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THE BIRTH CONTROL MOVEMENT
98 age for two months. If a lump in the breast, which has been diagnosed as benign, does not in this time show evidence of disappearance, he advocates simple amputation. In patients under 35, he would watch for changes in the swelling before, during, and after the menstrual period ; if there is no change he would amputate. The significance of a serohaemorrhagic discharge in these cases is considered by Klingenstein. He regards it as indicating the advent of intracystic or intraductal epithelial proliferation. Few surgeons would take the risk of not removing the breast in a case of mastitis complicated by a serous or serohaemorrhagic discharge, spontaneous or induced by gentle massage in the direction of the nipple. The great importance of sending every breast removed for pathological examination, if it were not otherwise recognised as a wise precaution, would be proved by the difficulty in recognising diffuse intraduct carcinoma. The macroscopic similarity between this admittedly rather rare condition and " cystic mastitis " has been sufficiently demonstrated. THE BIRTH CONTROL MOVEMENT THE National Birth Control Association, with which the Birth Control Investigation Committee is incorporated, has published this week its fifth annual report, and a history of five years of work offers to the governing body a good opportunity to summarise the past, review the present, and indicate plans for the future. When this Association started in 1930 the Ministry of Health had issued no memoranda defining the powers of local authorities in the matter of giving birth control instruction, and no local authorities had opened clinics although there were 16 voluntary bodies of this description. The staff consisted of the secretary and there were no local branches. To-day the Association has 28 local branches and the staff consists of seven; including three organisers-by no means an extravagant staff considering the amount of ground that is covered. The Ministry of Health has issued 3 memoranda, 66 municipal and 47 voluntary clinics have been established, 42 local authorities send patients to private doctors or clinics, 56 have passed favourable resolutions, while 14 have expressed themselves willing to lend or hire premises to local branches for voluntary clinics. The total expenditure, apart from research, has come to just over E6000 for five years’ work. The present situation indicates that the next five years should show an increasingly rapid development. In 1934 the circular issued by the Ministry of Health elucidated previous provisions and made it clear that the maternity and child welfare authority has the power to give advice at a gynaecological clinic to all women in need of medical counsel. The 56 local authorities mentioned above as having shown a favourable attitude towards the work must be induced to implement their goodwill; but there still remain over 250 child welfare authorities in England and Wales which have taken no action of any sort. The Association possesses evidence that organising work produces quick results, the words of the report being : In many a town, an organiser who on her first visit "
was greeted with suspicion and apprehension so that many of those upon whom she called were afraid to discuss birth control, has at the end of a few months established a branch with a strong committee, influential supporters, and a flourishing clinic."
The public attitude to the work is shown by quotations from the reports of medical officers of health
and from borough councils, one from a Welsh urban district council stating that a comparison with last year’s statistics shows that the number of women attending on account of debility, due to too frequent child-bearing, has increased from 18 to 26 per cent. There is also an increase in the number of patients. suffering from debility due to miscarriage or abortion. From the investigation committee, of which Sir Humphry Rolleston is chairman and Dr. C. P. Blacker the honorary secretary, and from the medical subcommittee, of which Dr. Helena Wright is chairman, come also evidence of progress, and, as might be expected, the increased activities call for, while they justify, increased income. The need, as stated, is an remarkably modest ; the Association wants, in order to pay its way and meet expansion, at least 1800 per annum, but possesses an income of 1000 only. Its call for further support is amply justified, and the latest record of work done should lead to the necessary increase of members. Subscriptions and donations should be sent to the hon. treasurer, National Birth Control Association, 26, Eccleston-street, London, S.W. 1. The annual subscription of members is SlIs. A BIOLOGICAL ASSAY OF LIVER EXTRACTS
MANY attempts have been made to devise a method for biological assay of liver preparations. None has hitherto proved of practical use. It has hitherto been essential to test all material of unknown potency upon patients with Addisonian pernicious anaemia. Such patients should have a red cell count below 2,000,000 per c.mm., and no complicating factors such as sepsis present. Recently however, two lines of attack on the problem have. promising been proposed. Miller and Rhoads1 by feeding swine with a modified form of the diet which produces black tongue in dogs have produced a symptom-complex, not unlike that of pernicious ansemia, which is relieved by the administration of potent liver extracts. These observations suggest that in the future such anaemic swine may2 be used as test animals. Landsberg and Thompson and Jacobson3 working independently have shown that the guinea-pig reacts to the administration of potent liver preparations by a reticulocytosis. Jacobson employed adult male pigs weighing between 300-800 g. and kept on a diet of oats, carrots, and lettuce. He found that 30-70 per cent. of the animals showed a significant rise in the number of reticulocytes following parenteral injection of active liver preparations when first given. The uninjected guinea-pigs offer no clue that might seem to differentiate between the two classes of guinea-pigsi.e., those that will react and those that will not. Further tests of initially non-reactive animals may show them later to have become reactive. Conditions in the guinea-pig necessary for a reaction to occur are not yet clear. Using known reactive animals, it has been possible to show that for every active material there exists a minimal effective dose which is termed the guinea-pig unit of haemopoietic activity and which is a quantitative expression of the degree of activity. It would appear justifiable to conclude that the capacity to induce a reticulocytosis is confined to materials effective in pernicious anaemia, since, when an assay on guinea-pigs of crude extract from human livers was made, a control healthy human 1 Miller, D. K., and Rhoads, C. P.: Jour. Clin. Invest., 1935, 153. xiv., 2 Landsberg, J. W., and Thompson, M. R.: Jour. Amer. Pharm. Assoc., 1934, xxiii., 964. 3 Jacobson, B. M.: Jour. Clin. Invest., 1935, xiv., 665 and 679.
was greeted with suspicion and apprehension so that many of those upon whom she called were afraid to discuss birth control, has at the end of a few months established a branch with a strong committee, influential supporters, and a flourishing clinic."
The public attitude to the work is shown by quotations from the reports of medical officers of health
and from borough councils, one from a Welsh urban district council stating that a comparison with last year’s statistics shows that the number of women attending on account of debility, due to too frequent child-bearing, has increased from 18 to 26 per cent. There is also an increase in the number of patients. suffering from debility due to miscarriage or abortion. From the investigation committee, of which Sir Humphry Rolleston is chairman and Dr. C. P. Blacker the honorary secretary, and from the medical subcommittee, of which Dr. Helena Wright is chairman, come also evidence of progress, and, as might be expected, the increased activities call for, while they justify, increased income. The need, as stated, is an remarkably modest ; the Association wants, in order to pay its way and meet expansion, at least 1800 per annum, but possesses an income of 1000 only. Its call for further support is amply justified, and the latest record of work done should lead to the necessary increase of members. Subscriptions and donations should be sent to the hon. treasurer, National Birth Control Association, 26, Eccleston-street, London, S.W. 1. The annual subscription of members is SlIs. A BIOLOGICAL ASSAY OF LIVER EXTRACTS
MANY attempts have been made to devise a method for biological assay of liver preparations. None has hitherto proved of practical use. It has hitherto been essential to test all material of unknown potency upon patients with Addisonian pernicious anaemia. Such patients should have a red cell count below 2,000,000 per c.mm., and no complicating factors such as sepsis present. Recently however, two lines of attack on the problem have. promising been proposed. Miller and Rhoads1 by feeding swine with a modified form of the diet which produces black tongue in dogs have produced a symptom-complex, not unlike that of pernicious ansemia, which is relieved by the administration of potent liver extracts. These observations suggest that in the future such anaemic swine may2 be used as test animals. Landsberg and Thompson and Jacobson3 working independently have shown that the guinea-pig reacts to the administration of potent liver preparations by a reticulocytosis. Jacobson employed adult male pigs weighing between 300-800 g. and kept on a diet of oats, carrots, and lettuce. He found that 30-70 per cent. of the animals showed a significant rise in the number of reticulocytes following parenteral injection of active liver preparations when first given. The uninjected guinea-pigs offer no clue that might seem to differentiate between the two classes of guinea-pigsi.e., those that will react and those that will not. Further tests of initially non-reactive animals may show them later to have become reactive. Conditions in the guinea-pig necessary for a reaction to occur are not yet clear. Using known reactive animals, it has been possible to show that for every active material there exists a minimal effective dose which is termed the guinea-pig unit of haemopoietic activity and which is a quantitative expression of the degree of activity. It would appear justifiable to conclude that the capacity to induce a reticulocytosis is confined to materials effective in pernicious anaemia, since, when an assay on guinea-pigs of crude extract from human livers was made, a control healthy human 1 Miller, D. K., and Rhoads, C. P.: Jour. Clin. Invest., 1935, 153. xiv., 2 Landsberg, J. W., and Thompson, M. R.: Jour. Amer. Pharm. Assoc., 1934, xxiii., 964. 3 Jacobson, B. M.: Jour. Clin. Invest., 1935, xiv., 665 and 679.