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BIRTH CONTROL.
414 sufficient without exposure to ultra-violet rays, but in severe and recurrent cases it is invaluable. The method is also indicated in sclero-keratitis and in some conjunctival affections, which fail to improve under ordinary measures : among these Mr. Duke-Elder includes trachoma but not spring catarrh. For applying the rays to the upper conjunctival fornix he has devised a special form of application to be used with his lamp.
efficacy of the commercial preparation
was found to be double that of the crude ointment as measured by the quantitative urinary excretion of uric acid. This heightened activity is attributed to the soap fat basis. It will be remembered that the question of the toxicity of phenyl-cinchoninic acid was fully discussed in our own columns not long ago by Dr. Geoffrey Evans and Dr. A. W.
Spence.2 BIRTH CONTROL.
Population Conference at Geneva in September, 1927, a body was formed called the International Medical Group for the Investigation of Birth Control. The second annual issue3 of their report, which is now obtainable, contains contributions from six different countries, those from Great Britain and the United States being the longest. The papers are for the most part written according to a common plan, the headings of which are : Statistical investigations, research work of a relevant kind, information about the general temper of the country towards birth miscellaneous remarks." control, and The section most likely to prove interesting to English medical readers is the one which concerns Great Britain, written by Dr. C. P. Blacker. In this article an attempt is made to summarise what is known statistically of the value of different contraceptive methods. These are found to be less effective than is generally assumed. The data analysed are those of certain birth control clinics. Among patients with whom the clinics maintain touch, the various methods taught are found in one way or another to be unsatisfactory by a percentage that ranges from 9 per cent. (Walworth) to 24 per cent. (North Kensington). Among patients with whom the clinic fails to maintain contact, a small number of whom were visited in their homes by a social worker of the North Kensington Clinic, the percentage is higher. In the United States the method which is thought the most reliable, and which is most usually taught, is a combination of pessary and spermaticidal jelly. The follow-up system that prevails in the American clinic, whose figures are analysed, is very thorough. It is interesting, therefore, to note that for this combination of methods, as taught in America, the " failure rate " is only5 per cent. It is acknowledged that the figures on which the British percentages are based are inadequate. A satisfactory system of keeping case records has only been evolved after much experience and thought, and the early records from which the percentages have been extracted are both incomplete and unsatisfactory. Even so, however, the figures give cause for disquietude. Nevertheless the report as a whole is encouraging in that it foreshadows the possibility of great improvement in contraceptive technique as a result
HOLIDAYS FOR FACTORY GIRLS.
AT the
To the Editor
SIR,—You have on many other occasions shown your sympathy with factory girls in need of a holiday, and have earned their sincere gratitude by allowing us to appeal through your columns to the generosity of your readers. May we again, in circumstances of urgency, invoke your friendly aid ? In heat such as we have experienced lately in our crowded towns, one longs more than ever for a dip in the sea or for a breath of air on the hills ; for meals out of doors, lunch in a bathing suit on the sands, a picnic tea
"
of certain research now in progress. The report attempts to appraise impartially the value of contraceptive methods in use in different countries, and to summarise medical information about birth control as it In view of the becomes known in different countries. great sociological importance of contraception it is possible that future reports may have considerable influence both at home and abroad.
’
under the shade of the trees. Whatever indeed the weather may be, one looks forward throughout the year to the summer holiday, for many the only appreciable holiday, in the hope that it will bring respite and rest and renewal of health. Some of your readers will know of hopes for a holiday frustrated, of plans long made brought to nought at the last moment. Those who have not been so unfortunate can at least imagine the bitter disappointment caused by the loss of a holiady long due. Such a disappointment will assuredly fall to many tired workers in factories this summer unless your readers, to whose generosity we appeal, are able to come to the rescue. Many factory girls who have done their best to make some provision for a holiday by putting aside their pence throughout the year, are waiting to go away ; but the funds which seek to supplement their savings are exhausted. We ask your readers to replenish them. The help thus given is accepted with lasting gratitude. It blesses those who give and those who take. Many letters, written by the girls in a spirit of deep thankfulness and describing the varied delights of a change of air and scene, testify eloquently to this. Quotations from such letters may be seen in the report of the fund. The fund helps chiefly the poorest class of factory workers. It helps those who, being often the main support of their families, are quite unable in this matter adequately to help themselves. They need this summer holiday, and one has only to see them before and after it to realise what wonders such a holiday can work. Subscriptions and donations will be thankfully received and acknowledged by the hon. treasurer, Mrs. Slater, or Miss Canney, 75, Lamb’s Conduit-street, London, W.C. 1. We are, Sir, yours faithfully, ALBERTA SANDWICH, (Signed) KATHERINE ATHOLL, A. F. LONDON, W. PETT RIDGE, ANNE SLATER (Hon. Treas.). J. FREDK. GREEN
ULTRA-VIOLET RAYS IN OPHTHALMOLOGY. THE positive and negative indications for the use of ultra-violet rays in diseases of the eye are defined in a recent paper by Mr. W. S. Duke-Elder.4 Tuberculous iridocyclitis, he says, is especially suitable for general light treatment combined with tuberculin, and another disease in which its value is very great is phlyctenular keratoconjunctivitis. In chronic cases, especially when general light baths are used in association with local application of light, the disease can almost invariably be overcome, although corneal opacities once formed may be permanent. The more important part of Mr. Duke-Elder’s paper concerns the local application of ultra-violet rays, for which he has devised a special ophthalmic radiation lamp. Many inflammatory and degenerative affections of the anterior segment of the eye are amenable to this treatment, but it is essential that it should be undertaken only by specially skilled hands, since an error in the focusing might easily cause permanent injury to the lens. For this reason it is only suitable for diseases of the cornea, iris, sclera, and conjunctiva. Pathogenic micro-organisms are killed, also the superficial cells of damaged corneal epithelium, and an intense vascular reaction floods the diseased cornea with bactericidal influences. Almost any kind of corneal ulcer, including hypopyon ulcer, responds well to the treatment. In mild affections the usual therapeutic methods may be 2 THE LANCET, 1929, i., 704. 3 Obtainable from the Hon. Mrs. Marjorie Farrer, 41B, Clanricarde-gardens, London, W. Price 6d. 4 Brit. Jour. Actinother. and Physiother,, July, 1929, p. 82.
of THE LANCET.
(Chairman).
A DISCLAIMER. To the Editor of THE LANCET.
SIR,—Reference an article in your issue of August 10th headed " An Ingenious Truss," describing an apparatus manufactured by the Uterpress Co., and named by them the " Colquhoun " truss, I should be glad if you will publish this, which is to the effect that I have no interest in the name, manufacture, or sale of the truss mentioned. I am, Sir, yours faithfully, GIDEON COLQUHOUN, F.R.C.S.
NATIONAL
HOSPITAL
FOR
THE
PARALYSED
AND
QUEEN-SQUARE.—Last year 1464 in-patients were treated at the hospital itself, at the Convalescent Home at East Finchley, and at Lonsdale House, Clapham, the EPILEPTIC,
branch for disabled sailors and soldiers. The cost of maintenance was £39,177, which exceeded the income by 24795. The board are anxious for the preservation of Queen-square House Garden, since the amenities of the hospital would be seriously affected if it were built over.
efficacy of the commercial preparation
was found to be double that of the crude ointment as measured by the quantitative urinary excretion of uric acid. This heightened activity is attributed to the soap fat basis. It will be remembered that the question of the toxicity of phenyl-cinchoninic acid was fully discussed in our own columns not long ago by Dr. Geoffrey Evans and Dr. A. W.
Spence.2 BIRTH CONTROL.
Population Conference at Geneva in September, 1927, a body was formed called the International Medical Group for the Investigation of Birth Control. The second annual issue3 of their report, which is now obtainable, contains contributions from six different countries, those from Great Britain and the United States being the longest. The papers are for the most part written according to a common plan, the headings of which are : Statistical investigations, research work of a relevant kind, information about the general temper of the country towards birth miscellaneous remarks." control, and The section most likely to prove interesting to English medical readers is the one which concerns Great Britain, written by Dr. C. P. Blacker. In this article an attempt is made to summarise what is known statistically of the value of different contraceptive methods. These are found to be less effective than is generally assumed. The data analysed are those of certain birth control clinics. Among patients with whom the clinics maintain touch, the various methods taught are found in one way or another to be unsatisfactory by a percentage that ranges from 9 per cent. (Walworth) to 24 per cent. (North Kensington). Among patients with whom the clinic fails to maintain contact, a small number of whom were visited in their homes by a social worker of the North Kensington Clinic, the percentage is higher. In the United States the method which is thought the most reliable, and which is most usually taught, is a combination of pessary and spermaticidal jelly. The follow-up system that prevails in the American clinic, whose figures are analysed, is very thorough. It is interesting, therefore, to note that for this combination of methods, as taught in America, the " failure rate " is only5 per cent. It is acknowledged that the figures on which the British percentages are based are inadequate. A satisfactory system of keeping case records has only been evolved after much experience and thought, and the early records from which the percentages have been extracted are both incomplete and unsatisfactory. Even so, however, the figures give cause for disquietude. Nevertheless the report as a whole is encouraging in that it foreshadows the possibility of great improvement in contraceptive technique as a result
HOLIDAYS FOR FACTORY GIRLS.
AT the
To the Editor
SIR,—You have on many other occasions shown your sympathy with factory girls in need of a holiday, and have earned their sincere gratitude by allowing us to appeal through your columns to the generosity of your readers. May we again, in circumstances of urgency, invoke your friendly aid ? In heat such as we have experienced lately in our crowded towns, one longs more than ever for a dip in the sea or for a breath of air on the hills ; for meals out of doors, lunch in a bathing suit on the sands, a picnic tea
"
of certain research now in progress. The report attempts to appraise impartially the value of contraceptive methods in use in different countries, and to summarise medical information about birth control as it In view of the becomes known in different countries. great sociological importance of contraception it is possible that future reports may have considerable influence both at home and abroad.
’
under the shade of the trees. Whatever indeed the weather may be, one looks forward throughout the year to the summer holiday, for many the only appreciable holiday, in the hope that it will bring respite and rest and renewal of health. Some of your readers will know of hopes for a holiday frustrated, of plans long made brought to nought at the last moment. Those who have not been so unfortunate can at least imagine the bitter disappointment caused by the loss of a holiady long due. Such a disappointment will assuredly fall to many tired workers in factories this summer unless your readers, to whose generosity we appeal, are able to come to the rescue. Many factory girls who have done their best to make some provision for a holiday by putting aside their pence throughout the year, are waiting to go away ; but the funds which seek to supplement their savings are exhausted. We ask your readers to replenish them. The help thus given is accepted with lasting gratitude. It blesses those who give and those who take. Many letters, written by the girls in a spirit of deep thankfulness and describing the varied delights of a change of air and scene, testify eloquently to this. Quotations from such letters may be seen in the report of the fund. The fund helps chiefly the poorest class of factory workers. It helps those who, being often the main support of their families, are quite unable in this matter adequately to help themselves. They need this summer holiday, and one has only to see them before and after it to realise what wonders such a holiday can work. Subscriptions and donations will be thankfully received and acknowledged by the hon. treasurer, Mrs. Slater, or Miss Canney, 75, Lamb’s Conduit-street, London, W.C. 1. We are, Sir, yours faithfully, ALBERTA SANDWICH, (Signed) KATHERINE ATHOLL, A. F. LONDON, W. PETT RIDGE, ANNE SLATER (Hon. Treas.). J. FREDK. GREEN
ULTRA-VIOLET RAYS IN OPHTHALMOLOGY. THE positive and negative indications for the use of ultra-violet rays in diseases of the eye are defined in a recent paper by Mr. W. S. Duke-Elder.4 Tuberculous iridocyclitis, he says, is especially suitable for general light treatment combined with tuberculin, and another disease in which its value is very great is phlyctenular keratoconjunctivitis. In chronic cases, especially when general light baths are used in association with local application of light, the disease can almost invariably be overcome, although corneal opacities once formed may be permanent. The more important part of Mr. Duke-Elder’s paper concerns the local application of ultra-violet rays, for which he has devised a special ophthalmic radiation lamp. Many inflammatory and degenerative affections of the anterior segment of the eye are amenable to this treatment, but it is essential that it should be undertaken only by specially skilled hands, since an error in the focusing might easily cause permanent injury to the lens. For this reason it is only suitable for diseases of the cornea, iris, sclera, and conjunctiva. Pathogenic micro-organisms are killed, also the superficial cells of damaged corneal epithelium, and an intense vascular reaction floods the diseased cornea with bactericidal influences. Almost any kind of corneal ulcer, including hypopyon ulcer, responds well to the treatment. In mild affections the usual therapeutic methods may be 2 THE LANCET, 1929, i., 704. 3 Obtainable from the Hon. Mrs. Marjorie Farrer, 41B, Clanricarde-gardens, London, W. Price 6d. 4 Brit. Jour. Actinother. and Physiother,, July, 1929, p. 82.
of THE LANCET.
(Chairman).
A DISCLAIMER. To the Editor of THE LANCET.
SIR,—Reference an article in your issue of August 10th headed " An Ingenious Truss," describing an apparatus manufactured by the Uterpress Co., and named by them the " Colquhoun " truss, I should be glad if you will publish this, which is to the effect that I have no interest in the name, manufacture, or sale of the truss mentioned. I am, Sir, yours faithfully, GIDEON COLQUHOUN, F.R.C.S.
NATIONAL
HOSPITAL
FOR
THE
PARALYSED
AND
QUEEN-SQUARE.—Last year 1464 in-patients were treated at the hospital itself, at the Convalescent Home at East Finchley, and at Lonsdale House, Clapham, the EPILEPTIC,
branch for disabled sailors and soldiers. The cost of maintenance was £39,177, which exceeded the income by 24795. The board are anxious for the preservation of Queen-square House Garden, since the amenities of the hospital would be seriously affected if it were built over.