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INFECTIOUS DISEASE IN ENGLAND AND WALES DURING THE WEEK ENDED JAN. 13TH, 1934
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NOTES, COMMENTS, AND ABSTRACTS not be mentioned without expressly specifying the ADVERTISING VITAMINS insufficiency of its quantity. IN June, 1931, a conference of experts, sitting in Although these instructions are approved they do London under the chairmanship of Prof. E. Mellanby, not come into force until July 1st, giving those some recommendations for standardising the concerned time to dispose of advertising material made vitamins which the state of knowledge then justified. which no longer conforms to them. It was agreed for instance at this conference to CHOLECYSTO-TYPHOID accept carotene as a provisional international standard of reference for vitamin A, and to hold a selected THE occurrence of acute cholecystitis at the height sample of cod-liver oil as a possible secondary stan- of an attack of typhoid fever-especially in the third dard ; to adopt a solution of irradiated ergosterol or fourth week-and also in convalescence is well for vitamin B to as the standard for vitamin D ; known, but it is very unusual to encounter this use the adsorption product of the medical laboratory complication at the onset. P. H. Hillemand, J. Mezard, at Batavia (Java ) ; for vitamin C the fresh juice of and G. Valensi (Paris Med., Jan. 13th, p. 47) record the lemon. examples of this rare event in a woman aged 42 and Since that time the United States Pharmacopoeia a boy aged 14. In both cases the first symptoms to has adopted these units for A and D, and although attract attention were pain and tenderness over the the standards are provisional they do form, as Prof. gall-bladder, resistance of the abdominal wall on J. C. Drummond pointed out in our correspondence palpation of the area, and the presence of a tender columns a fortnight ago, some sort of base line upon pyriform swelling below the margin of the loin, while which to correlate the results of assays made in the characteristic symptoms of typhoid fever did not different laboratories. In his letter Prof. Drummond appear until later. Both patients developed asked that statements regarding the vitamin potency myocarditis but otherwise made an uncomplicated of preparations should be expressed in terms of these recovery. Similar cases of pretyphoid cholecystitis provisional international units, and he deprecated were recorded by Worms and Hamant in 1912, Roger specially such vague claims as that a product is rich and Collard in 1915, and Fournier, Bertolini, Alvarez, in vitamins. The correspondence which Prof. Drumand Gath in 1928. These five cases justify the mond’s letter has provoked shows how timely was isolation of an atypical form of onset of typhoid fever his intervention. which maybe called cholecysto-typhoid on the It will interest readers to learn that the Swiss analogy of pneumo-typhoid, meningo -typhoid, orartbroauthorities havetaken action in this direction, as typhoid. Clinically there is nothing to suggest the true nature of pretyphoid cholecystitis. In four of may be read in detail in Chemistry and Industry for Jan. 19th (page 53). Switzerland, it is there remarked, the recorded cases, including those of Hillemand and has always had somewhat stringent food regulations his colleagues, the diagnosis was not established until and, perhaps we may add, with some reason, for after the appearance of rose spots as the result of Switzerland has always been the happy hunting blood culture. Fournier and his collaborators however ground of cranks and quacks of all kinds. Three emphasise the diagnostic importance of early epistaxis and the value of leucopenia occurring in acute years ago the Federal Service of Public Hygiene made it illegal to issue statements about the vitamin cholecystitis. content of foods without a certificate from a recognised authority that the vitamin content had been INFECTIOUS DISEASE notably increased by additions or by special treat- IN ENGLAND AND WALES DURING THE WEEK ENDED ment. The restrictions were good as far as they JAN. 13TH, 1934 went, but did not give sufficient guidance to the Cantonal inspecting authorities, and these have now Notifications.—The following cases of infectious disease were notified during the week : Small-pox, 13 been armed with detailed instructions drawn up by the Federal Service with the assistance of university (last week 3) ; scarlet fever, 3290 ; diphtheria, 1256 enteric fever, 15 ; acute pneumonia (primary or physiological institutes at Basle and Lausanne. When permission has been given for a product to influenzal), 1867 ; puerperal fever, 61 ; puerperal indicate a particularly high content of some vitamin pyrexia, 135 ; cerebro-spinal fever, 34 ; acute it would be permissible to indicate generally in the poliomyelitis, 8 ; acute polio-encephalitis, 1 ; encephaadvertising matter that vitamins are essential for a litis lethargica, 8 ; dysentery, 23 ; ophthalmia rational diet, especially for infants, and that among neonatorum, 96. No case of cholera, plague, or the substances known as vitamins the following have typhus fever was notified during the week. The number of cases in the Infectious Hospitals of the been recognised as indispensable for man-viz., the County Council on Jan. 16th-17th was as follows: anti-xerophthalmic vitamin A, the anti-beriberi London 20 under treatment ; 2 under observation (last Small-pox, vitamin B1, the anti-pellagra vitamin B2, the antiweek 14 and 0 respectively) ; scarlet fever, 2569 ; diphtheria, scorbutic vitamin C, and the anti-rachitic vitamin D. 2071 ; enteric fever, 7 ; measles, 997 ; whooping-cough, 239 ; puerperal fever, 19 mothers (plus 11 babies) ; encephalitis But the text of the advertisement must not give the 260 ; poliomyelitis, 5"other diseases," 242. At impression that the product contains other vitamins lethargica, St. Margaret’s Hospital there were 20 babies (plus 10 mothers) than those mentioned in the authorisation, and in with ophthalmia neonatorum. regard to each several vitamin the limit of what it Deaths.-In 118 great towns, including London, is permissible to state is expressly set out. For there was no death from small-pox, 1 (0) from enteric instance, if a particularly high content of vitamin A fever, 49 (14) from measles, 18 (4) from scarlet fever, has been certificated it may be mentioned that this 15 (3) from whooping-cough, 37 (2) from diphtheria, vitamin is necessary for normal growth of the body, 34 (16) from diarrhoea and enteritis under two years, and that its absence lessens the resistance of the and 100 (19) from influenza. The figures in parenorganism to infections. Packings and literature must theses are those for London itself. always give accurate statements of the vitamin The deaths from influenza during the’past few weeks (working content in the foodstuffs, and the figures must be backwards) have been as follows : 100, 109, 83, 97, 95, 70, 59. The 209 deaths during the first two weeks of the year compare those of the official analysis ; but it is forbidden to with 1715 deaths for the corresponding weeks of 1933. Nine reproduce or mention recommendations or certifi- deaths were this week attributed to influenza at Birmingham, cates, even if they have been provided by experts. 3 each at Southend-on-Sea, Leicester, and Plymouth ; no more in other than 2 town. Bradford reported the only any great In cases of a rational combination of different death from enteric fever outside London. Eleven fatal cases is of vitamins it them permissible to mention each of measles occurred at Manchester, 4 each at Leeds and Liverpool Of the fatal cases of diphtheria, 6 were reported from Leeds, as well as their action even if their presence has 3 each from Liverpool and Salford. been confirmed in moderate quantitybut if only The number of stillbirths notified during the week in a food product the simultaneous presence of two was 244 (corresponding to a rate of 37 per 1000 vitamins has been stated, one in considerable and total births), including 27 in London. the other in unimportant quantity, the second may ______________
NOTES, COMMENTS, AND ABSTRACTS not be mentioned without expressly specifying the ADVERTISING VITAMINS insufficiency of its quantity. IN June, 1931, a conference of experts, sitting in Although these instructions are approved they do London under the chairmanship of Prof. E. Mellanby, not come into force until July 1st, giving those some recommendations for standardising the concerned time to dispose of advertising material made vitamins which the state of knowledge then justified. which no longer conforms to them. It was agreed for instance at this conference to CHOLECYSTO-TYPHOID accept carotene as a provisional international standard of reference for vitamin A, and to hold a selected THE occurrence of acute cholecystitis at the height sample of cod-liver oil as a possible secondary stan- of an attack of typhoid fever-especially in the third dard ; to adopt a solution of irradiated ergosterol or fourth week-and also in convalescence is well for vitamin B to as the standard for vitamin D ; known, but it is very unusual to encounter this use the adsorption product of the medical laboratory complication at the onset. P. H. Hillemand, J. Mezard, at Batavia (Java ) ; for vitamin C the fresh juice of and G. Valensi (Paris Med., Jan. 13th, p. 47) record the lemon. examples of this rare event in a woman aged 42 and Since that time the United States Pharmacopoeia a boy aged 14. In both cases the first symptoms to has adopted these units for A and D, and although attract attention were pain and tenderness over the the standards are provisional they do form, as Prof. gall-bladder, resistance of the abdominal wall on J. C. Drummond pointed out in our correspondence palpation of the area, and the presence of a tender columns a fortnight ago, some sort of base line upon pyriform swelling below the margin of the loin, while which to correlate the results of assays made in the characteristic symptoms of typhoid fever did not different laboratories. In his letter Prof. Drummond appear until later. Both patients developed asked that statements regarding the vitamin potency myocarditis but otherwise made an uncomplicated of preparations should be expressed in terms of these recovery. Similar cases of pretyphoid cholecystitis provisional international units, and he deprecated were recorded by Worms and Hamant in 1912, Roger specially such vague claims as that a product is rich and Collard in 1915, and Fournier, Bertolini, Alvarez, in vitamins. The correspondence which Prof. Drumand Gath in 1928. These five cases justify the mond’s letter has provoked shows how timely was isolation of an atypical form of onset of typhoid fever his intervention. which maybe called cholecysto-typhoid on the It will interest readers to learn that the Swiss analogy of pneumo-typhoid, meningo -typhoid, orartbroauthorities havetaken action in this direction, as typhoid. Clinically there is nothing to suggest the true nature of pretyphoid cholecystitis. In four of may be read in detail in Chemistry and Industry for Jan. 19th (page 53). Switzerland, it is there remarked, the recorded cases, including those of Hillemand and has always had somewhat stringent food regulations his colleagues, the diagnosis was not established until and, perhaps we may add, with some reason, for after the appearance of rose spots as the result of Switzerland has always been the happy hunting blood culture. Fournier and his collaborators however ground of cranks and quacks of all kinds. Three emphasise the diagnostic importance of early epistaxis and the value of leucopenia occurring in acute years ago the Federal Service of Public Hygiene made it illegal to issue statements about the vitamin cholecystitis. content of foods without a certificate from a recognised authority that the vitamin content had been INFECTIOUS DISEASE notably increased by additions or by special treat- IN ENGLAND AND WALES DURING THE WEEK ENDED ment. The restrictions were good as far as they JAN. 13TH, 1934 went, but did not give sufficient guidance to the Cantonal inspecting authorities, and these have now Notifications.—The following cases of infectious disease were notified during the week : Small-pox, 13 been armed with detailed instructions drawn up by the Federal Service with the assistance of university (last week 3) ; scarlet fever, 3290 ; diphtheria, 1256 enteric fever, 15 ; acute pneumonia (primary or physiological institutes at Basle and Lausanne. When permission has been given for a product to influenzal), 1867 ; puerperal fever, 61 ; puerperal indicate a particularly high content of some vitamin pyrexia, 135 ; cerebro-spinal fever, 34 ; acute it would be permissible to indicate generally in the poliomyelitis, 8 ; acute polio-encephalitis, 1 ; encephaadvertising matter that vitamins are essential for a litis lethargica, 8 ; dysentery, 23 ; ophthalmia rational diet, especially for infants, and that among neonatorum, 96. No case of cholera, plague, or the substances known as vitamins the following have typhus fever was notified during the week. The number of cases in the Infectious Hospitals of the been recognised as indispensable for man-viz., the County Council on Jan. 16th-17th was as follows: anti-xerophthalmic vitamin A, the anti-beriberi London 20 under treatment ; 2 under observation (last Small-pox, vitamin B1, the anti-pellagra vitamin B2, the antiweek 14 and 0 respectively) ; scarlet fever, 2569 ; diphtheria, scorbutic vitamin C, and the anti-rachitic vitamin D. 2071 ; enteric fever, 7 ; measles, 997 ; whooping-cough, 239 ; puerperal fever, 19 mothers (plus 11 babies) ; encephalitis But the text of the advertisement must not give the 260 ; poliomyelitis, 5"other diseases," 242. At impression that the product contains other vitamins lethargica, St. Margaret’s Hospital there were 20 babies (plus 10 mothers) than those mentioned in the authorisation, and in with ophthalmia neonatorum. regard to each several vitamin the limit of what it Deaths.-In 118 great towns, including London, is permissible to state is expressly set out. For there was no death from small-pox, 1 (0) from enteric instance, if a particularly high content of vitamin A fever, 49 (14) from measles, 18 (4) from scarlet fever, has been certificated it may be mentioned that this 15 (3) from whooping-cough, 37 (2) from diphtheria, vitamin is necessary for normal growth of the body, 34 (16) from diarrhoea and enteritis under two years, and that its absence lessens the resistance of the and 100 (19) from influenza. The figures in parenorganism to infections. Packings and literature must theses are those for London itself. always give accurate statements of the vitamin The deaths from influenza during the’past few weeks (working content in the foodstuffs, and the figures must be backwards) have been as follows : 100, 109, 83, 97, 95, 70, 59. The 209 deaths during the first two weeks of the year compare those of the official analysis ; but it is forbidden to with 1715 deaths for the corresponding weeks of 1933. Nine reproduce or mention recommendations or certifi- deaths were this week attributed to influenza at Birmingham, cates, even if they have been provided by experts. 3 each at Southend-on-Sea, Leicester, and Plymouth ; no more in other than 2 town. Bradford reported the only any great In cases of a rational combination of different death from enteric fever outside London. Eleven fatal cases is of vitamins it them permissible to mention each of measles occurred at Manchester, 4 each at Leeds and Liverpool Of the fatal cases of diphtheria, 6 were reported from Leeds, as well as their action even if their presence has 3 each from Liverpool and Salford. been confirmed in moderate quantitybut if only The number of stillbirths notified during the week in a food product the simultaneous presence of two was 244 (corresponding to a rate of 37 per 1000 vitamins has been stated, one in considerable and total births), including 27 in London. the other in unimportant quantity, the second may ______________