2
338 is usually so adjusted that the ordinary acid solutions likely to be used in culinary operations only remove inappreciable amounts of antimony in cases where that element is a constituent of the glaze. Antimony was also found in the " lemonade " taken from the pails. Owing to an oversight the liquid from the bath, which it was found was not enamelled with a fritted glaze, but had been painted with zinc white in linseed oil, was not examined, and it is not certain that any of the liquid in this was consumed, although at first there was an impression that those who drank only from this supply were not attacked by sickness. The lemonade from the pails contained 0-013 per cent. of metallic antimony. This, as Dr. Dunn points out, would represent in an ordinary 10 oz. tumbler gr. 0-57 of antimony, or gr. 1-52 of tartar emetic, whilst the emetic dose given in the British Pharmacopoeia is gr. 0-5 to 1-0, so that drinking so little as one-third of a tumbler might be expected to cause sickness. No other heavy metals, such as arsenic or lead, were found in the drink, and the circumstances, including the symptoms observed, were all consistent with simple ’antimony poisoning. It is unfortunate that so kind and thoughtful an action on the part of the firm concerned should have led to so much pain and inconvenience, but the tale serves to point some morals. Esthetic and, perhaps, even common-sense considerations seem to, suggest hesitation in adapting utensils designed for one purpose to another. The German makers of slop-pails, in glazing their interiors with a rather low-grade antimonial enamel, could hardly have foreseen that in the pioneer country of sanitary science they would be ’used as containers for beverages. Possibly, having regard to the adaptable character of the Briton, it might be desirable for such vessels, when sold, to bear a label : " not to be used for food or drink." Occur- rences of this kind should receive the -widest publicity ; in fact, there should be some means whereby brief warnings could be compulsorily published in all news- papers. Further, some international standard for food containers might well be considered, as apart from acute visitations of the kind described, it is surely undesirable that the human body should become a receptacle for traces of antimony, tin, lead, arsenic, and other heavy metals. Last week 30 out of 60 of a party of boy scouts and girl guides were suddenly taken ill after having been regaled with cakes and lemonade, and were unable to return to camp until next morning. It is legitimate to wonder whether this outbreak was due to the same cause as the Newcastle one. ____ THROMBOSIS OF THE SPLENIC VEIN. THE diagnosis of splenic anaemia is often made in cases which conform only vaguely to what many authorities regard as at best a vague disorder. From the mixed collection of cases grouped together under this name certain examples of thrombosis of the ’splenic vein have been separated off, principally by Wallgren, whose original paper has already been noticed in our columns. 1 At the discussion on chronic enlargements of the spleen in children, at the British Medical Association’s meeting at Cardiff, Dr. Robert Hutchison referred to the occurrence of this condition in children, and described a case of his own; while in a recent article2 G. Westkott makes a further contribution to the subject. The essential features of these cases of thrombosis of the splenic vein are the occurrence of severe hsematetnesis in a3sociation with enlargement of the spleen-which enlargement is less during and immediately after the haemorrhage—and the absence of °any evidence of cirrhosis of the liver or other cause for the symptoms. Westkott had under his care a girl of ten who was admitted with a profound anaemia, due, he believes, to severe infection with the intestinal parasite, -Trichocephalus s di8par. There was a history of 1 THE LANCET, 1927, ii., 823. 2 Jahrb. f. Kinderheilkunde, June, 1928. haematemesis before admission, and a severe repetition of this followed a blood transfusion while she was, in hospital. Elaborate investigations were carried out which excluded other causes of splenic enlarge- : ment: the blood count showed a severe secondary ; anaemia with very slow gradual improvement, unlike that following a serious haemorrhage. In uTestkott’s paper the part played by the parasitic infection is discussed at some length, and the relation between this and the thrombosis of the splenic vein which was diagnosed is also considered. Operation was not performed, so that confirmation of the diagnosis was not possible. It is believed that thrombosis in these cases is probably the result of some infection. ’. although the possibility of its connexion with the severe loss of blood by the bowel due to the worm infection has also to be remembered. It may be- that the primary fault in these cases of splenic anaemia is a thrombosed splenic vein, and the splenomegaly which follows this may be responsible for the ansemia and also for the character of the white cell count. with leucopenia, so frequently found. Westkott does not come to any definite conclusions except to> confirm the idea advanced by Wallgren, that splenic vein thrombosis is a clinical entitv. The case he describes opens up further possibilities as to the- aetiology of the condition. THERAPEUTIC MIRACLES AT HEREFORD. IN his History of Hereford Cathedral the late Canon Bannister states that, as a general rule, the miracles recorded in the " Lives " of mediaeval saints are vaguely described and poorly attested. But of those wrought at the tomb of St. Thomas de Cantilupe it seems that there exists an official account, drawn up by six lawyers after investigations made by papal commissioners. Two of these-Ralph Baldock.. Bishop of London, and the Bishop of Mende-came to Hereford at the end of August, 1307, and stayed till Nov. 16th, omni die ex industria intuentes ecclesiam. Pope John XXII., in the Bull of canonisation, declares that 17 miracles were thoroughly investigated and found to be fidelibus probata testirnoniis. A large proportion of these 17 miracles were cures of cases of palsy, but three deal with cases of blindness, and Bannister says that the evidence for them is probably better attested than the evidence for marvellous cures at any other shrine. The fifteenth of the series concerns Agnes de la Brok, of the parish of St. Martin’s, Hereford, cured of blindness on the Friday after the octave of Easter, 1287. ’One witness affirmed that Agnes was well-to-do, so that there was no apparent reason for her wishing to make money out of her infirmity. Several witnesses deposed that she had not in her blinded eyes, vulnera, apostema, tumorern. maculam, vel aegritudionem vel aliquam apparenterrr laesionem. This seems to have been a case of hysterical blindness. Last in the series of cures come two small boys, brothers, aged 4 and 5 years respectively, healed of their blindness, also in 1287. Mali hicrrtores effluebant ex oculis, et aliquando claudebantur palpebrae dictorum oculorum : tunc ipsi’ oculi infiabantur, et putredine congregata in eis denuo palpebrae aperiebantzer. Obviously these were cases of simple catarrhal ophthalmia. Presumably Agnes and the children had died or passed out of ken during the 20 year? intervening between their miraculous cures and the bfficial inquiry, or their first-hand testimony would have been obtained. Judged by modern standards one feels that the six lawyers who investigated these cures must have been very easily satisfied, but the inquiry was held upon the findings of papal commissioners, and when St. Thomas de Cantilupe, recently dead, was at the- crest of his fame as a miracle worker. For this saint. one of the most celebrated of the Bishops of Hereford. died on August 25th, 1282, at Civita Vecchia. He is reputed to have been of a saintly disposition, and was certainly steadfast and unyielding in upholding the rights of the See. There is, so far as we are aware,.
