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THE TREATMENT OF PNEUMONIA BY ASPIRIN.
786 T Dose of 8 gr. aspirin given. Respirations 36, ; pulse from 92 to 72. Crisis on sixth day. 5. Male, aged 10, admitted third day. Aspirin 8 gr. given on fourth day. Crisis on fifth day. Respirations 48, fell to 24; To the Editor of THE LANCET. pulse from 112 to 78. 6. Male, aged 55, admitted on SIR,-I have read with much interest the account of Dr. fifth day. Two doses of 8 gr. aspirin given. Crisis on Ibotson’s case in THE LANCET of Feb. 15th. Instances of sixth day. Respirations fell from 66 to 34 ;pulse from 95 to 56. 7. Male, aged 23, admitted on third day. Three doses cases exhibiting such symptoms are, I think, worthy of more notice than they generally receive, for, judging from my own of 8 gr. aspirin given. Crisis on fourth night (early fifth experience, they appear to be of by no means infrequent morning). Respirations fell from 56 to 22; pulse from I believe that Dr. Ibotson is fully justified in 120 to 74. occurrence. All these cases recovered without any after complications. his diagnosis of implication of the sympathetic branch conAn eighth case did not respond so well. Three doses of I would out of the arm. the vascular point supply trolling that such symptoms are not necessarily associated with the 8 gr. aspirin were given from fourth to seventh day, but the crisis occurred only on eighth day. presence of cervical ribs. They may occur in cases where It might be argued that these cases were of a rheumatic the first rib is anatomically normal.’ Like the sensori-motor changes in"cervical rib," they origin, and therefore benefited by a drug of the salicylate of Southern India acute rheumatism is usually appear in early adult life, but may be exhibited at class. In these parts and it is difficult to believe that such Modification in the position of the shoulder practically unknown, any age. coincident with growth seems to determine their occurrence an explanation can account for the good results which are In certainly obtainable by the use of aspirin in the early stage in certain instances (see reference already quoted). others, specialised use of the arm would appear to stimulate of pneumonia. Is it due to the rapid elimination of toxins through the their appearance, as in Dr. Ibotson’s case. The pathological changes which occur in certain of these individuals; skin, &c., brought about by the profuse perspiration which I have figured in the Journal of Anatomy and Physiology for aspirin invariably causes ? I shall be glad of further light on this subject-I a.m. Sir. yours faithfully
THE
fifth day. fell to 26
EXHIBITION OF RAYNAUD’S PHENOMENA.
,
January, 1913.
The subject has, however, developed unexpectedly into one of wide significance, and for further elucidation reference may be made to recent volumes of the Journal of Anatomy and Physiolooy and the Anatomischer Anzeiger. It is especially interesting to read Dr. Ibotson’s account of complete recovery, a termination which is no less surprising than it is gratifying, if the pathological appearances to which I have made reference are to be considered typical of the condition. It is, however, probable that no such advanced changes as I have figured had occurred in Dr. Ibotson’s case. I am, Sir, yours faithfully, T. WINGATE TODD. Anatomical Laboratory, Western Reserve School of Medicine, Cleveland, Ohio, U.S.A., Feb. 27th, 1913.
THE TREATMENT OF PNEUMONIA BY ASPIRIN. To the Editor of THE LANCET. SiR,-Referring to a letter in THE LANCET of June 3rd, 1911, in which Mr. A. Scott, of Brighton, recorded eight successful cases in which 10-15 gr. of aspirin at the outset of an attack of pneumonia had apparently caused the disease to abort, and invited a trial by other members of the profession, I wish to state the following facts. I have been giving aspirin freely since that time to both pneumonia and typhoid patients, and have had much success in both diseases, but more especially in the former. On looking through the charts of our hospital for the last one and a half years I find seven cases in which I think one can clearly claim that the pneumonic condition was arrested before the time that the usual crisis was due. Our work lies chiefly among the Indian people of the native State of Travancore. Pneumonia in the rainy or colder season is fairly common and runs a typical course, with all the classical symptoms. The crisis sometimes happens on the seventh day, but is frequently delayed till the tenth or even the eleventh day. Herpes on the lip is never seen, but the physical signs and rusty sputum, with the presence of pneumococci in it, are absolutely
pathognomonic. The seven with typical
referred to above were : 1. Female, aged 9, pneumonic consolidation, admitted fifth day. Respirations 48 ; pulse 120. 8 gr. aspirin given. Crisis on sixth day. Respirations fell to 30 and next day to 24. 2. Female, aged 12, admitted second day, with increasing dulness and crepitations. Respirations 38 ; pulse 112. 10 gr. of aspirin given on fourth day. Crisis on fifth day. Respirations fell to 26 ; pulse 84. 3. Female, aged 22, admitted fourth day. Respirations 36 ; pulse 116. Dose of 10 gr. aspirin given or. fourth and fifth days. Crisis on sixth day Respirations 24 ; pulse 92. 4. Male, aged 25, admitted cases
1 See Descent of the Shoulder after Birth, Anatomischer Band xli., 1912.
Anzeiger,
JAMES
DAVIDSON, M.D. Edin.
THE ROYAL NATIONAL HOSPITAL FOR CONSUMPTION FOR IRELAND. To the Editor of THE LANCET. SIR, - With reference to the alarmist statement in the extract from THE LANCET which appeared in the Irish Ti?nes to-day-namely, that "the institution is left without scientific direction" by the resignation of the honorary medical staff, my letter which was published in the same issue will, I trust, show that the public need be under no apprehension on this point. So far from being left without scientific direction, the hospital is in charge of two resident medical officers and of a visiting physician of exceptional scientific and expert qualifications in the treatment of consumption, whose appointment has led to the present crisis. I may point out that the resignation of the consultant physicians, though sincerely deplored by the board, does not in any way affect the "scientific direction" of the hospital, as these gentlemen have never taken an active part in the direction or management, save on the occasion of the meeting of May 26th, 1911, referred to in my letter above mentioned.-I am, Sir, yours faithfully, JOHN R. ORPEN, Honorary Secretary. South Frederick-street, Dublin, March 8th, 1913. ** In the leading article in THE LANCET it was stated that the institution had two resident medical officers, and it was not suggested that these had resigned. We take this opportunity of correcting a slip which occurred in that article. In the fifth line from the bottom of the first column of p. 698 the words "only member " should have beenonly medical member. "-ED. L.
BRIGHTON
AND
HOVE HOSPITAL
FOR
WOMEN
CHILDREN.-One of the oldest medical institutions in Brighton is the Brighton and Hove Hospital for Women and Children, which has carried on its work for a long time in West-street, Brighton. The necessity for larger premises has been much felt, and preparations have been going on with the object of building a new hospital on a site presented by Mr. S. Copestake in D’Avigdor-road, Hove. For various reasons this has not been proceeded with, and in the meantime other new proposals have been brought forward, and on Feb. 25th, at :the annual meeting of the governors, the committee of was empowered to purchase the grammar school premises in Buckingham-road, Brighton, which are becoming vacant in September, for the purposes of the hospital, and, with the permission of Mr. Copestake, to sell the land in D’Avigdor-road. AND
management
THE
fifth day. fell to 26
EXHIBITION OF RAYNAUD’S PHENOMENA.
,
January, 1913.
The subject has, however, developed unexpectedly into one of wide significance, and for further elucidation reference may be made to recent volumes of the Journal of Anatomy and Physiolooy and the Anatomischer Anzeiger. It is especially interesting to read Dr. Ibotson’s account of complete recovery, a termination which is no less surprising than it is gratifying, if the pathological appearances to which I have made reference are to be considered typical of the condition. It is, however, probable that no such advanced changes as I have figured had occurred in Dr. Ibotson’s case. I am, Sir, yours faithfully, T. WINGATE TODD. Anatomical Laboratory, Western Reserve School of Medicine, Cleveland, Ohio, U.S.A., Feb. 27th, 1913.
THE TREATMENT OF PNEUMONIA BY ASPIRIN. To the Editor of THE LANCET. SiR,-Referring to a letter in THE LANCET of June 3rd, 1911, in which Mr. A. Scott, of Brighton, recorded eight successful cases in which 10-15 gr. of aspirin at the outset of an attack of pneumonia had apparently caused the disease to abort, and invited a trial by other members of the profession, I wish to state the following facts. I have been giving aspirin freely since that time to both pneumonia and typhoid patients, and have had much success in both diseases, but more especially in the former. On looking through the charts of our hospital for the last one and a half years I find seven cases in which I think one can clearly claim that the pneumonic condition was arrested before the time that the usual crisis was due. Our work lies chiefly among the Indian people of the native State of Travancore. Pneumonia in the rainy or colder season is fairly common and runs a typical course, with all the classical symptoms. The crisis sometimes happens on the seventh day, but is frequently delayed till the tenth or even the eleventh day. Herpes on the lip is never seen, but the physical signs and rusty sputum, with the presence of pneumococci in it, are absolutely
pathognomonic. The seven with typical
referred to above were : 1. Female, aged 9, pneumonic consolidation, admitted fifth day. Respirations 48 ; pulse 120. 8 gr. aspirin given. Crisis on sixth day. Respirations fell to 30 and next day to 24. 2. Female, aged 12, admitted second day, with increasing dulness and crepitations. Respirations 38 ; pulse 112. 10 gr. of aspirin given on fourth day. Crisis on fifth day. Respirations fell to 26 ; pulse 84. 3. Female, aged 22, admitted fourth day. Respirations 36 ; pulse 116. Dose of 10 gr. aspirin given or. fourth and fifth days. Crisis on sixth day Respirations 24 ; pulse 92. 4. Male, aged 25, admitted cases
1 See Descent of the Shoulder after Birth, Anatomischer Band xli., 1912.
Anzeiger,
JAMES
DAVIDSON, M.D. Edin.
THE ROYAL NATIONAL HOSPITAL FOR CONSUMPTION FOR IRELAND. To the Editor of THE LANCET. SIR, - With reference to the alarmist statement in the extract from THE LANCET which appeared in the Irish Ti?nes to-day-namely, that "the institution is left without scientific direction" by the resignation of the honorary medical staff, my letter which was published in the same issue will, I trust, show that the public need be under no apprehension on this point. So far from being left without scientific direction, the hospital is in charge of two resident medical officers and of a visiting physician of exceptional scientific and expert qualifications in the treatment of consumption, whose appointment has led to the present crisis. I may point out that the resignation of the consultant physicians, though sincerely deplored by the board, does not in any way affect the "scientific direction" of the hospital, as these gentlemen have never taken an active part in the direction or management, save on the occasion of the meeting of May 26th, 1911, referred to in my letter above mentioned.-I am, Sir, yours faithfully, JOHN R. ORPEN, Honorary Secretary. South Frederick-street, Dublin, March 8th, 1913. ** In the leading article in THE LANCET it was stated that the institution had two resident medical officers, and it was not suggested that these had resigned. We take this opportunity of correcting a slip which occurred in that article. In the fifth line from the bottom of the first column of p. 698 the words "only member " should have beenonly medical member. "-ED. L.
BRIGHTON
AND
HOVE HOSPITAL
FOR
WOMEN
CHILDREN.-One of the oldest medical institutions in Brighton is the Brighton and Hove Hospital for Women and Children, which has carried on its work for a long time in West-street, Brighton. The necessity for larger premises has been much felt, and preparations have been going on with the object of building a new hospital on a site presented by Mr. S. Copestake in D’Avigdor-road, Hove. For various reasons this has not been proceeded with, and in the meantime other new proposals have been brought forward, and on Feb. 25th, at :the annual meeting of the governors, the committee of was empowered to purchase the grammar school premises in Buckingham-road, Brighton, which are becoming vacant in September, for the purposes of the hospital, and, with the permission of Mr. Copestake, to sell the land in D’Avigdor-road. AND
management