- Email: [email protected]
"THE ACTION OF ASPARAGUS ON THE KIDNEYS."
"THE LOSS OF LIFE FROM PREVENTABLE DISEASE."
1645
rateable value of .f25 and under, and each authority certainly to my mind forbid its dietetic use to patients with since mothers and children are granular and contracted kidneys. T am- Sirs yours t,rnlvto be dealt with. The duties of such an inspector would be CHARLES H. RALFE. to visit all such property ; to impress upon those in charge of Queen Anne-street,, June 25th, 1894. children (a) the highlypreventable nature of whooping-cough and measles, (b) the gravity of these diseases and the great importance of early treatment and advice, and (c) the steps which must be taken to guard against their origin and " THE MALIGNANT TRANSFORMATION OF BENIGN LARYNGEAL TUMOURS AS A spread ; they would also have to see that their recommendations were acted up to, and they would report to the medical OF ENDO-LAKYNGEAL CONSEQUENCE officer all sanitary defects. There are many women trained OPERATIONS: A REJOINDER." annually by the National Health Society who are in every work. for this Such a method To the Editors presents of THE LANCET. respect fully qualified many advantages over the distribution of handbills of inforSIRS,—Notwithstanding that a communication almost mation, and it would cost far less than notification. A further identical with that which Dr. Newman has addressed to you gain would be that the many sanitary defects which con- has already appeared in the June number of a medical stantly crop up in the mostly old and jerry-built houses of published in the city of his residence, I cannot but the poor would be brought to the knowledge of the sanitary journal be pleased at its appearance in the leading medical journal authority much earlier than they can otherwise be, for in of the world, since it gives me the best possible opportunity most districts the number of sanitary inspectors appointed is for refuting these serious, though, as I hope to prove, untoo small to admit of an efficient and sufficiently frequent charges on my literary probity. house-to-house inspection of all poor-class properties, and it founded, as to any inaccuracy or misrepresentation on my First, is almost entirely by this means that one learns of their of Dr. Newman’s writings. Five and a half years ago part I am, Sirs, yours faithfully, sanitary defects. he reported a case in another journal,l to which you HENRY R. KENWOOD, fresh publication. It was that of a laryngeal Medical Officer of Health for Stoke Newington and for the generously give tumour in which the history and the subjective and objecFinchley District. tive symptoms all "favoured the diagnosis of an inflamed Adelaide-road, N.W., June 22nd. 1894. papilloma." The microscopic appearances of a removed fragment were those of a papillomatous adenoma, without the least suspicion of the structure of an epithelioma." A larger To the Editors of THE LANCET. is removed shortly after, of presumably an equally SIRS, -All who have had much experience in the treatment portion innocent character, though the report is silent on this point. of whooping-cough will, I think, cordially endorse the views a diffuse swelling appears in of Dr. Lee, advocating the necessity for the compulsory Following this second operation the neck, and seventeen days later, on subsidence of the notification of that disease. Whether founded on fact or not, two enlarged lymphatic glands are revealed, one on the middle and poorer classes of our large manufacturing swelling, either side of the thyroid cartilage, "at first supposed to be towns hold to the popular belief that the medical man due to inflammatory changes";2 but the case, now decided can do very little for the effective treatment and cure of to be an epithelioma, terminates fatally at a date not named. whooping-cough, and that the more outdoor air the patient Dr Newman complains that, in my abstract of his report, Hence the sufferer, in the earliest can have the better. for the word "believed," as applied to the innocent stages of the disease with its attending febricula and character of the first specimen, I have " substituted the term tendency to pulmonary complications, is exposed to all I demonstrated,’ tkerefore " (may I venture to substitute here vicissitudes of weather. I am of opinion, after a long the word ’thereby ’ ?) "altering his meaning entirely." It is experience, that notification with compulsory isolation for characteristic of Dr. Newman that, in his letter to you, he a reasonable period, necessitating the patient remaining makes light of the value of microscopic examination of a Dr. the as Lee would reduce indoors, mortality-which, removed fragment, notwithstanding that in the communicatruly states, is the largest of all our zymotic diseases-from tion containing this case he dwells strongly on its importance 50 to 70 per cent., and would at the same time very ’’ for the purpose of arriving at an early and reliable diamaterially limit the diffusion of the complaint. gnosis," than which, in his later published essay,"1 he says I am, Sirs, yours faithfully, "there is no method more certain"; and, with regard to OLIVER BARBER, M.D. Sheffield, June 26th, 1894. Dr. Newman’s denial that there was any "relationship between the operation and malignant transformation," I find in his later account of this same case4 that he removed the "THE ACTION OF ASPARAGUS ON THE second larger portion of this particular tumour "under the belief, founded on his certain methods, that the KIDNEYS." disease was benign, and that it might be: removed by an To the Editors of THE LANCET. intra-laryngeal operation." It is also to be noted that, although I used the word "demonstrated "--and, if the SIRS,—The discrepancy of opinion that exists with regard microscope does not demonstrate, what does it do?-I immeto the diuretic action of asparagus is due, I think, to the after, as Dr. Newman quotes, say that it was "supfact that increased frequency of micturition has been mis- diatelyto I leave it, Sirs, to you have demonstrated," &c. posed taken for increased diuresis. My own observations, personal and readers to decide whether, in all the circumstances, your as well as on patients, has been to show that after eating an the substitution by me of the word "demonstrated" for experimental quantity of asparagus, especially that with that of "believed" is an unjustifiable alteration of"the much white stalk, the tendency was to increased micturition, wording of Dr. Newman’s report to suit my own ends sometimes with uncomfortable feelings of irritation in the peri- therefore altering his meaning entirely " ; whether, indeed, neal region ; the amount of urine diminished about one-third, on the other hand, I am not fairer to Dr. Newman than he with sometimes a darkish tinge, and the highly characteristic is to himself in assuming that his belief was the result of a odour. With the green variety these conditions were not faith in evidence " demonstrated " by a method than lively so markedly noticed, and the characteristic odour only faint. he asserts, none is "more certain," instead of being From which I gather that the peculiar principle of asparagus which, the expression of a baseless credulity. merely probably resides in the stalk. Professor Neucki1 has isolated Dr. Newman asserts that"I have no right to Secondly, " this body as a yellow, crystalline substance, which, when claim him as an adherent of the opinion expressed by me heated, gives the characteristic odour of methyl mercaptan. that such simple laryngeal growths as an adenoma or papilIt would, therefore, be easy to determine the action of this loma may be by surgical interference transformed into a body by an experimental test. It is also important to malignant tumour" (not desiring to "alter" Dr. Newman’s determine whether it resides only in the white portion, or in meaning, I make no attempt at a " correction " of his both the green and white equally, or only in small quantities My reply is that I have such a right, not in the green. If, as I believe, the latter to be the case, English). on a reasonable only interpretation of the foregoing there would be no reason to forbid it to most invalids, but case, but on that of the repeated and deliberate utterances the decided inhibiting effects I have seen follow the ingestion of asparagus with a large amount of soft white stalk would 1 Brit. Med. Jour., 1889, vol. i., p. 133. 2 Diseases of the Nose and Throat, p. 104. Edinburgh, 1892. Malignant 1 Archiv f. 3 4 Bd. 3 102. u. Hefte and 4. xxviii., Op. cit., p. Op. cit., p. 103. Exp Path. Pharm.,
of
a
appointed a woman inspector,
-----
......
1645
rateable value of .f25 and under, and each authority certainly to my mind forbid its dietetic use to patients with since mothers and children are granular and contracted kidneys. T am- Sirs yours t,rnlvto be dealt with. The duties of such an inspector would be CHARLES H. RALFE. to visit all such property ; to impress upon those in charge of Queen Anne-street,, June 25th, 1894. children (a) the highlypreventable nature of whooping-cough and measles, (b) the gravity of these diseases and the great importance of early treatment and advice, and (c) the steps which must be taken to guard against their origin and " THE MALIGNANT TRANSFORMATION OF BENIGN LARYNGEAL TUMOURS AS A spread ; they would also have to see that their recommendations were acted up to, and they would report to the medical OF ENDO-LAKYNGEAL CONSEQUENCE officer all sanitary defects. There are many women trained OPERATIONS: A REJOINDER." annually by the National Health Society who are in every work. for this Such a method To the Editors presents of THE LANCET. respect fully qualified many advantages over the distribution of handbills of inforSIRS,—Notwithstanding that a communication almost mation, and it would cost far less than notification. A further identical with that which Dr. Newman has addressed to you gain would be that the many sanitary defects which con- has already appeared in the June number of a medical stantly crop up in the mostly old and jerry-built houses of published in the city of his residence, I cannot but the poor would be brought to the knowledge of the sanitary journal be pleased at its appearance in the leading medical journal authority much earlier than they can otherwise be, for in of the world, since it gives me the best possible opportunity most districts the number of sanitary inspectors appointed is for refuting these serious, though, as I hope to prove, untoo small to admit of an efficient and sufficiently frequent charges on my literary probity. house-to-house inspection of all poor-class properties, and it founded, as to any inaccuracy or misrepresentation on my First, is almost entirely by this means that one learns of their of Dr. Newman’s writings. Five and a half years ago part I am, Sirs, yours faithfully, sanitary defects. he reported a case in another journal,l to which you HENRY R. KENWOOD, fresh publication. It was that of a laryngeal Medical Officer of Health for Stoke Newington and for the generously give tumour in which the history and the subjective and objecFinchley District. tive symptoms all "favoured the diagnosis of an inflamed Adelaide-road, N.W., June 22nd. 1894. papilloma." The microscopic appearances of a removed fragment were those of a papillomatous adenoma, without the least suspicion of the structure of an epithelioma." A larger To the Editors of THE LANCET. is removed shortly after, of presumably an equally SIRS, -All who have had much experience in the treatment portion innocent character, though the report is silent on this point. of whooping-cough will, I think, cordially endorse the views a diffuse swelling appears in of Dr. Lee, advocating the necessity for the compulsory Following this second operation the neck, and seventeen days later, on subsidence of the notification of that disease. Whether founded on fact or not, two enlarged lymphatic glands are revealed, one on the middle and poorer classes of our large manufacturing swelling, either side of the thyroid cartilage, "at first supposed to be towns hold to the popular belief that the medical man due to inflammatory changes";2 but the case, now decided can do very little for the effective treatment and cure of to be an epithelioma, terminates fatally at a date not named. whooping-cough, and that the more outdoor air the patient Dr Newman complains that, in my abstract of his report, Hence the sufferer, in the earliest can have the better. for the word "believed," as applied to the innocent stages of the disease with its attending febricula and character of the first specimen, I have " substituted the term tendency to pulmonary complications, is exposed to all I demonstrated,’ tkerefore " (may I venture to substitute here vicissitudes of weather. I am of opinion, after a long the word ’thereby ’ ?) "altering his meaning entirely." It is experience, that notification with compulsory isolation for characteristic of Dr. Newman that, in his letter to you, he a reasonable period, necessitating the patient remaining makes light of the value of microscopic examination of a Dr. the as Lee would reduce indoors, mortality-which, removed fragment, notwithstanding that in the communicatruly states, is the largest of all our zymotic diseases-from tion containing this case he dwells strongly on its importance 50 to 70 per cent., and would at the same time very ’’ for the purpose of arriving at an early and reliable diamaterially limit the diffusion of the complaint. gnosis," than which, in his later published essay,"1 he says I am, Sirs, yours faithfully, "there is no method more certain"; and, with regard to OLIVER BARBER, M.D. Sheffield, June 26th, 1894. Dr. Newman’s denial that there was any "relationship between the operation and malignant transformation," I find in his later account of this same case4 that he removed the "THE ACTION OF ASPARAGUS ON THE second larger portion of this particular tumour "under the belief, founded on his certain methods, that the KIDNEYS." disease was benign, and that it might be: removed by an To the Editors of THE LANCET. intra-laryngeal operation." It is also to be noted that, although I used the word "demonstrated "--and, if the SIRS,—The discrepancy of opinion that exists with regard microscope does not demonstrate, what does it do?-I immeto the diuretic action of asparagus is due, I think, to the after, as Dr. Newman quotes, say that it was "supfact that increased frequency of micturition has been mis- diatelyto I leave it, Sirs, to you have demonstrated," &c. posed taken for increased diuresis. My own observations, personal and readers to decide whether, in all the circumstances, your as well as on patients, has been to show that after eating an the substitution by me of the word "demonstrated" for experimental quantity of asparagus, especially that with that of "believed" is an unjustifiable alteration of"the much white stalk, the tendency was to increased micturition, wording of Dr. Newman’s report to suit my own ends sometimes with uncomfortable feelings of irritation in the peri- therefore altering his meaning entirely " ; whether, indeed, neal region ; the amount of urine diminished about one-third, on the other hand, I am not fairer to Dr. Newman than he with sometimes a darkish tinge, and the highly characteristic is to himself in assuming that his belief was the result of a odour. With the green variety these conditions were not faith in evidence " demonstrated " by a method than lively so markedly noticed, and the characteristic odour only faint. he asserts, none is "more certain," instead of being From which I gather that the peculiar principle of asparagus which, the expression of a baseless credulity. merely probably resides in the stalk. Professor Neucki1 has isolated Dr. Newman asserts that"I have no right to Secondly, " this body as a yellow, crystalline substance, which, when claim him as an adherent of the opinion expressed by me heated, gives the characteristic odour of methyl mercaptan. that such simple laryngeal growths as an adenoma or papilIt would, therefore, be easy to determine the action of this loma may be by surgical interference transformed into a body by an experimental test. It is also important to malignant tumour" (not desiring to "alter" Dr. Newman’s determine whether it resides only in the white portion, or in meaning, I make no attempt at a " correction " of his both the green and white equally, or only in small quantities My reply is that I have such a right, not in the green. If, as I believe, the latter to be the case, English). on a reasonable only interpretation of the foregoing there would be no reason to forbid it to most invalids, but case, but on that of the repeated and deliberate utterances the decided inhibiting effects I have seen follow the ingestion of asparagus with a large amount of soft white stalk would 1 Brit. Med. Jour., 1889, vol. i., p. 133. 2 Diseases of the Nose and Throat, p. 104. Edinburgh, 1892. Malignant 1 Archiv f. 3 4 Bd. 3 102. u. Hefte and 4. xxviii., Op. cit., p. Op. cit., p. 103. Exp Path. Pharm.,
of
a
appointed a woman inspector,
-----
......