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BERI-BERI IN A WHALING EXPEDITION.
377
Correspondence. "Audi alteram partem."
RADIUM OR EXCISION FOR EPITHELIOMA OF THE TONGUE. To the Editor
of
THE LANCET.
commercially desirable, but are there no prospects of non-poisonous preparations being produced which will satisfy the requirements of farmer or gardener ? Quite apart from statute, there is a common-law duty of persons who possess poisons to take good care that they are so securely kept as not to be a source of injury to others. If it be true that weed-
killer is sometimes sold to minors or others without adequate inquiry, it would seem that this common-law duty is not discharged.-ED. L.
SiR,-Mr. Ogilvie’s letter contains a fallacy which appears likely to provide difficulties whenever any BERI-BERI IN A WHALING EXPEDITION. attempt is made to compare statistically the results To the Ed’itor of THE LANCET. of surgical treatment with those of treatment by radium, in that he does not take into account the was much interested in your annotation SIR,-I operability rate. To compare Regaud’s figures, (p. 250) on Dr. Nissen’s experience of beri-beri in an which are based on cases of which only some 20 per antarctic whaling During the 1927-28 cent. were operable when submitted to treatment, season I was in theexpedition. antarctic as medical officer on a with those of surgical excision which were necessarily and was called on several occasions to all to the whaling ship is to reduce statistical
operable,
comparison point which appears to me to be of far greater importance than statistics can ever convey is the fact that the patient treated by surgery is necessarily a mutilated patient, the one treated by radium is not. Actually the time has not yet come when statistical comparison between surgery and radium can fruitfully be made, but if we consider the patient as a human being rather than as a unit in d group of figures, then, in the case of cancer of the tongue at any rate, there can be little doubt as to absurd.
A further
which method has the most to offer him. I am, Sir, yours faithfully, E. G. SLESINGER. Wimpole-street, W., Feb. 9th, 1930.
other
ships
to
see cases
of beri-beri.
I had with
me a
quantity of marmite which I gave in small quamtities to these cases. The improvement shown in the few days prior to the men being sent to the base was so striking that I put in a strong recomvery limited
mendation to the company that in future all their ships should have an adequate supply of marmite on board, to be used for the prophylaxis of beri-beri. This has, I believe, been done with excellent results. I am, Sir, yours faithfully, JOHN B. Edinburgh, Feb. 5th, 1930.
ROLT, M.B.
SPINAL ANÆSTHESIA. To the Editor
of
THE LANCET.
THE SALE OF WEED-KILLER. To the Editor of THE LANCET. to direct your attention to a matter wish SIR,-I of grave importance-it is this : although no lay person can obtain poisons from a chemist without giving his or her name and address, anyone can go to an oil shop and purchase enough weed-killer to end the days of 50 persons without being asked
SiB,—Dr. Howard Jones says the explanation of the escape of the phrenic motor roots when numbness in the neck follows a novocain injection is simple ; and he suggests that it is as follows :" (1) The upper remnant of a heavy solution tends to affect the posterior roots more than the anterior." Quite so, but I am using a lighter solution. Clouds of witnesses will testify to this. They have seen the any questions. In the inquest on the Stanley family cerebro-spinal fluid as it comes into the syringe drop it was stated that a teaspoonful of weed-killer was by drop fall to the bottom leaving the spinocain or a fatal dose, and that mixed with ordinary food May and Baker’s solution at the top. The tendency it was quite tasteless. What a terrible state of therefore would be for it to affect the anterior roots. affairs this is, and how unsatisfactory for the medical " (2) The concentration in the cervical region is too dilute
a doctor cannot know that the patient to affect motor fibres." has taken weed-killer until he has had the vomit A few months ago I saw a patient unconscious, analysed, but by that time the patient is dead, analgesic from head to foot, and pulseless, whom the I trust you so that nothing can be done for him. to be dead-not only dead, but will use your influence to have this state of affairs surgeon declared that he smelt dead (this was partially true, for he had altered as soon as possible. four feet of completely gangrenous gut inside the I am, Sir, yours faithfully, I declared to be alive, simply on ERIC CLINE, M.R.C.S. Eng., L.R.C.P. Lond. abdomen)-whom the grounds that he was breathing regularly, albeit Feb. 1930. Weybridge, 8th, quietly. This ground proved to be solid rock, and * * Our correspondent rightly draws attention to the he recovered. Here, then, apparently Dr. Jones and perilous ease with which weed-killer can be purchased. I are agreed, that the concentration in the cervical But The law is not now so vigorous as in the time ofI region is too dilute to affect the motor fibres. Henry VIII. when, after a deplorable incident in the concentration used was amply sufficient for all the Bishop of Rochester’s household, Parliament operative procedures. In other words, in the conimposed on persons found guilty of wilful poisoning centration commonly used and necessary, novocain the penalty of being boiled to death. Nowadays, in paralyses receptors, leaving the phrenic motor roots, fipite of restrictions on the sale and possession of nerves, and diaphragm active. One case is not enough, so let me quote Jonesco, poisons and " dangerous drugs," a would-be murderer can easily equip himself with a tin of the right stuff who, using mostly stovaine, but also novocain, records at an oil store. The Arsenic Act of 1851 is still 1387 cases which he injected " au dessous de la upon the statute-book, but Section 2 of the Poisons proeminente," with successful analgesia without and Pharmacy Act of 1908 seems more anxious fatality. Here again the concentration in the cervical to encourage the sale of sheep-dip and weed-killer region was too dilute to affect the motor fibres-for than to protect His Majesty’s lieges from being all these patients must have breathed. The paper poisoned. The Section provides that sale is to be of Koster and Kasman, to which you referred in your under licence of the local authority and subject issue of Jan. 18th (p. 145), shows that novocain will to regulations. It is commonly said that local not paralyse the phrenics; it does not offer any authorities take these responsibilities lightly and explanation of the paralysis of the abdominal muscles. that the few formalities required by the regulations I think it is a fair inference from their paper to suppose .are neither widely known nor invariably observed. that in the strength used novocain paralyses Facilities for buying sheep-dip and weed-killer are abdominal muscles merely by cutting off afferent
profession ;
Correspondence. "Audi alteram partem."
RADIUM OR EXCISION FOR EPITHELIOMA OF THE TONGUE. To the Editor
of
THE LANCET.
commercially desirable, but are there no prospects of non-poisonous preparations being produced which will satisfy the requirements of farmer or gardener ? Quite apart from statute, there is a common-law duty of persons who possess poisons to take good care that they are so securely kept as not to be a source of injury to others. If it be true that weed-
killer is sometimes sold to minors or others without adequate inquiry, it would seem that this common-law duty is not discharged.-ED. L.
SiR,-Mr. Ogilvie’s letter contains a fallacy which appears likely to provide difficulties whenever any BERI-BERI IN A WHALING EXPEDITION. attempt is made to compare statistically the results To the Ed’itor of THE LANCET. of surgical treatment with those of treatment by radium, in that he does not take into account the was much interested in your annotation SIR,-I operability rate. To compare Regaud’s figures, (p. 250) on Dr. Nissen’s experience of beri-beri in an which are based on cases of which only some 20 per antarctic whaling During the 1927-28 cent. were operable when submitted to treatment, season I was in theexpedition. antarctic as medical officer on a with those of surgical excision which were necessarily and was called on several occasions to all to the whaling ship is to reduce statistical
operable,
comparison point which appears to me to be of far greater importance than statistics can ever convey is the fact that the patient treated by surgery is necessarily a mutilated patient, the one treated by radium is not. Actually the time has not yet come when statistical comparison between surgery and radium can fruitfully be made, but if we consider the patient as a human being rather than as a unit in d group of figures, then, in the case of cancer of the tongue at any rate, there can be little doubt as to absurd.
A further
which method has the most to offer him. I am, Sir, yours faithfully, E. G. SLESINGER. Wimpole-street, W., Feb. 9th, 1930.
other
ships
to
see cases
of beri-beri.
I had with
me a
quantity of marmite which I gave in small quamtities to these cases. The improvement shown in the few days prior to the men being sent to the base was so striking that I put in a strong recomvery limited
mendation to the company that in future all their ships should have an adequate supply of marmite on board, to be used for the prophylaxis of beri-beri. This has, I believe, been done with excellent results. I am, Sir, yours faithfully, JOHN B. Edinburgh, Feb. 5th, 1930.
ROLT, M.B.
SPINAL ANÆSTHESIA. To the Editor
of
THE LANCET.
THE SALE OF WEED-KILLER. To the Editor of THE LANCET. to direct your attention to a matter wish SIR,-I of grave importance-it is this : although no lay person can obtain poisons from a chemist without giving his or her name and address, anyone can go to an oil shop and purchase enough weed-killer to end the days of 50 persons without being asked
SiB,—Dr. Howard Jones says the explanation of the escape of the phrenic motor roots when numbness in the neck follows a novocain injection is simple ; and he suggests that it is as follows :" (1) The upper remnant of a heavy solution tends to affect the posterior roots more than the anterior." Quite so, but I am using a lighter solution. Clouds of witnesses will testify to this. They have seen the any questions. In the inquest on the Stanley family cerebro-spinal fluid as it comes into the syringe drop it was stated that a teaspoonful of weed-killer was by drop fall to the bottom leaving the spinocain or a fatal dose, and that mixed with ordinary food May and Baker’s solution at the top. The tendency it was quite tasteless. What a terrible state of therefore would be for it to affect the anterior roots. affairs this is, and how unsatisfactory for the medical " (2) The concentration in the cervical region is too dilute
a doctor cannot know that the patient to affect motor fibres." has taken weed-killer until he has had the vomit A few months ago I saw a patient unconscious, analysed, but by that time the patient is dead, analgesic from head to foot, and pulseless, whom the I trust you so that nothing can be done for him. to be dead-not only dead, but will use your influence to have this state of affairs surgeon declared that he smelt dead (this was partially true, for he had altered as soon as possible. four feet of completely gangrenous gut inside the I am, Sir, yours faithfully, I declared to be alive, simply on ERIC CLINE, M.R.C.S. Eng., L.R.C.P. Lond. abdomen)-whom the grounds that he was breathing regularly, albeit Feb. 1930. Weybridge, 8th, quietly. This ground proved to be solid rock, and * * Our correspondent rightly draws attention to the he recovered. Here, then, apparently Dr. Jones and perilous ease with which weed-killer can be purchased. I are agreed, that the concentration in the cervical But The law is not now so vigorous as in the time ofI region is too dilute to affect the motor fibres. Henry VIII. when, after a deplorable incident in the concentration used was amply sufficient for all the Bishop of Rochester’s household, Parliament operative procedures. In other words, in the conimposed on persons found guilty of wilful poisoning centration commonly used and necessary, novocain the penalty of being boiled to death. Nowadays, in paralyses receptors, leaving the phrenic motor roots, fipite of restrictions on the sale and possession of nerves, and diaphragm active. One case is not enough, so let me quote Jonesco, poisons and " dangerous drugs," a would-be murderer can easily equip himself with a tin of the right stuff who, using mostly stovaine, but also novocain, records at an oil store. The Arsenic Act of 1851 is still 1387 cases which he injected " au dessous de la upon the statute-book, but Section 2 of the Poisons proeminente," with successful analgesia without and Pharmacy Act of 1908 seems more anxious fatality. Here again the concentration in the cervical to encourage the sale of sheep-dip and weed-killer region was too dilute to affect the motor fibres-for than to protect His Majesty’s lieges from being all these patients must have breathed. The paper poisoned. The Section provides that sale is to be of Koster and Kasman, to which you referred in your under licence of the local authority and subject issue of Jan. 18th (p. 145), shows that novocain will to regulations. It is commonly said that local not paralyse the phrenics; it does not offer any authorities take these responsibilities lightly and explanation of the paralysis of the abdominal muscles. that the few formalities required by the regulations I think it is a fair inference from their paper to suppose .are neither widely known nor invariably observed. that in the strength used novocain paralyses Facilities for buying sheep-dip and weed-killer are abdominal muscles merely by cutting off afferent
profession ;