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CONTROL OF MEASLES
226
CORRESPONDENCE CONTROL OF MEASLES ’.1’0 the Li’f.a2tor
OJ
THE LANCET
SiR,—Dr. J. D. Rolleston’s historical resume of the subject of the serum prophylaxis of measles in your last issue (p. 168) was of great interest. Stating that Dr. Brincker was incorrect in his belief that the first attempt to modify measles in this way was first made only 40 years ago he refers to Frances Home’s pioneer work on this subject in 1765. He then states that Dr. Hugh Thompson, of Glasgow, employed this method successfully in two cases (1890). I was able to discuss this with the late Sir Leslie Mackenzie just before his death, and he then informed me that Thompson had subsequently published a considerably larger series of cases with similar results. I am unfortunately unable to find any reference to this series, and it would be of considerable interest to hear if any of your readers are able to give information with regard to this. I believe that I am correct in saying with regard to the modern method of prophylaxis and attenuation of measles by means of convalescent serum that I was the first to introduce it to this country some years prior1 to the epidemic of 1929-30 in which it was used with such success. I am, Sir, yours faithfully, W. S. C. C. COPEMAN. COPEMAN. Harley-street, W., Jan. 20th. SYNTROPAN IN SEA-SICKNESS
To the Editor
of
THE LANCET
SiR,—May I draw your attention to the effectiveness of the new synthetic vagus depressor, Syntropan, in sea-sickness. As ship’s surgeon travelling between Australia and London, and vice versa, during two very stormy periods, I have had some rather intensive experience. The first trip, homeward bound, in November-December, was made in a severe Mediterranean storm, and a severe Atlantic storm in which the wind reached gale force, as recorded in the ship’s log, for the best part of ten days. Conditions aboard ship were at their worst, and most passengers were sick-some exceedingly sick. On the outward journey in July-August, the monsoon was at its height, a man being lost overboard from a sister ship passing us. There were seven days of bad weather and much sickness. A total of 140 cases of sea-sickness was treated, 100 with Syntropan preparation No. 2190/14, and 40 with Vasano, and with the usual mixture of hyoscyamine and bromide. Syntropan and vasano were equally effective in removing almost instantly the feelings of nausea that precede the sickness. The hyoscyamus mixture was not so effective in ambulatory When vasano was replaced by syntropan, the passengers thereafter preferred the syntropan preparation because it did not give rise to the intensely dry mouth which is also produced by hyoscyamus. Two tablets, morning and afternoon, served to cure the worst cases. The usual difficulty in dealing with patients unable to keep the tablets down was overcome by using suppositories of the same material. Passengers who were occasionally overcome, when given two tablets of the syntropan preparation, were almost immediately restored, so that the efficiency of the preparation became a subject cases.
1 Jour. of Hyg., 1925, xxiv., 427 ; Proc. Roy. Sec. Med. (Sec. Epidem.), 1927, xx., 1609.
of comment ; one tablet sufficed in mild cases. Moreover, I cured a fellow officer, and myself, just as rapidly, by taking two tablets when the stage of real discomfort had been reached. Why syntropan should act so effectively on the gastric vagus and have so little action on the salivary parasympathetic supply, is not at all clear ; it may be a matter of differential rates of penetration of the drug into the neighbourhood of the various parasympathetic endings that is the explanation. The result, however, is remarkable, and anyone knowing the discomfort of the dry mouth produced by hyoscyamine will agree that a remedy so effective as that reported is indeed worthy of mention. The composition of the preparation is as follows :-
Syntropan...... Sedormid
......
0’01 g. 0’1 g. per tablet.
syntropan being phosphate of the 3-diethylamino2-2-dimethyl-propylester of tropic acid. I am, Sir, yours faithfully, C. STANTON HICKS, Nov. 6th, 1935.
Professor of Pharmacology and Human Physiology, University of Adelaide.
DR. ALBERT GRAY’S
TECHNIQUE
To the Editor
of THE amplification
LANCET
of the account of SiR,—May I in Dr. Albert Gray’s work contained in your obituary notice last week add something about the method of making transparencies of the membranous labyrinth which he devised and employed with such success in his work " The Labyrinth of Animals." This process yields at one stage perfect casts of the bony labyrinth, but the finished product is much more than a cast and contains all the structures of the membranous labyrinth, perfectly cleared and I am, Sir, yours faithfully, preserved. C. S. HALLPIKE. Ferens Institute of Otology, Middlesex Hospital Annexe, Jan. 20th.
COLLAPSE THERAPY IN PLEURISY AND PNEUMONIA To the Editor
of THE
LANCET
SIR,-I read with much interest the observations of Dr. C. Shaw in your issue of Dec. 7th, 1935 (p. 1280), on artificial pneumothorax for the relief of acute pleural pain. I made observations on 12 cases so treated (Calcutta Med. Jour., August, 1934) which did well and I remarked : " It was quite reasonable to think that it should be so, because the partial collapse of the lung at once stopped friction between the two inflamed layers of the pleura, gave rest to the diseased area, relieved local congestion and pain and hastened repair and convalescence. Further, by maintaining this state of partial collapse by
giving
more
fillings afterwards, healing
was
perfect, and
the chance of relapse or formation of adhesion or effusion was very much minimised. The author is in touch with some of these cases for over two years and they are keeping
perfectly
fit."
I read with equal interest Dr. W. E. Robertson’s paper in the same issue of THE LANCET (p. 1282), for I had treated similarly 20 cases of pneumonia with excellent results-only 3 deaths-my main difficulty being to find a sufficient number of suitable cases. Since the influenza pandemic of 1918-19, the infective organisms of acute catarrh of the respiratory
CORRESPONDENCE CONTROL OF MEASLES ’.1’0 the Li’f.a2tor
OJ
THE LANCET
SiR,—Dr. J. D. Rolleston’s historical resume of the subject of the serum prophylaxis of measles in your last issue (p. 168) was of great interest. Stating that Dr. Brincker was incorrect in his belief that the first attempt to modify measles in this way was first made only 40 years ago he refers to Frances Home’s pioneer work on this subject in 1765. He then states that Dr. Hugh Thompson, of Glasgow, employed this method successfully in two cases (1890). I was able to discuss this with the late Sir Leslie Mackenzie just before his death, and he then informed me that Thompson had subsequently published a considerably larger series of cases with similar results. I am unfortunately unable to find any reference to this series, and it would be of considerable interest to hear if any of your readers are able to give information with regard to this. I believe that I am correct in saying with regard to the modern method of prophylaxis and attenuation of measles by means of convalescent serum that I was the first to introduce it to this country some years prior1 to the epidemic of 1929-30 in which it was used with such success. I am, Sir, yours faithfully, W. S. C. C. COPEMAN. COPEMAN. Harley-street, W., Jan. 20th. SYNTROPAN IN SEA-SICKNESS
To the Editor
of
THE LANCET
SiR,—May I draw your attention to the effectiveness of the new synthetic vagus depressor, Syntropan, in sea-sickness. As ship’s surgeon travelling between Australia and London, and vice versa, during two very stormy periods, I have had some rather intensive experience. The first trip, homeward bound, in November-December, was made in a severe Mediterranean storm, and a severe Atlantic storm in which the wind reached gale force, as recorded in the ship’s log, for the best part of ten days. Conditions aboard ship were at their worst, and most passengers were sick-some exceedingly sick. On the outward journey in July-August, the monsoon was at its height, a man being lost overboard from a sister ship passing us. There were seven days of bad weather and much sickness. A total of 140 cases of sea-sickness was treated, 100 with Syntropan preparation No. 2190/14, and 40 with Vasano, and with the usual mixture of hyoscyamine and bromide. Syntropan and vasano were equally effective in removing almost instantly the feelings of nausea that precede the sickness. The hyoscyamus mixture was not so effective in ambulatory When vasano was replaced by syntropan, the passengers thereafter preferred the syntropan preparation because it did not give rise to the intensely dry mouth which is also produced by hyoscyamus. Two tablets, morning and afternoon, served to cure the worst cases. The usual difficulty in dealing with patients unable to keep the tablets down was overcome by using suppositories of the same material. Passengers who were occasionally overcome, when given two tablets of the syntropan preparation, were almost immediately restored, so that the efficiency of the preparation became a subject cases.
1 Jour. of Hyg., 1925, xxiv., 427 ; Proc. Roy. Sec. Med. (Sec. Epidem.), 1927, xx., 1609.
of comment ; one tablet sufficed in mild cases. Moreover, I cured a fellow officer, and myself, just as rapidly, by taking two tablets when the stage of real discomfort had been reached. Why syntropan should act so effectively on the gastric vagus and have so little action on the salivary parasympathetic supply, is not at all clear ; it may be a matter of differential rates of penetration of the drug into the neighbourhood of the various parasympathetic endings that is the explanation. The result, however, is remarkable, and anyone knowing the discomfort of the dry mouth produced by hyoscyamine will agree that a remedy so effective as that reported is indeed worthy of mention. The composition of the preparation is as follows :-
Syntropan...... Sedormid
......
0’01 g. 0’1 g. per tablet.
syntropan being phosphate of the 3-diethylamino2-2-dimethyl-propylester of tropic acid. I am, Sir, yours faithfully, C. STANTON HICKS, Nov. 6th, 1935.
Professor of Pharmacology and Human Physiology, University of Adelaide.
DR. ALBERT GRAY’S
TECHNIQUE
To the Editor
of THE amplification
LANCET
of the account of SiR,—May I in Dr. Albert Gray’s work contained in your obituary notice last week add something about the method of making transparencies of the membranous labyrinth which he devised and employed with such success in his work " The Labyrinth of Animals." This process yields at one stage perfect casts of the bony labyrinth, but the finished product is much more than a cast and contains all the structures of the membranous labyrinth, perfectly cleared and I am, Sir, yours faithfully, preserved. C. S. HALLPIKE. Ferens Institute of Otology, Middlesex Hospital Annexe, Jan. 20th.
COLLAPSE THERAPY IN PLEURISY AND PNEUMONIA To the Editor
of THE
LANCET
SIR,-I read with much interest the observations of Dr. C. Shaw in your issue of Dec. 7th, 1935 (p. 1280), on artificial pneumothorax for the relief of acute pleural pain. I made observations on 12 cases so treated (Calcutta Med. Jour., August, 1934) which did well and I remarked : " It was quite reasonable to think that it should be so, because the partial collapse of the lung at once stopped friction between the two inflamed layers of the pleura, gave rest to the diseased area, relieved local congestion and pain and hastened repair and convalescence. Further, by maintaining this state of partial collapse by
giving
more
fillings afterwards, healing
was
perfect, and
the chance of relapse or formation of adhesion or effusion was very much minimised. The author is in touch with some of these cases for over two years and they are keeping
perfectly
fit."
I read with equal interest Dr. W. E. Robertson’s paper in the same issue of THE LANCET (p. 1282), for I had treated similarly 20 cases of pneumonia with excellent results-only 3 deaths-my main difficulty being to find a sufficient number of suitable cases. Since the influenza pandemic of 1918-19, the infective organisms of acute catarrh of the respiratory