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THE PRODUCTION OF ARTIFICIAL PYREXIA
1348
ANNOTATIONS REGISTRATION OF FOREIGN DOCTORS
NOT long ago we gave an account of the first year’s working of the Academic Assistance Council in its task of assisting university teachers and investigators unable to carry on their work in their own country on grounds of religion, political opinion, or race.
Assistance was not confined to German exiles, and the resources of this council enabled it to make maintenance grants to 49 scientists or scholars and to place 129 others. It was no part of this council’s task to help medical men with foreign qualifications to find openings for practice in this country. It is however well known-and has been the subject of some adverse comment-that the Conjoint Board of Scotland is enabling a number of these foreign doctors to take the final qualifying examination after a short course of study. It was reported to a council meeting of the British Medical Association on June 6th that about 180 foreign doctors are availing themselves of this concession, and the chairman of the B.M.A. council said it was expected that about 150 of them would remain in Great Britain and Ireland, where an attempt would be made to place them in cities where there is a large Jewish element. Of the remainder some, he said, might go to South America, but there was every reason to believe that not a single one of them would find his way to Australia, New Zealand, or South Africa. They themselves had no money, and there was no body which had the funds necessary for the payment of passage money. The practical problem was therefore not that of safeguarding the Dominions and Colonies from inundation, but of dealing with at most 150 medical persons who would be settling in this country during the next 18 months for such period as the Home Office would allow them to stay. The Dominions Committee of the B.M.A. expressed the opinion that it was desirable to increase to three years the period of study in this country required before admission to a final qualifying examination. THE PRODUCTION OF ARTIFICIAL PYREXIA
WE have recently considered in these columns1 the thermostatic control of the warm-blooded animal and some of the outcomes of the attempt to evade this control and to produce artificial fever, local or general. It is important to be aware of the nature of the agencies employed. Until recently the term " diathermy " was limited to the production of heat in the human body by the passage of oscillating currents with a frequency of about 1,000,000 a second. These were generated by the discharge of a condenser through a coil of suitable inductance, or in some of the newer machines by causing a thermionic valve to generate oscillations. The mechanism in the latter case is more difficult to understand than in the simple spark machine, but it is analogous in some degree to the action of the balance wheel or pendulum of a clock. In the simplest arrangement, two circuits each containing an inductance and capacity are connected to the appropriate electrodes of the valve, and are at the same time so situated that they are inductively linked with one another. In this state any slight variation in one circuit will produce an enhanced variation in the other, owing to the amplifying properties of the valve. This induces a second impulse back into the first circuit, and under suitable 1 THE LANCET, May
19th, p. 1075, and May 26th, p. 1129.
conditions the valve will break into a sustained oscillation which continues as long as power is supplied to the circuit. The frequency of the oscillations produced depends entirely on the electrical constants of the circuits employed, but the intensity of the high-frequency circuit is a function of the size of the valve and its capacity for taking reasonable power without overheating. In recent years there has been considerable investigation of the action of currents of still higher frequency, of the order of 10 million a second. Such currents have been obtained from valve outfits almost exclusively, though one type of spark instrument suitable for local treatment has been made in this country. When such high frequency is in use, the patient is placed between two insulated plate electrodes which are not in contact with the skin, the tissues of the body forming part of the dielectric of a condenser. Smaller plates are used when local treatment is intended. In another form of instrument recently
devised, the Inductotherm, the currents are produced in a flexible insulated cable which is wound round the body or part to be treated. Such an arrangement would lead to a different distribution of the induced currents, but there is no essential difference between the two methods. In both cases the observed rise in temperature can be regarded as the result of induced currents of high frequency in the body. Merriman, Holmguest, and Osbome2 maintain that there is a difference in conductivity of various tissues towards these new currents as compared with diathermy, but it would be premature to deduce this from the results of experiments in which the methods differ so widely in detail. There is some difficulty in finding a suitable term for the description of the new therapeutic agent. In America the word radiothermy " has been suggested as being the production of heat by currents such as are used in wireless telegraphy. But the term might lead to confusion with radiant heat. There is a tendency to lay emphasis on the presence of electro-magnetic radiation as being the heating agent, which does not seem to be justified by consideration of the machinery used. The fact that the frequencies in question are the same as those used in so-called short-wave wireless has suggested the term " short-wave diathermy." While this may not satisfy everyone, the term is convenient and it emphasises’the relationship of the new agent to the original diathermy current. HÆMATOPORPHYRIA A RECENT number of Medicine (Baltimore) contains very complete review3 of this rare but interesting condition, together with an account of two cases which came to autopsy and offered material for the study of the nature of the histological changes in the nervous system. After explaining that haematoporphyrin is not actually the pigment involved (for only uroporphyrin and coproporphyrin are found in the urine), the authors distinguish four types of the disease-chronic, congenital, acute toxic, and acute idiopathic. The first two are characterised by the development of certain skin lesions on exposure to light, and the last two - by symptoms resembling Landry’s paralysis so closely as to suggest the advisability of a careful spectroscopic examination of the urine in all such cases. It is an interesting a
2 Amer. Jour. Med. Sci., May, 1934.
3 Mason, V. R., Courville, C., 1933, xii., 355.
and
Ziskind, E.:
Medicine,
ANNOTATIONS REGISTRATION OF FOREIGN DOCTORS
NOT long ago we gave an account of the first year’s working of the Academic Assistance Council in its task of assisting university teachers and investigators unable to carry on their work in their own country on grounds of religion, political opinion, or race.
Assistance was not confined to German exiles, and the resources of this council enabled it to make maintenance grants to 49 scientists or scholars and to place 129 others. It was no part of this council’s task to help medical men with foreign qualifications to find openings for practice in this country. It is however well known-and has been the subject of some adverse comment-that the Conjoint Board of Scotland is enabling a number of these foreign doctors to take the final qualifying examination after a short course of study. It was reported to a council meeting of the British Medical Association on June 6th that about 180 foreign doctors are availing themselves of this concession, and the chairman of the B.M.A. council said it was expected that about 150 of them would remain in Great Britain and Ireland, where an attempt would be made to place them in cities where there is a large Jewish element. Of the remainder some, he said, might go to South America, but there was every reason to believe that not a single one of them would find his way to Australia, New Zealand, or South Africa. They themselves had no money, and there was no body which had the funds necessary for the payment of passage money. The practical problem was therefore not that of safeguarding the Dominions and Colonies from inundation, but of dealing with at most 150 medical persons who would be settling in this country during the next 18 months for such period as the Home Office would allow them to stay. The Dominions Committee of the B.M.A. expressed the opinion that it was desirable to increase to three years the period of study in this country required before admission to a final qualifying examination. THE PRODUCTION OF ARTIFICIAL PYREXIA
WE have recently considered in these columns1 the thermostatic control of the warm-blooded animal and some of the outcomes of the attempt to evade this control and to produce artificial fever, local or general. It is important to be aware of the nature of the agencies employed. Until recently the term " diathermy " was limited to the production of heat in the human body by the passage of oscillating currents with a frequency of about 1,000,000 a second. These were generated by the discharge of a condenser through a coil of suitable inductance, or in some of the newer machines by causing a thermionic valve to generate oscillations. The mechanism in the latter case is more difficult to understand than in the simple spark machine, but it is analogous in some degree to the action of the balance wheel or pendulum of a clock. In the simplest arrangement, two circuits each containing an inductance and capacity are connected to the appropriate electrodes of the valve, and are at the same time so situated that they are inductively linked with one another. In this state any slight variation in one circuit will produce an enhanced variation in the other, owing to the amplifying properties of the valve. This induces a second impulse back into the first circuit, and under suitable 1 THE LANCET, May
19th, p. 1075, and May 26th, p. 1129.
conditions the valve will break into a sustained oscillation which continues as long as power is supplied to the circuit. The frequency of the oscillations produced depends entirely on the electrical constants of the circuits employed, but the intensity of the high-frequency circuit is a function of the size of the valve and its capacity for taking reasonable power without overheating. In recent years there has been considerable investigation of the action of currents of still higher frequency, of the order of 10 million a second. Such currents have been obtained from valve outfits almost exclusively, though one type of spark instrument suitable for local treatment has been made in this country. When such high frequency is in use, the patient is placed between two insulated plate electrodes which are not in contact with the skin, the tissues of the body forming part of the dielectric of a condenser. Smaller plates are used when local treatment is intended. In another form of instrument recently
devised, the Inductotherm, the currents are produced in a flexible insulated cable which is wound round the body or part to be treated. Such an arrangement would lead to a different distribution of the induced currents, but there is no essential difference between the two methods. In both cases the observed rise in temperature can be regarded as the result of induced currents of high frequency in the body. Merriman, Holmguest, and Osbome2 maintain that there is a difference in conductivity of various tissues towards these new currents as compared with diathermy, but it would be premature to deduce this from the results of experiments in which the methods differ so widely in detail. There is some difficulty in finding a suitable term for the description of the new therapeutic agent. In America the word radiothermy " has been suggested as being the production of heat by currents such as are used in wireless telegraphy. But the term might lead to confusion with radiant heat. There is a tendency to lay emphasis on the presence of electro-magnetic radiation as being the heating agent, which does not seem to be justified by consideration of the machinery used. The fact that the frequencies in question are the same as those used in so-called short-wave wireless has suggested the term " short-wave diathermy." While this may not satisfy everyone, the term is convenient and it emphasises’the relationship of the new agent to the original diathermy current. HÆMATOPORPHYRIA A RECENT number of Medicine (Baltimore) contains very complete review3 of this rare but interesting condition, together with an account of two cases which came to autopsy and offered material for the study of the nature of the histological changes in the nervous system. After explaining that haematoporphyrin is not actually the pigment involved (for only uroporphyrin and coproporphyrin are found in the urine), the authors distinguish four types of the disease-chronic, congenital, acute toxic, and acute idiopathic. The first two are characterised by the development of certain skin lesions on exposure to light, and the last two - by symptoms resembling Landry’s paralysis so closely as to suggest the advisability of a careful spectroscopic examination of the urine in all such cases. It is an interesting a
2 Amer. Jour. Med. Sci., May, 1934.
3 Mason, V. R., Courville, C., 1933, xii., 355.
and
Ziskind, E.:
Medicine,