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and J. S. Goodall, in a paper printed in our issue ofApril 23rd, discuss some of these criticisms. There isneed for an impartial survey of the two methods,founded upon a sufficiently prolonged experience of
THE HARVARD CANCER COMMISSION.
THE Annual Report of the Cancer Commission ofHarvard University, 19M-20, with which ig combinedthe Eighth Annual Report of the Collis P. HungtingtonHospital for Cancer Research, which lies before us,
gives rise to some reflections on the progress and courseof cancer research in this country and America. The
Hospital for Cancer Research was opened just beforethe war as an adjunct to the Cancer Research Labora-tories of Harvard, in which some of the best pioneerwork in the experimental study of cancer was carriedout. The present report shows to what an extent thehospital service has absorbed the activities of the
organisation, which are represented by the care andtreatment of 2143 in-patients, and the making of 6105out-patient visits. The laboratory work (biophysics,Dr. Duane and Dr. Bovie ; pathology, Dr. Goodpasture;chemistry, Dr. Lyman) is closely associated with theclinical study and treatment of the hospital material.The Biophysics Laboratory is principally engaged in theproblems arising out of the application of radium andX rays to the treatment of cancer, alone or in combina-tion with operation, and Dr. Duane has devised a newX ray tube working at high voltage and giving a radia-tion eight times as penetrating as the Coolidge tube. Theradiation emitted has a wave-length of 0’08 Angstromunit and suffers an absorption of 16-20 per cent. in
passing through the human body. The report, which Iis formal and business-like, ends with a complete list of89 papers published from the Harvard Cancer Com-mission since its beginning in 1900. Roughly, half ofthese communications deal with the properties of
ionising radiations, and since the hospital was openedthe papers on other subjects are mainly of clinicalrather than pathological interest. Those responsiblefor cancer investigations - in this country will be
impressed by the radical manner in which theHarvard investigations have been turned from thepurely scientific problems of cancer to the practicalwork of the care of patients.
THE INTERNECINE VENEREAL CAMPAIGN.
A DISCUSSION reported in our present issue on thedesirability of notifying venereal disease showed littleunanimity except on its value as applied to ophthalmianeonatorum. In the routine instillation of a silver pre-paration between the eyelids of a scarcely born childwe see the universal acceptance of the principle of pro-phylaxis, notification, and early treatment-in thatorder-of one of the venereal diseases. It is logicalto argue on purely medical grounds, ethical considera-tions excluded, that the prophylaxis, notification, andearly treatment of any communicable infection isdesirable. All this is familiar debating ground, while itremains true that as far as the infant victim is con-cerned it matters not whether the noxa is gonococcusor streptococcus. Perhaps the infant, like the royalprince who was born in Wales and spoke no English,might afford a basis of reconciliation between twoopposing camps. We have received, in common
with the lay press, correspondence which has
passed between the Society for the Preventionof Venereal Disease and the National Councilfor Combating Venereal Diseases. The Councilhad submitted to the Society a memorandum
defining its policy. In brief, this policy advo-cates propaganda to induce chastity and popularinstruction in sex hygiene and cleanliness as the surestmeans of combating venereal diseases. The Council Ipoints out that no legal difficulty exists to prevent the Ipurchase by individuals of disinfectants as a protectionagainst these diseases, but deprecates the issue of
official instructions which would, in its opinion, leadnot only to the appearance of official condonation, but
to the assumption that such disinfectants are an officialguarantee against disease. Also, that if the instructionswere not properly understood, aggravation of incidenceof disease and attempts at self-treatment might result ’’The Council recommends that the existing ablution or
disinfecting centres should be continued, but should beregarded definitely as experiments subject to carefuland official supervision from which accurate and wideexperience may be obtatned, so as. to afford a trust.worthy basis for any decision as to their extension.The Society, on the other hand, points out the futilityof drawing the line at a domestic standard of cleanliness, and regards as illogical the recognition of unofficialdisinfectants handed out with oral directions as opposedto official disinfectants issued with written instructions’.It is a nice point, but the issues in such a complexethico-medical problem are hardly as simple as theSociety would have us believe. It is conceivable, tous at least, that the value of immediate disinfectionmight vary with the sense, sex, age, or general habitsof the person affected. -
A CASE of this somewhat rare condition is reportedby Dr. Heyninx, of Brussels.1 The patient was a manof 77, a confirmed smoker. The black patch was infront of the circumvallate papillae, the commonestsituation in which it is found. It was covered by athick coat of black filaments half a centimetre in length.Biopsy showed hypertrophy of the villi; epitheliumthickened and." mortified." The chorion of the mucosawas infiltrated. The papillae were elongated by hyper-keratosis. Apparently the Rhizopu8 niger was not foundin this case, though Dr. Heyninx mentions that it hasbeen observed by others. He sums up the aetiology ofthis condition as follows. Predisposition is due, first,to general debility resulting from old age or syphilis,and, secondly, to chronic irritation of the tongue.Glossitis then supervenes, with infiltration of thechorion. Finally, epithelial thickening with hyper-keratosis of the papillary filaments and inflammatorypigmentation. The R3z-izopus niger, when present, wouldtend to increase the inflammatory processes. The hairyfilaments serve to differentiate true melanoglossia frompigmentation due to Addison’s disease or to other
causes, such as the inheritance of negro blood.
" BE SURE YOUR SIN WILL FIND YOU OUT."
IN "Notes upon the Preparation of Monographsand Reports for Publication " the Medical ResearchCouncil gives advice which, coupled with that con-
tained in Sir Clifford Allbutt’s standard work on thesubject, should, if perchance it be followed, materiallyhelp to prune the often over-luxurious tangle of scien-tific writings. There are two aspects of this subjectwhich deserve special comment, both referring to sinsof omission. Much scientific research leads to blindalleys, the charting of which is often almost as import-ant as that of avenues leading to success. Indeed, anapparently fruitless piece of research, if conducted onscientific lines, may be of far-reaching importance, notonly in saving other investigators from vain repetition,but also in yielding information which, viewed fromsome new angle, may shed a flood of light. In thepast, unfortunately, an enormous amount of suchtemporarily negative spade-work has been ignored; butit is to be hoped that, under the auspices of theMedical Research Council, it will be better utilised, andthat the comparatively thankless task of chartingblind alleys will not be left as an embarrassingmonopoly to a few altruistic workers. When we passfrom temporarily negative research to the subject ofmistakes and disasters, we are faced with certain
elementary psychological problems. Mistakes anddisasters are often singularly instructive, but theirperpetrators do not always experience an overwhelm-ing desire to benefit mankind by confession. Yet ifthe publication of such errors is left to others thantheir authors, a garbled version may be the result, and
1 Le Scalpel, April 2nd, p. 349.