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PHONETIC RECORDS IN DIAGNOSIS.
820
T
loosely applied, has largely responsible for the present highly
erroneous, when extended and
Annotations.
been
unsatisfactory and unscientific position of organotherapy and has led to a commercial boom in visceral and glandular extracts justified neither in theory nor in therapeutic results. For a ductless secretion to be
" Ne quid nimis. "
COCAINE AND ITS DISTRIBUTION. of use in treatment it should be both stable and THE illicit use of cocaine by many persons continues stored under normal conditions in the gland from to be forced upon the public notice by the reports of which it is obtained. These requirements, said Dr. prosecutions in the newspapers, and it has been Langmead, were met with certainty only by thyroxin, stated that the Government intends to bring in the secretion of the thyroid gland, explaining the legislation in the autumn which will increase the different order of value of thyroid extract from that penalties to be inflicted upon illicit sellers and im- of other glands. Researches into the physiology of porters of the drug. At the same time there is dis- other ductless glands has provided two potent cussion as to the possibility of instituting, through the, therapeutic agents, adrenalin and pituitrin, but he League of Nations or otherwise, international control pointed out that adrenalin no more represents the of the production and sale of cocaine and kindred whole secretion of the adrenal gland than does an drugs by manufacturers. Prevention of this kind extract of the posterior lobe that of the pituitary. must clearly be an effective solution of the problem Warnings like this are necessary, for in endocrine which arises out of the easy and profitable evasion of therapy desire tends to outrun performance. It is penal laws. The object to be arrived at must be the important for us to distinguish between true hormone cutting down of the supply of cocaine to the more therapy and treatment by extracts obtained from or less ascertainable requirements of medicine. Illicit different organs, and to keep close to the line of ascerusers of cocaine and their suppliers create a demand tained truths, if this branch of medicine is to be for a surplus over this which, no doubt, is paid for cleared from the pall of reckless assumptions and comat high rates, but the production of such a surpluss mercial enterprise in which it is now befogged. by known manufacturers is capable of prevention, if every Government concerned is willing to pass laws PHONETIC RECORDS IN DIAGNOSIS. ,
that will have that effect. Agreements, however, between nations, even with so desirable an end in view, may take some time to complete and carry into effect, and meanwhile we may have to be satisfied with such measures as our courts can enforce within their jurisdiction. It appears to be certain that an increase of the penalties already provided would meet with general approval, even from those who appreciate the fact that it is the difficulty of detecting offenders rather than the lack of power to punish them that enables the evil to continue. Some have even suggested flogging for illicit dealers in cocaine, not taking into account the fact that such a measure would merely mean the employment of more women, who, of course, cannot be flogged, in the work of distribution. The power to pass longer sentences of imprisonment and sentences of penal servitude after repeated convictions will no doubt be proposed, and it would seem advisable to provide for similar increased severity in the case of wholesale " traders, as distinct from the retailers of small quantities, who deal directly with drug addicts and who appear most frequently in the police courts. Cocaine must pass through many hands before it reaches these last, and through the hands of persons fully aware of its ultimate destination. The power to impose penal servitude upon any person found in the illicit possession of a defined substantial quantity might act as a deterrent, and as presumably the trade is handled by individuals rather than by firms, the relegation of one or two’of these to prison for some years would cause an appreciable interruption in the traffic. Longer terms of imprisonment and penal servitude will, however, have to be combined with a diminished production before this profitable and baneful form of smuggling is stamped out. "
THE
LIMITATIONS
OF
ENDOCRINE
ORGANOTHERAPY often consists in the
THERAPY.
of a substance of unknown composition and of doubtful stability, obtained in a manner unknown to the prescriber, for disorders the aetiology of which is obscure. This was the attitude taken by Prof. F. S. Langmead in a recent lecture before post-graduates at St. Mary’s Hospital Medical School. He deprecated the view, which has obtained many protagonists, that the ductless glands are the super-organs of the body, controlling it in health and in disease throughout life, determining sex, and moulding personality. Even physiologists, he thought, had too readily accepted the view that made from ductless glands represent the extracts internal secretions of those glands, and demonstrate their normal action. This conception, possibly quite
giving
A
RECENT
number of the Wiener Medizinische
Wochenschrift reports a lecture delivered by Dr. E. W. Scripture, at the University of Vienna, on experimental phonetics, in which he recounts the efforts
made to render this method serviceable to medicine. Speech is registered on a recording drum and analysed under a microscope. In disseminated sclerosis a peculiar wave form appears in the registrations in every case, even when no peculiarity of speech can be detected by the ear. This makes for early diagnosis. In general paralysis a characteristic tracing is recorded at a very early stage, again before anything can be heard. Dr. Scripture laid stress on the importance of any aid to correct diagnosis at a time when these conditions are apt to be confused with neurasthenia and hysteria. Microscopic measurement of the waves in phonetic records shows that idiopathic epilepsy is characterised by a peculiar form of speech melody which occurs in no other disease yet investigated and which cannot be imitated. Comparison with other records has satisfied Dr. Scripture that epilepsy is not a disease of the brain in the strict sense, but is the result of the epileptic’s peculiar mental constitution. His conclusion may be put in relation with the view, held on other grounds, that idiopathic epilepsy is a psychic and not a cortical disease. ____
A NEW RUSSIAN MEDICAL PERIODICAL. WE have received a copy of the first number of Meditzinskaia Bibliographia, a new medical periodical published by the Narkomzdrav of the Soviet Govern-" ment in Moscow. Narkomzdrav is a " portemanteau word for N arodnoi Kommissariat Zdravo-okhrawnia (N.K.Z.), or National Commission for Preservation of the Public Health. So little is known with accuracy of what is passing in Russia at the present time that any document which throws light on the conditions obtaining in that country is welcome. One section of the periodical is devoted to Decrees and Regulations of the Soviet of National Commissions ; from these it may be gathered that all publications, medical or others, are under the direct control of the central Soviet authorities. An article entitled Publications of the N.K.Z. states that between January, 1919, and January, 1922, 93 brochures and 52 leaflets on public health matters were issued, 1,594,000 copies of the former and over 9,000,000 of the latter having been distributed, and that literature aimed at diffusing knowledge on sanitary questions among the people was published not only in Russian, but also in the languages of the various racial minorities, such as Tartar, Tchuvash, and Hebrew. The present
T
loosely applied, has largely responsible for the present highly
erroneous, when extended and
Annotations.
been
unsatisfactory and unscientific position of organotherapy and has led to a commercial boom in visceral and glandular extracts justified neither in theory nor in therapeutic results. For a ductless secretion to be
" Ne quid nimis. "
COCAINE AND ITS DISTRIBUTION. of use in treatment it should be both stable and THE illicit use of cocaine by many persons continues stored under normal conditions in the gland from to be forced upon the public notice by the reports of which it is obtained. These requirements, said Dr. prosecutions in the newspapers, and it has been Langmead, were met with certainty only by thyroxin, stated that the Government intends to bring in the secretion of the thyroid gland, explaining the legislation in the autumn which will increase the different order of value of thyroid extract from that penalties to be inflicted upon illicit sellers and im- of other glands. Researches into the physiology of porters of the drug. At the same time there is dis- other ductless glands has provided two potent cussion as to the possibility of instituting, through the, therapeutic agents, adrenalin and pituitrin, but he League of Nations or otherwise, international control pointed out that adrenalin no more represents the of the production and sale of cocaine and kindred whole secretion of the adrenal gland than does an drugs by manufacturers. Prevention of this kind extract of the posterior lobe that of the pituitary. must clearly be an effective solution of the problem Warnings like this are necessary, for in endocrine which arises out of the easy and profitable evasion of therapy desire tends to outrun performance. It is penal laws. The object to be arrived at must be the important for us to distinguish between true hormone cutting down of the supply of cocaine to the more therapy and treatment by extracts obtained from or less ascertainable requirements of medicine. Illicit different organs, and to keep close to the line of ascerusers of cocaine and their suppliers create a demand tained truths, if this branch of medicine is to be for a surplus over this which, no doubt, is paid for cleared from the pall of reckless assumptions and comat high rates, but the production of such a surpluss mercial enterprise in which it is now befogged. by known manufacturers is capable of prevention, if every Government concerned is willing to pass laws PHONETIC RECORDS IN DIAGNOSIS. ,
that will have that effect. Agreements, however, between nations, even with so desirable an end in view, may take some time to complete and carry into effect, and meanwhile we may have to be satisfied with such measures as our courts can enforce within their jurisdiction. It appears to be certain that an increase of the penalties already provided would meet with general approval, even from those who appreciate the fact that it is the difficulty of detecting offenders rather than the lack of power to punish them that enables the evil to continue. Some have even suggested flogging for illicit dealers in cocaine, not taking into account the fact that such a measure would merely mean the employment of more women, who, of course, cannot be flogged, in the work of distribution. The power to pass longer sentences of imprisonment and sentences of penal servitude after repeated convictions will no doubt be proposed, and it would seem advisable to provide for similar increased severity in the case of wholesale " traders, as distinct from the retailers of small quantities, who deal directly with drug addicts and who appear most frequently in the police courts. Cocaine must pass through many hands before it reaches these last, and through the hands of persons fully aware of its ultimate destination. The power to impose penal servitude upon any person found in the illicit possession of a defined substantial quantity might act as a deterrent, and as presumably the trade is handled by individuals rather than by firms, the relegation of one or two’of these to prison for some years would cause an appreciable interruption in the traffic. Longer terms of imprisonment and penal servitude will, however, have to be combined with a diminished production before this profitable and baneful form of smuggling is stamped out. "
THE
LIMITATIONS
OF
ENDOCRINE
ORGANOTHERAPY often consists in the
THERAPY.
of a substance of unknown composition and of doubtful stability, obtained in a manner unknown to the prescriber, for disorders the aetiology of which is obscure. This was the attitude taken by Prof. F. S. Langmead in a recent lecture before post-graduates at St. Mary’s Hospital Medical School. He deprecated the view, which has obtained many protagonists, that the ductless glands are the super-organs of the body, controlling it in health and in disease throughout life, determining sex, and moulding personality. Even physiologists, he thought, had too readily accepted the view that made from ductless glands represent the extracts internal secretions of those glands, and demonstrate their normal action. This conception, possibly quite
giving
A
RECENT
number of the Wiener Medizinische
Wochenschrift reports a lecture delivered by Dr. E. W. Scripture, at the University of Vienna, on experimental phonetics, in which he recounts the efforts
made to render this method serviceable to medicine. Speech is registered on a recording drum and analysed under a microscope. In disseminated sclerosis a peculiar wave form appears in the registrations in every case, even when no peculiarity of speech can be detected by the ear. This makes for early diagnosis. In general paralysis a characteristic tracing is recorded at a very early stage, again before anything can be heard. Dr. Scripture laid stress on the importance of any aid to correct diagnosis at a time when these conditions are apt to be confused with neurasthenia and hysteria. Microscopic measurement of the waves in phonetic records shows that idiopathic epilepsy is characterised by a peculiar form of speech melody which occurs in no other disease yet investigated and which cannot be imitated. Comparison with other records has satisfied Dr. Scripture that epilepsy is not a disease of the brain in the strict sense, but is the result of the epileptic’s peculiar mental constitution. His conclusion may be put in relation with the view, held on other grounds, that idiopathic epilepsy is a psychic and not a cortical disease. ____
A NEW RUSSIAN MEDICAL PERIODICAL. WE have received a copy of the first number of Meditzinskaia Bibliographia, a new medical periodical published by the Narkomzdrav of the Soviet Govern-" ment in Moscow. Narkomzdrav is a " portemanteau word for N arodnoi Kommissariat Zdravo-okhrawnia (N.K.Z.), or National Commission for Preservation of the Public Health. So little is known with accuracy of what is passing in Russia at the present time that any document which throws light on the conditions obtaining in that country is welcome. One section of the periodical is devoted to Decrees and Regulations of the Soviet of National Commissions ; from these it may be gathered that all publications, medical or others, are under the direct control of the central Soviet authorities. An article entitled Publications of the N.K.Z. states that between January, 1919, and January, 1922, 93 brochures and 52 leaflets on public health matters were issued, 1,594,000 copies of the former and over 9,000,000 of the latter having been distributed, and that literature aimed at diffusing knowledge on sanitary questions among the people was published not only in Russian, but also in the languages of the various racial minorities, such as Tartar, Tchuvash, and Hebrew. The present