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RADIOLOGICAL INVESTIGATION ON THE ACTION OF PURGATIVES.
1281 RADIOLOGICAL INVESTIGATION ON THE ACTION OF PURGATIVES.
Parliamentary Intelligence.
the Editor of THE LANCET. the annotation in your issue of June 19th SiR,-In NOTES ON CURRENT TOPICS. on the recent radiological investigations on the action Disease Act (1917) Amendment Bill. Venereal of purgatives carried out by Prof. P. Alessandrini, had BASIL PETO it is stated that such Mr. of Rome, presented a Bill to permit the sale by investigations hitherto only been made on animals. It is, however, chemists of disinfectants for protection against venereal 18 years since Mr. F. Cook and Mr. E. G. Slesinger, disease. The Bill was read a first time. The object of the Bill which I am asking leave to introduce, then students and now assistant obstetric surgeon said Mr. Peto, is to give effect to the recommendation of and assistant surgeon respectively at Guy’s, carried the the Ministry of Health, which Committee, appointed out a series of radiological and other observations on sat under the chairmanshipby of Lord Trevethin, contained in the action of saline aperients with me. Our results Clause 14 of their report issued in 1923, and which is as communicated to the Therapeutical Section follows :were of the Royal Society of Medicine and were summarised, We think that the law should be altered so as to permit qualified chemists to sell ad hoc disinfectants, provided together with subsequent radiological investigations properly of my own on the action of aloes, cascara, castor oil, such disinfectants are sold in a form approved and with instructions for use approved by some competent authority." and calomel, in the first edition of my book on Clause 1 of the Bill amends Clause 2 of the Venereal Disease in In 1910 1909. Stierlin Constipation published made similar observations with senna, and in 1914 Act, 1917, so far as that Act relates to the prevention of Dr. W. R. Reynell, who was at that time my house disease, and Clause 2 of the Bill provides for the setting up of the authority. As to the present state of the physician, investigated the action of liquid paraffin. law I competent cannot do better than quote what the Minister of It is impossible to give more than a very short Health said in reply to a deputation which waited upon him summary of our results in a letter, but on the whole in July, 1923, and which was introduced by the late President they agree very closely with those of Prof. Alessandrini.of the Society for the Prevention of Venereal Disease (Lord We found that saline aperients act only on the colon. Willoughby de Broke). The Minister said :As they frequently act within an hour-i.e., long before I have been to the best foimtain I could, the Law Offices of the Crown, and I have put to them certain questions as to they have reached the large intestine, both accordingthe meaning of the relevant section to the Act of 1917. to Alessandrini’s and our observations-it is clear that We exact have this position, that to-day a chemist may sell ad hoc they cannot act, as is still commonly taught, bydisinfectants for the purpose of prevention. To-day a chemist verbally recommend to a customer such preparations for attracting fluid into the lumen of the bowel. Moreover,may I purposes. What he may not do is to give any written or the liquid stools contain no excess of the salt, which issuch printed instructions, although he may give verbally such i to the customer.... It is clear that it would chiefly excreted in the solid stool passed the next day. instructions We believed that they must, therefore, act only afterrequire an alteration in the law to permit the chemist to give or written instructions, and personally I think that if absorption, but in view of the reflex contractionthese iprintedthings are to be sold, printed or written instructions should of the gall-bladder, which Meltzer has shown occurs be 1 supplied with them. It would also be necessary to pass if the sale of these preparations is to be limited to when magnesium sulphate is introduced into thelegislation such as are approved by a competent authority." the it is that true duodenum, explanation possible is that the salts also give rise to a duodeno-colic ’There is agreement as to the desirability of taking all steps for the prevention of this terrible disease. The ] possible reflex, which evacuates the fluid contents of the trouble so far has been as to what should be the competent proximal colon. My observations showed thatauthority. A great deal of evidence as to the efficacy of cascara acts on the small as well as the large intestine, measures accumulated during the late war, of preventive the as stated and not only on latter by Alessandrini.,which I have only time to give two examples. Sir James On the other hand, aloes and senna act only on theBarrett, who was in medical charge of the Australian Forces colon. Castor oil acts on the small intestine as well (during the war, says :as the colon ; the delay it causes in the evacuation In my experience primary prophylaxis has been practically ( in its results." of the stomach is due to the inhibitory action it shares certain with all fats, as Pavlov showed many years ago. And he states that in one camp out of 4400 men who reported Lastly, liquid paraffin only accelerates the transitexposure to infection that as a result of primary prophylaxis < 13 infections resulted. Surgeon-Captain Hamilton through the colon. only ] who was in medical charge of the Naval Gunnery I entirely agree with your annotator that observa-Boyden, tions of this kind show that radiological methods areSchool at Portsmouth during the two years from 1918 to -’ says that 923 bottles of 1 in 1000 solution of potassium valuable in the study of the complex questions of1920, were supplied to men who intended to incur permanganate but it a seems pity experimental pharmacology, of infection, and only one man was infected. danger During in reviewing Italian work published in 1925 he 1917 the men at the Royal Artillery Barracks at Portsmouth have ignored the investigations on the subject donewere 1 to disinfect without instructed and out carefully delay, more than ten years earlier in England. < of 3750 only five were infected during a period of nine months. There is also evidence from Colonel Harrison as I am, Sir, yours faithfully, to what would be the effect of similar steps on the civil ARTHUR F. HURST. population. His experience during the war shows what New Lodge Clinic, Windsor Forest, June 21st, 1926. could be done to reduce venereal disease in the civil comTo
’*’
"
"
that should
UNIVERSITY
op
LONDON CLUB.-A well-attended
reception was held at the club on Tuesday evening, June 22nd, to meet Prof. Ernest Gardner, Vice-Chancellor of the University, Mr. S. L. Loney, chairman of Convocation, and members of the Senate, and there was a distinguished gathering of graduates in many faculties. The chairman of the club, Mr. Walter Seton, D.Lit., in welcoming the guests, referred to the recent introduction of a widened basis of membership in the club. Hitherto membership has been limited to graduates, teachers, and officers of the University of London and others connected with the Universitv and its colleges, schools, institutitns, and organisations. It has now been decided to admit to membership graduates of other universities, persons who, though not graduates of the University, hold one of the diplomas granted by the University, and others who have taken an approved professional qualification such as the M.R.C.S., L.R.C.P. He expressed the hope that the existing membership of 700 would soon be raised to 1000, which could be done without overcrowding the present accommodation. An admirable programme of music was provided in the club hall by the University of London Musical Society.
munity. It seems to me perfectly clear that the civilian population should have free access to reliable preventives against venereal disease. It is not only a question of the present generation, we have to consider the effect of this terrible scourge on future generations. The best medical opinion is unanimous that a very large proportion of the cases of paralysis, malformation, mental deficiency, insanity, epilepsy and blindness, which cost the country almost untold loss in the efficiency of the population, and a direct loss in keeping these unfortunate victims, are due directly to parental syphilis or gonorrhoea. I will give the House. Mr. Peto continued, one example as to blindness. The Report of the Departmental Committee on the Causes and Prevention of Blindness, which was issued by the Ministry of Health in 1922, states that of 1855 cases of school blindness occurring in the schools for the blind of the London Education Committee, in 1920 alone, 369 were due to parental gonorrhoea and 618 due to parental syphilis. The cost of the present method of dealing with this disease exclusively by curing it, instead of dealing with it,
as
far
as we
can, before the germ is allowed to
penetrate from the surface, is, according to the Annual Report of the Ministry of Health for z25, very great
Parliamentary Intelligence.
the Editor of THE LANCET. the annotation in your issue of June 19th SiR,-In NOTES ON CURRENT TOPICS. on the recent radiological investigations on the action Disease Act (1917) Amendment Bill. Venereal of purgatives carried out by Prof. P. Alessandrini, had BASIL PETO it is stated that such Mr. of Rome, presented a Bill to permit the sale by investigations hitherto only been made on animals. It is, however, chemists of disinfectants for protection against venereal 18 years since Mr. F. Cook and Mr. E. G. Slesinger, disease. The Bill was read a first time. The object of the Bill which I am asking leave to introduce, then students and now assistant obstetric surgeon said Mr. Peto, is to give effect to the recommendation of and assistant surgeon respectively at Guy’s, carried the the Ministry of Health, which Committee, appointed out a series of radiological and other observations on sat under the chairmanshipby of Lord Trevethin, contained in the action of saline aperients with me. Our results Clause 14 of their report issued in 1923, and which is as communicated to the Therapeutical Section follows :were of the Royal Society of Medicine and were summarised, We think that the law should be altered so as to permit qualified chemists to sell ad hoc disinfectants, provided together with subsequent radiological investigations properly of my own on the action of aloes, cascara, castor oil, such disinfectants are sold in a form approved and with instructions for use approved by some competent authority." and calomel, in the first edition of my book on Clause 1 of the Bill amends Clause 2 of the Venereal Disease in In 1910 1909. Stierlin Constipation published made similar observations with senna, and in 1914 Act, 1917, so far as that Act relates to the prevention of Dr. W. R. Reynell, who was at that time my house disease, and Clause 2 of the Bill provides for the setting up of the authority. As to the present state of the physician, investigated the action of liquid paraffin. law I competent cannot do better than quote what the Minister of It is impossible to give more than a very short Health said in reply to a deputation which waited upon him summary of our results in a letter, but on the whole in July, 1923, and which was introduced by the late President they agree very closely with those of Prof. Alessandrini.of the Society for the Prevention of Venereal Disease (Lord We found that saline aperients act only on the colon. Willoughby de Broke). The Minister said :As they frequently act within an hour-i.e., long before I have been to the best foimtain I could, the Law Offices of the Crown, and I have put to them certain questions as to they have reached the large intestine, both accordingthe meaning of the relevant section to the Act of 1917. to Alessandrini’s and our observations-it is clear that We exact have this position, that to-day a chemist may sell ad hoc they cannot act, as is still commonly taught, bydisinfectants for the purpose of prevention. To-day a chemist verbally recommend to a customer such preparations for attracting fluid into the lumen of the bowel. Moreover,may I purposes. What he may not do is to give any written or the liquid stools contain no excess of the salt, which issuch printed instructions, although he may give verbally such i to the customer.... It is clear that it would chiefly excreted in the solid stool passed the next day. instructions We believed that they must, therefore, act only afterrequire an alteration in the law to permit the chemist to give or written instructions, and personally I think that if absorption, but in view of the reflex contractionthese iprintedthings are to be sold, printed or written instructions should of the gall-bladder, which Meltzer has shown occurs be 1 supplied with them. It would also be necessary to pass if the sale of these preparations is to be limited to when magnesium sulphate is introduced into thelegislation such as are approved by a competent authority." the it is that true duodenum, explanation possible is that the salts also give rise to a duodeno-colic ’There is agreement as to the desirability of taking all steps for the prevention of this terrible disease. The ] possible reflex, which evacuates the fluid contents of the trouble so far has been as to what should be the competent proximal colon. My observations showed thatauthority. A great deal of evidence as to the efficacy of cascara acts on the small as well as the large intestine, measures accumulated during the late war, of preventive the as stated and not only on latter by Alessandrini.,which I have only time to give two examples. Sir James On the other hand, aloes and senna act only on theBarrett, who was in medical charge of the Australian Forces colon. Castor oil acts on the small intestine as well (during the war, says :as the colon ; the delay it causes in the evacuation In my experience primary prophylaxis has been practically ( in its results." of the stomach is due to the inhibitory action it shares certain with all fats, as Pavlov showed many years ago. And he states that in one camp out of 4400 men who reported Lastly, liquid paraffin only accelerates the transitexposure to infection that as a result of primary prophylaxis < 13 infections resulted. Surgeon-Captain Hamilton through the colon. only ] who was in medical charge of the Naval Gunnery I entirely agree with your annotator that observa-Boyden, tions of this kind show that radiological methods areSchool at Portsmouth during the two years from 1918 to -’ says that 923 bottles of 1 in 1000 solution of potassium valuable in the study of the complex questions of1920, were supplied to men who intended to incur permanganate but it a seems pity experimental pharmacology, of infection, and only one man was infected. danger During in reviewing Italian work published in 1925 he 1917 the men at the Royal Artillery Barracks at Portsmouth have ignored the investigations on the subject donewere 1 to disinfect without instructed and out carefully delay, more than ten years earlier in England. < of 3750 only five were infected during a period of nine months. There is also evidence from Colonel Harrison as I am, Sir, yours faithfully, to what would be the effect of similar steps on the civil ARTHUR F. HURST. population. His experience during the war shows what New Lodge Clinic, Windsor Forest, June 21st, 1926. could be done to reduce venereal disease in the civil comTo
’*’
"
"
that should
UNIVERSITY
op
LONDON CLUB.-A well-attended
reception was held at the club on Tuesday evening, June 22nd, to meet Prof. Ernest Gardner, Vice-Chancellor of the University, Mr. S. L. Loney, chairman of Convocation, and members of the Senate, and there was a distinguished gathering of graduates in many faculties. The chairman of the club, Mr. Walter Seton, D.Lit., in welcoming the guests, referred to the recent introduction of a widened basis of membership in the club. Hitherto membership has been limited to graduates, teachers, and officers of the University of London and others connected with the Universitv and its colleges, schools, institutitns, and organisations. It has now been decided to admit to membership graduates of other universities, persons who, though not graduates of the University, hold one of the diplomas granted by the University, and others who have taken an approved professional qualification such as the M.R.C.S., L.R.C.P. He expressed the hope that the existing membership of 700 would soon be raised to 1000, which could be done without overcrowding the present accommodation. An admirable programme of music was provided in the club hall by the University of London Musical Society.
munity. It seems to me perfectly clear that the civilian population should have free access to reliable preventives against venereal disease. It is not only a question of the present generation, we have to consider the effect of this terrible scourge on future generations. The best medical opinion is unanimous that a very large proportion of the cases of paralysis, malformation, mental deficiency, insanity, epilepsy and blindness, which cost the country almost untold loss in the efficiency of the population, and a direct loss in keeping these unfortunate victims, are due directly to parental syphilis or gonorrhoea. I will give the House. Mr. Peto continued, one example as to blindness. The Report of the Departmental Committee on the Causes and Prevention of Blindness, which was issued by the Ministry of Health in 1922, states that of 1855 cases of school blindness occurring in the schools for the blind of the London Education Committee, in 1920 alone, 369 were due to parental gonorrhoea and 618 due to parental syphilis. The cost of the present method of dealing with this disease exclusively by curing it, instead of dealing with it,
as
far
as we
can, before the germ is allowed to
penetrate from the surface, is, according to the Annual Report of the Ministry of Health for z25, very great