THE PHYSIOLOGICAL STANDARDISATION OF DIGITALIS.

1625 wrist. All the movements of the wrist were painful and limited. From time to time, especially at night, the patient felt neuralgic pains in the area of the median nerve. The thenar and hypothenar eminences were slightly atrophied. THE GOVERNMENTAL GRANTS FOR SCIENTIFIC There was an enlargement of the wrist at its external part. RESEARCH. Palpation showed that this was due to bony enlargement WE are informed that, in connexion with the annual grant which caused elevation of the region of " the anatomical voted by Parliament in aid of scientific investigations con- snuff-box." This sign enabled the diagnosis of fracture of cerning the causes and processes of disease, Mr. Burns, the the scaphoid bone to be made, which was confirmed by radioPresident of the Local Government Board, has authorised graphy. The scaphoid was broken into two equal parts, of the following special researches : 1. A continuation of the which the upper was displaced forwards and also had underinvestigation into protracted and recurrent infection in gone a movement of rotation. The semilunar bone had enteric fever, by Dr. Theodore Thomson, medical inspector almost completely, lost contact with the head of the of the Board, in conjunction with Dr. J. C. G. Ledingham os magnum. In consequence of these changes a guarded of the Lister Institute. 2. A continuation of the investiga- prognosis was given. The patient was told that he would tion into protracted and recurrent infection in diphtheria, have to remain under observation for a long time, and that by Dr. Theodore Thomson and Dr. C. J. Thomas. if the stiffness of the wrist increased or if signs of com3. A continuation of the investigation into flies as carriers pression of the median nerve appeared resection of the of infection, by Dr. S. Monckton Copeman, medical inspector carpus might be necessary. Massage, mobilisation, and of the Board, and by Professor Nuttall of Cambridge. baths were prescribed, and the treatment was energetically 4. A continuation of Dr. F. W. Andrewes’s investigation carried out. After three months there was some improveon the presence of sewage bacteria in sewer air, with a ment, but recovery was far from complete. It would be of view to ascertaining their number and the distance they can be interest to record any parallel cases known to our readers. carried by air currents ; also a continuation of Dr. Andrewes’s THE PHYSIOLOGICAL STANDARDISATION OF investigation into the part played by changes in bone marrow in the defensive mechanism of the body against infection. DIGITALIS. 5. A continuation of Dr. W. G. Savage’s investigations on the AN important contribution to our knowledge of the bacterial measurement of milk pollution and on the presence standardisation of preparations of digitalis has been made of the Gaertner group of bacilli in prepared meat and allied by Dr. Charles W. Edmunds and Dr. Worth Hale.’i The foods. 6. An investigation into the chemical and physical introductory portion of the Bulletin contains a succinct changes undergone by milk as the result of infection by account of the literature of the subject, from the chemical bacteria and into the relation of the pancreas to epidemic diar- and pharmacological points of view, showing the variability rhcea, by Dr. H. A. Scholberg and Mr. Wallis of University of preparations of digitalis, and the impossibility of College, Cardiff. 7. An investigation of the records of standardising them by a chemical assay of one or more charitable lying-in hospitals as to the nutrition of the mother of the active principles of the drug. The literature relating and other factors influencing the vitality of infants and their to the various biological methods of standardisation occupies progress in the first 14 days of life, by Mr. G. F. Darwall 16 pages and forms a most valuable summary of the subject. Smith, physician to the British Lying-in Hospital. 8. An It is shown that the various methods that have been investigation into the occurrence and importance, in relation employed fall into three primary groups, which may be to treatment, of mixed infections in pulmonary tuberculosis, classified as follows. First, a toxic method, in which frogs, by Dr. A. C. Inman, pathologist to the Brompton Hospital guinea-pigs, or some of the higher animals are used. Secondly, for Consumption. 9. An investigation on the relative import- a method based on the use of the frog’s heart and the subance of certain types of body-cells in defence against the sequent observation of the time that elapses before it stops in tubercle bacillus and the effect of tuberculin and other systole. The third method aims at a comparison of physioremedial agents on their activities, by Dr. J. Miller, patho- logical activity by means of the relative effects upon the logist to the General Hospital. Birmingham. blood pressure in some of the higher animals. Dr. Edmunds and Dr. Hale examined a number of official and proprietary FRACTURE OF THE SCAPHOID BONE. preparations of digitalis, in order partly to ascertain to what FRACTURE of the scaphoid bone of the wrist has received extent they varied in strength, but more particularly to find little or no attention in the text-books and is regarded as if possible a method of standardisation which was capable of entremely rare, but since the introduction of skiagraphy it yielding uniform results and possessed advantages over is one of the injuries which have been revealed with other methods. A superficial examination of the tables unexpected frequency. No doubt before the introduction of results would seem merely to cast doubt on the of this means of diagnosis fracture of the scaphoid bone as value of the biological methods of assay now in vogue, well as many other lesions were covered by the diagnosis but a closer examination of the tables showsed that of "sprain of the wrist." Probably also this fracture has the anomalies were exceptional, the majority of the been mistaken for Colles’s fracture or overlooked when thatresults being uniform. It is pointed out that methods fracture was also present. In the B1Ûletin de la Société de which employ as a standard the determination of the l’Internat des Hôpitaux de Paris for December, 1908, M. minimum lethal dose in the higher animals are not applicJudet has reported the following case. A youth, aged 20able to the physiological assay of preparations of digitalis, years, was thrown violently from his bicycle against a wall. because one solution might be very weak in its action The force of the injury was received on the palms of his upon the heart and yet contain decomposition products hands, which he put out to save himself. After the accident the typical action of which is upon the medulla. Preference the lower part of the right radial region was swollen, and is given for simple methods based upon the action of the later the whole of the forearm. A practitioner diagnosed drug upon the circulation rather than upon the nervous fracture of the radius, which he treated by massage system, the two best being the "12-hour toxic method and progressive mobilisation. Three months after the and the "one-hour method," in both of which frogs are accident the patient came under the care of M. Judet 1 Bulletin, No. 48, Hyg. Lab., U.S. Public Health and Marine Hospital because of loss of use of the wrist and pains in the Service, Washington, pp. 61 (1909).

acromegalic symptoms, is equally unknown. these suggest an interesting line of research investigators. -

Data such as for subsequent

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If

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1626 if only one or two cases be decision may easily be formed.

Full details of these methods are given in the which will doubtless afford assistance to the com. Bulletin, next British Pharmacopoeia. of the pilers

opinion ;

employed.

THE Tuberculosis

Exhibition, already announced in our opened at the Art Gallery, Whitechapel, on Wednesday last, organised by the National Association for the Prevention of Consumption and Other Forms of Tuberculosis. The exhibition will remain open until June 19th, during which time lectures especially directed to arouse popular attention will be delivered by well-known authorities, while a conference will take place next week on the best methods for the prevention, early detection, and the subsequent treatment of consumption. The exhibition was opened by the President of the Local Government Board in a long and eloquent address in which he suggested that for the popular title of the "White Scourge," the far more poetical description, Captain of the Men of Death " should be substituted, and truly the terrible figures quoted by Mr. Burns justify this But while these figures showed use of Bunyan’s phrase. the drain on our national vitality caused by tuberculosis the future is one of great promise, as also appeared from Mr. Burns’s statistics ; for in less than 40 years the death-rate from phthisis has declined by more than one-half, while the better education of the people is leading them in every direction to live their lives and shape their domestic policy towards further improvement. In particular the public is now awake to the danger that lies in unwholesome milk, and here again Mr. Burns is to the fore by introducing a Milk Bill. The text of this measure, which we shall shortly publish in our columns, makes it probable, alas, that many of the clauses will be vigorously contested, but the debates, we may be certain, will take place over details and not over principles, for the country is now roused to the perils that lie in contamination of the staple food-supply of our young and This wholesome feeling can only be advanced our invalids. by such exhibitions as that which has just been opened at Whitechapel, and we are glad to learn from Mr. George Harwas

A SUPPLEMENT to the thirty-seventh annual report of the Local Government Board for 1907-08, containing the report of the medical officer for the same period, has just been issued.

MOTORING NOTES.

"

BY C. T. W.

HIRSCH, M.R.C.S. ENG., L.R.C.P. LOND.

Concerninfj the Budget. AT present it seems unlikely that the rebate of half the duty on the quantity of petrol consumed in propulsion which is granted to commercial cars will be extended to automobiles

wood, M.P., the chairman of the exhibition, that it is intended to send the exhibition to different parts of the

metropolis and the country as a form of missionary enterprise. This proceeding has been attended in Ireland, as all our readers know, with highly satisfactory results. THE TREATMENT OF CANCER BY FERMENTS. DURING the last three or four years much work has been done in the treatment of inoperable malignant disease in man by means of the hypodermic injection of trypsin with and without amylopsin, but, though in a few cases some improvement appeared to follow, the ultimate result was unsatisfactory and the treatment has, we believe, been completely abandoned. Dr. J. A. Shaw-Mackenzie, who has worked on this subject, publishes in this number of THE LANCET a paper describing a series of experiments on the treatment of malignant disease in mice by means of hypodermic injections of extracts of the duodenal and intestinal mucosa, and of liver extract and also of mixed ferments. Control cases were kept. The result of the experiments has been that no definite beneficial action could be ascribed to any of the injections, though at one time it looked as if the injections had some influence. The failure of these attempts does not necessarily condemn all ferments in the treatment of malignant disease, but it inculcates the lesson that it is only by using a fair number of cases that we can arrive at a definite

an erroneous

IT is intended to hold a short service on Friday, June llth (Feast of St. Barnabas), at 1.15 P.M., at the Church of St. Magnus-the-Martyr, London Bridge, being the special effort of the united parishes of St. Magnus-the-Martyr, St. Margaret, New Fish-street, and St. Michael, Crookedlane, E.C., on behalf of the hospitals. The preacher will be the Right Rev. the Lord Bishop of Rochester. The Right Hon. the Lord Mayor, accompanied by the Sheriffs of London, will attend in state. The collection will be for the Metropolitan Hospital Fund.

THE TUBERCULOSIS EXHIBITION: MR. JOHN BURNS ON "THE WHITE SCOURGE."

columns,

employed,

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It is, therefore, most essential to used by medical men. look that squarely in the face which the whole profession will regard as an unjust burden, and to take such means as we can to minimise the evil. Perhaps it may in an indirect way With automatic do us, or rather our motor cars, good. carburettors wemay often be using more petrol than needful; this means too rich a mixture ; a deposition of soot in the cylinders and piston-heads, with probably overheating, pre-ignition, and loss of power; all troubles that can only be treated by taking down the cylinders and curetting their insides. Now that petrol is Is. 2d. the gallon we may perhaps be more careful, and although the pre-ignition knocks of our engine did not make us so, the Government’s attack on our pockets may. If so, well, it is but another proof that " It is an ill wind turns none to good." On top speed many engines run much better with an excess of air, and more air means less consumption of petrol and less liability to sooting. A simple way to bring about this condition is to cut two or three circular holes in the induction pipe as far away from the carburettor as possible, and, if practicable, equally distant from each inlet valve. Of course on some cars this latter cannot be done. The holes, about one-sixteenth to a quarter of an inch in diameter, should be guarded by fine gauze, and a sliding ring or sleeve should be fitted, so that on starting and on low speeds they can be closed. An ordinary tube slipped over the induction pipe and kept over the apertures by a spring answers admirably, and by means of a Bowden wire brought up to the dash-board, the tube, which should be just a close fit, can be drawn forward, and the extra air inlet so brought into use ; on releasing the wire, the spring will pull the tube over the inlet and so close the openings. We cannot produce petrol for ourselves, still, as I mentioned in THE LANCET of Jan. 9th, benzol is made in this country-in fact, in London, by the South Metropolitan Gas Company ; and benzol with the carburettor air inlet widely The one thing to open answers just as well as petrol. remember when using benzol is to open the air inlet of the carburettor as much as possible and, what is even better, to make an extra one. If that is done there need be no fear of sooting and deposit in the cylinders. A matter that will have to be settled is, Shall the tax be collected on the raw spirit as it arrives in this country or on the refined article as it is sent out in cans to the public?It looks rather as if the dealers expect to be charged on the raw material, for they have put the price up 4d., the extra penny being, I presume, for duty paid on spirit that is lost in distilling. As few medical men use cars of more than 16 h.-p. the new tax, as pointed out in THE LANCET of May 8th, for annual motor-car licences, even allowing for the rebate, will