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STIMULANTS OF THE UTERUS.
683 CHARLES CREIGHTON.
STIMULANTS OF THE UTERUS.
the Editor of THE LANCET. I SiR,—May express my gratitude to Prof. William Bulloch for his remarkable appreciation of a remarkable man contained in THE LANCET of July 30th. No one who has read that scholarly book " The History of Epidemics in Britain " (not Great Britain) or who ergotoxine. Although it is clear that the experiments made by has had occasion to study Creighton’s translation of the authors, whose work is under review, were carried Hirsch’s " Handbook of Geographical and Historical out with ergotamine in the form of ergotamine Pathology " can fail to have acquired a feeling of tartrate, and that their conclusions are based on the respect and admiration for their author-a feeling results obtained with this salt, your leader writer which the pathetic story of his life, so vividly portrayed appears to consider that the pharmacological simi- by Prof. Bulloch, serves to intensify. Dr. Charles Creighton was the last of the great larity between the two alkaloids entitles him, by an analogical process" of reasoning, to substitute the miasmatists, and his passing marks the end of an era which, starting some 2000 years ago, gave us word " ergotoxine for " ergotamine " throughout. We desire to make it clear that there are funda- Sydenham and a distinguished band of medical mental differences between ergotamine and ergo- philosophers. It is, however, not possible to account toxine. Ergotamine differs from ergotoxine in its for the attitude of detachment adopted by Creighton chemical composition. Ergotamine is a crystalline towards the discoveries of Pasteur and Koch, but, substance, whereas ergotoxine has always been as Prof. Bulloch hints, it may be that modern described as being amorphous. Ergotamine yields epidemiologists, as the result of discarding the spirit pure crystalline salts suitable for clinical use, and as well as the letter of his message, have failed to do ergotamine tartrate, under the name of Femergin, full justice either to him or to themselves. " We have has been available in unlimited quantities, and thrust," wrote Sir Clifford Allbutt, "ancient myth extensively used, for a considerable time. The and symbol too much aside as wholly fanciful ; we are abundant clinical evidence which proves that ergo- discovering now that they are apparitions, luminous tamine is a powerful and reliable agent appears to mists of truth-the edges and bordering lights growing be singularly lacking for any other constituent of in form from one incarnation to another." This view, I take it, represents in graceful literary ergot.-I am, Sir, yours faithfully, J. FLINT, form the standpoint of Creighton, and it may be that Manager, " Sandoz " Scientific and Research the day is not far distant when it will be recognised Department. ’ that the miasmatic concept does, after all, correspond 5, Wigmore-street, London, W. 1, Sept. 15th, 1927. with something in nature. In the meantime it is A. Bourne and Dr. J. H. diswhen Burn, *Mr. to learn that the anxieties of his latter days cussing the physiologically active substances in ergot,pleasing were relieved by an unsought civil pension-a gift say (Journal of Obstetrics and Gyncecology of the British honourable to the donor as to the recipient. Empire, XXXIV., No.2, p. 259) : " These are (1) the equally I am, Sir, yours faithfully, specific alkaloid of ergot, (2) histamine, (3) tyraC. A. GILL, mine. The specific alkaloid of ergot is known as Simla, India, Sept. lst, 1927. Lt.-Col , I M.S. ergotoxin, in which form it was originally isolated by Barger and Carr, and as ergotamine, a pharmacoloDEATH CERTIFICATION. gically identical and crystalline substance isolated by Stoll." In their summary (p. 267) it is stated : " The To the Editor of THE LANCET. specific alkaloid of ergot (ergotamine or ergotoxin) SIR,—It is clear that the majority of us have by exerts a very prolonged action, and appears to be anthis t time experience of the new form of death ideal agent for use after delivery." The leading ( certification ; but it is strange to me that it seems so article to which the above letter refers was designedfar f to have criticism. Apart from the form not to discuss any particular preparation but, in a (of certificateescaped and the suggested procedure descriptive general way, the specific alkaloid of ergot.-ED. L. (of the mode of death, both susceptible of improvement, there is a pitfall for the ingenuous in the MEDICAL LITERATURE FOR KENYA COLONY. mode of certifying. The certificate is to be delivered personally-or it may be posted-by the certifier to To the Editor of THE LANCET. the registrar of the subdistrict in which the death SiR,—With reference to the letter appearing under occurred. What does this imply ? To the ingenuous He would suppose that having excluded the above heading in your number of June 4th last privacy. (p. 1205), the Branch Council of the Kenya branch of the family circle he should proceed with complete the British Medical Association desires to express frankness to describe the mode of death along with strongly its disagreement with the statement made its every contributory factor. For example :(a) Hæmatemesis. therein, that the medical practitioners of Kenya would (b) Cirrhosis of liver. gratefully welcome gifts of fairly up-to-date books on (c) Chronic alcoholism. medicine and surgery. what result ? That an outraged relative may With The fact is that the medical department of the him the same evening with a copy obtained confront a maintains medical reference which is library colony from the registrar! I make no comment; but I accessible to all doctors in the colony. This contains all the best of the most recent medical publications and submit that the fact must be recognised. And then, as to the registrar-his name ? address ? takes in the majority of the standard medical and scientific journals published to-day. Furthermore, it hours of attendance ? These are not necessarily an is probable that the private libraries of medical men easy discovery, for they may entail the assistance of in this colony would compare favourably with those postal, or municipal authorities, or of undertakers or any other informed and obliging people. My own of their professional brethren at home. While grateful for the suggested vicarious generosity practice, for example, happens to lie in not less than of the President of the Victoria League, my Branch six different boroughs ; and it is my duty to ascertain Council fears that the statement that medical practi- when necessary the address of a registrar in, for all tioners in this colony feel a pressing need for text-books I know, any one of a dozen or perhaps a score of subWhat is to be done about such things ? of medicine and surgery may be misconstrued into a districts. It may be possible that some of your correspondents reflection on their professional efficiency. can make suggestions ; in any case the matter is I am, Sir, yours faithfully, susceptible of discussion and I should hope of remedy. J. B. CLARKE, I am, Sir, yours faithfully, President, Kenya Branch, British Medical Association. PRACTITIONER. Nairobi, August 24th, 1927. Sept. 12th, 1927. 7. To the Editor
of
To
THE LANCET.
SIR,-In your leading article in THE LANCET for Sept. 10th with this heading there appears to be a certain confusion in the mind of the writer as to the identities of the alkaloids of ergot, ergotamine and
4
I
STIMULANTS OF THE UTERUS.
the Editor of THE LANCET. I SiR,—May express my gratitude to Prof. William Bulloch for his remarkable appreciation of a remarkable man contained in THE LANCET of July 30th. No one who has read that scholarly book " The History of Epidemics in Britain " (not Great Britain) or who ergotoxine. Although it is clear that the experiments made by has had occasion to study Creighton’s translation of the authors, whose work is under review, were carried Hirsch’s " Handbook of Geographical and Historical out with ergotamine in the form of ergotamine Pathology " can fail to have acquired a feeling of tartrate, and that their conclusions are based on the respect and admiration for their author-a feeling results obtained with this salt, your leader writer which the pathetic story of his life, so vividly portrayed appears to consider that the pharmacological simi- by Prof. Bulloch, serves to intensify. Dr. Charles Creighton was the last of the great larity between the two alkaloids entitles him, by an analogical process" of reasoning, to substitute the miasmatists, and his passing marks the end of an era which, starting some 2000 years ago, gave us word " ergotoxine for " ergotamine " throughout. We desire to make it clear that there are funda- Sydenham and a distinguished band of medical mental differences between ergotamine and ergo- philosophers. It is, however, not possible to account toxine. Ergotamine differs from ergotoxine in its for the attitude of detachment adopted by Creighton chemical composition. Ergotamine is a crystalline towards the discoveries of Pasteur and Koch, but, substance, whereas ergotoxine has always been as Prof. Bulloch hints, it may be that modern described as being amorphous. Ergotamine yields epidemiologists, as the result of discarding the spirit pure crystalline salts suitable for clinical use, and as well as the letter of his message, have failed to do ergotamine tartrate, under the name of Femergin, full justice either to him or to themselves. " We have has been available in unlimited quantities, and thrust," wrote Sir Clifford Allbutt, "ancient myth extensively used, for a considerable time. The and symbol too much aside as wholly fanciful ; we are abundant clinical evidence which proves that ergo- discovering now that they are apparitions, luminous tamine is a powerful and reliable agent appears to mists of truth-the edges and bordering lights growing be singularly lacking for any other constituent of in form from one incarnation to another." This view, I take it, represents in graceful literary ergot.-I am, Sir, yours faithfully, J. FLINT, form the standpoint of Creighton, and it may be that Manager, " Sandoz " Scientific and Research the day is not far distant when it will be recognised Department. ’ that the miasmatic concept does, after all, correspond 5, Wigmore-street, London, W. 1, Sept. 15th, 1927. with something in nature. In the meantime it is A. Bourne and Dr. J. H. diswhen Burn, *Mr. to learn that the anxieties of his latter days cussing the physiologically active substances in ergot,pleasing were relieved by an unsought civil pension-a gift say (Journal of Obstetrics and Gyncecology of the British honourable to the donor as to the recipient. Empire, XXXIV., No.2, p. 259) : " These are (1) the equally I am, Sir, yours faithfully, specific alkaloid of ergot, (2) histamine, (3) tyraC. A. GILL, mine. The specific alkaloid of ergot is known as Simla, India, Sept. lst, 1927. Lt.-Col , I M.S. ergotoxin, in which form it was originally isolated by Barger and Carr, and as ergotamine, a pharmacoloDEATH CERTIFICATION. gically identical and crystalline substance isolated by Stoll." In their summary (p. 267) it is stated : " The To the Editor of THE LANCET. specific alkaloid of ergot (ergotamine or ergotoxin) SIR,—It is clear that the majority of us have by exerts a very prolonged action, and appears to be anthis t time experience of the new form of death ideal agent for use after delivery." The leading ( certification ; but it is strange to me that it seems so article to which the above letter refers was designedfar f to have criticism. Apart from the form not to discuss any particular preparation but, in a (of certificateescaped and the suggested procedure descriptive general way, the specific alkaloid of ergot.-ED. L. (of the mode of death, both susceptible of improvement, there is a pitfall for the ingenuous in the MEDICAL LITERATURE FOR KENYA COLONY. mode of certifying. The certificate is to be delivered personally-or it may be posted-by the certifier to To the Editor of THE LANCET. the registrar of the subdistrict in which the death SiR,—With reference to the letter appearing under occurred. What does this imply ? To the ingenuous He would suppose that having excluded the above heading in your number of June 4th last privacy. (p. 1205), the Branch Council of the Kenya branch of the family circle he should proceed with complete the British Medical Association desires to express frankness to describe the mode of death along with strongly its disagreement with the statement made its every contributory factor. For example :(a) Hæmatemesis. therein, that the medical practitioners of Kenya would (b) Cirrhosis of liver. gratefully welcome gifts of fairly up-to-date books on (c) Chronic alcoholism. medicine and surgery. what result ? That an outraged relative may With The fact is that the medical department of the him the same evening with a copy obtained confront a maintains medical reference which is library colony from the registrar! I make no comment; but I accessible to all doctors in the colony. This contains all the best of the most recent medical publications and submit that the fact must be recognised. And then, as to the registrar-his name ? address ? takes in the majority of the standard medical and scientific journals published to-day. Furthermore, it hours of attendance ? These are not necessarily an is probable that the private libraries of medical men easy discovery, for they may entail the assistance of in this colony would compare favourably with those postal, or municipal authorities, or of undertakers or any other informed and obliging people. My own of their professional brethren at home. While grateful for the suggested vicarious generosity practice, for example, happens to lie in not less than of the President of the Victoria League, my Branch six different boroughs ; and it is my duty to ascertain Council fears that the statement that medical practi- when necessary the address of a registrar in, for all tioners in this colony feel a pressing need for text-books I know, any one of a dozen or perhaps a score of subWhat is to be done about such things ? of medicine and surgery may be misconstrued into a districts. It may be possible that some of your correspondents reflection on their professional efficiency. can make suggestions ; in any case the matter is I am, Sir, yours faithfully, susceptible of discussion and I should hope of remedy. J. B. CLARKE, I am, Sir, yours faithfully, President, Kenya Branch, British Medical Association. PRACTITIONER. Nairobi, August 24th, 1927. Sept. 12th, 1927. 7. To the Editor
of
To
THE LANCET.
SIR,-In your leading article in THE LANCET for Sept. 10th with this heading there appears to be a certain confusion in the mind of the writer as to the identities of the alkaloids of ergot, ergotamine and
4
I