1
604 ANNOTATIONS THE NATIONAL LARDER THE storage of food may have been the beginning of capitalism, but certainly, under Joseph of Egypt, it was the beginning of state socialism. And today, several thousand years later, we have the Department of Scientific and Industrial Research stepping in to advise food importers how to preserve their foods to the best advantage, though not doing it for them, as Joseph did. Theoretically the old-fashioned econo- mists would have expected this knowledge to have been acquired without state intervention, but apparently the stable if not generous conditions of state employ- ment attract the scientific research worker whereas the pinchbeck and uncertain conditions of industrial research do not. The report of the Food Investigation Board for 1938 points out with some natural pride that 11 In the brief period of 5 years since the method [i.e. of storage of chilled beef in air enriched’ to a controlled extent with carbon dioxide] was introduced, the exports to us from Australia and New Zealand of chilled beef have increased nearly tenfold to a combined annual figure of 850,000 ewt. Since chilled beef has recently commanded a premium over frozen beef of about 1a. a pound the increased value of this meat is of the order of M00,000." That is certainly a remarkable achievement. It has made more of a satisfactory food available in better condition in a country which will never be able to supply all its wants in this direction. We hope that a fair propor- tion of that M00,000 has flowed back into the coffers of applied food research. Nothing is said about a reduction in price of chilled beef to the populace, but presumably that may happen as the result of the research, owing to economic laws. A more important research from the point of view of medicine and dietetics is that undertaken on behalf of the government of Palestine on the wastage of oranges during transport. One of the desiderata of a - good diet is an adequate supply of vitamin C, especially during the winter months. The orange is the most convenient and stable source of supply, for we cannot grow enough watercress for that purpose in this country. Anything which decreases the rotting of oranges by green mould is going to increase the supplies of vitamin C at a cheap rate. So far as the work has gone we learn that the November fruit wastes more rapidly than the March fruit (which is a pity) and that wastage can be lessened by ventila- tion and by low temperature. Wrapping in papers impregnated with hexamine and o-phenylphenol helped to prevent rotting. The report also notes that King Edward potatoes lifted in September and October have the high vitamin-C value of 43-45 mg. of ascorbic acid per 100 g. and that this amount falls with storage at 10° C., reaching asymptotically by the next April a figure of 10 mg. Six-month old pota- toes are therefore not to be despised as sources of vitamin C, having about a third or a quarter that of oranges and somewhat less than that of the Jamaica banana sold in this country. A mass experiment was undertaken on the gas storage of Cox’s orange pippin, and at the end of five months’ storage an apple was released which had most if not all of the qualities of a freshly picked apple. Since, however, the Cox’s orange pippin con- tains but little vitamin C, and few other protective qualities, the experiment is of more interest to gastro- nomes than to dietitians. We learn that July is the 1. H.M. Stationery Office. 1939. 4s. best month for kippering herrings, that the ripening of pears can be controlled so that they do not all ripen at once, that late and early apples should not be stored together, and that potatoes make use of a triose phos- phate in the oxidation of carbohydrate, just as if they were yeasts or frogs’ muscles. The report demonstrates the immense importance of liaison between academic research in biochemistry and the practice of supplying the nation with sound food. This work will undoubtedly continue to advance and both the research and the research workers deserve a satisfactory subsidy. PICROTOXIN IN BARBITURATE POISONING IN spite of the new Poisons and Pharmacy Act, suicides still find the barbiturates convenient for their purpose, and this fact together with the increasing use of these drugs for producing long narcosis in psychiatry provides a constant supply of toxic cases for treatment and study. Sixty-five years ago Crichton Browne suggested the trial of picrotoxin for chloral-hydrate poisoning and in 1931 Kline, Bigg and Whitney reported that this powerful convulsant was more effective than strychnine in barbitone poisoning in animals. Since then about a dozen cases treated with picrotoxin have been reported, and the results were reviewed in the Presse Médicale for Jan. 10. On another page Gillman describes the use of picrotoxin in four cases of poisoning arising during a hundred narcoses for psychiatric purposes and in a fifth case of suicidal poisoning. Unfortunately the treatment itself is not without danger, doses of picrotoxin large enough to be effective being accompanied by toxic symptoms, and in particular by grave secondary cortical depres- sion. Nevertheless, picrotoxin is a real and fast- working antidote to the barbiturates, and the attendant risk may well be justified. Lately Metrazol has been suggested as an alternative; this drug is said to be slightly safer in that secondary depression makes its appearance only after a dosage sufficient to cause convulsions. OCCIPITO-POSTERIOR PRESENTATIONS WHAT is the truth about labour in cases of occipito- posterior presentations °! That these give rise to anxiety and difficulty is shown in the reports of any maternity hospital, where about half of the cases admitted as " failed forceps " are found to be occipito- posterior with an improper application of instru- ments. Most of these must arise from a faulty understanding of labour. In a series of 2130 consecu- tive vertex deliveries, of which 1020 were occipito- posterior, Calkins found that usually little was to be feared if the patient was treated on expectant lines without undue interference. In 95 per cent. of his patients spontaneous rotation took place and the faetal mortality was only 2-8 per cent. These findings support the customary teaching of conservative mid- wifery. Uterine inertia, one of the banes of the obstetrician in these patients, was only present in 8’6 per cent. and here Calkins seems to have been fortunate for on an average labour was only H hours longer in the posterior than the anterior cases. This apparent freedom from inertia may have been partly due to the fact that all his patients were examined vaginally early in labour, and hence cases which might have been classified as anterior if examined later were 1. Kline, E. M., Bigg, E. and Whitney, H. A. K. J. Amer. med. Ass. 1937, 109, 328. 2. Calkins, L. A. Amer. J. Obstet. Gynec. 1939, 38, 993.

PICROTOXIN IN BARBITURATE POISONING

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604

ANNOTATIONS

THE NATIONAL LARDER

THE storage of food may have been the beginningof capitalism, but certainly, under Joseph of Egypt, itwas the beginning of state socialism. And today,several thousand years later, we have the Departmentof Scientific and Industrial Research stepping in toadvise food importers how to preserve their foodsto the best advantage, though not doing it for them,as Joseph did. Theoretically the old-fashioned econo-mists would have expected this knowledge to have beenacquired without state intervention, but apparentlythe stable if not generous conditions of state employ-ment attract the scientific research worker whereasthe pinchbeck and uncertain conditions of industrialresearch do not. The report of the Food InvestigationBoard for 1938 points out with some natural pridethat 11 In the brief period of 5 years since the method[i.e. of storage of chilled beef in air enriched’ to acontrolled extent with carbon dioxide] was introduced,the exports to us from Australia and New Zealandof chilled beef have increased nearly tenfold to a

combined annual figure of 850,000 ewt. Since chilledbeef has recently commanded a premium over frozenbeef of about 1a. a pound the increased value of thismeat is of the order of M00,000." That is certainlya remarkable achievement. It has made more of asatisfactory food available in better condition in acountry which will never be able to supply all itswants in this direction. We hope that a fair propor-tion of that M00,000 has flowed back into the coffersof applied food research. Nothing is said about areduction in price of chilled beef to the populace,but presumably that may happen as the result of theresearch, owing to economic laws.A more important research from the point of view

of medicine and dietetics is that undertaken on behalfof the government of Palestine on the wastage oforanges during transport. One of the desiderata ofa - good diet is an adequate supply of vitamin C,especially during the winter months. The orange isthe most convenient and stable source of supply, forwe cannot grow enough watercress for that purposein this country. Anything which decreases the rottingof oranges by green mould is going to increase thesupplies of vitamin C at a cheap rate. So far as thework has gone we learn that the November fruitwastes more rapidly than the March fruit (which isa pity) and that wastage can be lessened by ventila-tion and by low temperature. Wrapping in papersimpregnated with hexamine and o-phenylphenolhelped to prevent rotting. The report also notesthat King Edward potatoes lifted in September andOctober have the high vitamin-C value of 43-45 mg.of ascorbic acid per 100 g. and that this amount fallswith storage at 10° C., reaching asymptotically bythe next April a figure of 10 mg. Six-month old pota-toes are therefore not to be despised as sources ofvitamin C, having about a third or a quarter that oforanges and somewhat less than that of the Jamaicabanana sold in this country.A mass experiment was undertaken on the gas

storage of Cox’s orange pippin, and at the end offive months’ storage an apple was released which hadmost if not all of the qualities of a freshly pickedapple. Since, however, the Cox’s orange pippin con-tains but little vitamin C, and few other protectivequalities, the experiment is of more interest to gastro-nomes than to dietitians. We learn that July is the

1. H.M. Stationery Office. 1939. 4s.

best month for kippering herrings, that the ripeningof pears can be controlled so that they do not all ripenat once, that late and early apples should not be storedtogether, and that potatoes make use of a triose phos-phate in the oxidation of carbohydrate, just as if theywere yeasts or frogs’ muscles.The report demonstrates the immense importance of

liaison between academic research in biochemistry andthe practice of supplying the nation with sound food.This work will undoubtedly continue to advance andboth the research and the research workers deservea satisfactory subsidy.

PICROTOXIN IN BARBITURATE POISONING

IN spite of the new Poisons and Pharmacy Act,suicides still find the barbiturates convenient for theirpurpose, and this fact together with the increasing useof these drugs for producing long narcosis inpsychiatry provides a constant supply of toxic casesfor treatment and study. Sixty-five years agoCrichton Browne suggested the trial of picrotoxin forchloral-hydrate poisoning and in 1931 Kline, Bigg andWhitney reported that this powerful convulsant wasmore effective than strychnine in barbitone poisoningin animals. Since then about a dozen cases treatedwith picrotoxin have been reported, and the resultswere reviewed in the Presse Médicale for Jan. 10. Onanother page Gillman describes the use of picrotoxin infour cases of poisoning arising during a hundrednarcoses for psychiatric purposes and in a fifth case ofsuicidal poisoning. Unfortunately the treatment itselfis not without danger, doses of picrotoxin large enoughto be effective being accompanied by toxic symptoms,and in particular by grave secondary cortical depres-sion. Nevertheless, picrotoxin is a real and fast-working antidote to the barbiturates, and the attendantrisk may well be justified. Lately Metrazol has beensuggested as an alternative; this drug is said to beslightly safer in that secondary depression makes itsappearance only after a dosage sufficient to cause

convulsions.

OCCIPITO-POSTERIOR PRESENTATIONS

WHAT is the truth about labour in cases of occipito-posterior presentations °! That these give rise to

anxiety and difficulty is shown in the reports of anymaternity hospital, where about half of the cases

admitted as " failed forceps " are found to be occipito-posterior with an improper application of instru-ments. Most of these must arise from a faultyunderstanding of labour. In a series of 2130 consecu-tive vertex deliveries, of which 1020 were occipito-posterior, Calkins found that usually little was to befeared if the patient was treated on expectant lineswithout undue interference. In 95 per cent. of hispatients spontaneous rotation took place and thefaetal mortality was only 2-8 per cent. These findingssupport the customary teaching of conservative mid-wifery. Uterine inertia, one of the banes of theobstetrician in these patients, was only present in8’6 per cent. and here Calkins seems to have beenfortunate for on an average labour was only H hourslonger in the posterior than the anterior cases. Thisapparent freedom from inertia may have been partlydue to the fact that all his patients were examinedvaginally early in labour, and hence cases which mighthave been classified as anterior if examined later were

1. Kline, E. M., Bigg, E. and Whitney, H. A. K. J. Amer. med.Ass. 1937, 109, 328.

2. Calkins, L. A. Amer. J. Obstet. Gynec. 1939, 38, 993.