Document ppepo7VLwQ0gKGR5wvkGnokYj

Si MedicBarlitJisohurnal ial experiments ,tudy do not give pens m the lungs The study whirl; t answer to the e to measuie the uct of histamine jrine from cardisible in the near ect evidence, and tioned that in a workers an anti chloride, 5 mg the decrease of irking day of the extracts contain ydroxytryptamine demonstrated." : ic" shows that the e far too small to jronchi in vivo.' ect of dust extract histamine.1 Ltke; is very weak, as .es no contraction vo11 even though e the presence of je of interest to at it need not dis byssinosis. the only theory peculiar symptom arkers.1 A non its may also be 1 asthma, and this n of cotton dust is leoretical interest, ionai hygiene the ot the active agent tvs of the workers, from the dust the ' the lungs in intact tt stomach or the >n may be useful n effects of textile etc., A. Bouhuys. S.-E. Lindell. in, O., Brit. med. J., H. }., Arch, environ. Dingwall-Fordvce, I., d.. 1955. 12. 219. rerbehyg.. 1959 CO, 17, Brit. J. Industr. Med.. on Byssinosis. Permatssociation on Occupaer 24-26. I%2. ibeil, S.-H., Lunderen, Clin. Set. I960. 19. 79. amine. 1958. p. 172. ion Press, London. 333. Nov. 24, 1962 CORRESPONDENCE MedicBarlitJisohurnal 1397 Exposure to Asbestos Dust and Diffuse Pleural Mesotheliomas para 2, six para 3, and one each para 4, 5, 6, and 7 (unstated six). The stages of gestation were : Sir,--The letter of Dr. W. J. Smither and his colleagues (November 3, p. 1194) drawing attention to the dose association between diffuse pleural meso theliomas and exposure to asbestos dust prompts us to summarize our own experience of thts association. Several years ago one of us1 described 11 diffuse pleural mesotheliomas collected from the necropsy files of the Institute of Patholog\, Queen's University, Belfast. Since then a further four cases have accumulated. Recently we have screened the histological sections of lung from these 15 cases for asbestos bodies, anJ have found them in 12. In only one case were the bodies plentiful; in the remainder they were few and usually prolonged search was needed 32 weeks 1 33 ,, 1 36 ,, 2 37 2 40 41 weeks ,, 30 26 42 ,, 14 43 2 38 13 39 .. 8 The oil certainly lived up to its reputation of being a valuable purgative. In only six instances did a bowel action not follow. The average interval between the administration of the purge and the first response was 2 hours 40 minutes. The time interval varied from immediate to seven hours. The average number of actions was 2.8 per person, the number varying between 0 and 12 ! for their detection. Nine of these patients with pleural mesotheliomas with asbestos bodies have died since 1950, and an attempt has been made to get a detailed occupational history from their relatives. The results show that in four cases there was a clear-cut history of intermittent exposure to asbestos. One of these cases had worked in a factory processing asbestos for the shipyards some years before. In the live other cases no definite exposure was admitted by the relatives, but all had jobs in the shipyards which inevitably brought them into intermittent contact with asbestos work--for example, shipyard plumbing and furnace repairing. A few weeks ago we saw a patient in whom it was possible to make a firm diagnosis of diffuse pleural, mesothelioma from the clinical picture and biopsy material. He had to stop work because of his disease at 62 years. For all his working life he had been an engine-room fitter and had worked for periods each year cleaning down and dismantling machinery which had been embedded in asbestos insulation. The patients' reaction to the treatment was recorded as: Indifference 22 Toleration 49 Discomfort 10 Anguish 1 Twelve patients vomited copiously, two patients were extremely nauseated, and two patients seemed to enjoy both the oil and the result which followed. The efficacy of the oil as an oxytocic drug was not so marked. In 27 instances only did the patient go into labour. In 73 it failed, though five of these had a few uterine contrac tions which passed off. The 73 failures occurred a t : 32 33 weeks w i i 36 2 37 ] 38 ,, 8 39 weeks 4 40 24 41 19 42 ,, H 43 2 In most of these cases exposure to asbestos was not This apparently disproved the oft-repeated suggestion that continuous or prolonged and in ome irvo^nces there it is likelv to be successful at or after term. was a considerable gap between the last exposure and the onset of symptoms due to the tumour. Mean age at death was 6 5 | years.--We are, etc., Department of Pathology, W. T . E. McC aughey. pD,epart,men#t of Therapeutics and. -On. rL* . Wade. e Pharmacology, * fc-LMES. The Queen's University of Belfast. Reference * McCaughey, W. T., J. Path. Bad., 1958, 7, 517. The 27 successes occurred at: 37 weeks I 38 2 39 ,, 3 , 40 ,, 8 41 weeks 8 42 4 43 .. o 44 ,, 1 Now we have to decide if a 27 % success rate w arrants the discomfort, anguish, extreme nausea, and vomiting which were recorded in 25 % of patients, in an age when artificial rupture of the membranes is a safe and satisfactory method of achieving the desired result.-- I am, etc., Castor Oil for Induction o f Labour Sir,--Once upon a time a medical.induction of labour consisted of 2 oz. (57 ml.) of castor oil, enema saponis. C. K eith V artan. British Hospital for Mothers and Babies, London S.E.18 and a hot bath at hourly intervals followed by quinine sulphate 5 grains (0.32 g.) at two-hourly intervals, three Inducing Labour by Intra-amniotic Injection times, and pituitary extract 5 units at four-hourly Sir.-- Mr. F. J. Burke's letter (October 27, p. 1129) intervals, twice. concerning the induction of labour by intra-amniotic The last two ingredients have been put out of favour injection of hypertonic glucose solution prompts me to because the temptation to push up the dose of quinine write briefly to you. to 15 grains or higher and to repeat the pituitary extract I first started to use " uroselectan B " and hypertonic . too often was too much for the medical attendants to glucose solution for the induction of labour when I was resist and harm was being done to both m other and registrar at King's College Hospital in 1933. Two cases baby. It is only fair to say that in those days there so treated were included in a book that 1 submitted for was no sulphonamide and no antibiolic and therefore my M.R.C.O.G. examination later in that year. How surgical interference was more dreaded than it is to-day. ever, my purpose in writing is not in order to establish How effective is the medical induction shown of these precedence in connexion with this procedure, but rather two potent adjuvants 7 T hat is the question we recently to issue a word of warning to any who may be prompted sought to answer by keeping records of 100 patients. by th? recent paper by Mr. Carl Wood. Mr. R. T. Booth, The treatment was given 87 times to induce labour and nine times to find out if a patient who thought she was in labour was or was not. tn four instances the reason was not stated. The patients were 60 primigravidae, 15 para 1, nine and Professor John Pinkerton (September 15, p. 706) to try this method for themselves. After a very considerable experience I finally aban doned the method following a maternal death due to - --------*"T