- Email: [email protected]
PELVIC TUBERCULOSIS IN THE FEMALE
733
prejudiced examination of reveal a psychopath worthy
our
war
leaders
likely
to
to rival Hitler.
Dr. West, it would appear, anticipates Orwell’s Niueteen-eightyjom’ in contending that were men not besotted by propaganda there would be no cause which they would consider worth fighting for. This is not yet
Moreover he assumes that a threat of overforce could be offered by an organisation of whelming " power-units" which had abrogated some of their national sovereignty ; such a threat would suffice to deter aggression. The assumption is vain unless the . threat presented be real. The adherents of the new bloc must still believe that their way of life merits defence with arms. It is illogical, therefore, to deprecate fighting qualities which may yet be vitally needed. Dr. Comfort is so preoccupied with the avoidance of In his war that he has lost sight of the greater evil. distaste even for the limited coercion necessary for organised self-defence he advocates a course which would render almost inevitable a tyranny infinitely more grievous. Suppose that his philosophy of " rational disobedience," were to gain a wide following in democratic countries while achieving somewhat fewer disciples elsewhere. All recent precedent proclaims that the democracies who refused to fight would be annihilated. Yet it would be better that all life in this island should be obliterated by atomic bombs rather than that a degraded selection of its inhabitants should survive, destroyed in dignity and spirit, under a totalitarian occupation. To preserve peace, then, there must first be force, manifest and benevolent, ready to deter aggression. }fetternich’s motto " Force within Law " may be amplified to Force within World Law." With aggression rendered impracticable there yet remains to be decided what it is that projects in the minds of men the desire to attack their neighbours. For this communal resolve, it may be granted, is the cause of war. The role of the psychopath in office may well increase in the future but this factor has not hitherto been important. Most of the old motives are out of date. The specious Marxian theory of economic necessity can certainly be discounted. In modern times what hopes can be excited by the prospect of war*? What is it, for example, that gets into the Germans ? Here issue must again be taken with Dr. West. It was not ’’ we nor " mankind " nor any universal human infirmity that caused the last three great European Neither was it Hitler who instigated the most wars. recent one. Never in history can a ruler more completely have expressed the temper and purpose of his people than did Hitler in 1941. It was the Germans who caused these wars. Why ?’? The strange truth is that by 1941, when success, admittedly, had exalted their dearest anticipations, every German was fighting to win a little gang of slaves that he could have for his very own. In pursuit of this ideal he was prepared to live on one meal a day indefinitely. Such, in its fullest flowering, was the vision of the German Weltaitschauung. Because this aim was monstrous the peoples of the world outside Europe are now largely unable to believe that it existed. By contrast, on the Continent, it is too well understood even to merit discussion. It would be well if comprehension were more general, for only with recognition and acceptance can the menace of such behaviour be dissipated. The German aberration owes nothing to heredity. It is the result of conditioning. New contacts and a changed mental environment, if long enough continued, would effect a cure. In other nations today impulses of genuine fear may he shaping the minds of men towards " preventive true.
"
"
effort should be spared in the attempt identify allay such apprehensions. Whatever its origin, however, it is to be hoped that in future the remainder of the world will more readily accept evidence
aggression. No to
and
of aggressive intent. For the present it is unwise that Dr. West and Dr. Comfort should seek an end to wellIn doing so they must place in jeopardy tried loyalties. the only foundations which as yet offer practical hope for the defence of freedom. In the recent words of Winston Churchill : " How easy it is to impair great unities and how hard to make them." -
Bristol.
I. MCD. G. STEWART.
DANGER FROM THE NEWER INSECTICIDES
SiR,—I have read with interest your annotation of March 4, and the subsequent correspondence. As a layman, may I ask if, apart from any question of humanity, we are wise in using insecticides which, if so dangerous to man, must be death to small birds and the wild animals ? Have they no value ? Can we live in a desert ? Caterham, Surrey.
E. E. RICHARDS.
PELVIC TUBERCULOSIS IN THE FEMALE SiR,-Your account last week of a meeting of the Edinburgh Obstetrical Society recorded a high mortality in the surgical treatment of pelvic tuberculosis in the female, and ended with the statement that a controlled clinical investigation is urgently required into the effect on this disease of streptomycin and p-aminosalicylic acid. There is good reason to believe that an extended study of this problem will be arranged in the near future. In the meantime, we would report, for the encouragement of others, that of the last 6 women with tuberculous endometritis and salpingitis treated in this department with streptomycin alone, 5 have been apparently cured. The diagnosis was made only when a positive culture from the endometrium was obtained, and apparent cure was assumed only when three consecutive biopsies at monthly intervals yielded negative cultures and no histological evidence of disease. It is too early to state with assurance that the cure is absolute. In the last ten years, 49 women have been treated by us for pelvic tuberculosis. Prior to the use of streptomycin the only cures were obtained by radical surgery, using the same technique as we adopt for carcinoma of the corpus ; 14 patients were treated in this way with no operative and no postoperative deaths and no fistulae. If the encouraging results so far obtained with streptomycin continue, it may be possible in many cases to both cure the disease and preserve normally functioning organs. J. A. STALLWORTHY The Radcliffe Infirmary, D. N. STRUAN ROBERTSON. Oxford. ANTIGEN-ANTIBODY REACTIONS SIR,-I was much interested in Dr. Stratton’s article of Feb. 11. The concept of non-specificity was suggested very have urged me to use early. A number of workers " but I think that as a control Rh-negative hapten the conviction that hapten made from Rh-negative blood is inactive is based on a misconception. The term " " Rh-negative suggests that such blood lacks something ; but, of course, thanks to a number of workers, including R. R. Race and R. A. Fisher, we know that this is not the case. An individual who is Rh-negative (or Hr-positive) carries a factor in his blood which, in all probability, is very closely similar, biochemically speaking, to Rh. From the viewpoint of biochemistry, the difference between D and d may be not greater than the difference between glucose and fructose, or even d- and l-isomers. I have made hapten from Rh-negative blood ; and I have made other specific haptens from the various subtypes. These I have assayed very carefully. With an anti-D serum one obtains strong reactions with a D antigen, and weaker reactions with a C or an E or a ede
prejudiced examination of reveal a psychopath worthy
our
war
leaders
likely
to
to rival Hitler.
Dr. West, it would appear, anticipates Orwell’s Niueteen-eightyjom’ in contending that were men not besotted by propaganda there would be no cause which they would consider worth fighting for. This is not yet
Moreover he assumes that a threat of overforce could be offered by an organisation of whelming " power-units" which had abrogated some of their national sovereignty ; such a threat would suffice to deter aggression. The assumption is vain unless the . threat presented be real. The adherents of the new bloc must still believe that their way of life merits defence with arms. It is illogical, therefore, to deprecate fighting qualities which may yet be vitally needed. Dr. Comfort is so preoccupied with the avoidance of In his war that he has lost sight of the greater evil. distaste even for the limited coercion necessary for organised self-defence he advocates a course which would render almost inevitable a tyranny infinitely more grievous. Suppose that his philosophy of " rational disobedience," were to gain a wide following in democratic countries while achieving somewhat fewer disciples elsewhere. All recent precedent proclaims that the democracies who refused to fight would be annihilated. Yet it would be better that all life in this island should be obliterated by atomic bombs rather than that a degraded selection of its inhabitants should survive, destroyed in dignity and spirit, under a totalitarian occupation. To preserve peace, then, there must first be force, manifest and benevolent, ready to deter aggression. }fetternich’s motto " Force within Law " may be amplified to Force within World Law." With aggression rendered impracticable there yet remains to be decided what it is that projects in the minds of men the desire to attack their neighbours. For this communal resolve, it may be granted, is the cause of war. The role of the psychopath in office may well increase in the future but this factor has not hitherto been important. Most of the old motives are out of date. The specious Marxian theory of economic necessity can certainly be discounted. In modern times what hopes can be excited by the prospect of war*? What is it, for example, that gets into the Germans ? Here issue must again be taken with Dr. West. It was not ’’ we nor " mankind " nor any universal human infirmity that caused the last three great European Neither was it Hitler who instigated the most wars. recent one. Never in history can a ruler more completely have expressed the temper and purpose of his people than did Hitler in 1941. It was the Germans who caused these wars. Why ?’? The strange truth is that by 1941, when success, admittedly, had exalted their dearest anticipations, every German was fighting to win a little gang of slaves that he could have for his very own. In pursuit of this ideal he was prepared to live on one meal a day indefinitely. Such, in its fullest flowering, was the vision of the German Weltaitschauung. Because this aim was monstrous the peoples of the world outside Europe are now largely unable to believe that it existed. By contrast, on the Continent, it is too well understood even to merit discussion. It would be well if comprehension were more general, for only with recognition and acceptance can the menace of such behaviour be dissipated. The German aberration owes nothing to heredity. It is the result of conditioning. New contacts and a changed mental environment, if long enough continued, would effect a cure. In other nations today impulses of genuine fear may he shaping the minds of men towards " preventive true.
"
"
effort should be spared in the attempt identify allay such apprehensions. Whatever its origin, however, it is to be hoped that in future the remainder of the world will more readily accept evidence
aggression. No to
and
of aggressive intent. For the present it is unwise that Dr. West and Dr. Comfort should seek an end to wellIn doing so they must place in jeopardy tried loyalties. the only foundations which as yet offer practical hope for the defence of freedom. In the recent words of Winston Churchill : " How easy it is to impair great unities and how hard to make them." -
Bristol.
I. MCD. G. STEWART.
DANGER FROM THE NEWER INSECTICIDES
SiR,—I have read with interest your annotation of March 4, and the subsequent correspondence. As a layman, may I ask if, apart from any question of humanity, we are wise in using insecticides which, if so dangerous to man, must be death to small birds and the wild animals ? Have they no value ? Can we live in a desert ? Caterham, Surrey.
E. E. RICHARDS.
PELVIC TUBERCULOSIS IN THE FEMALE SiR,-Your account last week of a meeting of the Edinburgh Obstetrical Society recorded a high mortality in the surgical treatment of pelvic tuberculosis in the female, and ended with the statement that a controlled clinical investigation is urgently required into the effect on this disease of streptomycin and p-aminosalicylic acid. There is good reason to believe that an extended study of this problem will be arranged in the near future. In the meantime, we would report, for the encouragement of others, that of the last 6 women with tuberculous endometritis and salpingitis treated in this department with streptomycin alone, 5 have been apparently cured. The diagnosis was made only when a positive culture from the endometrium was obtained, and apparent cure was assumed only when three consecutive biopsies at monthly intervals yielded negative cultures and no histological evidence of disease. It is too early to state with assurance that the cure is absolute. In the last ten years, 49 women have been treated by us for pelvic tuberculosis. Prior to the use of streptomycin the only cures were obtained by radical surgery, using the same technique as we adopt for carcinoma of the corpus ; 14 patients were treated in this way with no operative and no postoperative deaths and no fistulae. If the encouraging results so far obtained with streptomycin continue, it may be possible in many cases to both cure the disease and preserve normally functioning organs. J. A. STALLWORTHY The Radcliffe Infirmary, D. N. STRUAN ROBERTSON. Oxford. ANTIGEN-ANTIBODY REACTIONS SIR,-I was much interested in Dr. Stratton’s article of Feb. 11. The concept of non-specificity was suggested very have urged me to use early. A number of workers " but I think that as a control Rh-negative hapten the conviction that hapten made from Rh-negative blood is inactive is based on a misconception. The term " " Rh-negative suggests that such blood lacks something ; but, of course, thanks to a number of workers, including R. R. Race and R. A. Fisher, we know that this is not the case. An individual who is Rh-negative (or Hr-positive) carries a factor in his blood which, in all probability, is very closely similar, biochemically speaking, to Rh. From the viewpoint of biochemistry, the difference between D and d may be not greater than the difference between glucose and fructose, or even d- and l-isomers. I have made hapten from Rh-negative blood ; and I have made other specific haptens from the various subtypes. These I have assayed very carefully. With an anti-D serum one obtains strong reactions with a D antigen, and weaker reactions with a C or an E or a ede