of 1 /1
779 the enormous importance of early and sustained treat- ment of venereal disease." The exposition is designed to place before the general practitioner a connected view of the treatment available and to be of use to all concerned in education and propaganda. Such a document, which is expressly confined to the work of the administrative institutions, cannot be criticised because it does not enter into detail on a complicated and difficult question like personal prophylaxis.-ED.L. HELIOTHERAPY IN PULMONARY TUBERCULOSIS. To the Editor of THE LANCET. SIR,-Dr. C. B. Heald in his letter last week under the above heading asks whether, in the experience of your readers, the inverse square law is strictly applicable in the case of ultra-violet rays in clinical use. May I draw his attention to my experimental results in this connexion, reported in detail in THE LANCET of August 22nd, 1925 (p. 369). When the source of ultra-violet rays was a mercury lamp the inverse square law did not apply, since it is not a point-source. Calculations based on this law are thus liable to give variable doses, and might account for anomalous results.-I am, Sir, yours faithfully P. R. PEACOCK SANATORIUM TREATMENT OF TUBERCULOSIS. To the Editor of THE LANCET. SiR,-The fact that the presence or absence of tubercle bacilli has not been taken into consideration by Messrs Stocks and Karn in the grouping of the cases robs this investigation of a great deal of its value. Indeed, it introduces a very serious fallacy. Again, as Dr. ’Valters has pointed out, sanatorium treatment, to be of any permanent value, must be of long duration, certainly at least 12 months. To regard as " sanatorium treated " patients who have been in an institution for 15 days only seems absurd. The cases should be classified as " otherwise treated." But one must admit that sanatorium treatment, especially if it is of short duration, has little or no effect on the ultimate progress of the cases discharged as improved or quiescent only. In them the mental factor comes into play ; the patient loses heart, and with the first set-back he goes downhill rapidly. That is the reason why we prefer to cure one case rather than " patch up " 20, and when institutions are anxious to get " suitable cases " they have this in mind, and not mere statistical considerations as the a.nfhors sne’peRt.—T a.m Sir. vonrs fait,hfnl1v. FELIX SAVY. IS IT COVERING ? To the Editor of THE LANCET. SiR,—Will you kindly give advice on a matter of medical ethics which may be of interest to others of your readers ? A medical practitioner with a diploma entitling him to practise in the British colony in which it is granted, but which is not registrable in Great Britain, takes up a practice in a country where his diploma is registrable and where those on the British Medical Register also may practise. Is there any ethical or legal objection to a man with a registered diploma (in Great Britain) acting as assistant or as partner to the said practitioner ? It is obviously needless for names of persons or places to be mentioned, so I sign myself LATITUDO. ** The essence of covering, as defined in the Warning Notice of the G.M.C., consists in enabling an unqualified or unregistered person to engage in ,professional practice as if he were qualified or regis- tered. The case related by our correspondent does not seem to come within this category, as both parties are legally entitled to practise under the medical aws of the country.-ED. L. LONDON MEDICAL EXHIBITION THIS exhibition opened at the Central Hall, West- minster, London, S.W., on Oct. 4th, and ivill close to-day (Friday), Oct. 8th, at 6.30 P.M. It is perhaps the largest of the series of exhibitions organised by British and Colonial druggists and the attendance has also been large. We give below a brief account of some of the more prominent stalls. DRUGS AND PHARMACEUTICAL PREPARATIONS. ALLEN AND HANBURYS, LTD. (37, Lombard-street, E.C., and 48, Wigmore-street, W.), showed a wide selection of pharmaceutical and dietetic preparations. Among new preparations was an " Acidophilus Culture " which is an improvement on the Acidophilus Jelly, being more stable, and Cellulose Flour for adding " bulk " material to diabetic preparations. Special attention was called to the Azoule Vacuum Extractors designed for taking samples of blood under conditions of sterility, and also to a stable form of sodium tetrabromphenolphthalein for X ray diagnosis of diseases of the gall-bladder. Prominence was also given to a toilet preparation, Odontase, a pleasant non-acid deodorant and germicidal dental cream, having for its basis magnesium hydroxide.—OppEN- HEIMER, SON AND Co. (179, Queen Victoria-street, E.C.) exhibited in large variety their Bi-palatinoids and Palatinoids as well as Roboleine, a vitamin preparation, and a selection of various preparations for colloidal therapy.-BuRROUGHS WELLCOME AND Co. (Snow Hill Buildings, E.C.). At this stall a wide range of products were exhibited. Grouped alongside photographs of the highly-magnified organisms responsible for certain diseases there were appropriate medicaments for dealing with the disorders, together with a selection of " Soloid " Microscopic Stains. A full range of " Tabloid " Animal Substances was shown, including " Tabloid " Thyroid Gland, " Tab- loid " Mixed Glands, and Tabloid " Parathyroid Gland. Attention was called to the Bismuth Salts of the firm, for which an exceptionally high standard of purity and physical and chemical uniformity is claimed. New drugs are " Avenyl " (a mercurial preparation soluble in hydnocarpus oil) and "Neostam." The former has been evolved for dealing with cases of syphilis complicated with leprosy. " Neostam " Stibamine Glucoside has been found of service in kala-azar, and in other conditions where tartar emetic has hitherto been used.—W. MARTIN- DALE (10, New Cavendish-street, W.). The following were prominently displayed : Methyl-Aspriodine, a new compound, containing the equivalent of 56-3 per cent. aspirin and 39-7 per cent. iodine, for inunction in rheumatic affections and as a local analgesic. " Auremetine," indicated in amoebic dysentery, being a combination of emetine, auramine, and iodine. " Mercurome," a valuable and potent anti- septic, of value in cystitis, pyelitis, and gonorrhoea. Aspriodine," a compound combining the thera- peutic properties of aspirin and iodine in stable combination, is said to be of value in rheumatic affections and arterio-sclerosis and wherever iodides have proved beneficial, being supplied in cachets or tablets. " Sedasprin " is the bromine analogue of aspriodine. ENDOCRINES, LTD. (72, Wigmore-street, W.). At this stall there were exhibited a large number of glandular preparations, particular prominence being given to Anabolin and Hepatic Extract. The first- named is in tablet form for administration per os, and has been found active in some 70 per cent. of the cases in which it has been used. Hepatic Extract, which is available in ampoule form for intramuscular injection, is said to have a pri found influence on blood pressure and it is stated that clinical experience has shown that in the average case of functional high blood pressure the intramuscular injection of 1 c.cm. of the extract results in a reduction of from 30 to 50 mm. during the first day.-G. W. CARNRiCK

IS IT COVERING ?

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779

the enormous importance of early and sustained treat-ment of venereal disease." The exposition is designedto place before the general practitioner a connectedview of the treatment available and to be of use toall concerned in education and propaganda. Sucha document, which is expressly confined to the workof the administrative institutions, cannot be criticisedbecause it does not enter into detail on a complicatedand difficult question like personal prophylaxis.-ED.L.

HELIOTHERAPY IN PULMONARYTUBERCULOSIS.

To the Editor of THE LANCET.SIR,-Dr. C. B. Heald in his letter last week under

the above heading asks whether, in the experienceof your readers, the inverse square law is strictlyapplicable in the case of ultra-violet rays in clinicaluse. May I draw his attention to my experimentalresults in this connexion, reported in detail in THELANCET of August 22nd, 1925 (p. 369). When the

source of ultra-violet rays was a mercury lamp theinverse square law did not apply, since it is not a

point-source. Calculations based on this law are

thus liable to give variable doses, and might accountfor anomalous results.-I am, Sir, yours faithfully

P. R. PEACOCK

SANATORIUM TREATMENT OFTUBERCULOSIS.

To the Editor of THE LANCET.SiR,-The fact that the presence or absence of

tubercle bacilli has not been taken into considerationby Messrs Stocks and Karn in the grouping of thecases robs this investigation of a great deal of itsvalue. Indeed, it introduces a very serious fallacy.Again, as Dr. ’Valters has pointed out, sanatoriumtreatment, to be of any permanent value, must beof long duration, certainly at least 12 months. Toregard as

" sanatorium treated " patients who havebeen in an institution for 15 days only seems absurd.The cases should be classified as " otherwise treated."But one must admit that sanatorium treatment,

especially if it is of short duration, has little or noeffect on the ultimate progress of the cases dischargedas improved or quiescent only. In them the mentalfactor comes into play ; the patient loses heart, andwith the first set-back he goes downhill rapidly. Thatis the reason why we prefer to cure one case ratherthan " patch up " 20, and when institutions are

anxious to get " suitable cases " they have this inmind, and not mere statistical considerations as thea.nfhors sne’peRt.—T a.m Sir. vonrs fait,hfnl1v.

FELIX SAVY.

IS IT COVERING ?To the Editor of THE LANCET.

SiR,—Will you kindly give advice on a matter ofmedical ethics which may be of interest to othersof your readers ? A medical practitioner with a

diploma entitling him to practise in the Britishcolony in which it is granted, but which is notregistrable in Great Britain, takes up a practice ina country where his diploma is registrable and wherethose on the British Medical Register also maypractise. Is there any ethical or legal objection toa man with a registered diploma (in Great Britain)acting as assistant or as partner to the saidpractitioner ? It is obviously needless for namesof persons or places to be mentioned, so Isign myself LATITUDO.** The essence of covering, as defined in the

Warning Notice of the G.M.C., consists in enablingan unqualified or unregistered person to engage in,professional practice as if he were qualified or regis-tered. The case related by our correspondent doesnot seem to come within this category, as both partiesare legally entitled to practise under the medicalaws of the country.-ED. L.

LONDON MEDICAL EXHIBITION

THIS exhibition opened at the Central Hall, West-minster, London, S.W., on Oct. 4th, and ivill closeto-day (Friday), Oct. 8th, at 6.30 P.M. It is perhapsthe largest of the series of exhibitions organised byBritish and Colonial druggists and the attendancehas also been large. We give below a brief accountof some of the more prominent stalls.

DRUGS AND PHARMACEUTICAL PREPARATIONS.

ALLEN AND HANBURYS, LTD. (37, Lombard-street,E.C., and 48, Wigmore-street, W.), showed a wideselection of pharmaceutical and dietetic preparations.Among new preparations was an " AcidophilusCulture " which is an improvement on the AcidophilusJelly, being more stable, and Cellulose Flour foradding " bulk " material to diabetic preparations.Special attention was called to the Azoule VacuumExtractors designed for taking samples of blood underconditions of sterility, and also to a stable form ofsodium tetrabromphenolphthalein for X ray diagnosisof diseases of the gall-bladder. Prominence was alsogiven to a toilet preparation, Odontase, a pleasantnon-acid deodorant and germicidal dental cream,having for its basis magnesium hydroxide.—OppEN-HEIMER, SON AND Co. (179, Queen Victoria-street,E.C.) exhibited in large variety their Bi-palatinoidsand Palatinoids as well as Roboleine, a vitaminpreparation, and a selection of various preparationsfor colloidal therapy.-BuRROUGHS WELLCOME ANDCo. (Snow Hill Buildings, E.C.). At this stall a widerange of products were exhibited. Grouped alongsidephotographs of the highly-magnified organismsresponsible for certain diseases there were appropriatemedicaments for dealing with the disorders, togetherwith a selection of " Soloid " Microscopic Stains.A full range of

" Tabloid " Animal Substances wasshown, including " Tabloid " Thyroid Gland, " Tab-loid " Mixed Glands, and Tabloid " ParathyroidGland. Attention was called to the Bismuth Salts ofthe firm, for which an exceptionally high standard ofpurity and physical and chemical uniformity isclaimed. New drugs are

" Avenyl " (a mercurialpreparation soluble in hydnocarpus oil) and"Neostam." The former has been evolved for dealingwith cases of syphilis complicated with leprosy." Neostam " Stibamine Glucoside has been found ofservice in kala-azar, and in other conditions wheretartar emetic has hitherto been used.—W. MARTIN-DALE (10, New Cavendish-street, W.). The followingwere prominently displayed : Methyl-Aspriodine, anew compound, containing the equivalent of 56-3 percent. aspirin and 39-7 per cent. iodine, for inunctionin rheumatic affections and as a local analgesic." Auremetine," indicated in amoebic dysentery,being a combination of emetine, auramine, andiodine. " Mercurome," a valuable and potent anti-septic, of value in cystitis, pyelitis, and gonorrhoea.Aspriodine," a compound combining the thera-peutic properties of aspirin and iodine in stablecombination, is said to be of value in rheumaticaffections and arterio-sclerosis and wherever iodideshave proved beneficial, being supplied in cachets ortablets. " Sedasprin " is the bromine analogue ofaspriodine.ENDOCRINES, LTD. (72, Wigmore-street, W.). At

this stall there were exhibited a large number ofglandular preparations, particular prominence beinggiven to Anabolin and Hepatic Extract. The first-named is in tablet form for administration per os,and has been found active in some 70 per cent. of thecases in which it has been used. Hepatic Extract,which is available in ampoule form for intramuscularinjection, is said to have a pri found influence on bloodpressure and it is stated that clinical experiencehas shown that in the average case of functionalhigh blood pressure the intramuscular injection of1 c.cm. of the extract results in a reduction of from30 to 50 mm. during the first day.-G. W. CARNRiCK