- Email: [email protected]
BLOOD-SUGAR IN ENCEPHALITIS.
885
Might not this be the of doing so ; this loss may be sudden and not due to of the greater incidence in present times ?P any infection that can be recognised at an autopsy. One should be extremely careful not to confuse the If the rate at which the men are lowered is the cause issue by including in evidence in favour of recovery of the disease, then the remedy is obvious. There is such a pother as to whether deficient from diabetes mellitus any case in which there has illumination or some toxic gas is the actual cause of been recovery from an infection. Cases of mild miners’ nystagmus that I humbly venture the above hypoglycopyresis appear to be suffering from true diabetes mellitus when absorbing toxins. tentative theory, at least as a potent factor. I am, Sir, yours faithfully, I am, Sir, yours faithfully, - - .J. PROSSER DAVIES, M.B., B.S. Lond. O. LEYTON. Portland-place, W., April 14th, 1926. Cardiff, April 16th, 1926.
and to much greater depths. cause
-
_
THE NEW HEALTH SOCIETY. To the Editor of THE LANCET. SiR,-We are very grateful to you for your appreciative article and kindly criticisms of the activities of the New Health Society. I am sure you will realise the aim of this Society is to reach the mass of the public who are sadly lacking in the knowledge of the rudimentary laws of health. The motto of the members of our Council is simplicity. We do not consider that controversial or medical questions should occupy a very prominent portion in the pages of our Bulletin, believing the proper place for such matters to be the pages of THE LANCET. In the early days of health propaganda, the necessary reiteration of the four primary laws of health of the body, as so simply and lucidly put by one of our Council, as fresh air, fresh water, fresh food, and a good drainage system, must have appeared monotonous to the instructed. We are always pleased to receive kindly criticism from a journal so justly popular, not only with the medical profession, but also with the lay public. I am, Sir, yours faithfully, W. ARBUTHNOT LANE, Sentinel House, Southampton-row, W.C., President. April 16th, 1926.
DIABETES. A RECOVERABLE DISEASE. To the Editor of THE LANCET. SIR,-I should like to congratulate Dr. Chapman Dr. Percival upon the success they have had with patients who were treated upon the lines I advocated In even before insulin was available in this country. February, 1923,1 I expressed the view that it was not hypoglycaemia that would prove the greatest danger when insulin could be given by all who practised medicine. The real danger would be the administration of too little insulin for the diet prescribed; this would lead to the sugar in the blood being kept at too high a level, and the pancreas would degenerate completely. This prophecy has proved correct and has been the experience of those who have either adopted the view expressed by Prof. H. MacLean in May, 1923,2 that diabetes mellitus is essentially a progressive disease, and therefore not attempted to keep the blood of their patients below some arbitrary percentage, or who have not had the facilities to do this. In February, 1925,3 I published curves of the rise in the sugar in the blood after intravenous injections of sugar before and after courses of insulin which had rendered the patients hypoglyceemic for several weeks. These demonstrated an improvement in the sugar-burning and/or storing mechanism. Although more than 450 cases of diabetes mellitus have been treated with insulin under my supervision, I should hesitate to express definitely the view that the disease is recoverable or that it is essentially progressive. The term diabetes mellitus is applied to several different conditions. The proof of this lies in the fact that some patients suffering from hyperglycaemia without any ascertainable infection do not react to insulin even when it is injected in enormous doses. Again occasionally, it is true rarely, a patient who has reacted to insulin loses the power
BLOOD-SUGAR IN ENCEPHALITIS. To the Editor of THE LANCET. SiR,—We have read with interest the article of Dr. McCowan and others (THE LANCET, April 17th, p. 802) on blood-sugar in encephalitis lethargica ; the more so, as we have recently made similar investigations with entirely different results. Of the five cases in which, amongst other things, we studied the glucose tolerance, basal metabolism, and nitrogen balance, the first was of a boy recovered from the acute stage of the illness and without Parkinsonism and the other four were Parkinsonian in type ; of these four, one showed pronounced stupor, two were typical examples of
myoclonic. In all five the by serial estimations of blood-sugar by the method of Folin and Wu, was definitely normal in type, without hyperglyceemia, and in one case (the stuporose) slightly suggestive of
bradykinesia,
Brit. Med. Jour., 1923, i., 709. THE LANCET, 1923, i., 1039. 3 Practitioner, February, 1925. 2
one was as shown
increased tolerance. In this last case, which appears to be similar to Dr. McCowan’s case whose glucose tolerance is illustrated by his Fig. 4, the flatness of our curve is in marked contrast to his parabola. As. determination of nitrogen and basal metabolism in these cases also gave normal results, the total N output being always less than intake and the basal metabolic rate showing very little variation from normal, we feel that our findings in the matter of glucose tolerance are, in some degree, confirmed. We are, Sir, yours faithfully, H. S. PEMBERTON. W. D. JEANS. Liverpool, April 19th, 1926.
andI
1
and
glucose tolerance,
IONIC MEDICATION. To the Editor
of THE
LANCET. SIR,-In your annotation on Mr. Morphy’s valuable paper on Ionic Medication in Dentistry, as well as in his paper, there is a point which I think should be corrected. The term " nascent"should be limited to the property shown by ions as they become atoms-that is, when they are about to give up an excess charge of electrons or are about to take up electrons to make up a deficiency. This occurs, as the primary or secondary effect of an electric current, at the contact of ions with metal or carbon electrodes with which they are not entering into chemical combination. There is no evidence to show that when ions form fresh comin the tissues there is any action due to a pounds " nascent " condition. I believe Mr. Morphy adopted this suggestion from the paper by Dr. David.Campbell, to which he refers. Dr. Campbell in that paper used the term " nascent " for conditions to which, in my opinion, it is not applicable. I am, Sir, yours faithfully, A. R. FRIEL. Devonshire-place, W., April 19th, 1926.
NEURITIS
I
AND
NEURALGIA.
To the Editor 0/THE LAN CRT. SrR,—Your reviewer in last week’s issue is "surprised to find no apparent description of, or reference " to, metatarsalgia ... which he very kindly goes on to say appears to be the only neuralgic condition not described in my book. If he will turn to the last chapter on Neuro-Fibrositis, page 409, line 6, he will find the reference to metatarsalgia which he has overlooked.-I am, Sir, yours faithfully, H
WILFRED HARRIS. BVimpole-street, W., April 20th, 1926.
Might not this be the of doing so ; this loss may be sudden and not due to of the greater incidence in present times ?P any infection that can be recognised at an autopsy. One should be extremely careful not to confuse the If the rate at which the men are lowered is the cause issue by including in evidence in favour of recovery of the disease, then the remedy is obvious. There is such a pother as to whether deficient from diabetes mellitus any case in which there has illumination or some toxic gas is the actual cause of been recovery from an infection. Cases of mild miners’ nystagmus that I humbly venture the above hypoglycopyresis appear to be suffering from true diabetes mellitus when absorbing toxins. tentative theory, at least as a potent factor. I am, Sir, yours faithfully, I am, Sir, yours faithfully, - - .J. PROSSER DAVIES, M.B., B.S. Lond. O. LEYTON. Portland-place, W., April 14th, 1926. Cardiff, April 16th, 1926.
and to much greater depths. cause
-
_
THE NEW HEALTH SOCIETY. To the Editor of THE LANCET. SiR,-We are very grateful to you for your appreciative article and kindly criticisms of the activities of the New Health Society. I am sure you will realise the aim of this Society is to reach the mass of the public who are sadly lacking in the knowledge of the rudimentary laws of health. The motto of the members of our Council is simplicity. We do not consider that controversial or medical questions should occupy a very prominent portion in the pages of our Bulletin, believing the proper place for such matters to be the pages of THE LANCET. In the early days of health propaganda, the necessary reiteration of the four primary laws of health of the body, as so simply and lucidly put by one of our Council, as fresh air, fresh water, fresh food, and a good drainage system, must have appeared monotonous to the instructed. We are always pleased to receive kindly criticism from a journal so justly popular, not only with the medical profession, but also with the lay public. I am, Sir, yours faithfully, W. ARBUTHNOT LANE, Sentinel House, Southampton-row, W.C., President. April 16th, 1926.
DIABETES. A RECOVERABLE DISEASE. To the Editor of THE LANCET. SIR,-I should like to congratulate Dr. Chapman Dr. Percival upon the success they have had with patients who were treated upon the lines I advocated In even before insulin was available in this country. February, 1923,1 I expressed the view that it was not hypoglycaemia that would prove the greatest danger when insulin could be given by all who practised medicine. The real danger would be the administration of too little insulin for the diet prescribed; this would lead to the sugar in the blood being kept at too high a level, and the pancreas would degenerate completely. This prophecy has proved correct and has been the experience of those who have either adopted the view expressed by Prof. H. MacLean in May, 1923,2 that diabetes mellitus is essentially a progressive disease, and therefore not attempted to keep the blood of their patients below some arbitrary percentage, or who have not had the facilities to do this. In February, 1925,3 I published curves of the rise in the sugar in the blood after intravenous injections of sugar before and after courses of insulin which had rendered the patients hypoglyceemic for several weeks. These demonstrated an improvement in the sugar-burning and/or storing mechanism. Although more than 450 cases of diabetes mellitus have been treated with insulin under my supervision, I should hesitate to express definitely the view that the disease is recoverable or that it is essentially progressive. The term diabetes mellitus is applied to several different conditions. The proof of this lies in the fact that some patients suffering from hyperglycaemia without any ascertainable infection do not react to insulin even when it is injected in enormous doses. Again occasionally, it is true rarely, a patient who has reacted to insulin loses the power
BLOOD-SUGAR IN ENCEPHALITIS. To the Editor of THE LANCET. SiR,—We have read with interest the article of Dr. McCowan and others (THE LANCET, April 17th, p. 802) on blood-sugar in encephalitis lethargica ; the more so, as we have recently made similar investigations with entirely different results. Of the five cases in which, amongst other things, we studied the glucose tolerance, basal metabolism, and nitrogen balance, the first was of a boy recovered from the acute stage of the illness and without Parkinsonism and the other four were Parkinsonian in type ; of these four, one showed pronounced stupor, two were typical examples of
myoclonic. In all five the by serial estimations of blood-sugar by the method of Folin and Wu, was definitely normal in type, without hyperglyceemia, and in one case (the stuporose) slightly suggestive of
bradykinesia,
Brit. Med. Jour., 1923, i., 709. THE LANCET, 1923, i., 1039. 3 Practitioner, February, 1925. 2
one was as shown
increased tolerance. In this last case, which appears to be similar to Dr. McCowan’s case whose glucose tolerance is illustrated by his Fig. 4, the flatness of our curve is in marked contrast to his parabola. As. determination of nitrogen and basal metabolism in these cases also gave normal results, the total N output being always less than intake and the basal metabolic rate showing very little variation from normal, we feel that our findings in the matter of glucose tolerance are, in some degree, confirmed. We are, Sir, yours faithfully, H. S. PEMBERTON. W. D. JEANS. Liverpool, April 19th, 1926.
andI
1
and
glucose tolerance,
IONIC MEDICATION. To the Editor
of THE
LANCET. SIR,-In your annotation on Mr. Morphy’s valuable paper on Ionic Medication in Dentistry, as well as in his paper, there is a point which I think should be corrected. The term " nascent"should be limited to the property shown by ions as they become atoms-that is, when they are about to give up an excess charge of electrons or are about to take up electrons to make up a deficiency. This occurs, as the primary or secondary effect of an electric current, at the contact of ions with metal or carbon electrodes with which they are not entering into chemical combination. There is no evidence to show that when ions form fresh comin the tissues there is any action due to a pounds " nascent " condition. I believe Mr. Morphy adopted this suggestion from the paper by Dr. David.Campbell, to which he refers. Dr. Campbell in that paper used the term " nascent " for conditions to which, in my opinion, it is not applicable. I am, Sir, yours faithfully, A. R. FRIEL. Devonshire-place, W., April 19th, 1926.
NEURITIS
I
AND
NEURALGIA.
To the Editor 0/THE LAN CRT. SrR,—Your reviewer in last week’s issue is "surprised to find no apparent description of, or reference " to, metatarsalgia ... which he very kindly goes on to say appears to be the only neuralgic condition not described in my book. If he will turn to the last chapter on Neuro-Fibrositis, page 409, line 6, he will find the reference to metatarsalgia which he has overlooked.-I am, Sir, yours faithfully, H
WILFRED HARRIS. BVimpole-street, W., April 20th, 1926.