- Email: [email protected]
LECTURES ON TAPE
421
eighteen months, is not harmful to the tissues, does not stick, and is water-soluble. Because of this the moisture in the wound and surrounding skin can pass through the gauze into the dressings outside it. It does not make the skin moist, and delayed healing and sensitisation are therefore unlikely. It can be prepared and used in a similar manner to paraffin gauze. It is easily removed from the hands, instruments, or the patient’s skin, by gentle swabbing with water or saline. It causes a minimum of inconvenience for the dresser and of discomfort for the patient. We have used it for both daily and less frequent dressings and it does not appear to delay healing nor does it give rise to any unpleasant odour. The macrogol gauze can be prepared with any desired percentage of an antibacterial agent. We have used it with 02% nitrofurazone in it, but this was abandoned when reports of sensitivity appeared. Many people are dissatisfied with preparations of soft paraffin gauze and I am sure that these difficulties must have been overcome in a diversity of ways; but in our experience macrogol gauze is a very satisfactory dressing with a wide range of application. After clinical trials had shown the gauze to fulfil all the claims made for it, we gave the formula to Messrs. Smith & Nephew, and we are now using their preparation called‘ Carbonet ’. H. K. BOURNS. AN UNUSUAL SOURCE OF MERCURY IN PINK DISEASE
SIR,—The relation between mercury and pink disease has been much discussed, and though the consensus of opinion seems to hold that a direct causal relationship is not proven," there is good evidence that the frequency
and a twenty-four-hour specimen of urine showed an excretion of 207 µg. of mercury. A further history taken from the parents at this stage did not reveal any access to mercury from any of the usual sources, but on close questioning it was discovered that just before the onset of the fits the lawn had been dressed with lawn sand. The weather had been fine at this time and it was some four days before rain washed the sand into the earth. In the meantime the child had been playing on the lawn most of each day. The child was not seen to eat the sand, but later in the ward he showed the usual tendency of his age to put everything in his mouth. A specimen of this lawn sand was found to contain about 1 part in 50,000 of mercury. The child’s subsequent progress was slow but uneventful. He remained irritable for some days and showed a tendency to an inverted sleep rhythm with wakefulness at night and drowsiness in the day. Before discharge the urinary mercury excretion was 17 p,g. in twenty-four hours. When last seen in June his good progress had been maintained, though he was backward in his speaking and had had two short episodes of urticaria.
Mercurised lawn sand is a dressing applied to lawns to kill unwanted moss. Its use is quite extensive in this country. The possibility of absorption of mercury from this source has not, to my knowledge, been recognised and I hope this case will draw attention to the fact. I should like to thank Dr. Wilfrid Sheldon for permission to report this the text.
case
and for his
Evelina Children’s Hospital, London, S.E.1.
help
and advice in the
preparation of
J. W. SCOPES.
"
of the association is more than incidental. The sources from which infants may absorb mercury are usually fairly well defined (teething powders, mercurial ointThe case described here seems ments, vermifuges, &c.). to be of interest since it involves an unusual source of mercury absorption in the infant. A boy child, aged 21/2 years, was admitted to the Hospital for Sick Children, Great Ormond Street, under the care of Dr. Wilfrid Sheldon, in May, 1958, after a series of epileptiform convulsions. He was a third child, and there was no history of birth trauma nor any family history of neurological disease or fits. His development had been possibly slightly retarded (he sat up at ten months, walked at twenty months, and at the age of two years spoke only a very few single words), but he had been otherwise well until October, 1957. At this time the whole family had influenza, and he had an acute pyrexial illness and a convulsion. He was admitted to the local hospital but made a quick recovery and no abnormality apart from his mental
slowness was noted. The child remained well until April 29, 1958, when quite suddenly he had a series of convulsions which continued for thirty-six hours until controlled by sedation. He was admitted to a local hospital where it was thought that he had become both deaf and blind and where a lumbar puncture was performed and found to be normal. On arrival at Great Ormond Street he was fully conscious but very irritable and tended to lie in the prone position with his legs curled under him and his eyes turned away from the light. He had a cold pinkness of his extremities, a mild desquamating rash over the lower part of his trunk, and an angular stomatitis. His pulse-rate was 120 and his bloodpressure 130/90 mm. Hg. Examination of the central nervous system revealed no localising abnormality; he could see and hear well, but his mental state was obviously retarded for a child of 2111,years. Investigations included chest and skull
X-rays, electroencephalography, serum-calcium, phosphorus, urea and sugar, urine for abnormal metabolites, Wassermann reaction, and blood-count, which were all essentially normal, but the erythrocyte-sedimentation rate was 40 mm. in one hour,
LECTURES ON TAPE
SIR,—Ihave just read your noteabout the suggestion of Graves and Graves2 that there should be a central library of tape-recordings and a collection of machines for hire. Each month about 30,000 American and 1000 Canadian doctors are doing just what this note suggests-i.e., keeping up with advances in medicine and surgery by
listening to tape-recordings prepared by our organisation. The Audio-Digest Foundation (a non-profit subsidiary of the California Medical Association, whose excess reserve funds are contributed to America’s 79 medical schools) issues 5 different series of programmes. Subscribers to surgery, internal medicine, obstetrics-gynaecology, and psediatric programmes receive a new hour-long tape every two weeks; those in general practice receive new programmes each week. The tape-recordings themselves survey the current world literature and provide the rural practitioner with expert scientific lectures by leaders in world medicine. Each programme contains at least 2 fifteen-minute lectures by an expert in his chosen specialty. I write to let your readers know how many of their
American and Canadian colleagues are keeping up with medical advances, and to suggest that these tapes (with appropriate equipment) might be set up in central locations throughout the British Isles for the use of interested doctors. In America the annual subscription to the specialties is$81.50, and for the weekly general-practice series it is$162. At present, customs and excise difficulties prevent the importation of our programmes into England, but with enough interest from the British medical profession it is possible that these obstacles might be overcome.
1919, Wilshire Boulevard, Angeles, 57, California.
Los 1. 2.
CLARON L. OAKLEY Editor, Audio-Digest Foundation.
Lancet, 1957, ii, 1346. Graves, J. C., Graves, V. Research Newsletter, College of General Practitioners, 1957, 4, 325.
eighteen months, is not harmful to the tissues, does not stick, and is water-soluble. Because of this the moisture in the wound and surrounding skin can pass through the gauze into the dressings outside it. It does not make the skin moist, and delayed healing and sensitisation are therefore unlikely. It can be prepared and used in a similar manner to paraffin gauze. It is easily removed from the hands, instruments, or the patient’s skin, by gentle swabbing with water or saline. It causes a minimum of inconvenience for the dresser and of discomfort for the patient. We have used it for both daily and less frequent dressings and it does not appear to delay healing nor does it give rise to any unpleasant odour. The macrogol gauze can be prepared with any desired percentage of an antibacterial agent. We have used it with 02% nitrofurazone in it, but this was abandoned when reports of sensitivity appeared. Many people are dissatisfied with preparations of soft paraffin gauze and I am sure that these difficulties must have been overcome in a diversity of ways; but in our experience macrogol gauze is a very satisfactory dressing with a wide range of application. After clinical trials had shown the gauze to fulfil all the claims made for it, we gave the formula to Messrs. Smith & Nephew, and we are now using their preparation called‘ Carbonet ’. H. K. BOURNS. AN UNUSUAL SOURCE OF MERCURY IN PINK DISEASE
SIR,—The relation between mercury and pink disease has been much discussed, and though the consensus of opinion seems to hold that a direct causal relationship is not proven," there is good evidence that the frequency
and a twenty-four-hour specimen of urine showed an excretion of 207 µg. of mercury. A further history taken from the parents at this stage did not reveal any access to mercury from any of the usual sources, but on close questioning it was discovered that just before the onset of the fits the lawn had been dressed with lawn sand. The weather had been fine at this time and it was some four days before rain washed the sand into the earth. In the meantime the child had been playing on the lawn most of each day. The child was not seen to eat the sand, but later in the ward he showed the usual tendency of his age to put everything in his mouth. A specimen of this lawn sand was found to contain about 1 part in 50,000 of mercury. The child’s subsequent progress was slow but uneventful. He remained irritable for some days and showed a tendency to an inverted sleep rhythm with wakefulness at night and drowsiness in the day. Before discharge the urinary mercury excretion was 17 p,g. in twenty-four hours. When last seen in June his good progress had been maintained, though he was backward in his speaking and had had two short episodes of urticaria.
Mercurised lawn sand is a dressing applied to lawns to kill unwanted moss. Its use is quite extensive in this country. The possibility of absorption of mercury from this source has not, to my knowledge, been recognised and I hope this case will draw attention to the fact. I should like to thank Dr. Wilfrid Sheldon for permission to report this the text.
case
and for his
Evelina Children’s Hospital, London, S.E.1.
help
and advice in the
preparation of
J. W. SCOPES.
"
of the association is more than incidental. The sources from which infants may absorb mercury are usually fairly well defined (teething powders, mercurial ointThe case described here seems ments, vermifuges, &c.). to be of interest since it involves an unusual source of mercury absorption in the infant. A boy child, aged 21/2 years, was admitted to the Hospital for Sick Children, Great Ormond Street, under the care of Dr. Wilfrid Sheldon, in May, 1958, after a series of epileptiform convulsions. He was a third child, and there was no history of birth trauma nor any family history of neurological disease or fits. His development had been possibly slightly retarded (he sat up at ten months, walked at twenty months, and at the age of two years spoke only a very few single words), but he had been otherwise well until October, 1957. At this time the whole family had influenza, and he had an acute pyrexial illness and a convulsion. He was admitted to the local hospital but made a quick recovery and no abnormality apart from his mental
slowness was noted. The child remained well until April 29, 1958, when quite suddenly he had a series of convulsions which continued for thirty-six hours until controlled by sedation. He was admitted to a local hospital where it was thought that he had become both deaf and blind and where a lumbar puncture was performed and found to be normal. On arrival at Great Ormond Street he was fully conscious but very irritable and tended to lie in the prone position with his legs curled under him and his eyes turned away from the light. He had a cold pinkness of his extremities, a mild desquamating rash over the lower part of his trunk, and an angular stomatitis. His pulse-rate was 120 and his bloodpressure 130/90 mm. Hg. Examination of the central nervous system revealed no localising abnormality; he could see and hear well, but his mental state was obviously retarded for a child of 2111,years. Investigations included chest and skull
X-rays, electroencephalography, serum-calcium, phosphorus, urea and sugar, urine for abnormal metabolites, Wassermann reaction, and blood-count, which were all essentially normal, but the erythrocyte-sedimentation rate was 40 mm. in one hour,
LECTURES ON TAPE
SIR,—Ihave just read your noteabout the suggestion of Graves and Graves2 that there should be a central library of tape-recordings and a collection of machines for hire. Each month about 30,000 American and 1000 Canadian doctors are doing just what this note suggests-i.e., keeping up with advances in medicine and surgery by
listening to tape-recordings prepared by our organisation. The Audio-Digest Foundation (a non-profit subsidiary of the California Medical Association, whose excess reserve funds are contributed to America’s 79 medical schools) issues 5 different series of programmes. Subscribers to surgery, internal medicine, obstetrics-gynaecology, and psediatric programmes receive a new hour-long tape every two weeks; those in general practice receive new programmes each week. The tape-recordings themselves survey the current world literature and provide the rural practitioner with expert scientific lectures by leaders in world medicine. Each programme contains at least 2 fifteen-minute lectures by an expert in his chosen specialty. I write to let your readers know how many of their
American and Canadian colleagues are keeping up with medical advances, and to suggest that these tapes (with appropriate equipment) might be set up in central locations throughout the British Isles for the use of interested doctors. In America the annual subscription to the specialties is$81.50, and for the weekly general-practice series it is$162. At present, customs and excise difficulties prevent the importation of our programmes into England, but with enough interest from the British medical profession it is possible that these obstacles might be overcome.
1919, Wilshire Boulevard, Angeles, 57, California.
Los 1. 2.
CLARON L. OAKLEY Editor, Audio-Digest Foundation.
Lancet, 1957, ii, 1346. Graves, J. C., Graves, V. Research Newsletter, College of General Practitioners, 1957, 4, 325.