- Email: [email protected]
THE REFUGEES
1545 ltZa-raagen2ent.- steam tent saline mixture and in addition.
brandy
and
was
used. A
glucose
were
simple employed
Results.-The physical signs cleared up in both in five days. Special note.-Both babies developed enteritisone on the eighth day, the other on the sixth. In each case the drug was stopped and in a day the enteritis ceased. cases
I would like to emphasise that good results were obtained in tiny babies with much smaller doses than are commonly used, and to point out the development of enteritis after about a week on the drug. I have had similar good results in primary bronchopneumonia in older children, and in secondary bronchopneumonia arising in the course of whooping-cough, where the response was dramatic. M. & B. 693 also gave good results in tonsillitis accompanied by herpes simplex-so-called influenzal tonsillitis. I would record my appreciation of the collaboration of the nursing staff at St. Anthony’s Hospital, Cheam, where I had charge of these pneumonias, and my thanks to Dr. William O’Neill for permission to publish these notes.
I am,
Sir, yours faithfully,
Carshalton, Dec. 21st.
C. GRANT NICOL.
THE " IRON LUNG " To the Editor of THE LANCET
Sm,-In your issue of Dec. 17th Dr. G. P. Crowden raises criticisms of the use of wood for the " iron lungs " which Lord Nuffield is so generously to manufacture and present to British hospitals. He quotes a paragraph from the American Journal of Pediatrics which states that :"
Suah respirators made with the best cabinet-quality wood and by skilled cabinet workers have checked and cracked in an annoyingly short time. Such failure is probably caused by the rapid pressure changes and dampness within the respirator. It is, therefore, risky to use such a machine, put it in storage in the basement and then expect it to be in working condition when the emergency arises. Theoretically, the wooden machines should last a long time. Practically, this has not proved to be the case."
I would like to point out that with modern methods of manufacture of laminated wood (of which the Both-Nuffield " lung " is constructed) past difficulties of warping, twisting, and cracking have been eliminated. The new " wooden lung " is built of a series of strips of timber glued with waterproof glue and covered with two sheets of veneer on both sides-in other words building up what is commonly called a block board. This method of construction is noted for its lack of movement, as a result of which it is very largely used for aeroplane construction. I have inspected at the London County Hall one of the " lungs " which the London County Council medical staff played a big part in designing. The experts there are of the opinion that in view of the methods of construction, and the material used, the " wooden lungs " will last for a period of forty, fifty, or more years. Since my inspection, which was a I feel it is only right to point one, very thorough out that, in my opinion, this method of construction and the employment of timber, will not give rise to the difficulties which Dr. Crowden suggests. Many people think of plywood as something out of which tea boxes are made, but the modern laminated board is quite a different thing. The L.C.C. have for the past three or four years been using ward cabinets, made of laminated timber, which are subjected to very severe treatment. They are usually standing
radiators and are frequently scrubbed with soap and water. Yet the L.C.C. experts have found that in their experience there has been no movement in any of these cabinets, and I see no reason why the laminated " wooden lungs " should not stand up to their work, without deterioration, for many years. I am, Sir, yours faithfully, E. H. B. BOULTON, Technical Director, Timber Development
against
Association Ltd.
King William-street, E.C., Dec. 22nd. THE REFUGEES A DESERVING GROUP
To the Editor
of THE LANCET SIR,—May appeal through your columns for assistance to certain colleagues of ours who are in we
serious straits? Appeals of this description are to-day unfortunately all too common ;9 but we have as a group a very justifiable reason for presenting this particular case. Each of us has for a period given his medical services to the Spanish Government either on behalf of the civilian population or in the medical units dispatched from this country. Now that all medical men of non-Spanish origin are leaving the Government service, a number of our colleagues, who are by nationality German or Austrian have been transferred to French territory ; and here their financial position, until arrangements can be made for their final destination, is desperate. Most of them are known personally to one or other of us. Like us they were moved by the consideration that it is better for the world that Spain should retain its independence than fall under the control of foreign totalitarian governments. They cannot return to their homes. Should any of your readers care to assist men and women whose misfortune it is to find themselves destitute on account of their generosity and courage, funds can be immediately transmitted to the medical organisation in Paris that si concerning itself with their welfare. Donations may be sent to Dr. C. F. Hill, 162,
Kingston-road, London, We are Sir
Dec. 23rd.
vDnra
S.W.19. faitllfnilv
A. L. COCHRANE, L. CROME, A. T. HART,
C. F. HILL, DOUGLAS JOLLY, R. S. SAXTON.
INFECTIOUS DISEASE IN ENGLAND AND WALES DURING THE WEEK ENDED DEC. 17TH, 1938
Notifications.-The following cases of infectious disease were notified during the week : Small-pox, 0 ; scarlet fever, 1849 ; diphtheria, 1467 ; enteric fever, 28 (26 expected "), pneumonia (primary or influenzal), 948 ; puerperal pyrexia, 154; cerebrospinal fever, 21 ; acute poliomyelitis, 31 ; acute "
polio-encephalitis, 1 ; encephalitis lethargica, 1 ; dysentery, 36 ; ophthalmia neonatorum, 94. No case of cholera, plague, or typhus fever was notified during
the week.
The combined notifications of acute poliomyelitis and acute polio-encephalitis total as follows for the current week and the previous 21 weeks (working backwards) : 32, 30, 37, 42, 47,
53,73, 74, 88, 85, 68, 56, 63, 83, 76, 82, 76, 83,
87, 63,
41,
29.
The number of cases in the Infectious Hospitals of the London County Council on Dec. 23rd was 3204, which included : Scarlet fever, 673 ; diphtheria, 1099 (carriers, 40) : measles, 11 ; whooping-cough, 526 ; puerperal fever, 9 mothers (plus 3 babies) ; encephalitis lethargica, 2 96 ; poliomyelitis, 8. At St. Margaret’s Hospital there were 30 babies (plus 16 mothers) with ophthalmia neonatorum.
Deaths.—In 126 great towns, including London, there was no death from small-pox, 2 (2) from enteric fever, 2 (0) from measles, 1 (1) from scarlet fever,
(Continued
at
foot of
next
page)
brandy
and
was
used. A
glucose
were
simple employed
Results.-The physical signs cleared up in both in five days. Special note.-Both babies developed enteritisone on the eighth day, the other on the sixth. In each case the drug was stopped and in a day the enteritis ceased. cases
I would like to emphasise that good results were obtained in tiny babies with much smaller doses than are commonly used, and to point out the development of enteritis after about a week on the drug. I have had similar good results in primary bronchopneumonia in older children, and in secondary bronchopneumonia arising in the course of whooping-cough, where the response was dramatic. M. & B. 693 also gave good results in tonsillitis accompanied by herpes simplex-so-called influenzal tonsillitis. I would record my appreciation of the collaboration of the nursing staff at St. Anthony’s Hospital, Cheam, where I had charge of these pneumonias, and my thanks to Dr. William O’Neill for permission to publish these notes.
I am,
Sir, yours faithfully,
Carshalton, Dec. 21st.
C. GRANT NICOL.
THE " IRON LUNG " To the Editor of THE LANCET
Sm,-In your issue of Dec. 17th Dr. G. P. Crowden raises criticisms of the use of wood for the " iron lungs " which Lord Nuffield is so generously to manufacture and present to British hospitals. He quotes a paragraph from the American Journal of Pediatrics which states that :"
Suah respirators made with the best cabinet-quality wood and by skilled cabinet workers have checked and cracked in an annoyingly short time. Such failure is probably caused by the rapid pressure changes and dampness within the respirator. It is, therefore, risky to use such a machine, put it in storage in the basement and then expect it to be in working condition when the emergency arises. Theoretically, the wooden machines should last a long time. Practically, this has not proved to be the case."
I would like to point out that with modern methods of manufacture of laminated wood (of which the Both-Nuffield " lung " is constructed) past difficulties of warping, twisting, and cracking have been eliminated. The new " wooden lung " is built of a series of strips of timber glued with waterproof glue and covered with two sheets of veneer on both sides-in other words building up what is commonly called a block board. This method of construction is noted for its lack of movement, as a result of which it is very largely used for aeroplane construction. I have inspected at the London County Hall one of the " lungs " which the London County Council medical staff played a big part in designing. The experts there are of the opinion that in view of the methods of construction, and the material used, the " wooden lungs " will last for a period of forty, fifty, or more years. Since my inspection, which was a I feel it is only right to point one, very thorough out that, in my opinion, this method of construction and the employment of timber, will not give rise to the difficulties which Dr. Crowden suggests. Many people think of plywood as something out of which tea boxes are made, but the modern laminated board is quite a different thing. The L.C.C. have for the past three or four years been using ward cabinets, made of laminated timber, which are subjected to very severe treatment. They are usually standing
radiators and are frequently scrubbed with soap and water. Yet the L.C.C. experts have found that in their experience there has been no movement in any of these cabinets, and I see no reason why the laminated " wooden lungs " should not stand up to their work, without deterioration, for many years. I am, Sir, yours faithfully, E. H. B. BOULTON, Technical Director, Timber Development
against
Association Ltd.
King William-street, E.C., Dec. 22nd. THE REFUGEES A DESERVING GROUP
To the Editor
of THE LANCET SIR,—May appeal through your columns for assistance to certain colleagues of ours who are in we
serious straits? Appeals of this description are to-day unfortunately all too common ;9 but we have as a group a very justifiable reason for presenting this particular case. Each of us has for a period given his medical services to the Spanish Government either on behalf of the civilian population or in the medical units dispatched from this country. Now that all medical men of non-Spanish origin are leaving the Government service, a number of our colleagues, who are by nationality German or Austrian have been transferred to French territory ; and here their financial position, until arrangements can be made for their final destination, is desperate. Most of them are known personally to one or other of us. Like us they were moved by the consideration that it is better for the world that Spain should retain its independence than fall under the control of foreign totalitarian governments. They cannot return to their homes. Should any of your readers care to assist men and women whose misfortune it is to find themselves destitute on account of their generosity and courage, funds can be immediately transmitted to the medical organisation in Paris that si concerning itself with their welfare. Donations may be sent to Dr. C. F. Hill, 162,
Kingston-road, London, We are Sir
Dec. 23rd.
vDnra
S.W.19. faitllfnilv
A. L. COCHRANE, L. CROME, A. T. HART,
C. F. HILL, DOUGLAS JOLLY, R. S. SAXTON.
INFECTIOUS DISEASE IN ENGLAND AND WALES DURING THE WEEK ENDED DEC. 17TH, 1938
Notifications.-The following cases of infectious disease were notified during the week : Small-pox, 0 ; scarlet fever, 1849 ; diphtheria, 1467 ; enteric fever, 28 (26 expected "), pneumonia (primary or influenzal), 948 ; puerperal pyrexia, 154; cerebrospinal fever, 21 ; acute poliomyelitis, 31 ; acute "
polio-encephalitis, 1 ; encephalitis lethargica, 1 ; dysentery, 36 ; ophthalmia neonatorum, 94. No case of cholera, plague, or typhus fever was notified during
the week.
The combined notifications of acute poliomyelitis and acute polio-encephalitis total as follows for the current week and the previous 21 weeks (working backwards) : 32, 30, 37, 42, 47,
53,73, 74, 88, 85, 68, 56, 63, 83, 76, 82, 76, 83,
87, 63,
41,
29.
The number of cases in the Infectious Hospitals of the London County Council on Dec. 23rd was 3204, which included : Scarlet fever, 673 ; diphtheria, 1099 (carriers, 40) : measles, 11 ; whooping-cough, 526 ; puerperal fever, 9 mothers (plus 3 babies) ; encephalitis lethargica, 2 96 ; poliomyelitis, 8. At St. Margaret’s Hospital there were 30 babies (plus 16 mothers) with ophthalmia neonatorum.
Deaths.—In 126 great towns, including London, there was no death from small-pox, 2 (2) from enteric fever, 2 (0) from measles, 1 (1) from scarlet fever,
(Continued
at
foot of
next
page)