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OPIUM-SMOKING
974 The fact is favour of a Klebs-Lomer infection. that the skin, particularly when it is inflamed or discharging, becomes a habitat of all sorts of organisms, which may be of primary but is more usually only of secondary causal importance. When the frequency of impetigo is compared with that of diphtheria it seems obvious to the impartial observer that they cannot be closely related. OPIUM-SMOKING
Mr. Leonard Lyall, who has ably presided over the Permanent Central Opium Board of the League of Nations, has lately written an informative essay1 entitled Does Opium-smoking Shorten a Man’s Life Informed opinion has differed over the physiological or other effects of opium whether ingested, inhaled, or injected. A distinguished pharmacologist has asserted that smoking is " by far the least objectionable way of taking opium." The official view in India however is that opium-smoking is a " vicious habit " and " harmful to the Burman race." We have travelled a long way from the findings of Lord Brassey’s Commission of 1895 which held opium to be "the universal household remedy. It is extensively administered to infants and the practice does not appear to any appreciable extent injurious." The same authority regarded the revenue derived from the export of opium, largely for smoking, to be "indispensable for carrying on with efficiency the Government of India." During the International Opium Conferences at Geneva in 1924-25 reproach was levelled against the British Government because " a very considerable proportion of the revenues of certain of the Crown Colonies is drawn from the traffic in opium for smoking, which is a criminal offence in the self-governing parts of the British Empire and which His Majesty’s Government is internationally bound to suppress." Since 1926 the policy enunciated by the late Lord Reading, when Viceroy, of progressively reducing the export of opium from India has been pursued. Nevertheless the objective set out in the Hague Convention of 1912-namely, " the gradual and effective suppression of the manufacture of, internal trade in and use of prepared opium (for smoking) and the prohibition of import and export of prepared opium "-remains, despite the Bangkok agreement, unfulfilled. Mr. Lyall’s opportune pamphlet, based largely on statistics prepared for the Japanese Government by Dr. Somei To of the Formosa Laboratories, conclusively shows that, at all ages, the death-rate among opium-smokers is higher than in non-smokers. NEW METHOD OF ASSAY FOR LIVER EXTRACTS
THERE are several reasons why progress should be slow in the analysis of the principle in liver extracts which is effective in pernicious anaemia. It is probably of a protein or polypeptide nature and the chemistry of such substances is intrinsically difficult. A greater obstacle is the difficulty in testing fractions because pernicious anaemia is relatively uncommon in man and cannot be reproduced with any certainty in animals. The nearest equivalents are the macrocytic anaemia produced in monkeys by deficient diet and the macrocytic anpemia associated with cirrhosis of the liver induced in the rabbit and other animals by chronic poisoning with carbon tetrachloride. Both of these conditions need a good deal of money and time to produce, and in the end it would appear that they are akin to, rather than identical with, 1
Issued by the Women’s International League for Peace and
Freedom, 55, Gower-street, London, W.C.1.
pernicious anaemia. They may react in a different way to different fractions of liver, and it seems that we should speak of a liver complex rather than a single principle. Jacobson and Subbarowsuggest that liver extract contains a primary factor and three chemically distinct accessory factors, of which one is tyrosine, another contains a complex purine, and the third is a peptide. The accessory factors are completely inert without the primary factor, while the primary factor is therapeutically only slightly active without the accessory factors. A new test for the anti-pernicious effect of liver extracts is proposed by Wolf, Weber, and Kroger.2 Rabbits injected daily with an extract of typhoid bacilli developed a progressive ansemia of high colour-index usually associated with leucopenia and thrombocytopenia, and died within two or three weeks. If liver extract was injected at the same time as the typhoid extract, there was a reticulocytosis about the twelfth day, the anaemia began to improve, and the animals remained alive and relatively well for eight weeks. As a corollary to these observations, liver extract is suggested in the treatment of typhoid fever in man. These results are surprising, for there seems little analogy between a toxic anaemia of this kind and pernicious anaemia, and infection depresses or neutralises the action of liver extract in megalocytic anaemias in man. The experimental procedures are so simple that we can be sure they will soon be repeated by other workers, and if it is confirmed that liver extract neutralises the action of typhoid toxin and that its power to do this runs parallel with its effect in pernicious anaemia, two great advances will have been made. CACAO SHELL AS A SOURCE OF VITAMIN D
THE
desirability
of
increasing
the
vitamin-D
content of the winter diet in this country-especially the winter diet of young children-is very generally
accepted.
The obvious vehicle for the purpose is
milk, but during the winter the antirachitic potency of .milk and its products decreases to less than half the summer value. A cheap method of raising the vitamin-D content of winter milk might thus be of great importance. Addition of irradiated yeast or cod-liver oil to the food of cattle will serve the desired purpose, but at a substantial cost. An interesting alternative now suggested is the use of cacao shella by-product, hitherto almost a waste product, of the cocoa industry-which has been found to be not only a useful cattle foodstuff but also, rather surprisingly in view of its vegetable origin, a rich source of vitamin D. The shell is said to have at least a quarter of the vitamin-D content of cod-liver oil,3 and experiments by Kon and Henry4 have shown that part of the vitamin D in cacao shell consumed by cows is conveyed to the milk, so that butter made in the winter from this milk may have a vitamin-D content equal to that of summer butter. The origin of vitamin D in the husk of the cacao bean has been shown by Knapp and Coward 5 to be the irradiation of an ergosterol-containing yeast, which develops in the mucilaginous pulp on the shell, and which, exposed during the drying process to tropical sunlight, develops strong antirachitic potency. Beans dried artificially or in the dark contain no vitamin D ; hence if cacao shell is being fed either to young farm 1
Jacobson, B. M., and Subbarow, Y.,
16, 573. 2
J. clin. Invest.
1937,
Wolf, H. J., Weber, L., and Kröger, E., Med. Welt,
August 21st, 1937, p. 1170. 3 Knapp, A. W., and Coward, K. H., Analyst, 1934, 59, 474. S. K., and Henry, K. M., Biochem. J. 1935, 29, 2051. 4 Kon, 5 Knapp, A. W., and Coward, K. H., Ibid, p. 2728.
Mr. Leonard Lyall, who has ably presided over the Permanent Central Opium Board of the League of Nations, has lately written an informative essay1 entitled Does Opium-smoking Shorten a Man’s Life Informed opinion has differed over the physiological or other effects of opium whether ingested, inhaled, or injected. A distinguished pharmacologist has asserted that smoking is " by far the least objectionable way of taking opium." The official view in India however is that opium-smoking is a " vicious habit " and " harmful to the Burman race." We have travelled a long way from the findings of Lord Brassey’s Commission of 1895 which held opium to be "the universal household remedy. It is extensively administered to infants and the practice does not appear to any appreciable extent injurious." The same authority regarded the revenue derived from the export of opium, largely for smoking, to be "indispensable for carrying on with efficiency the Government of India." During the International Opium Conferences at Geneva in 1924-25 reproach was levelled against the British Government because " a very considerable proportion of the revenues of certain of the Crown Colonies is drawn from the traffic in opium for smoking, which is a criminal offence in the self-governing parts of the British Empire and which His Majesty’s Government is internationally bound to suppress." Since 1926 the policy enunciated by the late Lord Reading, when Viceroy, of progressively reducing the export of opium from India has been pursued. Nevertheless the objective set out in the Hague Convention of 1912-namely, " the gradual and effective suppression of the manufacture of, internal trade in and use of prepared opium (for smoking) and the prohibition of import and export of prepared opium "-remains, despite the Bangkok agreement, unfulfilled. Mr. Lyall’s opportune pamphlet, based largely on statistics prepared for the Japanese Government by Dr. Somei To of the Formosa Laboratories, conclusively shows that, at all ages, the death-rate among opium-smokers is higher than in non-smokers. NEW METHOD OF ASSAY FOR LIVER EXTRACTS
THERE are several reasons why progress should be slow in the analysis of the principle in liver extracts which is effective in pernicious anaemia. It is probably of a protein or polypeptide nature and the chemistry of such substances is intrinsically difficult. A greater obstacle is the difficulty in testing fractions because pernicious anaemia is relatively uncommon in man and cannot be reproduced with any certainty in animals. The nearest equivalents are the macrocytic anaemia produced in monkeys by deficient diet and the macrocytic anpemia associated with cirrhosis of the liver induced in the rabbit and other animals by chronic poisoning with carbon tetrachloride. Both of these conditions need a good deal of money and time to produce, and in the end it would appear that they are akin to, rather than identical with, 1
Issued by the Women’s International League for Peace and
Freedom, 55, Gower-street, London, W.C.1.
pernicious anaemia. They may react in a different way to different fractions of liver, and it seems that we should speak of a liver complex rather than a single principle. Jacobson and Subbarowsuggest that liver extract contains a primary factor and three chemically distinct accessory factors, of which one is tyrosine, another contains a complex purine, and the third is a peptide. The accessory factors are completely inert without the primary factor, while the primary factor is therapeutically only slightly active without the accessory factors. A new test for the anti-pernicious effect of liver extracts is proposed by Wolf, Weber, and Kroger.2 Rabbits injected daily with an extract of typhoid bacilli developed a progressive ansemia of high colour-index usually associated with leucopenia and thrombocytopenia, and died within two or three weeks. If liver extract was injected at the same time as the typhoid extract, there was a reticulocytosis about the twelfth day, the anaemia began to improve, and the animals remained alive and relatively well for eight weeks. As a corollary to these observations, liver extract is suggested in the treatment of typhoid fever in man. These results are surprising, for there seems little analogy between a toxic anaemia of this kind and pernicious anaemia, and infection depresses or neutralises the action of liver extract in megalocytic anaemias in man. The experimental procedures are so simple that we can be sure they will soon be repeated by other workers, and if it is confirmed that liver extract neutralises the action of typhoid toxin and that its power to do this runs parallel with its effect in pernicious anaemia, two great advances will have been made. CACAO SHELL AS A SOURCE OF VITAMIN D
THE
desirability
of
increasing
the
vitamin-D
content of the winter diet in this country-especially the winter diet of young children-is very generally
accepted.
The obvious vehicle for the purpose is
milk, but during the winter the antirachitic potency of .milk and its products decreases to less than half the summer value. A cheap method of raising the vitamin-D content of winter milk might thus be of great importance. Addition of irradiated yeast or cod-liver oil to the food of cattle will serve the desired purpose, but at a substantial cost. An interesting alternative now suggested is the use of cacao shella by-product, hitherto almost a waste product, of the cocoa industry-which has been found to be not only a useful cattle foodstuff but also, rather surprisingly in view of its vegetable origin, a rich source of vitamin D. The shell is said to have at least a quarter of the vitamin-D content of cod-liver oil,3 and experiments by Kon and Henry4 have shown that part of the vitamin D in cacao shell consumed by cows is conveyed to the milk, so that butter made in the winter from this milk may have a vitamin-D content equal to that of summer butter. The origin of vitamin D in the husk of the cacao bean has been shown by Knapp and Coward 5 to be the irradiation of an ergosterol-containing yeast, which develops in the mucilaginous pulp on the shell, and which, exposed during the drying process to tropical sunlight, develops strong antirachitic potency. Beans dried artificially or in the dark contain no vitamin D ; hence if cacao shell is being fed either to young farm 1
Jacobson, B. M., and Subbarow, Y.,
16, 573. 2
J. clin. Invest.
1937,
Wolf, H. J., Weber, L., and Kröger, E., Med. Welt,
August 21st, 1937, p. 1170. 3 Knapp, A. W., and Coward, K. H., Analyst, 1934, 59, 474. S. K., and Henry, K. M., Biochem. J. 1935, 29, 2051. 4 Kon, 5 Knapp, A. W., and Coward, K. H., Ibid, p. 2728.