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HERPES ZOSTER OF UNUSUAL DISTRIBUTION.
1272
however, the celloidin sections of the kidneys and be deduced by reference to the Colonial Office other sections from portions embedded in paraffin and local Government regulations, but, if so, stained by haematogylin-eosine, or van Gieson’s no cells were found which showed the appearance of glycogenic infiltration as revealed by these stains. Further, no glycogen was found in the celloidin sections when treated with Lugol’s solution. The diabetic kidneys selected were, therefore, free from glycogenic infiltration, and were of no service as controls. Abundant glycogen was demonstrated in the Grawitz’s tumour on every occasion. No glycogen was found in any of the suprarenals. I am, Sir, yours faithfully, JIVRAJ N. MEHTA, M.D.Lond., M.R.C.P. Lond., were
method,
Assistant in the
HERPES
Pathological
Institute of the London
Hospital.
ZOSTER OF UNUSUAL DISTRIBUTION.
To the Editor of THE LANCET.
SIR,-A case of bilateral herpes zoster, the lesions having the following distribution, has just come under my care :—Front: A small patch in right submaxillary area (C. 3), a large patch just above right nipple, and a small one a little higher up on the left side (D. 4). Behind : Five small patches, one on and four behind the right ear (C. 3), a larger patch on the right shoulder (C. 4), a small one over the left scapula near the middle line (D. 4), and a larger one below the angle of the left scapula (D. 6). I believe I am correct in supposing that true herpes zoster of the body is very rarely bilateral, and send you this note accordingly. It may be only a coincidence that I recently saw a very severe herpes of the occipital nerve ’at this station, but Mr. John Procter, who has practised here for some years, tells me that he sees a good deal of it. I have certainly seen more than the average number of cases of ordinary febrile labial herpes, one at least bilateral, during the past few months.-I am, Sir, yours faithfully, GORDON WARD, M.D. Lond. Lydd, Nov. 26th, 1915. PS.-Lieutenant Adamson, R.A.M.C., who sees most of the daily sick at this station, also agrees that there is an unusually large number of cases of herpes zoster (of the body). MILITARY SERVICE AND THE POSITION OF THE OFFICERS OF THE WEST AFRICAN MEDICAL STAFF. To the Editor of THE LANCET.
SIR,-I should like to draw attention to the anomalous position of officers of the West African Medical Staff who are serving with the Nigerian Expeditionary Forces in the Cameroons. As far as I am aware, there is nothing in their contract with the Colonial Office which implies or states their liability to be sent on active service, and though I have not the least doubt that practically all of them would volunteer for active service, if volunteers had been called for, yet the fact remains that they were sent on active service without the option of declining, were placed under military discipline and regulations, and have not been given military rank. It is futile to argue that the medical officer, without military rank, obtains equal precedence and privileges with combatant officers of corresponding service; this argument might, no doubt,
such privileges begin on paper and end there, and the fact remains that the medical officer without military rank has not the same standing with either the other European officers or the native troops as a combatant officer of equal service. If this is true in time of peace, when one’s work is usually a combination of civil and military duties, as I believe it is, how much more is it likely to be true on active service ? All other civilian officials, whose services have been commanded with the troops, such as transport officers, intelligence officers, and the like, have all without exception been accorded temporary military rank, so as to remove any anomalies in connexion with their position, and it is difficult to see why the medical officers should be the solitary exception, and even presuming that for various reasons it is undesirable for officers of the West African Medical Staff to possess military rank in times of peace they should be certainly granted it when on active service, not only for their own sake, but also because it would obviously make it easier for the military authorities to deal with them. People who were conversant with conditions in the Royal Army Medical Corps before military rank was accorded to its officers will be aware, and be able to appreciate some of the difficulties likely to
arise when civilian medical officers are detached for purely military duties. I believe that the medical officers of the Uganda and East African Colonial Services serving with the troops have been given rank corresponding to their position, why not also the West African Medical Staff ? I am, Sir, yours faithfully, MEDICAL OFFICER ON ACTIVE SERVICE IN CAMEROONS. 1915. Sept.3Uth.l915.
MEDICAL STUDENTS AND THE WAR OFFICE. To the Editor of THE LANCET. SIR,-Professor A. E. Shipley in your issue of
Nov. 20th has stated very concisely and clearly what has been in my mind for some time past. The dearth of doctors, it must be admitted, if we are frank, is in large measure due to the past action of the now defunct Liberal Government. I do not wish to enter into the domain of politics and raise a polemical discussion on the good and bad side of the National Insurance Act. But we There was a shortage before know the facts. the war began, and now it has become acutely intensified by the call for men for active service. If we bear in mind that this will quickly amount to 10,000 doctors it is easy to see how the ranks of the profession have been, and will be, depleted, leaving the civil population barely cared for. It is to be feared that not a few of the 10,000 will fall victims to enemy bullets or disease during the rest of the campaign, while the annual loss from "natural causes " to the profession will maintain its usual average at least; possibly more owing to the extra strain on those left behind. It is not difficult to discern what will happen, therefore, when the war is over. Unless freshly qualified men are rapidly drafted in the shortage will last for years and be very embarrassing. I have just come
across a student advanced in his curriculum who has done seven months at a French base hospital in North France as a surgeon " assistant or adjutant," as I think the French call
however, the celloidin sections of the kidneys and be deduced by reference to the Colonial Office other sections from portions embedded in paraffin and local Government regulations, but, if so, stained by haematogylin-eosine, or van Gieson’s no cells were found which showed the appearance of glycogenic infiltration as revealed by these stains. Further, no glycogen was found in the celloidin sections when treated with Lugol’s solution. The diabetic kidneys selected were, therefore, free from glycogenic infiltration, and were of no service as controls. Abundant glycogen was demonstrated in the Grawitz’s tumour on every occasion. No glycogen was found in any of the suprarenals. I am, Sir, yours faithfully, JIVRAJ N. MEHTA, M.D.Lond., M.R.C.P. Lond., were
method,
Assistant in the
HERPES
Pathological
Institute of the London
Hospital.
ZOSTER OF UNUSUAL DISTRIBUTION.
To the Editor of THE LANCET.
SIR,-A case of bilateral herpes zoster, the lesions having the following distribution, has just come under my care :—Front: A small patch in right submaxillary area (C. 3), a large patch just above right nipple, and a small one a little higher up on the left side (D. 4). Behind : Five small patches, one on and four behind the right ear (C. 3), a larger patch on the right shoulder (C. 4), a small one over the left scapula near the middle line (D. 4), and a larger one below the angle of the left scapula (D. 6). I believe I am correct in supposing that true herpes zoster of the body is very rarely bilateral, and send you this note accordingly. It may be only a coincidence that I recently saw a very severe herpes of the occipital nerve ’at this station, but Mr. John Procter, who has practised here for some years, tells me that he sees a good deal of it. I have certainly seen more than the average number of cases of ordinary febrile labial herpes, one at least bilateral, during the past few months.-I am, Sir, yours faithfully, GORDON WARD, M.D. Lond. Lydd, Nov. 26th, 1915. PS.-Lieutenant Adamson, R.A.M.C., who sees most of the daily sick at this station, also agrees that there is an unusually large number of cases of herpes zoster (of the body). MILITARY SERVICE AND THE POSITION OF THE OFFICERS OF THE WEST AFRICAN MEDICAL STAFF. To the Editor of THE LANCET.
SIR,-I should like to draw attention to the anomalous position of officers of the West African Medical Staff who are serving with the Nigerian Expeditionary Forces in the Cameroons. As far as I am aware, there is nothing in their contract with the Colonial Office which implies or states their liability to be sent on active service, and though I have not the least doubt that practically all of them would volunteer for active service, if volunteers had been called for, yet the fact remains that they were sent on active service without the option of declining, were placed under military discipline and regulations, and have not been given military rank. It is futile to argue that the medical officer, without military rank, obtains equal precedence and privileges with combatant officers of corresponding service; this argument might, no doubt,
such privileges begin on paper and end there, and the fact remains that the medical officer without military rank has not the same standing with either the other European officers or the native troops as a combatant officer of equal service. If this is true in time of peace, when one’s work is usually a combination of civil and military duties, as I believe it is, how much more is it likely to be true on active service ? All other civilian officials, whose services have been commanded with the troops, such as transport officers, intelligence officers, and the like, have all without exception been accorded temporary military rank, so as to remove any anomalies in connexion with their position, and it is difficult to see why the medical officers should be the solitary exception, and even presuming that for various reasons it is undesirable for officers of the West African Medical Staff to possess military rank in times of peace they should be certainly granted it when on active service, not only for their own sake, but also because it would obviously make it easier for the military authorities to deal with them. People who were conversant with conditions in the Royal Army Medical Corps before military rank was accorded to its officers will be aware, and be able to appreciate some of the difficulties likely to
arise when civilian medical officers are detached for purely military duties. I believe that the medical officers of the Uganda and East African Colonial Services serving with the troops have been given rank corresponding to their position, why not also the West African Medical Staff ? I am, Sir, yours faithfully, MEDICAL OFFICER ON ACTIVE SERVICE IN CAMEROONS. 1915. Sept.3Uth.l915.
MEDICAL STUDENTS AND THE WAR OFFICE. To the Editor of THE LANCET. SIR,-Professor A. E. Shipley in your issue of
Nov. 20th has stated very concisely and clearly what has been in my mind for some time past. The dearth of doctors, it must be admitted, if we are frank, is in large measure due to the past action of the now defunct Liberal Government. I do not wish to enter into the domain of politics and raise a polemical discussion on the good and bad side of the National Insurance Act. But we There was a shortage before know the facts. the war began, and now it has become acutely intensified by the call for men for active service. If we bear in mind that this will quickly amount to 10,000 doctors it is easy to see how the ranks of the profession have been, and will be, depleted, leaving the civil population barely cared for. It is to be feared that not a few of the 10,000 will fall victims to enemy bullets or disease during the rest of the campaign, while the annual loss from "natural causes " to the profession will maintain its usual average at least; possibly more owing to the extra strain on those left behind. It is not difficult to discern what will happen, therefore, when the war is over. Unless freshly qualified men are rapidly drafted in the shortage will last for years and be very embarrassing. I have just come
across a student advanced in his curriculum who has done seven months at a French base hospital in North France as a surgeon " assistant or adjutant," as I think the French call