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general use. Such treatment necessitates theundivided attention of the physician himself through-out its duration, and presupposes a docility on thepart of the patient that cannot always be relied upon.Should accident or indiscipline produce a suddenalteration of current-strength, a burn or shock mayoccur. Wilde’s thermal couch, dependent as it isupon low-pressure steam heating, and necessitatingno pinioning of the patient in blankets, is free fromthese drawbacks, and its application can be safelyleft to a reliable nurse. With it a rise of mouth-temperature to 103° F. in 40 minutes is easilyobtained, and 106° F. or higher may be reached after60-90 minutes’ treatment.Such pyrexia is associated with profuse sweating

but with no subjective feelings of distress and withno excessive rise of pulse-rate. Rates of 130 beats perminute are rare. In the case of the patient who isvery ill, the treatment can be given by means of aportable apparatus, with equally satisfactory results.Should necessity arise, it can be terminated safely atany moment without risk of accidental damage. Suchbaths have been given without untoward effects inpost-encephalitic parkinsonism and in early cases ofG.P.I., and can be strongly recommended as a safeand simple method of applying artificial fever therapy.

I am, Sir, yours faithfully,C. E. SUNDELL.

Queen Anne-street, Cavendish-square, W., Sept. 6th, 1932.

C. E. SUNDELL.

THE INNERVATION OF DENTINE

To the Editor of THE LANCET

SIR,—In an annotation in THE LANCET of

August 20th (p. 408), on the important investigationsof 0. W. Tiegs into the innervation of the dentine,the following statement in regard to my work onthis subject occurs :

" He (D. Stewart) severed the inferior dental nerve in acat on one side and later compared the pulps of the teethwith those of the opposite side. He found that histo-logically the fibres which Mummery had assumed to benerve-fibres showed no difference in their staining reactionsfrom those on the normal side ; he concluded that if theywere nerve-fibres some change would be visible and thatthey must therefore be connective tissue fibres. But thiswork, significant though it be, does not take into account thepossibility of some nerve-supply through the sympatheticfibres accompanying the blood-vessels."

Might I be allowed to say that in a later paper(Jour. of Anatomy, 1928, lxiii., 1-6) I was able toshow that the fibres of Mummery were still presentafter both the inferior dental nerve and the peri-arterial nerve plexus around the inferior dentalartery had been divided.

I am, Sir, yours faithfully,D. STEWART.

Department of Anatomy, the University,Manchester, Sept. 7th, 1932.

I am, Sir, yours faithfully,D. STEWART.

Department of Anatomy the University

THE LONDON CLINIC AND NURSING HOME

To the Editor of THE LANCET

SIR,—Representing the medical group by whose ’initiative the London Clinic and Nursing Homecame into existence, we feel that it is our duty to

. make some statement regarding its present situation. 1The public announcement of the appointment of areceiver and manager of the affairs of the company must suggest to our profession and to the publicgenerally that the undertaking has come to a prem-ature end. Were this the case it would indeed be anational disaster, for the Home sets a new standard

in the medical and surgical treatment of private. patients.

It is true that the company has under-estimated, the amount of capital required for the building, itsequipment, and its working, and that arrangementsfor additional capital will have to be made. The

, appointment of the receiver and manager is, however,: not a destructive measure, but a protective measure,

designed to enable the work of the Home to be carriedon until arrangements for the additional capital canbe made.The medical group is affording the receiver all the

advice and assistance which its members can givetowards achieving efficient and economical working.They have no doubt of the ultimate success of theundertaking, and they are satisfied that during theperiod of financial reorganisation the reception of

patients and the working of the Home will be carriedon to the complete satisfaction of everyone concerned.#’

We are, Sir, yours faithfully,(Signed) H. MORELAND MCCREA,

G. LENTHAL CHEATLE,WALTER HOWARTH,H. S. SOUTTAR

Sept. 12th, 1932. (on behalf of the Harley-street group).

IODINE IN AVITAMINOSIS

To the Editor of THE LANCET

SIR,—In your issue of May 14th (p. 1031) Mr. L. J.Harris, D.Sc., has made several suggestions regardingthe mode of action of vitamin D which we believecan be further amplified by a report of our recentstudies on leg-weakness in fowls. The results of our

investigation, which will be more fully reported inEndocrinology (Chidester, Ashworth, Ashworth andWiles), would seem to indicate that the iodine of

cod-liver oil has long been an unconsidered factorin the prevention and treatment of rickets. Not

only did our group-find that thyroid extract preventedthe appearance of leg-weakness, but a clinical reportfurnished us by a poultryman indicates that iodineadministration prevented and cured leg-weaknessappearing in a flock that presumably was receivingan adequate supply of cod-liver oil supplemented byfish meal.

Our experiment was incidental to a study of the influenceof anterior pituitary extract intravenously injected. Previousworkers had found that under such conditions, after aperiod of three or four weeks, the thyroids were depleted iniodine. Some of our experimental animals treated formore than four months developed leg-weakness and " slippedtendon."

It is our belief from a consideration of chemical analysesof the pituitary gland that we produced a high-phosphoruslow-calcium rickets, and that we also drew upon the storediodine in the thyroid. It occurred to the writer that sincethe parathyroids apparently have such a profound influenceon calcium deposition, it might be possible that they functionas reservoirs of iodine. The long overlooked investigationof Gley indicates that such is the case. It is our beliefthat other analysts found the reservoirs empty, and hencereported a low iodine content.

It has been shown by several workers that both inorganicand organic iodine will prolong the lives of rats which havehad an excess of irradiated ergosterol. The fact that thewriter and associates (Chidester, Eaton, Speicher, Bourne,and Wiles) have been able to point out the great significanceof iodine in three other vitamins, and that he has shownthat the vitamin-A potency of cod-liver oil destroyed byoxygenation at a temperature of 120° C. for 24 hours canapparently be restored by adding iodine, naturally suggestsa reason for the failure of oxidised cod-liver oil in the controlof rickets, as described by Wagner and Wimberger (THELANCET, 1924, ii., 55), and by other workers since that time.

While cod-liver oil itself may be given in too largequantities, we have considerable evidence from long-