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PHILOSOPHY OF A PHYSICIST
1247
washings are examined bacteriologically or whether they rely wholly or in part on radiological examination. Thickening of the living membrane of the sinuses is often demonstrable by skiagraphy in allergic conditions of the nose, as in hay-fever, and is generally manifestation of the disease rather than Again, in 80 per cent. of their operation cases nasal polypi were present, and if these form a part of the series of 470 patients already mentioned it looks as though over 20 per cent. of their asthma patients had polypi, in which case they can hardly represent a true sample of the The claim, however, remains asthma population. that of 120 patients selected for operation, 84 showed definite improvement after operation on the sinuses, and 38 of them afterwards had asthma either rarely or not at all. Such a result cannot be lightly
considered a
a
factor in its causation.
passed
over.
PHILOSOPHY OF A PHYSICIST
SOME essays and addresses by one of the most distinguished leaders in modern mathematical physics1 provide an admirable illustration of the truth that in the right hands nearly all great principles are capable of simple expression. They would have made a more coherent whole if they had been amalgamated and rewritten; but they might well have become less interesting. Running through them are two leading ideas which all may ponder with advantage. Prof. Schrodinger wonders in the first place whether science is as objective as some, generally young, people often think. History is certainly
not, for none of us would read it if it had no colour from the interpreter. And he makes out a good case for the conclusion, almost blasphemous at first sight, that much the same applies to the higher physics, which, as he points out, reflect the fashion of thought of their day as well as the general outlook of their apostles. And in the second place he repeatedly reflects on what he calls the amazing discovery of statistical truth-propositions, that is, which are true for whole populations of atoms and not necessarily true for any individual. Hence one may predict the behaviour of populations but not that of individuals. The idea would have been less fresh to him if he had been a biologist; and its transference to the dead world is yet another example of the incorporation of conceptions derived from the live world into the explanations of the exact sciences. There is much edification to be had in contemplating the similarity between the behaviour of animals and the vagaries of a particle in Brownian movement; it is no superficial analogy. CUSHING’S DISEASE THOUGH it is only three years since Harvey Cushing published an account of the peculiar disease that bears his name, no less than 66 cases are now on record. These have lately been analysed by Dr. Vratislav Jonás,2 and he is able to add to their number 7 others observed in the clinic of Prof. Hynek in Prague. All 7 seem quite typical with the exception of the second. Here the patient was a woman of 28, and the disturbance started with diabetes insipidus: the pituitary gland, examined by serial sections, showed no abnormality in the anterior lobe, but the posterior lobe and pars
intermedia
reports
are
were replaced by scar given only for this and
tissue.
Autopsy
for the first case,
1 Science and the Human Temperament. By Erwin Schrödinger. Translated by J. Murphy. London: George Allen
and Unwin Ltd. 2
1935. Pp. 154. 7s. 6d. Cas. lék. ceskych, October, 1935.
in which a basophil adenoma of the anterior lobe disclosed. It is of interest that the urine was investigated for the presence of a follicle-stimulating substance and the result was positive in two instances only, in females aged 15 and 33 years. Jonas’s analysis of published reports shows that threequarters of the patients have been women. The
was
most
constant
symptom
was
a
rapidly acquired
but sexual disorders were found in twothirds. The most constant physical sign was arterial hypertension (88 per cent.), striae of the skin ranking next with 71 per cent., and obesity of characteristic distribution in about the same proportion. Skeletal decalcification was observed in 40 out of 55 examined cases, and a lowered tolerance for carbohydrate in 35 out of 49. It is noteworthy that an increase in the red blood-cell count was found in only 46 per cent. Sufferers from this disease are particularly liable to die from sepsis, but observation now seems to show that the illness need not necessarily be progressive and fatal ; in other words, there are benign forms. Jonas concludes from the histological reports that the pathogenesis is by no means clear, but from the clinical aspect this syndrome is sufficiently defined to merit its acceptance as a disease sui generis.
adiposity,
MALIGNANT CELLS IN SPUTUM
CANCER cells are rarely found in the sputum, but that is partly because they are not looked for or recognised when seen. As Hoesslin pointed out long ago in his monograph on the sputum, when present they are almost invariably in clumps of some size. L. S. Dudgeon and C. H. Wrigley have 1 elaborated a staining technique for detecting neoplastic cells in sputum, which is a further development of a method for the quick diagnosis of malignant tumours published by Dudgeon and C. V. Patrick some years ago.2 Wet films from sputum are fixed in Schaudinn’s fluid,
prepared by adding one volume of absolute alcohol to two volumes of a saturated aqueous solution of mercuric chloride. Immediately before use glacial acetic acid is added to the strength of 3 per cent. Fixation is achieved by immersing the slide in the fluid for 20 minutes; but if a rapid diagnosis is needed an immersion of two minutes is enough. The slide is then transferred to methylated spirit to which a few drops of tincture of iodine have been added and is then washed in distilled water. Films are stained for about two minutes or less in Mayer’s hsemalum (hsematoxylin 1 g. dissolved by heat in 1000 c.cm. distilled water; to this are added 0’2 g. sodium iodate, 50 g. ammonia alum, and finally 20 c.cm. -glacial acetic acid). The slide is then transferred to tap water and counterstained with a weak solution of eosin. Sputum from 58 cases of suspected malignant growth of the lung or respiratory tract was examined by this method. In 26 (68 per cent.) of 38 proved cases of carcinoma of the lung or larynx it was possible to establish the diagnosis from the examination of the sputum, and in the majority of instances the histological type of growth present could be distinguished. Particles of new growth in sputum, when fixed and stained by the authors’ method, presented two different types : (1) The common form associated with oat-cell carcinoma. These fragments, which stain deep blue, consist of a cluster of cells
containing typical oat-shaped cells. (2) Fragments of squamous or columnar cell growth. The individual cells in this group are differentiated from those of the oat-cell variety by their greater size, larger nuclei, and a considerable amount of protoplasm which stains 1 Jour. Laryng. and Otol. 1935, 1., 752. 2 Brit. Jour. Surg., 1927, xv., 250.
washings are examined bacteriologically or whether they rely wholly or in part on radiological examination. Thickening of the living membrane of the sinuses is often demonstrable by skiagraphy in allergic conditions of the nose, as in hay-fever, and is generally manifestation of the disease rather than Again, in 80 per cent. of their operation cases nasal polypi were present, and if these form a part of the series of 470 patients already mentioned it looks as though over 20 per cent. of their asthma patients had polypi, in which case they can hardly represent a true sample of the The claim, however, remains asthma population. that of 120 patients selected for operation, 84 showed definite improvement after operation on the sinuses, and 38 of them afterwards had asthma either rarely or not at all. Such a result cannot be lightly
considered a
a
factor in its causation.
passed
over.
PHILOSOPHY OF A PHYSICIST
SOME essays and addresses by one of the most distinguished leaders in modern mathematical physics1 provide an admirable illustration of the truth that in the right hands nearly all great principles are capable of simple expression. They would have made a more coherent whole if they had been amalgamated and rewritten; but they might well have become less interesting. Running through them are two leading ideas which all may ponder with advantage. Prof. Schrodinger wonders in the first place whether science is as objective as some, generally young, people often think. History is certainly
not, for none of us would read it if it had no colour from the interpreter. And he makes out a good case for the conclusion, almost blasphemous at first sight, that much the same applies to the higher physics, which, as he points out, reflect the fashion of thought of their day as well as the general outlook of their apostles. And in the second place he repeatedly reflects on what he calls the amazing discovery of statistical truth-propositions, that is, which are true for whole populations of atoms and not necessarily true for any individual. Hence one may predict the behaviour of populations but not that of individuals. The idea would have been less fresh to him if he had been a biologist; and its transference to the dead world is yet another example of the incorporation of conceptions derived from the live world into the explanations of the exact sciences. There is much edification to be had in contemplating the similarity between the behaviour of animals and the vagaries of a particle in Brownian movement; it is no superficial analogy. CUSHING’S DISEASE THOUGH it is only three years since Harvey Cushing published an account of the peculiar disease that bears his name, no less than 66 cases are now on record. These have lately been analysed by Dr. Vratislav Jonás,2 and he is able to add to their number 7 others observed in the clinic of Prof. Hynek in Prague. All 7 seem quite typical with the exception of the second. Here the patient was a woman of 28, and the disturbance started with diabetes insipidus: the pituitary gland, examined by serial sections, showed no abnormality in the anterior lobe, but the posterior lobe and pars
intermedia
reports
are
were replaced by scar given only for this and
tissue.
Autopsy
for the first case,
1 Science and the Human Temperament. By Erwin Schrödinger. Translated by J. Murphy. London: George Allen
and Unwin Ltd. 2
1935. Pp. 154. 7s. 6d. Cas. lék. ceskych, October, 1935.
in which a basophil adenoma of the anterior lobe disclosed. It is of interest that the urine was investigated for the presence of a follicle-stimulating substance and the result was positive in two instances only, in females aged 15 and 33 years. Jonas’s analysis of published reports shows that threequarters of the patients have been women. The
was
most
constant
symptom
was
a
rapidly acquired
but sexual disorders were found in twothirds. The most constant physical sign was arterial hypertension (88 per cent.), striae of the skin ranking next with 71 per cent., and obesity of characteristic distribution in about the same proportion. Skeletal decalcification was observed in 40 out of 55 examined cases, and a lowered tolerance for carbohydrate in 35 out of 49. It is noteworthy that an increase in the red blood-cell count was found in only 46 per cent. Sufferers from this disease are particularly liable to die from sepsis, but observation now seems to show that the illness need not necessarily be progressive and fatal ; in other words, there are benign forms. Jonas concludes from the histological reports that the pathogenesis is by no means clear, but from the clinical aspect this syndrome is sufficiently defined to merit its acceptance as a disease sui generis.
adiposity,
MALIGNANT CELLS IN SPUTUM
CANCER cells are rarely found in the sputum, but that is partly because they are not looked for or recognised when seen. As Hoesslin pointed out long ago in his monograph on the sputum, when present they are almost invariably in clumps of some size. L. S. Dudgeon and C. H. Wrigley have 1 elaborated a staining technique for detecting neoplastic cells in sputum, which is a further development of a method for the quick diagnosis of malignant tumours published by Dudgeon and C. V. Patrick some years ago.2 Wet films from sputum are fixed in Schaudinn’s fluid,
prepared by adding one volume of absolute alcohol to two volumes of a saturated aqueous solution of mercuric chloride. Immediately before use glacial acetic acid is added to the strength of 3 per cent. Fixation is achieved by immersing the slide in the fluid for 20 minutes; but if a rapid diagnosis is needed an immersion of two minutes is enough. The slide is then transferred to methylated spirit to which a few drops of tincture of iodine have been added and is then washed in distilled water. Films are stained for about two minutes or less in Mayer’s hsemalum (hsematoxylin 1 g. dissolved by heat in 1000 c.cm. distilled water; to this are added 0’2 g. sodium iodate, 50 g. ammonia alum, and finally 20 c.cm. -glacial acetic acid). The slide is then transferred to tap water and counterstained with a weak solution of eosin. Sputum from 58 cases of suspected malignant growth of the lung or respiratory tract was examined by this method. In 26 (68 per cent.) of 38 proved cases of carcinoma of the lung or larynx it was possible to establish the diagnosis from the examination of the sputum, and in the majority of instances the histological type of growth present could be distinguished. Particles of new growth in sputum, when fixed and stained by the authors’ method, presented two different types : (1) The common form associated with oat-cell carcinoma. These fragments, which stain deep blue, consist of a cluster of cells
containing typical oat-shaped cells. (2) Fragments of squamous or columnar cell growth. The individual cells in this group are differentiated from those of the oat-cell variety by their greater size, larger nuclei, and a considerable amount of protoplasm which stains 1 Jour. Laryng. and Otol. 1935, 1., 752. 2 Brit. Jour. Surg., 1927, xv., 250.