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TENNIS ELBOW: DISCLAIMERS.
251 in chronic constipation a much greater proportion of also bore well the strain of maternity and the faecal bacteria are dead than under normal conhousehold work. In higher grades of life, active and ditions, and there are good scientific grounds for this energetic business or professional careers, or the belief. Another instance of a high proportion of activities of the colonial settler were well borne. One dead faecal organisms is in the stool of the breast-fed case, after 20 years of observation, is still a mighty infant, in which numerous ghost forms, and what Tissier ca,lled " formes de souffrance " of the Bacillus hunter able to enjoy the country to the utmost. No reward in professional life is so great as to see bifidus may be seen. But there is at the present time in the long course of years these people enjoy full no exact method of estimating the proportions of vigour and health who otherwise might have been dead and living organisms in the very mixed flora in the stool of ah adult.. Certainly the methods employed crippled, enfeebled, and short-lived. I am, Sir, yours faithfully, by Dr. Watson throw no fresh light on the question. RICHARD CATON, C.B.E., M.D., F.R.C.P., LL.D., In the second place the methods which Dr. Watson Consulting Physician and Ex-President, Liverpool refers to as being in common use by bacteriologists Royal Infirmary; Pro-Chancellor, University in the investigation of faeces are not in fact those used of Liverpool. July 22nd, 1922. for such a purpose. For the methods used reference may be made to the papers of Tissier, Moro, Rodella,
joiners, stokers, foundrymen, sailors, or dock labourers. The
women
THE CARDIAC CHILD. Cahn, Mereshowsky, Jacobson, Noguchi, Distaso, Herter, Thiercelin, Schmitz, Torrey, and others, while To the Editor of THE LANCET. as to the special media in general use in laboratories SiR,—As one who has been working on these lines at the present time a recent edition of any text-book for some time past I welcome the leading article on on In his tests be consulted. bacteriology the Cardiac Child in your issue of July 15th as a Dr. Watson must may use not plain agar to compare with confirmation of the ideas and suggestions contained his " new " medium, but some of the media in common in my book entitled " The Prevention and Relief of use in such as the various whole blood, laboratories, Heart Disease." In that book I drew attention to and serum media, the extremely acid haemoglobin, the great economic importance of the subject, and media necessary for the isolation of the acid-tolerant to the fact that the mortality arising from heart such special media as Sabouraud’s maltose group, trouble is greater than that due to tuberculosis. And media, meat media (Robertson), and so on, agar, egg in your review of my book you say, " [the author] of course, anaerobic conditions are necessary as and, enters an earnest plea for the education of teachers well as It must, however, be obvious to all and parents as the first requisite in controlling heart with a aerobic. of bacteriology that no single knowledge at of school age, and advocates the setting up disease however complex, can ever be a substitute medium, To find my some sort of welfare association." for the variety of media necessitated by the wide example followed is encouragement of the right sort. variety of bacteria in the intestine. One need only T aiT) Sir TTYDifa fqiflifiillvmention the varying needs of different bacteria as. G. ARBOUR STEPHENS. regards physical environment, reaction, oxygen tension, Consulting Cardiologist, King Edward VII. Welsh and the presence of specific substances now supposed National Memorial Association. July 18th, 1922. to be of the order of vitamins to show how impossible such an attempt must be. THE INTESTINAL FLORA. Dr. Watson states that " in ordinary medical bacteriology milk is not commonly employed as a To the Editor of THE LANCET. culture medium, though its value in differentiating a paper by Dr. Chalmers Watson in your organisms of the coli-form type by chemical tests has issue of July 15th some statements are made which long been established." This is incorrect; if one invite criticism. The chief point of the paper is the wishes to isolate B. aerogenes capsulatus, for example, " introduction of a new " medium for the cultivation from the fseces, milk is the medium which is almost of intestinal organisms, and his main object in his own invariably employed, while its value for obtaining draw the attention of bacteriowords has been to culture of intestinal streptococci has long been primary logists and others to the facts recorded, with a view known. Further, milk incorporated in agar is not a of stimulating investigation ...."into, particularly, new but, on the contrary, an old idea. Usually the the subject of intestinal toxaemia. Writing as a was used rather than whole milk as a clear whey clinician, he combats " the commonly accepted view medium could be obtained. Other observations by Dr. that a large proportion of the organisms normally Watson, such as the claims as to the superiority of the present in the fasces are dead." This he does on new medium for the cultivation of yeasts, are valueless the grounds that on an agar medium containing for the reasons already given-that the comparative saccharose and milk (the " new " medium), intestinal tests were made on plain agar and not on media organisms can be cultivated which do not grow on suitable for the growth of those organisms. ‘‘ the medium commonly employed for the investigaI am, Sir, yours faithfully, tion of these general cases," and these media, according W. R. LOGAN. Edinburgh, July 20th, 1922. to Dr. are "
Watson, apparently " broth, agar, glucose is not made What is included in " &c." agar, &c." clear, but it is evident that it does not include media cultivated under anaerobic conditions. Indeed, in the experiments recorded comparative tests are given only between the " new " medium and plain agar. There are several misconceptions involved in this argument. In the first place the view which he attacks as being commonly held is not in fact commonly held by bacteriologists. About 20 years ago it was believed that most of the faecal organisms were dead, because aerobic cultures on media in use at that time resulted in the growth of only a few of the organisms seen in stained films. As cultural methods improved, and particularly since anaerobic methods were employed, this view was considerably modified (see, for instance, p. 1 of Herter’s " The Common Bacterial Infections of the Digestive Tract," published as long ago as 1907 by the Macmillan Company, New York). It is, however, believed that 1
THE LANCET, 1922, i., 132.
TENNIS ELBOW: DISCLAIMERS. To the Editor of THE LANCET. wish to state that the references in the lay SiR,—I press to my article on Lawn Tennis Elbow, which recently appeared in THE LANCET, have been without my
knowledge
or
approval.
I am, Sir, yours faithfully, FRANK ROMER. Seymour-street, BV., July 19th, 1922.
To the Editor
of THE LANCET.
SiR,—With reference to
some
notes in
a
London
to-day on the subject of Tennis Elbow, I shall be glad if you will allow me to say through your newspaper
columns that my name was mentioned without my sanction or approval. I am, Sir, yours faithfully, T: N. DARLING. London, W., July 13th, 1922.
joiners, stokers, foundrymen, sailors, or dock labourers. The
women
THE CARDIAC CHILD. Cahn, Mereshowsky, Jacobson, Noguchi, Distaso, Herter, Thiercelin, Schmitz, Torrey, and others, while To the Editor of THE LANCET. as to the special media in general use in laboratories SiR,—As one who has been working on these lines at the present time a recent edition of any text-book for some time past I welcome the leading article on on In his tests be consulted. bacteriology the Cardiac Child in your issue of July 15th as a Dr. Watson must may use not plain agar to compare with confirmation of the ideas and suggestions contained his " new " medium, but some of the media in common in my book entitled " The Prevention and Relief of use in such as the various whole blood, laboratories, Heart Disease." In that book I drew attention to and serum media, the extremely acid haemoglobin, the great economic importance of the subject, and media necessary for the isolation of the acid-tolerant to the fact that the mortality arising from heart such special media as Sabouraud’s maltose group, trouble is greater than that due to tuberculosis. And media, meat media (Robertson), and so on, agar, egg in your review of my book you say, " [the author] of course, anaerobic conditions are necessary as and, enters an earnest plea for the education of teachers well as It must, however, be obvious to all and parents as the first requisite in controlling heart with a aerobic. of bacteriology that no single knowledge at of school age, and advocates the setting up disease however complex, can ever be a substitute medium, To find my some sort of welfare association." for the variety of media necessitated by the wide example followed is encouragement of the right sort. variety of bacteria in the intestine. One need only T aiT) Sir TTYDifa fqiflifiillvmention the varying needs of different bacteria as. G. ARBOUR STEPHENS. regards physical environment, reaction, oxygen tension, Consulting Cardiologist, King Edward VII. Welsh and the presence of specific substances now supposed National Memorial Association. July 18th, 1922. to be of the order of vitamins to show how impossible such an attempt must be. THE INTESTINAL FLORA. Dr. Watson states that " in ordinary medical bacteriology milk is not commonly employed as a To the Editor of THE LANCET. culture medium, though its value in differentiating a paper by Dr. Chalmers Watson in your organisms of the coli-form type by chemical tests has issue of July 15th some statements are made which long been established." This is incorrect; if one invite criticism. The chief point of the paper is the wishes to isolate B. aerogenes capsulatus, for example, " introduction of a new " medium for the cultivation from the fseces, milk is the medium which is almost of intestinal organisms, and his main object in his own invariably employed, while its value for obtaining draw the attention of bacteriowords has been to culture of intestinal streptococci has long been primary logists and others to the facts recorded, with a view known. Further, milk incorporated in agar is not a of stimulating investigation ...."into, particularly, new but, on the contrary, an old idea. Usually the the subject of intestinal toxaemia. Writing as a was used rather than whole milk as a clear whey clinician, he combats " the commonly accepted view medium could be obtained. Other observations by Dr. that a large proportion of the organisms normally Watson, such as the claims as to the superiority of the present in the fasces are dead." This he does on new medium for the cultivation of yeasts, are valueless the grounds that on an agar medium containing for the reasons already given-that the comparative saccharose and milk (the " new " medium), intestinal tests were made on plain agar and not on media organisms can be cultivated which do not grow on suitable for the growth of those organisms. ‘‘ the medium commonly employed for the investigaI am, Sir, yours faithfully, tion of these general cases," and these media, according W. R. LOGAN. Edinburgh, July 20th, 1922. to Dr. are "
Watson, apparently " broth, agar, glucose is not made What is included in " &c." agar, &c." clear, but it is evident that it does not include media cultivated under anaerobic conditions. Indeed, in the experiments recorded comparative tests are given only between the " new " medium and plain agar. There are several misconceptions involved in this argument. In the first place the view which he attacks as being commonly held is not in fact commonly held by bacteriologists. About 20 years ago it was believed that most of the faecal organisms were dead, because aerobic cultures on media in use at that time resulted in the growth of only a few of the organisms seen in stained films. As cultural methods improved, and particularly since anaerobic methods were employed, this view was considerably modified (see, for instance, p. 1 of Herter’s " The Common Bacterial Infections of the Digestive Tract," published as long ago as 1907 by the Macmillan Company, New York). It is, however, believed that 1
THE LANCET, 1922, i., 132.
TENNIS ELBOW: DISCLAIMERS. To the Editor of THE LANCET. wish to state that the references in the lay SiR,—I press to my article on Lawn Tennis Elbow, which recently appeared in THE LANCET, have been without my
knowledge
or
approval.
I am, Sir, yours faithfully, FRANK ROMER. Seymour-street, BV., July 19th, 1922.
To the Editor
of THE LANCET.
SiR,—With reference to
some
notes in
a
London
to-day on the subject of Tennis Elbow, I shall be glad if you will allow me to say through your newspaper
columns that my name was mentioned without my sanction or approval. I am, Sir, yours faithfully, T: N. DARLING. London, W., July 13th, 1922.