- Email: [email protected]
STIMULANTS OF METABOLISM
1357
CORRESPONDENCE To the Editor of THE LANCET
SiR,—We are anxious to direct the attention of the medical profession to a letter, signed by General Smuts, Mr. Bruce, Sir Robert Borden, Sir James Parr, and Lord Lugard, and a leading article in the Times of May 27th. In this letter an appeal is made to the public to support financially a scheme for the completion and endowment of London House, an institution which has already proved invaluable to a large number of post-graduate medical students from overseas and which is destined to play a very important part in the educational life of the Empire. London House, situated in Mecklenburgh-square and opened in 1931, owes its origin largely to the enthusiasm and hard work of the late Mr. Frederick C. Goodenough, whose ambition it was to establish a home for students from all parts of the Empire with amenities and facilities for the completion of their education similar to those afforded by the colleges of our more ancient universities. The Carnegie Corporation, already generous donors, have promised a further sum of £ 0,000, provided that :f:30,00O can be raised from other sources, and it is calculated that the total of at least ;B;50,000 will be necessary for further building and endowment purposes. This year is remarkable for efforts to make London a worthy centre of Imperial Medicine, and to bring members of our profession all over the world into closer relationship. The opening of the Postgraduate School at Hammersmith by Their Majesties the King and Queen is to be followed by a meeting of the British Medical Association in Melbourne, which means that several hundred practitioners will be traversing and visiting several of the Dominions. We are afforded, therefore, the opportunity for making the advantages and needs of London House well known all over the Empire and for stimulating the profession and its friends, overseas as well as at home, to unite in giving a great project all the support and encouragement it deserves. Contributions may be sent to the Hon. Treasurer of London House, 54, Lombard-street, London, E.C. 3. We are, Sir, yours faithfully, FREDERICK MENZIES, DAWSON OF PENN, W. LANGDON-BROWN, HOLBURT WARING, E. FARQUHAR BUZZARD. MOYNIHAN, HORDER, May 31st.
LEAGUE
OF NATIONS REPORT ON TREATMENT OF SYPHILIS To the Editor of THE LANCET
SIR,-Since the publication
THE
of the Quarterly Bulletin of the Health March, 1935, Organisation of the League of Nations, which contains the report of an expert committee summarised in your issue of May 18th (p. 1170), I have repeatedly been asked why it is that among the 29 British clinics which submitted their records the name of no Manchester or Salford treatment centre appears. For Manchester I cannot speak ; but so far as Salford is concerned the reason is that no invitation was issued to it. This explanation seems to be necessary in view of the statement made in the report that " In each of these countries the dermatological and venereal disease
for
appealed to for their support, and a large majority readily responded." It might be thought, on looking at the table of British clinics, that the Salford municipal clinic-one of the largest in the country-refused to take part in the investigation. I want to make it perfectly clear that not only was clinics
LONDON HOUSE
were
this clinic not asked to submit its records, but it did not receive any official intimation that such an inquiry was in progress. The omission of the Salford municipal clinic is the more remarkable because it and one other are the only treatment centres in Great Britain where the alternating and continuous method of therapy is in I am, Sir, yours operation. E. T. BURKE. Municipal Clinic, Salford, May 30th.
faithfully,
STIMULANTS OF METABOLISM
To the Editor of THE LANCET SiB,—We fear that Dr. Newcomb has misinterpreted our letter in THE LANCET of May 25th. Sir William Willcox conveyed the impression that given in recognised therapeutic doses nitrophenols cause damage to liver and kidney. We emphasised that in therapeutic doses it was impossible to obtain any evidence of damage to liver or kidney. Dr. Newcomb, however, was referring to a case in which there was a gross overdosage. We feel that it is only fair to stress the difference between his observations and our own results obtained from a study of persons and animals to whom normal doses of the substance were administered. We wish to make it clear that we were concerned solely with the alleged toxicity of these compounds and made no reference to the relative merits of various methods of treatment for obesity. The question of the state of mind of one of us (E. C.D.) on this point does not therefore arise. We are, Sir, yours faithfully, E. C. DODDS, J. D. ROBERTSON. Courtauld Institute of Biochemistry, Middlesex ..L
Hospital, June 3rd.
ADMINISTRATION OF CARBON TETRACHLORIDE FOR HOOKWORM To the Editor of THE LANCET
SiR,—In your last issue Dr. A. S. Tuxford suggests that to give carbon tetrachloride shaken up in castor oil makes for safety. G. Giglioli felt that the same result was produced by shaking it up in water (Trans. Roy. Soc. Trop. Med. and Hyg., 1924, xviii., 111). Both opinions are formed on uncontrolled experiments of insufficient extent, and accordingly have no stable foundation. As to efficacy both series of observations were made by treating men in herd fashion, it being unknown whether, at the time of treatment, they
were
even
infected;
accordingly
the efficacy of the treatment used by Dr. Tuxford is unknown. As to animal experiment, the only evidence in any way apposite which I have traced is by Maurice C. Hall (Jour. Agric. Research, 1921, xxi., 157), who recovered no hookworms after treating a dog with 0-3 c.cm. of carbon tetrachloride per kg. body-weight, followed immediately by castor oil; the sufficiently meagre evidence is against the anthelmintic value of the suggested method of administration, but this can never be determined by herd treatment. I am dealing more widely with the general subject in a paper which will be published I am, Sir, yours faithfully, shortly. CLAYTON LANE. Ealing, May 31st.
CORRESPONDENCE To the Editor of THE LANCET
SiR,—We are anxious to direct the attention of the medical profession to a letter, signed by General Smuts, Mr. Bruce, Sir Robert Borden, Sir James Parr, and Lord Lugard, and a leading article in the Times of May 27th. In this letter an appeal is made to the public to support financially a scheme for the completion and endowment of London House, an institution which has already proved invaluable to a large number of post-graduate medical students from overseas and which is destined to play a very important part in the educational life of the Empire. London House, situated in Mecklenburgh-square and opened in 1931, owes its origin largely to the enthusiasm and hard work of the late Mr. Frederick C. Goodenough, whose ambition it was to establish a home for students from all parts of the Empire with amenities and facilities for the completion of their education similar to those afforded by the colleges of our more ancient universities. The Carnegie Corporation, already generous donors, have promised a further sum of £ 0,000, provided that :f:30,00O can be raised from other sources, and it is calculated that the total of at least ;B;50,000 will be necessary for further building and endowment purposes. This year is remarkable for efforts to make London a worthy centre of Imperial Medicine, and to bring members of our profession all over the world into closer relationship. The opening of the Postgraduate School at Hammersmith by Their Majesties the King and Queen is to be followed by a meeting of the British Medical Association in Melbourne, which means that several hundred practitioners will be traversing and visiting several of the Dominions. We are afforded, therefore, the opportunity for making the advantages and needs of London House well known all over the Empire and for stimulating the profession and its friends, overseas as well as at home, to unite in giving a great project all the support and encouragement it deserves. Contributions may be sent to the Hon. Treasurer of London House, 54, Lombard-street, London, E.C. 3. We are, Sir, yours faithfully, FREDERICK MENZIES, DAWSON OF PENN, W. LANGDON-BROWN, HOLBURT WARING, E. FARQUHAR BUZZARD. MOYNIHAN, HORDER, May 31st.
LEAGUE
OF NATIONS REPORT ON TREATMENT OF SYPHILIS To the Editor of THE LANCET
SIR,-Since the publication
THE
of the Quarterly Bulletin of the Health March, 1935, Organisation of the League of Nations, which contains the report of an expert committee summarised in your issue of May 18th (p. 1170), I have repeatedly been asked why it is that among the 29 British clinics which submitted their records the name of no Manchester or Salford treatment centre appears. For Manchester I cannot speak ; but so far as Salford is concerned the reason is that no invitation was issued to it. This explanation seems to be necessary in view of the statement made in the report that " In each of these countries the dermatological and venereal disease
for
appealed to for their support, and a large majority readily responded." It might be thought, on looking at the table of British clinics, that the Salford municipal clinic-one of the largest in the country-refused to take part in the investigation. I want to make it perfectly clear that not only was clinics
LONDON HOUSE
were
this clinic not asked to submit its records, but it did not receive any official intimation that such an inquiry was in progress. The omission of the Salford municipal clinic is the more remarkable because it and one other are the only treatment centres in Great Britain where the alternating and continuous method of therapy is in I am, Sir, yours operation. E. T. BURKE. Municipal Clinic, Salford, May 30th.
faithfully,
STIMULANTS OF METABOLISM
To the Editor of THE LANCET SiB,—We fear that Dr. Newcomb has misinterpreted our letter in THE LANCET of May 25th. Sir William Willcox conveyed the impression that given in recognised therapeutic doses nitrophenols cause damage to liver and kidney. We emphasised that in therapeutic doses it was impossible to obtain any evidence of damage to liver or kidney. Dr. Newcomb, however, was referring to a case in which there was a gross overdosage. We feel that it is only fair to stress the difference between his observations and our own results obtained from a study of persons and animals to whom normal doses of the substance were administered. We wish to make it clear that we were concerned solely with the alleged toxicity of these compounds and made no reference to the relative merits of various methods of treatment for obesity. The question of the state of mind of one of us (E. C.D.) on this point does not therefore arise. We are, Sir, yours faithfully, E. C. DODDS, J. D. ROBERTSON. Courtauld Institute of Biochemistry, Middlesex ..L
Hospital, June 3rd.
ADMINISTRATION OF CARBON TETRACHLORIDE FOR HOOKWORM To the Editor of THE LANCET
SiR,—In your last issue Dr. A. S. Tuxford suggests that to give carbon tetrachloride shaken up in castor oil makes for safety. G. Giglioli felt that the same result was produced by shaking it up in water (Trans. Roy. Soc. Trop. Med. and Hyg., 1924, xviii., 111). Both opinions are formed on uncontrolled experiments of insufficient extent, and accordingly have no stable foundation. As to efficacy both series of observations were made by treating men in herd fashion, it being unknown whether, at the time of treatment, they
were
even
infected;
accordingly
the efficacy of the treatment used by Dr. Tuxford is unknown. As to animal experiment, the only evidence in any way apposite which I have traced is by Maurice C. Hall (Jour. Agric. Research, 1921, xxi., 157), who recovered no hookworms after treating a dog with 0-3 c.cm. of carbon tetrachloride per kg. body-weight, followed immediately by castor oil; the sufficiently meagre evidence is against the anthelmintic value of the suggested method of administration, but this can never be determined by herd treatment. I am dealing more widely with the general subject in a paper which will be published I am, Sir, yours faithfully, shortly. CLAYTON LANE. Ealing, May 31st.