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DIATHERMY BY THE HIGH-FREQUENCY APPARATUS.
BY THE HIGH-FREQUENCY APPARATUS. DIATHERMY ..
1677
^. deducible from these observationsfallen from 7 per cent. in 1906 to 1’4 in 1910 and 1 per cent. has to go short of water for onein 1911. Employments are very carefully provided for the.day the effect on the water available for perspiration, thatmen’s spare time; thus the band is voluntary; there areis, for temperature regulation, may persist, even in a well- picture shows, tennis-courts, and company baseball com-The mere fact that a petitions. Men stand service in the Canal Zone best on their’ trained man, for about 48 hours. plentiful supply of water is available on the next day will first visit ; recruits endure the tropics best. Captain G. H. only tend to increase his urinary secretion, not to redress at Richardson used tincture of iodine (7 per cent.) as an appli-once the disturbance in water content of his dehydrated cation to all erythemata and blisters about the feet, telling tissues....... It is extremely important to regulate the the men to report themselves next day. ’’ All who reported-’ but in not from to also the of were course well and needed no further treatment." Likeday day, only invariably supply every day." 2. The importance of training in lessening the so many continental surgeons, he is concerning himself with, demand for "water available " due almost certainly to more the best method of carrying iodine tincture on active service. efficient" condition. As long as a man is soft his water- At the meeting of the association Major Charles Lynch, thesupply needs far more careful regulation than it does editor of the Military Svrgeon, handed in his resignation,. when he has got into good campaigning condition. (The which was received with regret, and the association presented’ fluid actually drunk did not include alcoholic stimulants.) him with a silver salver to mark its appreciation of the’ Spinal Analgesia is the subject of a paper by Major J. W. H. zeal and ability with which he has conducted this splendidlyHoughton, which he concludes by recommending the method educational paper. The association took the greatest interest. to those engaged in surgical work as being most useful in the in the account of the field training of the Royal Army army. In a series of 400 operations under spinal analgesia Medical Corps at Aldershot as it was detailed to them byat the Cambridge Hospital, Aldershot, the injection was Lieutenant-Colonel S. Hickson, R.A.M.C., and Major E. L. quite satisfactory, and in none was there any cause for anxiety Munson declared that the medical officers of the Royal ArmyThe Training and Working of Medical Corps had reached the goal to which they in theas to the patient’s condition.l an Indian Sanitary Section are discussed by Major R. Tilbury United States were striving. DEATHS IN THE SERVICES. Brown ; and an ex-soldier (G. Fahey), of the 88th Connaught Rangers, whose interesting and useful articles on Practical Thomas Stick Veale, late I.M.S., Brigade-Surgeon Hints on Marching and Health on Active Service were in his eighty-second year. He served in the-’ recently recently concluded, now takes up the subject of rations on Indian Mutiny, 1857-58 ; with the Bhootan Expedition, active service. Under the title of Organic Development on 1865-66 ; and in the Afghan war, 1879-80 (a medal on each) the Earth: the Evidence and its Meaning, Colonel R. F. Firth occasion). He was a surgeon at the Army Civil Hospital at. systematises some thoughts which were suggested to him by Renkioi during the Crimean war. a perusal of Dr. Arthur Keith’s Hunterian Lectures for 1912 HEALTH OF THE ARMY IN 1911. on Certain Phases in the Evolution of Man. The annual report on the health of theDirector-General’s THE MILITARY SURGEON. for the year 1911 (Vol. LIII.) has just been published army In the November issue is a full account of the annual His Majesty’s Stationery Office, and is now on sale at themeeting of the Association of Military Surgeons, U.S.A., at by of ls. 8d. each copy. In his introductory letter to theBaltimore, Maryland, in October. There a paper was read price of the War Office, Sir William Gubbins states that Secretary by Surgeon-Major S. H. Chang, of the Chinese War Office, the improvement in the health of the troops is maintained,. on Health and Individual Sanitation on Active Service, in and it is satisfactory to report that the ratios for admissions. which, with many other excellent rules, he advised that, if to hospital, invalids discharged, and the average numberwater should not be available for clothes washing, the soldier sick are the lowest recorded, while those forconstantly should be taught to brush his underclothing thoroughly with deaths and invalids sent home are practically the same as’ a stiff clothes brush, especially about the seams, and then last year, which were up till then the lowest on record. expose it to sunlight, for in campaign it is sometimes hard to prevent vermin," as was the experience often in South Africa. Major E. L. Munson, in a most important paper, shows that the fate of nations has at times been altered by the ruin brought on their armies by preventable diseases. Thus he holds that the promising plans of the United Audi alteraI.ù partem." States for the capture of Canada in 1775-6 were brought to ruin mainly by small-pox, dysentery, and camp diseases. The armies started from the United States some 4000 DIATHERMY BY THE HIGH-FREQUENCY APPARATUS. strong ; both were ruined by disease. At the last, Quebec was besieged by an American force which had dwindled to To the Editor of THE LANCET. 1600 men, of whom 900 were sick and 700 only were fit for SIR,-In a communication to the Sixth International duty. Small-pox killed more men than did the enemy. A of Medical Electrology and Radiology, held laot Congress surgeon of that time describes the camps : " Their camp is that at the Third Inter-nastier than anything I could conceive, their latrines, October at Prague, I pointed out of held in Paris in April, national Physiotherapy, Congress kitchens, graves, and places for slaughtering cattle all mixed Dr. Nagelsmith, of Berlin, presented a communication 1910, Munson the of Then quotes great expedition Major up.’’ on diathermy, or thermopenetration, by the use of a special Napoleon to St. Domingo in 18OZ. More than 0,000 men landed there in February, 10,000 later. 15,000 men perished apparatus with which I have had an opportunity of experiof yellow fever in two months ; in six months the force was menting upon myself, first in Barcelona, and subsequentlythe Charite, Paris. Diathermy, however, is not a annihilated, and Napoleon’s great scheme to establish France at as Dr. Nagelsmith would have us believe. novel method, in Louisiana was shattered. As a result he sold it to the United States, which, no longer hemmed in on the west by He regards it as a recent method, superior to d’Arson-In the discussion Dr. Bouchon very rightly the Mississippi, had the way clear to the Pacific Coast. valisation. Mahan introduced historians to"The Influence of Sea Power remarked that the thermic action of high-frequency currents. was made known in 1901, through a communication by Pro-on History " ; perhaps his countryman Major Munson may
discipline are
which
seem
:-1. ’’ That if
a man
"
Correspondence. "
d’Arsonval to the Academy of Sciences, in which. companion work on ’’ The Influence of Sanitation fessor he says that a person will clearly experience the sensation of when we will as his that he take motto History," hope on taking hold with his hands of the poles of a small pregnant saying of the great Sidney Herbert, prevention heat solenoid. Dr. Cicera Salse. of Barcelona, also presented a us cure us Assistant gives soldiers, gives pensioners." of the local diathermic applications of high-frequency Surgeon-General W. C. Rucker, of the Public Health study the Congress at Barcelona Dr. Bonnefoy, of Service, gave an address on the Master Key of Sanitation, currents.in In a communication on the action of high-frequency Cannes, the principle that was behind all preventive work, and that, he said, was non-promiscuity ; keeping disease away from currents on the circulation and the temperature of thethat since 1903 he had published in the one, by avoiding the persons, parasites, or things infected organism, reported or carrying it. P. A. Surgeon I. G. Liegler tells us Annals of Electrobiology many clinical cases proving the In October, 1904, that the sick list of a marine detachment at Panama has thermic effects of d’Arsonvalisation. in a further study he had published other observa1 ee THE LANCET, Oct. 12th, 1912, p. 1003. tions confirming the first, and a year later he had,
yet give
us a
on
,
THE THERAPEUTICS OF SCARLET RED.
1678
to the British Electro-therapeutic Society a .further communication dealing with the same subject. . :Subsequently to this, Dr. W. F. Sommerville, of Glasgow, -undertook his very interesting thermometric researches which proved the influence of high-frequency currents dn theelevation of temperature. But Dr. Bonnefoy, in his remarkable book on arthritism and its treatment by the ! -high-frequency and high-tension currents, observes that the .sensation of heat can be obtained after many daily applications. He also says that in cases in which after 15 or 20 .days’ treatment heat is not yet felt, he makes two applica’’’.tions daily, and so obtains the desired result in the course of .a few days. For more than four years I made applications of high-frequency currents by the condensator bed, like Dr. Bonnefoy, but after a treatment lasting several days my patients scarcely felt heat. Among them one (H. M.), after ’-treatment lasting many months, never experienced the --slightest sensation of heat. At the Congress at Barcelona in September, 1910, the --statement of Professor Doumer that the condensator bed But on seemed to him doomed to disappear surprised me. return Cairo I discarded At to condensator bed. my my - first I connected one pole of the small solenoid with a bifurcated wire joined to two manchons,"which are held The other pole is attached by a single ,one in each hand. wire to a plate fixed on a wooden plank, on which the patient ,places his bare feet. By this means I felt from the first the .heat in the arms exactly as with the special apparatus of Beiniger, Gebbert, and Schall. H. M., who with the condensator bed had never felt the heat before, declared at the second application by this method that he felt it well. In August, 1911, I treated H. C.. a female patient, who was suffering from elephantiasic obesity, and who weighed M6 kilos. Every day before the light bath she had an application of diathermy for a quarter of an hour. Immediately - cafter the first application she declared that she felt the ’heat up to the shoulders, and in a week’s time she felt it ’"very deeply all over the body, more than in the light bath. -J. C., an arthritic male, 65 years old, declared at the end of the first application of ten minutes that he felt the heat all over his body. On the following days he began to perspire five minutes from the beginning of the application, and in ten minutes the perspiration dropped down his face and
presented
-
and the symptoms disappeared, only to return a week later when its use was resumed. On a third attempt no toxic symptoms occurred. In regard to Lyle’s case it may be remarked that similar effects have followed the application of boric ointment itself to large raw areas. I personally use a 6 per cent. ointment, and in some 110 cases have not found any such untoward results. I am. Sir, vours faithfully, JAMES RAE. Park Hospital, Hither Green, Lewisham, S.E., Dec. 3rd, 1912.
THE HISTOLOGY OF EXPERIMENTAL RHEUMATISM.
To the Editor of THE LANCET. SIR,-I note that neither Dr. R. Miller nor Dr. Carey Coombs, nor Professor J. M. Beattie, is opposed to the view that the Irheumococcus " is present in the normal alimentary tract. The fact that Dr. T. J. Horder was led to demonstrate this point primarily as the result of application of my differential tests to streptococci isolated from cases of malignant endocarditis is certainly not evidence of their unsoundness. I regard the question whether or no the streptococcus most abundant in normal human saliva can produce the microscopic le-ions of acute rheumatism in the rabbit as all-important in the present connexion, because if this is so then we can, perhaps, understand how the blood in cases of acute rheumatism shows no growth; for is not the local focus already present ? and how common it is to get negative blood cultures in instances where streptococcus pyogenes is the local infecting agent-e.g., in cases of cellulitis and in some types of puerperal sepsis. I wish to thank Professor Beattie and Dr. E. W. Ainley Walker for their last letters, and I have hopes that as the result of the present correspondence we are beginning to get what the diplomatists call a basis for an agreement." I am the last person to deny the importance of adaptation among bacteria, and especially among streptococci as brought out by Dr. Walker, and I repeat that neither I nor anyone else has claimed for the tests a specific value. Much more work will have to be done before we can arrive at ,hands. a decision on this matter, What I do maintain, both from For the last two years I have adopted this simple modificaown experience and from that of others, is that my my ’tion. Among my patients were a corpulent middle-aged streptococcus tests are capable of giving reliable evidence as ’.Egyptian and an English lady of great stature. At the end to the source and significance of a streptococcus as met with ’,of the first application they declared that they felt the heat in cultures from the human body, or from air, dust, sewage, ,f1 over the body to the extent of almost perspiring, notwith- or other media contaminated recently by material derived standing that it was in winter. I hope that this simplified from the alimentary tract of man or animals, such as mode of treatment by the high-frequency current may soon the horse. be applied on a large scale and may take the high place it Furthermore, Sir, I venture to think that it would be a deserves in therapeutics for the welfare of the patients. great advantage and a saving of time if we had in this I am, Sir, yours faithfully, a specially qualified Court of Appeal to which country Dr.S.C DAMOGLOU. Cairo, Nov. 9th, 1912. matters such as are at present under dispute could be submitted. This committee could hear both sides, weigh the THE THERAPEUTICS OF SCARLET RED. evidence, do their own experiments, and arrive at a decision. If research in medicine is to become organised, as appears To the -Editor of THE LANCET. possible under the Insurance Act, some such tribunal would SIR,-Your annotation of Sept. 30th, 1911, on the probably be of much value in defining our knowledge on a ’therapeutics of scarlet red induced me then to give my own variety of controversial subjects, not the least important of rheumatism ; and if to their experience of the preparation. At that time I did not know which is the etiology of acutethe members of this tribunal of any untoward effects having followed its use. In the scientific and judicial qualities Medical Record of Nov. 16th, 1912, p. 897, Lyle describes a added a capacity of synthetic criticism they would rank in 1 my humble view higher than any legal court at present case in which these occurred, and quotes one which Gurbski has recorded, both suffering from headache, dizziness, extant, not excluding the High Court of Parliament. T a.m. Sir. vours fa.ithfnllvgastralgia, intense nausea, and vomiting. Gurbski’s patient M. H. GORDON. 1912. Dec. 8th, a was a child of 11, who, 15 hours after the application (to burn involving the greater part of the right lower extremity) of amidoazotoluolsalbe, suffered from dizziness, vomiting, DRUNKENNESS AND THE EFFECTS OF cyanosis, and albuminuria. A similar effect occurred ALCOHOL. with a woman of 50, treated by Lyle for burns of the chest, To the Editor of THE LANCET. iorearms, and wrists. Dry applications were used until of SIR,-The exigencies your space compelled you to sloughs separated, when scarlet-red ointment (8 per cent. in the U. S P. boric ointment) was applied to a small area, and abbreviate my Birmingham address, so that in places it is gradually extended. On the 16th day of this treatment she rather inconsequent. May I inform, through you, the had headache and dizziness, followed by intense epigastric numerous applicants for reprints that it will shortly be pain and vomiting of a violent kind. Later, the pain affected published in full in the Jlidland 141medical Raviem. and that in the right upper quadrant of the abdomen, and was most marked at the pyloric area. The ointment was intermitted, 1
Centralblatt für
Chirurgie, 1910, 37,1550.
this edition the statistical paragraph, whose inaccuracy I admit and regret, will be omitted, as not necessary to the I am, Sir, yours faithfully, argument ? CHAS. MERCIER. Parkstone, Dec. 7th, 1912.
1677
^. deducible from these observationsfallen from 7 per cent. in 1906 to 1’4 in 1910 and 1 per cent. has to go short of water for onein 1911. Employments are very carefully provided for the.day the effect on the water available for perspiration, thatmen’s spare time; thus the band is voluntary; there areis, for temperature regulation, may persist, even in a well- picture shows, tennis-courts, and company baseball com-The mere fact that a petitions. Men stand service in the Canal Zone best on their’ trained man, for about 48 hours. plentiful supply of water is available on the next day will first visit ; recruits endure the tropics best. Captain G. H. only tend to increase his urinary secretion, not to redress at Richardson used tincture of iodine (7 per cent.) as an appli-once the disturbance in water content of his dehydrated cation to all erythemata and blisters about the feet, telling tissues....... It is extremely important to regulate the the men to report themselves next day. ’’ All who reported-’ but in not from to also the of were course well and needed no further treatment." Likeday day, only invariably supply every day." 2. The importance of training in lessening the so many continental surgeons, he is concerning himself with, demand for "water available " due almost certainly to more the best method of carrying iodine tincture on active service. efficient" condition. As long as a man is soft his water- At the meeting of the association Major Charles Lynch, thesupply needs far more careful regulation than it does editor of the Military Svrgeon, handed in his resignation,. when he has got into good campaigning condition. (The which was received with regret, and the association presented’ fluid actually drunk did not include alcoholic stimulants.) him with a silver salver to mark its appreciation of the’ Spinal Analgesia is the subject of a paper by Major J. W. H. zeal and ability with which he has conducted this splendidlyHoughton, which he concludes by recommending the method educational paper. The association took the greatest interest. to those engaged in surgical work as being most useful in the in the account of the field training of the Royal Army army. In a series of 400 operations under spinal analgesia Medical Corps at Aldershot as it was detailed to them byat the Cambridge Hospital, Aldershot, the injection was Lieutenant-Colonel S. Hickson, R.A.M.C., and Major E. L. quite satisfactory, and in none was there any cause for anxiety Munson declared that the medical officers of the Royal ArmyThe Training and Working of Medical Corps had reached the goal to which they in theas to the patient’s condition.l an Indian Sanitary Section are discussed by Major R. Tilbury United States were striving. DEATHS IN THE SERVICES. Brown ; and an ex-soldier (G. Fahey), of the 88th Connaught Rangers, whose interesting and useful articles on Practical Thomas Stick Veale, late I.M.S., Brigade-Surgeon Hints on Marching and Health on Active Service were in his eighty-second year. He served in the-’ recently recently concluded, now takes up the subject of rations on Indian Mutiny, 1857-58 ; with the Bhootan Expedition, active service. Under the title of Organic Development on 1865-66 ; and in the Afghan war, 1879-80 (a medal on each) the Earth: the Evidence and its Meaning, Colonel R. F. Firth occasion). He was a surgeon at the Army Civil Hospital at. systematises some thoughts which were suggested to him by Renkioi during the Crimean war. a perusal of Dr. Arthur Keith’s Hunterian Lectures for 1912 HEALTH OF THE ARMY IN 1911. on Certain Phases in the Evolution of Man. The annual report on the health of theDirector-General’s THE MILITARY SURGEON. for the year 1911 (Vol. LIII.) has just been published army In the November issue is a full account of the annual His Majesty’s Stationery Office, and is now on sale at themeeting of the Association of Military Surgeons, U.S.A., at by of ls. 8d. each copy. In his introductory letter to theBaltimore, Maryland, in October. There a paper was read price of the War Office, Sir William Gubbins states that Secretary by Surgeon-Major S. H. Chang, of the Chinese War Office, the improvement in the health of the troops is maintained,. on Health and Individual Sanitation on Active Service, in and it is satisfactory to report that the ratios for admissions. which, with many other excellent rules, he advised that, if to hospital, invalids discharged, and the average numberwater should not be available for clothes washing, the soldier sick are the lowest recorded, while those forconstantly should be taught to brush his underclothing thoroughly with deaths and invalids sent home are practically the same as’ a stiff clothes brush, especially about the seams, and then last year, which were up till then the lowest on record. expose it to sunlight, for in campaign it is sometimes hard to prevent vermin," as was the experience often in South Africa. Major E. L. Munson, in a most important paper, shows that the fate of nations has at times been altered by the ruin brought on their armies by preventable diseases. Thus he holds that the promising plans of the United Audi alteraI.ù partem." States for the capture of Canada in 1775-6 were brought to ruin mainly by small-pox, dysentery, and camp diseases. The armies started from the United States some 4000 DIATHERMY BY THE HIGH-FREQUENCY APPARATUS. strong ; both were ruined by disease. At the last, Quebec was besieged by an American force which had dwindled to To the Editor of THE LANCET. 1600 men, of whom 900 were sick and 700 only were fit for SIR,-In a communication to the Sixth International duty. Small-pox killed more men than did the enemy. A of Medical Electrology and Radiology, held laot Congress surgeon of that time describes the camps : " Their camp is that at the Third Inter-nastier than anything I could conceive, their latrines, October at Prague, I pointed out of held in Paris in April, national Physiotherapy, Congress kitchens, graves, and places for slaughtering cattle all mixed Dr. Nagelsmith, of Berlin, presented a communication 1910, Munson the of Then quotes great expedition Major up.’’ on diathermy, or thermopenetration, by the use of a special Napoleon to St. Domingo in 18OZ. More than 0,000 men landed there in February, 10,000 later. 15,000 men perished apparatus with which I have had an opportunity of experiof yellow fever in two months ; in six months the force was menting upon myself, first in Barcelona, and subsequentlythe Charite, Paris. Diathermy, however, is not a annihilated, and Napoleon’s great scheme to establish France at as Dr. Nagelsmith would have us believe. novel method, in Louisiana was shattered. As a result he sold it to the United States, which, no longer hemmed in on the west by He regards it as a recent method, superior to d’Arson-In the discussion Dr. Bouchon very rightly the Mississippi, had the way clear to the Pacific Coast. valisation. Mahan introduced historians to"The Influence of Sea Power remarked that the thermic action of high-frequency currents. was made known in 1901, through a communication by Pro-on History " ; perhaps his countryman Major Munson may
discipline are
which
seem
:-1. ’’ That if
a man
"
Correspondence. "
d’Arsonval to the Academy of Sciences, in which. companion work on ’’ The Influence of Sanitation fessor he says that a person will clearly experience the sensation of when we will as his that he take motto History," hope on taking hold with his hands of the poles of a small pregnant saying of the great Sidney Herbert, prevention heat solenoid. Dr. Cicera Salse. of Barcelona, also presented a us cure us Assistant gives soldiers, gives pensioners." of the local diathermic applications of high-frequency Surgeon-General W. C. Rucker, of the Public Health study the Congress at Barcelona Dr. Bonnefoy, of Service, gave an address on the Master Key of Sanitation, currents.in In a communication on the action of high-frequency Cannes, the principle that was behind all preventive work, and that, he said, was non-promiscuity ; keeping disease away from currents on the circulation and the temperature of thethat since 1903 he had published in the one, by avoiding the persons, parasites, or things infected organism, reported or carrying it. P. A. Surgeon I. G. Liegler tells us Annals of Electrobiology many clinical cases proving the In October, 1904, that the sick list of a marine detachment at Panama has thermic effects of d’Arsonvalisation. in a further study he had published other observa1 ee THE LANCET, Oct. 12th, 1912, p. 1003. tions confirming the first, and a year later he had,
yet give
us a
on
,
THE THERAPEUTICS OF SCARLET RED.
1678
to the British Electro-therapeutic Society a .further communication dealing with the same subject. . :Subsequently to this, Dr. W. F. Sommerville, of Glasgow, -undertook his very interesting thermometric researches which proved the influence of high-frequency currents dn theelevation of temperature. But Dr. Bonnefoy, in his remarkable book on arthritism and its treatment by the ! -high-frequency and high-tension currents, observes that the .sensation of heat can be obtained after many daily applications. He also says that in cases in which after 15 or 20 .days’ treatment heat is not yet felt, he makes two applica’’’.tions daily, and so obtains the desired result in the course of .a few days. For more than four years I made applications of high-frequency currents by the condensator bed, like Dr. Bonnefoy, but after a treatment lasting several days my patients scarcely felt heat. Among them one (H. M.), after ’-treatment lasting many months, never experienced the --slightest sensation of heat. At the Congress at Barcelona in September, 1910, the --statement of Professor Doumer that the condensator bed But on seemed to him doomed to disappear surprised me. return Cairo I discarded At to condensator bed. my my - first I connected one pole of the small solenoid with a bifurcated wire joined to two manchons,"which are held The other pole is attached by a single ,one in each hand. wire to a plate fixed on a wooden plank, on which the patient ,places his bare feet. By this means I felt from the first the .heat in the arms exactly as with the special apparatus of Beiniger, Gebbert, and Schall. H. M., who with the condensator bed had never felt the heat before, declared at the second application by this method that he felt it well. In August, 1911, I treated H. C.. a female patient, who was suffering from elephantiasic obesity, and who weighed M6 kilos. Every day before the light bath she had an application of diathermy for a quarter of an hour. Immediately - cafter the first application she declared that she felt the ’heat up to the shoulders, and in a week’s time she felt it ’"very deeply all over the body, more than in the light bath. -J. C., an arthritic male, 65 years old, declared at the end of the first application of ten minutes that he felt the heat all over his body. On the following days he began to perspire five minutes from the beginning of the application, and in ten minutes the perspiration dropped down his face and
presented
-
and the symptoms disappeared, only to return a week later when its use was resumed. On a third attempt no toxic symptoms occurred. In regard to Lyle’s case it may be remarked that similar effects have followed the application of boric ointment itself to large raw areas. I personally use a 6 per cent. ointment, and in some 110 cases have not found any such untoward results. I am. Sir, vours faithfully, JAMES RAE. Park Hospital, Hither Green, Lewisham, S.E., Dec. 3rd, 1912.
THE HISTOLOGY OF EXPERIMENTAL RHEUMATISM.
To the Editor of THE LANCET. SIR,-I note that neither Dr. R. Miller nor Dr. Carey Coombs, nor Professor J. M. Beattie, is opposed to the view that the Irheumococcus " is present in the normal alimentary tract. The fact that Dr. T. J. Horder was led to demonstrate this point primarily as the result of application of my differential tests to streptococci isolated from cases of malignant endocarditis is certainly not evidence of their unsoundness. I regard the question whether or no the streptococcus most abundant in normal human saliva can produce the microscopic le-ions of acute rheumatism in the rabbit as all-important in the present connexion, because if this is so then we can, perhaps, understand how the blood in cases of acute rheumatism shows no growth; for is not the local focus already present ? and how common it is to get negative blood cultures in instances where streptococcus pyogenes is the local infecting agent-e.g., in cases of cellulitis and in some types of puerperal sepsis. I wish to thank Professor Beattie and Dr. E. W. Ainley Walker for their last letters, and I have hopes that as the result of the present correspondence we are beginning to get what the diplomatists call a basis for an agreement." I am the last person to deny the importance of adaptation among bacteria, and especially among streptococci as brought out by Dr. Walker, and I repeat that neither I nor anyone else has claimed for the tests a specific value. Much more work will have to be done before we can arrive at ,hands. a decision on this matter, What I do maintain, both from For the last two years I have adopted this simple modificaown experience and from that of others, is that my my ’tion. Among my patients were a corpulent middle-aged streptococcus tests are capable of giving reliable evidence as ’.Egyptian and an English lady of great stature. At the end to the source and significance of a streptococcus as met with ’,of the first application they declared that they felt the heat in cultures from the human body, or from air, dust, sewage, ,f1 over the body to the extent of almost perspiring, notwith- or other media contaminated recently by material derived standing that it was in winter. I hope that this simplified from the alimentary tract of man or animals, such as mode of treatment by the high-frequency current may soon the horse. be applied on a large scale and may take the high place it Furthermore, Sir, I venture to think that it would be a deserves in therapeutics for the welfare of the patients. great advantage and a saving of time if we had in this I am, Sir, yours faithfully, a specially qualified Court of Appeal to which country Dr.S.C DAMOGLOU. Cairo, Nov. 9th, 1912. matters such as are at present under dispute could be submitted. This committee could hear both sides, weigh the THE THERAPEUTICS OF SCARLET RED. evidence, do their own experiments, and arrive at a decision. If research in medicine is to become organised, as appears To the -Editor of THE LANCET. possible under the Insurance Act, some such tribunal would SIR,-Your annotation of Sept. 30th, 1911, on the probably be of much value in defining our knowledge on a ’therapeutics of scarlet red induced me then to give my own variety of controversial subjects, not the least important of rheumatism ; and if to their experience of the preparation. At that time I did not know which is the etiology of acutethe members of this tribunal of any untoward effects having followed its use. In the scientific and judicial qualities Medical Record of Nov. 16th, 1912, p. 897, Lyle describes a added a capacity of synthetic criticism they would rank in 1 my humble view higher than any legal court at present case in which these occurred, and quotes one which Gurbski has recorded, both suffering from headache, dizziness, extant, not excluding the High Court of Parliament. T a.m. Sir. vours fa.ithfnllvgastralgia, intense nausea, and vomiting. Gurbski’s patient M. H. GORDON. 1912. Dec. 8th, a was a child of 11, who, 15 hours after the application (to burn involving the greater part of the right lower extremity) of amidoazotoluolsalbe, suffered from dizziness, vomiting, DRUNKENNESS AND THE EFFECTS OF cyanosis, and albuminuria. A similar effect occurred ALCOHOL. with a woman of 50, treated by Lyle for burns of the chest, To the Editor of THE LANCET. iorearms, and wrists. Dry applications were used until of SIR,-The exigencies your space compelled you to sloughs separated, when scarlet-red ointment (8 per cent. in the U. S P. boric ointment) was applied to a small area, and abbreviate my Birmingham address, so that in places it is gradually extended. On the 16th day of this treatment she rather inconsequent. May I inform, through you, the had headache and dizziness, followed by intense epigastric numerous applicants for reprints that it will shortly be pain and vomiting of a violent kind. Later, the pain affected published in full in the Jlidland 141medical Raviem. and that in the right upper quadrant of the abdomen, and was most marked at the pyloric area. The ointment was intermitted, 1
Centralblatt für
Chirurgie, 1910, 37,1550.
this edition the statistical paragraph, whose inaccuracy I admit and regret, will be omitted, as not necessary to the I am, Sir, yours faithfully, argument ? CHAS. MERCIER. Parkstone, Dec. 7th, 1912.