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EVIPAN IN DENTISTRY
200
neurotropic mouse-fixed yellow fever virus and human yellow fever immune serum. They include civil and military officials, medical officers, and nursing sisters of the West African Medical Service, missionaries, traders, and the wives of officials proceeding to the West Coast, as well as laboratory workers. The men numbered 152, the women 48, and they may be divided into three groups, according to the relative amounts of immune serum and virus injected. Group I. (40 persons) was inoculated subcutaneously in the abdomen with from 0-3 to 0-5 c.cm. of human immune yellow fever serum per kg. of body-weight followed, four to six hours later by from 0-25 to 0-5 c.cm. of a 10 per cent. suspension of virus in normal human serum injected subcutaneously in the arm. Twenty-five (62 per cent.) of those inoculated by this method developed febrile reactions with a rise of temperature above 99° F. Group II. (110 persons) was inoculated intradermally in the abdomen with 1.0 c.cm. of human immune yellow fever serum, followed two hours later by from 0- to 0-5 c.cm. of 10 per cent. suspension of virus injected into the same area. Forty-six (41-8 per cent.) of those thus inoculated developed febrile reactions. Group III. (50 persons) was inoculated intradermally with 1 c.cm. of human immune yellow fever serum, followed two hours later by the intradermal injection of from 0-00625 to 0-05 c.cm. of 10 per cent. virus, together with the subcutaneous injection of 5 c.cm. of human immune yellow fever serum. Fifteen (30 per cent.) of those thus inoculated developed febrile reactions. The reactions consisted chiefly of headache, aching in the limbs and back lasting for from 24 to 48 hours, accompanied by a leucopenia and slight bradycardia. In no case did there develop any encephalitis or " paralytic accident," and in only a very small number was the reaction severe. The
115 persons were examined for the of immune bodies after immunisation, and it was found that immune bodies begin to appear in the blood stream seven to eight days after inoculation and attain their maximum titre in from three to four weeks. Ten to eleven months after immunisation the immune body titre decreases, but Dr. Findlay said that protective immune bodies can still be detected up to at least sixteen months after inoculation, and probably for considerably longer. Since the introduction of the method, it is noted, there have been none of the accidental infections among laboratory workers which were at one time so common. sera
of
development
EVIPAN IN DENTISTRY ENTHUSIASM for new anaesthetics is apt to fade as they are better known. This is understandable, for unless a drug is very dangerous many administrations will be required before its full potentialities are brought to light. At the present time evipan is in the stage of welcome, and its transitory action recommends it especially to dental surgeons.1 It will be a mistake, however, if it is pressed too eagerly into the place of nitrous oxide ; for one cannot assume that it may always be used with perfect safety on patients who are to go home soon after an extraction. The speed with which it acts and the absence of unpleasant effects are striking and attractive; and there are patients resistant to gas who will profit by its use. These, however, are exceptional, and we agree with Dr. Stephen Coffin2 that "the space left between a good nasal gas and oxygen in the chair, and an intubated gas and oxygen (preceded by a Basal Narcotic) in the theatre is small." This is another way of saying that there are very few patients for dental operation who cannot be satisfactorily dealt with in one of the ways he specifies. When such persons are met with they can quite well be treated with ether, after proper preliminaries ; so that even here the use of evipan is not essential, 1 Brit. Dent. Jour., Jan. 1st, pp. 23 and 25.
2 Ibid.,
p.
36.
though probably convenient and justifiable. For the present, we believe, the latter adjective does not apply to its general employment for ordinary extractions in the dental chair.
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VITAL STATISTICS FOR 1933
THE Registrar-General has issued a provisional statement of the figures for birth-rate, death-rate, and infant mortality during the year 1933.
The smaller towns are those with estimated resident of 25,000-50,000 at the 1931 census. The birth- and death-rates for England and Wales as a whole are calculated on the estimated mid-1933 population, the remaining rates on the estimated mid-1932 populations.
populations
The Registrar-General remarks that for the fifth year in succession the birth-rate is the lowest on record, being 0-9 per 1000 below that of 1932 and 1-4 below that of 1931. The death-rate is 0-3 above that for 1932 and is the same as that for 1931. The infant mortality-rate is 1 per 1000 below that for 1932, and with the one exception of the year 1930 (60) is the lowest on record. The rates are provisional and are issued for the information of medical officers of health, but they are not likely to require substantial modification. SIR WILLIAM HARDY
WE regret to record the death on Tuesday last at Cambridge of Sir William Bate Hardy, director of food investigation in the Department of Scientific and Industrial Research. As undergraduate, fellow, tutor, and lastly president of Gonville and Caius College, he was intimately known to more than two generations of scientific and medical members of the University and revered as a leader of the highest standard. To the wider public, through his official positions and his long secretaryship of the Royal Society, his genial personality was a familiar one; in all departments of scientific endeavour he stood as a, model of honesty and enterprise. Starting as a his and made him brilliant flexible intellect histologist an authority along different lines of research, as physicist, mathematician, and biochemist, while his investigations in connexion with food storage have had practical results of the highest consequence to the country. His death will be widely deplored. THE Hunterian Oration of the Royal College of of England will be given at the College, Lincoln’s Inn-fields, London, W.C., on Tuesday, Feb. 13th, at 4 P.M., by Sir Cuthbert Wallace. Dr. Robert Hutchison will deliver the sixth Sir Charles Hastings Lecture on the Food of the Growing Child, in the Great Hall of the British Medical Association, on Wednesday, March 7th, at 8 P.M. The chair will be taken by Lord Horder, and after the lecture, which is public, relevant questions may be submitted in writing. Admission will be free by tickets obtainable on application to the financial
Surgeons
secretary, B.M.A., Tavistock-square, London, W.C., and seats not occupied by ticket-holders at 7.50 P.M. will be available for others.
neurotropic mouse-fixed yellow fever virus and human yellow fever immune serum. They include civil and military officials, medical officers, and nursing sisters of the West African Medical Service, missionaries, traders, and the wives of officials proceeding to the West Coast, as well as laboratory workers. The men numbered 152, the women 48, and they may be divided into three groups, according to the relative amounts of immune serum and virus injected. Group I. (40 persons) was inoculated subcutaneously in the abdomen with from 0-3 to 0-5 c.cm. of human immune yellow fever serum per kg. of body-weight followed, four to six hours later by from 0-25 to 0-5 c.cm. of a 10 per cent. suspension of virus in normal human serum injected subcutaneously in the arm. Twenty-five (62 per cent.) of those inoculated by this method developed febrile reactions with a rise of temperature above 99° F. Group II. (110 persons) was inoculated intradermally in the abdomen with 1.0 c.cm. of human immune yellow fever serum, followed two hours later by from 0- to 0-5 c.cm. of 10 per cent. suspension of virus injected into the same area. Forty-six (41-8 per cent.) of those thus inoculated developed febrile reactions. Group III. (50 persons) was inoculated intradermally with 1 c.cm. of human immune yellow fever serum, followed two hours later by the intradermal injection of from 0-00625 to 0-05 c.cm. of 10 per cent. virus, together with the subcutaneous injection of 5 c.cm. of human immune yellow fever serum. Fifteen (30 per cent.) of those thus inoculated developed febrile reactions. The reactions consisted chiefly of headache, aching in the limbs and back lasting for from 24 to 48 hours, accompanied by a leucopenia and slight bradycardia. In no case did there develop any encephalitis or " paralytic accident," and in only a very small number was the reaction severe. The
115 persons were examined for the of immune bodies after immunisation, and it was found that immune bodies begin to appear in the blood stream seven to eight days after inoculation and attain their maximum titre in from three to four weeks. Ten to eleven months after immunisation the immune body titre decreases, but Dr. Findlay said that protective immune bodies can still be detected up to at least sixteen months after inoculation, and probably for considerably longer. Since the introduction of the method, it is noted, there have been none of the accidental infections among laboratory workers which were at one time so common. sera
of
development
EVIPAN IN DENTISTRY ENTHUSIASM for new anaesthetics is apt to fade as they are better known. This is understandable, for unless a drug is very dangerous many administrations will be required before its full potentialities are brought to light. At the present time evipan is in the stage of welcome, and its transitory action recommends it especially to dental surgeons.1 It will be a mistake, however, if it is pressed too eagerly into the place of nitrous oxide ; for one cannot assume that it may always be used with perfect safety on patients who are to go home soon after an extraction. The speed with which it acts and the absence of unpleasant effects are striking and attractive; and there are patients resistant to gas who will profit by its use. These, however, are exceptional, and we agree with Dr. Stephen Coffin2 that "the space left between a good nasal gas and oxygen in the chair, and an intubated gas and oxygen (preceded by a Basal Narcotic) in the theatre is small." This is another way of saying that there are very few patients for dental operation who cannot be satisfactorily dealt with in one of the ways he specifies. When such persons are met with they can quite well be treated with ether, after proper preliminaries ; so that even here the use of evipan is not essential, 1 Brit. Dent. Jour., Jan. 1st, pp. 23 and 25.
2 Ibid.,
p.
36.
though probably convenient and justifiable. For the present, we believe, the latter adjective does not apply to its general employment for ordinary extractions in the dental chair.
-
VITAL STATISTICS FOR 1933
THE Registrar-General has issued a provisional statement of the figures for birth-rate, death-rate, and infant mortality during the year 1933.
The smaller towns are those with estimated resident of 25,000-50,000 at the 1931 census. The birth- and death-rates for England and Wales as a whole are calculated on the estimated mid-1933 population, the remaining rates on the estimated mid-1932 populations.
populations
The Registrar-General remarks that for the fifth year in succession the birth-rate is the lowest on record, being 0-9 per 1000 below that of 1932 and 1-4 below that of 1931. The death-rate is 0-3 above that for 1932 and is the same as that for 1931. The infant mortality-rate is 1 per 1000 below that for 1932, and with the one exception of the year 1930 (60) is the lowest on record. The rates are provisional and are issued for the information of medical officers of health, but they are not likely to require substantial modification. SIR WILLIAM HARDY
WE regret to record the death on Tuesday last at Cambridge of Sir William Bate Hardy, director of food investigation in the Department of Scientific and Industrial Research. As undergraduate, fellow, tutor, and lastly president of Gonville and Caius College, he was intimately known to more than two generations of scientific and medical members of the University and revered as a leader of the highest standard. To the wider public, through his official positions and his long secretaryship of the Royal Society, his genial personality was a familiar one; in all departments of scientific endeavour he stood as a, model of honesty and enterprise. Starting as a his and made him brilliant flexible intellect histologist an authority along different lines of research, as physicist, mathematician, and biochemist, while his investigations in connexion with food storage have had practical results of the highest consequence to the country. His death will be widely deplored. THE Hunterian Oration of the Royal College of of England will be given at the College, Lincoln’s Inn-fields, London, W.C., on Tuesday, Feb. 13th, at 4 P.M., by Sir Cuthbert Wallace. Dr. Robert Hutchison will deliver the sixth Sir Charles Hastings Lecture on the Food of the Growing Child, in the Great Hall of the British Medical Association, on Wednesday, March 7th, at 8 P.M. The chair will be taken by Lord Horder, and after the lecture, which is public, relevant questions may be submitted in writing. Admission will be free by tickets obtainable on application to the financial
Surgeons
secretary, B.M.A., Tavistock-square, London, W.C., and seats not occupied by ticket-holders at 7.50 P.M. will be available for others.