thicillin (Celbenin, Ayerst) at 10 pm on gastrointestinal tract series and barium Mar. 4, 1973 by Soluset containing 100 enema showed regional enteritis involving ml of 5% glucose in water. At 11 pm the small and large bowel. Treatment with he was found to have a rectal temperature prednisone, 20 mg tid, brought initial reof 38 0C when he was having violent rigors lief. However, 4 days later the diarrhea lasting approximately 20 minutes. He and abdominal pain recurred. Intravenous received a subsequent dose of methicillin hyperalimentation via a subclavian line at 2 pm on Mar. 5. At 4 pm he felt chilly. was started and the prednisone was reHis rectal temperature was 38.8 0C. An- placed by methylprednisolone (Soluother brand of methicillin was substituted medrol) given intravenously. The patient (Staphcillin, Bristol). The patient did not remained on hyperalimentation for 2 weeks. After the 1st week he was pain have any further chills or rigors. free, his diarrhea had stopped and he felt The second patient received 2 g of much better. When the Celbenin on Mar. 7, 1973 for staphylococ- was discontinued, fluidshyperalimentation were given by cal infection of skin and about an hour mouth and his diet was slowly increased. later had rigors and a choking sensation A repeat upper gastrointestinal tract in her throat. Her rectal temperature was and follow-through showeo great series imelevated to 38.5 0C and there was cyanosis provement in the enteritis and the patient and tachycardia. The drug was discon- was discharged on a maintenance dose of tinued immediately and Staphcillin sub- prednisone, 20 mg/d. stituted. Intravenous hyperalimentation is an At this time the medical staff at effective method of putting Ayerst Laboratories was contacted and at rest while still maintainingthe bowel an adean intensive investigation of the prob- quate nutritional for a prolonged blem yielded negative results. Subse- period of time. Itstatus is not without comquently, however, we learned1 that plications and should be used judiciAyerst had recalled Celbenin lot no. ously in special cases only by qualified (L) 3928-QK, stating "pyrogenic reac- staff, but it certainly a role to play tion" as a reason. The Celbenin pre- in the management ofhas severe attacks of scribed for the two patients in New ulcerative colitis and regional enteritis. Mount Sinai Hospital had been from I. FEFERMAN, MD that lot. New Mount Sinai Hospital Toronto, Ont. Although none of these patients suffered any serious lasting complications, they were greatly distressed by the Therapeutic abortion rigors, but the most serious aspect of To the editor: I can't help but feel a these episodes was that some patients twinge of ironic humour when I obwere unnecessarily branded as "aller- serve our male-dominated legislators gic" to the penicillins until the nature and the equally righteous virile memof the reaction was appreciated. bers of our medical profession attemptThese problems have now been seen ing to pontificate on a problem as percomplicating methicillin as well as sonal as a woman's reproductive descloxacillin therapy in Baltimore,' Mont- tiny. Although I have discussed this real and Toronto, and they seem to be problem with many patients with an related to the one manufacturer. unwanted pregnancy, I can only partially appreciate the emotional and phyJOHN A. SMITH, MD Division of microbiology siological forces involved in the situaNew Mount Sinai Hospital Toronto, Ont. tion. Conversion is not my purpose. Most people who have chosen their References ranks will probably remain loyal despite any argumentational artillery. So 1. Recalls, seizures, suspensions and refused entries. Rx Bull 5: 6, 1974 the war goes on! 2. SPENGLER RF, MELVIN VB, LIETMAN PS, We are supposedly living in a deet al: Febrile reactions after niethicillin (C). Lancet 1: 168, 1974 mocratic society where the freedom of the individual carries some weight. A Gallup poll in October 1974 showed Treatment of ulcerative colitis that 62% of Canadians believed that the abortion decision should be left to To the editor: In his excellent article a woman and her physician, 31 % dis"Some aspects of medical management agreed and 7% couldn't say. Arguing of gastrointestinal disease. Part II" (Can about how many can stand on Med Assoc J 112: 331, 1975) Badley the head of a pinangels does little to solve discusses a regimen for the intensive the dilemma and is but an irrelevant treatment of severe ulcerative colitis. I philosophic diversion. When prohibiwould like to suggest the addition to tion was outlawed it allowed those who this regimen of intravenous hyperali- wanted to have a drink the freedom mentation (total parenteral nutrition). to do so but it didn't force alcohol on Recently a 23-year-old man was ad- the teetotallers. Similarly, the existence mitted to our hospital with a history of of Catholicism does not prohibit one diarrhea for 6 weeks and a weight loss from worshipping in one's own faith, of about 5.5 kg. Examination by upper whatever it may be. If a woman and
her physician (and let's face it, it's usually the woman!) make a decision for abortion, then this is not infringing on the rights of the pro-lifers or Birthrightists as people concerned about their own lives. One does not legislate the treatment for schizophrenia. There are conscientious and responsible people on both sides of the issue and their detailed arguments can be read elsewhere. I am not for abortion, but for preconceptive family planning. If the laws are liberalized there will be abuses; we are imperfect creatures. But because we are human and individuals with personally significant problems requiring solutions, we should be permitted to be treated as individual humans. GElD SCHNEIDER, MD
1303 Richmond Rd. Ottawa. Ont.
International Society of Tropical Dermatology To the editor: I would like to acquaint the readers of the Journal with the aims of the International Society of Tropical Dermatology. We represent not "another" dermatologic society but the only international society of individual dermatologists. Our interests are by no means restricted to tropical dermatology. By direction of our constitution we encourage investigation of the geographic ecology of skin and venereal disease and basic research. This means good dermatology and venereology. Our field of interest is growing, and the opportunities for the exchange of ideas have so expanded that our official publication, International Journal of Dermatology, formerly issued quarterly, became bimonthly in January 1973 and is now monthly. Its main objective is continuing medical education. In addition to publishing a journal of quality we sponsor world congresses. Our first was in 1962 in Napoli, Italy; the second in 1969 in Kyoto, Japan; and the third in 1974 in S.o Paulo, Brazil. At that time the Castellani-Reiss medal and a $1000 cash prize were awarded to a Canadian, Dr. John C. Mitchell of Vancouver, for the best paper presented by a member of the society. Further information regarding this award may be obtained from Professor Kasuki Ito, chairman of the medal committee and chief of the department of dermatology of Gifu University medical college, Gifu City, Japan. Our society has also organized two well attended international mycology symposia. The first was held in Bratislava in 1966, the second in Bucharest in 1973 in cooperation with the Romanian Dermatologic Society.
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