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UNITED STATES OF AMERICA
1269
UNITED STATES OF AMERICA.-SCOTLAND
health.-Lord SNELL in responding remarked (with intentional bluntness), " You came here to hear about the medical profession ; well, you are going to hear about it," and speaking as part of the raw material without which doctors could not live at all he told them what the patients thought of them. He went on to express his warm recognition of what the administrative staff of our public bodies do for the community. These bodies are the guardians of the nation’s health and it is the doctors who give them the assurance they need. The municipality which neglects their advice is gambling on the future. When anything goes wrong it is the doctor who is blamed, when it may well be that what has happened is the result of his advice not having been taken.The company adjourned early to dancing and cabaret.
UNITED STATES OF AMERICA (FROM OUR OWN CORRESPONDENT) TREATMENT OF PNEUMONIA
THE committee on public health relations of the New York Academy of Medicine have just issued a report on " Community provision for the serum treatment of pneumococci pneumonia." They point out that specific serum therapy for pneumonia is making its way slowly and suggest as reasons for delay : (1) the lingering of the dictum that the disease is self-limited ; (2) hesitation on the part of general practitioners to employ serum intravenously ; (3) the difficulty in obtaining serums and their high cost ; (4) lack of facilities for the differentiation of pneumococci ; (5) failure on the part of health authorities, except in New York, Massachusetts, and several other communities, to recognise the communicable character of the pneumonias, and to urge appropriations for the free distribution of the antipneumococcus serum. The average number of pneumonia cases in New York City during the last few years has been 26,000 per annum, and the committee estimate that about 10,000 per annum would be benefited by specific serum therapy. They recall that New York State prepared type I serum for general distribution in 1915 and in 1917 included sputum-typing among the procedures that must be undertaken by laboratories wishing to qualify for State approval. An intensive study carried on in Massachusetts from 1931 to 1935, with financial aid from the Commonwealth Fund, paved the way for an effective plan of administrative organisation. The use of serum requires expert knowledge. The committee recommend a consulting service in the health department under a physician well trained in the technique of serum therapy. Since the effectiveness of serum depends upon its early administration facilities for rapid free diagnostic laboratory service should be provided. They recommend further that pneumonia patients treated in hospitals should be properly " segregated and cubicled." Pneumonia should be treated as an emergency and the admission policy and the service policy for pneumonia cases should be on the same basis as for surgical emergencies. The full report will be found- in the Bulletin of the New York Academy of Medicine for October and in the Journal of the American Medical Association for Oct. 23rd. WHEN IS A FEVER SCARLET A paper read to the epidemiology section of the American Public Health Association by E. L. Stebbins,
Eel S. Ingraham, and Elizabeth Reed, all of the New York State department of health, described seven milk-borne epidemics, three of them classified as " scarlet fever" and four as "septic sore-throat." Six of the seven epidemics were traced to streptococcal mastitis in members of the producing herds. In five cases a history strongly suggestive of streptococcal infection in milk-handlers, antedating the bovine infection, was also obtained. In the one case where no mastitis was found in the producing herd the milk had been bottled by a man with a sorethroat. All of the milk involved was raw. The only observable clinical distinction between " septic sore-throat " and " scarlet fever " in the victims of these seven epidemics was that in 60 per cent. of cases classified as scarlet fever there was seen a rash almost always followed by desquamation. Complications were similar in nature and frequency in both classes. The authors observe also that the cases in all epidemics would clinically be indistinguishable (except for the rash) from cases which in the absence of any epidemic are usually diagnosed as A previous attack of scarlet fever severe tonsillitis. to have appeared given no immunity to subsequent but it did confer a relative infection streptococcal immunity to the skin manifestations of streptococcal infection. Stebbins and his colleagues were too cautious to suggest-though at least. one member of their audience could not help reflecting-that their observations tend to cast doubt upon the value of active immunisation against scarlet fever by the present accepted method. RESIGNATION OF HON. JOSEPHINE ROCHE
Few will disagree with Surgeon-General Parran when he says that " with the resignation of Assistant Secretary Roche, the Government loses its ablest and most sincere advocate of public health." The resignation was accepted by President Roosevelt on Oct. 28th " with the greatest reluctance." At the same time Secretary of the Treasury Morgenthau announced that her post would be held open for her for an indefinite period in the hope that she would find it possible to return. She became assistant secretary of the Treasury in November, 1934, being the first woman to hold this office. Assigned to take charge of the United States public health service, she was appointed to serve on the President’s cabinet committee on economic security, and took an important part in the formulation of the social security programme as a whole. Her resignation is said to be dictated by the need of her personal supervision of the affairs of the Rocky Mountain Fuel Company of which she was formerly president.
(FROM
SCOTLAND CORRESPONDENT)
OUR OWN
DIET AND DYSPEPSIA
IN the fifth of the series of Honyman Gillespie lectures delivered to post-graduates in Edinburgh Dr. John D. Comrie said that epithelial degeneration, especially of the alimentary tract, due to lack of vitamin A is often a cause of dyspepsia. The vitamin-B complex contained in cabbage, tomato, and other vegetables has a positive value in diabetes since it helps in oxidation, especially of carbohydrates. It has been shown experimentally, and in north Russia in practice, that sour milk is a most valuable
UNITED STATES OF AMERICA.-SCOTLAND
health.-Lord SNELL in responding remarked (with intentional bluntness), " You came here to hear about the medical profession ; well, you are going to hear about it," and speaking as part of the raw material without which doctors could not live at all he told them what the patients thought of them. He went on to express his warm recognition of what the administrative staff of our public bodies do for the community. These bodies are the guardians of the nation’s health and it is the doctors who give them the assurance they need. The municipality which neglects their advice is gambling on the future. When anything goes wrong it is the doctor who is blamed, when it may well be that what has happened is the result of his advice not having been taken.The company adjourned early to dancing and cabaret.
UNITED STATES OF AMERICA (FROM OUR OWN CORRESPONDENT) TREATMENT OF PNEUMONIA
THE committee on public health relations of the New York Academy of Medicine have just issued a report on " Community provision for the serum treatment of pneumococci pneumonia." They point out that specific serum therapy for pneumonia is making its way slowly and suggest as reasons for delay : (1) the lingering of the dictum that the disease is self-limited ; (2) hesitation on the part of general practitioners to employ serum intravenously ; (3) the difficulty in obtaining serums and their high cost ; (4) lack of facilities for the differentiation of pneumococci ; (5) failure on the part of health authorities, except in New York, Massachusetts, and several other communities, to recognise the communicable character of the pneumonias, and to urge appropriations for the free distribution of the antipneumococcus serum. The average number of pneumonia cases in New York City during the last few years has been 26,000 per annum, and the committee estimate that about 10,000 per annum would be benefited by specific serum therapy. They recall that New York State prepared type I serum for general distribution in 1915 and in 1917 included sputum-typing among the procedures that must be undertaken by laboratories wishing to qualify for State approval. An intensive study carried on in Massachusetts from 1931 to 1935, with financial aid from the Commonwealth Fund, paved the way for an effective plan of administrative organisation. The use of serum requires expert knowledge. The committee recommend a consulting service in the health department under a physician well trained in the technique of serum therapy. Since the effectiveness of serum depends upon its early administration facilities for rapid free diagnostic laboratory service should be provided. They recommend further that pneumonia patients treated in hospitals should be properly " segregated and cubicled." Pneumonia should be treated as an emergency and the admission policy and the service policy for pneumonia cases should be on the same basis as for surgical emergencies. The full report will be found- in the Bulletin of the New York Academy of Medicine for October and in the Journal of the American Medical Association for Oct. 23rd. WHEN IS A FEVER SCARLET A paper read to the epidemiology section of the American Public Health Association by E. L. Stebbins,
Eel S. Ingraham, and Elizabeth Reed, all of the New York State department of health, described seven milk-borne epidemics, three of them classified as " scarlet fever" and four as "septic sore-throat." Six of the seven epidemics were traced to streptococcal mastitis in members of the producing herds. In five cases a history strongly suggestive of streptococcal infection in milk-handlers, antedating the bovine infection, was also obtained. In the one case where no mastitis was found in the producing herd the milk had been bottled by a man with a sorethroat. All of the milk involved was raw. The only observable clinical distinction between " septic sore-throat " and " scarlet fever " in the victims of these seven epidemics was that in 60 per cent. of cases classified as scarlet fever there was seen a rash almost always followed by desquamation. Complications were similar in nature and frequency in both classes. The authors observe also that the cases in all epidemics would clinically be indistinguishable (except for the rash) from cases which in the absence of any epidemic are usually diagnosed as A previous attack of scarlet fever severe tonsillitis. to have appeared given no immunity to subsequent but it did confer a relative infection streptococcal immunity to the skin manifestations of streptococcal infection. Stebbins and his colleagues were too cautious to suggest-though at least. one member of their audience could not help reflecting-that their observations tend to cast doubt upon the value of active immunisation against scarlet fever by the present accepted method. RESIGNATION OF HON. JOSEPHINE ROCHE
Few will disagree with Surgeon-General Parran when he says that " with the resignation of Assistant Secretary Roche, the Government loses its ablest and most sincere advocate of public health." The resignation was accepted by President Roosevelt on Oct. 28th " with the greatest reluctance." At the same time Secretary of the Treasury Morgenthau announced that her post would be held open for her for an indefinite period in the hope that she would find it possible to return. She became assistant secretary of the Treasury in November, 1934, being the first woman to hold this office. Assigned to take charge of the United States public health service, she was appointed to serve on the President’s cabinet committee on economic security, and took an important part in the formulation of the social security programme as a whole. Her resignation is said to be dictated by the need of her personal supervision of the affairs of the Rocky Mountain Fuel Company of which she was formerly president.
(FROM
SCOTLAND CORRESPONDENT)
OUR OWN
DIET AND DYSPEPSIA
IN the fifth of the series of Honyman Gillespie lectures delivered to post-graduates in Edinburgh Dr. John D. Comrie said that epithelial degeneration, especially of the alimentary tract, due to lack of vitamin A is often a cause of dyspepsia. The vitamin-B complex contained in cabbage, tomato, and other vegetables has a positive value in diabetes since it helps in oxidation, especially of carbohydrates. It has been shown experimentally, and in north Russia in practice, that sour milk is a most valuable