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Page 1: PATHOLOGY OF THE PERIPHEAL CIRCULATION

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to be decidedly less among children attending thecentres than among the general population. Super-vision and instruction was instituted among negro mid-wives, many of whom had had no previous training,and the value of antenatal medical attention wasstressed as much as possible, with good results.During the four years 1920-23 the deaths of 372children were recorded ; the deaths during the

period of the demonstration fell short of this numberby 124, and though it is impossible to draw definiteconclusions from such figures it seems probablethat the health campaign played a part in thereduction. Since the end of the demonstration a

ruthless demand for economy has cut down theadditions to the health service so thoroughly thatonly the full-time laboratory service and three

PROPOSED NEW FORMULÆ FOR THE B.P.

A Pharmacy Subcommittee of the PharmacopoeiaCommission was formed in September, 1929, andhas now issued its first report, which incorporatessuggestions for some new formulae. An importanteconomy would be effected by the permission to useindustrial methylated spirit in making solid extractsand certain other preparations, subject to the regula-tions of the Board of Customs and Excise. For

example, among the new formulae set out in thereport the use of industrial methylated spirit is

suggested in the preparation of extractum bella-donnae siccum, extractum cinchonae, extractum

, colchici siccum, fel bovinum purificatum (in future

I to be known as extractum fellis bovini), linimentumand emplastrum belladonnae, liquor picis carbonis,

and certain resins. Another economy is proposed inthe replacement of olive oil by cotton-seed oil incertain preparations, such as unguentum hydrargyricompositum, and in linimentum camphorae, since ahigh-grade olive oil will be described in the Pharma-copoeia. In parts of the Empire outside the BritishIsles the use of arachis oil or sesame oil will bepermitted. The subcommittee recommend that forconvenience in manufacture the quantities in theformulae for glycerins should be expressed in weight.The error involved in measuring glycerin would thusbe avoided. They also recommend the inclusion inthe Pharmacopoeia of concentrated preparationswhich, when diluted with seven times their volumeof distilled water, will be equivalent in strength, if Inot in flavour, to fresh infusions. Practitioners whoprefer fresh infusions would be able to ensure thatthese will be dispensed by adding the word " recens

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to the name of the infusion. Digitalis should bedispensed only in fresh infusion. In response to the

suggestion that lard and benzoated lard should bereplaced as far as possible by a base not liable todevelop rancidity, experiments have been made withmixtures of paraffin and various fats, with the resultthat a formula has been devised under the name ofunguentum simplex. This consists of wool fat (1 part),hard paraffin (2 parts), and soft paraffin (17 parts),and could be used for certain of the official ointmentswhich are now made with lard. Since an internationalagreement requires that the name " tincture " shallnot be given to simple solutions of chemical sub-

1 Pharmacopœia Commission. Reports of Subcommittees.I. Report of Pharmacy Subcommittee, August, 1930. Pub-lished by authority of the General Medical Council. London :44, Hallam-street, W. Pp. 35. 1s.

stances, the two tinctures of iodine official in theB.P. 1914 should be renamed and classed as solutions,the present names being retained as synonyms. Wecan confirm the conclusion of the subcommittee thatan official preparation corresponding to the " Frenchtincture of iodine " is required ; they propose thatthe need would be met by a 10 per cent. w/v solutionof iodine in alcohol (95 per cent.), which might benamed liquor iodi simplex. A preliminary surveyof the report does not suggest that the criticismswhich are invited in cordial terms will be drastic.We are assured that careful consideration will begiven to all opinions evoked by the report, andrecommend physicians to study it with attention.

PATHOLOGY OF THE PERIPHEAL CIRCULATION.ST.ARR1 reports that he has used the histamine

reaction to investigate the state of the circulationof the feet in pathological conditions. Three of11 cases of arterio-sclerosis with hypertension showeda deficient circulation, as also did two more after

) the onset of cardiac failure. These results suggest. that an increase in the systemic blood pressure mayi compensate an impairment of the circulation due; to arterio-sclerosis. In cardiac failure the reaction mayI be within normal limits even in the presence of, cedema, and it is not until other signs of failure are

well marked that the reaction becomes definitelyabnormal. The investigation of cases with a lesion ofthe peripheral nerves confirmed Lewis’s conclusionsthat the flare is nervous in origin, these cases developinga well-marked wheal but no flare. In diabetesmellitus the reaction enables one to assess the degreeto which the arterio-sclerosis of the main vessels hasbeen compensated by a rise in blood pressure or bythe opening up of anastomotic channels. The reactionresponded fairly rapidly to alterations in the generalcondition of the patient and also to improvement withtreatment. It is also suggested that the reactionshould be of value in deciding the level at whichamputation should be performed in cases of gangTene.

THE annual dinner of the Royal Society of Medicinewill be held at the Mayfair Hotel on Thursday,Nov. 20th, at 7.30 for 8 P.M. The Duke of York willattend the dinner, and the Bishop of Birminghamand Sir John Simon will be present as guests ofhonour.

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THE Fifth Conference on Maternal Mortality willbe held at Friends House, Euston-road, on Oct. 27th,at 2.30 the Duchess of Atholl presiding. The

principal speaker will be the Minister of Health,Mr. Arthur Greenwood. Miss Marion Phillips, D.Se.,and Lady Erleigh will also take part.

AT the opening meeting of the Section of Medicineof the Royal Society of Medicine, to be held at 5 P.M.,next Tuesday, Oct. 28th, a discussion on Research inClinical Medicine will be opened by Dr. J. A. Ryle,physician to Guy’s Hospital; Dr. H. Francis Moore,professor of medicine at University College, Dublin;and Dr. Helen M. M. Mackay, late Ernest Hart andBeit Memorial Research Scholar, who will deal brieflywith the natural scope and limitations of such researchand the measures, if any, which should be taken forits direction and encouragement.

1 Starr, I., jun. : Amer. Jour. Med. Sci., August, 1930.

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