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HOSPITAL SYRINGE SERVICE
225 whom plasma-salicylate concentrations regarded as ° necessary for adequate therapy had been attained.1O It is therefore our opinion that the available experimental evidence by no means proves that the action of salicylates is primarily mediated through the pituitary and adrenal glands, and that the generalised conclusion reached by Hetzel and Hine is not warranted. B. W. MEADE King’s College Hospital Medical School, M. J. H. SMITH. London, S.E.5 CETRIMIDE SHAMPOO FOR SEBORRHŒA
SiR,—Since cetrimide was added to the armoury of skin-sterilising agents some of us have been tempted to experiment with this detergent in conditions other than
surgical uses for which it is ordinarily used. May I recommend the following preparation, which have found particularly efficacious, in controlling
the I
seborrhcea and seborrhoeic dermatitis : Cetrimjde
gr. 150 (10 g.) Ether q.s. to 2 oz. vini meth. 2 oz. Spirit. Water to 6 oz. 1/. oz. to 1 pint of water.
This is used
shampoo on alternate nights for one once weekly. I have treated more cases in the last six months with extremely
as a
week, and thereafter than
a
dozen
gratifying results. The following case illustrates this point : A man, aged 32, inclined to obesity and with a greasy skin, complained of an itchy scalp and a rash on the face and neck. The scalp was extremely scurfy, and patches of dermatitis were present. The shaving area, nape of the neck, and chest
He had showed typical lesions of seborrhosic dermatitis. previously used various coal-tar derivatives with temporary amelioration only. He was treated with cetrimide shampoo twice to three times weekly for three weeks. All the lesions had then cleared up completely. He now uses the shampoo only once a fortnight and has remained clear of lesions for over two and a half months -the longest period of freedom for some 3-4 years. The hair, which was previously " falling," seems now to have ceased to do
so.
JAMES P. S. HODGES.
Wembley, Middlesex.
SALE OF CONTRACEPTIVES
your issue of July 21 you refer to a statement the council of the Pharmaceutical Society with regard by to the sale of contraceptives by pharmacists. The society has expressed the opinion that " the only satisfactory course is for no indication either direct or indirect to be given at any pharmacy that contraceptives are sold there." The My association regards this as most unfortunate. " Commission on said that Royal public Population policy should assume and seek to encourage the spread of voluntary parenthood." The Commission also found that " the great majority of married couples nowadays practise some form of birth control in order to limit their families," and that if mechanical methods of contraception were not available " other means would be used, and some of them, e.g., criminal abortion, the prevalence of which is even now distressingly high, are very undesirable." There can be no doubt that there is a large demand for reliable contraceptives by married couples ; if this demand is not met by pharmacists it will be met in other and much less satisfactory ways. Without making any exaggerated advertisement or display it should be possible for pharmacists to indicate that they can supply contraceptives, and thus follow the public policy recommended by the Royal Commission. &iR,—In
Family Planning Association, 64, Sloane Street, London, S.W.1. 10. Meade, B. W.,
Smith, M. J. H.
IRENE M. JAMES General Secretary.
Ibid,
p. 773.
HOSPITAL SYRINGE SERVICE
SIR,—In the interesting articles of July 14 by Dr. Horley (p. 50) and Dr. Gibson (p. 52) their figs. 3 and 2,
respectively, illustrate a common practice that holds a potential danger. Both test-tubes could have their contents taken out and the cotton-wool replaced leaving the word " sterile " intact on the side of the containers. Labels should be stuck across the top of the bottles or tubes so that the word " sterile " is destroyed when the container is opened ; otherwise it is better to avoid the use of this word. K. B. ROGERS Children’s Hospital, Clinical Pathologist. Birmingham
SIR,—I was interested to read the articles by Dr. Horley and Dr. Gibson. A sterile-syringe service was started in Robroyston Hospital, Glasgow, in 1947. It has been operated throughout from the dispensary under the supervision of the chief pharmacist, Miss S. M. Graham. The used syringes and needles are steeped overnight in a solution of lysol and ’Sulphonated lorol,’ as they are then more easily washed in water. In the morning they are rinsed out with methylated spirit and .ether, and when dry are finally lubricated with silicone d.c. 550 one part, methylated ether four parts. It has been found that liquid paraffin and ether char at a temperature of 160°C. Each syringe is fitted into a rimless glass Pyrex’ tube of correct dimension and sealed with ’ Cellophane.’ Gauze and non-absorbent cotton-wool have been found unsuitable The needles are fitted into glass as these introduce fibres. tubes with a grooved neck, and sealed with cellophane with a rip cord to facilitate the removal of the cellophane. Needles and syringes are placed in a thermostatically controlled hotair oven at 160°C. Kjer Petersen, Clive Riviere, and aspirating needles used in the tuberculosis section of the hospital are fitted into glass tubes and placed in tins which are sealed on removal from the oven. A Brown sterilising control tube is placed inside a test tube and packed along with the syringes in the oven each night, to ensure that the required temperature is reached. - Bacteriological tests are carried out
periodically. This hospital of 800 beds and clinics are now supplied with a service of syringes and needles. These are issued, and returns received, from 3 to 3.30 P.M. daily, requirements being stated on a printed form. A complete record is kept for each ward and department of the
hospital. Robroyston Hospital, Glasgow.
WALTER M. BORTHWICK.
SICKLE-CELL ANEMIA IN GREECE
SIR,—The discovery of a focus of sickle-cell disease in Greece by Professor Choremis and his colleaguesmust raise the hopes of many students of the disease that an answer to some of its unsolved problems may be near at hand. Provided that further study can clarify the differential diagnosis-perhaps even to the extent of satisfying the exacting criticism of Dr. Lehmann 2-the concentration of so many cases where the population is static, where genealogies are known, where reasonably accurate histories can be taken, and where competent investigators can attack the problem, offers advantages not to be found together in America, still less in Africa. There are already indications of the answers to some of the four problems that the Greek workers pose : and chronic undernourishment are rampant Central Africa, where the incidence of the sickling trait is in the region of 20%, yet a review of the available literature3 suggests that sickle-cell anæmia -is rare there. 2. The anthropological aspect can only be elucidated in Greece, but may well be related to the importation of negroes in the days of Turkish domination. 1. Malaria
throughout
1. Choremis, C., Zervos, N., Constantinides, V., Zannos, L. Lancet, 1951, i, 1147. 2. Lehmann, H. Ibid, p. 1279. 3. Raper, A. B. J. trop. Med. Hyg. 1950, 53, 49.
SiR,—Since cetrimide was added to the armoury of skin-sterilising agents some of us have been tempted to experiment with this detergent in conditions other than
surgical uses for which it is ordinarily used. May I recommend the following preparation, which have found particularly efficacious, in controlling
the I
seborrhcea and seborrhoeic dermatitis : Cetrimjde
gr. 150 (10 g.) Ether q.s. to 2 oz. vini meth. 2 oz. Spirit. Water to 6 oz. 1/. oz. to 1 pint of water.
This is used
shampoo on alternate nights for one once weekly. I have treated more cases in the last six months with extremely
as a
week, and thereafter than
a
dozen
gratifying results. The following case illustrates this point : A man, aged 32, inclined to obesity and with a greasy skin, complained of an itchy scalp and a rash on the face and neck. The scalp was extremely scurfy, and patches of dermatitis were present. The shaving area, nape of the neck, and chest
He had showed typical lesions of seborrhosic dermatitis. previously used various coal-tar derivatives with temporary amelioration only. He was treated with cetrimide shampoo twice to three times weekly for three weeks. All the lesions had then cleared up completely. He now uses the shampoo only once a fortnight and has remained clear of lesions for over two and a half months -the longest period of freedom for some 3-4 years. The hair, which was previously " falling," seems now to have ceased to do
so.
JAMES P. S. HODGES.
Wembley, Middlesex.
SALE OF CONTRACEPTIVES
your issue of July 21 you refer to a statement the council of the Pharmaceutical Society with regard by to the sale of contraceptives by pharmacists. The society has expressed the opinion that " the only satisfactory course is for no indication either direct or indirect to be given at any pharmacy that contraceptives are sold there." The My association regards this as most unfortunate. " Commission on said that Royal public Population policy should assume and seek to encourage the spread of voluntary parenthood." The Commission also found that " the great majority of married couples nowadays practise some form of birth control in order to limit their families," and that if mechanical methods of contraception were not available " other means would be used, and some of them, e.g., criminal abortion, the prevalence of which is even now distressingly high, are very undesirable." There can be no doubt that there is a large demand for reliable contraceptives by married couples ; if this demand is not met by pharmacists it will be met in other and much less satisfactory ways. Without making any exaggerated advertisement or display it should be possible for pharmacists to indicate that they can supply contraceptives, and thus follow the public policy recommended by the Royal Commission. &iR,—In
Family Planning Association, 64, Sloane Street, London, S.W.1. 10. Meade, B. W.,
Smith, M. J. H.
IRENE M. JAMES General Secretary.
Ibid,
p. 773.
HOSPITAL SYRINGE SERVICE
SIR,—In the interesting articles of July 14 by Dr. Horley (p. 50) and Dr. Gibson (p. 52) their figs. 3 and 2,
respectively, illustrate a common practice that holds a potential danger. Both test-tubes could have their contents taken out and the cotton-wool replaced leaving the word " sterile " intact on the side of the containers. Labels should be stuck across the top of the bottles or tubes so that the word " sterile " is destroyed when the container is opened ; otherwise it is better to avoid the use of this word. K. B. ROGERS Children’s Hospital, Clinical Pathologist. Birmingham
SIR,—I was interested to read the articles by Dr. Horley and Dr. Gibson. A sterile-syringe service was started in Robroyston Hospital, Glasgow, in 1947. It has been operated throughout from the dispensary under the supervision of the chief pharmacist, Miss S. M. Graham. The used syringes and needles are steeped overnight in a solution of lysol and ’Sulphonated lorol,’ as they are then more easily washed in water. In the morning they are rinsed out with methylated spirit and .ether, and when dry are finally lubricated with silicone d.c. 550 one part, methylated ether four parts. It has been found that liquid paraffin and ether char at a temperature of 160°C. Each syringe is fitted into a rimless glass Pyrex’ tube of correct dimension and sealed with ’ Cellophane.’ Gauze and non-absorbent cotton-wool have been found unsuitable The needles are fitted into glass as these introduce fibres. tubes with a grooved neck, and sealed with cellophane with a rip cord to facilitate the removal of the cellophane. Needles and syringes are placed in a thermostatically controlled hotair oven at 160°C. Kjer Petersen, Clive Riviere, and aspirating needles used in the tuberculosis section of the hospital are fitted into glass tubes and placed in tins which are sealed on removal from the oven. A Brown sterilising control tube is placed inside a test tube and packed along with the syringes in the oven each night, to ensure that the required temperature is reached. - Bacteriological tests are carried out
periodically. This hospital of 800 beds and clinics are now supplied with a service of syringes and needles. These are issued, and returns received, from 3 to 3.30 P.M. daily, requirements being stated on a printed form. A complete record is kept for each ward and department of the
hospital. Robroyston Hospital, Glasgow.
WALTER M. BORTHWICK.
SICKLE-CELL ANEMIA IN GREECE
SIR,—The discovery of a focus of sickle-cell disease in Greece by Professor Choremis and his colleaguesmust raise the hopes of many students of the disease that an answer to some of its unsolved problems may be near at hand. Provided that further study can clarify the differential diagnosis-perhaps even to the extent of satisfying the exacting criticism of Dr. Lehmann 2-the concentration of so many cases where the population is static, where genealogies are known, where reasonably accurate histories can be taken, and where competent investigators can attack the problem, offers advantages not to be found together in America, still less in Africa. There are already indications of the answers to some of the four problems that the Greek workers pose : and chronic undernourishment are rampant Central Africa, where the incidence of the sickling trait is in the region of 20%, yet a review of the available literature3 suggests that sickle-cell anæmia -is rare there. 2. The anthropological aspect can only be elucidated in Greece, but may well be related to the importation of negroes in the days of Turkish domination. 1. Malaria
throughout
1. Choremis, C., Zervos, N., Constantinides, V., Zannos, L. Lancet, 1951, i, 1147. 2. Lehmann, H. Ibid, p. 1279. 3. Raper, A. B. J. trop. Med. Hyg. 1950, 53, 49.