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TOXIC EFFECTS OF INTRAVENOUS SALYRGAN.
324
thought part of that saving was undoubtedly had partly limited the rapidity with which an insured improved administration and to more effective person could run from one doctor to another. That cooperation between the panel doctors, the regional had been done in the interests of the medical proThe fession, as well as in the interests of the insured medical officers, and the approved societies. last of had continued year during the persons, and the Ministry stood by that action. He improvement first half of this year, and the sickness claims for the was satisfied that in the long run it would be found quarter which had just finished were the lowest for to be in the interests of the medical profession. In any quarter for several years past ; so that the steps connexion with institutional services there was a that had been taken were now beginning to prove conflict of opinion between the doctors and the effective. approved societies. There was a reasonable working In reply to Sir E. Graham-Little, he might say that scheme which, while it did not completely satisfy they had not got rid of the free choice of doctor. They everybody, was working pretty well. but he due to
CORRESPONDENCE of polygraph tracings,
VASCULAR PERISTALSIS.
To the Editor
of THE
LANCET.
SIR,-I was much interested in your reference to book, " The Hearts of Man," in your annotation (p. 254) on Vascular Peristalsis. The book was read by the late Sir James Mackenzie, to whom I had the my
a number of years. He would neither accept nor reject my findings, but agreed with me that no explanation which entirely satisfied him had been given of the so-called dicrotic
honour to be assistant for
all of which were submitted to Sir James Mackenzie. The work of Luisada, to which you refer, certainly seems to lend support to these ideas. I
a,m.
Sir.
vours
faithfullv. R. M. WILSON.
TOXIC EFFECTS OF INTRAVENOUS SALYRGAN.
To the Editor
of THE LANCET.
SIR,-In his article in your issue of July 18th Dr. C. T. Andrews attributes the symptoms observed You say in your annotation : " It is difficult to him in one case immediately following the intraconceive of a peristaltic wave which could travel at by venous injection of salyrgan to the toxic effects of the drug. May I venture to suggest that these symptoms were not due to the salyrgan, but to the intravenous injection, per se, in an individual whose cardiovascular system and water-balance were already very much at fault ? One experiences symptoms of similar nature occasionally after the administration of almost any kind of intravenous injection. Some years ago, when engaged in studying the effect of isotonic, hypertonic, and hypotonic solution upon the waterbalance, I sometimes saw similar effects from small quantities of distilled water. My personal experience with salyrgan dates from its first introduction, and I have never seen any unfavourable results, although I well remember toxic effects, and even death, after novasurol. The symptoms in these cases were those of acute mercurial poisoning. May I mention that I always give salyrgan in its original concenthe same rate as the pulse, while if it did not do tration, without further dilution by distilled waterQ so a pulse tracing should show two different and I am, Sir, yours faithfully, asynchronous waves." It was my contention that O. B. BODE. this is exactly what pulse tracings do show. They show (1) the main wave caused by the contraction of the left ventricle, and (2) smaller waves called dicrotic or post-dicrotic, which, I suggested, are VEHICLES FOR CHEMICAL CONTRACEPTIVES. To the Editor of THE LANCET. really peristaltic waves in the vessel wall and not waves set up by the closure of the aortic valves. Sir,,-The annotation in your issue of August 1st I tried to explain myself by reference to the bowel me to report the progress made since the encourages when is the are where, active, peristalsis sphincters of the article to which you refer. During open in inhibition and where, when the sphincterspublication last few the years, under the auspices of the Birth are active-i.e., shut-peristalsis is inhibited, and Control Committee, I have tested the Investigation would therefore not be seen in a tracing. The heart was recognised by Gaskell as a sphincter, and is spermicidal powers of many foaming tablets and, innervated like the other sphincters. The inner- cocoa-butter suppositories. I have found foaming. vation of the larger arteries seems, on the contrary, tablets the more spermicidal, with both human and to be similar to that of the bowel between the guinea-pig sperms. Now many clinical workers sphincters, until the arterioles are reached, when a consider cocoa-butter suppositories more reliable than similar innervation to that of the heart is encountered. foaming tablets. A few insoluble substances (e.g., I visualised these arterioles, therefore, as so many stearin and paraffin) have been said to be harmful to. " hearts " acting in unison certain micro-organisms and sperms, if placed in the. small sphincters or same dish.l This phenomenon, however, will not. (synchronously) with the heart itself. The accom1 panying diagram illustrates the mechanism. These Drzewina, A., and Bohn, G.: Compt. rend. de l’Acad. des findings were arrived at by a very prolonged study Sci., 1927, clxxxv., 875. waves.
I
thought part of that saving was undoubtedly had partly limited the rapidity with which an insured improved administration and to more effective person could run from one doctor to another. That cooperation between the panel doctors, the regional had been done in the interests of the medical proThe fession, as well as in the interests of the insured medical officers, and the approved societies. last of had continued year during the persons, and the Ministry stood by that action. He improvement first half of this year, and the sickness claims for the was satisfied that in the long run it would be found quarter which had just finished were the lowest for to be in the interests of the medical profession. In any quarter for several years past ; so that the steps connexion with institutional services there was a that had been taken were now beginning to prove conflict of opinion between the doctors and the effective. approved societies. There was a reasonable working In reply to Sir E. Graham-Little, he might say that scheme which, while it did not completely satisfy they had not got rid of the free choice of doctor. They everybody, was working pretty well. but he due to
CORRESPONDENCE of polygraph tracings,
VASCULAR PERISTALSIS.
To the Editor
of THE
LANCET.
SIR,-I was much interested in your reference to book, " The Hearts of Man," in your annotation (p. 254) on Vascular Peristalsis. The book was read by the late Sir James Mackenzie, to whom I had the my
a number of years. He would neither accept nor reject my findings, but agreed with me that no explanation which entirely satisfied him had been given of the so-called dicrotic
honour to be assistant for
all of which were submitted to Sir James Mackenzie. The work of Luisada, to which you refer, certainly seems to lend support to these ideas. I
a,m.
Sir.
vours
faithfullv. R. M. WILSON.
TOXIC EFFECTS OF INTRAVENOUS SALYRGAN.
To the Editor
of THE LANCET.
SIR,-In his article in your issue of July 18th Dr. C. T. Andrews attributes the symptoms observed You say in your annotation : " It is difficult to him in one case immediately following the intraconceive of a peristaltic wave which could travel at by venous injection of salyrgan to the toxic effects of the drug. May I venture to suggest that these symptoms were not due to the salyrgan, but to the intravenous injection, per se, in an individual whose cardiovascular system and water-balance were already very much at fault ? One experiences symptoms of similar nature occasionally after the administration of almost any kind of intravenous injection. Some years ago, when engaged in studying the effect of isotonic, hypertonic, and hypotonic solution upon the waterbalance, I sometimes saw similar effects from small quantities of distilled water. My personal experience with salyrgan dates from its first introduction, and I have never seen any unfavourable results, although I well remember toxic effects, and even death, after novasurol. The symptoms in these cases were those of acute mercurial poisoning. May I mention that I always give salyrgan in its original concenthe same rate as the pulse, while if it did not do tration, without further dilution by distilled waterQ so a pulse tracing should show two different and I am, Sir, yours faithfully, asynchronous waves." It was my contention that O. B. BODE. this is exactly what pulse tracings do show. They show (1) the main wave caused by the contraction of the left ventricle, and (2) smaller waves called dicrotic or post-dicrotic, which, I suggested, are VEHICLES FOR CHEMICAL CONTRACEPTIVES. To the Editor of THE LANCET. really peristaltic waves in the vessel wall and not waves set up by the closure of the aortic valves. Sir,,-The annotation in your issue of August 1st I tried to explain myself by reference to the bowel me to report the progress made since the encourages when is the are where, active, peristalsis sphincters of the article to which you refer. During open in inhibition and where, when the sphincterspublication last few the years, under the auspices of the Birth are active-i.e., shut-peristalsis is inhibited, and Control Committee, I have tested the Investigation would therefore not be seen in a tracing. The heart was recognised by Gaskell as a sphincter, and is spermicidal powers of many foaming tablets and, innervated like the other sphincters. The inner- cocoa-butter suppositories. I have found foaming. vation of the larger arteries seems, on the contrary, tablets the more spermicidal, with both human and to be similar to that of the bowel between the guinea-pig sperms. Now many clinical workers sphincters, until the arterioles are reached, when a consider cocoa-butter suppositories more reliable than similar innervation to that of the heart is encountered. foaming tablets. A few insoluble substances (e.g., I visualised these arterioles, therefore, as so many stearin and paraffin) have been said to be harmful to. " hearts " acting in unison certain micro-organisms and sperms, if placed in the. small sphincters or same dish.l This phenomenon, however, will not. (synchronously) with the heart itself. The accom1 panying diagram illustrates the mechanism. These Drzewina, A., and Bohn, G.: Compt. rend. de l’Acad. des findings were arrived at by a very prolonged study Sci., 1927, clxxxv., 875. waves.
I