tragedy, but nevertheless I believe that the delaying tactics of the health protection branch are to the detriment of medicine in Canada and not to its advantage. G.S.L. WILSON, MB Drumheller, Alta.
Jatrogenic and egogenic diseases
The otitis drop designed to penetrate wax.
colymycin otlo
The only .otic with thonzonium bromide to help the active ingredients cret riqht to the site of infection - even through cerumen and debris.
DESTROYS COMMON PATH 0GENS - Provides the broad-spectrum bactericidal actions of colistin sulphate and neomycin sulphate. REDUCES SWELLING, RELIEVES ITCHING-Also contains the proven benefits of hydrocortisone acetate.
with perforated eardrum or in long standing otitis media because of the possibility of ototoxicity caused by neomycin.
Composition: Each ml. contains - Colistin base activity 3.0 mg. (as the sulphate); neomycin base activity 3.3 mg. (as the sulphate); hydrocortisone acetate 10.0 mg.; thonzonium bromide 0.5 mg.
Supplied: 5 ml. bottles. Full information is avaliable on request.
Conlraindications: COLY-MYCIN OTIC- is contraindicated if there is a history of sensitivity to any of its components, or in tubercular, fungal, and most viral lesions, especially herpes simplex, vaccinia and varicella.
Dosage: Instil 4 drops bid. Precautions: If sensitivity or irritation occurs, medication should be discontinued promptly. Overgrowth of resistant organisms is possible. use with care in cases
556 CMA JOURNAL/MARCH 8, 1975/VOL. 112
WARNER/CHILCOTT Laboratories Co. Limited Toronto, Canada
To the editor: In this age of instant communication to a sophisticated public, physicians' errors are often sensationally publicized. The possibility of such unfortunate occurrences as drug reactions, unexpected postoperative complications and even outright mistakes is so widely recognized, and the critics of the medical profession are so eloquent, that these unfortunate sequelae are grouped together under the term iatrogenic (physician-induced) diseases. However, patients may also contribute to their own ill health by errors of omission or commission. Such conditions as smokers' cancer, alcoholism, obesity, unsafe driving habits, improper diet, lack of exercise, drug abuse, inattention to dental or bodily hygiene, and even failure to follow sound medical advice all fit into this category. It is unbelievable that no medical term exists to describe this group of diseases. A recognized term would emphasize that maintenance of health is a dual responsibility for both doctor and patient. It would also be helpful in defending physicians against malpractice claims for alleged iatrogenic disorders in which at least a portion of the fault can be shown to lie with the patient. We suggest for such conditions, induced by neglect or wilful action on the part of the patient, the term "egogenic diseases". L.C. BARTLE¶1-r, MD, rRCS[C] SHIRLEY LUMSDEN, RRL E.G. DELIOs, MB
Medical Arts Building Winnipeg, Man.
Amitriptyline and isoproterenol: fatal drug combination To the editor: A 30-year-old obese married white woman who had had asthma for over 10 years died unexpectedly. A used but capped container of isoproterenol aerosol was found near her body. The autopsy blood sample contained 0.07 mg/ dl of amitriptyline and traces of phenobarbital. Death was due to aspiration of gastric contents in response to cardiac arrhythmia induced by interaction between isoproterenol and amitriptyline. The lungs were overdistended but there was no indication of mucous plugging. During the last 10 years of her life she had been treated with corticosteroids, antibiotics, desensitizing antigens,
Jatrogenic and egogenic diseases
The otitis drop designed to penetrate wax.
colymycin otlo
The only .otic with thonzonium bromide to help the active ingredients cret riqht to the site of infection - even through cerumen and debris.
DESTROYS COMMON PATH 0GENS - Provides the broad-spectrum bactericidal actions of colistin sulphate and neomycin sulphate. REDUCES SWELLING, RELIEVES ITCHING-Also contains the proven benefits of hydrocortisone acetate.
with perforated eardrum or in long standing otitis media because of the possibility of ototoxicity caused by neomycin.
Composition: Each ml. contains - Colistin base activity 3.0 mg. (as the sulphate); neomycin base activity 3.3 mg. (as the sulphate); hydrocortisone acetate 10.0 mg.; thonzonium bromide 0.5 mg.
Supplied: 5 ml. bottles. Full information is avaliable on request.
Conlraindications: COLY-MYCIN OTIC- is contraindicated if there is a history of sensitivity to any of its components, or in tubercular, fungal, and most viral lesions, especially herpes simplex, vaccinia and varicella.
Dosage: Instil 4 drops bid. Precautions: If sensitivity or irritation occurs, medication should be discontinued promptly. Overgrowth of resistant organisms is possible. use with care in cases
556 CMA JOURNAL/MARCH 8, 1975/VOL. 112
WARNER/CHILCOTT Laboratories Co. Limited Toronto, Canada
To the editor: In this age of instant communication to a sophisticated public, physicians' errors are often sensationally publicized. The possibility of such unfortunate occurrences as drug reactions, unexpected postoperative complications and even outright mistakes is so widely recognized, and the critics of the medical profession are so eloquent, that these unfortunate sequelae are grouped together under the term iatrogenic (physician-induced) diseases. However, patients may also contribute to their own ill health by errors of omission or commission. Such conditions as smokers' cancer, alcoholism, obesity, unsafe driving habits, improper diet, lack of exercise, drug abuse, inattention to dental or bodily hygiene, and even failure to follow sound medical advice all fit into this category. It is unbelievable that no medical term exists to describe this group of diseases. A recognized term would emphasize that maintenance of health is a dual responsibility for both doctor and patient. It would also be helpful in defending physicians against malpractice claims for alleged iatrogenic disorders in which at least a portion of the fault can be shown to lie with the patient. We suggest for such conditions, induced by neglect or wilful action on the part of the patient, the term "egogenic diseases". L.C. BARTLE¶1-r, MD, rRCS[C] SHIRLEY LUMSDEN, RRL E.G. DELIOs, MB
Medical Arts Building Winnipeg, Man.
Amitriptyline and isoproterenol: fatal drug combination To the editor: A 30-year-old obese married white woman who had had asthma for over 10 years died unexpectedly. A used but capped container of isoproterenol aerosol was found near her body. The autopsy blood sample contained 0.07 mg/ dl of amitriptyline and traces of phenobarbital. Death was due to aspiration of gastric contents in response to cardiac arrhythmia induced by interaction between isoproterenol and amitriptyline. The lungs were overdistended but there was no indication of mucous plugging. During the last 10 years of her life she had been treated with corticosteroids, antibiotics, desensitizing antigens,
