THE LANCET,] PANCREATIC EXTRACT IN DIABETES. [DEc. 2, 1922 1195
of the vibrations of those fibres whose periods lie "MORCELLEMENT" OF TONSILS.
well outside the period intervening between the first To the Editor of THE LANCET
and second noise. If the period between the third
and second noise does not differ too much from that SIR,-s the translator of " Oto-Rhino-Laryngo-
between the second and first, those fibres of the logy" by Georges Laurens, may I be allowed to make
basilar membrane whose periodicity corresponds to a few remarks on the review of this work, which
this period will still be vibrating when the third appeared inyourissueof Nov. 18th ? "Morcellement"
impulse reaches them, and this vibration will be for the removal of tonsils is, I agree, not so much in
favour, save in specially selected cases, here as in
reinforced, whilst a further number of outlying vibra- Franc save in specally selected cases, here as in
tions will be damped ont. The process will be e. During the past 15 years I have enucleated
tachns will be da~mped out. The process will be
repeated with each succeeding impulse. Thus the over 1400 pairs of tonsils, but only in 5 per cent. of
crest of the standing wave will tend to become better the cases was the morcelleur used, the practice
defined, and to move up the scale in correspondence adopted being complete removal with the guillotine
with the successive shortening of the interval between in the case of children, and by dissection in adults.
the impulses. The sensation of a rising tone will b I much regret not having inserted a footnote anent
I much regret onot having inserted a footnote anent
teiproduced. Tesnainoariigtu ile the subject in the translation. With very few other
I am quite conscious that the subject of sound exceptions, the methods of treatment as set forth
perception is a difficult one, and that many of its are those adopted in this country.
details remain obscure. I do not think that the I am, Sir, yours faithfully,
resonance theory can either be established or disposed NeW avendish-street, W., Nov. 23rd. H. CLAYTON Fox.
of in a summary manner or by any single convincing
argument. The question must be studied in all its INTESTINAL WORMS AND PF,RITONITIS.
bearings. In delicate adjustment and balance of To the Editor of THE LANCET
mechanical factors the cochlea is probably the most
refined piece ofr mhechaunism with which he mos SIR,-The article in THE LANCET Of Nov. 18th by
weaeDr. WT. Nicol!, entitled Observations on the Occur-
acquainted. Yet I venture to think that in the lightDr. W. Nicol, etitled Observations on the Occur-
rence and Prevalence of Parasitic Intestinal Worms
of the resonance hypothesis the relation of function rence sd Prevaleuce of Parasiti Intestinal Worms
to structure is at least as clearly traceable in the ur the dari s to throw some light on the
cochlea as il the connexzion between the machine cause of the death of Herod as recorded in the Acts
cochleai as is the connexion between the machine
and its working in other parts of the body. Could of the Apostles. The account of Josephus is (I quote
we, for instance, deduce the song of the birds from from memory) that " Herod was seized with a violent
a study of the syrinx, or the complexities of human pain in his belly and died five days afterwards." If
we assume that Luke refers to intestinal worms the
speech and song from the anatomy of the larynx and two accounts would trlly. lu an age sud ta a corme
upper air-passages ?-I am, Sir, yours faithfully, in which embalming was sO prevalent the average
Sheffield, Nov. 22nd, 1922. G. WILKINSON. physician must have had considerable knowledge of
the morbid anatomy of the abdomen and would not
be likely to err on the side of attributing too few
PANCEATIC EXTRACT IN DIABETES. deaths to intestinal parasites. We appeair to be on
To the Editor of THE LANCET. safe ground if we conclude that Josephus supplies the
SIR,-In THE LANCET of iFeb. 27th, 190, you fthful description of an intelligent layman, while
SIR--In THE LANCET of Feb. 27th, 1909, youLkeunssancurtcrtfcaofdthi
published an article by me on the successful treatment Luke furnishes an accurte certificate of death in
of diabetes in a young girl with "whole" extract of harmony with the most recent pathology.
the pancreas given by the mouth. In the Dublin I am, Sir, yours faithfully,
Journal of Medical Science for May, 1910, appeared a Belfast, Nov. 20th, 1922. R. M. FRASER, M.D.
further paper by me on a New Pancreatic Extract for
the Treatment of Diabètes. This extract was made for THE MERITS OF PROPORTIONAL
rme by Messrs. Fairchild, the process being the heating REPRESENTATION.
of the press-juice of fresh pig's pancreas to 80° C.,
which precipitated the proteins and destroyed all the GENERAL ELECTION, 1922-COMBINED ENGLISH
external secretions, leaving the internal secretion UNIVERSITIES.
intact. I obtained very encouraging results with this To the Editor of THE LANCET.
given by the mouth, distinctly more carbohydrate SIR,-The methods of counting votes under the
being utilised, and there was a manifest increase in system of Proportional Representation used at Univer-
the feeling of well-being of the patients. Further, it sity contests are puzzling in their application. The
was powerful enough in internal secretion when votes cast for me were many more than the officially
injected to arrest the oncoming symptoms of coma. recorded 90. I do not suppose that I was credited with
It never occurred to me as practical, nor does it a single vote from the members of the Conservative
now, to treat such cases by giving injections three Graduates Association, who put me up for election !
times a day. Will it never be generally realised that They had been urged to vote for "Faraday and
the important thing is the amount of food materials- Lawrence"; what more natural than to vote
carbohydrate, fat, and proteins-utilisedthatmatters, Faraday 1, Lawrence 2 ? My recorded poll of 90
not the amount excreted ? In my first paper I stated consisted of "plumpers," or first preferences. Whilst
that the lesion in the pancreas was microbial in origin, I was unable to receive any addition whatever to my
and have always taught so since. I am glad this is poll from any second preference votes given to me,
now accepted. In my paper, the Nature of the in the course of four subsequent counts, the totals of
Internal Secretion of the Pancreas (Dublin Journal, other candidates received large additions from that
July, 1921), I showed that the internal secretion was source and (I believe) later preferences. Sir Martin
not a hormone in the proper sense of the word, but Conway did not reach his quota until after Lawrence
was an essential part of a compound ferment, the and Faraday votes had been transferred and a third
heat-labile part of which was produced by the tissue count made. Mr. Fisher did not arrive at the same
cells. goal until after the transfer of votes for Lawrence,
The Toronto workers can, therefore, not claimn Faraday, and Woolf, and a fifth count had been made.
priority of the idea to produce a pancreatic extract The fourth count was concerned in distributing the
containing the internal secretion alone; nor can they surplus of Conway votes which originally had been
claim priority of the idea to destroy the external mostly first preferences for my colleague Faraday I
ferment-producing cells by occlusion of the duct-this My first election experiences leave me in doubt whether
was a well-known method; nor did they invent the the "Proportional Representation " method of voting
pancreas or its cell-islands. and counting votes is as perfect and just a system as,
I am, Sir, yours faithfully, its advocates allege.-I am, Sir, yours faithfully,
W. M. CuROrONu. SIDNEY C. LA\VRENCE, M.B. Birm.
University- College, Dublie, Nov. 27th, 1922. Bournemouth, Nov. 21st, 1922.