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Food. Its Destiny Was Presumably Cooking Purposes,In Minutes, and Appears to Think Ill of the Method 827 importance of washing out the stomach to There could be little doubt of its rancidity get rid of irritating matter that causes the since the analyst reported that it contained pylorospasm, while others think this unnecessary ; 3’16 per cent. of fatty acids compared with a the administration of warm water enemas is often figure for fresh butter of well under 0’5 per cent. advised. In Germany the passage of sounds or The magistrate, after hearing chiefly chemical and catheters through the contracted pylorus to dilate practically no physiological evidence, decided that it mechanically has been widely advocated during the butter was fit for human consumption, and so the last five years. Hess argues that if a No. 15 no order was made under the regulations and the catheter will pass the pylorus there is no organic consignment was released. It does not appear to be stenosis. Dr. Delprat has tried this mode of treat- disputed that the butter was rancid, the question to ment several times, but could not make sure of decide being whether in that case it was unfit for passing the sound into the duodenum within 15 food. Its destiny was presumably cooking purposes,in minutes, and appears to think ill of the method. which its rancidity would become more or less Finally, the treatment of pylorospasm by drugs is obscured. Having regard to the nature of the process discussed. Among the drugs used have been opiates of rancidity, we may be wise in entertaining a and antispasmodics, such as cocaine, atropine sul- suspicion that rancid butter is not a wholesome phate, or novocaine (1 milligramme five times a day food. It appears that though air plays a part in before food), dionine (1 milligramme every three this process the change is due not directly to air, hours), anoesthesin (5 centigrammes before each feed), but to the stimulus of oxygen given to certain and papaverine hydrochloride (5-10 milligrammes micro-organisms, amongst which are included subcutaneously or by the mouth half an hour oldium lactis, B. fluorescens liquefaciens, and before food). Papaverine, one of the alkaloids of cladosporium butyri. The fact that such a butter opium, relieves the spasm of involuntary muscle, would be objectionable and unpalatable in the and has been used extensively to treat the pyloro- ordinary way self-condemns it. Any food, generally spasm of infants. Dr. Delprat gives an account speaking, that excites nausea must be regarded as of its use in 5 cases-in 3 with success, in 2 unwholesome. ____ without it; and the conclusion reached is that paperavine is not a specific for the treatment GANGRENOUS EPIPLOIC APPENDIX SIMULATING of pylorospasm. Details of 16 more cases of APPENDICITIS. pylorospasm treated in other ways are given; IN the Boston Medical and Surgical Journal Dr. it is noted that 5 out of the total of 21 A. R. Kimpton has reported a case of a rare con- patients were breast-fed. In a general way dition-gangrenous epiploic appendix Dr. advises that the infant should be simulating Delprat appendicitis. A man, aged 42 years, was seen at kept very quiet before and after feeding ; usually midnight for acute abdominal symptoms. For 10 small feeds are given in the 24 hours, rather 30 hours he had been suffering from pain in the than five large feeds, and at the outset 10-15 c.c. lower of the abdomen, which had should be hour. Subcutaneous right quadrant given every injec- been increasing. For the past four or five hours tions of physiological salt solution are advised. Of hot fomentations had been applied with but slight the 21 infants 1 was lost 1 died treated, sight of, relief. When examined the had a great from while from the patient pneumonia recovering pyloro- deal of nausea, almost to the point of vomiting. 6 died from and the 13 spasm, inanition, remaining He had had one or two similar attacks, which had had recovered or were well on the way to recovery been of short duration. The bowels had acted when Dr. wrote. Delprat regularly. The patient was very obese. The temperature was 98’8° F. and the pulse 80. The lower of the abdomen showed RANCID BUTTER. right quadrant moderate rigidity and spasm with marked tender- IT seems logical to conclude that when a food ness over McBurney’s point. There were thus becomes unpleasant to the taste and develops a signs of appendicitis. A right rectus incision was disagreeable smell it is no longer fit for consump- made. There was no free fluid in the abdomen tion. That view, at all events, will surely be accepted and no evidence of fat necrosis. In the region in the case of the evil-smelling egg and probably of the appendix an almost black body was found; of rancid butter also. The rancidity of butter is this was an epiploic appendix which had apparently due to a change in the composition of the fat, twisted upon itself. It was tied off and removed. brought about probably by bacterial agencies stimu. The vermiform appendix itself was perfectly normal air and the lated by and light, likely enough products but was removed. The abdomen was closed in layers are The removal of these unwholesome. products without drainage. Convalescence was uneventful with the addition of a little by washing, perhaps except for ether bronchitis and some breaking down carbonate of soda or other neutraliser, renders the of the superficial fat in the abdominal wall. fat sweet and non-acid again. Some months ago a consignment of rancid butter was seized in the of the metropolitan borough Bermondsey by food LONDON INSURANCE COMMITTEE. inspector, who gave it as his opinion that the butter was rancid and unfit for human consumption. AT a meeting of the London Insurance Com- This opinion was confirmed by the medical officer mittee marked attention was called to the financial of health, Dr. R. King Brown, and the public analyst position of the committee by Mr. Handel Booth, who analysed the butter, and also samples of cake M.P., and others, including Mr. Rockcliffe, chairman and shortbread which had been made with this of the Finance Committee. As a result of the butter. A stop order had been placed on the butter discussion which took place upon this subject a in accordance with the Unsound Food Regulations committee was appointed to confer with the of the Local Government Board, and eventually a Insurance Commissioners on the subject of the summons was applied for at the Tower Bridge committee’s finances. The difficulty which many police-court in order that the magistrate should committees share with the London Committee decide whether the butter was unfit for consumption. arises out of the inadequacy of the funds at their.
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