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OBSERVATIONS ON DIET.
1724 tissues of another individual of the same species." He states that ovarian and testicular dermoids probably arise from the germ cells, and he therefore includes them in the teratomata, but what about dermoids in other situations’.’ Are they, then, blastomata, or do they arise from wandering germ cells’! Can Professor Adami tell us at what point an ovarian ovum ceases to belong to the ovary and becomes a separate individual-? Again, in the case of transplantation of tumours from one animal to another does a tumour which is a blastoma in the first animal become a teratoma in the second. I do not think that any single term is necessary to designate collectively the ordinary tumours as distinct from the teratomata, and, if it were, the term I I blastomawould not be suitable since this meaning is not implied in it. The tumours to which I have applied the term "blastoma" are best illustrated by the congenital mixed tumours of the kidney and many parotid growths. These tumours are neither sarcomata nor carcinomata in the accepted meanings of these terms. The fundamental cells of these growths are indifferent cells, and as proliferation proceeds some of them become differentiated into epithelial cells and others into the various forms of connective tissue cells and sometimes into muscle cells. Now, Sirs, in the terms h broblast, erythroblast,&c., the termination-blast signifies that the cells to which these terms are applied are immature. The term "blast" (&bgr;&lgr;a&sgr;&tgr;bs, germ) without any prefix would naturally signify an undifferentiated cell-that is, one which is not the precursor of any definite kind of cell but which may become differentiated into any kind of mature cell. We have also the old term "blastema" which was used to designate the undifferentiated substance from which the cells were supposed to be formed. The natural meaning, therefore, of the term "blastoma" " is a tumour the essential components Af which are undifferentiated cells and it is in this sense that I have u-ed it, and I think that both by derivation and by analogy with cognate words I am justified in so using it. In conclusion I must apologise to Professor Adami for not referred in my lectures to his having, through an oversight, " use of the term blastoma. I am, Sirs, yours faithfully, CHARLES POWELL WHITE. Me,lical School, Leeds, June 9th, UJOZ.
transgressed repeatedly and constantly laid-down diet. restricted lines." It is quite time we as a profession began to revise our practice and preconceived notions in certain directions where diet is concerned, and as an ounce of practice is worth a pound of theory, here goes. Of the cases quoted by me in the afore-mentioned paper every one is at present alive and well, after periods ranging from three to seven years, living; on the fat of the land now, where previously they sank rapidly to dissolution on moderate diet. To these have sincebeen added many others quite as, if not more, striking illustrations of the success of the reverse of a "spare diet." J, feel confident that were it possible to take ten aged persons. (cardiac, lung, and kidney complications included)-not ten healthy aged persons, but ten downright "broken-downs," typical "foot-in-the-grave" old people-and to place five on an anti-anything-on e -likes "spare diet" and the other five on a generous, good, full diet (not omitting the provision of false teeth), the whole of the spare diet seniles would be dead and gone before two (any two) of the full-fed seniles had succumbed. Verb. sap., but euz bono.".’’ nas on
I am, June 9th, 1902.
Sirs, F.
yours
truly,
W. FORBES ROSS,
M.D. Edin.
’
THE ROYAL NAVY MEDICAL SERVICE AND THE ROYAL ARMY MEDICAL CORPS: A COMPARATIVE VIEW. To the Editors of THE LANCET.
SIRS,-AS you have done me the honour in THE LANCET of June 7th, not alone of publishing my letter with the
above heading (p. 1645). but also of commenting upon it in an annotation (p. 1613), may I be allowed to reply to some points raised in the latter. I shall not trouble you again, the time involved in the necessary searching through intricate regulations is too much for me ta spare, and but for the kindly assistance of a, retired naval oflicer would have compelled me to silence on. Your annotator implies that my the present occasion. comparison is "partial, incomplete, and misleading." I hope to show that this is not so and that to some extent thelatter term may be fairly retorted on him in regard to certain omissions he has made. Let me begin, as he does, with the of allowances and take them as applying to a. question OBSERVATIONS ON DIET. Staff Surgeon, R.N., and a Major R.A.M.C., each of 12 years’ To the Editors of THE LANCET. As your annotator states, the former has a furservice. nished cabin and a servant, but he omits to state that Here is a in &c. When doctors SIRS,-" point disagree," he has to pay rent for the furniture of the former and wages question and in emphatic contrast. Dr. Harry Campbell,1 to the latter; he has, as stated, a mess which costs him in a highly theoretic and erudite contribution to your pages, 2-. but this is for food only, I am told, and takes no per day, says : Icannot too emphatically impress upon my readers the desirability-nay, the necessity-of keeping the aged on account of other mess subscriptions and all this has to come Do not let us extinguish the flickering fire of out of his pay of 438 per annum, whereas the Major a spare diet. in addition to his pay of E430 per annum, has on by age piling too much fuel." With your kind permission R.A.M.C., I have the honour to join issue here with Dr. Harry Campbell allowances (vide Appendix to New Warrant) of .6157 12s. 10d. with which to meet the same expenses, his pay being left. in no uncertain terms. Speaking from actual practical intact apparently. Wherefore I venture to doubt your annotaI be with cases should inclined to be many experience confident statement that the army man cannot live as equally emphatic but would substitute the word "full"" for tor’s the word " spareand the word withholding"for the well with his allowances as the navy man can without them. He must be poor at getting an equivalent for his money if he words "piling on"in the above auotation. Many of the cannot. On the general question of these allowances I as reasons advanced by Dr. Campbell I personally like would to refer your annotator, as I have been referred, indications for the exact reverse in the treatment. The only modifications experience has led me to introduce into the to a letter by Mr. James Cantlie in the Britislt .fl’Iedical; Journal of May 10th, p. 1182. ,above are the words "suitably prepared full diet." Now to take up your annotator’s remarks on the points I In the British Medical Journal of Oct. 13th, 1900, is published a paper by myself on the Dietetic Treatment of raised. 1. Surely it is not the intention of those drafting’ Cardiac Failure in the Aged, based on a matured practical new regulations for the King’s service to insert words which "can be safely ignored." 2. It is a fact that there are experience of full feeding of aged persons, and inasmuch as officers now on the staff surgeons’ list "with but four or heart failure is the main cause of death in the aged (lung and kidney diseases not being excluded) and a full diet five years’ service as surgeons," but your annotator omits state that these early promotions have been for war having been found in my hands far and away more satis- to service (vide Lean’s Royal Navy List), and these arethe than I be over excused for reverse, may factory appearing enthusiastic and dogmatic on this matter. So much does my not unknown in the Army Medical Service. But all this is entirely beside the question raised in paragraph 2 own experience (I cannot speak of the experience of others) force me to a contrary opinion to that expressed by Dr. of my letter which referred to promotion by examina that I have now come to look at the word tion. 4. The hospital allowances mentioned as given toCampbell " metabolism " as a veritable pitfall for those who have the naval doctors when so serving are said to be in °’ lieu of for themselves and their servants and for fuel and care of an aged and failing patient. Rather"meta(dia)- 1provisions " bolism " of starvation than"diet "-secundum artem where the light. I am told that in England they are .B53 for a fleet or a staff surgeon, and that it is only abroad they aged are concerned. "Lived in spite of them all " is oftensurgeon the grinr chuckle of the wilful, disobedient aged person whoreach the higher figures named, and surely they should be compared with the army doctor’s allowances for the same 1 THE sort of thing and not with his charge-pay for being in chargeLANCET, May 31st, 1902, p. 1554.
regard
transgressed repeatedly and constantly laid-down diet. restricted lines." It is quite time we as a profession began to revise our practice and preconceived notions in certain directions where diet is concerned, and as an ounce of practice is worth a pound of theory, here goes. Of the cases quoted by me in the afore-mentioned paper every one is at present alive and well, after periods ranging from three to seven years, living; on the fat of the land now, where previously they sank rapidly to dissolution on moderate diet. To these have sincebeen added many others quite as, if not more, striking illustrations of the success of the reverse of a "spare diet." J, feel confident that were it possible to take ten aged persons. (cardiac, lung, and kidney complications included)-not ten healthy aged persons, but ten downright "broken-downs," typical "foot-in-the-grave" old people-and to place five on an anti-anything-on e -likes "spare diet" and the other five on a generous, good, full diet (not omitting the provision of false teeth), the whole of the spare diet seniles would be dead and gone before two (any two) of the full-fed seniles had succumbed. Verb. sap., but euz bono.".’’ nas on
I am, June 9th, 1902.
Sirs, F.
yours
truly,
W. FORBES ROSS,
M.D. Edin.
’
THE ROYAL NAVY MEDICAL SERVICE AND THE ROYAL ARMY MEDICAL CORPS: A COMPARATIVE VIEW. To the Editors of THE LANCET.
SIRS,-AS you have done me the honour in THE LANCET of June 7th, not alone of publishing my letter with the
above heading (p. 1645). but also of commenting upon it in an annotation (p. 1613), may I be allowed to reply to some points raised in the latter. I shall not trouble you again, the time involved in the necessary searching through intricate regulations is too much for me ta spare, and but for the kindly assistance of a, retired naval oflicer would have compelled me to silence on. Your annotator implies that my the present occasion. comparison is "partial, incomplete, and misleading." I hope to show that this is not so and that to some extent thelatter term may be fairly retorted on him in regard to certain omissions he has made. Let me begin, as he does, with the of allowances and take them as applying to a. question OBSERVATIONS ON DIET. Staff Surgeon, R.N., and a Major R.A.M.C., each of 12 years’ To the Editors of THE LANCET. As your annotator states, the former has a furservice. nished cabin and a servant, but he omits to state that Here is a in &c. When doctors SIRS,-" point disagree," he has to pay rent for the furniture of the former and wages question and in emphatic contrast. Dr. Harry Campbell,1 to the latter; he has, as stated, a mess which costs him in a highly theoretic and erudite contribution to your pages, 2-. but this is for food only, I am told, and takes no per day, says : Icannot too emphatically impress upon my readers the desirability-nay, the necessity-of keeping the aged on account of other mess subscriptions and all this has to come Do not let us extinguish the flickering fire of out of his pay of 438 per annum, whereas the Major a spare diet. in addition to his pay of E430 per annum, has on by age piling too much fuel." With your kind permission R.A.M.C., I have the honour to join issue here with Dr. Harry Campbell allowances (vide Appendix to New Warrant) of .6157 12s. 10d. with which to meet the same expenses, his pay being left. in no uncertain terms. Speaking from actual practical intact apparently. Wherefore I venture to doubt your annotaI be with cases should inclined to be many experience confident statement that the army man cannot live as equally emphatic but would substitute the word "full"" for tor’s the word " spareand the word withholding"for the well with his allowances as the navy man can without them. He must be poor at getting an equivalent for his money if he words "piling on"in the above auotation. Many of the cannot. On the general question of these allowances I as reasons advanced by Dr. Campbell I personally like would to refer your annotator, as I have been referred, indications for the exact reverse in the treatment. The only modifications experience has led me to introduce into the to a letter by Mr. James Cantlie in the Britislt .fl’Iedical; Journal of May 10th, p. 1182. ,above are the words "suitably prepared full diet." Now to take up your annotator’s remarks on the points I In the British Medical Journal of Oct. 13th, 1900, is published a paper by myself on the Dietetic Treatment of raised. 1. Surely it is not the intention of those drafting’ Cardiac Failure in the Aged, based on a matured practical new regulations for the King’s service to insert words which "can be safely ignored." 2. It is a fact that there are experience of full feeding of aged persons, and inasmuch as officers now on the staff surgeons’ list "with but four or heart failure is the main cause of death in the aged (lung and kidney diseases not being excluded) and a full diet five years’ service as surgeons," but your annotator omits state that these early promotions have been for war having been found in my hands far and away more satis- to service (vide Lean’s Royal Navy List), and these arethe than I be over excused for reverse, may factory appearing enthusiastic and dogmatic on this matter. So much does my not unknown in the Army Medical Service. But all this is entirely beside the question raised in paragraph 2 own experience (I cannot speak of the experience of others) force me to a contrary opinion to that expressed by Dr. of my letter which referred to promotion by examina that I have now come to look at the word tion. 4. The hospital allowances mentioned as given toCampbell " metabolism " as a veritable pitfall for those who have the naval doctors when so serving are said to be in °’ lieu of for themselves and their servants and for fuel and care of an aged and failing patient. Rather"meta(dia)- 1provisions " bolism " of starvation than"diet "-secundum artem where the light. I am told that in England they are .B53 for a fleet or a staff surgeon, and that it is only abroad they aged are concerned. "Lived in spite of them all " is oftensurgeon the grinr chuckle of the wilful, disobedient aged person whoreach the higher figures named, and surely they should be compared with the army doctor’s allowances for the same 1 THE sort of thing and not with his charge-pay for being in chargeLANCET, May 31st, 1902, p. 1554.
regard