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THE LANGUAGE OF MEDICINE.
1131
Correspondence. "Audi alteram partem."
THE CAUSE OF DEATH IN ANGINA PECTORIS. To the Editor of THE LANCET. leave the very courteous letter of cannot SIR,—I Dr. Walter Verdon, in your issue of May 26th, unacknowledged. But I have no objection to make It to the substance of Dr. Verdon’s arguments. seems to me convenient to confine the name angina pectoris to cases of organic disease, and to classify the functional cases with their different phenomena and issues under some other name, or some qualification of the name. I have remarked in my book on arterial diseases, as Dr. Verdon says, how often in cases of true angina death occurs in the slighter seizures. In these cases the heart is very degenerate, but the severer pains seem to arouse more systemic resistance. I am, Sir, yours faithfully, CLIFFORD ALLBUTT. Cambridge, May 26th, 1923.
THE CLAIMS OF NON-PANEL PRACTITIONERS. To the Editor of THE LANCET. SIR,—In view of the probable alteration of the Insurance Act this year, I should like to bring forward the claims of two classes : (1) Those members of the medical profession who held to their word at the time of the agitation in 1911, and (2) those members of the public who prefer to pay for their attendance privately, although also compelled to pay panel contributions. The promise of the author of the Act was that such patients should have full choice of doctors, even if they were not on the panel, and patients who wished to choose such doctors could do so under the contracting-out clause with its pooling scheme. However, by the action of the local insurance committees these conditions have been rendered a dead-letter. Would it not be a simple act of justice to have these wrongs remedied in the
15 gr. of beta-naphthol in tabloid form were administered to the patient each morning, for ten consecutive mornings, on an empty stomach along with a cup of tea, no food being allowed until lunch time. The result was altogether satisfactory, no trace of the worm ever after being seen. This treatment has been tested both by myself and others in many subsequent cases, and in no instance it been known to fail.-I am, Sir, yours faithfully. JOHN W. TOMB, M.D., D.P.H. Mines Board of Health, Asansol, Bengal, India, May 10th.
has
THE LANGUAGE OF MEDICINE. To the Editor of THE LANCET. SIR,—The reform of the English in which much medical literature is written would be a task of terrifying magnitude, involving, as it would, nothing less than the reform of the writers, but I should like to enter a protest against one common offence, the of hybrid compound words, such employment " as and " hypo-somnia." What peri-aqueductal would be thought of the education of a writer who dealt in such impossible barbarisms as " TeteSchmerz " or " Doppel-entendre " ? Yet it is only general ignorance that makes the former more tolerable than the latter. If it is beyond our power to express our meaning with the assistance of Greek or Latin without employing impossible compounds, why should we not make a serious effort to say what we have to say in English ? The language possesses a splendid vocabulary and an august literature, and the moderate labour involved in writing in a manner worthy of both these great possessions would result in making our medical journals much better reading, and would be of very real benefit to the writers. I am, Sir, yours faithfully, F. C. POYNDER. East Grinstead, May 21st, 1923. "
DIETETIC TREATMENT AFTER GASTROENTEROSTOMY. To the Editor
of THE LANCET.
much interested in March 31st (received
reading in yesterday)
THE Sir Berkeley Moynihan’s interesting address on the treatment of duodenal ulcer, in which he sets out the menu which he gives to all his gastric and duodenal cases after operation. In this he mentions " meat cooked a second time," " boiled milk," and " the teeth and gums and the inside of the cheeks should be brushed with care two or three times daily." As to the first, I prefer meat once "cooked to a turn"-i.e., juicy tender flesh which dissolves in the mouth during mastication. I consider over-cooked meat-all the sap remaining in the oven-on a par with cooked timber, absolutely useless as a food ; and after long experience in this land of meat-eating I have A TREATMENT FOR TAPEWORM. been forced to the conclusion that it acts as a foreign To the Editor of THE LANCET. body and as such is a fertile source of cancer of the SIR,—With reference to the article on the Treatment stomach. In reference to the second, I happen to be of Intestinal Worms in your issue of April 14th, I a believer in the dictum " boil milk and you spoil desire to draw attention to a treatment for tape- milk," and consequently I order fresh milk when it e worm which will. I think, be found on trial to give can be obtained from a healthy cow ; but if any doubt should exist as to the latter I recommend consistently satisfactory results. Some years ago the writer was called upon to treat scalding, always with primary scalding of the vessel in a case of very intractable tapeworm (saginata) which it is about to be retained. In many adults there infection, which had existed for over a year, and had seems to be an extraordinary repugnance to milk, survived three vigorous treatments with freshly which boiling intensifies, a dislike which I can only prepared emulsion of ethereal extract of male fern, explain bv the difficulty they find in digesting it. in addition to one with pelletierine tannate, the whole This may be ameliorated by the addition of barley- or worm on each occasion, with the exception of the mineral-water, and a few grains of citrate of soda. head, having been evacuated en bloc. On considera- In suitable cases a teaspoonful of whisky to each tion it seemed to me that in such cases, after the glass of milk is a helpful combination. I never permit expulsion of the bulk of the worm with male fern, milk to be taken with a meat meal-for which instead of the usual policy of wait-and-see, additional (dinner) champagne is my nomination. measures should at once be instituted with a view to As to the last-quoted item-"brushing of teeth, inhibit the growth of further segments from the gums, and cheeks "-I have no experience of brushing retained head. Accordingly, immediately after a the two latter, but have had an extended one in the fourth treatment with male fern which, as before, brushing of teeth. Rightly or wrongly, I have come to removed all the worm with the exception of the head, the conclusion that a large percentage of human woe-
SIR,—I
impending changes ?
town of industrial people, I have felt that the numerous patients who still hold to me, in spite of being allotted a panel doctor, are worthy of consideration, and that to them contractingout on reasonable terms should be allowed without unnecessary restrictions in the way of forms and files. I can see no reason why panel doctors should object to this if they recall that the non-panel men still stand where they once stood before the debacle. I am, Sir, yours faithfully, RAYMOND H. SHAW, M.S., M.B., Senior Surgeon, Great Yarmouth Hospital. May 25th, 1923.
Practising
as
I do in
a
LANCET
was
of
Correspondence. "Audi alteram partem."
THE CAUSE OF DEATH IN ANGINA PECTORIS. To the Editor of THE LANCET. leave the very courteous letter of cannot SIR,—I Dr. Walter Verdon, in your issue of May 26th, unacknowledged. But I have no objection to make It to the substance of Dr. Verdon’s arguments. seems to me convenient to confine the name angina pectoris to cases of organic disease, and to classify the functional cases with their different phenomena and issues under some other name, or some qualification of the name. I have remarked in my book on arterial diseases, as Dr. Verdon says, how often in cases of true angina death occurs in the slighter seizures. In these cases the heart is very degenerate, but the severer pains seem to arouse more systemic resistance. I am, Sir, yours faithfully, CLIFFORD ALLBUTT. Cambridge, May 26th, 1923.
THE CLAIMS OF NON-PANEL PRACTITIONERS. To the Editor of THE LANCET. SIR,—In view of the probable alteration of the Insurance Act this year, I should like to bring forward the claims of two classes : (1) Those members of the medical profession who held to their word at the time of the agitation in 1911, and (2) those members of the public who prefer to pay for their attendance privately, although also compelled to pay panel contributions. The promise of the author of the Act was that such patients should have full choice of doctors, even if they were not on the panel, and patients who wished to choose such doctors could do so under the contracting-out clause with its pooling scheme. However, by the action of the local insurance committees these conditions have been rendered a dead-letter. Would it not be a simple act of justice to have these wrongs remedied in the
15 gr. of beta-naphthol in tabloid form were administered to the patient each morning, for ten consecutive mornings, on an empty stomach along with a cup of tea, no food being allowed until lunch time. The result was altogether satisfactory, no trace of the worm ever after being seen. This treatment has been tested both by myself and others in many subsequent cases, and in no instance it been known to fail.-I am, Sir, yours faithfully. JOHN W. TOMB, M.D., D.P.H. Mines Board of Health, Asansol, Bengal, India, May 10th.
has
THE LANGUAGE OF MEDICINE. To the Editor of THE LANCET. SIR,—The reform of the English in which much medical literature is written would be a task of terrifying magnitude, involving, as it would, nothing less than the reform of the writers, but I should like to enter a protest against one common offence, the of hybrid compound words, such employment " as and " hypo-somnia." What peri-aqueductal would be thought of the education of a writer who dealt in such impossible barbarisms as " TeteSchmerz " or " Doppel-entendre " ? Yet it is only general ignorance that makes the former more tolerable than the latter. If it is beyond our power to express our meaning with the assistance of Greek or Latin without employing impossible compounds, why should we not make a serious effort to say what we have to say in English ? The language possesses a splendid vocabulary and an august literature, and the moderate labour involved in writing in a manner worthy of both these great possessions would result in making our medical journals much better reading, and would be of very real benefit to the writers. I am, Sir, yours faithfully, F. C. POYNDER. East Grinstead, May 21st, 1923. "
DIETETIC TREATMENT AFTER GASTROENTEROSTOMY. To the Editor
of THE LANCET.
much interested in March 31st (received
reading in yesterday)
THE Sir Berkeley Moynihan’s interesting address on the treatment of duodenal ulcer, in which he sets out the menu which he gives to all his gastric and duodenal cases after operation. In this he mentions " meat cooked a second time," " boiled milk," and " the teeth and gums and the inside of the cheeks should be brushed with care two or three times daily." As to the first, I prefer meat once "cooked to a turn"-i.e., juicy tender flesh which dissolves in the mouth during mastication. I consider over-cooked meat-all the sap remaining in the oven-on a par with cooked timber, absolutely useless as a food ; and after long experience in this land of meat-eating I have A TREATMENT FOR TAPEWORM. been forced to the conclusion that it acts as a foreign To the Editor of THE LANCET. body and as such is a fertile source of cancer of the SIR,—With reference to the article on the Treatment stomach. In reference to the second, I happen to be of Intestinal Worms in your issue of April 14th, I a believer in the dictum " boil milk and you spoil desire to draw attention to a treatment for tape- milk," and consequently I order fresh milk when it e worm which will. I think, be found on trial to give can be obtained from a healthy cow ; but if any doubt should exist as to the latter I recommend consistently satisfactory results. Some years ago the writer was called upon to treat scalding, always with primary scalding of the vessel in a case of very intractable tapeworm (saginata) which it is about to be retained. In many adults there infection, which had existed for over a year, and had seems to be an extraordinary repugnance to milk, survived three vigorous treatments with freshly which boiling intensifies, a dislike which I can only prepared emulsion of ethereal extract of male fern, explain bv the difficulty they find in digesting it. in addition to one with pelletierine tannate, the whole This may be ameliorated by the addition of barley- or worm on each occasion, with the exception of the mineral-water, and a few grains of citrate of soda. head, having been evacuated en bloc. On considera- In suitable cases a teaspoonful of whisky to each tion it seemed to me that in such cases, after the glass of milk is a helpful combination. I never permit expulsion of the bulk of the worm with male fern, milk to be taken with a meat meal-for which instead of the usual policy of wait-and-see, additional (dinner) champagne is my nomination. measures should at once be instituted with a view to As to the last-quoted item-"brushing of teeth, inhibit the growth of further segments from the gums, and cheeks "-I have no experience of brushing retained head. Accordingly, immediately after a the two latter, but have had an extended one in the fourth treatment with male fern which, as before, brushing of teeth. Rightly or wrongly, I have come to removed all the worm with the exception of the head, the conclusion that a large percentage of human woe-
SIR,—I
impending changes ?
town of industrial people, I have felt that the numerous patients who still hold to me, in spite of being allotted a panel doctor, are worthy of consideration, and that to them contractingout on reasonable terms should be allowed without unnecessary restrictions in the way of forms and files. I can see no reason why panel doctors should object to this if they recall that the non-panel men still stand where they once stood before the debacle. I am, Sir, yours faithfully, RAYMOND H. SHAW, M.S., M.B., Senior Surgeon, Great Yarmouth Hospital. May 25th, 1923.
Practising
as
I do in
a
LANCET
was
of