THE WILLIAM HARVEY MEMORIAL

269

THE WILLIAM HARVEY MEMORIAL

they should be readily differentiated from the occupational enlargements of the parotids seen in glass-blowers and players of wind instruments and occasionally in malingerers, for in these the swellings For the rest it must be admitted are pneumatoceles. that no uniform explanation is applicable to the groups of cases now being considered. The rapid development of the parotid swellings in early life and their frequent association with allergic symptoms are striking features, as is also the observation that in adults they are associated with emotional instability. As seen on X ray examination the changes in the alike in children and adults. Whether the obstruction is allergic, spasmodic, or catarrhal primary is uncertain, but once it has developed, it is followed by dilatation and sooner or later by infection. In childhood it may be found that the attacks cease with the elimination of certain articles of food from the diet, with the clearing-up of buccal infection or with simple massage of the parotid gland. In adults the same methods may be successful, but where organic changes are more advanced, slitting and dilatation of the duct, auriculo-temporal avulsion, and X ray treatment may all give better results. ducts

are

PHYSIOLOGICAL CHANGES

DURING

PUBERTY

ALTHOUGH much statistical information is available concerning growth in the years of puberty, it is mostly based on the study of large groups of children at different age-periods. Thus it has been shown that about two years before puberty begins there is a slowing in vertical growth, followed by a rapid increase during several subsequent years, girls being taller than boys. The maximum increase in weight occurs slightly later than the maximum increase in height. Of the signs of puberty in girls, breast development is usually the first, and it is followed by rounding of the hips and the appearance of pubic and axillary hair, in that order. As a rule menstruation is the last, or almost the last, sign, becoming established when breast development is nearly

complete. Thinking

in terms of the individual rather than the Gustav Nylin1 has made an intensive Dr. age-group study of 12 girls in the four years during which the onset of puberty might be expected. They were inmates of the State Institute for the Blind at Tomleboda, and were most of them suffering from congenital eye defects, but they were chosen because their physical and psychical status was otherwise Conditions of examinaas nearly as possible normal. tion were standardised. In all but one subject the maximum growth in height was found to correspond with the commencement of puberty, though the age at which this occurred varied considerably (from 9-8years to 14 years, with an average of 1]-8). The duration of this maximum height increase varied from 471 to 884 days, and in most cases breast development was complete when growth ceased. As breast development was found to be the first sign of puberty, there therefore appeared to be a close between breast development and height increase. The thyroid also seemed to increase in size during the same period, but as the means of measuring its growth were not accurate, little emphasis can be laid on this impression. Nylin also found that the height-increase declined when menstruation began. The arteriovenous oxygen difference under standard conditions proved singularly constant during growth, from which he concludes that the blood flow is a

relationship

1 Physiology of the Circulation during Fuberty. Scand., Suppl. lxix., 1935, p. 77.

direct function of standard metabolism, since the latter was observed to increase considerably during the period of maximum growth. The pulse-rate fell throughout the period of study, and showed but no signs of rising with the onset of puberty ; there was a rise in both systolic and diastolic blood pressure during the period of development. The vital capacity also increased during development, though its increase became manifest later than the other functional changes. THE WILLIAM HARVEY MEMORIAL

WE wish to impress earnestly upon our readers the situation of the Harvey Memorial Fund instituted some time back with the object of rebuilding the fallen tower of Hempstead Church, Essex. Our readers have been kept informed of this movement and must

sincerely

hope that

with us it will

soon

come

a

to

satisfactory

conclusion, for the delay has been regretted

by many, though strenuefforts have far failed to abbreviate it. The present position is that the work of restoration, which so far has been exceedingly well carried out, has proceeded, and about twothirds of the structure has been restored ; but the fund exhausted is now and progress has ceased. The last third of the work, which includes the rehanging of the bells, remains to be dealt with, and a sum of approximately f2000 is yet required for the termination of the undertaking. Lord Horder has become chairman of the committee in the place of the late Sir John Rose Bradford, and all donations should be made payable to the Harvey Memorial Fund and sent to Dr. G. de Bec Turtle, Royal College of Physicians, Pall Mall East, London, S.W.I. ous

so

AN ANTISTREPTOCOCCAL AGENT

INTEREST has lately been aroused by the claims of German workers to have synthesised a chemotherapeutic compound efficient against streptococcal infections. This substance, which has been named Prontosil, when given either subcutaneously or by the mouth, protected mice against a lethal dose of streptococci injected into the peritoneal cavity. Whereas in untreated animals there were enormous numbers of cocci in the peritoneal exudate, in those treated with prontosil the organisms were few and mainly undergoing phagocytosis. The drug has no appreciable bactericidal action in vitro, and the mechanism by which it acts in the body was therefore obscure. At a discussion in London last autumn1

Acta Med. 1 THE

LANCET, 1935, B,

840.