NASAL SINUSITIS IN CHILDHOOD

.HOSPITAL AMALGAMATION IN LIVERPOOL

that board shall not have power to purchase any instruor apparatus without the previous sanction of the general committee " now reads " The medical board shall have the supervision of the medical and surgical work of the Hospital save that all matters relating to the purchase of surgical instruments and apparatus shall be dealt with by the general committee." (c) The governing body of the Liverpool United Hospital according to the amended Bill will consist of fifty-three and not fifty-one members, the representation of the .Merseyside Hospitals Council having been raised from two to four persons. In addition, Mr. Bedwell draws attention to three ments

233

Surely a photograph, and the process used in obtaining such, is so similar that it would seem more reasonable to associate the accepted terms photograph, to photograph, photographic, and photographer, with radiograph, to radiograph, radiographic, and radioarraDher.—I

am.

Sir.

yours

faithfully, JAMES F. BRAILSFORD.

of THE LANCET SiR,-In your supplement " On Writing for THE LANCET " there is one thing and one thing only with which I disagree, and that is the use of the words radiogram " and " radiograph." Whether we like To the Editor

specific problems. The first concerns a provision permitting the allocation of a percentage of the it or not these terms are now wedded for ever to receipts from the Merseyside Hospitals Council to staff funds. The amendment suggested to meet this apparatus for the combined reception of broadcasting and the production of gramophone records, as well point authorises members of the honorary medical as being also used for telegrams transmitted by and surgical staffs of the hospital " to receive payI think an effort should be made in medical wireless. in respect ments under any special arrangements skiagram " ; of " services provided or rendered by the Hospital journals to popularise the use of a and if you do not like the verb " to X ray," why to patients students or probationers or to instishould we not say that the patient was examined by tutions local authorities or other bodies." Secondly, Mr. Bedwell refers to the omission of a X rays ?-I am, Sir, yours faithfully, "

"

"

reference to the constitution of the Associated Voluntary Hospitals Board. This body, which represents the nine teaching hospitals in Liverpool, has been empowered by them to make recommendations concerning candidates for posts on the honorary staffs of all Liverpool teaching hospitals, and it is hoped that thereby the work of these hospitals may be coordinated to a degree impossible under the system whereby appointments in the past have been made by each individual hospital without relation to other hospitals associated with the same medical school. In the opinion of Parliamentary Counsel a close definition of the constitution of the Associated Voluntary Hospitals Board is unnecessary in the

London, W., Jan. 8th.

A MEDICAL JOURNALIST.

**Our preference for radiogram is based on the analogy of telegraph and telegram. Telegraph dates from the eighteenth century, but it was not until the 1850’s that the need was felt for something simpler than telegraphic message, and telegram was devised to signify what was written by the telegraph. The " Oxford Dictionary " points out that the great bulk of the words ending in -graph is composed of technical terms of very recent invention, mostly expressing the general sense of "that which writes, portrays or records." In medicine, as elsewhere, there are various examples of -graph in the agent sense which have been complemented by -gram in United Hospitals Bill. the passive or resultant sense (e.g., electrocardiograph, Thirdly, Mr. Bedwell states that there is no electrocardiogram). Photograph, which Dr. Brailsprovision for the representation on the medical ford quotes as precedent, is really an unlucky exception board of specialists other than physicians and surto a convenient rule : the public for some reason geons (together with dental surgeons, pathologists, never took to photogram-perhaps because there was and an2esthetists for whom specific provision is made). no chance of confusing photograph with camera. This is not the case. In the first instance the medical The earliest reference we can find to radiogram is board of the United Hospital is to consist, by in and not we definition, of the holders of all posts set forth in wereApril, 1896, our own long afterwards, alas, pitch by using queering radiograph Part I of the annexe to the Bill, and the posts there for the picture rather than the machine that makes it. set forth include the obstetricians, gynaecologists, a wireless telegram, was as Radiogram, radiologists, and other specialists to whom Mr. current in 1905 meaning and at that time the wireless ; Bedwell refers. All persons subsequently appointed also claimed radiography as their own. The to fill vacancies which occur in the list of posts set experts medical profession seems to have regained radioforth in Part I of the annexe, and all persons and it might still regain radiogram. As appointed to :fill all additional offices of a character graphy "A Medical Journalist" says, there is nothing much similar to those held by the persons whose names against skiagramexcept that skiascopy (which would are set out in Part One of the Annexe " will become be the equivalent of radioscopy) already means the members of the medical board. determination of the refracting action of the eye. I am, Sir, yours faithfully, We mentioned " the skiagram of a sireniform A. V. J. HINDS, monster " in April, 1896, and are prepared, if need Secretary, Associated Voluntary Hospitals Board. be, to do so again. But if the medical profession in this country is really to retire in disorder before RADIOGRAM AND RADIOGRAPH the advancing host of gramophone-cum-radio manuTo the Editor of THE LANCET facturers, would it not be best to join forces with and take our stand on Sm,-In reading through the supplement to your our American colleagues and roentgenogram-words whose issue of Jan. 2nd I note that you state your preference roentgenograph no one is likely to dispute ?-ED. L. possession for the word radiogram. Personally I have always used during the past 20 years the term radiograph in NASAL SINUSITIS IN CHILDHOOD all my writings-a procedure which is in accord with To the Editor of THE LANCET the Shorter Oxford English Dictionary (p. 1649). I have with read with interest Mr. Asherson’s SIR,-I agree your call for uniformity and I am willing to comply; but I should be glad to know why you letter in your last issue. He says that " a difficult use the term radiogram which is commonly used problem arises in considering the treatment of the for wireless messages and for radiogramophones. chronic cases-and many become so in spite of all "

TUBERCULOUS DISEASE OF THE ABDOMINAL LYMPHATIC GLANDS

234

of treatment." It is to be regretted that no mention is made of one of the most useful forms of treatment in such cases-i.e., radiotherapy. By this I mean treatment with short (wireless) waves and infra-red rays, the application of ultra-violet rays by means of quartz applicators attached to the Kromayer mercury-vapour lamp to the nostrils and the postnasal space, and general ultra-violet irradiation to increase the patient’s general resisting powers. I have described elsewhere (Therapeutic Uses of Infra-red Rays, 3rd ed.) the technique and rationale of this treatment. The majority of such children suffer from hypovitaminosis ; therefore general ultra-violet irradiation of itself must be particularly beneficial to them. Suffice it to say that many of us have treated a great number of such cases, and the results are rarely disappointing. Almost all the patients are relieved if not cured. The fact that this form of treatment causes no pain or discomfort from its inception must make it a pleasing alternative to the methods suggested by Mr. Asherson.-I am, Sir, yours faithfully, W. ANNANDALE TROUP.

types

INFORMATION SERVICE FOR RESEARCH WORKERS IN HUMAN GENETICS

To the Editor

THE LANCET executive committee invites your coöperaSIR,-My tion in making known the service here announced. One activity contemplated in setting up the ClearingHouse for Human Heredity is the organisation of information service for research workers in the subject. The value of such a plan has been demonstrated in the information service already established for It should be noted that workers on drosophila, &c. apart from convenience of ascertaining easily centres at which comparable work is going on, the circulation of notice of their work by those engaged in a particular inquiry is a safeguard in dating priority-a point to which it is natural to attach some importance. Workers are requested to address to the Bureau a short paragraph describing the work on which they are engaged. These notices will be multiplied and circulated to all those cooperating. In the first instance this bulletin will be issued every twelve months. Later supplementary bulletins will be issued more frequently. Those using this service are asked to subscribe 5s., a sum equalling approximately onequarter of a pound sterling equivalent in the currency of their country. The accepted languages are French, -TTia’r)

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R. RUGGLES GATES, Chairman, Bureau of Human Heredity. TUBERCULOUS DISEASE OF THE ABDOMINAL LYMPHATIC GLANDS To the Editor of THE LANCET

SIR,-May I state my views on this subject from the point of view of a medical superintendent of an institution for non-pulmonary tuberculosis Almost all the cases that are admitted do extremely well on the usual form of treatment for all kinds of tuberculosis-viz., fresh air, nourishing food, and rest. In addition they receive artificial light (carbon arc), the old-fashioned ung. hydrarg. rubbed into the abdomen, fresh tomato juice (one ounce three times a day), and careful regulation of the bowels with liquid paraffin when necessary. I am convinced, however, that the fresh air, good food, and rest are the -main essentials of the treatment. The response to treatment is much more rapid than in other forms

of non-pulmonary tuberculosis. Among the minority which do badly are those which have had surgical intervention before admission. They often have an indolent operation wound discharging pus which is very resistant to treatment, while others have that distressing condition—faecal fistula. We do not see the type of case that is admitted to a general hospital with acute symptoms simulating other abdominal conditions, and in which the diagnosis is in doubt until the operation is performed. With the exception of this type of case I am of the opinion that the place for patients suffering from tuberculous abdominal lymphatic glands is an open-air hospital, and that the treatment should be on conservative lines. I most heartily agree with Mr. Colt and Mr. Clark (THE LANCET, Jan. 16th, p. 125) in their final conclusion that " Tuberculosis of the mesenteric glands tends in the main to natural cure," but not with their statement earlier in the paper that " it seems also that when a pre-operative diagnosis of caseous glands has been made the safest treatment is removal." My view is that when a pre-operative diagnosis of tuberculous mesenteric glands has been made the safest treatment is non-surgical in the vast majority of cases.-I am. Sir. vours faithfullv. E. H. ALLON PASK, Medical Superintendent.

Wrightington Hospital, Appley Bridge, near

Wigan, Jan. 19th.

DR. RENALD FERNALD

We have received the following questions from a lady named Fernald who is seeking information

concerning "

I am Fernald

ancestor: trying to locate my ancestor Dr. Renald an

(Fernall, Fernell, Furnell, Farnell; or Fernefold or Fernewold), who went to America about 1630 or 31 as ’chirurgeon ’ of the Piscatagua Colony (Mason’s Plantation), now Portsmouth, New Hampshire, but for a while part of Maine. He was a leader in town affairs, being one of the first to sign a grant of Glebe for church land in 1640, and a petition to Boston General Court in 1653 to change the name of the town, then Strawberry Bank, to Portsmouth. He was first town

possibly,

clerk and recorder, commissioner, surveyor, as well aschirurgeon.’ He thus was apparently a welleducated man, but we do not know anything of the English home of the family. I have hoped to locate him through his profession, but so far without There is a tradition that he came from success. Chester or from near Chester and that he resigned from the English Navy to go to America. I have been through a number of the Harleian MSS. (unpublished ones) in the British Museum relating to officers in the Navy at that time but no names are given. A coat of arms of the Fernefold family of Sussex was accepted by some members of our family four or five generations ago as being that of Dr. Renald’s family, but I do not believe it has anything to do with us. Dr. Renald’s will, referred to by several of his children, has never been found, but his wife’s is preserved at Concord, New Hampshire, and is signed ’Johanna Fernall.’ Dr. Renald probably used a final , d ’ because it went well with his first name. I have been told that there are records (of the late fifteenth and/or first half of the sixteenth century) showing that each ’doctor ’ or ’chirurgeon ’ who was qualified had a certificate showing that he possessed a set of chirurgeon’s instruments and that be was qualified +o enter the profession. How true is this and to what extent was it enforced, if true ? Does anyone know ? And were there lists kept of those to whom As far as Dr. Renald certificates were issued ? Fernald was concerned we only know that his wife Johanna willed to her son Johnall the surgery books and instruments that were his father’s with " his chest.’