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SELECTIVE TISSUE DESTRUCTION.
430
put to bed for the whole course, usually of the children and young people after the liberaextending over ten days, and restricted at first to tion of Lille showed their development to have foods which leave no residue, such as broths, been arrested and about 20,000 young subjects to whey, and albumin water. Milk is to be added only have become "degenerates" as a result of insuf0after the fifth or sixth day. A dose of castor oil cient or bad food, the high prices of which during should be given on the morning of the first day the German occupation were, to quote M. Calmette, and in the evening 10 to 15 pills, each containing "fantastic." As might have been expected in the 5 gr. of ipecacuanha. They are to be swallowed circumstances, births rapidly declined, although slowly with a little water. No nourishment is to not quite to vanishing point, falling from a total of be allowed for two hours preceding and for six 4885 in the year 1913, to 602 in 1917, and 609 in hours following administration of the pills. Each 1918. Infant mortality diminished considerably at succeeding night the same plan is repeated. It the same time owing, M. Calmette suggests, to the may be necessary, especially if there is any lack of cow’s milk in the city and the consequent depressing effect, to discontinue the pills for one disappearance of infantile gastro-enteritis. Mothers night. The nurse records the number of pills suckled their own infants or fed them on the conwhich may be passed undissolved in the stool, so densed milk provided by the American Committee. as to determine the total amount of ipecacuanha These are only some of the points of interest retained. The complete dosage includes the reten- contained in M. Calmette’s study. tion of 100 pills (500 gr. of ipecacuanha). This is usually accomplished in 10 days and only rarely requires two weeks. If vomiting is troublesome an THE paper on Picric-Brass Preparations in the extra coating of salol should be given to the pills. For reasons not clear a large number of pills may Treatment of Lupus contributed to our present he passed undissolved, even with a diminished issue by Dr. H. A. Ellis covers a good deal of coating. One or two punctures may then be made unexplored territory. The selective destruction of in the pills. When under rare conditions the tissue is an aspect of the antiseptics question ipecacuanha is not tolerated in pill form, daily which has attracted the attention of bacterioinstillations of 30 gr. of ipecacuanha, suspended in logists and clinicians alike since the early days of water, may be given by duodenal intubation, using the antiseptics controversy. It has long been Gross’s method of introducing the tube. The recognised that the various tissues of the body have problem of effective treatment hinges on concen- widely differing powers of resistance, and that this tration of the active constituents of the drug at the difference has a very practical bearing on matters site of infection in the large bowel. When emetin so diverse as the laboratory standardisation of is administered hypodermically or by mouth it antiseptics on the one hand and phagocytosis on is enormously diluted before it is brought by the the other. The work of Ehrlich and his colleagues blood stream into actual contact with the affected on the salvarsan compounds gave unmistakable indications of differences existing between the intestinal wall. must be
SELECTIVE TISSUE DESTRUCTION.
____
THE
HEALTH OF LILLE DURING GERMAN OCCUPATION.
Professor A. Calmette, who has now leftthe Pasteur Institute at Lille to direct the parent institute in Paris, has recently laid before the Academy of Medicine his first-hand impressions of the effect of the German occupation of Lille upon the health of its inhabitants. He remained at his post during the whole of this period. Before the war the population of the city was 220,000, but at the time of its liberation by the Allies the number had decreased to precisely one-half. In 1914, when the Germans were advancing through Belgium on Northern France, about 60,000 persons fled from Lille in panic to seek safety in other parts of France or in adjoining neutral countries. When the Germans arrived they deported about 25,000 young women and youths to Germany to work there in factories and workshops; others were compelled to do forced labour in the trenches or work in some other way in the war zone under conditions of great danger to life and health. Those who remained were naturally the elderly and weakly, as well as a large proportion of children. The annual death-rate from all causes in the city before the war averaged 19’1 per 1000, but it rose gradually in the altered population from 27’7 in 1915 to 415 in 1918. Among the chief causes of death were tuberculosis, diseases of the heart, epidemic dysentery, and scurvy, as also those other diseases which are provoked or aggravated by insufficient nourishment. The death-rate from tuberculosis had been, before the German occupation. 3’3 per 1000, but from 1916 to 1918 it rose to 5’7. Professor Calmette states on high authority that examination
selective destruction of tissue in diseases due to
protozoa, such as syphilis, and diseases due to the pyogenic organisms. Again, the recent work of Lorrain Smith, Dakin, Browning, and others on the newer antiseptics has shown that free hydrogen ion concentration, electrolytic dissociation, and numerous other physico-chemical phenomena enter very largely into the question. In applying similar principles to tuberculosis difficulties arise, the chief of which is that the histological tubercle is an avascular growth. We await further details of Dr. Ellis’s work with interest.
PLANT
ULTRA-VIOLET RAYS. SOME remarkable experiments have recently been made in regard to the influence of ultra-violet rays on the development of the sugar cane, the pineapple, and the banana, which seem to show that if it were not that the atmosphere largely absorbed these rays from sunlight the world’s production of vegetable foodstuffs would be very materially increased. For example, three lots of sugar cane were planted, the first being covered with coloured glass to exclude 50 per cent. of the sun’s ultrarays, the second being exposed normally violet to sunlight, and the third to the combined action of sunlight and of the ultra-violet rays from a mercury vapour lamp. Beyond this distinction other things were equal, as, for example, supplying the plant with the same kind and amount of fertiliser. After several months the second lot was found to contain as much as 30 per cent. more sugar than the first, and the third lot contained 8 per cent. more sugar than the second. It is suggested that, according to this experiment, the time taken normally for the development of STIMULATION
BY
put to bed for the whole course, usually of the children and young people after the liberaextending over ten days, and restricted at first to tion of Lille showed their development to have foods which leave no residue, such as broths, been arrested and about 20,000 young subjects to whey, and albumin water. Milk is to be added only have become "degenerates" as a result of insuf0after the fifth or sixth day. A dose of castor oil cient or bad food, the high prices of which during should be given on the morning of the first day the German occupation were, to quote M. Calmette, and in the evening 10 to 15 pills, each containing "fantastic." As might have been expected in the 5 gr. of ipecacuanha. They are to be swallowed circumstances, births rapidly declined, although slowly with a little water. No nourishment is to not quite to vanishing point, falling from a total of be allowed for two hours preceding and for six 4885 in the year 1913, to 602 in 1917, and 609 in hours following administration of the pills. Each 1918. Infant mortality diminished considerably at succeeding night the same plan is repeated. It the same time owing, M. Calmette suggests, to the may be necessary, especially if there is any lack of cow’s milk in the city and the consequent depressing effect, to discontinue the pills for one disappearance of infantile gastro-enteritis. Mothers night. The nurse records the number of pills suckled their own infants or fed them on the conwhich may be passed undissolved in the stool, so densed milk provided by the American Committee. as to determine the total amount of ipecacuanha These are only some of the points of interest retained. The complete dosage includes the reten- contained in M. Calmette’s study. tion of 100 pills (500 gr. of ipecacuanha). This is usually accomplished in 10 days and only rarely requires two weeks. If vomiting is troublesome an THE paper on Picric-Brass Preparations in the extra coating of salol should be given to the pills. For reasons not clear a large number of pills may Treatment of Lupus contributed to our present he passed undissolved, even with a diminished issue by Dr. H. A. Ellis covers a good deal of coating. One or two punctures may then be made unexplored territory. The selective destruction of in the pills. When under rare conditions the tissue is an aspect of the antiseptics question ipecacuanha is not tolerated in pill form, daily which has attracted the attention of bacterioinstillations of 30 gr. of ipecacuanha, suspended in logists and clinicians alike since the early days of water, may be given by duodenal intubation, using the antiseptics controversy. It has long been Gross’s method of introducing the tube. The recognised that the various tissues of the body have problem of effective treatment hinges on concen- widely differing powers of resistance, and that this tration of the active constituents of the drug at the difference has a very practical bearing on matters site of infection in the large bowel. When emetin so diverse as the laboratory standardisation of is administered hypodermically or by mouth it antiseptics on the one hand and phagocytosis on is enormously diluted before it is brought by the the other. The work of Ehrlich and his colleagues blood stream into actual contact with the affected on the salvarsan compounds gave unmistakable indications of differences existing between the intestinal wall. must be
SELECTIVE TISSUE DESTRUCTION.
____
THE
HEALTH OF LILLE DURING GERMAN OCCUPATION.
Professor A. Calmette, who has now leftthe Pasteur Institute at Lille to direct the parent institute in Paris, has recently laid before the Academy of Medicine his first-hand impressions of the effect of the German occupation of Lille upon the health of its inhabitants. He remained at his post during the whole of this period. Before the war the population of the city was 220,000, but at the time of its liberation by the Allies the number had decreased to precisely one-half. In 1914, when the Germans were advancing through Belgium on Northern France, about 60,000 persons fled from Lille in panic to seek safety in other parts of France or in adjoining neutral countries. When the Germans arrived they deported about 25,000 young women and youths to Germany to work there in factories and workshops; others were compelled to do forced labour in the trenches or work in some other way in the war zone under conditions of great danger to life and health. Those who remained were naturally the elderly and weakly, as well as a large proportion of children. The annual death-rate from all causes in the city before the war averaged 19’1 per 1000, but it rose gradually in the altered population from 27’7 in 1915 to 415 in 1918. Among the chief causes of death were tuberculosis, diseases of the heart, epidemic dysentery, and scurvy, as also those other diseases which are provoked or aggravated by insufficient nourishment. The death-rate from tuberculosis had been, before the German occupation. 3’3 per 1000, but from 1916 to 1918 it rose to 5’7. Professor Calmette states on high authority that examination
selective destruction of tissue in diseases due to
protozoa, such as syphilis, and diseases due to the pyogenic organisms. Again, the recent work of Lorrain Smith, Dakin, Browning, and others on the newer antiseptics has shown that free hydrogen ion concentration, electrolytic dissociation, and numerous other physico-chemical phenomena enter very largely into the question. In applying similar principles to tuberculosis difficulties arise, the chief of which is that the histological tubercle is an avascular growth. We await further details of Dr. Ellis’s work with interest.
PLANT
ULTRA-VIOLET RAYS. SOME remarkable experiments have recently been made in regard to the influence of ultra-violet rays on the development of the sugar cane, the pineapple, and the banana, which seem to show that if it were not that the atmosphere largely absorbed these rays from sunlight the world’s production of vegetable foodstuffs would be very materially increased. For example, three lots of sugar cane were planted, the first being covered with coloured glass to exclude 50 per cent. of the sun’s ultrarays, the second being exposed normally violet to sunlight, and the third to the combined action of sunlight and of the ultra-violet rays from a mercury vapour lamp. Beyond this distinction other things were equal, as, for example, supplying the plant with the same kind and amount of fertiliser. After several months the second lot was found to contain as much as 30 per cent. more sugar than the first, and the third lot contained 8 per cent. more sugar than the second. It is suggested that, according to this experiment, the time taken normally for the development of STIMULATION
BY