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Correspondence.

VEGETARIANISM AND PHYSIQUE.

66 Audi alteram partem."

To the Editor of THE LANCET.

SIR,-I have read with great interest your annotation onthe above subject.l I am in complete agreement with itsmain contention that "vegetarianism is a fallacy," and Iwould add, often a dangerous fallacy. In upwards of aquarter-of a century of dietetic experience I have seen manywhose well-intentioned but ignorant endeavours after the

impossible have ended in their own destruction. I also agreethat the amount of proteid recommended by Chittenden willnot be found sufficient if watched over a longer period andwith wider experience. I believe, however, that part of thedifficulty of the natives of Bengal is poverty; they couldtake more proteid and would be stronger if they could get it.With the natives of Western Europe the difficulty is ofanother kind. They have become accustomed to the use ofproteid in very concentrated forms-e.g., meat, fish, game,eggs-and are now unable to take enough when it is presentedin the more diffused forms.

There are several ways out of this difficulty, but the vege-tarians, who in my experience have seriously injured them-selves, have for one reason or another not made use of anyof them. If they are to remain true vegetarians theypractically must take nuts, yet, though numbers in variouscountries live to a large extent on nuts, those who have been30 or 40 years on flesh foods have so modified their digestionand injured their digestive organs that nut digestion may bepractically impossible. Healthy children and young adults,on the other hand, can digest most nuts, so that for themtrue vegetarianism is possible. The other way out of their

difficulty is to add animal foods, such as milk or cheese (themost concentrated proteid food we have), to make up thenecessary albumins. This is done in other parts to a muchlarger extent than in Western Europe, possibly because themeat-eating habit has here to some extent driven out otheralbuminous foods.

It is the purin-free dietists who have added these moreconcentrated foods in sufficient quantity who have furnishedthe remarkable records of strength and endurance discussedby Professor Irving Fisher,2 Professor P. Fauvel,3 andothers, records which may be said to have established thepractical superiority of a fleshless diet when sufficient proteidis taken. Vegetarianism has been a great thorn in my sidein advocating, as I do, a physiological and purin-free diet(vegetarianism is neither of these), because those who haveseen the unfortunate results of vegetarian ignorance havenot kept in mind the important physiological points in regardto which I differ so completely from them ; for " the mixtureof those things by speech which by nature are divided is themother of all error." "

I am, Sir, yours faithfully,Brook-street, W., Nov. 21st, 1908. ALEXANDER HAIG.ALEXANDER HAIG.

A SERUM TREATMENT OF CARCINOMAIN MICE.

To the Editor of THE LANCET.

SIR,-Dr. Blair Bell says in his letter, published inTHE LANCET of Nov. 21st :-I Mainly my complaintwas, then, that no reference at all was made by Mr.Walker to the work of others on similar lines...... andI carefully mentioned in my remarks that there 7vas

a difference in technique in some of the work, butthat there was no essential difference." At the meetingof the Liverpool Medical Institution on Oct. 22nd, in

reply to Dr. Blair Bell’s criticisms, I stated that thoughfamiliar with the work of Dr. Borrel, I was unaware of hishaving done anything similar to my experiments. I dealt

chiefly with Dr. Borrel because Dr. Bell represented his workas being most like to my own. As Dr. Bell has thus on twooccasions declined to accept my well-considered statement,

1 THE LANCET, Nov. 21st, 1908, p. 1537.2 Yale Medical Journal, March, 1907.

3 Monographies Cliniques, No. 49, Paris, 1907, p. 42.

I took the only step that, under the conditions chosen byhim, would make an absolutely conclusive answer possible-I wrote to Dr. Borrel, inclosing a copy of my paper, and,

asking him whether he had ever done any experiments similarto those I described. Obviously I cannot write to everyonewho has worked with mouse cancer. Im Dr. Borrel’s replyto me, dated from the Pasteur Institute, Nov. 12th, 1908, hesays : "I I have never treated mice by inoculating them witha serum obtained with the testicles of mice....... I tried to

produce immunity in mice by injecting them with crushedtestes ; the results were published by Bridré, (they were)negative. But (I have done) nothing resembling the experi.ments you describe.

" I may point out that, as well as theexperiments with testis serum, those with tumour serum

were described in detail in the paper I sent to Dr. Borrel.In the résumé of his remarks upon my paper, furnished by

himself to the secretary of the institution, Dr. Bell empha.sised the words testis serum." He also quoted Dr. Borrelas having done experiments similar to the rest of my experi-ments. Dr. Bell also quoted Dr. Borrel and others as havingproduced immunisation in mice by injecting the cells ofvarious tissues, "and hand-in-hand, of course, with this inproducing curative effects on these animal growths." Besidesthe contradiction of this assertion, made by Dr. Borrelhimself, I may say that the statement contained in myformer letter that the sera that had been found to produceimmunisation "possessed no curative effect whatever uponalready existing tumours," was taken from a general résuméof all the work done upon this point, written by Dr. Borrellate in 1907.

I have nothing further to say than that there is no morefoundation in fact for the other statements made by Dr.Bell than there is in the case of his statement that Dr. Borrelhad worked with " testis serum." (The inverted commas areDr. Bell’s.) I inclose Dr. Borrel’s letter of Nov. 12th inorder that you may see that my statements are correct.

I am, Sir, yours faithfully,CHARLES WALKER.

Cancer Research Laboratory, University of Liverpool,Nov. 23rd, 1908.

CHARLES WALKER.LiverpoolCancer Research Laboratory, University of Liverpool,

Nov. 23rd, 1908.

** We have received Dr. Borrel’s letter to Mr. Walker

containing the sentences quoted.-ED. L.

EARLY RECOGNITION OF MALIGNANTDISEASE.

70 the Editor of THE LANCET.

SIR,-A great deal has been written in recent yearsregarding the importance of thorough removal of malignantdisease when at all possible. The adoption of this has ledto greatly improved results and less frequent recurrence.Can our profession not do a little more in order to encouragepatients to consult their medical advisers at an earlier datethan they do ? 2 It is a delicate matter to speak of suchthings to patients, but some general information might begiven so that instead of women consulting their medicalmen when a cancer of the breast is far advanced and givingpain they would do so whenever they noticed anythingabnormal. The cancer would be operated on when itwas entirely local and the results would be very muchbetter. Until the cause of cancer is discovered I amsatisfied that some decided effort must be made in thedirection of earlier recognition. A great deal is being donewith regard to tuberculosis and a large amount of instruc-tion has been given to the public on the subject. Similarefforts ought to be made in connexion with malignantdisease. I am, Sir, yours faithfully,

Glasgow, Nov. 21st, 1908. J. CRAWFORD RENTON.J. CRAWFORD RENTON.

THE CAUSE AND PREVENTION OFDENTAL CARIES.

10 the Editor of THE LANCET.

SIR,-Will you kindly extend to me the courtesy of yourcolumns so that I may draw attention to the fact that Mr.F. Coleman’s criticism is not only justified but that it hasbeen anticipated, inasmuch as a reviewer in the IJenta.1Surgeon drew attention to the point he raises in his letterin THE LANCET of Nov. 21st so long ago as 1905. Thenotice in question, which was otherwise entirely favourable,

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dealt with Dr. J. S. Wallace’s "The R61e of Modern Dieteticsin the Causation of Diaease and from it (p. 458, D.S.,June 3rd, 1905) is taken the following passage : " Dr. Wallacehas, we must point out, fallen into one error. He seems tothink that the value of the use of hard and resistant foodand general exercise of the jaw muscles as prophylacticsagainst dental -caries is a new discovery. We do not

agree with him, and for this reason. ’ Coleman’s Manual,of Dental Surgery and Pathology,’ published as far back

as 1881, contains on pp. 103, 104 an exhaustive argumenton this very point. It is thereon pointed out what changes,both in character and preparation, the food of man has

undergone during the last few centuries. The differencesin his bread, meat, cooking, and manner of devouring hisfood are fully pointed out, special stress being laid upon thefact that since the introduction of the knife and fork theincisors and cuspidati by which in former ages the meat wastorn from the bone have had their office converted intoalmost a sinecure. "

In anticipation of your .courtesy,I am, with thanks,

THE EDITOR OF THE " DENTAL SURGEON."Nov. 23rd, 1908.

THE ELECTROLYTIC ADMINISTRATIONOF DRUGS.

To the Editor of THE LANCET.

SIR,-I would like to point out that cataphoric medicationis not only not new to medicine but that it has been usedalso in dental surgery for many years (personally for 21years). 11 years ago I wrote 1 describing the nwdus operandifor dissipating periodontitis, alveolar abscess, for obtundingsensitive dentine, and for bleaching discoloured teeth bycataphoresis. In ancther journal 2 described about 30 caseswhere I had interr alia so obtunded the dentine that it couldbe drilled for the purpose of

" filling " without the slightest

pain or else anaesthetised the pulp that it could be extractedwithout the patient suffering any discomfort. I was there-fore somewhat amused when the "Diurnal Reflector" "

heralded forth cataphoresis as another of its great medicaldiscoveries, especially as the process is probably olderthan most of us living.

I am, Sir, yours faithfully,H. FIELDEN BRIGGS, M.D. Brux., L.A.H. Dub.,

L.D.S. Glasg., D.D.S. Univ. Mich.Eastbourne, Nov. 20th, 1908.

H. FIELDEN BRIGGS, M.D. Brux., L.A.H. Dub.,L.D.S. Glasg., D.D.S. Univ. Mich.

EPSOM COLLEGE: LATE ARCHDEACONTHORNTON MEMORIAL FUND.

10 the Editor of THE LANCET.

SIR,-May I be permitted through your columns to thankthe very numerous Old Epsomians of the late headmaster’stime (1855 to 1870), so large a proportion of whom are inthe medical profession, for their generous donations to thisfund, and also to inform them that it has been decided toplace a very beautiful stained-glass window in the Collegechapel as the most fitting memorial to so esteemed a man.The window will be unveiled next Founders’ Day and allsubscribers will in due course receive notice of, and aninvitation to, the ceremonial.

. I am, Sir, yours faithfully,PERCIVAL TURNER,

London, W.C., Nov. 24th, 1908. Honorary Secretary.PERCIVAL TURNER,

Honorary Secretary.

UNUSUAL FOREIGN BODY IN THE EAR.To the Editor of THE LANCET.

SIR,-The following interesting case came to my con-sulting-room this week. There is nothing particular aboutit clinically but the circumstances are certainly very un-usual. The patient, a prominent volunteer, came tome complaining of deafness. His account of his case

was as follows. He had just purchased some artificialear drums, and on inserting one he became very deafindeed; on withdrawing the instrument the deafnessremained the same. He was the victim of suppuratingears and as a consequence somewhat hard of hearing and

1 The Medical Annual, 1897, p. 187 et seq.2 The Dental Record, April, 1897.

hence the attempt to use the artificial drum. This greatincrease of deafness after using the artificial drum broughthim to me. On examining his ear I found deep in the canala pultaceous mass of pus and debris and a black-lookingbody. On removing this with the forceps it proved to be alarge earwig. The patient then told me that last August,being at camp, during one night he was awakened byfearful humming and buzzing in the ear. Energetically withhis little finger he endeavoured to stop it and finallysucceeded ; he felt sure that the insect had dropped out, andthought no more about it. It seems strange that this largeinsect could remain in an ear, and that a suppurating one,for three months without causing more disturbance. How

long it would have remained without notice had the patientnot attempted to use the artificial drum one can onlyspeculate. It is somewhat singular that whilst in the publicmind this insect is so closely associated with the ear oneshould so seldom find any actual cases.

I am, Sir, yours faithfully,JOHN FOSTER, F.R.C.S. Edin.,

Ophthalmic and Aural Surgeon, Cameron and HartlepoolsWest Hartlepool, Nov. 19th, 1908. Hospitals.

JOHN FOSTER, F.R.C.S. Edin.,Ophthalmic and Aural Surgeon, Cameron and Hartlepools

Hospitals.

PURE SODA-WATER.10 the Editor of THE LANCET.

SIR,-With reference to your extract in THE LANCET ofNov. 14th from the report of Dr. W. Collingridge, medicalofficer of health of the City of London, concerning impuritiesin soda-water, I should be glad to point out in your columns,with your permission, that the fault is not so much that ofthe soda-water manufacturers themselves as that of the

public who place, or allow to be placed, the empty bottles inany convenient corner, regardless of the fact that these

empty bottles will afterwards be collected, sent back to themineral water manufacturers, and by them refilled, after

washing in a manner which is not always effective. Themicrobes discovered upon analysis by Dr. E. E. Klein,bacteriologist to the City council-viz. : (a) 11 cocci " ;(b) "sporing bacilli"; and (c) "small Gram-positive non-mobile bacilli, which in shape resembled diphtheroidmicrobes "-prove, although they gave no Neisser stainingor caused any change in a guinea-pig’s subcutaneous tissuewhen injected in large doses, that some of the emptybottles collected must have been deposited, somewhere andfor some time, amidst garbage such as anyone with themost elementary knowledge of hygienic principles wouldseriously avoid. I would like to add that personally Iprefer to purchase from a chemist liquid carbonic acid gasin small steel bulbs and then to aerate by this means boiledwater in a special syphon provided for the purpose which also obtained from my chemist. As the syphon is myproperty, remains in my home, and can be cleaned as oftenas considered necessary, I feel secure from the ravages ofdiphtheria, at least from this source.

I am, Sir, yours faithfully,Nov. 18th, 1908. CAUTIOUS.

DEATH CERTIFICATION AND MEDICALSECRECY.

To the Editor of THE LANCET.

SIR,-I understand that the Brussels Medical Prac-titioners’ College having pointed out to the communalcouncil of that city that the form of death certificate

supplied for the cause of death to be filled in by themedical attendant having to be handed open to the familyof the deceased obliges the medical man to violate hisobligation of professional secrecy, a promise has been given bythe director of the sanitary service of the city that a new formfor a ’’ confidential medical certificate " shall be supplied. Thiswill be handed, sealed, to the family, and after having beenutilised for registration and statistical purposes (for whichthe name of the deceased is not required) it will be burnt.Thus there will be no permanent record of the cause of death.Surely this, though a most desirable change from the open certi-ficate, which is necessarily sometimes so partial a statement oftruth that it is practically false, is carrying medical secrecyto a dangerous length. There are many criminal trials wherethe certificate of the cause of death plays a very importantpart and it would surely be as easy to devise a system by