- Email: [email protected]
ERGOTAMINE TARTRATE FOR MIGRAINE
164 each story has in main a similar design, certain differences. On the ground floor are rooms for patients being discharged, the ward sister, and the visitors. On the second floor (Fig. 3) there is an up-to-date operating theatre for general operations, with special facilities for ear, nose,
Though
there there
are
and throat surgery. Sterilising and anaesthetic rooms lead into the theatre. The four-bedded wards on the top story could be used for any prevailing disease to supplement the existing accommodation of the hospital, which has a complement of 200 beds. It will be remembered that the London Fever Hospital is the only voluntary hospital in London which accepts private patients suffering from every kind of infectious disease other than small-pox. The
fee payable in general wards is 3 guineas a week, and no extra charge will be made to those who are kept in private rooms in the isolation block, which will shortly be open to receive patients. The fees for patients who wish to have private rooms in the main
guineas (14 rooms) or 10 guineas (12 rooms). suffering from typhoid fever, cerebro-spinal fever, erysipelas, anterior poliomyelitis, varicella, mumps, rheumatic fever, encephalitis lethargica, pneumonia, and influenza are nursed in single rooms. Certain concessions in fees are offered to patients recommended by subscribers and governors. The hospital is making a special appeal to increase
buildings
7
are
Patients
the number of these and raise the balance of the cost of building the new block, towards which only 10,000 has as yet been provided.
CORRESPONDENCE CONVALESCENCE ON THE COAST To the Editor of THE LANCET
SiR,—The article by Dr. Fortescue Fox and Dr. Lloyd in your issue of July 2nd will, I hope, stimulate increased study and research with regard to the value of particular health resorts for particular forms of ill health, especially in children. The records of results of medical inspection of school-children indicate that some 20 per cent. of them are found to require treatment for physical ailments in spite of the progress in preventive medicine in recent years. It is true that the importance of building up a good constitution rather than concentration on curing illness has gradually more and more been recognised, but the fact that one child in five at school age requires medical treatment indicates that a better rate of progress is desirable. " Health resorts," ’as the title implies, have a vague reputation for health-giving properties, but everyone must welcome the earnest endeavours of those like Dr. Fortescue Fox who wish to ascertain the value of these resorts, and of any particular resort, on a more scientific basis. That Dr. Fox’s committee has now been able to establish a centre of research in one of our prominent health resorts is a beginning in this direction which must commend itself to all who are anxious to see an accelerated rate of reduction in the amount of general ill health that exists, especially in children. I am, Sir, yours faithfully, W. G. WILLOUGHBY, July llth.
Medical Officer of Health and School Medical Officer, Eastbourne
To the Editor of THE LANCET SIR,-A scientific inquiry into the effects of a stay at the seaside promoting the convalescence of children should lead to interesting results. One thing is, I think, certain-that children on a given diet who are kept shut up in a room artificially heated will do no better at the seaside than inland. I am, Sir, yours faithfully, LEONARD HILL. Chalfont St. Peter, Bucks, July 11th. ERGOTAMINE TARTRATE FOR MIGRAINE
To the Editor
of
THE LANCET
SiR,-On March 27th, 1937, you published a letter describing my experience of the administra-
from me tion of
ergotamine tartrate (Sandoz) in migraine. from the number of letters I received from medical men all over the British Isles it was evident that my letter had created a great deal of interest
Judging
and that knowledge of the use and effect of this alkaloid in migraine was very limited. Many of my correspondents, alluding to my experience of over a year’s regular administration of two or three injections a week without any sign of side-effects, expressed doubts as to the safety of continued treat. ment of this nature. It may therefore interest them, and indeed the profession generally, to learn that just over a year ago I decided, as my headaches, although generally not severe, were very frequent, to regularly use the alkaloid prophylactically. Since that time I have nightly injected the contents of a Sandoz 0-5 c.cm. ampoule (actually containing 0-75 c.cm. 0-375 mg. ergotamine tartrate) without the slightest ill effect of any kind, and with complete elimination of the morning headache that I invariably ==
experienced
on
I
awakening. am.
Sir.
faithfullv. T. W. GORDON KELLY.
vours
Desford, Leicestershire, June 2
9th.
CHEMOTHERAPY IN PNEUMONIA
To the Editor
of THE
LANCET
value of the new sulphonamide B. 693 in the treatment of lobar pneumonia as shown by the series of 100 cases reported by Drs. Evans and Gaisford is very striking. While the effect of the drug upon many different types of pneumococci has been demonstrated by Dr. Whitby, no similar action upon staphylococci has so far been
SiR,-The
M. &.
reported. It is remarkable that of the 8 cases in the series of 100 which failed to respond satisfactorily to the treatment, 4 had been suffering from chronic bron. chitis, and 2 others were found to have staphylococcal as well as pneumococcal infection. It seems possible that there may have been staphylococcal infection in the cases of chronic bronchitis, and that in 6 of the 8 cases staphylococci may have had a share in the infection. If so this perhaps might account for their failure to respond to the treatment. I note that in only 44 of the series was it found possible to identify the type from the sputum. Sputum is not always obtainable, but it should be possible in every case to obtain a culture of the pathogenic organisms responsible. It is quite a simple matter to puncture the pneumonic area of the lung with the needle of an exploring syringe and to draw some infected fluid into the barrel. If a local anaesthetic is injected previously this should cause little or no pain or inconvenience to the patient. I am. Sir. vours faithfully, HERBERT H. BROWN. Worthing, July 9th.
Though
there there
are
and throat surgery. Sterilising and anaesthetic rooms lead into the theatre. The four-bedded wards on the top story could be used for any prevailing disease to supplement the existing accommodation of the hospital, which has a complement of 200 beds. It will be remembered that the London Fever Hospital is the only voluntary hospital in London which accepts private patients suffering from every kind of infectious disease other than small-pox. The
fee payable in general wards is 3 guineas a week, and no extra charge will be made to those who are kept in private rooms in the isolation block, which will shortly be open to receive patients. The fees for patients who wish to have private rooms in the main
guineas (14 rooms) or 10 guineas (12 rooms). suffering from typhoid fever, cerebro-spinal fever, erysipelas, anterior poliomyelitis, varicella, mumps, rheumatic fever, encephalitis lethargica, pneumonia, and influenza are nursed in single rooms. Certain concessions in fees are offered to patients recommended by subscribers and governors. The hospital is making a special appeal to increase
buildings
7
are
Patients
the number of these and raise the balance of the cost of building the new block, towards which only 10,000 has as yet been provided.
CORRESPONDENCE CONVALESCENCE ON THE COAST To the Editor of THE LANCET
SiR,—The article by Dr. Fortescue Fox and Dr. Lloyd in your issue of July 2nd will, I hope, stimulate increased study and research with regard to the value of particular health resorts for particular forms of ill health, especially in children. The records of results of medical inspection of school-children indicate that some 20 per cent. of them are found to require treatment for physical ailments in spite of the progress in preventive medicine in recent years. It is true that the importance of building up a good constitution rather than concentration on curing illness has gradually more and more been recognised, but the fact that one child in five at school age requires medical treatment indicates that a better rate of progress is desirable. " Health resorts," ’as the title implies, have a vague reputation for health-giving properties, but everyone must welcome the earnest endeavours of those like Dr. Fortescue Fox who wish to ascertain the value of these resorts, and of any particular resort, on a more scientific basis. That Dr. Fox’s committee has now been able to establish a centre of research in one of our prominent health resorts is a beginning in this direction which must commend itself to all who are anxious to see an accelerated rate of reduction in the amount of general ill health that exists, especially in children. I am, Sir, yours faithfully, W. G. WILLOUGHBY, July llth.
Medical Officer of Health and School Medical Officer, Eastbourne
To the Editor of THE LANCET SIR,-A scientific inquiry into the effects of a stay at the seaside promoting the convalescence of children should lead to interesting results. One thing is, I think, certain-that children on a given diet who are kept shut up in a room artificially heated will do no better at the seaside than inland. I am, Sir, yours faithfully, LEONARD HILL. Chalfont St. Peter, Bucks, July 11th. ERGOTAMINE TARTRATE FOR MIGRAINE
To the Editor
of
THE LANCET
SiR,-On March 27th, 1937, you published a letter describing my experience of the administra-
from me tion of
ergotamine tartrate (Sandoz) in migraine. from the number of letters I received from medical men all over the British Isles it was evident that my letter had created a great deal of interest
Judging
and that knowledge of the use and effect of this alkaloid in migraine was very limited. Many of my correspondents, alluding to my experience of over a year’s regular administration of two or three injections a week without any sign of side-effects, expressed doubts as to the safety of continued treat. ment of this nature. It may therefore interest them, and indeed the profession generally, to learn that just over a year ago I decided, as my headaches, although generally not severe, were very frequent, to regularly use the alkaloid prophylactically. Since that time I have nightly injected the contents of a Sandoz 0-5 c.cm. ampoule (actually containing 0-75 c.cm. 0-375 mg. ergotamine tartrate) without the slightest ill effect of any kind, and with complete elimination of the morning headache that I invariably ==
experienced
on
I
awakening. am.
Sir.
faithfullv. T. W. GORDON KELLY.
vours
Desford, Leicestershire, June 2
9th.
CHEMOTHERAPY IN PNEUMONIA
To the Editor
of THE
LANCET
value of the new sulphonamide B. 693 in the treatment of lobar pneumonia as shown by the series of 100 cases reported by Drs. Evans and Gaisford is very striking. While the effect of the drug upon many different types of pneumococci has been demonstrated by Dr. Whitby, no similar action upon staphylococci has so far been
SiR,-The
M. &.
reported. It is remarkable that of the 8 cases in the series of 100 which failed to respond satisfactorily to the treatment, 4 had been suffering from chronic bron. chitis, and 2 others were found to have staphylococcal as well as pneumococcal infection. It seems possible that there may have been staphylococcal infection in the cases of chronic bronchitis, and that in 6 of the 8 cases staphylococci may have had a share in the infection. If so this perhaps might account for their failure to respond to the treatment. I note that in only 44 of the series was it found possible to identify the type from the sputum. Sputum is not always obtainable, but it should be possible in every case to obtain a culture of the pathogenic organisms responsible. It is quite a simple matter to puncture the pneumonic area of the lung with the needle of an exploring syringe and to draw some infected fluid into the barrel. If a local anaesthetic is injected previously this should cause little or no pain or inconvenience to the patient. I am. Sir. vours faithfully, HERBERT H. BROWN. Worthing, July 9th.