HISTIDINE AND PEPTIC ULCER

946 the hours spent at the centre being graded and Slow healing areas covered with a film of cod-liver controlled according to the response made. The oil and then irradiated with small doses of ultrakind of work should conform in some measure with violet light undoubtedly respond better than with what was being done at the time of the accident. cod-liver oil treatment or ultra-violet treatment It is not of much use to train a bricklayer to make alone. Presumably it is possible that the ultrarush mats and thought would have to be given to violet light may assist the synergism of vitamins the nature of the work and where that work could be I am, Sir, yours faithfully, A and B. most readily obtained. In the rehabilitation centre C. B. HEALD. the convalescent workman would continue his outPark-crescent, Portland-place, W., Oct. 12th. patient treatment and undertake gradually increasing THE INCIDENCE OF SERIOUS DEAFNESS work financially approximating to the work he will be expected to do when he is signed off and due to To the Editor of THE LANCET return to full work. He would be helped by the careful medical supervision provided at the centre, SIR,-We are endeavouring to obtain information on the incidence of serious deafness in youth and adult a to over watch keep psychiatrist any including life, or that degree of deafness which makes conversa. symptoms of psychological trauma. either difficult or impossible and may lead to the Objection may be raised to such a scheme on the tion loss of employment. So far as we know, no figures grounds that it would be uneconomical and nonto the whole population are available in this relating not be productive. Obviously a dock labourer could or any other country ; but it has been suggested to to his actual in an but trade occupational centre, put remedial exercises could be designed so that in us that possibly some of your readers may be able effect he is increasing the amount of his exertion every to give us useful information on this subject concerning particular areas, groups, or trades. If so, we day whilst under treatment. His labour can hardly shall be grateful for any information on the incidence his be paid for in addition to compensation allowance, of serious deafness even if it refers only to limited but it might be possible to send the labourer out to of persons, or for any direction to the sources jobs which will re-educate him in his actual work for numbers of such information, whether at home or abroad. short periods every day, and the amount of work I am, Sir, yours faithfully, which he does in this way would be credited to him A. J. STORY, in addition to his allowance. Any man who is keen Secretary, National Institute for the Deaf. to get back to work will make every effort to get his 105, Gower-street, London, W.C.1, Oct. 7th. full capacity returned once he has begun to earn from his routine daily work. If only for this reason HISTIDINE AND PEPTIC ULCER alone the majority of cases will respond to treatment at the rehabilitation centre, and the compensation To the Editor of THE LANCET period will be cut down. SIR,-In the correspondence following Mr. Barry I am, Sir, yours faithfully, and Prof. Florey’s paper on the histidine treatment JOHN P. STEEL. of peptic ulcer, Dr. Denys Jennings refers to my Medical Superintendent, Smithdown-road Hospital, theory of ulcer formation as being based on " unlucky Liverpool, Oct. 10th. family tradition of cooking." Although I claim that EUTHANASIA AND OTHER ESSAYS faulty diet, especially the consumption of fat, is at the basis of the formation of the ulcer, this is only To the Editor of THE LANCET considered as an indirect cause, the direct one being SiR,-May I steal an inch of your valuable space regurgitation of the upper intestinal juices into the to express my appreciation of your witty and in-seeing stomach, thus allowing the bile to act in an acid editorial reference to my recently published volume medium with destructive effects on the gastric of essays 1 Especially I applaud your diagnosis of mucous membrane. Also in your last issue Dr. But my opinion as to the localisation of angels. Hurst refers to lamentable diagnoses through which in your illustration of my two-mindedness, have you patients suffering from carcinoma of the oesophagus not overlooked the two words " as such" in the and stomach, and even of the rectum, have been opening sentence of the passage you quote’? diagnosed and treated as gastro-duodenal ulcers. T am. Sir. vours faithfullv. This, I think, happens because it is not realised that, HARRY ROBERTS. whenever there is obstruction in any part of the Harford-street, Stepney, Oct. 10th. bowel, either functional or organic, ulcer symptoms COD-LIVER OIL TREATMENT OF WOUNDS may be simulated, or actual ulcers produced. I think that this is a further proof that retroperistalsis is an To the Editor of THE LANCET essential factor in ulcer production. Experimental SIR,-The articles in THE LANCET of Sept. 26th by evidence in support of this view is given by Slocumb Dr. J. Davson and Dr. S. Sander on the use of cod(quoted by McCann, Arch. of Surg., 1929, xix., 600) liver oil in the treatment of slow healing wounds who noted " inflammatory changes and multiple are interesting. ulcers in the duodenum of dogs in which he established But the method of employing codliver oil in these conditions is not new, as fourteen partial obstruction of the duodenum by surgical It will be obvious, therefore, how years ago it was in use at the Royal Free Hospital measures." with considerable success. Shortly, however, a pracit is first to establish a proper diagnosis important tical difficulty was encountered-namely, the nauseatbefore relying on obtaining results from some fancy ing smell of this oil for those not accustomed to it. treatment. I should also like to add that my experience in Finally, a patient informed me that although the oil was helping him, he had had to wipe it off, as he respect of the use of histidine corresponds to Dr. to down followed Inn-road Hurst’s, and that I have not found it either desirable being objected Gray’s by the cats of the neighbourhood ! It was this or necessary as an adjunct to my own treatment. I am, Sir, yours faithfully, unusual complaint by a patient that fixes the date J. JACQUES SPIRA. in my mind. I should like to employ cod-liver oil it 1 can be overcome. Can this if 10th. Oct. W., Chesterfield-gardens, Mayfair, difficulty again