1
922 and J. S. Goodall, in a paper printed in our issue of April 23rd, discuss some of these criticisms. There is need for an impartial survey of the two methods, founded upon a sufficiently prolonged experience of both.. THE HARVARD CANCER COMMISSION. THE Annual Report of the Cancer Commission of Harvard University, 19M-20, with which ig combined the Eighth Annual Report of the Collis P. Hungtington Hospital for Cancer Research, which lies before us, gives rise to some reflections on the progress and course of cancer research in this country and America. The Hospital for Cancer Research was opened just before the war as an adjunct to the Cancer Research Labora- tories of Harvard, in which some of the best pioneer work in the experimental study of cancer was carried out. The present report shows to what an extent the hospital service has absorbed the activities of the organisation, which are represented by the care and treatment of 2143 in-patients, and the making of 6105 out-patient visits. The laboratory work (biophysics, Dr. Duane and Dr. Bovie ; pathology, Dr. Goodpasture; chemistry, Dr. Lyman) is closely associated with the clinical study and treatment of the hospital material. The Biophysics Laboratory is principally engaged in the problems arising out of the application of radium and X rays to the treatment of cancer, alone or in combina- tion with operation, and Dr. Duane has devised a new X ray tube working at high voltage and giving a radia- tion eight times as penetrating as the Coolidge tube. The radiation emitted has a wave-length of 0’08 Angstrom unit and suffers an absorption of 16-20 per cent. in passing through the human body. The report, which I is formal and business-like, ends with a complete list of 89 papers published from the Harvard Cancer Com- mission since its beginning in 1900. Roughly, half of these communications deal with the properties of ionising radiations, and since the hospital was opened the papers on other subjects are mainly of clinical rather than pathological interest. Those responsible for cancer investigations - in this country will be impressed by the radical manner in which the Harvard investigations have been turned from the purely scientific problems of cancer to the practical work of the care of patients. THE INTERNECINE VENEREAL CAMPAIGN. A DISCUSSION reported in our present issue on the desirability of notifying venereal disease showed little unanimity except on its value as applied to ophthalmia neonatorum. In the routine instillation of a silver pre- paration between the eyelids of a scarcely born child we see the universal acceptance of the principle of pro- phylaxis, notification, and early treatment-in that order-of one of the venereal diseases. It is logical to argue on purely medical grounds, ethical considera- tions excluded, that the prophylaxis, notification, and early treatment of any communicable infection is desirable. All this is familiar debating ground, while it remains true that as far as the infant victim is con- cerned it matters not whether the noxa is gonococcus or streptococcus. Perhaps the infant, like the royal prince who was born in Wales and spoke no English, might afford a basis of reconciliation between two opposing camps. We have received, in common with the lay press, correspondence which has passed between the Society for the Prevention of Venereal Disease and the National Council for Combating Venereal Diseases. The Council had submitted to the Society a memorandum defining its policy. In brief, this policy advo- cates propaganda to induce chastity and popular instruction in sex hygiene and cleanliness as the surest means of combating venereal diseases. The Council I points out that no legal difficulty exists to prevent the I purchase by individuals of disinfectants as a protection against these diseases, but deprecates the issue of official instructions which would, in its opinion, lead not only to the appearance of official condonation, but to the assumption that such disinfectants are an official guarantee against disease. Also, that if the instructions were not properly understood, aggravation of incidence of disease and attempts at self-treatment might result ’’ The Council recommends that the existing ablution or disinfecting centres should be continued, but should be regarded definitely as experiments subject to careful and official supervision from which accurate and wide experience 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 futility of drawing the line at a domestic standard of cleanli ness, and regards as illogical the recognition of unofficial disinfectants handed out with oral directions as opposed to official disinfectants issued with written instructions’. It is a nice point, but the issues in such a complex ethico-medical problem are hardly as simple as the Society would have us believe. It is conceivable, to us at least, that the value of immediate disinfection might vary with the sense, sex, age, or general habits of the person affected. - MELANOGLOSSIA. A CASE of this somewhat rare condition is reported by Dr. Heyninx, of Brussels.1 The patient was a man of 77, a confirmed smoker. The black patch was in front of the circumvallate papillae, the commonest situation in which it is found. It was covered by a thick coat of black filaments half a centimetre in length. Biopsy showed hypertrophy of the villi; epithelium thickened and." mortified." The chorion of the mucosa was infiltrated. The papillae were elongated by hyper- keratosis. Apparently the Rhizopu8 niger was not found in this case, though Dr. Heyninx mentions that it has been observed by others. He sums up the aetiology of this 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 the chorion. Finally, epithelial thickening with hyper- keratosis of the papillary filaments and inflammatory pigmentation. The R3z-izopus niger, when present, would tend to increase the inflammatory processes. The hairy filaments serve to differentiate true melanoglossia from pigmentation 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 Monographs and Reports for Publication " the Medical Research Council gives advice which, coupled with that con- tained in Sir Clifford Allbutt’s standard work on the subject, should, if perchance it be followed, materially help to prune the often over-luxurious tangle of scien- tific writings. There are two aspects of this subject which deserve special comment, both referring to sins of omission. Much scientific research leads to blind alleys, the charting of which is often almost as import- ant as that of avenues leading to success. Indeed, an apparently fruitless piece of research, if conducted on scientific lines, may be of far-reaching importance, not only in saving other investigators from vain repetition, but also in yielding information which, viewed from some new angle, may shed a flood of light. In the past, unfortunately, an enormous amount of such temporarily negative spade-work has been ignored; but it is to be hoped that, under the auspices of the Medical Research Council, it will be better utilised, and that the comparatively thankless task of charting blind alleys will not be left as an embarrassing monopoly to a few altruistic workers. When we pass from temporarily negative research to the subject of mistakes and disasters, we are faced with certain elementary psychological problems. Mistakes and disasters are often singularly instructive, but their perpetrators do not always experience an overwhelm- ing desire to benefit mankind by confession. Yet if the publication of such errors is left to others than their authors, a garbled version may be the result, and 1 Le Scalpel, April 2nd, p. 349.

THE INTERNECINE VENEREAL CAMPAIGN

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922

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

both..

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. -

MELANOGLOSSIA.

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.