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HOSPITAL TREATMENT OF MEASLES AND WHOOPING-COUGH.
1591 infected blood into their mouths ; he also demonstrated that this trypanosome was capable of passing through
whooping-cough in the Metropolitan Asylums Board hospitals. It is well known that the case-mortality in the Metropolitan Asylums Board hospitals, both of scarlet fever and of diphtheria, has steadily declined in recent years, and it is somewhat surprising to find that the result of hospital treatment of measles and whooping-cough has resulted in case-mortalitiea very considerably exceeding those recently recorded of scarlet fever and of diphtheria. It is a fact, however, that the case-mortality among the 2226 completed cases of diphtheria treated in the Metropolitan Asylums Board hospitals during the first 21 weeks of this year did not exceed 10’1 per cent., whereas the mortality was 15 4 per cent. among completed cases of measles and 23’ 0 per cent. among those of whooping-cough.
sound skin and reaching the circulation. More recently G. Martin and Ringenbach published similar experiments with T. gambiense. Guinea-pigs contracted the disease when infected blood was allowed to enter the vagina. Hindle tried feeding experiments on rats by giving them for food the organs of animals which had died from sleeping sickness, but without success. This failure was attributed to the effect of digestive fluids on the trypanosome. But in another series of experiments, when infected blood was introduced into the mouth of each rat by means of a syringe, the animals invariably became infected. Although a few experiments were carried out with a view to ascertain if T. gambiense can be transferred from the infected to the healthy rat by sexual coitus they had no positive result. But when VACCINE CULTURE IN THE SHEEP. infected blood was carefully introduced into the vagina all VACCINE is ordinarily prepared by the inoculation of the animals became infected within a period of five to but calves are not everywhere available abroad, calves, eight days. Other observations made by Hindle led him to It has in nearly all countries sheep are found. conclude that T. gambiense is able to penetrate a sound though therefore been investigated in the Royal Institute for mucous membrane and also the undamaged skin of an Infectious Diseases in Berlin and elsewhere in Germany animal, and he has no reason to doubt that the trypanosome whether the sheep is an animal through which vaccine can possesses similar powers in its normal host-man. It is be usefully passed. It is found that if sheep are inoculated obvious from the above that personal prophylaxis now with glycerinated vaccine (1-20), the first crop of vaccine is becomes of great importance, more especially for the pathosome 20 times the original, and that the resulting lymph, logist or laboratory worker who comes in contact with no longer virulent enough to infect another sheep, infected material. If when blood is dried on the hairy though will raise good vaccine vesicles on a calf, and therefore skin of a rat the trypanosomes will go through and infect, it on men. Dr. Claus Schilling, from whose paper in is quite probable that in man blood allowed to dry upon the probably a recent issue of the Aroltiv fiir Schiffs- und Tropen-Hygiene skin may in like manner cause infection, apart from the we quote, concludes that if no calves are available at any presence of any abrasion. place but only sheep, it may be worth while on an HOSPITAL TREATMENT OF MEASLES AND emergency to pass the available lymph through a sheep in order to multiply the available quantity by 20. He begs for WHOOPING-COUGH. THE treatment of cases of measles and of whooping-cough further investigations of this question in other races of sheep in the of the Board is an and in the tropics. -
hospitals Metropolitan Asylums interesting experiment, affording, as it does, useful statistics of case mortality of those diseases which would not otherwise be available. It appears, from returns issued by the Metropolitan Asylums Board, that during the first .21 weeks of this year 1983 completed cases of measles in their hospitals were reported ; of these, 1678 cases were discharged
recovered and 305 were deaths. The deaths were therefore in the proportion of 15’ 4 per cent. of the completed cases. This somewhat unexpectedly high rate of case-mortality for this disease is the more noteworthy when compared with the rate of mortality among the completed cases of the same disease treated in the London Fever Hospital. During the same period of 21 weeks, 514 completed cases of measles were reported from the London Fever Hospital, of which 512 were cases discharged recovered, and only 2 were deaths ; in this hospital, therefore, the proportion of deaths did not exceed 0’4 per cent. of the completed cases, whereas it was equal, at stated above, to 15’ 4 per cent. in the Metropolitan Asylums Board hospitals. It is difficult to suggest a
satisfactory explanation of this startling contrast in the casemortality of measles, although it may be partly due to difference in the condition on admission of patients treated in the Metropolitan Asylums Board hospitals and in the London Fever Hospital. The number of completed cases of whooping-cough treated by the Metropolitan Asylums Board during the period of 21 weeks under notice did not exceed 326, including 251 cases discharged recovered and 75 deaths, equal to a case-mortality of 23-0 per cent. Thus in the Metropolitan Asylums Board hospitals the case-mortality of whooping-cough since the beginning of this year has been still higher than among cases of measles. As no cases of whooping-cough appear to have been treated in the London Fever Hospital there is no available standard with which to compare the case-mortality of
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QUININE AND BLACKWATER FEVER. WE have received an interesting clinical account of a case of blackwater fever in the Eastern Transvaal, which pressure on our columns prevents us from reproducing in detail. Dr. J. Stanley Avery, who reports the case, states that the patient, a resident in the Barberton district, had contracted malarial fever in November, 1909, and had suffered from relapses duringthe year following. In November, 1910, he fell ill with general malaise, headache, ansemia, nausea, and bilious vomiting; at the beginning of December blood appeared in the urine, and he went into hospital at Newington. The presence of haemoglobin was demonstrated by the spectroscope, but after three days the oxy-hæmoglobin bands were replaced by the broad band characteristic of urobilin, which persisted for a fortnight. Albumin was present for a few days, then fell toamere trace, but reappeared together with the oxy-hsemoglobin for a few days. There was enlargement of the liver and spleen lasting for a fortnight. Jaundice was a prominent symptom in the first week of the illness, and obstinate constipation continued throughout five weeks. No malarial parasites were detected in blood films, two of which were examined at intervals of a fortnight. Quinine was purposely withheld during the first three weeks on account of the absence of malarial parasites in the blood films and of the presence of blood in the urine. It was then administered, as bi-hydrochloride, in gradually increasing doses, until as much as 30 gr. daily were given, without favourably influencing the course of the fever, which, however, came to an end. Dr. Avery refers to the confusion that exists with regard to blackwater fever. There are three principal theories as to its etiology: (1) that it is due to malaria; (2) that it is due to quinine ; and (3) that it is a distinct specific disease. He does
whooping-cough in the Metropolitan Asylums Board hospitals. It is well known that the case-mortality in the Metropolitan Asylums Board hospitals, both of scarlet fever and of diphtheria, has steadily declined in recent years, and it is somewhat surprising to find that the result of hospital treatment of measles and whooping-cough has resulted in case-mortalitiea very considerably exceeding those recently recorded of scarlet fever and of diphtheria. It is a fact, however, that the case-mortality among the 2226 completed cases of diphtheria treated in the Metropolitan Asylums Board hospitals during the first 21 weeks of this year did not exceed 10’1 per cent., whereas the mortality was 15 4 per cent. among completed cases of measles and 23’ 0 per cent. among those of whooping-cough.
sound skin and reaching the circulation. More recently G. Martin and Ringenbach published similar experiments with T. gambiense. Guinea-pigs contracted the disease when infected blood was allowed to enter the vagina. Hindle tried feeding experiments on rats by giving them for food the organs of animals which had died from sleeping sickness, but without success. This failure was attributed to the effect of digestive fluids on the trypanosome. But in another series of experiments, when infected blood was introduced into the mouth of each rat by means of a syringe, the animals invariably became infected. Although a few experiments were carried out with a view to ascertain if T. gambiense can be transferred from the infected to the healthy rat by sexual coitus they had no positive result. But when VACCINE CULTURE IN THE SHEEP. infected blood was carefully introduced into the vagina all VACCINE is ordinarily prepared by the inoculation of the animals became infected within a period of five to but calves are not everywhere available abroad, calves, eight days. Other observations made by Hindle led him to It has in nearly all countries sheep are found. conclude that T. gambiense is able to penetrate a sound though therefore been investigated in the Royal Institute for mucous membrane and also the undamaged skin of an Infectious Diseases in Berlin and elsewhere in Germany animal, and he has no reason to doubt that the trypanosome whether the sheep is an animal through which vaccine can possesses similar powers in its normal host-man. It is be usefully passed. It is found that if sheep are inoculated obvious from the above that personal prophylaxis now with glycerinated vaccine (1-20), the first crop of vaccine is becomes of great importance, more especially for the pathosome 20 times the original, and that the resulting lymph, logist or laboratory worker who comes in contact with no longer virulent enough to infect another sheep, infected material. If when blood is dried on the hairy though will raise good vaccine vesicles on a calf, and therefore skin of a rat the trypanosomes will go through and infect, it on men. Dr. Claus Schilling, from whose paper in is quite probable that in man blood allowed to dry upon the probably a recent issue of the Aroltiv fiir Schiffs- und Tropen-Hygiene skin may in like manner cause infection, apart from the we quote, concludes that if no calves are available at any presence of any abrasion. place but only sheep, it may be worth while on an HOSPITAL TREATMENT OF MEASLES AND emergency to pass the available lymph through a sheep in order to multiply the available quantity by 20. He begs for WHOOPING-COUGH. THE treatment of cases of measles and of whooping-cough further investigations of this question in other races of sheep in the of the Board is an and in the tropics. -
hospitals Metropolitan Asylums interesting experiment, affording, as it does, useful statistics of case mortality of those diseases which would not otherwise be available. It appears, from returns issued by the Metropolitan Asylums Board, that during the first .21 weeks of this year 1983 completed cases of measles in their hospitals were reported ; of these, 1678 cases were discharged
recovered and 305 were deaths. The deaths were therefore in the proportion of 15’ 4 per cent. of the completed cases. This somewhat unexpectedly high rate of case-mortality for this disease is the more noteworthy when compared with the rate of mortality among the completed cases of the same disease treated in the London Fever Hospital. During the same period of 21 weeks, 514 completed cases of measles were reported from the London Fever Hospital, of which 512 were cases discharged recovered, and only 2 were deaths ; in this hospital, therefore, the proportion of deaths did not exceed 0’4 per cent. of the completed cases, whereas it was equal, at stated above, to 15’ 4 per cent. in the Metropolitan Asylums Board hospitals. It is difficult to suggest a
satisfactory explanation of this startling contrast in the casemortality of measles, although it may be partly due to difference in the condition on admission of patients treated in the Metropolitan Asylums Board hospitals and in the London Fever Hospital. The number of completed cases of whooping-cough treated by the Metropolitan Asylums Board during the period of 21 weeks under notice did not exceed 326, including 251 cases discharged recovered and 75 deaths, equal to a case-mortality of 23-0 per cent. Thus in the Metropolitan Asylums Board hospitals the case-mortality of whooping-cough since the beginning of this year has been still higher than among cases of measles. As no cases of whooping-cough appear to have been treated in the London Fever Hospital there is no available standard with which to compare the case-mortality of
-
QUININE AND BLACKWATER FEVER. WE have received an interesting clinical account of a case of blackwater fever in the Eastern Transvaal, which pressure on our columns prevents us from reproducing in detail. Dr. J. Stanley Avery, who reports the case, states that the patient, a resident in the Barberton district, had contracted malarial fever in November, 1909, and had suffered from relapses duringthe year following. In November, 1910, he fell ill with general malaise, headache, ansemia, nausea, and bilious vomiting; at the beginning of December blood appeared in the urine, and he went into hospital at Newington. The presence of haemoglobin was demonstrated by the spectroscope, but after three days the oxy-hæmoglobin bands were replaced by the broad band characteristic of urobilin, which persisted for a fortnight. Albumin was present for a few days, then fell toamere trace, but reappeared together with the oxy-hsemoglobin for a few days. There was enlargement of the liver and spleen lasting for a fortnight. Jaundice was a prominent symptom in the first week of the illness, and obstinate constipation continued throughout five weeks. No malarial parasites were detected in blood films, two of which were examined at intervals of a fortnight. Quinine was purposely withheld during the first three weeks on account of the absence of malarial parasites in the blood films and of the presence of blood in the urine. It was then administered, as bi-hydrochloride, in gradually increasing doses, until as much as 30 gr. daily were given, without favourably influencing the course of the fever, which, however, came to an end. Dr. Avery refers to the confusion that exists with regard to blackwater fever. There are three principal theories as to its etiology: (1) that it is due to malaria; (2) that it is due to quinine ; and (3) that it is a distinct specific disease. He does