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BACTERIAL CONTENT OF ICE-CREAM.
157 is it to tell working girls not to eat whiteclerks to take more exercise in order to escape influenza when we have no gleam of certitude thyroid as to the invading agent in that disease ? Can these authorities not join the natives of the Solomon Islands or the peasants of Siberia and gorge themselves with vitamins in silence until the next pandemic carries them off:’ As to the public health authorities their produces pathological changes. The absence of some- responsibility is great. They have the power to enforce thing cannot produce anything ! In pellagra, as in investigation by the laboratories. Instead of doing beri-beri, it is believed that in the absence of some so they continue to exhibit tact in their dealings with vital element a toxin may develop and produce the their professional brethren, and diplomacy and inertia make happy bedfellows. pathological changes in the body. I am- Sir. vours faithfully. Breaking away from these gloomy reflections (which HUGH S. STANNUS. London, Jan. luth, 1927. are shared by many) I must return to my work, which will probably be less interrupted if I subscribe myself, Yours faithfully, INFLUENZA AND SOME GLOOMY
from his observations are not essentially correctnamely, that there is in pellagra: (1) A deficiency in secretion. (2) A neuritis of certain nerves in preference to others. (3) Skin lesions corresponding to tlm cutaneous distribution of those nerves." And 1 should like to protest against the view often quoted by those who hold that pellagra is a deficiency disease—namely, that the absence of some element
REFLECTIONS.
Of what
bread
or
use
to
warn
X.
Jan. Sth, 1927.
.
_
To the Editor
of THE LANCET. ADOLESCENT ALBUMINURIA. SIR,—In common with the majority of my professional To the Editor of THE LANCET. brethren 1 am at the present time called upon to visit SIR,-It must be confessed that the want of a large numbers of people suffering from some disease influenza " is perforce given. simple and reliable test for the condition of the kidneys to which the label of This annual experience is alwaysattended by con- is an opprobrium to modern medicine. The injection siderable personal fatigue and discomfort and, in my of dyes and blood examination are disappointing where most required ; indeed, there seems no reason of an case at any rate, by a certain amount of shame. The laity jibe at our profession because we cannot a priori nature why these methods should detect slight back on urinalysis two we cure a protective catchwords with renal defects. If we are thrown in are desiderata experience. The first our important my the we which to change conversation ; suppress "
cold ;
acquire
recover our self-esteem as best we can -the charge remains true. When the common cold is epidemic and approaches a severity sufficient to cause it to be renauled "influenza," the layman’s accusation becomes a serious one, and that is why I am ashamed both of myself and my profession at this moment. Nine years ago some 20 million hmnan beings died within 12 months, apparently of this same disease, and as a member of that group of their fellows which is supposed to be interested in the technique of the suppression of such catastrophes I find something frankly disgraceful in the complacent indifference of the bacteriologists, physicians, and public health authorities at a time when serious endeavour could be made towards discovering the nature and cure of this disease. Particularly are the bacteriologists to blame. Any of us who have attended their meetings and discussions have heard technicians, not all equally competent, recount their experience in growing a microbe which they call the influenza bacillus, the discussion being enlivened by adherents of hypotheses which leave death and disease unaffected. They appear to be making no serious effort to discover the causal organism. What is being done about the work of Otitzky and Gates ? Whether this work is correct or not it is sufficiently suggestive to merit largescale investigation ; it has gone on for a number of years, neither dogs nor monkeys are required for its repetition, and there is no rival set of observations with any serious number of adherents. But I have not met a single bacteriologist in this country who is actively studying this work. There are certain researches which stand out as being of such immense potential importance that any self-respecting nation should imniediately take full and proper steps to refute or confirm them. The work of Rosenthal on faecal sepsis is one instance, the work of Banting and Best on insulin is another, the work of Gye on cancer is a third, and the work of Olitzky and Gates is clearly a fourth. Yet as far as I know there is no representative body of bacteriologists in this country who can with authority tell us whether Olitzky and Gates have isolated the virus of influenza or not. And until they do we remain futile in the eyes of the layman. Phvsicians and public health authorities I blame toa lesser degree for this supineness. But physicians might at least spare us imbecile articles in the newspapers on the prevention and cure of influenza which may endanger the mental balance of the convalescent.
irritation and
is some common agreement as to what constitutes albuminuria. If one practitioner examines by heating and acidulating the upper layers of urine in the testtube, or by salicyl-sulphonic acid, while another relies on nitric acid, or on heating the bottom of the testtube, the discrepancy in results will be important. The second desideratum is the following up of the clue afforded by the modifying action of rest. One often asks oneself : What is the active element in " rest." Is it the horizontal position, equable warmth,. muscular immobility, cessation of the ingestion of proteids, or raising of a serum threshold ? This is a fascinating problem which should make appeal to many a biochemist, and which might eventually throw light on the early stages of nephritis. I am. Sir. vours faithfullvR. M. FRASER, M.D. Belfast, Jan. 4th, 1927.
BACTERIAL CONTENT OF ICE-CREAM. To the Editor
of THE LANCET.
SIR,-The report by Dr. E. G. Rawlinson that appears under this heading in THE LANCET of Dec. 18th should be of great interest to those who study health as a positive entity, and not merely as the-
absence of disease.
The evidence, I believe
so
far-
unchallenged, shows that great quantities of coliform organisms, streptococci, and B. enteritidis sporogenes were consumed in ice-cream last summer, and nobody one pennyworth the worse-i.e., no resulting epidemic reported. One wonders whether an infantile type of
reaction such as " D and V " would not have been a healthier response on the part of the consumer, especially if, as Dr. Rawlinson suggests, these organismsmay act detrimentally later on. The strains in these specimens must have come from a variety of sources, but one naturally wonders whether the one common factor, the low temperature, played a part in temporarily inactivating the cultures. Whatever the temperature of the ice-cream received at the laboratory, it is unlikely that the public would buy and eat it unless cold enough to appear semi-solid. If this is the explanation, the ice-cream vendor’s role is that of a public alimentary vaccina,tor ! The increase in numbers of street vendors and the more rapid methods used in distribution in recent years render Dr. Rawlinson’s results still more significant.—I am. Sir. yours faithfullv. J. E. CHEESMAN. Public Health Department, Leyton, K., Jan. loth, 1927.
from his observations are not essentially correctnamely, that there is in pellagra: (1) A deficiency in secretion. (2) A neuritis of certain nerves in preference to others. (3) Skin lesions corresponding to tlm cutaneous distribution of those nerves." And 1 should like to protest against the view often quoted by those who hold that pellagra is a deficiency disease—namely, that the absence of some element
REFLECTIONS.
Of what
bread
or
use
to
warn
X.
Jan. Sth, 1927.
.
_
To the Editor
of THE LANCET. ADOLESCENT ALBUMINURIA. SIR,—In common with the majority of my professional To the Editor of THE LANCET. brethren 1 am at the present time called upon to visit SIR,-It must be confessed that the want of a large numbers of people suffering from some disease influenza " is perforce given. simple and reliable test for the condition of the kidneys to which the label of This annual experience is alwaysattended by con- is an opprobrium to modern medicine. The injection siderable personal fatigue and discomfort and, in my of dyes and blood examination are disappointing where most required ; indeed, there seems no reason of an case at any rate, by a certain amount of shame. The laity jibe at our profession because we cannot a priori nature why these methods should detect slight back on urinalysis two we cure a protective catchwords with renal defects. If we are thrown in are desiderata experience. The first our important my the we which to change conversation ; suppress "
cold ;
acquire
recover our self-esteem as best we can -the charge remains true. When the common cold is epidemic and approaches a severity sufficient to cause it to be renauled "influenza," the layman’s accusation becomes a serious one, and that is why I am ashamed both of myself and my profession at this moment. Nine years ago some 20 million hmnan beings died within 12 months, apparently of this same disease, and as a member of that group of their fellows which is supposed to be interested in the technique of the suppression of such catastrophes I find something frankly disgraceful in the complacent indifference of the bacteriologists, physicians, and public health authorities at a time when serious endeavour could be made towards discovering the nature and cure of this disease. Particularly are the bacteriologists to blame. Any of us who have attended their meetings and discussions have heard technicians, not all equally competent, recount their experience in growing a microbe which they call the influenza bacillus, the discussion being enlivened by adherents of hypotheses which leave death and disease unaffected. They appear to be making no serious effort to discover the causal organism. What is being done about the work of Otitzky and Gates ? Whether this work is correct or not it is sufficiently suggestive to merit largescale investigation ; it has gone on for a number of years, neither dogs nor monkeys are required for its repetition, and there is no rival set of observations with any serious number of adherents. But I have not met a single bacteriologist in this country who is actively studying this work. There are certain researches which stand out as being of such immense potential importance that any self-respecting nation should imniediately take full and proper steps to refute or confirm them. The work of Rosenthal on faecal sepsis is one instance, the work of Banting and Best on insulin is another, the work of Gye on cancer is a third, and the work of Olitzky and Gates is clearly a fourth. Yet as far as I know there is no representative body of bacteriologists in this country who can with authority tell us whether Olitzky and Gates have isolated the virus of influenza or not. And until they do we remain futile in the eyes of the layman. Phvsicians and public health authorities I blame toa lesser degree for this supineness. But physicians might at least spare us imbecile articles in the newspapers on the prevention and cure of influenza which may endanger the mental balance of the convalescent.
irritation and
is some common agreement as to what constitutes albuminuria. If one practitioner examines by heating and acidulating the upper layers of urine in the testtube, or by salicyl-sulphonic acid, while another relies on nitric acid, or on heating the bottom of the testtube, the discrepancy in results will be important. The second desideratum is the following up of the clue afforded by the modifying action of rest. One often asks oneself : What is the active element in " rest." Is it the horizontal position, equable warmth,. muscular immobility, cessation of the ingestion of proteids, or raising of a serum threshold ? This is a fascinating problem which should make appeal to many a biochemist, and which might eventually throw light on the early stages of nephritis. I am. Sir. vours faithfullvR. M. FRASER, M.D. Belfast, Jan. 4th, 1927.
BACTERIAL CONTENT OF ICE-CREAM. To the Editor
of THE LANCET.
SIR,-The report by Dr. E. G. Rawlinson that appears under this heading in THE LANCET of Dec. 18th should be of great interest to those who study health as a positive entity, and not merely as the-
absence of disease.
The evidence, I believe
so
far-
unchallenged, shows that great quantities of coliform organisms, streptococci, and B. enteritidis sporogenes were consumed in ice-cream last summer, and nobody one pennyworth the worse-i.e., no resulting epidemic reported. One wonders whether an infantile type of
reaction such as " D and V " would not have been a healthier response on the part of the consumer, especially if, as Dr. Rawlinson suggests, these organismsmay act detrimentally later on. The strains in these specimens must have come from a variety of sources, but one naturally wonders whether the one common factor, the low temperature, played a part in temporarily inactivating the cultures. Whatever the temperature of the ice-cream received at the laboratory, it is unlikely that the public would buy and eat it unless cold enough to appear semi-solid. If this is the explanation, the ice-cream vendor’s role is that of a public alimentary vaccina,tor ! The increase in numbers of street vendors and the more rapid methods used in distribution in recent years render Dr. Rawlinson’s results still more significant.—I am. Sir. yours faithfullv. J. E. CHEESMAN. Public Health Department, Leyton, K., Jan. loth, 1927.