vaccination : the modern view

1
1034 have been futile as I do not remember hearing of any satisfactory photographic result. There was however a sequel to this exposure, for about ten days afterwards my brother showed me his chest and asked my opinion. I noticed a round discoloured patch about 8 inches in diameter, with the bullet wound as centre, very similar to a sunburn, or what we now see after an overdose of ultra-violet rays. The only conclusion I could come to was that the condition was directly due to the action of the X rays, and I urged my brother to make the discovery known. This he never did, and it was not until some time later that a similar phenomenon was observed and recorded. Perhaps one of your readers can tell me the first recorded case of X ray dermatitis. My brother died in the Manchester Royal Infirmary in 1927, having never suffered any ill-effects from the embedded bullet.-I am, Sir, yours faithfully, J. 0. NICHOL, B.Sc., A.M.I.E.E. Manchester, May 3rd. J. O. NICHOL, B.Sc., A.M.I.E.E. A DISCLAIMER To the Editor of THE LANCET SIR,-In view of the publicity given in the press to my informal talk to the Ladies’ Association of Queen Charlotte’s Hospital, I should like to make it clear that I did not know that reporters were to be present, nor did I know that the proceedings were to be published.-I am, Sir, yours faithfully, Harley-street, W., May 7th. LOUIS CARNAC RIVETT. LOUIS CARNAC RIVETT. THE SELENIDE TREATMENT OF CANCER Dr. A. T. TODD writes to point out that the annota- tion on p. 963 of our last issue gives too pessimistic an account of his results in the treatment of cancer. In particular the statement that ten of the patients described as apparent cures are alive " more than a year after the beginning of treatment " requires revision. The duration of the " apparent cures " is calculated, he informs us, from the end of treatment (which lasts at least a year) to the month of October, 1933, when his paper was compiled. At least 19 months, therefore, has now to be added to the duration of these " apparent cures" in order to obtain the period of survival as ordinarily reckoned ; and on this it is seen that 7 out of 15 are alive and free from symptoms three years or more after their treatment began, while the other 8 have all survived more than two years. Publication of the figures has been delayed, Dr. Todd says, until it was likely that the results were reasonably permanent. He adds in conclusion: "Though I only accept what are called scrap-heap cases, there is no reason why the method should not be applied to current surgical practice. If my results in my cases are what is given, what is likely to follow the application of the method to cases after presumed complete operation ? " VACCINATION : THE MODERN VIEW A LETTER from Colonel W. G. King, I.M.S. retd., and Major Myer Coplans, late R.A.M.C. (T.A.), reaches us commenting on the opening speech made by Dr. S. Monckton Copeman at the recent discussion under this heading which took place on Feb. 23rd in the section of epidemiology of the Royal Society of Medicine. The writers criticise Dr. Copeman for claiming to have introduced glycerinated lymph, but allow that his reference may have been due to the belated action of the British Government in issuing such lymph from an officially recognised institution. They consider that accuracy requires detailed mention of previous work in similar directions, and give detailed references in support, while they 6 recognise that our report of Dr. Copeman’s words was necessarily only a brief resume. Those who are historically minded may refer to a leading article in THE LANCET of April 28th, 1900 (p. 1216). THE SERVICES ROYAL NAVAL MEDICAL SERVICE Surg. Comdrs. to be Surg. Capts. : G. R. McCowen, H. F. Briggs, C. F. 0. Sankey, and F. J. D. Twigg. F. H. Ward, E. J. Littledale, M. A. Rugg-Gunn, and S. H. Rhys Price to be Surg. Lts. The following appointments are notified : Surg. Comdrs. G. B. Cockrem to Effingham and J. Kirker to Victory, for R.N.B. Surg. Lt. Comdrs. E. C. Davis to President for course, and F. R. P. Williams to Victory for R.N.B. Surg. Lt. J. G. V. Smith to Pembroke for R.N. Hospital, Chatham. ARMY MEDICAL SERVICES , Col. W. D. C. Kelly, late R.A.M.C., retires on retd. pay. ROYAL ARMY MEDICAL CORPS Lt.-Col. E. W. M. Paine, having attained the age for retirement, is placed on retd. pay. Maj. C. L. Franklin to be Lt.-Col. Maj. & Bt. Lt.-Col. C. H. H. Harold and Maj. D. W. Pailthorpe retire on retd. pay. The undermentioned Lts. to be Capts. (Provl.): A. Macdonald and W. R. M. Drew. Capt. J. C. Collins to be Maj. TERRITORIAL ARMY Lt. R. B. Brew to be Capt. Lt. H. Rogers resigns his commn. and retains his rank. Lt. W. F. Dorward resigns his commn. E. H. Jaques (late Cadet, Durham Univ. Contgt., Sen. Div., O.T.C.) to be Lt. Supernumerary for service with O.T.O.- 2nd Lt. R. W. Rattray to be Lt. supern. for serv. with Med. unit, Edin- burgh Univ. Contgt., Sen. Div., O.T.C. INDIAN MEDICAL SERVICE Majs. M. L. Treston, A. Chand, R. Lee, T. S. Shastry, C. de C. Martin, J. H. Smith, J. B. de W. Molony, K. R. Batra, B. H. Singh, 0. R. Unger, A. H. Harty, N. Briggs, F. R. Thornton, R.’L. Vance, F. Griffith, and J. P. Huban to be Lt. Cols. Temp. Lts. T. R. Pahwa, M. A. Gaffar, and J. N. Vasu- deva to be Temp. Capts. The undermentioned Lts. (on prob.) are rest. to the estabt. : W. M. E. Anderson and J. W. D. Goodall. P. 1. Franks, H. B. Wright, J. M. Davidson, D. P. Dewe, M. G. Leane, and G. E. S. Stewart to be Lts. (on prob.). Lt.-Col. S. J. Bhathena retires. ROYAL AIR FORCE Flight Lt. (Hon. Squadron Leader) G. S. Ware relin- quishes his temporary commission on completion of service and is permitted to retain the honorary rank of Squadron Leader. Flight Lt. (Hon. Squadron Leader) J. G. Skeet relin- quishes his temporary commission on completion of service. COLONIAL MEDICAL SERVICE The following appointments have been made : Dr. H. C. Armstrong, Dr. J. W. Denoon, Dr. F. J. Sladen, and Dr. G. Watt, Medical Officers to the Gold Coast, and Dr. N. E. W. Anderson, Dr. S. A. B. Black, Dr. R. D. Harding, Dr. A. C. Howard, and Dr. T. H. L. Mont- gomery, Medical Officers, Nigeria. Dr. W. K. Connell becomes a Junior Surgical Specialist, and Dr. C. F. Shelton a Junior Medical Specialist, Tanganyika. Dr. H. M. Nevin has been appointed Pathologist II., Institute for Medical Research, in the Federated Malay States. Dr. J. T. Lydon has been appointed Admiralty Surgeon and Agent for Kingstown, and Mr. P. J. Smyth for Dublin.

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Page 1: VACCINATION : THE MODERN VIEW

1034

have been futile as I do not remember hearing ofany satisfactory photographic result. There washowever a sequel to this exposure, for about ten

days afterwards my brother showed me his chestand asked my opinion. I noticed a round discolouredpatch about 8 inches in diameter, with the bulletwound as centre, very similar to a sunburn, or whatwe now see after an overdose of ultra-violet rays.The only conclusion I could come to was that thecondition was directly due to the action of the X rays,and I urged my brother to make the discovery known.This he never did, and it was not until some timelater that a similar phenomenon was observed andrecorded. Perhaps one of your readers can tell methe first recorded case of X ray dermatitis.My brother died in the Manchester Royal Infirmary

in 1927, having never suffered any ill-effects from theembedded bullet.-I am, Sir, yours faithfully,

J. 0. NICHOL, B.Sc., A.M.I.E.E.Manchester, May 3rd.

J. O. NICHOL, B.Sc., A.M.I.E.E.

A DISCLAIMER

To the Editor of THE LANCETSIR,-In view of the publicity given in the press

to my informal talk to the Ladies’ Association ofQueen Charlotte’s Hospital, I should like to make itclear that I did not know that reporters were to bepresent, nor did I know that the proceedings were tobe published.-I am, Sir, yours faithfully,

Harley-street, W., May 7th. LOUIS CARNAC RIVETT.LOUIS CARNAC RIVETT.

THE SELENIDE TREATMENT OF CANCER

Dr. A. T. TODD writes to point out that the annota-tion on p. 963 of our last issue gives too pessimistican account of his results in the treatment of cancer.In particular the statement that ten of the patientsdescribed as apparent cures are alive " more than ayear after the beginning of treatment " requiresrevision. The duration of the " apparent cures " iscalculated, he informs us, from the end of treatment(which lasts at least a year) to the month of October,1933, when his paper was compiled. At least 19

months, therefore, has now to be added to the durationof these " apparent cures" in order to obtain theperiod of survival as ordinarily reckoned ; and onthis it is seen that 7 out of 15 are alive and free fromsymptoms three years or more after their treatmentbegan, while the other 8 have all survived morethan two years. Publication of the figures hasbeen delayed, Dr. Todd says, until it was likelythat the results were reasonably permanent. Headds in conclusion: "Though I only accept whatare called scrap-heap cases, there is no reason whythe method should not be applied to current surgicalpractice. If my results in my cases are what is

given, what is likely to follow the application of themethod to cases after presumed complete operation ? "

VACCINATION : THE MODERN VIEW

A LETTER from Colonel W. G. King, I.M.S. retd.,and Major Myer Coplans, late R.A.M.C. (T.A.),reaches us commenting on the opening speech made byDr. S. Monckton Copeman at the recent discussionunder this heading which took place on Feb. 23rdin the section of epidemiology of the Royal Societyof Medicine. The writers criticise Dr. Copeman forclaiming to have introduced glycerinated lymph,but allow that his reference may have been due tothe belated action of the British Government in

issuing such lymph from an officially recognisedinstitution. They consider that accuracy requiresdetailed mention of previous work in similar directions,and give detailed references in support, while they

6

recognise that our report of Dr. Copeman’s wordswas necessarily only a brief resume.

Those who are historically minded may refer toa leading article in THE LANCET of April 28th, 1900(p. 1216).

THE SERVICES

ROYAL NAVAL MEDICAL SERVICE

Surg. Comdrs. to be Surg. Capts. : G. R. McCowen,H. F. Briggs, C. F. 0. Sankey, and F. J. D. Twigg.

F. H. Ward, E. J. Littledale, M. A. Rugg-Gunn, andS. H. Rhys Price to be Surg. Lts.The following appointments are notified : Surg. Comdrs.

G. B. Cockrem to Effingham and J. Kirker to Victory, forR.N.B.

Surg. Lt. Comdrs. E. C. Davis to President for course,and F. R. P. Williams to Victory for R.N.B.

Surg. Lt. J. G. V. Smith to Pembroke for R.N. Hospital,Chatham.

ARMY MEDICAL SERVICES ,

Col. W. D. C. Kelly, late R.A.M.C., retires on retd. pay.ROYAL ARMY MEDICAL CORPS

Lt.-Col. E. W. M. Paine, having attained the age forretirement, is placed on retd. pay.

Maj. C. L. Franklin to be Lt.-Col.Maj. & Bt. Lt.-Col. C. H. H. Harold and Maj. D. W.

Pailthorpe retire on retd. pay.The undermentioned Lts. to be Capts. (Provl.): A.

Macdonald and W. R. M. Drew.

Capt. J. C. Collins to be Maj.TERRITORIAL ARMY

Lt. R. B. Brew to be Capt.Lt. H. Rogers resigns his commn. and retains his rank.Lt. W. F. Dorward resigns his commn.E. H. Jaques (late Cadet, Durham Univ. Contgt., Sen.

Div., O.T.C.) to be Lt.Supernumerary for service with O.T.O.- 2nd Lt. R. W.

Rattray to be Lt. supern. for serv. with Med. unit, Edin-burgh Univ. Contgt., Sen. Div., O.T.C.

INDIAN MEDICAL SERVICE

Majs. M. L. Treston, A. Chand, R. Lee, T. S. Shastry,C. de C. Martin, J. H. Smith, J. B. de W. Molony, K. R.Batra, B. H. Singh, 0. R. Unger, A. H. Harty, N. Briggs,F. R. Thornton, R.’L. Vance, F. Griffith, and J. P. Hubanto be Lt. Cols.

Temp. Lts. T. R. Pahwa, M. A. Gaffar, and J. N. Vasu-deva to be Temp. Capts.The undermentioned Lts. (on prob.) are rest. to the

estabt. : W. M. E. Anderson and J. W. D. Goodall.P. 1. Franks, H. B. Wright, J. M. Davidson, D. P.

Dewe, M. G. Leane, and G. E. S. Stewart to be Lts. (onprob.).

Lt.-Col. S. J. Bhathena retires.

ROYAL AIR FORCE

Flight Lt. (Hon. Squadron Leader) G. S. Ware relin-

quishes his temporary commission on completion ofservice and is permitted to retain the honorary rank ofSquadron Leader.

Flight Lt. (Hon. Squadron Leader) J. G. Skeet relin-quishes his temporary commission on completion ofservice.

COLONIAL MEDICAL SERVICEThe following appointments have been made : Dr. H. C.

Armstrong, Dr. J. W. Denoon, Dr. F. J. Sladen, andDr. G. Watt, Medical Officers to the Gold Coast, andDr. N. E. W. Anderson, Dr. S. A. B. Black, Dr. R. D.Harding, Dr. A. C. Howard, and Dr. T. H. L. Mont-gomery, Medical Officers, Nigeria. Dr. W. K. Connellbecomes a Junior Surgical Specialist, and Dr. C. F. Sheltona Junior Medical Specialist, Tanganyika. Dr. H. M.Nevin has been appointed Pathologist II., Institute forMedical Research, in the Federated Malay States.

Dr. J. T. Lydon has been appointed Admiralty Surgeonand Agent for Kingstown, and Mr. P. J. Smyth for Dublin.