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474
TUBERCLE
LIVERPOOL OPEN-AIR HOSPITAL FOR CHTLDHEN, LEASOWE. The report for the year 1922 contains a full statement of th e accounts of the h ospital. The cost per week p er child work s out at £1 18s. Uid., the interesting feature of this being the low cost of pr ovision s at 9s. 9d. Dom~stic 7s. 6 ~d ., establishment 6s. 3~d ., and sals:nes a nd wages 7s. 9d. a ppear in com . parrson unduly high. Dr. P. Hartl ey Ma.rt in, the senlor m edical officer , rep orts gene ra lly fav ourable resul ts in compar ison to th e previ ou s year, 88 per clint. of cases boing discharged .. dIsea se .q uiescent." Much disappoin tment arose ow ing to the unusual nature of the weatber dUring the summer months. Owing to lack of. ~ u n h gh t , the usual routine exp osure of the Ch ildren could not be practised and the marked improvement usually gained thereby was n ot experienced. 'I'he ' number of dis. charged ca ses Was thereby decreased, as the period of stay, owing to bad weath er cond itions, ',Vas increased. Also owing to poor ·~co n o m lc condit ion s in many of the homes ~t was deemed advisable to continue the st ay III hospital to avoid tho relapse wh ich the home con d ition s might engender. Dr. Martin cal! s for help for those cases wh o ca n not, OWing to cripplin g and deformity, obt ai n empl oym en t on dis charge. About 25 per cent. a~e thus affected, 73 per cent. of these being LIp and sp ina l ca ses. In deal ing with th e ch ildren of sc hool age, 5 '8 per cent. were unable to attend the ordinary school, and
[July, 1928
1'94 per cent. only, were totally unfitted .for sch ool life (83 per cen t . of these havlDg suffered from tuberculou s spine).
NEWCASTLE-UPON.TYNE VOLUNTARY TUBERCULOSIS CARE COUNCIL. In a small annual report for the year ended 1922, a descripti on i , given of the aims of the Council, togeth er with a report . by the Tubercul osis Medical Officer, Dr. Dickenson , The Council has decided to take action on the one hand to promote prevention, and on the other to assist cas es to raise their resistance when once attacked by the di sease. The latter i~ to be accomplished by grants of extra nourishment, warm cl othing, assi sting unemployed patients, and improving, where .P?ssible, ~he living conditions. Lastly by gIVIng advice, Funds were subscribed by the City Council, the Insurance Committee and private donors, amounting in all to £400. The number of cases assisted was 177 with an expenditure of about £300. As Dr. Dickenson says : .. The work is not spectacular as it is largely preventive' but as at leas t 80 per cant. of treatment afte; the disease has been definitely diagnosed is given in the patient's home, this part of tuberculosis work is of th e most important. 'I'be Council very rightly express the intention of keeping in touch indefini tely with all cases during and after treatment. "
AT HOME AND ABROAD. UNITED STATES OF AMERICA. (FROM O UR OWN C ORRr-:SPONDEN T.)
~I'his is th e Season of post-graduate school s in tuhercul'lsis . The Trudeau Sch ool at Saranac Lake is in -fulI career and that at Colorado Springs ill the far far West begins on July 2 (0. very a t t ractive prospectus with some interesting ph otographs may be bad by writing to the Secre.ary, 402, Burns Building, Colorado Bprings). Here at Saranac Lake we have heen enjoy inl1 0. remarkable series of lectures by Dr. A. JC Krause of Johns Hopkins, on various aspects of tuberculosis treated from the hiatorical view point, a form of education which admirably increases one's scepticism towards .1111 current cla ims to have di scovered .. specific cure. Last Wednesday (May 23), at an open lecture ill the Free Library, ·D r. Krause broached th e t horny subject of epidemiology. He pointed ou t that to base our eet iolog ica l conc epts up on mortality figures onl y is not -enougb , Infection and morbidity ar e factors in the epid emi ology of tubercl e less easy of statistical control but n ot less importa nt . Ho -discussed t he contributory causes of each of theBC three factors, coucluding that cow's milk aud human sputum are by far the m ost impor-
tant sources of infection and tbat environmental changes are probably the mo st important factor in morbidity and mortality. In particular .he drew attention to th e rapid decline of mortality pre ceding any possible eflect of the discovery of t he tubercle bacillus but coinciding with the introduction of the electrical era, Tho report for the year 1922 of the Trudeau Sanatorium is now available and will be exchanged with the reports of other sanatoria, or can he purchased at 50 cents each from Dr. E. R. Baldwin, the director of the Saranao library. The scheme of the American Sanatorium Association for the classification of patients both on admission and subsequently, is given in full and will be found of interest. It is based on sym ptom s, physical signs and X-ray findings. 'l'h e re sults ot research in the Saranac laboratory appear as reprints from the Am erican RevwlO of Tubercul osis and other journals and form a fine record of a single year's work ; The important work don.e by 1..lr . Petroff during the year in collaboratIon WIth Professor Zinsser is mentioned ae follows: .. They attempted t o produce sk in hypersens it iveness at first by th e use of dead tubercle bacilli killed by various degrees of heat and later by the use of two fractions of the tubercle
July, 1923J
BIBLIOGRA.PHY
bacillus obtained by hydrolysis. They were successful and discovered two bodies, one corn. plex, a mixture of nucleo-proteins, which produced hyperseusit.iveness and also caused skin reaction, and a second. less complex, which produced no hypersensitiveness, but caused a more pronounced skin reactiou than the first. 'I'his fundamental work has opened up mo.ny interesting problems which are now under investigation." A cure for pulmonary tuberculosis has been discovered in Pennsylvania. Dr. Nolan has announced to the Westmoreland County Medical Society that a mixture of carbon with certain calcium salts invartubly resulted in cure-at least in the 72 cases on which
475
it had been tried. The bureau of investigation of the American Medical Associut.ion has searched contemporary medical literature in vain for any contribution on this remedy. But the doctor is real enough. And it. wou.ld seem that the publicity given to Ins discovery has resulted in many inquiries, for he has a form letter to answer the same. This states, amongst other things, that .. the treatment can he taken at home with wonderful results. From week to week your family doctor can examine the patient and note the changes. The Nolan Inhaler with sufficient medicine and fnll inst,ruction~, will be sent upon receipt of $100 " "Money back is not guaranteed in case of failure to cure.
LETTERS. To the Editor of " Tubercle." DEAR Sm,-In regard to my paper on the "Female Pbtbisis Deatb- rate " in your issue of June, 1923, Table I should be called" The Average l'hthisis Deaths per 1,000. 1851-60, Welsh Counties." This omission arose through an error of my own in reading the proofs and is in no way
connected with your Journal; but I hope you will kindly calf attention to the omission in your next issue as there is a difference between incidence per tl;ousand in Wales and the average incidence per thousand in Welsh Counties. Yours faithfully, Memorial Offices, S. L. CUMMINS, Westgafe St., Cardiff'. June 11, 1923,
BIBLIOGRAPHY. ORIGINAL ARTICLES POBLISHEIJ :MARCH-JUl"E. (See also previous Numbers.) Acta Radiologica.- Vol. ii, Fasc. 2. Das Rontgenbild von interlobularen Exsudaten und Pleuraverdickuugeu mit besonderer Riicksicht auf die Differentialdiagnoss von t uberku losen Infiltraten in dem obersten rechten Lappen. P. FLEMMll"G.MDLLERp.139. Ame:>ican Journal of Medical ScIences. MAY.
The Clinical Criteria of Activity in Pul. mcnary Tuberculosis. P. H. RINGERp.742. American Journal of Obstetrics and Gynlllcology.-ApRIL. Renal Tuberculosis, Diagnosis and Treatment. H. D. FURNISS- p. 386. American Journal of Roentgenology.-MA¥. A Study of Lobar Pneumonia and its Pul. mcnary Complications. L. R. SANTEp. 351. Prognosis in 'I'uberculosis of the Lungs.-A. H. PIRIE- p. 366.
American Review of Tuberculosis.-ApRIL. The Nature of Tuberculosis of the Eye.-W. C. FINNOFF-p. 67. Tuberculosis of the Eye and its Tre~tment. A Review of Recent Literature. C. A. CLAPP --po 81. Tissue Changes Produced hy the Action of the Lipins of Tubercle, Grass and Colon Baoilli, and of Liver. W. R. LEIGHTON and J. S. SHIPMAN-p.88. Fat-splitt.ing Ferments in Lymphocytes. C. C. REED-p. 105. DemineraJisation in Tuberculosis. Distribution of Calcium in the Tuberculous Guineapig. C. BAllKUS-p. 111. The Dish 'rowel as a Source of Tuberculous Infection. C. FLOYD and L. SIKORSKYp.117. Apical Tuberculosis. C. H. BROWN-·p. 120. Corporation Care of Tuberculous Employees. An Experiment as C..rried out in Colfax by a Large Corporation. R. A. PEERS-po 133. MAY. The Reticulum of the Lung, its Relation to Early 'I'uberculous Processes. W. S. MILLER -po 141.
TUBERCLE
LIVERPOOL OPEN-AIR HOSPITAL FOR CHTLDHEN, LEASOWE. The report for the year 1922 contains a full statement of th e accounts of the h ospital. The cost per week p er child work s out at £1 18s. Uid., the interesting feature of this being the low cost of pr ovision s at 9s. 9d. Dom~stic 7s. 6 ~d ., establishment 6s. 3~d ., and sals:nes a nd wages 7s. 9d. a ppear in com . parrson unduly high. Dr. P. Hartl ey Ma.rt in, the senlor m edical officer , rep orts gene ra lly fav ourable resul ts in compar ison to th e previ ou s year, 88 per clint. of cases boing discharged .. dIsea se .q uiescent." Much disappoin tment arose ow ing to the unusual nature of the weatber dUring the summer months. Owing to lack of. ~ u n h gh t , the usual routine exp osure of the Ch ildren could not be practised and the marked improvement usually gained thereby was n ot experienced. 'I'he ' number of dis. charged ca ses Was thereby decreased, as the period of stay, owing to bad weath er cond itions, ',Vas increased. Also owing to poor ·~co n o m lc condit ion s in many of the homes ~t was deemed advisable to continue the st ay III hospital to avoid tho relapse wh ich the home con d ition s might engender. Dr. Martin cal! s for help for those cases wh o ca n not, OWing to cripplin g and deformity, obt ai n empl oym en t on dis charge. About 25 per cent. a~e thus affected, 73 per cent. of these being LIp and sp ina l ca ses. In deal ing with th e ch ildren of sc hool age, 5 '8 per cent. were unable to attend the ordinary school, and
[July, 1928
1'94 per cent. only, were totally unfitted .for sch ool life (83 per cen t . of these havlDg suffered from tuberculou s spine).
NEWCASTLE-UPON.TYNE VOLUNTARY TUBERCULOSIS CARE COUNCIL. In a small annual report for the year ended 1922, a descripti on i , given of the aims of the Council, togeth er with a report . by the Tubercul osis Medical Officer, Dr. Dickenson , The Council has decided to take action on the one hand to promote prevention, and on the other to assist cas es to raise their resistance when once attacked by the di sease. The latter i~ to be accomplished by grants of extra nourishment, warm cl othing, assi sting unemployed patients, and improving, where .P?ssible, ~he living conditions. Lastly by gIVIng advice, Funds were subscribed by the City Council, the Insurance Committee and private donors, amounting in all to £400. The number of cases assisted was 177 with an expenditure of about £300. As Dr. Dickenson says : .. The work is not spectacular as it is largely preventive' but as at leas t 80 per cant. of treatment afte; the disease has been definitely diagnosed is given in the patient's home, this part of tuberculosis work is of th e most important. 'I'be Council very rightly express the intention of keeping in touch indefini tely with all cases during and after treatment. "
AT HOME AND ABROAD. UNITED STATES OF AMERICA. (FROM O UR OWN C ORRr-:SPONDEN T.)
~I'his is th e Season of post-graduate school s in tuhercul'lsis . The Trudeau Sch ool at Saranac Lake is in -fulI career and that at Colorado Springs ill the far far West begins on July 2 (0. very a t t ractive prospectus with some interesting ph otographs may be bad by writing to the Secre.ary, 402, Burns Building, Colorado Bprings). Here at Saranac Lake we have heen enjoy inl1 0. remarkable series of lectures by Dr. A. JC Krause of Johns Hopkins, on various aspects of tuberculosis treated from the hiatorical view point, a form of education which admirably increases one's scepticism towards .1111 current cla ims to have di scovered .. specific cure. Last Wednesday (May 23), at an open lecture ill the Free Library, ·D r. Krause broached th e t horny subject of epidemiology. He pointed ou t that to base our eet iolog ica l conc epts up on mortality figures onl y is not -enougb , Infection and morbidity ar e factors in the epid emi ology of tubercl e less easy of statistical control but n ot less importa nt . Ho -discussed t he contributory causes of each of theBC three factors, coucluding that cow's milk aud human sputum are by far the m ost impor-
tant sources of infection and tbat environmental changes are probably the mo st important factor in morbidity and mortality. In particular .he drew attention to th e rapid decline of mortality pre ceding any possible eflect of the discovery of t he tubercle bacillus but coinciding with the introduction of the electrical era, Tho report for the year 1922 of the Trudeau Sanatorium is now available and will be exchanged with the reports of other sanatoria, or can he purchased at 50 cents each from Dr. E. R. Baldwin, the director of the Saranao library. The scheme of the American Sanatorium Association for the classification of patients both on admission and subsequently, is given in full and will be found of interest. It is based on sym ptom s, physical signs and X-ray findings. 'l'h e re sults ot research in the Saranac laboratory appear as reprints from the Am erican RevwlO of Tubercul osis and other journals and form a fine record of a single year's work ; The important work don.e by 1..lr . Petroff during the year in collaboratIon WIth Professor Zinsser is mentioned ae follows: .. They attempted t o produce sk in hypersens it iveness at first by th e use of dead tubercle bacilli killed by various degrees of heat and later by the use of two fractions of the tubercle
July, 1923J
BIBLIOGRA.PHY
bacillus obtained by hydrolysis. They were successful and discovered two bodies, one corn. plex, a mixture of nucleo-proteins, which produced hyperseusit.iveness and also caused skin reaction, and a second. less complex, which produced no hypersensitiveness, but caused a more pronounced skin reactiou than the first. 'I'his fundamental work has opened up mo.ny interesting problems which are now under investigation." A cure for pulmonary tuberculosis has been discovered in Pennsylvania. Dr. Nolan has announced to the Westmoreland County Medical Society that a mixture of carbon with certain calcium salts invartubly resulted in cure-at least in the 72 cases on which
475
it had been tried. The bureau of investigation of the American Medical Associut.ion has searched contemporary medical literature in vain for any contribution on this remedy. But the doctor is real enough. And it. wou.ld seem that the publicity given to Ins discovery has resulted in many inquiries, for he has a form letter to answer the same. This states, amongst other things, that .. the treatment can he taken at home with wonderful results. From week to week your family doctor can examine the patient and note the changes. The Nolan Inhaler with sufficient medicine and fnll inst,ruction~, will be sent upon receipt of $100 " "Money back is not guaranteed in case of failure to cure.
LETTERS. To the Editor of " Tubercle." DEAR Sm,-In regard to my paper on the "Female Pbtbisis Deatb- rate " in your issue of June, 1923, Table I should be called" The Average l'hthisis Deaths per 1,000. 1851-60, Welsh Counties." This omission arose through an error of my own in reading the proofs and is in no way
connected with your Journal; but I hope you will kindly calf attention to the omission in your next issue as there is a difference between incidence per tl;ousand in Wales and the average incidence per thousand in Welsh Counties. Yours faithfully, Memorial Offices, S. L. CUMMINS, Westgafe St., Cardiff'. June 11, 1923,
BIBLIOGRAPHY. ORIGINAL ARTICLES POBLISHEIJ :MARCH-JUl"E. (See also previous Numbers.) Acta Radiologica.- Vol. ii, Fasc. 2. Das Rontgenbild von interlobularen Exsudaten und Pleuraverdickuugeu mit besonderer Riicksicht auf die Differentialdiagnoss von t uberku losen Infiltraten in dem obersten rechten Lappen. P. FLEMMll"G.MDLLERp.139. Ame:>ican Journal of Medical ScIences. MAY.
The Clinical Criteria of Activity in Pul. mcnary Tuberculosis. P. H. RINGERp.742. American Journal of Obstetrics and Gynlllcology.-ApRIL. Renal Tuberculosis, Diagnosis and Treatment. H. D. FURNISS- p. 386. American Journal of Roentgenology.-MA¥. A Study of Lobar Pneumonia and its Pul. mcnary Complications. L. R. SANTEp. 351. Prognosis in 'I'uberculosis of the Lungs.-A. H. PIRIE- p. 366.
American Review of Tuberculosis.-ApRIL. The Nature of Tuberculosis of the Eye.-W. C. FINNOFF-p. 67. Tuberculosis of the Eye and its Tre~tment. A Review of Recent Literature. C. A. CLAPP --po 81. Tissue Changes Produced hy the Action of the Lipins of Tubercle, Grass and Colon Baoilli, and of Liver. W. R. LEIGHTON and J. S. SHIPMAN-p.88. Fat-splitt.ing Ferments in Lymphocytes. C. C. REED-p. 105. DemineraJisation in Tuberculosis. Distribution of Calcium in the Tuberculous Guineapig. C. BAllKUS-p. 111. The Dish 'rowel as a Source of Tuberculous Infection. C. FLOYD and L. SIKORSKYp.117. Apical Tuberculosis. C. H. BROWN-·p. 120. Corporation Care of Tuberculous Employees. An Experiment as C..rried out in Colfax by a Large Corporation. R. A. PEERS-po 133. MAY. The Reticulum of the Lung, its Relation to Early 'I'uberculous Processes. W. S. MILLER -po 141.