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TREATMENT OF THE COMMON COLD
116
CORRESPONDENCE OVER-ACTIVITY OF THE POSTERIOR PITUITARY
To the Editor
of
THE LANCET
SiR,—I should like, if I may, to call the attention of Dr. E. Idris Jones to the work carried out by Libman and myself on the influence of posterior pituitary extracts on carbohydrate metabolism, for our experimental observations in man appear to corroborate his findings in the case he reported in your last issue as " a new syndrome due to over-activity of the posterior pituitary." In discussing carbohydrate metabolism and the pituitary gland he writes, " The relation of the posterior lobe extract (Pituitrin) to carbohydrate somewhat disputed." Libman and metabolism is I (Quart. J. Med. 1936, n.s. 5, 169) showed that subcutaneous injections of posterior pituitary extracts, even if repeated at half-hourly intervals for two or three doses, were without any appreciable effect on the blood-sugar ; but if 50 g. of glucose be given and at the same time, or shortly afterwards, 0.5-1.0 c.cm. of pituitrin is injected subcutaneously, instead of the normal glucose-tolerance curve resulting sustained hyperglycaemia follows. We showed a later (Ibid, 1937, n.s. 6, 157) that posterior pituitary extracts antagonised the action of insulin by retarding the peripheral utilisation of the blood-sugar. Dr. Idris Jones’s patient showed but a very slightly raised fasting blood-sugar. After taking 50 g. of glucose he had a sustained hyperglycsemia. If the subcutaneous injection of 0’5-l’0 c.cm. of pituitrin in the fasting state were followed by no constant or appreciable rise in the blood-sugar, he would conform fully to our experimental findings in man and additional confirmation would be afforded of Dr. Idris Jones’s suggestion that the clinical findings in his patient are the expression of overactivity of the posterior pituitary. I am, Sir, yours faithfully, HENRY COHEN. ...
TREATMENT OF THE COMMON COLD
To the Editor
of
THE LANCET
article in last that the common cold primarily to a virus with secondary catarrhal infection. A personal experience some years ago lends colour to this view. A cold was running through the house of a family of five persons and I took postnasal cultures with a guarded West swab. Each member of the family had a different microbe. It would be easy to explain this otherwise surprising result on the virus hypothesis. As quinine is said to be of value in aborting virus disease, I have recently taken five grains whenever I have felt the early tickle of a cold and, if it has not gone in an hour, another five grains. So far this has been successful. In addition to the quinine, I have as a rule used a nasal preparation containing a vegetable oil as the excipient instead of liquid paraffin. This brings me to another point : the use of a mineral oil for local treatment of the nose. I believe the constant instillation of liquid paraffin to be dangerous, as it is so easy to allow some of this bland and soothing mixture to trickle down the pharynx and enter the trachea, and this not only in infants, on which as a cause of pneumonia you have lately commented (Lancet, 1937, 1, 1239), but also in adults. It is not perhaps realised
SIR,-Referring
week’s is due
issue, it
to your
seems
likely
leading
that a mineral oil is not absorbed and therefore remains in the lung. I am credibly informed that in a recent post-mortem 150 c.cm. of liquid paraffin was discovered in the lungs as the result of two years’ use of a nasal oil. I am, Sir, yours faithfully, H. WARREN CROWE. ELECTRICAL
INTERFERENCE IN CARDIOGRAPHY
To the Editor
of
ELECTRO-
THE LANCET
5,,-I have been advised by the Cambridge Instrument Co. that the use of the instrument to patient earthing lead, that I suggested in your issue of Nov. 27th last, is not without risk when using the Standard instrument as it is constructed at present. There is a possibility of inadvertently switching the patient on to the main supply. This risk does not apply to the Portable model with which it may be used with impunity. In my letter I referred only to the Portable model, but I think it is desirable to ask you to issue this warning for the benefit of those who use the Standard model. I am, Sir, yours faithfully, PAUL C. GIBSON. "DIET AND HIGH BLOOD PRESSURE"
To the Editor
of
THE LANCET
SIR,-Kindly allow me to comment on the review of this book in THE LANCET of Dec. 25th. This volume was written for the non-medical reader. It is however based on an inquiry in which strictly scientific methods unusual in clinical medicine were used, the result of which has been published by the Oxford University Press under the title " High Blood Pressure." (The hypothesis at the end of the book must not be confused with the conclusions drawn from the purely experimental work.) We. all know it is difficult to upset current beliefs, however slender the evidence on which they are based. This is particularly regrettable in this instance, because the volume contains an account of a method of treatment of hypertony which is the only one I know which materially prolongs the lives of sufferers from this malady. I would suggest that my colleagues, instead of expressing doubt for no particular reason, repeat my experiments and observe clinically cases under strict scientific control, as I am doing. Those of your readers who have studied the facts as elucidated by the volume mentioned above without bias will easily convince themselves that the conclusions are based on overwhelming evidence. I am, Sir, yours faithfully, I. HARRIS. .
ROYAL SANITARY INSTITUTE. The institute has arranged for a discussion on the national campaign for physical fitness to take place in the town hall, Darlington, on Friday, Jan. 21st, at 4.45 P.M. The discussion will be opened by Dr. G. A. Dawson, medical officer of health for Darlington. Dr. W. E. Orchard will describe the place of social hygiene, Dr. Isabel Brown the school medical services, and Dr. W. W. Forsyth the r6le of the general practitioner. On Saturday morning the members present will see a colour film of Darlington’s health services, after which they will visit -
the health centre, the fever
school.
hospital,
and
an
elementary
CORRESPONDENCE OVER-ACTIVITY OF THE POSTERIOR PITUITARY
To the Editor
of
THE LANCET
SiR,—I should like, if I may, to call the attention of Dr. E. Idris Jones to the work carried out by Libman and myself on the influence of posterior pituitary extracts on carbohydrate metabolism, for our experimental observations in man appear to corroborate his findings in the case he reported in your last issue as " a new syndrome due to over-activity of the posterior pituitary." In discussing carbohydrate metabolism and the pituitary gland he writes, " The relation of the posterior lobe extract (Pituitrin) to carbohydrate somewhat disputed." Libman and metabolism is I (Quart. J. Med. 1936, n.s. 5, 169) showed that subcutaneous injections of posterior pituitary extracts, even if repeated at half-hourly intervals for two or three doses, were without any appreciable effect on the blood-sugar ; but if 50 g. of glucose be given and at the same time, or shortly afterwards, 0.5-1.0 c.cm. of pituitrin is injected subcutaneously, instead of the normal glucose-tolerance curve resulting sustained hyperglycaemia follows. We showed a later (Ibid, 1937, n.s. 6, 157) that posterior pituitary extracts antagonised the action of insulin by retarding the peripheral utilisation of the blood-sugar. Dr. Idris Jones’s patient showed but a very slightly raised fasting blood-sugar. After taking 50 g. of glucose he had a sustained hyperglycsemia. If the subcutaneous injection of 0’5-l’0 c.cm. of pituitrin in the fasting state were followed by no constant or appreciable rise in the blood-sugar, he would conform fully to our experimental findings in man and additional confirmation would be afforded of Dr. Idris Jones’s suggestion that the clinical findings in his patient are the expression of overactivity of the posterior pituitary. I am, Sir, yours faithfully, HENRY COHEN. ...
TREATMENT OF THE COMMON COLD
To the Editor
of
THE LANCET
article in last that the common cold primarily to a virus with secondary catarrhal infection. A personal experience some years ago lends colour to this view. A cold was running through the house of a family of five persons and I took postnasal cultures with a guarded West swab. Each member of the family had a different microbe. It would be easy to explain this otherwise surprising result on the virus hypothesis. As quinine is said to be of value in aborting virus disease, I have recently taken five grains whenever I have felt the early tickle of a cold and, if it has not gone in an hour, another five grains. So far this has been successful. In addition to the quinine, I have as a rule used a nasal preparation containing a vegetable oil as the excipient instead of liquid paraffin. This brings me to another point : the use of a mineral oil for local treatment of the nose. I believe the constant instillation of liquid paraffin to be dangerous, as it is so easy to allow some of this bland and soothing mixture to trickle down the pharynx and enter the trachea, and this not only in infants, on which as a cause of pneumonia you have lately commented (Lancet, 1937, 1, 1239), but also in adults. It is not perhaps realised
SIR,-Referring
week’s is due
issue, it
to your
seems
likely
leading
that a mineral oil is not absorbed and therefore remains in the lung. I am credibly informed that in a recent post-mortem 150 c.cm. of liquid paraffin was discovered in the lungs as the result of two years’ use of a nasal oil. I am, Sir, yours faithfully, H. WARREN CROWE. ELECTRICAL
INTERFERENCE IN CARDIOGRAPHY
To the Editor
of
ELECTRO-
THE LANCET
5,,-I have been advised by the Cambridge Instrument Co. that the use of the instrument to patient earthing lead, that I suggested in your issue of Nov. 27th last, is not without risk when using the Standard instrument as it is constructed at present. There is a possibility of inadvertently switching the patient on to the main supply. This risk does not apply to the Portable model with which it may be used with impunity. In my letter I referred only to the Portable model, but I think it is desirable to ask you to issue this warning for the benefit of those who use the Standard model. I am, Sir, yours faithfully, PAUL C. GIBSON. "DIET AND HIGH BLOOD PRESSURE"
To the Editor
of
THE LANCET
SIR,-Kindly allow me to comment on the review of this book in THE LANCET of Dec. 25th. This volume was written for the non-medical reader. It is however based on an inquiry in which strictly scientific methods unusual in clinical medicine were used, the result of which has been published by the Oxford University Press under the title " High Blood Pressure." (The hypothesis at the end of the book must not be confused with the conclusions drawn from the purely experimental work.) We. all know it is difficult to upset current beliefs, however slender the evidence on which they are based. This is particularly regrettable in this instance, because the volume contains an account of a method of treatment of hypertony which is the only one I know which materially prolongs the lives of sufferers from this malady. I would suggest that my colleagues, instead of expressing doubt for no particular reason, repeat my experiments and observe clinically cases under strict scientific control, as I am doing. Those of your readers who have studied the facts as elucidated by the volume mentioned above without bias will easily convince themselves that the conclusions are based on overwhelming evidence. I am, Sir, yours faithfully, I. HARRIS. .
ROYAL SANITARY INSTITUTE. The institute has arranged for a discussion on the national campaign for physical fitness to take place in the town hall, Darlington, on Friday, Jan. 21st, at 4.45 P.M. The discussion will be opened by Dr. G. A. Dawson, medical officer of health for Darlington. Dr. W. E. Orchard will describe the place of social hygiene, Dr. Isabel Brown the school medical services, and Dr. W. W. Forsyth the r6le of the general practitioner. On Saturday morning the members present will see a colour film of Darlington’s health services, after which they will visit -
the health centre, the fever
school.
hospital,
and
an
elementary