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DRIED MILK IN INFANTILE SCURVY.
780 the fifth, and so on, never agree with those that go before it. There is nothing to kill off the free vibrations of the whole lot, started each time, and nothing to agree with the period of any one resonator. A vowel in speech would at each instant set all the " resonators" in action and would favour none. A vowel sung against piano strings sets a series of them in vibration, but a vowel spoken against them sets them all more or less in action. These facts are well illustrated by an apparatus devised by Dr. H. Hartridge of Cambridge. A series of weights are hung by threads from a bar. A single movement imparted to this bar sets all the pendulums in vibration. A. regularly repeated movement starts them all, but soon kills off all but the corresponding one. These objections to the Helmholtz theory I have stated in Nature (April 22nd, 1922, p. 518), and a picture of Dr. Hartridge’s apparatus was given in Nature (May 20th, 1922, p. 649). I am, Sir, vours faithfully, E. W. SCRIPTURE. 1’CW
,UVUUU16LL-SUrCUU, VV., aCjJL. LVL,11, J.v:;::j’’:;:;.
DRIED MILK IN INFANTILE SCURVY. To the Editor of THE LANCET. a lecture delivered at the Hospital for SIR,-In Sick Children, Great Ormond-street, and published in THE LANCET of Sept. 9th, Dr. J. H. Thursfield says :-It is still disputed by some authorities whether the preparation of the various forms of dried milk leads to the destruction of the vitamins, though to us clinicians the practical proof of their destruction is frequently obvious. In all but one of the cases of infantile scurvy which I have seen since the end of the war, the diet on which the victims had been nourished was a well-known and extensively advertised form of dried milk. His experience is at variance with that of many
other physicians. My own attention was especially drawn to dried milk when I was in charge of Government laboratories as far back as 1910, when I carried out a series of analyses and experiments on behalf of the Government of India. As the result of my investigations I not only advocated the adoption of dried milk for military purposes, but formed such a favourable impression of the product, that I have ever since strongly advocated its adoption as a substitute for cow’s milk in infant feeding. The evidence of infant welfare clinics is unanimous as to the absence of scurvy on a diet of dried milk. At the Birmingham Congress of the Royal Sanitary Institute in 1920 I read a paper on the subject which was discussed by a representative gathering of medical officers of health, all of whom were agreed that they had never seen a case of infantile scurvv in a child fed on dried milk, and my own experience both in the tropics and at home supports this view. In my practice dried milk has been of special value to infants among the poorer classes who have been doing badly. I have used dried milk with success in several cases of persistent vomiting, and have seen a rickety infant steadily improve on it. Drs. Miele and du Quesne recently reported to the Congres National de Laiterie remarkable results from feeding atrophic children on dried milk ; in pure atrophy cure was assured in six weeks, provided careful supervision was exercised. I think I have said enough to show that Dr. Thursfield’s experience has been unfortunate, and I venture to refer him to the reports of Hart, Steenbock, and Ellis of recent work at the University of Wisconsin, published in the JOU1’nal of Bio-Chemistry, 1921, xlvi., 309. I suggest that the cases at Great Ormond-street may have been due to the use either of faulty preparations or of defective or aged samples, such as were on the market after the war. No clinician claims that dried milk is a solution of all difficulties of infant feeding ; but where, as so often happens, pure cow’s milk is not available, it is, I confidently submit, the most reliable substitute in the hand-feeding of infants. I am, Sir, yours faithfully, R. J. BLACKHAM, M.D., M.R.C.P. D.P.II. Lond. Folkestone, Sept. 28th, 1922. --
-
---
Edin.,
THE FIBROID DIATHESIS. To
the
Editor
of
THE
LANCET.
SIR,-In the course of a very interesting lecturereported in THE LANCET of Sept. 30th (p. 702)-Prof. E. S. Reynolds asks whether it is possible to include chronic enlargement of the prostate and excessive stricture of the urethra occurring after gonorrhoea as evidence of the fibrous diathesis. On urethroscoping thousands of cases of gonorrhoea, my experience has been that there is always a certain amount of infiltration, but in some the amount is out of all proportion to the inflammation present, severe fibrous contraction taking place. It has been observed that in the black races severe stricture alwaystakes place after an attack of gonorrhoea, while in my observation the prostate is always involved, more or less, during an attack of gonorrhcea ; in some there is a large amount of pus formation and in others a slow fibrous change This might be explained by tissue takes place. immunity on the one hand, or a low grade of virulence of the gonococcus on the other, but I ain inclined to accept Prof. Reynolds’s view. For these reasons I recently emphasised1 the necessity for dilatation of the urethra and massage of the prostate after every case nf o’rmftTfhrfa——T
am
Stir
VOl1’N’:
Harley-street, W., Sept. 30th, 1922.
fai’hfii11v
M. W. BROWDY.
HAS CANCER A PIGMENTARY ORIGIN? To the Editor of THE LANCET. paper with this title, published in THE LANCET of Sept. 23rd, Sir George Beatson raises many interesting points concerning the inter-relation of various organs. The last paragraph of his article encourages me to send this note of certain results I have recently obtained experimentally. Under the influence of inoculation with suprarenal hormones, white rats showed marked increase of fat formation, degeneration of reproductive organs, and invasion of lymph and haemolymph glands by proliferating cells of epithelial type. When the preparation used contained adrenalin there was in addition to the changes mentioned above (which are due to the cortical hormones) a marked formation of melanoblast cells, which were found in almost any organ, but in greatest numbers in the haemolymph and lymph glands. Further, in a case of Addison’s disease (the details of which I hope to publish shortly), in addition to diminution of body fat, there was marked increase of melanin pigment, and almost complete atrophy of the testes. What the bearing of these findings may be I do not venture to suggest, but the connexion is interesting in view of the theory put forward by Sir
SiR,-In his
George Bertson -I
Sir
am,
yours
faithfully
EVELYN E. London (R.F.H.). School of Medicine for Women, Sept. 27th, 1922. 1
HEWER,
D.Sc.
Practitioner, October, 1921.
ST. FAITH’S UNION INFIRMARY, NORWICH.-It has been decided by the Board of Guardians, on the advice of the Ministry of Health, to close this institution permanently. The infirmary accommodated about 40 paupers, many oí them bedridden. During the war the major part of the premises was utilised for billeting soldiers. Recently a disastrous fire occurred at the infirmary. All the patients were rescued, owing largely to the prompt action of the master, and were removed to the workhouse at Aylshaui. eight miles away.
MUNICIPAL GRANTS
TO
HOSPITALS
AT
MANCHESTER.
A sum of 86000 is provided in the annual estimates for contributions to hospitals, and will be distributed as follows : Manchester Royal Infirmary, £1500 ; Manchester Children’s Hospital and Dispensary, 8300; Ancoats Hospital, £1200; St. Mary’s Hospitals, 8750 ; Manchester’Royal Eye Hospital, .8620 ; Manchester Hospital for Consumption and Diseases of the Throat and Chest, 8300 ; Hospital for Skin Diseases. 8200 ; Manchester Victoria Memorial Jewish Hospital, 9150-, Northern Hospital, 8320 ; Dental Hospital of Manchester, £150 ; Manchester Ear Hospital, .8200 ; Hulme Dispensary, £120 ; St. John’s Hospital of Manchester and Salford for the Ear, £50 : Chorlton-upon-Medlock Dispensary, iE40: Christie (Cancer) Hospital, 8200.
,UVUUU16LL-SUrCUU, VV., aCjJL. LVL,11, J.v:;::j’’:;:;.
DRIED MILK IN INFANTILE SCURVY. To the Editor of THE LANCET. a lecture delivered at the Hospital for SIR,-In Sick Children, Great Ormond-street, and published in THE LANCET of Sept. 9th, Dr. J. H. Thursfield says :-It is still disputed by some authorities whether the preparation of the various forms of dried milk leads to the destruction of the vitamins, though to us clinicians the practical proof of their destruction is frequently obvious. In all but one of the cases of infantile scurvy which I have seen since the end of the war, the diet on which the victims had been nourished was a well-known and extensively advertised form of dried milk. His experience is at variance with that of many
other physicians. My own attention was especially drawn to dried milk when I was in charge of Government laboratories as far back as 1910, when I carried out a series of analyses and experiments on behalf of the Government of India. As the result of my investigations I not only advocated the adoption of dried milk for military purposes, but formed such a favourable impression of the product, that I have ever since strongly advocated its adoption as a substitute for cow’s milk in infant feeding. The evidence of infant welfare clinics is unanimous as to the absence of scurvy on a diet of dried milk. At the Birmingham Congress of the Royal Sanitary Institute in 1920 I read a paper on the subject which was discussed by a representative gathering of medical officers of health, all of whom were agreed that they had never seen a case of infantile scurvv in a child fed on dried milk, and my own experience both in the tropics and at home supports this view. In my practice dried milk has been of special value to infants among the poorer classes who have been doing badly. I have used dried milk with success in several cases of persistent vomiting, and have seen a rickety infant steadily improve on it. Drs. Miele and du Quesne recently reported to the Congres National de Laiterie remarkable results from feeding atrophic children on dried milk ; in pure atrophy cure was assured in six weeks, provided careful supervision was exercised. I think I have said enough to show that Dr. Thursfield’s experience has been unfortunate, and I venture to refer him to the reports of Hart, Steenbock, and Ellis of recent work at the University of Wisconsin, published in the JOU1’nal of Bio-Chemistry, 1921, xlvi., 309. I suggest that the cases at Great Ormond-street may have been due to the use either of faulty preparations or of defective or aged samples, such as were on the market after the war. No clinician claims that dried milk is a solution of all difficulties of infant feeding ; but where, as so often happens, pure cow’s milk is not available, it is, I confidently submit, the most reliable substitute in the hand-feeding of infants. I am, Sir, yours faithfully, R. J. BLACKHAM, M.D., M.R.C.P. D.P.II. Lond. Folkestone, Sept. 28th, 1922. --
-
---
Edin.,
THE FIBROID DIATHESIS. To
the
Editor
of
THE
LANCET.
SIR,-In the course of a very interesting lecturereported in THE LANCET of Sept. 30th (p. 702)-Prof. E. S. Reynolds asks whether it is possible to include chronic enlargement of the prostate and excessive stricture of the urethra occurring after gonorrhoea as evidence of the fibrous diathesis. On urethroscoping thousands of cases of gonorrhoea, my experience has been that there is always a certain amount of infiltration, but in some the amount is out of all proportion to the inflammation present, severe fibrous contraction taking place. It has been observed that in the black races severe stricture alwaystakes place after an attack of gonorrhoea, while in my observation the prostate is always involved, more or less, during an attack of gonorrhcea ; in some there is a large amount of pus formation and in others a slow fibrous change This might be explained by tissue takes place. immunity on the one hand, or a low grade of virulence of the gonococcus on the other, but I ain inclined to accept Prof. Reynolds’s view. For these reasons I recently emphasised1 the necessity for dilatation of the urethra and massage of the prostate after every case nf o’rmftTfhrfa——T
am
Stir
VOl1’N’:
Harley-street, W., Sept. 30th, 1922.
fai’hfii11v
M. W. BROWDY.
HAS CANCER A PIGMENTARY ORIGIN? To the Editor of THE LANCET. paper with this title, published in THE LANCET of Sept. 23rd, Sir George Beatson raises many interesting points concerning the inter-relation of various organs. The last paragraph of his article encourages me to send this note of certain results I have recently obtained experimentally. Under the influence of inoculation with suprarenal hormones, white rats showed marked increase of fat formation, degeneration of reproductive organs, and invasion of lymph and haemolymph glands by proliferating cells of epithelial type. When the preparation used contained adrenalin there was in addition to the changes mentioned above (which are due to the cortical hormones) a marked formation of melanoblast cells, which were found in almost any organ, but in greatest numbers in the haemolymph and lymph glands. Further, in a case of Addison’s disease (the details of which I hope to publish shortly), in addition to diminution of body fat, there was marked increase of melanin pigment, and almost complete atrophy of the testes. What the bearing of these findings may be I do not venture to suggest, but the connexion is interesting in view of the theory put forward by Sir
SiR,-In his
George Bertson -I
Sir
am,
yours
faithfully
EVELYN E. London (R.F.H.). School of Medicine for Women, Sept. 27th, 1922. 1
HEWER,
D.Sc.
Practitioner, October, 1921.
ST. FAITH’S UNION INFIRMARY, NORWICH.-It has been decided by the Board of Guardians, on the advice of the Ministry of Health, to close this institution permanently. The infirmary accommodated about 40 paupers, many oí them bedridden. During the war the major part of the premises was utilised for billeting soldiers. Recently a disastrous fire occurred at the infirmary. All the patients were rescued, owing largely to the prompt action of the master, and were removed to the workhouse at Aylshaui. eight miles away.
MUNICIPAL GRANTS
TO
HOSPITALS
AT
MANCHESTER.
A sum of 86000 is provided in the annual estimates for contributions to hospitals, and will be distributed as follows : Manchester Royal Infirmary, £1500 ; Manchester Children’s Hospital and Dispensary, 8300; Ancoats Hospital, £1200; St. Mary’s Hospitals, 8750 ; Manchester’Royal Eye Hospital, .8620 ; Manchester Hospital for Consumption and Diseases of the Throat and Chest, 8300 ; Hospital for Skin Diseases. 8200 ; Manchester Victoria Memorial Jewish Hospital, 9150-, Northern Hospital, 8320 ; Dental Hospital of Manchester, £150 ; Manchester Ear Hospital, .8200 ; Hulme Dispensary, £120 ; St. John’s Hospital of Manchester and Salford for the Ear, £50 : Chorlton-upon-Medlock Dispensary, iE40: Christie (Cancer) Hospital, 8200.