Notes, Short Comments, and Answers to Correspondents.
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1090 Notes, Short Comments, and Answers to Correspondents. SOME CHEMICAL REASONS FOR DETERIORATION IN LIQUID MEDICINES. IN Merck’s Report for March Mr. Frederic E. Niece calls attention to a number of chemical substances which do not keep well in solution. Chloroform water readily decomposes under the influence of heat, light, and air with the formation of acid by-products and the develop- ment of odours resembling those of phosphoretted hydrogen or decomposed marine algse. The addition of 4 per cent. of alcohol is sufficient to keep this preparation indefinitely. Solutions of iodoform in chloroform are less stable than alcoholic solutions, because chloroform acts as a carrier of oxygen which liberates iodine in the solution under the influence of sunlight. Chloroform itself is decomposed in the presence of iodoform and the by-products tend to react with the iodine. Solutions of potassium iodide show the presence of free iodine within a very short time and afterwards potassium iodate, and so become a source of trouble from incompati- bility and by producing unpleasant symptoms after administration. These changes may be retarded by keeping the solution in a cool, dark place, in full bottles, and by adding 0’2 per cent. of sodium thio- sulphate. Ammonium iodide likewise readily forms free iodine when kept in solution, but the change may be lessened or prevented by the addition of a few drops of diluted ammonia. The decomposition of solutions of sodium hypobromite is a constant source of annoyance to many practitioners, owing to the deeper colour and loss in strength produced by the solution of traces of manganates from amber bottles. To prevent this change it ’, is advisable to store the solution in green, blue, flint, or paraffin bottles with the addition of 10 per cent. of potassium bromide. The red colour produced in solutions of salts of eserine is caused by the combined action of light, atmospheric oxygen, and alkali present in the glass. This difficulty may be partially, if not completely, over- come by keeping the solution, prepared with sterile distilled water, in the dark in bottles coated on the inside with paraffin wax. As a further precaution Mr. Niece recommends the practice of covering the solution with a layer of washed and boiled liquid paraffin. This method is generally applicable in the case of sensitive and costly chemical substances which it is desired to keep in solution. In order to withdraw the solution from beneath the paraffin layer it is neces- sary to use a pipette, and since a solution of eserine is generally used for eye lesions the presence of a trace of oil is not objectionable. Solutions of lead acetate form heavy white precipitates of lead carbonate on exposure, unless restrained by the presence of a trace of acetic acid. These illustrations serve to show the dangers that may lurk in bottles of solutions and stock mixtures which have been kept for some time. A SUGGESTION FOR TREATMENT. To the’Editor of THE LANCET. SIR,—In reference to the treatment of the case mentioned by your correspondent "Perplexed" in THE LANCET of Feb. 20th, p. 589, allow me to suggest that he try ovarian extract. He states that the attacks seemingly have nothing to do with the menstrual period, but ovulation does not necessarily occur simultaneously with menstruation, and taking into consideration the age of the patient, I imagine that the headaches may be due to the approaching menopause. In two cases presenting somewhat similar symptoms I have been able to give relief by administering ovarian extract in five-grain doses three times a day for about a week at a time. Sometimes it was necessary to give it for a longer period, but I allowed myself to be guided by the symptoms. A young woman, aged 26 years, on whom a panhysterectomy had been performed, consulted me complaining of severe headache. She had been treated by several practitioners, including an ophthalmologist, and had been given all kinds of treatment, including morphine, but without any permanent relief. I pre- scribed ovarian extract and the headaches became progressively less severe. Instead of being confined to bed for one week out of every month she gradually improved till by taking the remedy for a day or two she could avert an attack. The attacks in this case were preceded by "nervous" symptoms such as frequently usher in a menstrual period. I believe that the headache was due to loss of the internal secretion of the ovaries, and in my opinion in many cases the headaches occurring at the menopause are due to the same cause. I trust that this may be of service to "Perplexed." I am, Sir, yours faithfully, Chicago, U.S.A., March 15th, 1909. M.D. ACCIDENTS TO RAILWAY SERVANTS. WE have received from Mr. T. A. Broekelbank a copy of a pamphlet dealing with a large number of accidents occurring among railway servants and advocating the adoption by English railways of auto- matic couplings. The fignres in the pamphlet are very impressive and bring before us well the risks which have to be run by the employees of railways. AN .. ASEPTIC SCHOOL BOX." WE have had forwarded to us a metal "school box" for the use of children. It is a flat box made of tinned iron, and measuring-, 9 inches by 2 inches by inch. Inside are metal partitions which. divide it into convenient spaces for pen, pencil, and ruler. The box, which is made by the South Wales Canister Company,. is stamped with the name, " Cymric Aseptic School Box." It could undoubtedly be made aseptic by boiling, but we fear that its normal contents will hardly be aseptic when in use. We would also suggest that if the " tin" edges of the box should damage the hands of its owner the advantage of its asepticity would very likely be counterbalanced by the complexion of the aforesaid hands. A wooden box, even though not aseptic, will to many seem prefer- able for the reception of the child’s implements of learning as less likely to cause any abrasion. COMMUNICATIONS not noticed in our present issue will receive attention. in our next. Medical Diary for the ensuing Week. SOCIETIES. ROYAL SOCIETY OF MEDICINE, 20, Hanover-square, W. THURSDAY. DERMATOLOGICAL SECTION (Hon. Secretaries—Arthur Whitfield, E. G. Graham Little): at 5 P.M. Exhibition of Cases. FRIDAY. ELECTRO-THERAPEUTICAL SECTION (Hon. Secretary—Reginald Morton): at 8.30 P.M. Dr. Sloan : Vulvo-vaginal Electrode for Ionic Medication. Mr. T. J. Bokenham: Treatment of Haemorrhoids by Zinc Mercury Ionisation. Mr. N. S. Finzi: Treatment of Ulcers by Ionic Medication. Dr. Horace Manders will show an Apparatus for the Production, of Continuous Oscillations. N.B.-Fellows of the Society are entitled to attend and to speak at all Meetings. UNITED SERVICES MEDICAL SOCIETY. Royal Army Medical College, Millbank, S.W. WEDNESDAY.-8.30 P.M., Surgeon K. D. Bell, R.N.: Physical, Training and the Medical Profession. LECTURES, ADDRESSES, DEMONSTRATIONS, &c. NORTH-EAST LONDON POST-GRADUATE COLLEGE, Prince of Wales’s General Hospital, Tottenham, N. WEDNESDAY.—Clinics :—2.30 P.M., Medical Out-patient (Dr. T. R. Whipham); Skin (Dr. G. N. Meachen); Eye (Mr. R. P. Brooks). 3 P.M., Demonstration :-Dr. F. Thomson: Infectious Fevers (at the North-Eastern Fever Hospital, St. Ann’s-road, N.). THURSDAY.-2.30 P.M., Gynaecological Operations (Dr. A. E. Giles). Clinics :-Medical Out-patient (Dr. A. J. Whiting); Surgical (Mr. H. W. Carson); X Rays. 3 P.M., Medical In-patient (Dr. G. P. Chappel). FRIDAY.-10 A.M., Clinic:—Surgical Out-patient (Mr. H. Evans). 2.30 P.M., Operations (Mr. W. Edmunds). Clinics :-Medical Out- patient (Dr. A. G. Auld); Eye (Mr. R. P. Brooks). 3 P.M., Medical In-patient (Dr. R. M. Leslie). WEST-END HOSPITAL FOR DISEASES OF THE NERVOUS SYSTEM, 73, Welbeck-street, W. MONDAY.-3 P.M., Clinical Demonstration: Dr. H. Campbell. TUESDAY.—5 P.M., Clinical Demonstration: Dr. J. Mackenzie. WEDNESDAY.-3 P.M., Clinical Demonstration: Dr. F. Palmer. THURSDAY.-3 P.M., Clinical Demonstration: Dr. T. D. Savill. FRIDAY.-2 P.M., Clinical Demonstration: Dr. P. Stewart. 5.30 P.M.. Clinical Demonstration: Dr. E. Macnamara. CENTRAL LONDON THROAT AND EAR HOSPITAL, Gray’s Inn- road, W.C. TUESDAY.--3.45 P.M., Lecture :-Mr. C. Nourse: Middle Ear and. Labyrinth. FRIDAY.-3.45 P.M., Lecture :-Mr. C. Nourse: Middle Ear and, Labyrinth. SOCIETY OF TROPICAL MEDICINE AND HYGIENE, 11, Chandos- street, Cavendish-square, W. ’ FRIDAY.-8.30 P.M., Dr. L. Braddon (Seremban) and Dr. A. R Wellington (Singapore): The Etiology of Beri-Beri. OPERATIONS. METROPOLITAN HOSPITALS. MONDAY (12th).—London (2 P.M.), St. Bartholomew’s (1.30 P.M.), St. Thomas’s (3.30 P.M.), St. George’s (2 P.M.), St. Mary’s (2.30 P.M.), Middlesex (1.30 P.M.), Westminster (2 P.M.), Chelsea (2 P.M.),. Samaritan (Gynaecological, by Physicians, 2 P.M.), Soho-square (2 P.M.), City Orthopaedic (4 P.M.), Gt. Northern Central (2.30 P.M.), West London (2.30 P.M.), London Throat (9.30 A.M.), Royal Free (2 P.M.), Guy’s (1.30 P.M.), Children, Gt. Ormond-street (9 A.M.), St. Mark’s (2.30 P.M.).
Transcript of Notes, Short Comments, and Answers to Correspondents.
1090
Notes, Short Comments, and Answersto Correspondents.
SOME CHEMICAL REASONS FOR DETERIORATION INLIQUID MEDICINES.
IN Merck’s Report for March Mr. Frederic E. Niece calls attention to anumber of chemical substances which do not keep well in solution.Chloroform water readily decomposes under the influence of heat,light, and air with the formation of acid by-products and the develop-ment of odours resembling those of phosphoretted hydrogen or
decomposed marine algse. The addition of 4 per cent. of alcohol issufficient to keep this preparation indefinitely. Solutions of iodoformin chloroform are less stable than alcoholic solutions, becausechloroform acts as a carrier of oxygen which liberates iodine in thesolution under the influence of sunlight. Chloroform itself is
decomposed in the presence of iodoform and the by-products tend toreact with the iodine. Solutions of potassium iodide show thepresence of free iodine within a very short time and afterwards
potassium iodate, and so become a source of trouble from incompati-bility and by producing unpleasant symptoms after administration.These changes may be retarded by keeping the solution in a cool,dark place, in full bottles, and by adding 0’2 per cent. of sodium thio-sulphate. Ammonium iodide likewise readily forms free iodinewhen kept in solution, but the change may be lessened or
prevented by the addition of a few drops of diluted ammonia.The decomposition of solutions of sodium hypobromite is a
constant source of annoyance to many practitioners, owing tothe deeper colour and loss in strength produced by the solution oftraces of manganates from amber bottles. To prevent this change it ’,is advisable to store the solution in green, blue, flint, or paraffinbottles with the addition of 10 per cent. of potassium bromide. Thered colour produced in solutions of salts of eserine is caused by thecombined action of light, atmospheric oxygen, and alkali present inthe glass. This difficulty may be partially, if not completely, over-come by keeping the solution, prepared with sterile distilled water,in the dark in bottles coated on the inside with paraffin wax. As afurther precaution Mr. Niece recommends the practice of coveringthe solution with a layer of washed and boiled liquid paraffin. Thismethod is generally applicable in the case of sensitive and costlychemical substances which it is desired to keep in solution. In orderto withdraw the solution from beneath the paraffin layer it is neces-
sary to use a pipette, and since a solution of eserine is generally usedfor eye lesions the presence of a trace of oil is not objectionable.Solutions of lead acetate form heavy white precipitates of leadcarbonate on exposure, unless restrained by the presence of a trace ofacetic acid. These illustrations serve to show the dangers that maylurk in bottles of solutions and stock mixtures which have been keptfor some time.
A SUGGESTION FOR TREATMENT.
To the’Editor of THE LANCET.
SIR,—In reference to the treatment of the case mentioned by yourcorrespondent "Perplexed" in THE LANCET of Feb. 20th, p. 589, allowme to suggest that he try ovarian extract. He states that the attacks
seemingly have nothing to do with the menstrual period, butovulation does not necessarily occur simultaneously with menstruation,and taking into consideration the age of the patient, I imagine thatthe headaches may be due to the approaching menopause. In twocases presenting somewhat similar symptoms I have been able to
give relief by administering ovarian extract in five-grain doses threetimes a day for about a week at a time. Sometimes it was necessaryto give it for a longer period, but I allowed myself to be guided by thesymptoms.A young woman, aged 26 years, on whom a panhysterectomy had
been performed, consulted me complaining of severe headache.She had been treated by several practitioners, including an
ophthalmologist, and had been given all kinds of treatment,including morphine, but without any permanent relief. I pre-scribed ovarian extract and the headaches became progressively lesssevere. Instead of being confined to bed for one week out of every monthshe gradually improved till by taking the remedy for a day or two shecould avert an attack. The attacks in this case were preceded by"nervous" symptoms such as frequently usher in a menstrual period.I believe that the headache was due to loss of the internal secretion ofthe ovaries, and in my opinion in many cases the headaches occurringat the menopause are due to the same cause. I trust that this may beof service to "Perplexed." I am, Sir, yours faithfully,Chicago, U.S.A., March 15th, 1909. M.D.
ACCIDENTS TO RAILWAY SERVANTS.
WE have received from Mr. T. A. Broekelbank a copy of a pamphletdealing with a large number of accidents occurring among railwayservants and advocating the adoption by English railways of auto-matic couplings. The fignres in the pamphlet are very impressiveand bring before us well the risks which have to be run by theemployees of railways.
AN .. ASEPTIC SCHOOL BOX."WE have had forwarded to us a metal "school box" for the use
of children. It is a flat box made of tinned iron, and measuring-,9 inches by 2 inches by inch. Inside are metal partitions which.divide it into convenient spaces for pen, pencil, and ruler. Thebox, which is made by the South Wales Canister Company,. isstamped with the name,
" Cymric Aseptic School Box." Itcould undoubtedly be made aseptic by boiling, but we fearthat its normal contents will hardly be aseptic when in use. Wewould also suggest that if the " tin" edges of the box should damagethe hands of its owner the advantage of its asepticity would verylikely be counterbalanced by the complexion of the aforesaid hands.A wooden box, even though not aseptic, will to many seem prefer-able for the reception of the child’s implements of learning as lesslikely to cause any abrasion.
COMMUNICATIONS not noticed in our present issue will receive attention.in our next.
Medical Diary for the ensuing Week.SOCIETIES.
ROYAL SOCIETY OF MEDICINE, 20, Hanover-square, W.THURSDAY.
DERMATOLOGICAL SECTION (Hon. Secretaries—Arthur Whitfield,E. G. Graham Little): at 5 P.M.
Exhibition of Cases.
FRIDAY.ELECTRO-THERAPEUTICAL SECTION (Hon. Secretary—ReginaldMorton): at 8.30 P.M.
Dr. Sloan : Vulvo-vaginal Electrode for Ionic Medication.Mr. T. J. Bokenham: Treatment of Haemorrhoids by Zinc
Mercury Ionisation.Mr. N. S. Finzi: Treatment of Ulcers by Ionic Medication.Dr. Horace Manders will show an Apparatus for the Production,
of Continuous Oscillations.
N.B.-Fellows of the Society are entitled to attend and to speakat all Meetings.
UNITED SERVICES MEDICAL SOCIETY. Royal Army MedicalCollege, Millbank, S.W.WEDNESDAY.-8.30 P.M., Surgeon K. D. Bell, R.N.: Physical,
Training and the Medical Profession.
LECTURES, ADDRESSES, DEMONSTRATIONS, &c.NORTH-EAST LONDON POST-GRADUATE COLLEGE, Prince ofWales’s General Hospital, Tottenham, N.
WEDNESDAY.—Clinics :—2.30 P.M., Medical Out-patient (Dr. T. R.Whipham); Skin (Dr. G. N. Meachen); Eye (Mr. R. P. Brooks).3 P.M., Demonstration :-Dr. F. Thomson: Infectious Fevers(at the North-Eastern Fever Hospital, St. Ann’s-road, N.).
THURSDAY.-2.30 P.M., Gynaecological Operations (Dr. A. E. Giles).Clinics :-Medical Out-patient (Dr. A. J. Whiting); Surgical(Mr. H. W. Carson); X Rays. 3 P.M., Medical In-patient (Dr.G. P. Chappel).
FRIDAY.-10 A.M., Clinic:—Surgical Out-patient (Mr. H. Evans).2.30 P.M., Operations (Mr. W. Edmunds). Clinics :-Medical Out-patient (Dr. A. G. Auld); Eye (Mr. R. P. Brooks). 3 P.M.,Medical In-patient (Dr. R. M. Leslie).
WEST-END HOSPITAL FOR DISEASES OF THE NERVOUSSYSTEM, 73, Welbeck-street, W.MONDAY.-3 P.M., Clinical Demonstration: Dr. H. Campbell.TUESDAY.—5 P.M., Clinical Demonstration: Dr. J. Mackenzie.WEDNESDAY.-3 P.M., Clinical Demonstration: Dr. F. Palmer.THURSDAY.-3 P.M., Clinical Demonstration: Dr. T. D. Savill.FRIDAY.-2 P.M., Clinical Demonstration: Dr. P. Stewart. 5.30 P.M..
Clinical Demonstration: Dr. E. Macnamara.
CENTRAL LONDON THROAT AND EAR HOSPITAL, Gray’s Inn-road, W.C.TUESDAY.--3.45 P.M., Lecture :-Mr. C. Nourse: Middle Ear and.
Labyrinth.FRIDAY.-3.45 P.M., Lecture :-Mr. C. Nourse: Middle Ear and,
Labyrinth.SOCIETY OF TROPICAL MEDICINE AND HYGIENE, 11, Chandos-
street, Cavendish-square, W. ’
FRIDAY.-8.30 P.M., Dr. L. Braddon (Seremban) and Dr. A. RWellington (Singapore): The Etiology of Beri-Beri.
OPERATIONS.METROPOLITAN HOSPITALS.
MONDAY (12th).—London (2 P.M.), St. Bartholomew’s (1.30 P.M.), St.Thomas’s (3.30 P.M.), St. George’s (2 P.M.), St. Mary’s (2.30 P.M.),Middlesex (1.30 P.M.), Westminster (2 P.M.), Chelsea (2 P.M.),.Samaritan (Gynaecological, by Physicians, 2 P.M.), Soho-square(2 P.M.), City Orthopaedic (4 P.M.), Gt. Northern Central (2.30 P.M.),West London (2.30 P.M.), London Throat (9.30 A.M.), Royal Free(2 P.M.), Guy’s (1.30 P.M.), Children, Gt. Ormond-street (9 A.M.),St. Mark’s (2.30 P.M.).
