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A NATIONAL DENTAL SERVICE FOR SWEDEN
1281 of the heart shadow. The child was confined to bed and given a varied diet rich in vitamin C accompanied by liver concentrate, iron, and a concentrate of vitamin D. After quite a short period the temperaoxygen mixtures. In Boston when operations upon ture dropped to normal and the anaemia improved, goitre are in question it is usual for the anaesthetic . and after six months the patient was discharged in good health with no evidence whatever of cardiac apparatus to have a cylinder of helium attached. disease, this regression being confirmed by a normal AN EXHIBITION OF BRITISH ARCHITECTURE radiographic appearance of the cardiac shadow. the most interesting feature of this unusual THE Royal Academy is preparing for January and Perhaps case lies in the evidence afforded that murmurs such February, 1937, an Exhibition of British Architecture as those mentioned may occur in the absence of in the Twentieth Century, in which it hopes to show, valvular disease. in a wide variety of examples and without restriction as to style, the best work done by British architects A NATIONAL DENTAL SERVICE FOR SWEDEN in the past thirty-six years. The work will be classed GROWING attention has been paid in Sweden in six main sections-Domestic, Civil, Monumental, Commercial, Ecclesiastical, Bridges-and will consist during the past twenty years to the possibilities of a for the most part of the architects’ own working comprehensive dental scheme on a national scale, drawings; illustrated by photographs, perspective and a committee of inquiry has reported to the views, and models. A retrospective section, surveying Government. The proposals made by this committee, British architecture from the seventeenth century, which are described by Dr. Nils Hellstrom, are will be included. A representative committee of ambitious ; for skilled dentistry is to be available for members of the Royal Academy and other well- every Swede, irrespective of income, from the cradle known architects has undertaken the selection to the grave. Dental work of a purely aesthetic of the works. Architects who wish to offer one or character does not, of course, enter into the scheme, two examples of their completed work for the choice but otherwise there seem to be no limits to the dental of the committee in any of the classes mentioned are welfare envisaged. It is anticipated that ultimately requested to apply without delay to the secretary, the public dental service will assure an annu.al overRoyal Academy of Arts, Piccadilly, W. 1, for forms haul for all who want it, but this will not be realised and instructions as to sending in works. With the until the scheme has been adopted throughout the The actual extent of dental caries in extensive construction, reconstruction, and recon- country.
helium available at a cost comparable to that of oxygen in the United States. After Dr. Barach had related his experience it was pointed out that in certain clinics anaesthetists are already using helium-
that is now taking place in hospitals, an exhibition giving examples of modern work and theories should be of high value to the medical
ditioning
profession. THE HEART IN VITAMIN DEFICIENCY
THE fact that there is often cardiac enlargement in beri-beri has attracted attention to the possible relationship of disorders of the heart to deficiency of vitamin other than B. Claims have been made for a scorbutic basis, for example, in cardiac rheumatism, and even vitamin-D deficiency has been suggested as a possible cause of cardiac enlargement in young children. Rabinowitz and Rogers1 now report a remarkable example of chronic avitaminosis in a four-year-old child with serious affection of the heart which became quite normal following adequate treatment. This child, who had been late in sitting and standing, had been fed on a thoroughly unsatisfactory diet in which the solid elements consisted of some bread, jelly, and cake, the only other food or medicine taken being milk and Karo syrup. When he came under observation there was severe anaemia, haemorrhages round the gums, fever, and muscular flabbiness. The most important findings, however, were in the cardiovascular system, of which the following is a description: " the pulse was rapid, small, and irregular with the presence of a transitory gallop rhythm. A precordial thrill was present. The area of cardiac dulness was markedly extended to the left axilla. Loud blowing systolic and diastolic. murmurs were heard over the mitral area transmitted to the axilla and back, and entirely obliterating the heart sounds. A blowing diastolic murmur was noted in the pulmonic area transmitted down the sternum. The aortic first sound was louder than the aortic second sound, while the first pulmonic sound was softer than the second pulmonic sound." X ray examination of the chest showed much enlargement 1Rabinowitz, L., and Rogers, E. J.: New. Eng. Jour. Med., Oct. 1st, 1936, p. 621.
different parts of Sweden is unknown, and a survey would have helped the committee to calculate the amount of work likely to be required in each dental area; but the cost of such an investigation was considered prohibitive, and the committee has had to be satisfied with an approximate estimate according to which a dentist employed by the public dental service would devote 1000 hours a year to school dentistry and 1100 hours a year to other dental activities. Some 425 dental districts would be staffed created, by 575 district dentists and 40 assistants. Each district dentist would be aided by at least one dental nurse, who would be entitled to a pension. Provision is also made for the dental care of the insane and mentally defective, for prisoners and the occupants of hospitals and sanatoria. It is calculated that this scheme will cost the State 4,658,000 kronor (:f256,500) a year, the local authorities 2,034,500 kronor, and the four principal towns with more or less independent health organisations 408,000 kronor. CHEMISTRY OF DERMATITIS IN a paper read last month to the London section of the Society of Chemical Industry, Mr. H. E. Cox, D.Sc., points out that dermatitis is a biochemical problem requiring collaboration for its solution. The question is why does the dermatitis resulting from one of the chemicals in Dr. Cox’s list, or from simple salt or sugar, from cement or turpentine, continue for months or years, long after every trace of the causal irritant has been swept away ?There are of course answers in plenty, but nearly all of them rest on a basis of theory that is hard to put to the proof. One great exception that escapes mention in his otherwise admirable summary is the experimental work of the late Bruno Bloch, so far the most significant achievement in this difficult field, in that it definitely fixes the site of the reaction we 1
Bull.
de l’off. internat. d’hyg. pub., August, 1936. Jour. Soc. Chem. Indust., Oct. 5th, 1936.
mens. 2
helium available at a cost comparable to that of oxygen in the United States. After Dr. Barach had related his experience it was pointed out that in certain clinics anaesthetists are already using helium-
that is now taking place in hospitals, an exhibition giving examples of modern work and theories should be of high value to the medical
ditioning
profession. THE HEART IN VITAMIN DEFICIENCY
THE fact that there is often cardiac enlargement in beri-beri has attracted attention to the possible relationship of disorders of the heart to deficiency of vitamin other than B. Claims have been made for a scorbutic basis, for example, in cardiac rheumatism, and even vitamin-D deficiency has been suggested as a possible cause of cardiac enlargement in young children. Rabinowitz and Rogers1 now report a remarkable example of chronic avitaminosis in a four-year-old child with serious affection of the heart which became quite normal following adequate treatment. This child, who had been late in sitting and standing, had been fed on a thoroughly unsatisfactory diet in which the solid elements consisted of some bread, jelly, and cake, the only other food or medicine taken being milk and Karo syrup. When he came under observation there was severe anaemia, haemorrhages round the gums, fever, and muscular flabbiness. The most important findings, however, were in the cardiovascular system, of which the following is a description: " the pulse was rapid, small, and irregular with the presence of a transitory gallop rhythm. A precordial thrill was present. The area of cardiac dulness was markedly extended to the left axilla. Loud blowing systolic and diastolic. murmurs were heard over the mitral area transmitted to the axilla and back, and entirely obliterating the heart sounds. A blowing diastolic murmur was noted in the pulmonic area transmitted down the sternum. The aortic first sound was louder than the aortic second sound, while the first pulmonic sound was softer than the second pulmonic sound." X ray examination of the chest showed much enlargement 1Rabinowitz, L., and Rogers, E. J.: New. Eng. Jour. Med., Oct. 1st, 1936, p. 621.
different parts of Sweden is unknown, and a survey would have helped the committee to calculate the amount of work likely to be required in each dental area; but the cost of such an investigation was considered prohibitive, and the committee has had to be satisfied with an approximate estimate according to which a dentist employed by the public dental service would devote 1000 hours a year to school dentistry and 1100 hours a year to other dental activities. Some 425 dental districts would be staffed created, by 575 district dentists and 40 assistants. Each district dentist would be aided by at least one dental nurse, who would be entitled to a pension. Provision is also made for the dental care of the insane and mentally defective, for prisoners and the occupants of hospitals and sanatoria. It is calculated that this scheme will cost the State 4,658,000 kronor (:f256,500) a year, the local authorities 2,034,500 kronor, and the four principal towns with more or less independent health organisations 408,000 kronor. CHEMISTRY OF DERMATITIS IN a paper read last month to the London section of the Society of Chemical Industry, Mr. H. E. Cox, D.Sc., points out that dermatitis is a biochemical problem requiring collaboration for its solution. The question is why does the dermatitis resulting from one of the chemicals in Dr. Cox’s list, or from simple salt or sugar, from cement or turpentine, continue for months or years, long after every trace of the causal irritant has been swept away ?There are of course answers in plenty, but nearly all of them rest on a basis of theory that is hard to put to the proof. One great exception that escapes mention in his otherwise admirable summary is the experimental work of the late Bruno Bloch, so far the most significant achievement in this difficult field, in that it definitely fixes the site of the reaction we 1
Bull.
de l’off. internat. d’hyg. pub., August, 1936. Jour. Soc. Chem. Indust., Oct. 5th, 1936.
mens. 2