Peroral Endoscopy: Simplified Technique*

The problem of haemorrhage in jaundice has recently been reviewed by Illingworth (1939). Butt, Snell, and Osterberg (1939) found that the effects of intramuscular administration of vitamin K concentrates were not striking. The results herein reported of the use of 2-methyl-i:4-naphthoquinone as a synthetic substitute for natural vitamin K are most striking. This preparation, when given to four cases of obstructive jaundice with low prothrombin indices, has raised the index considerably in all of them within two days. In the last case the change was evident within twelve hours: it is probable that the effect was present in the other cases at that stage too, but was not recognized because the index was not estimated soon enough. It is hoped that, when conditions are favourable, further work will be done on the question of the rapidity of this change.