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Notes and News
. OVERDOSE OF AMPHETAMINE
WE are grateful to Dr. Richard Worsley for the followingnote.A girl, aged 21/4 years, was seen in the casualty department
of the Leeds Public Dispensary and Hospital at 2.50 P.M.on Aug. 22. The mother stated that one to two hours
previously the child had swallowed some " energy " tabletswhich her son had acquired while serving in the Forces inAfrica. She produced a small unlabelled tube which stillcontained ten tablets. The full tube would have held twentytablets ; and the mother did not know how many the tubehad contained before the child got hold of it. The tabletsresembled 5 mg. amphetamine sulphate tablets, and somewere sent for analysis. A stomach wash revealed no trace ofthe tablets. The child appeared normal in all respects and wassent home after the mother had been instructed to bring herback again if she noted anything unusual. At about 11.45 p.ut.the same evening, the mother returned with the child, whowas now overactive and would not stay in bed. Both hadwalked most of the 3 miles to the hospital. The child wasadmitted to the ward. On examination no abnormality wasevident except overactivity and refusal to stay in bed. At12.30 A.M. she was given chloral hydrate gr. 5 ; she settleddown at 2 A.M. and slept until 4 A.M. At 6 A.M. this dosewas repeated as the child was noisy and restless ; she wasstill awake at 8 A.M. and remained so throughout that dayalthough taking her food normally. After a further dose ofchloral at 5 P.M. the child slept for an hour and then had anormal night’s sleep without further sedation. She was dis-
charged from hospital next day, Aug. 24, quite normal inevery way.The child’s condition did not cause any real anxiety to those
in charge. Some of the tablets were undoubtedly absorbed,and the insomnia and excitability were compatible withmild amphetamine intoxication.
THE INDIAN MIDDLE-CLASS BUDGET
As elsewhere the Indian middle class has suffered more
severely from inflation since 1939 than any other section ofthe community. This is brought out by a report on familybudgets among middle-class State employees of undividedIndia recently published by the central government. Thisdeals with a sample of 5000 persons drawing less than Rs. 500per month, subdivided according to fesidence in four majorcities and seven regional groupings. It gives an illuminatinginsight into their living conditions. Since it covers budgetsonly up to 1946 it is somewhat out of date, but has the advan-tage of erring on the conservative side inasmuch as the impactof inflation is now more severe. It has the additional meritof covering Pakistan as well.According to this report average family incomes ranged
from Rs. 159 per month in rural Madras to Rs. 286 in Delhi,the salary and allowances of the head of, the family accountingfor 82-92% of the total. The average was depressed by theconvention of regarding all clerks-sometimes on a monthlybasic salary as low as Rs. 30-as members of the middle class.Nevertheless, it was found that only one in five of the Madrasisand two in five of the Delhi residents had surplus budgets.The percentage of families in debt varied from 37% in thePunjab to over 75% in Calcutta, the main causes of indebted-ness being sickness and marriage expenses. Resident depen-dents per family earner ranged from 4-5 in Bombay city to6-7 in Bihar and Orissa, and non-resident dependents from0-3 in Madras to 1-4 in the United Provinces. The reportconcludes that " expenditure was nowhere in reasonablecorrespondence with family income." Up to half the incomewas spent on food, milk, and fats. In housing governmentservants are far better placed than the general mass of people,yet even they lived at an average density of 1-9-2-8 personsper room; the cost of 10% or a little over in cities was notexcessive, but the quality was deplorable. Fuel and clothingabsorbed 12-15% of the income. The miscellaneous residueof 30-40% was expended on travel to work, children’s educa-tion, toilet and household requisites, postage, medical bills,taxes, servants, laundry, share of a sweeper, &c. ; outlay ontobacco, pansupari, and holidays was relatively modest, yetthere was little margin left for a rainy day.
These details make depressing reading. Nor is there anyobvious and immediate remedy. Continuous wage pressureonly adds to the inflationary spiral. Permanent improvement
of middle-class incomes, as indeed of others, can only comefrom greater productivity. Richer classes in India, apart fromwar-time profiteers, may be poorer than they were, but havegreater scope for economy. Among the labouring poor thereis undoubtedly distress ; but the organised worker at least,aided by arbitration tribunals and cost-of-living awards, hasto some extent been cushioned against the worst effects. Themiddle classes have standards of respectability to maintainand relatives and dependents to support. Among themgovernment employees are in a comparatively privilegedcategory, and the disabilities they suffer weigh more heavilyon less privileged sections of the middle class.
MODERN PATTERNS IN CANCER RESEARCH
BiRD’s-EYE views of medicine are unsatisfactory unlessthe bird appointed is something of an eagle ; for it takesa widely ranging eye to see enough of any field to survey itfairly. The New York Academy of Medicine’s lectures tothe laity have long been given by accepted eagles ; and theset of six lectures published in March of Medicine, 1948,1are authoritative little surveys of the atom in civil life, foodand civilisation, on being old too young, perspectives incancer research, psychiatry for everyday needs, and theinterrelation of pure and applied science in the field ofmedicine. All of these are worth reading, by doctors no lessthan by laymen, but in his discussion of cancer researchDr. Cornelius P. Rhoads, director of the New York MemorialHospital, is perhaps specially adept in bringing an exuberantsubject into perspective.
Cancer is rightly being examined in many ways at once:growth in general is being studied by chemical, physical, andbiological methods, and so is the behaviour of cancers, withoutreference to cure ; at the same time new methods of controland cure are being devised, and existing methods of diagnosisand treatment are being steadily improved. In spite of someequivocal evidence it is not possible to indict a virus finallyas a cause of cancer in mammals ; and even if it were, Dr.Rhoads asks, what would have been gained in terms of cancercontrol ? The finding would only suggest, he thinks, thatcancer might be contagious, and that patients should beisolated to avoid intecting others ; and, since we know fromexperience that this is not so, we should not be much furtheron. In other words, discovery of the cause will not necessarilylead direct to the cure. Genetic studies have produced anotherkind of puzzle. X rays can cause mutations in strains ofbacteria, amoebse, moulds, insects, and even mammals;and they can cause mutation of normal cells into cancercells. The unusual thing is that the mutant cancer cell ismore competent than the ordinary cell-" viciously com-petent," as Dr. Rhoads puts it. " The cancer cell," he says," is better able to survive in the environment in which it isborn than is its parent strain of normal cells." Some dietarystudies complicate the picture further : it has been shownthat a dye which caused cancer of the liver in animals willonly do so when riboflavine is absent from the diet. Again,a low-calorie diet reduces the incidence of cancer in mice ;and this is true however the cancer is produced-whetherspontaneously or by chemicals, or by ultraviolet light. Theimportant factor seems to be reduced endocrine activity.Thus it may be (and microscopic studies support the suggestion)that cancer cells are formed and lie dormant for long periods,and they only become active when some change in the
chemistry of the body fluids gives them their opportunity.Cancer control, then, might be a matter of preserving somechemical state which restrained the growth of cancer cells ;and indeed we have found already that cancer of the prostateand the breast can be irregularly and temporarily controlledby altering the endocrine balance.Some cancers can be controlled by direct chemical means :
Hodgkin’s disease, leukaemia, and lymphosarcoma, nowadaysregarded as cancers of the blood-forming system, respond totwo different groups of compounds-the nitrogen mustardsand urethane. Or a radioactive substance may be used toattack the cancer from inside ; thus thyroid cancer has beentreated with the radioactive isotope of iodine. Dr. Rhoads
suggests that we need intensive study of the synthesis andmetabolism of steroid hormones resembling those formed
by the sex glands and the adrenals ; study of chemical
agents which are now weakly active in controlling cancer,and an empiric search for new ones ; and the pursuit of newisotopes capable of killing cancer cells without forming1. Perspectives in Medicine. Columbia University Press. London:
Oxford University Press 1949. Pp. 163. 14s.
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dangerous concentrations in normal cells. Meanwhile, thankslargely ’to better and earlier surgical intervention, andadvances in radiotherapy, the death-rate for cancer adjustedfor the age of the population " is clearly and sharply on thedown grade." The whole prospect is much more hopefulthan it used to be ; pieces of the jig-saw are being collectedat a prodigious rate, and one day will inevitably fit together.
Society of Apothecaries of LondonAt recent meetings of the court of assistants, over which
Prof. E. C. Dodds, F.R.S., the master, presided, Mr. DuncanC. L. Fitzwilliams was elected master from Aug. 24, and Dr.Frank Howitt and Dr. G. Roche Lynch were elected wardens.Dr. J. F. Carter-Braine took his seat on the court ofassistants.The following examiners were sworn in : Mr. Anthony Charles
and Mr. Norman White {midwifery) ; Mr. Paul Haas, D.SC.(chemistry). Dr. Thomas Hunt was appointed examiner forthe diploma in industrial health.
R. M. Haines was clothed by the master with the livery.The following were admitted to the freedom of the society byredemption :
F. C. Blaaberg, L. H. Lampitt, Sir Stanford Cade, R. T. Brain.K. J. Franklin, Kenneth Robson, J. C. N. Wakeley, E. R. Boland,H. B. O. Cardew, Sir James Walton, A. J. Walton, E. J. Crisp,A. E. M. Woolf, G. H. Hogben, E. T. D. Fletcher, Edith C. Hudgell,G. R. M. Cordiner, Sir George Aylwen (Lord Mayor), S. W. Davidson,N. R. Barrett, C. B. Perry, W. P. Cleland, J. G. Scadding, A. W,Spence, P. R. Allison.
The following were granted the diploma in industrial healthon examination :
J. A. Herd, C. N. D. Cruickshank, C. Crowley, G. G. Mathew,W. G. White.
The diploma of L.M.S.S.A. Lond. was granted on
examination to the following : -
H. T. H. Beach, J. L. Jarvis, D. Redpath, G. E. Hanks, F. W.Retief, M. P. Cardew, K. C. Horrocks, E. M. Tiger, H. V. White,M. P. M. Coupland, R. J. Aspinall, C. J. G. Menzies, C. R. May,M. C. H. Jackson, H. E. G. Dyer, F. Walton, F. E. Bramwell,E. R. Goodall, D. J. Joubert, G. B. Stephenson, W. G. BurvillHolmes, G. T. Cecil, G. A. R. Giri, P. B. Poole. A. K. Kantarjian,L. Kader, J. D. Morris, C. T. Jones, E. W. Melia, M. C. Gilbert,A. S. Murad.
Edinburgh Post-Graduate Board for MedicineOn Tuesday, Sept. 6, at 4.30 P.M., in the anatomy theatre
of Edinburgh University, Prof. D. V. Davies is giving a lectureon Synovial Membrane in Health and Disease.Scottish Intelligence Survey
Speaking in Oxford at a summer school of the NationalUnion of Teachers, Sir Godfrey Thomson, D.se., professor ofeducation in the University of Edinburgh, announced thatthe Nuffield Foundation would finance the first 5 years of the20-year plan for testing the intelligence of Scottish school-children. The children are to be selected from among thoseborn in 1936 in every type of family.Royal Photographic SocietyThe annual exhibition of this society will be held at
16, Princes Gate, London, S.W.7. This year the exhibitionis to be divided into two parts. Pictorial, colour, and stereo-scopic exhibits will be shown from Sept. 9 to Oct. 2, andscientific, nature, record, and technical exhibits from Oct.8 to 26.
National Association for the Prevention of Tuberculosis
A joint meeting of the association and the Society ofMedical Officers of Health will take place in B.M.A. House,Tavistock Square, London, W.C.1, on Thursday, Sept. 15, at2.30 to discuss social and aftercare arrangements bylocal health authorities under the National Health Service.The following will open the discussion : Sir Allen Daley,Dr. G. W. H. Townsend, Dr. W. Alcock, Dr. Neville Irvine,and Miss Anne Topley.Preventive DentistryThe Ministry of Education has set up a Working Party to
direct and organise an investigation on the prophylacticeffect of the local application of a solution of fluorides toschool-children’s teeth. The members are : R. Weaver,D,T.D., F.D.S., Ministry of Education (chairman) ; E. R.
Bransby, PH.D., Miss J. R. Forrest, L.D.s., and W. G. Senior,PH.D., r.D.s., Ministry of Health ; G. J. Parfitt, M.R.O.S.,L.D.s., department of preventive dentistry, Eastman Clinic ;B. R. Townend, F.D.s., West Riding local education authority ;W. Ritchie Young, F.D.s., London County Council ; andA. T. Wynne, M.D., B.D.s., Ministry of Education (secretary).
King’s College Hospital Medical SchoolSir Hugh Cairns will deliver the inaugural address at the
opening of the 120th session of the medical school, DenmarkHill, London, S.E.5, on Friday, Sept. 30, at 3 P.M.
A Second Pair of GlassesTo relieve the present difficulties in the supply of glasses,
the Minister of Health has decided, after consultation with theappropriate organisations, to introduce arrangements whichwill enable ophthalmic medical practitioners and ophthalmicopticians, at their discretion, to postpone ordering a secondpair of glasses which, although necessary for the correctionof vision, is not urgently required for the patient’s comfortand daily needs.
Churches Council of HealingThe London joint committee of this council is holding,
during the autumn and winter months, two courses of sixlectures, one on the devotional side entitled the Way toWholeness and the other on the medical and scientific sideentitled Health and Healing. The lectures will take place atFriends House, Euston Road, London, N.W.1, and furtherparticulars may be had from Mrs. Michael Thomas, HughendenManor, High Wycombe, Bucks.
Medical Defence UnionAt the annual meeting of this body on Sept. 20, members
will consider a recommendation by the council that theordinary annual subscription should be increased from ii 1to .E2, except for those joiningwithin three years of registra-tion, who for each of the first three years of membership wouldpay only 91. Since 1947 expenditure has exceeded income,partly owing to the public’s increased litigiousness and theaward by the courts of damages on a higher scale than beforethe war.
Dame Dehra Parker, D.B.E., M.r., has been appointedNorthern Ireland minister of health and local government insuccession to the late Mr. William Grant.
Prof. Alexander Kennedy will leave by air for Australiaon Sept. 11 for a six-week visit arranged by the BritishCouncil. He has been invited by the government of Victoriato advise them on mental health and psychiatric organisation,and the presentation to the Victorian parliament of a Bill
dealing with this question is being delayed until after his visit.The proceedings of the First International Congress on
B.C.&., held last year in Paris and Lille, have now been
published. They are obtainable (price 750 francs for membersof the congress and 1000 francs for others) from the documen-tation centre of the B.c.G. department, Institut Pasteur,25, rue du Dr. Roux, Paris 15e.
Births, Marriages, and Deaths
BIRTHSCURL.—On Aug. 22, at Norwich, the wife of Dr. O. J. Curl-a
daughter.HAMILTON.—On Aug. 20, the wife of Dr. J. J. Hamilton-a daughter.JoLLEs.-On Aug. 23, at Northampton, the wife of Dr. Benjamin
Jolles—a son.KEELE.—On Aug. 16, in London, the wife of Dr. K. D. Keele-
a son.MCAFEE.—On Aug. 19, at West Kirby, the wife of Dr. Lewis McAfee
—a daughter.NABARRo.-On Aug. 26, in London, the wife of Dr. J. D. N.
Nabarro-a son.TEOMFSON.—On Aug. 23, at Nairobi, the wife of Dr. F. A. Thompson
—a daughter.UNSWORTH.—On Aug. 21, at Bolton, the wife of Dr. James Unsworth
—a son.
MARRIAGESBOLTON—HALL.—On Aug. 31, at Ashton-under-Lyne, Harold Bolton,
F.R.c.s., to Barbara Hall, M.B.REDFEARN—SHAFIR.—On Aug. 19, in London, Joseph William
Thorpe Redfearn, M.D., to Shulamith Shafir.
DEATHSBLABER.-On Aug. 21, at Twyford, Berks, Percy Leonard Blaber,
M.R.C.s., aged 77.DUFFY.—On Aug. 23, at Oldham, James Joseph Duffy, M.B. N.U.I.ENGLISH.—On Aug. 25, at Sudbury, Suffolk, Thomas Crisp English,
K.C.M.G., M.B. Lond., F.R.C.S.FERGUSON.—On Aug. 27, James Ferguson, C.B.E., M.B. R.U.I.
D.P.H.SHAvE.-On Aug. 22, Edward Simpson Shave, M.R.C.s., aged 93.