Ian Aird

Relationship Between Cancer of Stomach and the ABO Blood Groups

It was shown by Stocks (1950) that the standardized mortality of cancer of the stomach tended to be greater in northern than in southern towns in England. Stocks considered this to be consistent with the hypothesis that gastric cancer depends on an irritant. The only environmental factor which appeared to correlate in any way with the varying incidence of cancer of the stomach was hardness of water, towns with a water supply of moderate hardness tending to have lower rates than towns with soft or very hard water. This correlation was not a very close one. He showed also that the standardized mortality of cancer of the stomach was greater in towns with a low proportion of people of advanced age and in towns with a high proportion of men in unskilled and partly skilled occupations. Stocks did not explore, and apparently did not take into account, any possible genetic difference in the populations which he examined, nor was this possibility mentioned by Legon (1951, 1952) in attempts to correlate the geographical variations in the mortality from gastric cancer with variations in the organic content of the soil. It occurred to one of us that there might be a correlation between the high northern incidence of cancer of the stomach and the genetic differences which are reflected in the ABO blood groups, the frequency of blood group 0 being greater, that of A less, in northern than in southern populations, B and AB being similar in all geographical areas in England and Scotland. Previous published work on the association of the ABO blood groups with cancer has been on very small series of cases without adequate controls. The results have been diverse and without statistical significance (Alexander, 1921 ; Johannsen, 1925; Goldfeder and Fershing, 1937).

The Blood Groups in Relation to Peptic Ulceration and Carcinoma of Colon, Rectum, Breast, and Bronchus

We have previously shown an association between the ABO blood groups and cancer of the stomach, group A being significantly commoner in patients suffering from cancer of the stomach than in controls drawn from the same hospitals (Aird, Bentall, and Roberts, 1953). The further diseases for which fairly large numbers have so far been obtained are peptic ulceration and carcinoma of the colon, rectum, breast, and bronchus. The results are presented in this paper, which also includes some data on Rhesus grouping. In addition, further calculations have been made on the figures for cancer of the stomach already published. A detailed examination of our data follows. The results have proved remarkably clear-cut: blood group 0 is strikingly high and the other three groups correspondingly low in patients suffering from peptic ulcer. The three cancers now studied, unlike cancer of the stomach, showed no significant blood-group association.

ABO Blood Groups and Cancer of Oesophagus, Cancer of Pancreas, and Pituitary Adenoma

It is a striking fact that up to the present time the diseases for which really strong evidence of associations with the ABO blood groups have emerged are, with one exception, conditions of, or associated with, the upper part of the gastro-intestinal tract. The one exception is Helmbolds (1958) finding of a highly significant excess of group A among women suffering from uterine cancers. Hence diseases of the gastro-intestinal tract not hitherto studied are of particular interest. Cancer of the pancreas and cancer of the oesophagus are diseases for which serious operation is often required, hence blood-grouping is frequently carried out and retrospective studies become possible. Neither condition is, however, common enough to make it easy to secure adequate numbers. The series reported in this paper are distinctly small, but it is hoped that other workers may be able to add further samples in due course.

Bilateral anterior transabdominal adrenalectomy.

and Lewis, A. A. 0. (1953). Ibid., 1, 153. Moore, F. D., and Ball, M. R. (1951). The Metabolic Response to Surgery. Thomas, Illinois, U.S.A. Platt, R. (1950). Clin. Sd., 9, 367. Randall, H. T., Habif, D. V., Lockwood, J. S., and Werner, S. C. (1949). Surgery, 26, 341. Simpson, S. A., Tait, J. F., Wettstein, A., Neher, R., Euw, J. v., and Reichstein, T. (1953). Experlentia (Basel), 9, 333. Stein, J. D., Bennett, L. L., Batts, A. A., and Li, C. H. (1952). Amer. J. Physiol., 171, 587. Tait, J. F., Simpson, S. A., and Grundy, H. M. (1952). Lancet, 1, 122. Von Pesaulles, P., Tripod, J., and Schuler, W. (1953). Schweiz. med. Wschr., 83, 1088. Wilkinson, A. W., Billing, B. H., Nagy, G., and Stewart, C. P. (1951). Lancet, 1, 315. Winter, C. A., Gross, E. G., and Ingram, W. R. (1938). J. exp. Med., 67. 251.

Acute Non-specific Mesenteric Lymphadenitis

The suggestion is put forward that improvement in the joint condition and the changes in the E.S.R. may be related to changes in the plasma proteins, but no evidence is available to support this view. The induction of jaundice in rheumatoid arthritis is justifiable only as a research measure. Its aim is to identify the substance or mechanism responsible for the remission of the joint condition and ultimately to reproduce this mechanism by other less dangerous methods.

Blood-group Antigens and Peptic Ulcer

Conspers. zinc. undecen. B.N.F.-Zinc undecenoate 10% and undecenoic acid 2% in powder base. Decilderm Powder (Duncan, Flockhart). Desenex Powder (Wallace and Tierman). Mycota Powder (Boots). These contain zinc undecenoate 20% and undecenoic acid 2% in powder base. Tineafax Powder (Burroughs Wellcome).-Zinc undecenoate 10% in powder base. Procelium Powder (Genatosan).-Zinc undecenoate 5% and sodium propionate 5% in powder base. These fungicides are not new, but they are probably as good as most substances used for the treatment of ringworm. They have the advantage of being less likely to irritate or sensitize the skin than some antimycotic agents. In the long-term treatment of low-grade ringworm infections of the feet, and in the prevention of relapses, a powder is probably better than greasy applications. In general, the treatment of ringworm is not very satisfactory, but the formulation of these powders is reasonable. They are perhaps best administered for low-grade infections, and for the prevention of relapses after the patient has recovered from an attack or greatly improved. Used in this type of case, they may be expected to give favourable results. N.H.S. basic price: conspers. zinc. undecen. B.N.F., 2 oz., Is. 21d.; decilderm, 1+ oz., 2s.; desenex, 2 oz., 2s. 7+d.; mycota, 2+ oz., Is. 8d.; tineafax, 25 g., Is. lOd.; procelium, 25 g., ls. 9d.

Blood Groups and Hypertension

in the neighbourhood of trauma was a change in the constitution of the intercellular substance from gel to sol; the hyaluronidase content of burned tissue was increased. The third group of substances concerned were polypeptides. Stimulation of the nerve to the salivary glands liberated acetylcholine, which stimulates secretion and had been shown by Hilton and Lewis to release an intracellular enzyme which appears in the saliva and in the tissue spaces, where it splits proteins into polypeptides resembling bradykinin. The depressor action of saliva was due to an enzyme which splits protein. A polypeptide, possibly bradykinin, was also released by diluting serum and by the contact of plasma with glass or metal. Bradykinin might be the pain-producing substance. Other polypeptides possibly concerned were Menkins factors leucotaxin and exudin, the action of the former being suppressed by cortisone and corticotrophin, the latter by corticotrophin only. Finally, said Feldberg, Miles and Schachter had found that when guinea-pig plasma is diluted 1 in 400 and left for an hour an a globulin is found which increases vascular permeability and appears to be a protease, since it is inhibited by the trypsin inhibitor found in soya bean.

Increasing the Brain's Blood Supply

SIR,-Dr. Rex Binning (January 14, p. 128) expressed concern lest the lessons of medical tactics learnt in the war of 1939-45 might be in danger of being forgotten. In particular he feared that early surgical treatment was not being afforded those who were wounded in the operations against the bandits-in Malaya. I should like to reassure Dr. Binning that the valuable medical lessons of the last war are not forgotten, and the experience gained in the campaigns in Burma forms the basis on which our present medical tactical doctrine in Malaya is founded.-I am, etc., N. CANTLIE, London, S.W.I. Lieut.-General; Director-General, Army Medical Services.