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EXANTHEMA SUBITUM
1047 from the other refractive states. The explanation of myopia demands an exhaustive study of the changes in the premyopic state. We want a fuller understanding of the physiology of the growing eye, of the process of correlation during the period of growth, of the presumably great change in the anterior segment of the eye which neutralises the 30-40 dioptres increase in refraction caused by elongation of eye during the process of growth, and of the value of the different components of refraction during the active phase of developing myopia. LETTSOM
Coakley Lettsom was born in the West Indies 1744 and became the leading physician in London,
John in
where he died in 1815. He was a Quaker and implacably industrious-two qualities common to many great men-and as he knew everyone from the court to the gaols and had his finger in almost every available pie, an account of his life and contacts such as Mr. Abraham has writtenmakes a straggling picture in which the hero is not always very visible. And in following up, generally in great detail, a good proportion of the side tracks which Lettsom’s activities brought him to, he has, we think, produced a more generally acceptable book than a compact and exclusive biography, for we learn a good deal about a number of interesting people and occasions which would never have been monographed for their own sake. Lettsom started in practice in London under favourable auspices : " many amiable females conceived it an honour to have his acquaintance," and he was the protege and, later, the successor of Dr. John Fothergill. In the first two or three years, after he was married and set up in 1770, he published " Refiections on the General Treatment and Cure of Fevers," "The Natural History of the Tea-tree, with Observations on the ... Effects of Tea Drinking," and "The Naturalist’s and Traveller’s Companion," and so he went on through life. He founded the Medical Society of London in 1773, and was elected into the Royal Society; he had much to do with starting the Royal Humane Society, in promoting Jenner’s claim to have found out something useful, in prison reform, and (which Mr. Abraham thinks his most original achievement) in founding the Sea-Bathing Hospital at Margate (1791). And in telling this tale Mr. Abraham makes us acquainted with all sorts and conditions of people Lettsom met by the way, such as Dr. John Whitehead, who quarrelled with the Medical Society and survives in a picture of John Wesley’s death-bed, or pretty Betty Fothergill, who was not overpleased when Lettsom married someone else, or the Americans Waterhouse and Rush. Wherever one dips there is something worth reading about, and generally some germane pictures. The book is sure to be a great success, and our only quarrel with it is that it is printed on such heavy paper that it is physically awkward to read in the desultory moments for which it is particularly suitable. EXANTHEMA SUBITUM Dr. Maria Abb,2 of the Children’s Clinic of Wiirzburg University, puts the question whether the condition known as exanthema subitum is an independent disease or not. It was first described under the name of roseola infantilis in 1913 by Zahorsky, who had seen 33 cases in infants under 2i years of age. In 1921 Veeder and Hempelmann gave it the name of exanthema subitum, and since then numerous cases 1 Lettsom :
His
Life, Times, Friends,
By J. Johnston Abraham, M.D., F.R.C.S. 1933. Pp. 498. 30s. Heinemann, Ltd. 2
Descendants. London: William
and
Zeits. f. Kinderheilk., 1933, lv., 339.
have been described in Hungary, Germany, Switzerland, and elsewhere, though not in this country. The characteristic features are cough, sneezing, conjunctivitis, glandular enlargement, a fever of three days’ duration, and a maculo-papular eruption which appears as the fever is subsiding and disappears in 24 hours without leaving any desquamation or pigmentation. The blood shows a leucopenia and relative lymphocytosis. Complications do not occur, and recovery always takes place. So far no agreement has been reached about the aetiology. While most clinicians regard exanthema subitum as an independent disease, owing to the peculiar course of the fever, the eruption, and the blood picture, Ido, Willi, Friedrichson, Gottche, and Rietschel consider it to be merely a manifestation of influenza. As the result of her observations in Prof. Rietschel’s clinic, Abb comes to the conclusion that exanthema subitum is not a disease sui generis, but is merely an influenzal infection in which the eruption represents an allergic reaction. The final decision, however, as she points out, must be left to bacteriologists, who have as yet paid little attention to the condition. NATIONAL INSTITUTE FOR THE DEAF THE ninth annual report of the executive committee of the National Institute for the Deaf must have been a satisfactory document to those who issued it, for the story is one of real progress. The report of the chairman, Lord Charnwood, shows that despite the considerable public misconception of the affliction under which deaf persons suffer, the work of the Institute has grown rapidly, while the inquiry carried out by the late Dr. Eichholz, which made its appearance as a Government report, had produced a powerful effect on the public and official mind. There are now maintained by the Institute the Richardson House at Barrowford and the Poolemead House at Tiverton-on-Avon, both for women, a hostel for working deaf boys at Highbury Quadrant, and a centre of instruction in lip reading which is in regular session at the Swedenborg Rooms, Hart-street, London. For the management of the two latter, Mr. A. J. Story, the secretary of the Institute, is responsible in addition to other duties. Further evidence of a widening of sympathy is shown by the foundation of bodies affiliated to the Institute ; these are six in number, viz., the Northern, Midland, and Eastern Counties’ associations, the London and Home Counties’ association, and the Scottish association. The record of activity is aptly assisted by a favourable pecuniary position. The Institute is not rich-so far from this, its need for money is real ; but its developments have been carried on within its resources, and the hon. treasurer, Mr. John Tennant, was able to announce the possession of a favourable balance.
BONE-GRAFTING FOR RECURRENT SHOULDER DISLOCATION
A COMMUNICATION to the French surgical congress suggested a successful form of treatment for relapsing dislocation of the shoulderjoint. Dr. S. Hybbinette, senior surgeon to the Sabbatsberg Hospital in Stockholm, has during the past 16 years inserted a bone graft in 31 cases with complete restoration of mobility of the joint in 29 of the cases, along with a sense of security which enabled the patients to regain their normal working capacity. The case which gave the clue to this operation was that of a woman, an epileptic, whose shoulder had been out of joint some hundred times, and on whom Dr. Hybbinette operated in 1917.
recently held
Coakley Lettsom was born in the West Indies 1744 and became the leading physician in London,
John in
where he died in 1815. He was a Quaker and implacably industrious-two qualities common to many great men-and as he knew everyone from the court to the gaols and had his finger in almost every available pie, an account of his life and contacts such as Mr. Abraham has writtenmakes a straggling picture in which the hero is not always very visible. And in following up, generally in great detail, a good proportion of the side tracks which Lettsom’s activities brought him to, he has, we think, produced a more generally acceptable book than a compact and exclusive biography, for we learn a good deal about a number of interesting people and occasions which would never have been monographed for their own sake. Lettsom started in practice in London under favourable auspices : " many amiable females conceived it an honour to have his acquaintance," and he was the protege and, later, the successor of Dr. John Fothergill. In the first two or three years, after he was married and set up in 1770, he published " Refiections on the General Treatment and Cure of Fevers," "The Natural History of the Tea-tree, with Observations on the ... Effects of Tea Drinking," and "The Naturalist’s and Traveller’s Companion," and so he went on through life. He founded the Medical Society of London in 1773, and was elected into the Royal Society; he had much to do with starting the Royal Humane Society, in promoting Jenner’s claim to have found out something useful, in prison reform, and (which Mr. Abraham thinks his most original achievement) in founding the Sea-Bathing Hospital at Margate (1791). And in telling this tale Mr. Abraham makes us acquainted with all sorts and conditions of people Lettsom met by the way, such as Dr. John Whitehead, who quarrelled with the Medical Society and survives in a picture of John Wesley’s death-bed, or pretty Betty Fothergill, who was not overpleased when Lettsom married someone else, or the Americans Waterhouse and Rush. Wherever one dips there is something worth reading about, and generally some germane pictures. The book is sure to be a great success, and our only quarrel with it is that it is printed on such heavy paper that it is physically awkward to read in the desultory moments for which it is particularly suitable. EXANTHEMA SUBITUM Dr. Maria Abb,2 of the Children’s Clinic of Wiirzburg University, puts the question whether the condition known as exanthema subitum is an independent disease or not. It was first described under the name of roseola infantilis in 1913 by Zahorsky, who had seen 33 cases in infants under 2i years of age. In 1921 Veeder and Hempelmann gave it the name of exanthema subitum, and since then numerous cases 1 Lettsom :
His
Life, Times, Friends,
By J. Johnston Abraham, M.D., F.R.C.S. 1933. Pp. 498. 30s. Heinemann, Ltd. 2
Descendants. London: William
and
Zeits. f. Kinderheilk., 1933, lv., 339.
have been described in Hungary, Germany, Switzerland, and elsewhere, though not in this country. The characteristic features are cough, sneezing, conjunctivitis, glandular enlargement, a fever of three days’ duration, and a maculo-papular eruption which appears as the fever is subsiding and disappears in 24 hours without leaving any desquamation or pigmentation. The blood shows a leucopenia and relative lymphocytosis. Complications do not occur, and recovery always takes place. So far no agreement has been reached about the aetiology. While most clinicians regard exanthema subitum as an independent disease, owing to the peculiar course of the fever, the eruption, and the blood picture, Ido, Willi, Friedrichson, Gottche, and Rietschel consider it to be merely a manifestation of influenza. As the result of her observations in Prof. Rietschel’s clinic, Abb comes to the conclusion that exanthema subitum is not a disease sui generis, but is merely an influenzal infection in which the eruption represents an allergic reaction. The final decision, however, as she points out, must be left to bacteriologists, who have as yet paid little attention to the condition. NATIONAL INSTITUTE FOR THE DEAF THE ninth annual report of the executive committee of the National Institute for the Deaf must have been a satisfactory document to those who issued it, for the story is one of real progress. The report of the chairman, Lord Charnwood, shows that despite the considerable public misconception of the affliction under which deaf persons suffer, the work of the Institute has grown rapidly, while the inquiry carried out by the late Dr. Eichholz, which made its appearance as a Government report, had produced a powerful effect on the public and official mind. There are now maintained by the Institute the Richardson House at Barrowford and the Poolemead House at Tiverton-on-Avon, both for women, a hostel for working deaf boys at Highbury Quadrant, and a centre of instruction in lip reading which is in regular session at the Swedenborg Rooms, Hart-street, London. For the management of the two latter, Mr. A. J. Story, the secretary of the Institute, is responsible in addition to other duties. Further evidence of a widening of sympathy is shown by the foundation of bodies affiliated to the Institute ; these are six in number, viz., the Northern, Midland, and Eastern Counties’ associations, the London and Home Counties’ association, and the Scottish association. The record of activity is aptly assisted by a favourable pecuniary position. The Institute is not rich-so far from this, its need for money is real ; but its developments have been carried on within its resources, and the hon. treasurer, Mr. John Tennant, was able to announce the possession of a favourable balance.
BONE-GRAFTING FOR RECURRENT SHOULDER DISLOCATION
A COMMUNICATION to the French surgical congress suggested a successful form of treatment for relapsing dislocation of the shoulderjoint. Dr. S. Hybbinette, senior surgeon to the Sabbatsberg Hospital in Stockholm, has during the past 16 years inserted a bone graft in 31 cases with complete restoration of mobility of the joint in 29 of the cases, along with a sense of security which enabled the patients to regain their normal working capacity. The case which gave the clue to this operation was that of a woman, an epileptic, whose shoulder had been out of joint some hundred times, and on whom Dr. Hybbinette operated in 1917.
recently held