976 REPORTS AND ANALYTICAL RECORDS.

Reports and Analytical Records.BRUSSON’S GLUTEN BREAD.

(BRUSSON, JEUNE AND Co., 311, GRAY’S INN-ROAD, W.C. 1.)THIS preparation is sold in the form of rolls, each

contained in a separate wrapper, and weighingabout 1 oz. The rolls are extremely light, and con-sequently bulky in appearance. When analysed thefollowing results were obtained :-Moisture 12-5 per cent.Ash 0-6 "

Fat 1-3 "

Protein 36-8 "

Starch and dextrin 42.7 "

Undetermined matter, fibre, &c... 6-1 "

100-0Matter soluble in cold water.. 12-4 per cent. ’

For purposes of comparison it may be noted thatordinary household bread, with a moisture adjustedto 12-5 per cent., contains 9-7 per cent. of protein and73 per cent. of starch and dextrin. The Brusson breadis thus much richer in protein and poorer in starchand dextrin.Formerly an almost complete absence, or at least

a very marked reduction, of carbohydrates was con-sidered an essential characteristic of a true " diabetic "food. Whilst a diminution of the carbohydrates inthe diet of the diabetic is still deemed necessary,modern practice allows a somewhat more liberal useof carbohydrates than in the past, and under certainconditions some practitioners of recognised authorityeven permit, for a limited period, foods of high carbo-hydrate content, such as oatmeal, potatoes, and rice.

CLUBLAND WHITE PORT.(T. R. PARKINGTON AND Co., LTD., 161, NEW BOND-STREET,W.1.)When analysed this wine gave the following

results :-Present gravity...... 1.0161Alcohol per cent. by volume.. 21Total extractives...... 10-5 per cent.

Consisting of-Sugar 9-05

Total acidity as tartaric acid.. 0-36Volatile acidity as acetic acid.. 0-03

These analytical figures are characteristic of a goodport. The wine itself is of a " full character," wellmatured, soft to the palate, and with an agreeablebouquet.

(1) CIBALGIN; (2) AGOMENSIN ANDSISTOMENSIN; (3) CORAMINE.

(CLAYTON ANILINE CO., LTD., 68t, UPPER TFLAMES-ST., E.C. 4.)

(1) Cibalgin presents in combination the analgesicand antipyretic properties of amidopyrin, a smalldose of dial having been introduced for its sedativeproperties. It is, however, primarily intended as anon-narcotic analgesic. The manufacturers state thatextensive pharmaceutical and clinical tests have con-firmed the value of the compound as rapidly relievingpain without conducing to the formation of habit.The drug is available in the form of tablets andliquid for oral use, while ampoules are supplied forhypodermic injections.

(2) A claim was made recently, which has receivedsupport on the continent, that two active principlesisolated from bovine corpora lutea may be used for theregulation of menstruation. These active principlesor hormones have been termed Agomensin andSistomensin, the first of which is recommended in casesof delayed menstruation, and the second in conditionsaccompanied by an over-profuse flow. Agomensinis of value in retarded menstrual flow occurringduring an expected period or following a too scantymenstrual flow. Sistomensin appears from clinicalresults to act as a stabiliser of menstruation in casesof hyper-function, its use, therefore, being indicatedin dysmenorrhoea and menorrhagia. With regard toboth preparations interesting cases can be quoted-

from French and German medical literature, andconsidering the frequently obstinate nature of thesymptoms to be relieved, and their prevalence in suchvaried associations, both drugs might well be giventrial under carefully observed medical conditions.

(3) Coramine is the trade name for pyridine-/3-carbonic acid diethylamide, which was the subject ofan article by Prof. E. Stanton Faust published inTHE LANCET of June 27th, 1925. This new syntheticchemical possesses a distinctive camphor-like action,and for many years unsuccessful attempts have beenmade to produce a water-soluble form of camphorhaving the typical therapeutic properties associatedwith the drug. Prof. Faust seems to have demon-strated that the action of Coramine is almost identicalwith that of camphor, and, indeed, superior in itsaction on the heart. According to him, in smalldoses it exhibits an effect similar to that of digitalis,while its stimulating effect extends to both the motorand sensory nervous systems. Coramine should be,therefore, indicated in such conditions as heartasthenia following infectious diseases, the appropriaterenal affections, poisoning through narcotics, andasphyxia of the new born, and records of such casesand of cases of bronchial asthma and emphysema arereported where its use has been efficacious. The drugis available in the form of liquid for oral use and inampoules for parenteral administration.

OPOIDINE.(J. F. MACFARLAN AND Co., EDINBURGH AND LONDON.)

Towards the end of 1922 we noticed Opoidinefavourably as an example of a mixture of the totalalkaloids of opium in soluble form. The drug con-tains about 50 per cent of morphine, the remaining50 per cent. consisting of other opium alkaloids, con-cerning the latter of which there is evidence that theyare of value in particular directions. Messrs. J. F.Macfarlan and Co. have now introduced a solutionof opoidine in combination with scopolamine in

ampoules, and they have received evidence of thevalue of the combination, one practitioner writingin respect of the production of " twilight sleep,"stating that he has obtained in a certain numberof cases complete amnesia after the first dose of thecombination.

CAPROKOL (HEXYL RESORCINOL B.D.H.).(THE BRITISH DRUG HOUSES. LTD,, 16-30. GRAHAM-STREET,

CITY-ROAD, N. 1.)

Caprokol is a new urinary antiseptic syntheticremedy for oral administration. It was first broughtto the attention of the medical profession at theannual meeting of the American Medical Associationlast year, when Dr. Veader Leonard, of Johns HopkinsUniversity, gave a description of work carried on athis department of bacteriology over a series of yearson the alkyl resorcinols. These are claimed to be morepowerfully germicidal than any other known classof substances of equally low toxicity. Clinical reportspublished on the introduction of hexyl resorcinol andothers since received indicate that it possesses valuableproperties, in that it is chemically stable, non-toxic,and non-irritating to the urinary tract, and adminis-trable by the mouth. The reports submitted to us goto show that Caprokol exhibits a powerful antisepticaction in high dilution in urine of any reaction, whileits elimination in the urine has a local antisepticinfluence. A short series of cases of urinary tractinfections treated with Caprokol is published underDr. Leonard’s authority, and indicates that manyobstinate cases hitherto resistant to treatment hadlost their symptoms under use of the drug. Referenceto the discovery and properties of hexyl resorcinolhave already appeared in THE LANCET, and wecomment this week in an annotation upon the resultsobtained by Dr. R. B. Henline through the employmentof this urinary antiseptic.

Iodosal is the correct name of the " supertonic tablesalt " supplied by Messrs. Francis Newbery and Sonand noticed in this column on Oct. 24th.

977STATUTORY DENTAL BENEFIT.

THE LANCET.

LONDON : SATURDAY, NOVEMBER 7, 1925.

STATUTORY DENTAL BENEFIT.THOSE who have read the evidence submitted to

the Royal Commission on the National Health Insur-ance Act, during the investigation which is now

drawing to a close, must have been struck by theunanimity with which all sorts and conditions ofwitnesses testified to the desirability of makingdental treatment a statutory benefit under an

amended Act. Long before the evidence given bythe various dental societies was reached, representa-tives of approved societies were paying generoustribute to the good which had resulted from the

partial dental treatment at present given as an

additional benefit, paid for to a certain limited degreeout of the funds released under the first valuation,and were advocating its conversion into a statutorybenefit. Many of the witnesses, indeed, were so

convinced of the necessity for this that they recom-mended a partial pooling of their future surplusfunds in order that all insured persons might benefitfrom the treatment. The members of the Commis-sion, also, by their questions showed that theyappreciated the desirability of extending the incidenceof dental treatment over at least the whole of thepresent insured population. The case for makingdental treatment a statutory benefit is, in fact,proved to the hilt. There remain, however, certainquestions concerning which no unanimity exists-for example, the extent to which it is possible ordesirable to make statutory dental benefit completein the near future, and the manner in which suchbenefit as may be decided upon is to be administered.To give complete dental treatment will require,annually, a large sum of money, and if an increasein the present contribution be excluded as a possiblesource of supply, as indeed seems necessary in thefinancial state of the country, the money requiredcan only be got by some rearrangement of the mannerin which the funds obtained from the present con-tribution are spent. It seems evident that somesuch rearrangement will be made, but there are

certain payments in connexion with medical treat-ment which have a first claim on any such funds, andit is doubtful whether what will be left when theseclaims are satisfied, even were it devoted entirely tothe payment of the cost of dental treatment, wouldbe sufficient. It may be assumed, therefore, thatthose schemes of complete dental treatment, not onlyfor insured persons but also for their dependants,which were put forward by the dental and certainother witnesses, must be taken as ideals which cannotbe realised as a result of the present inquiry, buttowards the ultimate realisation of which it may bepossible to take a very definite step. It is question-able whether any responsible dental authority, fullyacquainted with all the circumstances of the presentposition, would desire to see complete dental treat-ment given as a statutory benefit at the present time,and it would seem from a careful reading of theirevidence that the dental witnesses rather contemplate-between the realisation of such an ideal and thepresent chaotic condition of dental treatment as

additional benefit-the prudent intermediate stageof a statutory dental benefit partial in its scope andlimited in its time of application, which would affordthe knowledge, not available at present, on whichan effective and complete scheme of national dentaltreatment might be based.

There was agreement on the part of all the witnessesbefore the Commission that, for the present at least,payment of the dentist should be for services actuallyrendered on an agreed scale of fees and not by acapitation fee. One reason for this proposed differ-ence from medical benefit is that it is quite impossibleat present to estimate with any approach to exacti-tude the numbers of insured persons who would takeadvantage of dental treatment were it offered tothem on terms similar to those under which medicalbenefit is given. Comparatively little can be learnedfrom the experience of dental treatment as additionalbenefit, for there are many circumstances whichtend to restrict applications on the part of insuredpersons for this treatment at the present time. Onlymembers of certain approved societies fortunate

enough to have surplus funds and which have adopteddental benefit are eligible. The formalities necessaryin claiming the benefit and the fact that only about25 per cent. of the dentist’s fee is paid by the societieshave also tended to keep down the number of personsobtaining the benefit. In one society consisting ofwomen of a class likely to appreciate and to desiredental treatment, where every possible effort wasmade to bring the treatment under the notice of themembers and to induce them to accept it, and wherespecial means were available to assist those who haddifficulty in finding a proportion of the fee, the claimsall over the society did not exceed 12 per cent. ofthe membership. No dental witness contemplated ademand approaching 12 per cent. of the number ofinsured persons, and, indeed, were that proportionof claims to be expected, at the average expense percase which has ruled during the last five years underadditional benefit, the cost of dental treatment wouldin the near future be prohibitive. Instead of makingpayment for any statutory dental benefit a firstcharge on the available contributions as in the caseof medical benefit and making payment of the dentistby a capitation fee, the trend of the evidence givenseems to point to the setting aside of a definite sumof an agreed fraction of a penny from the weeklycontribution which, with the appropriate Govern-ment grant, would form a central fund or pool fromwhich the cost of a certain definite amount of dentalbenefit for every insured person claiming it would bedefrayed. There were various ways suggested wherebythe treatment provided could be limited in accordancewith the money available, as, for example, by givingfree operative treatment, and, in addition, paying aproportion of the cost of any necessary dentures, thepatient being left to find the remainder. Assuminga demand of 6 per cent., it was calculated that thisamount of treatment would cost 3s. 3d. per annumper head of the insured population, and would leavethe patient to find approximately one-third of thecost. The actuary of the British Dental Associationsubmitted a modification of this scheme which wouldreduce the cost to a little below 3s., an amount whichwould be covered by a payment of 0’5M. per memberout of the weekly contribution with the correspondingState grant added. This approximates to the d. perweek suggested by the representatives of one of theapproved societies and indicates a feasible beginning.The professional evidence shows that practicallyeverything in connexion with this matter of costof dental treatment can be calculated with a fair