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COLLOIDAL SILVER IN TRENCH FEVER.
583 246 per 1000, and an infantile mortality of 101-3 of children under one year? The Chief Secretary should act
household
possible, but the constitution of his "Irish Public Health Council"has lost him the confidence of the Irish medical profession, upon whom will depend the working of any scheme he may in the future carry in Parliament. as soon as
I am,
Sir, yours faithfully,
F. R. C. S. I.
April 1st. 1919.
COLLOIDAL SILVER IN TRENCH FEVER. To the Fditor of THE LANCET. SIR,-I was interested to see in your issue of Feb. 15th
a
J. E. Sweet and Lieutenant H. B. Wilmer, U.S.M.O., on the effect of collargol in trench fever. In the winter of 1916-17 I tried a similar drug on cases of trench The preparation I used was electrargol (argent fever. colloidal électrique à petits grains) prepared by the Laboratoires Clin, Paris. I endeavoured to vary the manner and the time of administration in relation to the phases of the disease. Thus, I gave it intravenously to some of the cases, subcutaneously to others, and by both routes to yet others. I gave it intravenously every third day for three doses ; to others intravenously or subcutaneously the day of, or the day before, the expected relapsing pyrexial spike" " or bout. Sometimes I followed this by small daily subcutaneous doses. The dose varied from 5 to 10 c.cm. and the cases (about 30 in all) included examples of the acute and of the subacute (myalgic type) fever. In no single case could I satisfy myself that the drug had any effect at all on the course of the disease ; the acute cases continued to have their relapsing bouts of fever and the subacute (myalgic type) their pains. I remember seeing in theDaily Review of the Foreign Press"for February, 1918, the note regarding Richter’s findings, and I thought that his cases of trench fever and the ones I had dosed must have varied from each other to have given such different results to similar treatment. Perhaps this is the explanation that also underlies Major Sweet’s and Lieutenant Wilmer’s apparently more successful attempts than mine.-I am, Sir, yours faithfully, J. H. LLOYD, M.D. Lond., Major, R.A.M.C. T.F., 58th C.C. Station. note
by Major
In several instances where some of the attacked during the period, October and December, and the other inmates escaped, the position has been reversed in February and March. My own personal experience also points to there being a distinct immunity. I had a bad attack of influenza in 1890. I ran free through the epidemics of 1891 and 1892, and at that time congratulated myself on being immune. However, I again contracted it the end of 1893, and from that till last May I developed slight attacks each time influenza occurred. Last May I had a very severe attack with a high temperature lasting a week, insomnia, delirium, and patches of broncho-pneumonia. I resumed work in July, so far with complete immunity. My experience makes me, therefore, argue that the duration of immunity depends on the severity of the attack. I have had very little experience of the immunity conferred by vaccine treatment, but I have had several cases who developed influenza after vaccine treatment, some shortly after the vaccine and some two months afterwards. This rather suggests that a bigger dose of vaccine would give a longer immunity, and that the doses recommended at the conference held at the War Office in October last were far I am, Sir, yours faithfully, too small. JOHN GEO. GIBBON, M.D. Mullingar, March 31st, 1919. no recurrence.
were
CORNS ON BABIES’ NOSES. To the Editor of THE LANCET.
SIR,-Babies, like bull-dogs, have snub-noses to enable them to breathe while holding on to the soft, yielding skin with their mouths. In most babies the shape of the nosethe button-ended, turned-up nose-varies little ; but in races in which the parents have a hooked nose the end of the baby’s nose is often turned down into a partial hook." I once observed this shape in a baby of ancient British lineage. Careful inspection showed a smooth, yellow, flat, horny surface at the tip of the nose which seemed to compress the end into a "hook." After a few days a horny scale separated and the nose assumed the usual shape, " tiptilted, like the petal of a flower." I have seen two similar The corn reminds one of the cases in hospital patients. bill-scale or"hammer"" on the chicken’s beak which enables it to break the egg-shell, and is perhaps produced WOMEN CHIEFS? friction of the baby’s hands against the end of the To the Editor of THE LANCET. nose in utero. This friction would be favoured by scantiSIR,-I see that a body called the Women’s Watching ness of liquor amnii or vernix caseosa, as to which I have no Council has been pressing for one of the consultative councils notes in the cases mentioned. Perhaps some colleague will to the Ministry of Health to consist solely of women, and for supply the deficiency.-I am, Sir, yours faithfully, HERBERT R. SPENCER, M.D. some important appointments on the administrative staff to Harley-street, W., March 25th,1919. be similarly reserved. The position of all present municipal medical employees is that they were appointed under a system where medical HOT LIQUIDS AND CANCER. men never had to work under medical women ; as I think To the Editor of THE LANCET. rightly, because the former are vastly more numerous, and the latter, two generations of them, have never made a noteSIR,--In Mr. D’Arcy Power’s interesting Bradshaw lecture worthy discovery or even written a standard text-book ; while on Cancer of the Tongue, of which you gave a report in there is no living woman with first-rate knowledge of sanitary THE LANCET of Jan llth (p. 75) no mention is made of the science. However that may be, I think there will be trouble constant thermal irritation to which some tongues are subif the unwritten condition I have alluded to is altered. jected from tea and coffee drinking. Mr. D’Arcy Power’s I am, Sir, yours faithfully, remarks about the increased consumption of tobacco apply W. C. RIVERS. March 20th, 1919. also to that of tea and coffee, beverages which are constantly taken hot, and very frequently too hot, and thereby are ACQUIRED IMMUNITY IN INFLUENZA. produced frequent slight irritative thermal injuries on the delicate mucous membrane of the tongue. This thermal To the Editor of THE LANCET. corresponds closely to that of kangri cancer, and that SIR,-Referring to the interesting question of acquired injury of the adult male Chinaman who, sitting at the head of his influenza raised in article of immunity against your leading Mai ch 8th, 1 am of the opinion that undoubtedly an attack table, is always served first with the hot rice, and being of influenza carries with it immunity for a certain time, that about the only person in China to suffer from carcinoma of the immunity lasts for six months at least, and that the the stomach. There can be no doubt but this factor cannot duration of the immunity possibly depends on the severity of be neglected, more especially as it is notorious that the male the attack. Daring the last three waves of the epidemic I tongue is capable of comfortably supporting more irritation than the female have had to deal with the sick of 2000 (two thousand) from tobacco, hot liquids, curries, &c., we must state that syphilis, Therefore, tongue. summing up, troops, and during this time we treated in hospital over 400 cases. No cases admitted in June, July, or August tobacco, thermal irritation, and unhealthy teeth conditions are responsible factors if we wish to adopt prophylaxis in were readmitted in October, November, or December, and no cases admitted in either of these two periods treatment of lingual carcinoma. I am, Sir, yours faithfully. were readmitted in February this year. Unfortunately, M. J. PETTY, jun., M.B. Camb., F.R.C.S. Eng., I am unable to trace the cases into March as the Assistant Surgeon to the Kawson Hospital, in Buenos Aires. Feb. 20th 1919. troops were changed. Again, private practice I have had I
am,Sir,yours
faithfully,
by
household
possible, but the constitution of his "Irish Public Health Council"has lost him the confidence of the Irish medical profession, upon whom will depend the working of any scheme he may in the future carry in Parliament. as soon as
I am,
Sir, yours faithfully,
F. R. C. S. I.
April 1st. 1919.
COLLOIDAL SILVER IN TRENCH FEVER. To the Fditor of THE LANCET. SIR,-I was interested to see in your issue of Feb. 15th
a
J. E. Sweet and Lieutenant H. B. Wilmer, U.S.M.O., on the effect of collargol in trench fever. In the winter of 1916-17 I tried a similar drug on cases of trench The preparation I used was electrargol (argent fever. colloidal électrique à petits grains) prepared by the Laboratoires Clin, Paris. I endeavoured to vary the manner and the time of administration in relation to the phases of the disease. Thus, I gave it intravenously to some of the cases, subcutaneously to others, and by both routes to yet others. I gave it intravenously every third day for three doses ; to others intravenously or subcutaneously the day of, or the day before, the expected relapsing pyrexial spike" " or bout. Sometimes I followed this by small daily subcutaneous doses. The dose varied from 5 to 10 c.cm. and the cases (about 30 in all) included examples of the acute and of the subacute (myalgic type) fever. In no single case could I satisfy myself that the drug had any effect at all on the course of the disease ; the acute cases continued to have their relapsing bouts of fever and the subacute (myalgic type) their pains. I remember seeing in theDaily Review of the Foreign Press"for February, 1918, the note regarding Richter’s findings, and I thought that his cases of trench fever and the ones I had dosed must have varied from each other to have given such different results to similar treatment. Perhaps this is the explanation that also underlies Major Sweet’s and Lieutenant Wilmer’s apparently more successful attempts than mine.-I am, Sir, yours faithfully, J. H. LLOYD, M.D. Lond., Major, R.A.M.C. T.F., 58th C.C. Station. note
by Major
In several instances where some of the attacked during the period, October and December, and the other inmates escaped, the position has been reversed in February and March. My own personal experience also points to there being a distinct immunity. I had a bad attack of influenza in 1890. I ran free through the epidemics of 1891 and 1892, and at that time congratulated myself on being immune. However, I again contracted it the end of 1893, and from that till last May I developed slight attacks each time influenza occurred. Last May I had a very severe attack with a high temperature lasting a week, insomnia, delirium, and patches of broncho-pneumonia. I resumed work in July, so far with complete immunity. My experience makes me, therefore, argue that the duration of immunity depends on the severity of the attack. I have had very little experience of the immunity conferred by vaccine treatment, but I have had several cases who developed influenza after vaccine treatment, some shortly after the vaccine and some two months afterwards. This rather suggests that a bigger dose of vaccine would give a longer immunity, and that the doses recommended at the conference held at the War Office in October last were far I am, Sir, yours faithfully, too small. JOHN GEO. GIBBON, M.D. Mullingar, March 31st, 1919. no recurrence.
were
CORNS ON BABIES’ NOSES. To the Editor of THE LANCET.
SIR,-Babies, like bull-dogs, have snub-noses to enable them to breathe while holding on to the soft, yielding skin with their mouths. In most babies the shape of the nosethe button-ended, turned-up nose-varies little ; but in races in which the parents have a hooked nose the end of the baby’s nose is often turned down into a partial hook." I once observed this shape in a baby of ancient British lineage. Careful inspection showed a smooth, yellow, flat, horny surface at the tip of the nose which seemed to compress the end into a "hook." After a few days a horny scale separated and the nose assumed the usual shape, " tiptilted, like the petal of a flower." I have seen two similar The corn reminds one of the cases in hospital patients. bill-scale or"hammer"" on the chicken’s beak which enables it to break the egg-shell, and is perhaps produced WOMEN CHIEFS? friction of the baby’s hands against the end of the To the Editor of THE LANCET. nose in utero. This friction would be favoured by scantiSIR,-I see that a body called the Women’s Watching ness of liquor amnii or vernix caseosa, as to which I have no Council has been pressing for one of the consultative councils notes in the cases mentioned. Perhaps some colleague will to the Ministry of Health to consist solely of women, and for supply the deficiency.-I am, Sir, yours faithfully, HERBERT R. SPENCER, M.D. some important appointments on the administrative staff to Harley-street, W., March 25th,1919. be similarly reserved. The position of all present municipal medical employees is that they were appointed under a system where medical HOT LIQUIDS AND CANCER. men never had to work under medical women ; as I think To the Editor of THE LANCET. rightly, because the former are vastly more numerous, and the latter, two generations of them, have never made a noteSIR,--In Mr. D’Arcy Power’s interesting Bradshaw lecture worthy discovery or even written a standard text-book ; while on Cancer of the Tongue, of which you gave a report in there is no living woman with first-rate knowledge of sanitary THE LANCET of Jan llth (p. 75) no mention is made of the science. However that may be, I think there will be trouble constant thermal irritation to which some tongues are subif the unwritten condition I have alluded to is altered. jected from tea and coffee drinking. Mr. D’Arcy Power’s I am, Sir, yours faithfully, remarks about the increased consumption of tobacco apply W. C. RIVERS. March 20th, 1919. also to that of tea and coffee, beverages which are constantly taken hot, and very frequently too hot, and thereby are ACQUIRED IMMUNITY IN INFLUENZA. produced frequent slight irritative thermal injuries on the delicate mucous membrane of the tongue. This thermal To the Editor of THE LANCET. corresponds closely to that of kangri cancer, and that SIR,-Referring to the interesting question of acquired injury of the adult male Chinaman who, sitting at the head of his influenza raised in article of immunity against your leading Mai ch 8th, 1 am of the opinion that undoubtedly an attack table, is always served first with the hot rice, and being of influenza carries with it immunity for a certain time, that about the only person in China to suffer from carcinoma of the immunity lasts for six months at least, and that the the stomach. There can be no doubt but this factor cannot duration of the immunity possibly depends on the severity of be neglected, more especially as it is notorious that the male the attack. Daring the last three waves of the epidemic I tongue is capable of comfortably supporting more irritation than the female have had to deal with the sick of 2000 (two thousand) from tobacco, hot liquids, curries, &c., we must state that syphilis, Therefore, tongue. summing up, troops, and during this time we treated in hospital over 400 cases. No cases admitted in June, July, or August tobacco, thermal irritation, and unhealthy teeth conditions are responsible factors if we wish to adopt prophylaxis in were readmitted in October, November, or December, and no cases admitted in either of these two periods treatment of lingual carcinoma. I am, Sir, yours faithfully. were readmitted in February this year. Unfortunately, M. J. PETTY, jun., M.B. Camb., F.R.C.S. Eng., I am unable to trace the cases into March as the Assistant Surgeon to the Kawson Hospital, in Buenos Aires. Feb. 20th 1919. troops were changed. Again, private practice I have had I
am,Sir,yours
faithfully,
by