SOCIETY OF TUBERCULOSIS OFFICERS
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1722 in the manner which I have just indicat.ed. ,,1 eed hardly say we are all grateful to Dr. Hunt for telling us of the existence of this important, though, relatively rare, group of thenar and .hypothenar! atrophies. But purely motQr nerves have, no, existence. I am, Sir, yours f alithf Lilly, London, N.W., June 6th, 1914. LEONARD J. KIDD. THYROID INSUFFICIENCY. To the Editor of THE LANCET. ’ SIR,-The interesting letter of Dr. C.W. Crawshaw I in THE LANCET of May 30th on Thyroid Extract in‘ Nervous Disorders leads me to call attention to another class of cases in which there seems to be some insufficiency of thyroid secretion, although not enough to cause the classic symptoms of myxoedema. My attention was called to this class of cases some years ago by my friend Dr. Morgan Dockrell, of London, and since then I have met several, all of which have been much benefited by the administration of thyroid extract. The following case is typical. A middle-aged man, organically sound, had suffered for many years from bad circulation, feelings of cold, and liability to chill. His tempera- ture was usually about 1°F. below the normal. In winter he had to use an enormous quantity of bed- clothes, and, even with those, he usually woke up feeling cold and miserable. There was breathless- ness on exertion. He had become quite bald in early life. After taking thyroid extract for a little, while he began to experience an unwonted feeling of warmth. Cold feet and hands became warm. He gradually dispensed with some of the bed- clothes, so that he now uses only about one-third as much as formerly. The temperature rose to normal. The heart’s action became stronger and steadier, and he can now take violent exercise which was formerly impossible. The progressive loss of hair has ceased, and the scalp, which was fomaerly as polished as a billiard ball, now shows an at&idant growth of downy hairs. The amount of Aair on the body has also increased. The patient feels quite a new man and much more vigorous than formerly. I have had several other cases in which allevia- tion of similar symptoms has been brought about by thyroid extract, and it seems, I think, quite evident that the extract supplies something which in these instances is wanting in the system. I am, Sir, yours faithfully, JOHN P. HENRY, M.D., B.Ch. Dub. Galway, June 1st, 1914. LONDON PANEL COMMITTEE AND THE SUPPLY OF LOCUM TENENTS. To the Editor of THE LANCET. SIR,—Our attention has been drawn to the report in the British Medical Journal Supplement of May 30th last of a meeting of the London Panel Committee which was held on May 25th. That committee passed a resolution undertaking to supply " deputies " to panel practitioners, and we learn with no slight astonishment that the pro- ,posal was stated to have met " with the approval of the medical and transfer agencies." As we have never been approached on the matter we take this opportunity of informing the medical profession that we strongly object to this unautho- rised assertion, and the more so as we know that the. above committee further discussed the question ,of undertaking the transfer of practices. Whilst reserving our opinion as to its statutory powers to transact such business, we are reluctant ,to believe that medical men can be in sympathy ,wH4 this movement. z... We are, Sir, yours faithfully, J. FIELD HALL (Field Hall, Ltd.). HERBERT NEEDES. J. C. NEEDES. PEACOCK AND HADLEY. J. A. REASIDE (The Medical Agency). A. V. STOREY (General Manager of the Scholastic, Clerical, and Medical Association, Ltd.). PERCIVAL TURNER. London, W.C., June 9th, 1914. MUST THE DOCTOR BE A COMMON INFORMER ? To the Editor of THE LANCET. SIR,-As the matter is of such grave moment r wish to draw your readers’ attention to, the decision of the General Medical Council in one of the recent penal cases. A practitioner attended a female who had had a, miscarriage. She pledged him to secrecy. The patient died from peritonitis. The doctor being. bound by law to certify the " cause of death " wrote in his certificate " peritonitis and cardiac failure." Because he did not also state the concomitant fact of the abortion the General Medical Council con- cludes that he has been properly convicted of a misdemeanour. It is not permissible to, say more,. for the case has not formally concluded, but the opinion already given by the General Medical Council seems to lay a new burthen on practi-- tioners 1. Cause is usually interpreted in law to mean immediate operative antecedent. Now it seems we must not only give immediate cause of death, as peritonitis, but, under peril of being unfrockedp the cause of peritonitis, as dirty instrument; the cause of virulence of dirt, as streptococci; the cause of activity of streptococci, as mixed infection, &c. 2. Every medical man in practice is often asked to bring about abortion. This alone being a criminal offence, it would seem he is bound to. hand over the offender to justice. 3. Transmission of contagious disease being a grave offence, it would seem that to prevent this misdemeanour the doctor is bound to notify the wife or other person likely to be affected by the patient suffering from infectious sore. T om Sir, yours faithfully I Dublin, June 7th, 1914. J. C. MCWALTER, M.D., LL.B., Barrister-at-Law. SOCIETY OF TUBERCULOSIS OFFICERS. To the Editor of THE LANCET. SIR,-With reference to Dr. Thompson Campbell’s letter on the above subject, in your issue of to-day’s date, may I say that I recently joined the Tuberculosis Society (secretary, Dr. W. 0. Pitt, Walthamstow, Essex), and that I was informed that this body already numbered about 60 tubeT- culosis officers amongst its members ? I am. Sir, vours faithfullv. I June 6th, 1914. TUBERCULOSIS OFFICEFt.
Transcript of SOCIETY OF TUBERCULOSIS OFFICERS
1722
in the manner which I have just indicat.ed. ,,1 eedhardly say we are all grateful to Dr. Hunt fortelling us of the existence of this important, though,relatively rare, group of thenar and .hypothenar!atrophies. But purely motQr nerves have, no,existence.
I am, Sir, yours f alithf Lilly,London, N.W., June 6th, 1914. LEONARD J. KIDD.
THYROID INSUFFICIENCY.To the Editor of THE LANCET. ’
SIR,-The interesting letter of Dr. C.W. Crawshaw Iin THE LANCET of May 30th on Thyroid Extract in‘Nervous Disorders leads me to call attention toanother class of cases in which there seems to besome insufficiency of thyroid secretion, althoughnot enough to cause the classic symptoms ofmyxoedema. My attention was called to this classof cases some years ago by my friend Dr. MorganDockrell, of London, and since then I have metseveral, all of which have been much benefited bythe administration of thyroid extract. The followingcase is typical.A middle-aged man, organically sound, had
suffered for many years from bad circulation,feelings of cold, and liability to chill. His tempera-ture was usually about 1°F. below the normal. Inwinter he had to use an enormous quantity of bed-clothes, and, even with those, he usually woke upfeeling cold and miserable. There was breathless-ness on exertion. He had become quite bald inearly life. After taking thyroid extract for a little,while he began to experience an unwonted feelingof warmth. Cold feet and hands became warm.He gradually dispensed with some of the bed-clothes, so that he now uses only about one-thirdas much as formerly. The temperature rose tonormal. The heart’s action became stronger andsteadier, and he can now take violent exercise whichwas formerly impossible. The progressive loss ofhair has ceased, and the scalp, which was fomaerly aspolished as a billiard ball, now shows an at&idantgrowth of downy hairs. The amount of Aair onthe body has also increased. The patient feelsquite a new man and much more vigorous thanformerly.
I have had several other cases in which allevia-tion of similar symptoms has been brought aboutby thyroid extract, and it seems, I think, quiteevident that the extract supplies something whichin these instances is wanting in the system.
I am, Sir, yours faithfully,JOHN P. HENRY, M.D., B.Ch. Dub.
Galway, June 1st, 1914.
LONDON PANEL COMMITTEE AND THESUPPLY OF LOCUM TENENTS.
To the Editor of THE LANCET.
SIR,—Our attention has been drawn to the reportin the British Medical Journal Supplement of
May 30th last of a meeting of the London PanelCommittee which was held on May 25th. Thatcommittee passed a resolution undertaking to
supply " deputies " to panel practitioners, and welearn with no slight astonishment that the pro-,posal was stated to have met " with the approvalof the medical and transfer agencies."As we have never been approached on the matter
we take this opportunity of informing the medicalprofession that we strongly object to this unautho-rised assertion, and the more so as we know that
the. above committee further discussed the question,of undertaking the transfer of practices.
Whilst reserving our opinion as to its statutorypowers to transact such business, we are reluctant,to believe that medical men can be in sympathy,wH4 this movement.z... We are, Sir, yours faithfully,
J. FIELD HALL(Field Hall, Ltd.).
HERBERT NEEDES.
J. C. NEEDES.
PEACOCK AND HADLEY.
J. A. REASIDE(The Medical Agency).
A. V. STOREY(General Manager of the Scholastic,Clerical, and Medical Association, Ltd.).
PERCIVAL TURNER.London, W.C., June 9th, 1914.
MUST THE DOCTOR BE A COMMONINFORMER ?
To the Editor of THE LANCET.
SIR,-As the matter is of such grave moment rwish to draw your readers’ attention to, the decisionof the General Medical Council in one of the recentpenal cases.A practitioner attended a female who had had a,
miscarriage. She pledged him to secrecy. Thepatient died from peritonitis. The doctor being.bound by law to certify the " cause of death " wrotein his certificate " peritonitis and cardiac failure."Because he did not also state the concomitant factof the abortion the General Medical Council con-cludes that he has been properly convicted of amisdemeanour. It is not permissible to, say more,.for the case has not formally concluded, but theopinion already given by the General MedicalCouncil seems to lay a new burthen on practi--tioners
1. Cause is usually interpreted in law to meanimmediate operative antecedent. Now it seemswe must not only give immediate cause of death,as peritonitis, but, under peril of being unfrockedpthe cause of peritonitis, as dirty instrument; thecause of virulence of dirt, as streptococci; the causeof activity of streptococci, as mixed infection, &c.
2. Every medical man in practice is often askedto bring about abortion. This alone being a
criminal offence, it would seem he is bound to.hand over the offender to justice.
3. Transmission of contagious disease being agrave offence, it would seem that to prevent thismisdemeanour the doctor is bound to notify the wifeor other person likely to be affected by the patientsuffering from infectious sore.
T om Sir, yours faithfully
I Dublin, June 7th, 1914.J. C. MCWALTER, M.D., LL.B.,
Barrister-at-Law.
SOCIETY OF TUBERCULOSIS OFFICERS.To the Editor of THE LANCET.
SIR,-With reference to Dr. Thompson Campbell’sletter on the above subject, in your issue ofto-day’s date, may I say that I recently joinedthe Tuberculosis Society (secretary, Dr. W. 0. Pitt,Walthamstow, Essex), and that I was informedthat this body already numbered about 60 tubeT-culosis officers amongst its members ?
I am. Sir, vours faithfullv.I June 6th, 1914. TUBERCULOSIS OFFICEFt.
