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VITAMIN C FROM PARSLEY
130
Annotations VITAMIN
C
FROM
PARSLEY
WATERCRESS, usually looked upon
as
the best of the
salad
vegetables as a source of vitamin C, is far surpassed by parsley, for Morgan1 has found an average of just short of 280 mg. of ascorbic acid per 100 g. in nine samples of parsley leaves gathered in Cambridge this spring, whereas Olliver gives 61 mg. per 100 g. as the average figure for watercress. Morgan therefore advocates a much greater consumption of parsley and rightly says it easy and a decorative crop to grow in the it is available all the year round, Moreover garden. though it remains to be seen whether the vitamin content is as large in winter. On Morgan’s findings 60 mg. of ascorbic acid-the optimal daily requirement for a 11I stone adult-would be contained in about 4oz. of parsley, a large handful, but no-one would suggest taking the whole of their vitamin in this form. It will be best to eat the fresh leaves, either in a salad or sandwiches, though Morgan found no loss of vitamin from keeping them in water for two days. Chopping with a sharp stainless-steel knife reduces the ascorbic-acid content by 20%. Morgan gives a recipe for parsley lemonade. An ounce of picked leaves are pressed down in a jug,’:, a pint of boiling water is poured on and allowed to stand for 2 minutes, and the whole is then squeezed through muslin or calico. This produces a cloudy, lemon-yellow infusion containing 40-56 mg. of ascorbic acid (equivalent to the juice of an average orange) and tasting only slightly of parsley. It can be flavoured with, for example, one of the lemon substitutes.
is both
, .
an
NUFFIELD RESEARCH AT OXFORD IN view of the
‘
founding of the new Nuffield chair in social medicine, it is timely to recall the other Nuffield foundations at Oxford. The old observatory, with its perfect lines and bland windos, houses the Nunield Institute of Medical Research where Prof. J. A. Gunn, the director, carries on his research in pharmacology and Dr. A. E. Barclay, Sir Joseph Barcroft and Dr. K. J. Franklin are continuing their study of the circulation by X-ray cinema. Apart from the institute, four of the Nuffield research departments-medicine under Prof. L. J. Witts, neurosurgery under Prof. H. W. B. Cairns, obstetrics and gynaecology under Prof. J. Chassar Moir, and anaesthetics under Prof. R. R. Macintosh-are associated with the Radcliffe Infirmary; the department of orthopaedics, under Prof.H. J. Seddon,is at the WingfieldMorris Hospital. The departments of neurosurgery and of gynaecology and obstetrics occupy new blocks of buildings, attached to the infirmary, with good wards, theatres, offices and equipment. Medicine, anaesthetics and clinical biochemistry share temporary buildings for their laboratories and treat patients in pre-existing wards and theatres of the Radcliffe Infirmary. Hopes of new quarters have naturally been suspended by the The department of neurosurgery is closely linked war. with the Services through the hospital at St. Hugh’s College and the combined research on head injuries ; and the department of orthopaedic surgery is acting as one of the special centres for the study of nerve injuries. The work of the research departments has been much affected by other war-time changes. It was intended that they should serve as training grounds for experts capable of taking up appointments elsewhere, and in this respect they have more than fulfilled their obligations, for each -department has released a large share of its personnel to the Services. For young research teams (the departments were only started in 1937) this has been a heavy loss ; and, owing to the decision of the university to extend the education of medical students to cover the clinical years, the departments have had to undertake 1. Morgan, E. J. Nature, Lond. July 18, 1942, p. 92.
teaching responsibilities unforeseen a,t the time of their foundation. The principle that a university should undertake the training of students while maintaining research is, of course, an old and good one ; but the double obligation has perhaps fallen rather hardly on these young departments, founded primarily for research alone. The scheme for giving a complete clinical was begun as a war-time measure, and training at Oxford may perhaps end with the war ; on the other hand it is a plan of such promise that if it can be thoroughly developed many would wish it to survive. Should it become permanent it seems that the position of the Nuffield departments will have to be considered afresh. If they are to be pre-eminently research departments, the research beams must be released from those more exacting aspects of teaching which could be delegated to a less specialised staff ; to train experts, however, will remain a natural function of the departments and one which they will be ready enough to fulfil. SUCTION DRAINAGE OF TUBERCULOUS CAVITIES THE distension type of tuberculous cavity in the lung has proved singularly resistant to collapse therapy. The work of Caryllos and his colleagues, extending over the last decade, has shown that these cavities depend on a check-valve mechanism in the supply bronchus, due either to kinking or to tuberculous disease. The partial obstruction allows air to enter but prevents its exit, and so leads to the formation of a very large cavity. Secretions collect in it and atelectatic lung tissue, capable of reinflation, forms the wall. The insertion of needles and even tubes into such cavities is not novel; in England, Pearsonhas studied cavity pressures by such methods for many years ; but it is only recently that Monaldi and others in Italy have devised a method for the successful drainage of these cavities. This closed suction method was discussed at a meeting of the Tuberculosis Association at Oxford on July 3. Mr. T. Holmes Sellors outlined the technique of the operation. For success, the layers of the pleura must be adherent If a space is found when a over the cavity to be drained. is needle pneumothorax introduced some air is injected followed later by a sclerosing solution such as auri et sodii thiosulphas (BPC), silver nitrate or the patient’s own blood. As soon as the layers are firmly fused the site of the cavity is determined by screening the patient in the exact position that he will occupy on the operating table, and the chosen point of entry marked. The risk to the operator’s hands is too great for the operation to be performed under the screen. The chest wall is locally anaesthetised and a fine trocar and cannula are inserted into the cavity, the correct depth being ascertained by manometric readings. The anterior approach is preferred and healthy lung tissue can be traversed without risk. As soon as the cavity has been reached the trocar is withdrawn and a bariumloaded catheter with multiple side-eyes is threaded into the cavity and allowed to coil up within it. The cannula, is removed and the tube attached to a suction Suction is maintained at 3-5 mm. Hg conpump. tinuously from the first post-operative day onwards for weeks or months. An apparatus for suction drainage easily composed of materials to hand by anyone who can use a soldering iron has been described in our columns by Mr. Arthur Edmunds.2 -The tube in the cavity is gradually withdrawn under serial X-ray control. Mr. Sellors finds that in favourable cases the sputum and secretions become negative for tubercle bacilli, and at the finish the size of the residual cavity, which may have been reduced to a mere fistulous track, can be estimated radiographically by running in some opaque oil through the catheter. Sellors’s results in his first 41 cases are : cavity completely closed in 6 cases ; considerable reduction in the size of the cavity in 27 ; no appreciable diminution in size in 8 cases ; 3 patients died during the 1. See Lancet 1941, i, 825. 2. Ibid, 1941, ii, 235.
Annotations VITAMIN
C
FROM
PARSLEY
WATERCRESS, usually looked upon
as
the best of the
salad
vegetables as a source of vitamin C, is far surpassed by parsley, for Morgan1 has found an average of just short of 280 mg. of ascorbic acid per 100 g. in nine samples of parsley leaves gathered in Cambridge this spring, whereas Olliver gives 61 mg. per 100 g. as the average figure for watercress. Morgan therefore advocates a much greater consumption of parsley and rightly says it easy and a decorative crop to grow in the it is available all the year round, Moreover garden. though it remains to be seen whether the vitamin content is as large in winter. On Morgan’s findings 60 mg. of ascorbic acid-the optimal daily requirement for a 11I stone adult-would be contained in about 4oz. of parsley, a large handful, but no-one would suggest taking the whole of their vitamin in this form. It will be best to eat the fresh leaves, either in a salad or sandwiches, though Morgan found no loss of vitamin from keeping them in water for two days. Chopping with a sharp stainless-steel knife reduces the ascorbic-acid content by 20%. Morgan gives a recipe for parsley lemonade. An ounce of picked leaves are pressed down in a jug,’:, a pint of boiling water is poured on and allowed to stand for 2 minutes, and the whole is then squeezed through muslin or calico. This produces a cloudy, lemon-yellow infusion containing 40-56 mg. of ascorbic acid (equivalent to the juice of an average orange) and tasting only slightly of parsley. It can be flavoured with, for example, one of the lemon substitutes.
is both
, .
an
NUFFIELD RESEARCH AT OXFORD IN view of the
‘
founding of the new Nuffield chair in social medicine, it is timely to recall the other Nuffield foundations at Oxford. The old observatory, with its perfect lines and bland windos, houses the Nunield Institute of Medical Research where Prof. J. A. Gunn, the director, carries on his research in pharmacology and Dr. A. E. Barclay, Sir Joseph Barcroft and Dr. K. J. Franklin are continuing their study of the circulation by X-ray cinema. Apart from the institute, four of the Nuffield research departments-medicine under Prof. L. J. Witts, neurosurgery under Prof. H. W. B. Cairns, obstetrics and gynaecology under Prof. J. Chassar Moir, and anaesthetics under Prof. R. R. Macintosh-are associated with the Radcliffe Infirmary; the department of orthopaedics, under Prof.H. J. Seddon,is at the WingfieldMorris Hospital. The departments of neurosurgery and of gynaecology and obstetrics occupy new blocks of buildings, attached to the infirmary, with good wards, theatres, offices and equipment. Medicine, anaesthetics and clinical biochemistry share temporary buildings for their laboratories and treat patients in pre-existing wards and theatres of the Radcliffe Infirmary. Hopes of new quarters have naturally been suspended by the The department of neurosurgery is closely linked war. with the Services through the hospital at St. Hugh’s College and the combined research on head injuries ; and the department of orthopaedic surgery is acting as one of the special centres for the study of nerve injuries. The work of the research departments has been much affected by other war-time changes. It was intended that they should serve as training grounds for experts capable of taking up appointments elsewhere, and in this respect they have more than fulfilled their obligations, for each -department has released a large share of its personnel to the Services. For young research teams (the departments were only started in 1937) this has been a heavy loss ; and, owing to the decision of the university to extend the education of medical students to cover the clinical years, the departments have had to undertake 1. Morgan, E. J. Nature, Lond. July 18, 1942, p. 92.
teaching responsibilities unforeseen a,t the time of their foundation. The principle that a university should undertake the training of students while maintaining research is, of course, an old and good one ; but the double obligation has perhaps fallen rather hardly on these young departments, founded primarily for research alone. The scheme for giving a complete clinical was begun as a war-time measure, and training at Oxford may perhaps end with the war ; on the other hand it is a plan of such promise that if it can be thoroughly developed many would wish it to survive. Should it become permanent it seems that the position of the Nuffield departments will have to be considered afresh. If they are to be pre-eminently research departments, the research beams must be released from those more exacting aspects of teaching which could be delegated to a less specialised staff ; to train experts, however, will remain a natural function of the departments and one which they will be ready enough to fulfil. SUCTION DRAINAGE OF TUBERCULOUS CAVITIES THE distension type of tuberculous cavity in the lung has proved singularly resistant to collapse therapy. The work of Caryllos and his colleagues, extending over the last decade, has shown that these cavities depend on a check-valve mechanism in the supply bronchus, due either to kinking or to tuberculous disease. The partial obstruction allows air to enter but prevents its exit, and so leads to the formation of a very large cavity. Secretions collect in it and atelectatic lung tissue, capable of reinflation, forms the wall. The insertion of needles and even tubes into such cavities is not novel; in England, Pearsonhas studied cavity pressures by such methods for many years ; but it is only recently that Monaldi and others in Italy have devised a method for the successful drainage of these cavities. This closed suction method was discussed at a meeting of the Tuberculosis Association at Oxford on July 3. Mr. T. Holmes Sellors outlined the technique of the operation. For success, the layers of the pleura must be adherent If a space is found when a over the cavity to be drained. is needle pneumothorax introduced some air is injected followed later by a sclerosing solution such as auri et sodii thiosulphas (BPC), silver nitrate or the patient’s own blood. As soon as the layers are firmly fused the site of the cavity is determined by screening the patient in the exact position that he will occupy on the operating table, and the chosen point of entry marked. The risk to the operator’s hands is too great for the operation to be performed under the screen. The chest wall is locally anaesthetised and a fine trocar and cannula are inserted into the cavity, the correct depth being ascertained by manometric readings. The anterior approach is preferred and healthy lung tissue can be traversed without risk. As soon as the cavity has been reached the trocar is withdrawn and a bariumloaded catheter with multiple side-eyes is threaded into the cavity and allowed to coil up within it. The cannula, is removed and the tube attached to a suction Suction is maintained at 3-5 mm. Hg conpump. tinuously from the first post-operative day onwards for weeks or months. An apparatus for suction drainage easily composed of materials to hand by anyone who can use a soldering iron has been described in our columns by Mr. Arthur Edmunds.2 -The tube in the cavity is gradually withdrawn under serial X-ray control. Mr. Sellors finds that in favourable cases the sputum and secretions become negative for tubercle bacilli, and at the finish the size of the residual cavity, which may have been reduced to a mere fistulous track, can be estimated radiographically by running in some opaque oil through the catheter. Sellors’s results in his first 41 cases are : cavity completely closed in 6 cases ; considerable reduction in the size of the cavity in 27 ; no appreciable diminution in size in 8 cases ; 3 patients died during the 1. See Lancet 1941, i, 825. 2. Ibid, 1941, ii, 235.