- Email: [email protected]
INQUIRY INTO THE ÆTIOLOGY OF CANCER
898 will doctors be justified in sanctioning such treatment at the various institutions. Meanwhile they must find time to treat their own patients and to charge
the
following day. She had not been vaccinated since infancy. She became ill on April 5th, with a temperature -of 1010 F., and backache which was attributed to the pregnancy. She aborted on April 8th, but the pain in the back persisted. On April 9th her doctor received a telephone
message that she was dead. On examination he noticed a purpuric rash round the groin, and asked Dr. Thomas to see her. The doctor had not been informed by the patient’s friends that she was a small-pox contact, nor had the public health department been notified that she was ill, though inspectors from the department had visited the house and inquired as to her welfare. Dr. Thomas found a purpuric rash on both groins extending on the right side as far as the axilla, there was subconjunctival haemorrhage, and the beginning of a focal rash (two spots) on the right forearm. On the same day the husband, who was ill, was seen by Dr. ’Thomas, who found a rash just coming out and becoming - confluent. He died on April 16th at Joyce Green Hospital, Dartford.
accordingly.-I
FUNCTIONAL
Correspondence. Audi alteram partem."
THE NEW IMPORTANCE OF RADIUM. To the Editor of THE LANCET. SIR,—In the report of the Radium Subcommittee of the Committee of Civil Research, which you summarised last week, allusion is made (p. 5) to the so-called " surgery of access," which has sprung into existence as the value of radium in medical treatment has been progressively recognised. We do not doubt," the report states, that as further knowledge is obtained in regard to the possibilities of this radiumsurgery, its use will develop rapidly, and in an increasing measure it will replace the use of the knife in the treatment of cancer." Personally I think a statement like this is likely to mislead not only the public but the medical profession. The main point is whether in a
tumour is
susceptible
or
INQUIRY
not to
of radium at a distance from the body, a wide field to be covered and a fairly homogeneous intensity of irradiation to be given to a moderate depth below the surface of the body.
quantities
which enables
yours
faithfully, G. E. BIRKETT.
Manchester and District Radium Institute, April 20th, 1929.
THE "PHYSIOTHERAPY CLINIC" AND THE PRACTITIONER. To the Editor of THE LANCET. SIR,—Dr. Ray’s letter in your last issue calls for comment. To my mind physiotherapy is too wide a term. It should surely be divided into balneology and electro-therapeutics, the latter requiring skilled and
you
qualified operators. In a leading article which published some months ago on unqualified
THE LANCET.
I am, Sir, yours faithfully, J. D. D.M.R.E. Camb. J. D. KIDD, KIDD, M.B., Ch.B., D.M.R.E.Camb. Cavendish-square, W., April 22nd, 1929.
surgery which provides access to a tumour is not going to influence this. Secondly, surgery of access only enables a localised method of treatment to come into play. The logical development of our present-day knowledge is the use of large
Sir,
of
SIR,—I was somewhat surprised to notice that in the discussion at the Royal Society of Medicine (War Section) on April 8th (reported in your issue of April 13th, p. 773) no mention was made of the examination of the teeth. Apart from the presence of oral sepsis it is recognised that in certain cases unerupted and impacted molar teeth may, by reflex irritation from pressure of the second molar, be the causal factor of such conditions as neurasthenia, hysteria, chorea, epilepsy, or even insanity. This suggests to my mind that routine radiographic examination of the teeth would assist the diagnosis and indicate a line of treatment. Many cases in which such impacted molars have been found and extracted have greatly improved, and a certain percentage have completely recovered. I know of a physician who, acting as honorary medical adviser to a missionary society, has stipulated that all candidates shall have dental radiograms taken before they are finally accepted as he is convinced that, if the large number of Europeans who are employed and reside in the East had such an examination carried out, many cases of so-called tropical neurasthenia would never occur.
Obviously
I am,
faithfully,
NERVOUS DISORDERS IN
’1’0the Editor
"
irradiation.
yours
THE SERVICES.
"
"the first instance
Sir,
W. S. WHITCOMBE. Harley-street, W., April 20th, 1929.
The number of stillbirths reported during the week was 299 (corresponding to a rate of 40 per thousand births), including 54 in London.
"
am,
-
INTO THE ÆTIOLOGY OF CANCER
To the Editor of THE LANCET. SIR,—In THE LANCET of June 16th last (p. 1250), an appeal was made to your readers to help in a statistical research into the aetiology of cancer, by answering a schedule of questions relating to a cancer patient and a non-cancer patient of the same sex and about the same age as control case. The response to this appeal, though somewhat disappointing, was sufficient to justify printing the schedules and starting the investigation, and some medical practitioners have rendered most useful service by their careful work in completing these forms. In order that sufficient data may be secured more volunteers are needed, and since many of your readers doubtless did not see or give careful consideration to the first appeal, may I again ask that any who are in touch with cases of cancer, whether in general, specialist, or hospital practice, and who are prepared to devote a few hours to assist in this research, will communicate with me at the Galton Laboratory ? Unfortunately, it is not possible to offer any kind of remuneration for this service, but I feel sure that there are some who will be prepared to make this voluntary sacrifice of a little time to help in a form of cancer research which can only be carried out by team work. I am, Sir, yours faithfully, PERCY STOCKS, M.D., D.P.H., Reader in Medical Statistics, University of London.
electro-therapeutists you called proper attention to Galton Laboratory. University College, London, W.C., this crying evil. Before then I myself had drawn the April 23rd, 1929. attention of Dr. Ray and others to the proper remedy for this dangerous practice, which can only be stopped THE ÆTIOLOGY OF UROLITHIASIS. by legislation. The political section of the British Medical Association has, I am glad to say, taken the To the Editor of THE LANCET. matter up and it will be pushed through in due course. SIR,—In your issue of April 20th (p. 847) Dr. Levick My suggestion was that no one should be allowed to carry out such treatment unless he had passed a says that he does not think that Europeans in the thorough examination in the physics of electro- tropics suffer from urolithiasis as the result ofI therapeutics and held a certificate to that effect issued excessive exposure to the solar ultra-violet rays. by a proper board of examiners. Then, and only then, have no doubt that Dr. Levick is right and, so far as
the
following day. She had not been vaccinated since infancy. She became ill on April 5th, with a temperature -of 1010 F., and backache which was attributed to the pregnancy. She aborted on April 8th, but the pain in the back persisted. On April 9th her doctor received a telephone
message that she was dead. On examination he noticed a purpuric rash round the groin, and asked Dr. Thomas to see her. The doctor had not been informed by the patient’s friends that she was a small-pox contact, nor had the public health department been notified that she was ill, though inspectors from the department had visited the house and inquired as to her welfare. Dr. Thomas found a purpuric rash on both groins extending on the right side as far as the axilla, there was subconjunctival haemorrhage, and the beginning of a focal rash (two spots) on the right forearm. On the same day the husband, who was ill, was seen by Dr. ’Thomas, who found a rash just coming out and becoming - confluent. He died on April 16th at Joyce Green Hospital, Dartford.
accordingly.-I
FUNCTIONAL
Correspondence. Audi alteram partem."
THE NEW IMPORTANCE OF RADIUM. To the Editor of THE LANCET. SIR,—In the report of the Radium Subcommittee of the Committee of Civil Research, which you summarised last week, allusion is made (p. 5) to the so-called " surgery of access," which has sprung into existence as the value of radium in medical treatment has been progressively recognised. We do not doubt," the report states, that as further knowledge is obtained in regard to the possibilities of this radiumsurgery, its use will develop rapidly, and in an increasing measure it will replace the use of the knife in the treatment of cancer." Personally I think a statement like this is likely to mislead not only the public but the medical profession. The main point is whether in a
tumour is
susceptible
or
INQUIRY
not to
of radium at a distance from the body, a wide field to be covered and a fairly homogeneous intensity of irradiation to be given to a moderate depth below the surface of the body.
quantities
which enables
yours
faithfully, G. E. BIRKETT.
Manchester and District Radium Institute, April 20th, 1929.
THE "PHYSIOTHERAPY CLINIC" AND THE PRACTITIONER. To the Editor of THE LANCET. SIR,—Dr. Ray’s letter in your last issue calls for comment. To my mind physiotherapy is too wide a term. It should surely be divided into balneology and electro-therapeutics, the latter requiring skilled and
you
qualified operators. In a leading article which published some months ago on unqualified
THE LANCET.
I am, Sir, yours faithfully, J. D. D.M.R.E. Camb. J. D. KIDD, KIDD, M.B., Ch.B., D.M.R.E.Camb. Cavendish-square, W., April 22nd, 1929.
surgery which provides access to a tumour is not going to influence this. Secondly, surgery of access only enables a localised method of treatment to come into play. The logical development of our present-day knowledge is the use of large
Sir,
of
SIR,—I was somewhat surprised to notice that in the discussion at the Royal Society of Medicine (War Section) on April 8th (reported in your issue of April 13th, p. 773) no mention was made of the examination of the teeth. Apart from the presence of oral sepsis it is recognised that in certain cases unerupted and impacted molar teeth may, by reflex irritation from pressure of the second molar, be the causal factor of such conditions as neurasthenia, hysteria, chorea, epilepsy, or even insanity. This suggests to my mind that routine radiographic examination of the teeth would assist the diagnosis and indicate a line of treatment. Many cases in which such impacted molars have been found and extracted have greatly improved, and a certain percentage have completely recovered. I know of a physician who, acting as honorary medical adviser to a missionary society, has stipulated that all candidates shall have dental radiograms taken before they are finally accepted as he is convinced that, if the large number of Europeans who are employed and reside in the East had such an examination carried out, many cases of so-called tropical neurasthenia would never occur.
Obviously
I am,
faithfully,
NERVOUS DISORDERS IN
’1’0the Editor
"
irradiation.
yours
THE SERVICES.
"
"the first instance
Sir,
W. S. WHITCOMBE. Harley-street, W., April 20th, 1929.
The number of stillbirths reported during the week was 299 (corresponding to a rate of 40 per thousand births), including 54 in London.
"
am,
-
INTO THE ÆTIOLOGY OF CANCER
To the Editor of THE LANCET. SIR,—In THE LANCET of June 16th last (p. 1250), an appeal was made to your readers to help in a statistical research into the aetiology of cancer, by answering a schedule of questions relating to a cancer patient and a non-cancer patient of the same sex and about the same age as control case. The response to this appeal, though somewhat disappointing, was sufficient to justify printing the schedules and starting the investigation, and some medical practitioners have rendered most useful service by their careful work in completing these forms. In order that sufficient data may be secured more volunteers are needed, and since many of your readers doubtless did not see or give careful consideration to the first appeal, may I again ask that any who are in touch with cases of cancer, whether in general, specialist, or hospital practice, and who are prepared to devote a few hours to assist in this research, will communicate with me at the Galton Laboratory ? Unfortunately, it is not possible to offer any kind of remuneration for this service, but I feel sure that there are some who will be prepared to make this voluntary sacrifice of a little time to help in a form of cancer research which can only be carried out by team work. I am, Sir, yours faithfully, PERCY STOCKS, M.D., D.P.H., Reader in Medical Statistics, University of London.
electro-therapeutists you called proper attention to Galton Laboratory. University College, London, W.C., this crying evil. Before then I myself had drawn the April 23rd, 1929. attention of Dr. Ray and others to the proper remedy for this dangerous practice, which can only be stopped THE ÆTIOLOGY OF UROLITHIASIS. by legislation. The political section of the British Medical Association has, I am glad to say, taken the To the Editor of THE LANCET. matter up and it will be pushed through in due course. SIR,—In your issue of April 20th (p. 847) Dr. Levick My suggestion was that no one should be allowed to carry out such treatment unless he had passed a says that he does not think that Europeans in the thorough examination in the physics of electro- tropics suffer from urolithiasis as the result ofI therapeutics and held a certificate to that effect issued excessive exposure to the solar ultra-violet rays. by a proper board of examiners. Then, and only then, have no doubt that Dr. Levick is right and, so far as