CANCER OF THE CERVIX.

1264 a recent test has been found to lung, the gall-bladder, and elsewhere are common its enough. On the other hand, tumours derived from preserve antigenic specificity unimpaired. It would seem that the best way to proceed is to squamous epithelium may show such lack of difprepare antiserum to each of the types of meningo- ferentiation that their source can only be suspected. coccus separately, and to pool these sera for use Experience may enable us to recognise them for what until the type of the coccus infecting the patient is they are, but as individuals they merit no more known, and then to employ monotypical serum. This definite a name than carcinoma simplex. is sometimes said to be impracticable, but we did it If Prof. Browne has in mind the squamous-celled during the latter part of the war, and the results carcinoma of, say, the gall-bladder when he refuses were encouraging. At least, all samples of poly- to define a squamous epithelioma as a cancer derived valent serum should contain demonstrable antibody from squamous epithelium, there is much to be said to Type I. for his point of view. If, however, he prefers a Last summer the Medical Research Council invited cytological to a histogenetic classification he will a conference of representatives of the three Fighting increase our difficulties considerably unless he takes Services, of the Ministry of Health, and of those account of the abnormal potentialities of the maliginterested in the manufacture and supply of this nant cell. I am, Sir, yours faithfully, kind of serum, for the discussion of the various E. H. KETTLE. St. Bartholomew’s Hospital, problems involved. Two practical results have followed the recommendations of the conference. The Council have secured the supply of diagnostic antiTo the Editor of THE LANCET. meningococcus sera from their Standards Laboratory at Oxford. These are now announced as ready for SIR,—Prof. F. J. Browne’s letter in your issue of Their use will allow the identification of Nov. 28th contains opinions which few will issue. accept. meningococcus type in the event of any outbreak His novel definition of a squamous epithelioma is of cerebro-spinal fever, and indicate the therapeutic unlikely to meet with general approval, for it excludes serum to be used. Arrangements have also been from this category any squamous-celled carcinoma made for the manufacture of polyvalent serum, in which does not contain prickle cells, and it denies the preparation of which the various strains of that a squamous epithelioma may be derived from organisms isolated from different outbreaks of the the basal cells of squamous epithelium. I think disease have been collected through the Ministry of it unlikely that present views will be modified by the Health laboratory. opinion of Prof. Browne. The same arguments that Unless I am greatly mistaken, treatment both I used in my letter of Nov. 21st can still be used prophylactic and therapeutic by specific antisera will against Prof. Browne’s point of view. The common be in demand more and more as immunological know- form of carcinoma of the cervix is a squamousledge advances. In the prevention and treatment of celled growth, and the differences from a carcinoma virus diseases of man, for instance, the application of the skin can quite adequately be explained along of specific antisera is at present in its earliest infancy. the lines indicated in my previous letter. I am, Sir, yours faithfully, I do not think that Prof. Browne’s sugAgain, M. H. GORDON. gested classification of the forms of carcinoma of the St. Bartholomew’s Hospital, cervix will be much favoured. The subject has been dealt with already in Germany, France, and America, and Prof. Browne’s scheme cannot compare with CANCER OF THE CERVIX. those that have been published in these countries. To the Editor of THE LANCET. I am, Sir, yours faithfully, WILFRED SHAW. SiR,-The classification and labelling of tumours a has been source of pleasure to many, and, indeed, it is a very agreeable pastime so long as it is not pursued too seriously. But there has always been a CALCIUM IN BRONCHIAL ASTHMA. tendency on the part of certain exponents of the To the Editor of THE LANCET. game to introduce a system of conventions which converts what should be a pleasant relaxation for SIR,—Ihave read with great interest Dr. Camthe many into a serious occupation for the few. midge’s account of two cases of bronchial asthma Many of these conventions come from America, their in your issue of Nov. 14th (p. 1070), although some natural home, but Krompecher, who first recognised of his findings, especially the calcium-content of the the basal-celled carcinoma, must be held responsible blood and his inferences drawn therefrom, do not for the confusion which surrounds the squamous- entirely comport with my experience. The lessened celled carcinomata, a confusion to which I am sorry calcium-content which he found does not, in my to see Prof. F. J. Browne contributing. Surely any opinion, place asthma among the deficiency diseases. attempt to force the tumours derived from squamous I would not place this deficiency in the line of causaepithelium into fixed and unalterable groups must tion but a step further on as an effect, a natural fail from the very nature of the tissue concerned. attempt at cure. Prickle cells, granular cells, and squames are merely In pneumonia there is a great deficiency of calcium stages in the development of the cells of the Mal- in the blood, and one of the earliest signs of the pighian layer, every one of which is a potential disease is an almost complete absence of calcium in The malignant epithelial tumour may the urine. squame. The calcium is thrown out with the reproduce with exactitude normal epithelium, or it fibrin into the air cells, and there is very little left may be so dedifferentiated or anaplastic as to fail to to be excreted in the urine. The more tough and form not only granular and horny cells but even scanty the expectoration the better the prognosis, prickle cells. Every pathologist could produce basal- while, on the other hand, the more liquid and haemorcelled carcinomata which show here and there rhagic the expectoration the worse the prognosis. excellent differentiation ; and perfectly typical meta- Thus plenty of calcium in the blood and high blood plastic squamous-celled carcinomata occurring in the pressure stand in the line of prevention and cure.

Cultures, and in