the stagnant secretion for the transmission of a disease which, far from being by organisms present in the ducts or gaining access trivial, may result in fatal complications. Dr. Barbary to them by way of the nipple. Cracks of the nipple declares for compulsory notification in order that increase the liability to infection in so far as pain specific measures may be taken for the detection of leads to curtailment of suckling and hence to engorge-suspects and the protection of contacts. Early ment. Aspiration is most successful when infection diagnosis is facilitated by the cough-plate method remains localised, but watch must always be kept for and should be followed by isolation. For the contacts multiple infection. Where the suppurative process Dr. Barbary advocates either passive immunisation is of the cellulitic type it is better to incise and explore by means of convalescent serum or active immunisa- with the finger until all pockets have been opened into tion by means of vaccines. one main cavity. Before starting aspiration, the The problem of the control of whooping-cough baby is taken off the affected breast, which is emptied in rural France presents the same features in urban by a pump. Battle and Bailey use a 25 c.cm. syringe England. It is true that in the large cities a com- and a needle of 2-5 mm., and they have two or three mencement towards its solution has been made by of such needles in readiness. They prefer a syringe hospitalisation upon a fairly large scale ; at the with a Luer fitting instead of the Record, which is. present time, for example, not far short of 700 too narrow in calibre. The breast surface is cleansed children suffering from whooping-cough are in the with ether, and a point with definite fluctuation, wards of the infectious diseases hospitals of the or, in patients seen before this is present, a point of London County Council. Since, however, as is the maximum tenderness, is selected. Novocain (2 per case in measles, patients are removed to hospital cent.) is injected through the tissues down to the only when the phase of maximum infectivity has abscess cavity. The wide-bore needle is inserted, passed, hospitalisation is mainly a curative measure. the pus aspirated, and an equal quantity injected 1 Bull. Acad. de Méd. de Paris, 1936, cxv., 192.
1 Brit. Jour. Surg., January, 1936, p. 640.