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R a d i u m 219
eight months had elapsed after the first symptoms appeared. The length
of time between the appearance of symptoms and diagnosis was on the
average 1.4 years for 148 cases."
"5. Irradiation has had little effect on prolonging the life of these
patients. I he early institution of irradiation as yet does not promise an
important increase of life expectancy. The average duration of life
after the first symptom of the disease in fifty-two nonirradiated patients
was 3.04 years, and in seventy-eight irradiated patients 3.5 years. Of
these 130 patiems, 42 per cent, lived from two to four years, and 12 per
cent, more than five and up to ten vears.'-'
"6. Continued, properly administered irradiation produces symptomatic
benefit, which is often marked, and offers to the patient the best
guarantee of the longest possible preservation of his working capacity.
As the disease progresses, efficiency decreases, in spite of continued
therapy."
"7. All but 5 per cent, of Ihe seventy-eight patients were benefited
sufficiently by radium or roentgen ray to remain able and useful for
varying |>eriods of time. At least 50 per cent, became temporarily symptomatically
well. This is in contrast *o the fact that but 6 per cent, of
the fifty-two nonirradiated patients had moderate remissions."
"8. The duration of efficient life as compared to the length of life
after diagnosis or beginning irradiation, cither early or late, shows that
on the average it is at least 30 per cent longer in irradiated patients.
This percentage time of useful and able existence and the degree of efficiency
are both much greater when treatment is begun before than after
the middle of the disease."
"9. The actual duration laverage 1.6 years for seventy-eight patients)
of useful life after ihe first irradiation is pro|X>rtional to the
duration of the disease."
"10. The statistics given enable one to forecast the probabilities of
the duration of life and the general ability of the patient with chronic
myelogenous leukemia. 'The forecast can be made more accurately if
information, not discussed here, concerning the clinical state, the blood.
the metabolism and the irradiation is properly evaluated."
* * * * * *
Burt Russell Shurly, M. D. (Detroit). The Removal of Tonsils,
with Special Reference to Methods Other than Complete Enucleation.
Journal of the American Medical Association, lxxxi, 800-802, Sept.
8, 1923.
"A perusal of tonsil literature during the last quarter century, with
its many examples of radicalism and conservatism, with its illustrations
of hundreds of new, now useless, instruments, with its story of frequent
imaginative results and methods without logic is. nevertheless, a
tale of scientific progress. The useless procedures, to supply a demand,
that promised absorption of pathological tonsils such as arsenical paste.
iodin. electrolysis, and the galvanocautery, received a long trial, failed,
and are now only memories of early laryngology. During this period
there was a prevalent idea among the laity that the removal of tonsils
lessened the powers of sexual function. Today we are again asked to
meet and classify the value of new methods of absorption, to establish
the proper therapeutic indications, and to tabulate the results from the
use of radium or the roentgen ray."
"While it is true that hundreds of cases are now under treatment