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THE WORLD WE LIVE IN
627 THE EDINBURGH PREGNANCY DIAGNOSIS
STATION
To the Editor
of
THE LANCET
a letter sent out as from the Pregnancy Station here to those medical practitioners Diagnosis whom it has served in the past it would appear that the station is closing down in Edinburgh and is reopening in London. Actually this is not so. It is the case that, to my great regret, Dr. Wiesner, to whom is due all the credit for the inception and successful development of the station, is leaving this Institute and is moving to London where he intends to continue his diagnostic and advisory work. But during the past five years the station has become a necessity to many practitioners and accordingly will not be closed. At least it must continue to serve Edinburgh and the East of Scotland and to do this it must serve a much wider area, for its efficiency must be largely determined by its size and this must depend on the number of clients. To ensure efficient running, prompt reliable service, and low charges several thousands of tests must be made annually. Its income must be sufficient to provide skilled medical supervision, an efficient technical staff, smooth routine, and above all sufficient data, for only then can the records possess any considerable scientific value. I have to hope therefore that this laboratory will be used by practitioners from all parts of Great Britain. If the facts were better understood there would of course be room for more diagnostic laboratories than at present exist. It is irritating to recognise that even yet so many practitioners either do not know that there is such a service in most of the larger cities or, knowing, take no advantage of its existence. It should not be necessary to keep repeating that the tests now used yield an accuracy of not less 97 per cent. ; that pregnancy can be recognised as early as 10-14 days after conception ; that the report on any given specimen can be despatched after 24 hours, 48 hours, or 5 days according to the particular test made, and that all that is required is 50 c.cm. of
SIR,-From
morning urine. The interest of this work is not commercial, it is to be found in the unusual and the exceptional; for in these cases is the seed of knowledge which being disclosed will contribute largely to the endocrine therapy of the immediate future. I am, Sir, yours faithfully, F. A. E. CREW. Institute of Animal Genetics, Edinburgh. Sept. 8th.
cultivating one of his most God-like faculties-the creative ingenuity of the engineer. To me Sir Alfred’s address conveyed an impression wholly opposite to that which it seems to have created in your mind, Sir. His view can hardly be styled a " gloomy misconception nor does it appear to be inconsistent with " the plain experiences of life." Science is being prostituted all over the world in the "
service of sectional interests and in order to forward motives hostile to human welfare. The " knaves or fools " have the whip-hand in many places and they constitute a very real danger to civilisation. How 1 comes it that " no naturalist could believe that If your concluding paragraph refers to some technical point in philosophy then I must ask you to allow me to withdraw this criticism ; but if, on the other hand, it refers to the " plain experiences of life " then I feel sure you must have mis-read Sir Alfred Ewing or else hold a view of certain modern tendencies which appears to me wholly opposed to the weight of the evidence. "
I am,
Sir,
yours
faithfully, LOCKHART, M.D.
LEONARD P. Beeston, Notts, Sept. 8th.
*** We take the opportunity of regretting the misprint of Yale for York as the locus of Sir (James) Alfred Ewing’s address two years ago.-ED. L. HYPEREMESIS GRAVIDARUM To the Editor of THE LANCET
SiR,-In support of Dr. Hurst’s view that there is an important functional element in the vomiting of pregnancy, it would perhaps be of interest to two cases. 1. A husband asked
quote
me
to
Park-square West, N.W., Sept. 5th. THE WORLD WE LIVE
see
his wife in the
country. She had lost her first baby from hyperemesis gravidarum ; she was pregnant for the second time and seemed likely to do the same as she was vomiting repeatedly. I saw her and explained things to her that evening and again next morning. Her vomiting ceased and she carried her child to term. 2. A patient of mine went abroad, being pregnant At three months she was vomiting at the time. practically everything and was subsisting (if I remember rightly) on sponge-cake. She was so ill that she returned to England. I saw her and to her the of an presence hysterical element explained in her vomiting, told her to get up and have a good square meal at the Berkeley with a cheery companion She went with her husband and her vomiting ceased’ I am, Sir, yours faithfully, C. H. RIPMAN.
IN
To the Editor
of THE LANCET SiR,-Your leading article in to-day’s
issue on Sir James Jeans’s address to the British Association ends with a paragraph that appears somewhat confused. You state that no naturalist could believe the proposition that man’s control over nature has outstripped his moral control over himself. This proposition you derive from the presidential address at the York meeting of the Association in 1932 when Sir Alfred Ewing stated his belief that man was ethically unprepared for so great a bounty as had been conferred upon him by modern engineering science. He added that this bounty in the hands of knaves or fools might easily wreck our civilisation, but he ended the theme with a declaration that he could not think that man was destined to atrophy through
JOHN KNIGHT, SERJEANT SURGEON
To the Editor
of THE LANCET SiB,—In addition to the interesting account of Mr. Serjeant Surgeon Knight given in your annotation last week, the following extracts from the Calendar of State Papers quoted by Morgan Richards in his " Chronology of Medicine " may be useful to " E. M. C." Grant to Richard Pile, of the office to the King and of first Serjeant Surgeon ; and similar grants to John Knight and Hum. Painter, with annuities of n50 each. 1661, March (? 1662 historical year). Petition of John Knight, Serjeant Surgeon to the King. Having served his Majesty abroad was continued with others in their respective places on the Restoration, received the usual fee belonging to his office for embalming the Duke of
1661, July llth.
of first
Principal Surgeon
STATION
To the Editor
of
THE LANCET
a letter sent out as from the Pregnancy Station here to those medical practitioners Diagnosis whom it has served in the past it would appear that the station is closing down in Edinburgh and is reopening in London. Actually this is not so. It is the case that, to my great regret, Dr. Wiesner, to whom is due all the credit for the inception and successful development of the station, is leaving this Institute and is moving to London where he intends to continue his diagnostic and advisory work. But during the past five years the station has become a necessity to many practitioners and accordingly will not be closed. At least it must continue to serve Edinburgh and the East of Scotland and to do this it must serve a much wider area, for its efficiency must be largely determined by its size and this must depend on the number of clients. To ensure efficient running, prompt reliable service, and low charges several thousands of tests must be made annually. Its income must be sufficient to provide skilled medical supervision, an efficient technical staff, smooth routine, and above all sufficient data, for only then can the records possess any considerable scientific value. I have to hope therefore that this laboratory will be used by practitioners from all parts of Great Britain. If the facts were better understood there would of course be room for more diagnostic laboratories than at present exist. It is irritating to recognise that even yet so many practitioners either do not know that there is such a service in most of the larger cities or, knowing, take no advantage of its existence. It should not be necessary to keep repeating that the tests now used yield an accuracy of not less 97 per cent. ; that pregnancy can be recognised as early as 10-14 days after conception ; that the report on any given specimen can be despatched after 24 hours, 48 hours, or 5 days according to the particular test made, and that all that is required is 50 c.cm. of
SIR,-From
morning urine. The interest of this work is not commercial, it is to be found in the unusual and the exceptional; for in these cases is the seed of knowledge which being disclosed will contribute largely to the endocrine therapy of the immediate future. I am, Sir, yours faithfully, F. A. E. CREW. Institute of Animal Genetics, Edinburgh. Sept. 8th.
cultivating one of his most God-like faculties-the creative ingenuity of the engineer. To me Sir Alfred’s address conveyed an impression wholly opposite to that which it seems to have created in your mind, Sir. His view can hardly be styled a " gloomy misconception nor does it appear to be inconsistent with " the plain experiences of life." Science is being prostituted all over the world in the "
service of sectional interests and in order to forward motives hostile to human welfare. The " knaves or fools " have the whip-hand in many places and they constitute a very real danger to civilisation. How 1 comes it that " no naturalist could believe that If your concluding paragraph refers to some technical point in philosophy then I must ask you to allow me to withdraw this criticism ; but if, on the other hand, it refers to the " plain experiences of life " then I feel sure you must have mis-read Sir Alfred Ewing or else hold a view of certain modern tendencies which appears to me wholly opposed to the weight of the evidence. "
I am,
Sir,
yours
faithfully, LOCKHART, M.D.
LEONARD P. Beeston, Notts, Sept. 8th.
*** We take the opportunity of regretting the misprint of Yale for York as the locus of Sir (James) Alfred Ewing’s address two years ago.-ED. L. HYPEREMESIS GRAVIDARUM To the Editor of THE LANCET
SiR,-In support of Dr. Hurst’s view that there is an important functional element in the vomiting of pregnancy, it would perhaps be of interest to two cases. 1. A husband asked
quote
me
to
Park-square West, N.W., Sept. 5th. THE WORLD WE LIVE
see
his wife in the
country. She had lost her first baby from hyperemesis gravidarum ; she was pregnant for the second time and seemed likely to do the same as she was vomiting repeatedly. I saw her and explained things to her that evening and again next morning. Her vomiting ceased and she carried her child to term. 2. A patient of mine went abroad, being pregnant At three months she was vomiting at the time. practically everything and was subsisting (if I remember rightly) on sponge-cake. She was so ill that she returned to England. I saw her and to her the of an presence hysterical element explained in her vomiting, told her to get up and have a good square meal at the Berkeley with a cheery companion She went with her husband and her vomiting ceased’ I am, Sir, yours faithfully, C. H. RIPMAN.
IN
To the Editor
of THE LANCET SiR,-Your leading article in to-day’s
issue on Sir James Jeans’s address to the British Association ends with a paragraph that appears somewhat confused. You state that no naturalist could believe the proposition that man’s control over nature has outstripped his moral control over himself. This proposition you derive from the presidential address at the York meeting of the Association in 1932 when Sir Alfred Ewing stated his belief that man was ethically unprepared for so great a bounty as had been conferred upon him by modern engineering science. He added that this bounty in the hands of knaves or fools might easily wreck our civilisation, but he ended the theme with a declaration that he could not think that man was destined to atrophy through
JOHN KNIGHT, SERJEANT SURGEON
To the Editor
of THE LANCET SiB,—In addition to the interesting account of Mr. Serjeant Surgeon Knight given in your annotation last week, the following extracts from the Calendar of State Papers quoted by Morgan Richards in his " Chronology of Medicine " may be useful to " E. M. C." Grant to Richard Pile, of the office to the King and of first Serjeant Surgeon ; and similar grants to John Knight and Hum. Painter, with annuities of n50 each. 1661, March (? 1662 historical year). Petition of John Knight, Serjeant Surgeon to the King. Having served his Majesty abroad was continued with others in their respective places on the Restoration, received the usual fee belonging to his office for embalming the Duke of
1661, July llth.
of first
Principal Surgeon