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THE SPASTIC CHILD
967 not only helps to get over the possible criticism that the normal group, being residential in a school and subject to differences of diet and environment, is not strictly comparable as a control group, but it also leaves the rheumatic group alone as excreting more acid because of some essential difference in the biochemistry of the patients. Dr. Payne concludes that the rheumatic child in a quiescent interval excretes more acid than does either an asthmatic or a normal child. This excess production of acid is insufficient to disturb the equilibrium of the blood. ANGIOKERATOMA syndrome to which the name of angiokeratoma, or telangiectatic warts, is applied was described by Mibelli in 1889. The patient is usually a young woman, often tuberculous and with a history of winter chilblains or other sign of circulatory weakness, and the condition is an eruption distributed on the dorsal surfaces of the hands and feet. Histologically, the lesions are composed of a na3void mass of dilated papillary vessels, with hypertrophy of the overlying epidermis (hyperkeratosis, granulosis, and acanthosis). In a case described by L. E. Pierini and N. 0. Sanchez Basso (Semana med., 1934, xli., 1940) the sufferer was a girl of 20, who had had haemoptysis at the age of 17. The disease became evident when she was 7, affecting the hands only. At first there were chilblains, recurring each winter, and then the characteristic eruption began to appear. Physical examination disclosed a marked’habitus phthisicus,’ acrocyanosis, and signs of pulmonary tuberculosis, which X ray examination confirmed. The hands were small, with tapering fingers, the terminal
THE
phalanges especially being extremely slender, and there was ankylosis of the terminal joint of the right little finger, radiography revealing areas of decalcification. The eruption was irregularly distributed on the distal part of the hand and the fingers, and was almost confined to the dorsal surface. The spots were purplish, varying in size from a pinpoint to a pea, disappearing on pressure with a glass slide, and rough to the touch. Histological examination of an excised lesion confirmed the diagnosis. " KEY OF ALL WALES" : A SEQUEL WE have received from the office of the Western Mail and Echo a pamphlet written by Sir John LynnThomas in continuation of work published two years ago and recording researches made during the previous four years on the estuary of the river Tefi. These pointed to a Phœnician occupation of the country between 1500 and 1000 B.C. Clearly only a skilled archaeologist can decide on the value of the discoveries and we cannot presume to judge between Sir John and various sceptical authorities of whose attitude he complains in vigorous terms. The pamphlet is very detailed and it is obvious that the author has taken infinite pains to verify his theories. He concludes with a statement that Wales is in dire need of a professor of archaeology in its University and of research workers who, speaking colloquial Welsh, would be able to obtain first-hand information from the inhabitants. THE SPASTIC CHILD A LITTLE book/ written by the mother of two spastic children, is a record of persistent and successful effort to overcome the disability of Little’s disease. The account of the method by which this result was achieved is of considerable therapeutic interest. Mrs. Fischel’s first child was a severe case and died in early childhood. In the second the disease took a milder shape, and appears to have escaped diagnosis in the first few years. At the age of four energetic treatment was started and carried out, for the most part by the author herself, until at the age of 16 the disablement had been reduced to comparative insignificance. The methods adopted are described 1
The
Spastic Child.
Henry Kimpton.
1934.
By
Marguerite K. Fischel.
Pp. 97.
6s.
London:
in full, and illustrated by excellent diagrams. By far the best part of the book is the description of relaxation and speech exercises. The author’s object is to give assistance to parents of spastic children, and from this standpoint the book must be judged. It should bring conviction and encouragement to those who are inclined to doubt that so great a On the other measure of cure could be attained. hand, the procedures described could, we think, be improved upon in a few ways, and the treatment in the early years rendered less exacting. But if used as a supplement to detailed medical instructions this book should be extremely helpful to parents. NEW PREPARATIONS ACETYLCHOLINE BROMIDE.—A sterile stable solution of this substance has been issued by Burroughs Wellcome and Co., Snow Hill Buildings, London, as a Hypoloid " product. It is issued in E.C., " Hypoloid ampoules, each presenting O’lg. in 1 c.cm. in boxes of 10. (The following notice is enclosed in the sample box which has reached us. " As the ampoules are shorter than formerly, they may be found to slip out of the rack when used in the No. 62’Hypoloid’ Case. This can be overcome by the use of paper tubes supplied free on request.") Acetylcholine is the acetyl ester of choline. It has been isolated in chemically recognisable quantities from the spleen and from the placenta, and is present in minute traces in other organs. It is highly active ; dilutions of one in a million millions in the blood of the cat will produce a transitory fall of blood pressure. Its action is evanescent, as it is rapidly hydrolysed to acetic acid and choline in blood and tissues. The drug is usually administered by intramuscular injection and has proved successful in counteracting paralysis of the intestine such as occurs after laparotomy and intestinal operations. It may be used to relieve severe post-operative gas distension and pain, and has been found to relieve acute constipation and to be of value in certain types of vascular disturbances associated with arteriolar spasm.
VALERIAN-DISPERT AND DESITIN OINTMENT.-We have received these two preparations from Messrs. Coates and Cooper, Clerkenwell-road, E.C., acting as distributing agents for the foreign manufacturers. The desitin ointment is a preparation of cod-liver oil, vaseline, lanoline, oxide of zinc, and purified talc, and has proved of service as a dressing for skin lesions, such as eczema and sunburn, and also in varicose ulcers and bedsores. Valerian-dispert is a preparation of valerian compounded in accordance with the desiccation process-the Krause processwhich is described in literature accompanying the preparation. It is claimed that this process provides for stability in the preparation and for certainty of dosage. Valerian-dispert is made up in small dragées, and is recommended for prescription in all circumstances where valerian is well known to be useful; these are numerous and a convenient mode for the exhibition of the drug should be of practical value. MINTOES.-We have received from Messrs. William Nuttall Ltd., Doncaster, specimens of a sweetmeat for which they claim the advantage of particular purity. The sweets are a combination of butter, treacle, and sugar. The day has gone by when nauseous
preparations
were
commonly prescribed ;
there are, however, useful medicines that children definitely dislike, and here the bribe of a pure sweetmeat may be of service. LEMON BARLEY WATER.—We have received from Messrs. L.B.W., Ltd., of 41, Eastcheap, London, E.C. 3, samples of a concentrated fluid prepared from lemons and pearl barley, from which a palatable beverage can be made by the addition of three parts of water. No endorsement is needed of the claim made by the manufacturers that lemon barley water is a wholesome and efficient thirst-quencher. The L.B.W. preparation is supplied in air-tight screwcapped bottles, with the statement that it can be kept on hand with safety as it does not deteriorate.
THE
phalanges especially being extremely slender, and there was ankylosis of the terminal joint of the right little finger, radiography revealing areas of decalcification. The eruption was irregularly distributed on the distal part of the hand and the fingers, and was almost confined to the dorsal surface. The spots were purplish, varying in size from a pinpoint to a pea, disappearing on pressure with a glass slide, and rough to the touch. Histological examination of an excised lesion confirmed the diagnosis. " KEY OF ALL WALES" : A SEQUEL WE have received from the office of the Western Mail and Echo a pamphlet written by Sir John LynnThomas in continuation of work published two years ago and recording researches made during the previous four years on the estuary of the river Tefi. These pointed to a Phœnician occupation of the country between 1500 and 1000 B.C. Clearly only a skilled archaeologist can decide on the value of the discoveries and we cannot presume to judge between Sir John and various sceptical authorities of whose attitude he complains in vigorous terms. The pamphlet is very detailed and it is obvious that the author has taken infinite pains to verify his theories. He concludes with a statement that Wales is in dire need of a professor of archaeology in its University and of research workers who, speaking colloquial Welsh, would be able to obtain first-hand information from the inhabitants. THE SPASTIC CHILD A LITTLE book/ written by the mother of two spastic children, is a record of persistent and successful effort to overcome the disability of Little’s disease. The account of the method by which this result was achieved is of considerable therapeutic interest. Mrs. Fischel’s first child was a severe case and died in early childhood. In the second the disease took a milder shape, and appears to have escaped diagnosis in the first few years. At the age of four energetic treatment was started and carried out, for the most part by the author herself, until at the age of 16 the disablement had been reduced to comparative insignificance. The methods adopted are described 1
The
Spastic Child.
Henry Kimpton.
1934.
By
Marguerite K. Fischel.
Pp. 97.
6s.
London:
in full, and illustrated by excellent diagrams. By far the best part of the book is the description of relaxation and speech exercises. The author’s object is to give assistance to parents of spastic children, and from this standpoint the book must be judged. It should bring conviction and encouragement to those who are inclined to doubt that so great a On the other measure of cure could be attained. hand, the procedures described could, we think, be improved upon in a few ways, and the treatment in the early years rendered less exacting. But if used as a supplement to detailed medical instructions this book should be extremely helpful to parents. NEW PREPARATIONS ACETYLCHOLINE BROMIDE.—A sterile stable solution of this substance has been issued by Burroughs Wellcome and Co., Snow Hill Buildings, London, as a Hypoloid " product. It is issued in E.C., " Hypoloid ampoules, each presenting O’lg. in 1 c.cm. in boxes of 10. (The following notice is enclosed in the sample box which has reached us. " As the ampoules are shorter than formerly, they may be found to slip out of the rack when used in the No. 62’Hypoloid’ Case. This can be overcome by the use of paper tubes supplied free on request.") Acetylcholine is the acetyl ester of choline. It has been isolated in chemically recognisable quantities from the spleen and from the placenta, and is present in minute traces in other organs. It is highly active ; dilutions of one in a million millions in the blood of the cat will produce a transitory fall of blood pressure. Its action is evanescent, as it is rapidly hydrolysed to acetic acid and choline in blood and tissues. The drug is usually administered by intramuscular injection and has proved successful in counteracting paralysis of the intestine such as occurs after laparotomy and intestinal operations. It may be used to relieve severe post-operative gas distension and pain, and has been found to relieve acute constipation and to be of value in certain types of vascular disturbances associated with arteriolar spasm.
VALERIAN-DISPERT AND DESITIN OINTMENT.-We have received these two preparations from Messrs. Coates and Cooper, Clerkenwell-road, E.C., acting as distributing agents for the foreign manufacturers. The desitin ointment is a preparation of cod-liver oil, vaseline, lanoline, oxide of zinc, and purified talc, and has proved of service as a dressing for skin lesions, such as eczema and sunburn, and also in varicose ulcers and bedsores. Valerian-dispert is a preparation of valerian compounded in accordance with the desiccation process-the Krause processwhich is described in literature accompanying the preparation. It is claimed that this process provides for stability in the preparation and for certainty of dosage. Valerian-dispert is made up in small dragées, and is recommended for prescription in all circumstances where valerian is well known to be useful; these are numerous and a convenient mode for the exhibition of the drug should be of practical value. MINTOES.-We have received from Messrs. William Nuttall Ltd., Doncaster, specimens of a sweetmeat for which they claim the advantage of particular purity. The sweets are a combination of butter, treacle, and sugar. The day has gone by when nauseous
preparations
were
commonly prescribed ;
there are, however, useful medicines that children definitely dislike, and here the bribe of a pure sweetmeat may be of service. LEMON BARLEY WATER.—We have received from Messrs. L.B.W., Ltd., of 41, Eastcheap, London, E.C. 3, samples of a concentrated fluid prepared from lemons and pearl barley, from which a palatable beverage can be made by the addition of three parts of water. No endorsement is needed of the claim made by the manufacturers that lemon barley water is a wholesome and efficient thirst-quencher. The L.B.W. preparation is supplied in air-tight screwcapped bottles, with the statement that it can be kept on hand with safety as it does not deteriorate.