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INFECTIOUS DISEASE IN 1936
90
INFECTIOUS DISEASE IN 1936
designed in 1923 by Dr. Panis, and is now on country (through Messrs. George Grose and Co.). It is more compact than the swinging stretchers, but more expensive. In this appliance the thorax and abdomen of the patient, lying prone, are supported on a platform which is inclined so that the neck end is a few inches from the ground. was
sale in this
A wide strap attached to the base of the resuscitator fastens round the lower part of the patient’s back. By movement of a long lever the operator lowers the neck end of the platform towards the ground against the resistance of springs. The abdominal end is raised at the same time, so that expiration is forced. The instrument is easy to work and needs only one operator, who must stand continuously. Respiration is certainly effected by this method, although the cycle is rather jerky as the pressure is not evenly distributed throughout the stroke, but becomes suddenly greater when the springs are tightly compressed. There are several points in which the instrument could be improved. The leatherette rests for chest, axilla, and chin are comfortable, but not easily cleaned. The belt which goes round the patient’s back can only be adjusted within small limits, so that the careless or uninstructed will press the thorax instead of the abdomen. Lastly, the instructions are underneath the appliance where they will be read only by the porter who unpacks it. INFECTIOUS DISEASE IN 1936
THE review by Ch. Dopter, contributed to Paris Médical of June 5th, is both comprehensiveit includes many tropical diseases hardly likely to be encountered in France-and limited, for with few exceptions the work quoted is exclusively French, and the writer is preoccupied with the neurological complications of the exanthemata which, while always interesting, are well established. He begins with an evaluation of Burnet’s anatoxin in staphyloExcellent results are claimed coccal conditions. for this preparation in the minor manifestations of infection, but there is clearly a difference of opinion about its value in the more severe, especially osteomyelitis. To avoid accidents an intradermal susceptibility test is recommended before administration. The value of serum therapy in many streptococcal infections is now fully recognised, but most clinicians in this country would be surprised at the figures quoted from Vincent-81 per cent. of recoveries in 312 cases of streptococcal septicaemia and meningitis." They would like more information about the findings on which diagnosis was based. The recent and promising work on Prontosil is also referred to. A number of cases of permanent paralysis following central lesions in diphtheria are quoted, and Chalier’s researches on the azotsemia occurring in this disease are recalled. This worker’s aphorism " that if the "
excreted in the 24 hours is one gramme might prove a valuable prognostic pointer. The combination of ascorbic acid with adrenaline in malignant cases is recommended, and also the administration of very large doses of strychnine-in view of the success of this therapy in poisoning by the barbitone derivatives. The theory of Duliscouet and Ballet that certain strains of staphylococci symbiotically enhance the invasive power of 0. diphtherice, while other strains inhibit it, is suggestive. For the carrier state, gargling with a solution of the neutral sulphate of o-oxyquinoleine, 1 in 5000, is said to be a speedy and effective method of producing sterilisation. Attention is directed to the cerebral complications of measles, and of course to the treatment with amount of
or
urea
more, death is almost certain"
adult and convalescent serum. In Poulain’s opinion this is effective even up to the stage of initial catarrh, preventing, if not the disease, at least the complications. If this is hardly the trend of opinion in this country, it should be remembered that the dosage recommended is vastly greater than is customary here. The work of Bayer on pertussis is also dealt with. This investigator found that half his cases showed changes in the cerebro-spinal fluid, sometimes an increase in pressure and sometimes an increase in the protein and the cells, with dilated ventricles as shown by ventriculography. He has also employed a complement-fixation test which gives a steadily increasing proportion of positives from 25 per cent. in the first week to 100 per cent. between the fourth and ninth. This is recommended for diagnostic where doubt exists. Cases of mumps compurposes plicated by meningo-encephalitis are quoted, and the experimental evidence as to the 2etiology of this disease is assessed. In the post-encephalitis-lethargica syndrome atropine is still preferred to stramonium in continental circles. An epidemic of poliomyelitis gave Violle and Montus the opportunity to observe that " no two cases occurred in the same family, the same house, or the same street," but Jensen’s experience was exactly the reverse. The former authors were equally successful with Pettit’s serum, convalescent serum, or the serum of unaffected contacts, whereas Jensen got his best results from the serum of the abortive cases. The pros and cons of prophylactic vaccination are discussed at length. A parkinsonian syndrome developing and disappearing in the course of an attack of enteric, which is here recorded, is surely unique. In this disease a skin test performed with endotoxin is advanced as of prognostic value ; a rapidly developing well-marked reaction indicates a mild infection, and vice versa. Prophylactic vaccination is warmly commended in undulant fever, bacillary dysentery, and plague. In the last case, living organisms of an avirulent strain have been employed. It is clear however that the maintenance of this avirulence must become a matter of some anxiety. MEDICINE STAMP DUTY LEAKAGE THE Select Committee of the House of Commons, when appointed in fulfilment of the promise made by the Chancellor of the Exchequer as reported in our parliamentary intelligence last week, need not go far outside the 1914 report of the Select Committee in Patent Medicines. This report, which failed to get a hearing in a world at war, was republished as a supplement to THE LANCET of Jan. 10th, 1925. One of the recommendations of that committee was that " unreasonable exceptions " to liability to stamp duty should be removed, and it was emphasised that the distinction between the name of an ailment and the name of an organ, the seat of the ailment, ought to be abandoned. In the opinion of the committee there should be no distinction for the purpose of assessment of duty between a medicine described " as a cough mixture " and one described as a chest mixture " ; or between a " corn paint " and a " toe paint " ; or between a " headache powder " and a Yet according to the law as " head powder." administered the use of the name of an ailment renders a medicine liable to duty, while by using the name of the seat of the ailment as a description of the medicine liability to duty may be escaped. But that anomaly is almost a natural one compared with some of the more subtle means of avoidance of the tax which the wit of the legal mind, working sedulously through many pettifogging generations, has "
INFECTIOUS DISEASE IN 1936
designed in 1923 by Dr. Panis, and is now on country (through Messrs. George Grose and Co.). It is more compact than the swinging stretchers, but more expensive. In this appliance the thorax and abdomen of the patient, lying prone, are supported on a platform which is inclined so that the neck end is a few inches from the ground. was
sale in this
A wide strap attached to the base of the resuscitator fastens round the lower part of the patient’s back. By movement of a long lever the operator lowers the neck end of the platform towards the ground against the resistance of springs. The abdominal end is raised at the same time, so that expiration is forced. The instrument is easy to work and needs only one operator, who must stand continuously. Respiration is certainly effected by this method, although the cycle is rather jerky as the pressure is not evenly distributed throughout the stroke, but becomes suddenly greater when the springs are tightly compressed. There are several points in which the instrument could be improved. The leatherette rests for chest, axilla, and chin are comfortable, but not easily cleaned. The belt which goes round the patient’s back can only be adjusted within small limits, so that the careless or uninstructed will press the thorax instead of the abdomen. Lastly, the instructions are underneath the appliance where they will be read only by the porter who unpacks it. INFECTIOUS DISEASE IN 1936
THE review by Ch. Dopter, contributed to Paris Médical of June 5th, is both comprehensiveit includes many tropical diseases hardly likely to be encountered in France-and limited, for with few exceptions the work quoted is exclusively French, and the writer is preoccupied with the neurological complications of the exanthemata which, while always interesting, are well established. He begins with an evaluation of Burnet’s anatoxin in staphyloExcellent results are claimed coccal conditions. for this preparation in the minor manifestations of infection, but there is clearly a difference of opinion about its value in the more severe, especially osteomyelitis. To avoid accidents an intradermal susceptibility test is recommended before administration. The value of serum therapy in many streptococcal infections is now fully recognised, but most clinicians in this country would be surprised at the figures quoted from Vincent-81 per cent. of recoveries in 312 cases of streptococcal septicaemia and meningitis." They would like more information about the findings on which diagnosis was based. The recent and promising work on Prontosil is also referred to. A number of cases of permanent paralysis following central lesions in diphtheria are quoted, and Chalier’s researches on the azotsemia occurring in this disease are recalled. This worker’s aphorism " that if the "
excreted in the 24 hours is one gramme might prove a valuable prognostic pointer. The combination of ascorbic acid with adrenaline in malignant cases is recommended, and also the administration of very large doses of strychnine-in view of the success of this therapy in poisoning by the barbitone derivatives. The theory of Duliscouet and Ballet that certain strains of staphylococci symbiotically enhance the invasive power of 0. diphtherice, while other strains inhibit it, is suggestive. For the carrier state, gargling with a solution of the neutral sulphate of o-oxyquinoleine, 1 in 5000, is said to be a speedy and effective method of producing sterilisation. Attention is directed to the cerebral complications of measles, and of course to the treatment with amount of
or
urea
more, death is almost certain"
adult and convalescent serum. In Poulain’s opinion this is effective even up to the stage of initial catarrh, preventing, if not the disease, at least the complications. If this is hardly the trend of opinion in this country, it should be remembered that the dosage recommended is vastly greater than is customary here. The work of Bayer on pertussis is also dealt with. This investigator found that half his cases showed changes in the cerebro-spinal fluid, sometimes an increase in pressure and sometimes an increase in the protein and the cells, with dilated ventricles as shown by ventriculography. He has also employed a complement-fixation test which gives a steadily increasing proportion of positives from 25 per cent. in the first week to 100 per cent. between the fourth and ninth. This is recommended for diagnostic where doubt exists. Cases of mumps compurposes plicated by meningo-encephalitis are quoted, and the experimental evidence as to the 2etiology of this disease is assessed. In the post-encephalitis-lethargica syndrome atropine is still preferred to stramonium in continental circles. An epidemic of poliomyelitis gave Violle and Montus the opportunity to observe that " no two cases occurred in the same family, the same house, or the same street," but Jensen’s experience was exactly the reverse. The former authors were equally successful with Pettit’s serum, convalescent serum, or the serum of unaffected contacts, whereas Jensen got his best results from the serum of the abortive cases. The pros and cons of prophylactic vaccination are discussed at length. A parkinsonian syndrome developing and disappearing in the course of an attack of enteric, which is here recorded, is surely unique. In this disease a skin test performed with endotoxin is advanced as of prognostic value ; a rapidly developing well-marked reaction indicates a mild infection, and vice versa. Prophylactic vaccination is warmly commended in undulant fever, bacillary dysentery, and plague. In the last case, living organisms of an avirulent strain have been employed. It is clear however that the maintenance of this avirulence must become a matter of some anxiety. MEDICINE STAMP DUTY LEAKAGE THE Select Committee of the House of Commons, when appointed in fulfilment of the promise made by the Chancellor of the Exchequer as reported in our parliamentary intelligence last week, need not go far outside the 1914 report of the Select Committee in Patent Medicines. This report, which failed to get a hearing in a world at war, was republished as a supplement to THE LANCET of Jan. 10th, 1925. One of the recommendations of that committee was that " unreasonable exceptions " to liability to stamp duty should be removed, and it was emphasised that the distinction between the name of an ailment and the name of an organ, the seat of the ailment, ought to be abandoned. In the opinion of the committee there should be no distinction for the purpose of assessment of duty between a medicine described " as a cough mixture " and one described as a chest mixture " ; or between a " corn paint " and a " toe paint " ; or between a " headache powder " and a Yet according to the law as " head powder." administered the use of the name of an ailment renders a medicine liable to duty, while by using the name of the seat of the ailment as a description of the medicine liability to duty may be escaped. But that anomaly is almost a natural one compared with some of the more subtle means of avoidance of the tax which the wit of the legal mind, working sedulously through many pettifogging generations, has "