410

Apparently none of the filariæ were alive when excised;at least there is mention only of partly calcifiedspecimens, though this change was not in all casesextensive enough to throw a detectable X ray shadow.In some other cases of elephantiasis reported upon,shadows corresponding to those thrown by calcifiedfilariæ were found in considerable chains. It is clear,then, that numbers of F. bancrofti may lie scatteredin the subcutaneous tissue or strung out in distal

lymphatic vessels. It is also pointed out that evenextensively calcified specimens are hard to detectunless the limb has been so arranged that they lie inits profile. Nevertheless, the belief is expressed inthe paper that since excision from an elephantoidlimb of areas containing living worms has improvedsymptoms, the X ray demonstration of calcifiedfilariaa may aid in localising the attack on the disease.

AN OFFICIAL CORRECTION FROM THE M.R.C.

PENDING a reply from their American house theSandoz Chemical Works, Pharmaceutical Department(5, Wigmore-street, London, W. 1), desire us to publishthe following extract from the Pharmaceutical Journalof Feb. 20th, 1926 :-

PHARMACEUTICAL SOCIETY OF GREAT BRITAIN : THEPHARMACOLOGICAL LABORATORIES.

(Text of a pamphlet which is being supplied to inquirersby the Secretary of the Society, 17, Bloomsbury-square,

London, W.C. 1.)These laboratories are now in a position to test the drugs

and preparations dealt with in detail hereafter.3. Ergot.-Samples of ergot will be accepted to be tested

in the form of the powdered ergot. The Geneva Conferencehas made no recommendations in the matter of ergot. Thechief active substances which may be present in extractsare ergotamine (or ergotoxin), histamine, and tyramine. Itwill be assumed that the therapeutically active substanceis the specific alkaloid ergotamine, and a test for its amountwill be applied to an acid alcoholic extract of the powdereddrug.As standard a sample of ergotamine tartrate is available,prepared by the Sandoz Chemical Works, Basle.jttt The test applied will be the capacity of an acid alcoholicextract prepared from the sample to reverse the action ofadrenaline either on the blood pressure of a pithed cat or onthe isolated uterus of the rabbit. After consultation withthe Director of the Department of Biological Standards,Medical Research Council, it has been decided to approveas good samples of ergot those containing not less than1 mgm. per gram of the specific alkaloid.

INSULIN IN OIL.

IN the treatment of diabetes mellitus the idealtowards which the physician strives is to keep theblood-sugar of the patient within normal limitsthroughout the 24 hours. The attainment of this idealis often prevented because insulin, as usually.administered in aqueous solution, is completelyabsorbed within eight hours of injection. Severalattempts have been made to overcome this difficultyby incorporating insulin with some vehicle whichwill delay the absorption of the hormone. Some18 months ago Dr. 0 Leyton described in these<columns some experiments with a suspension of

powdered insulin in castor oil, in the proportion of100 units to each cubic centimetre. He found thatthe period of absorption was increased to as muchas 16 hours and that correspondingly large doses ofinsulin could be administered in this way withoutprovoking hypoglyc&aelig;mic symptoms. More recently,M. Labbe, R. Boulin, and H. Gouli&eacute; have worked onthe same lines using olive oil containing 20 units ofinsulin per cubic centimetre. They examined 2

1 THE LANCET, 1929, i., 756. 2 Bull. et. m&eacute;m. de la soc. m&eacute;d. des h&ocirc;p. de Paris, July 7th,

p. 1190.

the blood-sugar curve after 20 units of this suspension,and after the same dose of aqueous insulin, but foundlittle difference between the two curves. They alsoobserved that in diabetics on a fixed diet the glycosuriaincreased when the oily preparation was substitutedin similar doses for ordinary insulin. They concludethat oily suspensions of insulin do not retard absorp-tion. The results of most other workers, however,tend to support Leyton’s opposite conclusion,although there is no general agreement concerning thedegree of delay which can be obtained. Apart fromthis question the use of oil as a medium for sub-cutaneous injections is not entirely free from objection.Vegetable oils such as castor oil do not usually exciteany notable inflammatory reaction in the surroundingtissues, but it is often a matter of weeks before theoil is completely absorbed-an obvious objection incircumstances where repeated injections are necessary.

MILK FEVER.

; THE last of this year’s Goulstonian lecturesl on. the significance to clinical medicine of studies incalcium and phosphorus metabolism was concerned

partly with the contribution to therapeutics of theresearches which Dr. Donald Hunter had described.The use of calcium therapy in tetany, lead poisoning,oedema, and acute necroses of the liver was discussedwith reference to human patients, and a brief con-cluding section noted the work of Prof. H. Dryerreand Prof. J. R. Greig2 3 on the milk fever of cows.At the International Veterinary Congress, held inLondon from August 5th to 9th, Prof. Greig gave ahistorical account of the steps whereby the aetiologyof this curious condition has been elucidated.

Milk fever is a disease of sudden onset which attacksmilk cows, producing partial or complete prostrationand paralysis of the hind quarters, sometimes alsoof other parts. Primiparae are rarely affected. The

period of greatest susceptibility in the milking lifeof an individual cow corresponds to the period of

greatest milk secretion. Many hypotheses have fromtime to time been formulated to explain the natureof milk fever. On the theory that the cause was aninfection J. J. Schmidt in 1897 injected into theudders of a series of cases a solution of iodide ofpotassium, which was at that time believed to haveantiseptic properties. The treatment met withremarkable success, and reduced the mortality fromthe disease from 60 or 70 per cent. to 15 per cent.Later a modification, devised by Andersen (Skander-borg) and others, replaced the injection of fluidsby mammary inflation, and to-day the mortalityis less than 1 per cent. But while a specific curefor the disease had been discovered empirically, thecause of milk fever remained a mystery until, in1924, Prof. Dryerre and Prof. Greig began to investi-gate the pathology of the condition, starting withthe fact that specific cure resulted, no matter whetherantiseptic fluids, sterile water, oxygen or air wereinjected into the udder. They decided that simpledistension of the mammae must act either (1) byeliciting some endocrine disturbance, or (2) bymechanically retarding or arresting milk secretion,and so preventing the loss in the milk of some sub-stance vital to the organism. It occurred to themthat the colostrum of the cow is rich in calcium,and that the onset of a profuse lactation mightoccasion a rapid reduction in the concentration ofthe blood calcium. This idea seemed to be supported

1 THE LANCET, 1930, i., 526, 897, 947, 999.2 Vet. Record, 1925, v., 225 ; 1928, viii., 721.

3 Greig, J. R.: Vet. Rec., 1929, ix., 509 ; 1930, x., 115.