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STERILISING VASELINE DRESSINGS
553 the grounds of the presence inhibitor substance, or substances, with properties similar to those of anterior pituitary extracts. I am, however, not satisfied that all the variations in insulin action can be explained by the presence in varying amounts of such an inhibitor of insulin. For example, the variations in insulin action resulting from dietary change still appear to occur to in insulina slight extent after hypophysectomy 3 ; insensitive cases of diabetes mellitus the presence of an inhibitor of insulin has only been demonstrated in those cases associated with hyperpituitarism, and attempts to demonstrate a similar inhibitor of insulin in cases of insulin-insensitive diabetes mellitus unassociated with hyperpituitarism have so far failed 4Krebs and Eggleston55 have shown in vitro that insulin is susceptible of activation. The present position therefore is this. The majority of the results which I originally interpreted as suggesting the relative lack of an insulin-kinase can in the light of present knowledge be more easily interpreted as being due to the presence of varying degrees of inhibition of insulin action. This conclusion, however, should not be extended to mean either that the possibility of insulin requiring activation has been excluded, or that the known physiological or pathological variations in insulin sensitivity are now completely explained on the basis of varying degrees of inhibition of insulin action by substances similar to, or identical with, the " antiinsulin factor " of the anterior pituitary gland. H. P. HIMSWORTH. University College Hospital medical school.
easily explicable
are more of a relative excess
of
STERILISING VASELINE DRESSINGS SIR,—in its notes on the treatment ot burns (Lancet, March 29, p. 425) the Ministry of Health tell us that we can prepare sterilised Vaseline dressings by melting the vaseline in a tin, adding the dressings, and keeping the tin in a dish of boiling water for half an hour. This does not seem to conform to accepted teaching for the sterilisation of either vaseline or dressings. In the Extra Pharmacopoeia (21st ed., vol. 11, p. 913) one reads : " Oils, fats and waxes (including liquid, soft and hard paraffins). These can only be sterilised by heating to 150° for 1 hour in a hot air bath " (all temperatures are Centigrade in this publication). The temperature in the middle of our tin is likely to be appreciably below 100° C. ;will the dressings be effectively sterilised ? A. T. FORBES. Cuminestown, Aberdeenshire. THE CASE FOR MASS RADIOGRAPHY SiB,—In a leading article on page 512 of your last
made to the examination of Royal a cost of less than 1d. each." This statement reminds me of one frequently made by amateur photographers, who possess expensive miniature cameras, when the high cost of the camera is overlooked as well as the degree of technical ability and skill required to obtain satisfactory results. It is now well known that special and expensive apparatus is required for successful miniature screen radiography, as well as a fairly large and highly trained personnel, whose salaries (or the equivalent) have to be taken into account. A special report on the subject, recently adopted by the Joint Tuberculosis Council, is now in the press. Copies may be obtained from the hon. secretary, Dr. J. B. Preston Hall, Aylesford, Kent. McDougall, rJ1,..’h..a:l’..n..,lr..n’;"" n.;",,...^"rt.,...,.................. T 4-T JESSEL. G.. .TTT’CTT’T.Tuberculosis Dispensary, Leigh, T Lancs.
issue reference
Public Health
on
an
was
naval personnel " at
INDUCTION OF LABOUR WITH UROSELECTAN B SIR,-In your annotation of April 5 a faithful synopsis of Playfair’s article includes the words, " Playfair has now used the drug as a deliberate method of inducing labour," which infers that the method has not been used before. Uroselectan B has in fact been used as a means of inducing labour since 1933, and so far as I know I was the first person to employ this procedure and to publish a series of cases, a fact not mentioned by Playfair although he quotes my article (J. Obstet.
From the Annual
COMPARING four typical English towns of small sizearea 8629 acres, population 86,000 ; Dewsbury, area 6729 acres, population 53,000 ; Accrington, area 4418 acres, population 40,000 ; and Kettering, area 4546 acres, population 35,000-we meet with curious differences in the mortalities, the explanation of which is far from obvious. The birth-rates of the towns in the order ’given above were : 14-6, 14,4, 10-1, 13-1. The death-rates were : 11-5, 13-3,14.7, 10-8. These show Accrington to differ from the other three in having a falling population and with this go many factors which .disturb the death table. The infantile mortality, which is not influenced by the age-sex distribution of the population, but is affected by some of the factors which determine shifts of population, was not far from level49, 50, 45, 44. When we come to certified causes of death we meet with some surprises. If we standardise the recorded numbers from the four towns to what they would be if all had populations equal in number to that of Ipswich, we find :-
Ipswich,
cancer deaths are nearly equal in Ipswich and Accrington. and in Dewsbury and Kettering are also nearly equal but about a fifth less than in the first two. The probable explanation is population age : Ipswich old because it is partly residential ; Accrington old because of emigration of young people ; Dewsbury and Kettering average working towns. Tuberculosis in Ipswich and Kettering are equal, and in Dewsbury and Accrington are equal but only half that in the first pair. A probable explanation in Accrington is emigration. In Dewsbury, low tuberculosis is associated with low respiratory mortality. In Accrington this is not so definite though Cardiovascular disease is equal in it is apparent. Ipswich and Dewsbury, high in Accrington and low in Kettering, in which latter town digestive deaths are also low, though diabetes is high. Vital statistics reflect the nature of populations more clearly than their health, and this invalidates many medical statistics relating to
The
the results of treatment.
COLCHESTER
From Dr. W. F. Corfield’s much abridged reports we learn that in this borough in 1939 the infantile mortality was 28-5, a low record for the town. There were 769 live births and 32 stillbirths (14 males and 18 females). The only death from notifiable diseases apart from tuberculosis was from encephalitis lethargica. There were 6 deaths from diabetes, 84 from cancer and 28 from tuberculosis ; 7 deaths can with certainty be attributed to syphilis, apart from those included in the heart and circulatory diseases other than aneurysm. An unusual incident was the condemnation of a consignment of 489 imported sheep and lamb carcasses. We imagine this must have been due to some breakdown in
transport
or
storage.
NORTHAMPTONSHIRE
F. J. BURKE.
3. Himsworth, H. P. and Scott, D. B. M. J. Physiol. 1938, 91, 447. 4. Himsworth and Kerr, R. B. Clin. Sci. 1940, 4, 287. 5. Krebs, H. A. and Eggleston, L. V. Biochem. J. 1938, 32, 913.
’
In Dr. Corfield’s school report there is a table of the incidence of head-lousiness in the schools of the borough showing the increase or decrease on the previous year in each department of every school. The variation is The percentage of children found from + 49 to - 31. verminous varied from 11-8 to 0. Out of 30 departments 7 had a louse-index of less than 1%. The general incidence was 2-9%. At routine inspections 95-8% of the heads were clean and 4’3% verminous.
Gyntee. 1935, 43, 1096). Sunderland.
Reports
FOUR TOWNS
In the last
tuberculosis began to rise as soon as hostilities started, but the fear that the process might be repeated in this war is somewhat allayed by the war
easily explicable
are more of a relative excess
of
STERILISING VASELINE DRESSINGS SIR,—in its notes on the treatment ot burns (Lancet, March 29, p. 425) the Ministry of Health tell us that we can prepare sterilised Vaseline dressings by melting the vaseline in a tin, adding the dressings, and keeping the tin in a dish of boiling water for half an hour. This does not seem to conform to accepted teaching for the sterilisation of either vaseline or dressings. In the Extra Pharmacopoeia (21st ed., vol. 11, p. 913) one reads : " Oils, fats and waxes (including liquid, soft and hard paraffins). These can only be sterilised by heating to 150° for 1 hour in a hot air bath " (all temperatures are Centigrade in this publication). The temperature in the middle of our tin is likely to be appreciably below 100° C. ;will the dressings be effectively sterilised ? A. T. FORBES. Cuminestown, Aberdeenshire. THE CASE FOR MASS RADIOGRAPHY SiB,—In a leading article on page 512 of your last
made to the examination of Royal a cost of less than 1d. each." This statement reminds me of one frequently made by amateur photographers, who possess expensive miniature cameras, when the high cost of the camera is overlooked as well as the degree of technical ability and skill required to obtain satisfactory results. It is now well known that special and expensive apparatus is required for successful miniature screen radiography, as well as a fairly large and highly trained personnel, whose salaries (or the equivalent) have to be taken into account. A special report on the subject, recently adopted by the Joint Tuberculosis Council, is now in the press. Copies may be obtained from the hon. secretary, Dr. J. B. Preston Hall, Aylesford, Kent. McDougall, rJ1,..’h..a:l’..n..,lr..n’;"" n.;",,...^"rt.,...,.................. T 4-T JESSEL. G.. .TTT’CTT’T.Tuberculosis Dispensary, Leigh, T Lancs.
issue reference
Public Health
on
an
was
naval personnel " at
INDUCTION OF LABOUR WITH UROSELECTAN B SIR,-In your annotation of April 5 a faithful synopsis of Playfair’s article includes the words, " Playfair has now used the drug as a deliberate method of inducing labour," which infers that the method has not been used before. Uroselectan B has in fact been used as a means of inducing labour since 1933, and so far as I know I was the first person to employ this procedure and to publish a series of cases, a fact not mentioned by Playfair although he quotes my article (J. Obstet.
From the Annual
COMPARING four typical English towns of small sizearea 8629 acres, population 86,000 ; Dewsbury, area 6729 acres, population 53,000 ; Accrington, area 4418 acres, population 40,000 ; and Kettering, area 4546 acres, population 35,000-we meet with curious differences in the mortalities, the explanation of which is far from obvious. The birth-rates of the towns in the order ’given above were : 14-6, 14,4, 10-1, 13-1. The death-rates were : 11-5, 13-3,14.7, 10-8. These show Accrington to differ from the other three in having a falling population and with this go many factors which .disturb the death table. The infantile mortality, which is not influenced by the age-sex distribution of the population, but is affected by some of the factors which determine shifts of population, was not far from level49, 50, 45, 44. When we come to certified causes of death we meet with some surprises. If we standardise the recorded numbers from the four towns to what they would be if all had populations equal in number to that of Ipswich, we find :-
Ipswich,
cancer deaths are nearly equal in Ipswich and Accrington. and in Dewsbury and Kettering are also nearly equal but about a fifth less than in the first two. The probable explanation is population age : Ipswich old because it is partly residential ; Accrington old because of emigration of young people ; Dewsbury and Kettering average working towns. Tuberculosis in Ipswich and Kettering are equal, and in Dewsbury and Accrington are equal but only half that in the first pair. A probable explanation in Accrington is emigration. In Dewsbury, low tuberculosis is associated with low respiratory mortality. In Accrington this is not so definite though Cardiovascular disease is equal in it is apparent. Ipswich and Dewsbury, high in Accrington and low in Kettering, in which latter town digestive deaths are also low, though diabetes is high. Vital statistics reflect the nature of populations more clearly than their health, and this invalidates many medical statistics relating to
The
the results of treatment.
COLCHESTER
From Dr. W. F. Corfield’s much abridged reports we learn that in this borough in 1939 the infantile mortality was 28-5, a low record for the town. There were 769 live births and 32 stillbirths (14 males and 18 females). The only death from notifiable diseases apart from tuberculosis was from encephalitis lethargica. There were 6 deaths from diabetes, 84 from cancer and 28 from tuberculosis ; 7 deaths can with certainty be attributed to syphilis, apart from those included in the heart and circulatory diseases other than aneurysm. An unusual incident was the condemnation of a consignment of 489 imported sheep and lamb carcasses. We imagine this must have been due to some breakdown in
transport
or
storage.
NORTHAMPTONSHIRE
F. J. BURKE.
3. Himsworth, H. P. and Scott, D. B. M. J. Physiol. 1938, 91, 447. 4. Himsworth and Kerr, R. B. Clin. Sci. 1940, 4, 287. 5. Krebs, H. A. and Eggleston, L. V. Biochem. J. 1938, 32, 913.
’
In Dr. Corfield’s school report there is a table of the incidence of head-lousiness in the schools of the borough showing the increase or decrease on the previous year in each department of every school. The variation is The percentage of children found from + 49 to - 31. verminous varied from 11-8 to 0. Out of 30 departments 7 had a louse-index of less than 1%. The general incidence was 2-9%. At routine inspections 95-8% of the heads were clean and 4’3% verminous.
Gyntee. 1935, 43, 1096). Sunderland.
Reports
FOUR TOWNS
In the last
tuberculosis began to rise as soon as hostilities started, but the fear that the process might be repeated in this war is somewhat allayed by the war