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Estimation of young peoples' ages by a radiological method
196
CORRESPONDENCE
Sarcocystis has been recorded occasionally in man and has been described in a large number of domestic and wild animals (LEVlNE, 1961; SAHASRABUDHEand SHAH, 1966). Among the primates it has been recorded in the rhesus monkey (Macaca mulatta) and the red huzzar monkey (Erythrocebus paras) (MANDOUR, 1964). This seems to be the first record of the parasite in Nycticebus coucang. I am, etc., V. ZAMAN, Department of Parasitology, Faculty of Medicine, 29 October, 1969 University of Singapore. REFERENCES LEVlNE, N. D. (1961). Protozoan Parasites of Domestic Animals and of Man. Burgers. MAXDOUR, A. M. (1964). Trans. R. Soc. trop. Med. Hyg., 58~ 287. SAHASRABUDHE,O. K. & SHAH,H. L. (1966). J. Protozool., 13, 531.
Minneapolis:
DISTRIBUTIONOF EGGSOF SCHISTOSOMA HAEMATOBIUM IN THE URINARYSTREAM SIR,--In some observations on the distribution of bilharzia eggs in the urinary stream, which you kindly published in the Transactions (1962, 56, 74-6), I stated that the urine of the children studied was collected directly into a series of test-tubes. The brevity of this statement has given scope for misinterpretation (WEBER,BLAIR and CLARKE, 1967); It seemed scarcely necessary to add that the tubes into which the children micturated were held in racks,manipulated by a laboratory assistant; the children had only to pass urine. No claim was made that every drop of urine was recovered; the object was to obtain as many samples of the stream as possible, without other regard to spillage and without interference with the flow of urine. The tubes were necessarily small but of bore several times the cross-section of the stream. These details do not affect the results or the conclusions reached. They may resolve doubts raised in your readers, who may have seen the Rhodesian paper. I am etc., REGINALD B. GOVE, P.O. Box 917, Kabwe, 3 November, 1969 Zambia. REFERENCE WEBER, M. C., BLAIR, D. M. & CLARKE, V. DE V. (1967).
C. Afr. J. A/Ied., 13, 75.
ESTIMATIONOF YOUNGPEOPLES' AGESBY A RADIOLOGICALMETHOD SIR,--In East Africa it is usually impossible to get accurate information about peoples' ages. We estimated those of young people by comoaring the radiological appearances of tile right wrist with MACKAY'S~1952) standards. The method was convenient and fairly accurate. The births of 23 Zanzibari patients were registered, and their exact ages were known. I n 20 (87"0%) of them the estimated age was within 2 years of the actual age, but i n the 3 others the estimated age differed from the actual age by 2 years or more. 159 Zanzibari schoolchildren were examined radiologically in 1964 and again in 1966. I n 145 (91-2%) of them the estimated age had increased by 1, 2 or 3 years between examinations. But in 3 patients there was little difference between successive films of the right wrist, and in 11 others the estimatcd age had increased by 4 years or more between examinations. There was no significant difference in the mean gains in heights and weights in these 3 groups of children.
CORRESPONDENCE
197
Generally the radiological method was more accurate for estimating ages of females fllan for males, but the difference was not statistically significant. I am, etc., D. M. FORSYTH, 5 November, 1969 Senior W H O Adviser, Project UAR-0049. MACKAY, D. H. (1952).
REFERENCE Trans. R. Soc. trop. Med. Hyg., 46, 135.
A REMARKABLEDESCRIPTIONOF 'ALEPPO BOIL' IN 1839 SIR,--I record here a description of oriental sore by an observant Englishman in Aleppo 130 years ago, with a suggestion of the possible mode of transmission. E . L . Mitford journeyed from England to Ceylon by land, 7,000 of the 10,000 miles on horseback. His path took him through "Dalmatia, Montenegro, Turkey, Asia Minor, Syria, Palestine, Assyria, Persia, Afghanistan, Scinde, India" and finally to Ceylon, where he joined the Ceylon Civil Service and served for 22 years. He maintained a descriptive record of his journey, lasting 2 years and 10 months, which he published 45 years later in 1884. On 30 November 1839 he had this to say about the city of Aleppo and its dreaded disease:-" T h e people of Aleppo and Aintab are subject to a most afflicting disease, called here 'the Aleppo boil.' It is not peculiar to the natives as strangers are said invariably to be attacked with it after a week's residence; however, it appears there are exceptions, as I was there a month without the visitation. It generally attacks the face, but often the arms, feet and other parts of the body, beginning with a red swelling, which increases and spreads till it often penetrates to the bone, sometimes carrying away the nose, and always leaving most ungainly cicatrices: infants are not exempted from this scourge, and I have seen ladies' faces quite seamed with the marks of it. I should advise no lady, who has any regard for her beauty, to visit Aleppo. No remedy has been found to check the progress of this afflicting disease by the medical practitioners of the Pacha's troops, who themselves suffer much from it, but cautery, which also leaves a scar, besides the danger attending it. No origin has been found for it except that attributed to most maladies, that it is caused by water." I n a footnote 611 the same page, Mitford goes on to say "I afterwards found this complaint at Baghdad, where I was told it was caused by eating dates, and consequently called the 'Date-mark,' It had the same features as at Aleppo, and was as common. Although they consume dates at the latter place, they do not grow there; but I have no doubt, if inquiry were made, this peculiar complaint would be found to extend over the whole course of the Euphrates and may arise from some mineralogical impregnation of the water, or some minute insect that inhabits it." Mitford's description summarizes some of the salient features of what we know today about cutaneous leishmaniasis: the incubation period; the clinical manifestations; the affected age groups; the extent of the disease in the Euphrates basin; and even the hypothesis "that some minute insect" may be responsible for the disease. Mitford's description of Aleppo boil is a remarkable example of the accuracy of observation and record, and the knowledge, of an intrepid traveller of 1839. I am, etc., BRENDON W. M. GOONERATNE, 10 December, 1969 London School of Hygiene and Tropical Medicine. REFERENCE MITFORD, E. L. (1884). A Land March from England to Ceylon. W. H. Allen and Co.
Vol. 1.
p. 160.
London
THE INFECTIVITYOF SCHISTOSOMA MANSONI CERCARIAECONCENTRATEDBY A CONTINUOUS FLOW CENTRIFUGE SIR,--Field studies of the free-living stages of human schistosomes are complicated by the difficulty of recovering these fragile organisms from natural waters. OLIVIER(1966) reviewed the various techniques available for recovering cercariae and discussed the drawbacks of the two methods most widely used: filtration and animal exposure. T o overcome some of these problems he proposed the use of a continuous flow centrifuge and described
CORRESPONDENCE
Sarcocystis has been recorded occasionally in man and has been described in a large number of domestic and wild animals (LEVlNE, 1961; SAHASRABUDHEand SHAH, 1966). Among the primates it has been recorded in the rhesus monkey (Macaca mulatta) and the red huzzar monkey (Erythrocebus paras) (MANDOUR, 1964). This seems to be the first record of the parasite in Nycticebus coucang. I am, etc., V. ZAMAN, Department of Parasitology, Faculty of Medicine, 29 October, 1969 University of Singapore. REFERENCES LEVlNE, N. D. (1961). Protozoan Parasites of Domestic Animals and of Man. Burgers. MAXDOUR, A. M. (1964). Trans. R. Soc. trop. Med. Hyg., 58~ 287. SAHASRABUDHE,O. K. & SHAH,H. L. (1966). J. Protozool., 13, 531.
Minneapolis:
DISTRIBUTIONOF EGGSOF SCHISTOSOMA HAEMATOBIUM IN THE URINARYSTREAM SIR,--In some observations on the distribution of bilharzia eggs in the urinary stream, which you kindly published in the Transactions (1962, 56, 74-6), I stated that the urine of the children studied was collected directly into a series of test-tubes. The brevity of this statement has given scope for misinterpretation (WEBER,BLAIR and CLARKE, 1967); It seemed scarcely necessary to add that the tubes into which the children micturated were held in racks,manipulated by a laboratory assistant; the children had only to pass urine. No claim was made that every drop of urine was recovered; the object was to obtain as many samples of the stream as possible, without other regard to spillage and without interference with the flow of urine. The tubes were necessarily small but of bore several times the cross-section of the stream. These details do not affect the results or the conclusions reached. They may resolve doubts raised in your readers, who may have seen the Rhodesian paper. I am etc., REGINALD B. GOVE, P.O. Box 917, Kabwe, 3 November, 1969 Zambia. REFERENCE WEBER, M. C., BLAIR, D. M. & CLARKE, V. DE V. (1967).
C. Afr. J. A/Ied., 13, 75.
ESTIMATIONOF YOUNGPEOPLES' AGESBY A RADIOLOGICALMETHOD SIR,--In East Africa it is usually impossible to get accurate information about peoples' ages. We estimated those of young people by comoaring the radiological appearances of tile right wrist with MACKAY'S~1952) standards. The method was convenient and fairly accurate. The births of 23 Zanzibari patients were registered, and their exact ages were known. I n 20 (87"0%) of them the estimated age was within 2 years of the actual age, but i n the 3 others the estimated age differed from the actual age by 2 years or more. 159 Zanzibari schoolchildren were examined radiologically in 1964 and again in 1966. I n 145 (91-2%) of them the estimated age had increased by 1, 2 or 3 years between examinations. But in 3 patients there was little difference between successive films of the right wrist, and in 11 others the estimatcd age had increased by 4 years or more between examinations. There was no significant difference in the mean gains in heights and weights in these 3 groups of children.
CORRESPONDENCE
197
Generally the radiological method was more accurate for estimating ages of females fllan for males, but the difference was not statistically significant. I am, etc., D. M. FORSYTH, 5 November, 1969 Senior W H O Adviser, Project UAR-0049. MACKAY, D. H. (1952).
REFERENCE Trans. R. Soc. trop. Med. Hyg., 46, 135.
A REMARKABLEDESCRIPTIONOF 'ALEPPO BOIL' IN 1839 SIR,--I record here a description of oriental sore by an observant Englishman in Aleppo 130 years ago, with a suggestion of the possible mode of transmission. E . L . Mitford journeyed from England to Ceylon by land, 7,000 of the 10,000 miles on horseback. His path took him through "Dalmatia, Montenegro, Turkey, Asia Minor, Syria, Palestine, Assyria, Persia, Afghanistan, Scinde, India" and finally to Ceylon, where he joined the Ceylon Civil Service and served for 22 years. He maintained a descriptive record of his journey, lasting 2 years and 10 months, which he published 45 years later in 1884. On 30 November 1839 he had this to say about the city of Aleppo and its dreaded disease:-" T h e people of Aleppo and Aintab are subject to a most afflicting disease, called here 'the Aleppo boil.' It is not peculiar to the natives as strangers are said invariably to be attacked with it after a week's residence; however, it appears there are exceptions, as I was there a month without the visitation. It generally attacks the face, but often the arms, feet and other parts of the body, beginning with a red swelling, which increases and spreads till it often penetrates to the bone, sometimes carrying away the nose, and always leaving most ungainly cicatrices: infants are not exempted from this scourge, and I have seen ladies' faces quite seamed with the marks of it. I should advise no lady, who has any regard for her beauty, to visit Aleppo. No remedy has been found to check the progress of this afflicting disease by the medical practitioners of the Pacha's troops, who themselves suffer much from it, but cautery, which also leaves a scar, besides the danger attending it. No origin has been found for it except that attributed to most maladies, that it is caused by water." I n a footnote 611 the same page, Mitford goes on to say "I afterwards found this complaint at Baghdad, where I was told it was caused by eating dates, and consequently called the 'Date-mark,' It had the same features as at Aleppo, and was as common. Although they consume dates at the latter place, they do not grow there; but I have no doubt, if inquiry were made, this peculiar complaint would be found to extend over the whole course of the Euphrates and may arise from some mineralogical impregnation of the water, or some minute insect that inhabits it." Mitford's description summarizes some of the salient features of what we know today about cutaneous leishmaniasis: the incubation period; the clinical manifestations; the affected age groups; the extent of the disease in the Euphrates basin; and even the hypothesis "that some minute insect" may be responsible for the disease. Mitford's description of Aleppo boil is a remarkable example of the accuracy of observation and record, and the knowledge, of an intrepid traveller of 1839. I am, etc., BRENDON W. M. GOONERATNE, 10 December, 1969 London School of Hygiene and Tropical Medicine. REFERENCE MITFORD, E. L. (1884). A Land March from England to Ceylon. W. H. Allen and Co.
Vol. 1.
p. 160.
London
THE INFECTIVITYOF SCHISTOSOMA MANSONI CERCARIAECONCENTRATEDBY A CONTINUOUS FLOW CENTRIFUGE SIR,--Field studies of the free-living stages of human schistosomes are complicated by the difficulty of recovering these fragile organisms from natural waters. OLIVIER(1966) reviewed the various techniques available for recovering cercariae and discussed the drawbacks of the two methods most widely used: filtration and animal exposure. T o overcome some of these problems he proposed the use of a continuous flow centrifuge and described