- Email: [email protected]
INFORMATION WANTED
1358
regards initial cost, but what is even more important, also in administration and maintenance. It is hardly necessary to stress the importance of avoiding extravagant buildings when the present financial difficulties of many of our hospitals are well known. A widely spaced plan as envisaged by your correspondent would have been impossible and undesirable for many reasons. The accepted plan is simple, admirably lit, direct, and capable of easy administration, and very ably conforms to the requirements laid down in the conditions of competition. Judging from other of the comments, I can only conclude that your correspondent has not completely understood the plans. With regard to the placing of the beds in the wards, the merits of the two systems in vogue were most carefully considered before a both
AMŒBIC DYSENTERY IN INFANCY
To the Editor
of THE
LANCET
as
SiB,—We note that Dr. Manson-Bahr doubts whether amoebic dysentery can occur in infancy, as he states in his letter that he has never encountered a case in a child under the age of 5 years. It may be of interest to draw attention to a paper published by us in the Transactions of the Royal Society of Tropical Medicine and Hygiene (1929, xxii., 511), in which we gave details of a laboratory investigation of 500 cases of acute intestinal conditions in children and infants in Egypt. The setiological agent in 73 of these patients was E. histolytica, and in 80 per cent. of these amoebic cases the age varied from 5 years to 1 year. We can state definitely that no fallacy occurred in the misinterpretation of macrophage cells as vegetative forms of E. histolytica, to decision was reached. It may interest your correwhich Dr. Manson-Bahr refers, as the examinations spondent to know that the authorities concerned were personally conducted by us. The diagnosis was with the new Birmingham Hospital Centre have made established by the demonstration of actively motile a similar decision and for the same reasons. I am, Sir, yours faithfully, entamoebae in fresh specimens.. As an explanation for his opinion that amoebic HUBERT M. FAIRWEATHER, Fellow. Fellow, R.I.B.A. dysentery does not occur in infancy, Dr. Manson- 12, Carteret-street, S.W.I, Dec. 13th, 1932. Bahr refers to the common methods of infection well known to those interestedin the epidemiology of this disease as .it affect adults:—e.g., transference INFORMATION WANTED of cysts by water and by contaminated uncooked To the Editor of THE LANCET green vegetables. Whilst it is true that these factors SIR,-If any registered practitioner should receive cannot play any serious part in the conveyance of ; infection to infants, we would point out that there an application from someone using the name of are other channels of infection which would account Mr. A. E. Thomas, M.B., Ch.B. 1918, U.Oxford, for for the incidence of the disease in the infants noted employment as locum tenens, or if any practitioner in our cases. The children concerned in the investi- is able to give the address in England of a person gation referred to above were drawn from the poorest using this name, I should be obliged if he would classes in Cairo, and anyone acquainted with the communicate with me at the earliest possible moment. I am, Sir, yours faithfully, nature of their surroundings during the height of NORMAN C. KING, the fly-breeding season will appreciate that the General Medical Council. Registrar, infective cysts can be transmitted either directly by 44, Hallam-street, Portland-place, W.1, Dec. 7th, 1932: flies, which are so commonly seen clustered around the mouths of these children, or’by the contamination INFECTIOUS DISEASE of goat’s or cow’s milk by these pests. Whilst concurring with the now well-established IN ENGLAND AND WALES DURING THE WEEK ENDED DEC. 3RD, 1932 view, confirmed by our own findings, that bacillary cases of infectious Notifications.-The for by far the larger pro- disease were notified following dysentery is responsible the week :-Small-pox, 27 during in of these intestinal infections the Near portion (last week 14) ; scarlet fever, 2295 ; diphtheria, 1044 ; East, we submit that, given favourable conditions enteric -fever, 39 ; acute pneumonia (primary or for its transmission, E. histolytica can, and does, influenzal), 1232 ; puerperal fever, 46 ; puerperal occur in children under the age of 5 years. pyrexia, 110 ; cerebro-spinal fever, 24; acute We are, Sir, yours faithfully, poliomyelitis, 10 ; acute polio-encephalitis, 3 ; H. MARRIAN PERRY, encephalitis lethargica, 9 ; dysentery, 21 ; ophthalmia H. J. BENSTED. neonatorum, 65. No case of cholera, plague, or Royal Army College, Millbank. Millbank, S.W., Army Medical College. typhus fever was notified during the week. c
.
"
I
Dec. 10th, 1932.
-
HOSPITAL DESIGN To the Editor of THE LANCET
SiR,-As assessor in connexion with the recent competition for the proposed new Scarborough Hospital, referred to by Dr. Hugh Gainsborough
-
in your current issue, may I be allowed to make one I can only conclude that the or two observations. criticisms of the premiated schemes were made by your correspondent without full knowledge of the facts, and that he is unacquainted with the undulating characteristics of the site, otherwise I feel sure that he would agree as to the wisdom of adopting a compact plan. The site is such that any extended plan of building would have involved expensive foundations and unnecessary underbuilding. The first and second premiated schemes were among the few submitted which solved the problem in an economic manner,
The number of cases in the Infectious Hospitals of the London County Council on Dec. 6th-7th.was as follows:Small-pox, 56 under treatment, 5 under observation (last week 59 and 3 respectively) ; scarlet fever; 1966 ; diphtheria, 1763 ; enteric fever, 13 ; measles, 229 ; whooping-cough, 408 ; puerperal fever, 22 (plus 5 babies) ; encephalitis lethargica, 230 ; poliomyelitis, 5 ; " other diseases," 163. At St. Margaret’s Hospital there were 15 babies (plus 6 mothers) with ophthalmia neonatorum.
Deaths.-In 117 great towns, including London, there was no death from small-pox, 4 (1) from enteric fever, 8 (0).from measles, 7 (0) from scarlet fever, 15 (3) from whooping-cough, 24 (3) from diphtheria, 59 (20) from diarrhoea and enteritis under two years, and 33 (6) from influenza. The figures in parentheses are those for London itself. Barking, Watford, and Wigan each reported 1 death
from enteric fever. Two deaths from measles occurred at Hull, Liverpool, and Birmingham, and 2 from whoopingcough at Liverpool and Sheffield. The number of stillbirths notified during the week was 220 (corresponding to a rate of 38 per 1000
total
births), including
32 in London.
regards initial cost, but what is even more important, also in administration and maintenance. It is hardly necessary to stress the importance of avoiding extravagant buildings when the present financial difficulties of many of our hospitals are well known. A widely spaced plan as envisaged by your correspondent would have been impossible and undesirable for many reasons. The accepted plan is simple, admirably lit, direct, and capable of easy administration, and very ably conforms to the requirements laid down in the conditions of competition. Judging from other of the comments, I can only conclude that your correspondent has not completely understood the plans. With regard to the placing of the beds in the wards, the merits of the two systems in vogue were most carefully considered before a both
AMŒBIC DYSENTERY IN INFANCY
To the Editor
of THE
LANCET
as
SiB,—We note that Dr. Manson-Bahr doubts whether amoebic dysentery can occur in infancy, as he states in his letter that he has never encountered a case in a child under the age of 5 years. It may be of interest to draw attention to a paper published by us in the Transactions of the Royal Society of Tropical Medicine and Hygiene (1929, xxii., 511), in which we gave details of a laboratory investigation of 500 cases of acute intestinal conditions in children and infants in Egypt. The setiological agent in 73 of these patients was E. histolytica, and in 80 per cent. of these amoebic cases the age varied from 5 years to 1 year. We can state definitely that no fallacy occurred in the misinterpretation of macrophage cells as vegetative forms of E. histolytica, to decision was reached. It may interest your correwhich Dr. Manson-Bahr refers, as the examinations spondent to know that the authorities concerned were personally conducted by us. The diagnosis was with the new Birmingham Hospital Centre have made established by the demonstration of actively motile a similar decision and for the same reasons. I am, Sir, yours faithfully, entamoebae in fresh specimens.. As an explanation for his opinion that amoebic HUBERT M. FAIRWEATHER, Fellow. Fellow, R.I.B.A. dysentery does not occur in infancy, Dr. Manson- 12, Carteret-street, S.W.I, Dec. 13th, 1932. Bahr refers to the common methods of infection well known to those interestedin the epidemiology of this disease as .it affect adults:—e.g., transference INFORMATION WANTED of cysts by water and by contaminated uncooked To the Editor of THE LANCET green vegetables. Whilst it is true that these factors SIR,-If any registered practitioner should receive cannot play any serious part in the conveyance of ; infection to infants, we would point out that there an application from someone using the name of are other channels of infection which would account Mr. A. E. Thomas, M.B., Ch.B. 1918, U.Oxford, for for the incidence of the disease in the infants noted employment as locum tenens, or if any practitioner in our cases. The children concerned in the investi- is able to give the address in England of a person gation referred to above were drawn from the poorest using this name, I should be obliged if he would classes in Cairo, and anyone acquainted with the communicate with me at the earliest possible moment. I am, Sir, yours faithfully, nature of their surroundings during the height of NORMAN C. KING, the fly-breeding season will appreciate that the General Medical Council. Registrar, infective cysts can be transmitted either directly by 44, Hallam-street, Portland-place, W.1, Dec. 7th, 1932: flies, which are so commonly seen clustered around the mouths of these children, or’by the contamination INFECTIOUS DISEASE of goat’s or cow’s milk by these pests. Whilst concurring with the now well-established IN ENGLAND AND WALES DURING THE WEEK ENDED DEC. 3RD, 1932 view, confirmed by our own findings, that bacillary cases of infectious Notifications.-The for by far the larger pro- disease were notified following dysentery is responsible the week :-Small-pox, 27 during in of these intestinal infections the Near portion (last week 14) ; scarlet fever, 2295 ; diphtheria, 1044 ; East, we submit that, given favourable conditions enteric -fever, 39 ; acute pneumonia (primary or for its transmission, E. histolytica can, and does, influenzal), 1232 ; puerperal fever, 46 ; puerperal occur in children under the age of 5 years. pyrexia, 110 ; cerebro-spinal fever, 24; acute We are, Sir, yours faithfully, poliomyelitis, 10 ; acute polio-encephalitis, 3 ; H. MARRIAN PERRY, encephalitis lethargica, 9 ; dysentery, 21 ; ophthalmia H. J. BENSTED. neonatorum, 65. No case of cholera, plague, or Royal Army College, Millbank. Millbank, S.W., Army Medical College. typhus fever was notified during the week. c
.
"
I
Dec. 10th, 1932.
-
HOSPITAL DESIGN To the Editor of THE LANCET
SiR,-As assessor in connexion with the recent competition for the proposed new Scarborough Hospital, referred to by Dr. Hugh Gainsborough
-
in your current issue, may I be allowed to make one I can only conclude that the or two observations. criticisms of the premiated schemes were made by your correspondent without full knowledge of the facts, and that he is unacquainted with the undulating characteristics of the site, otherwise I feel sure that he would agree as to the wisdom of adopting a compact plan. The site is such that any extended plan of building would have involved expensive foundations and unnecessary underbuilding. The first and second premiated schemes were among the few submitted which solved the problem in an economic manner,
The number of cases in the Infectious Hospitals of the London County Council on Dec. 6th-7th.was as follows:Small-pox, 56 under treatment, 5 under observation (last week 59 and 3 respectively) ; scarlet fever; 1966 ; diphtheria, 1763 ; enteric fever, 13 ; measles, 229 ; whooping-cough, 408 ; puerperal fever, 22 (plus 5 babies) ; encephalitis lethargica, 230 ; poliomyelitis, 5 ; " other diseases," 163. At St. Margaret’s Hospital there were 15 babies (plus 6 mothers) with ophthalmia neonatorum.
Deaths.-In 117 great towns, including London, there was no death from small-pox, 4 (1) from enteric fever, 8 (0).from measles, 7 (0) from scarlet fever, 15 (3) from whooping-cough, 24 (3) from diphtheria, 59 (20) from diarrhoea and enteritis under two years, and 33 (6) from influenza. The figures in parentheses are those for London itself. Barking, Watford, and Wigan each reported 1 death
from enteric fever. Two deaths from measles occurred at Hull, Liverpool, and Birmingham, and 2 from whoopingcough at Liverpool and Sheffield. The number of stillbirths notified during the week was 220 (corresponding to a rate of 38 per 1000
total
births), including
32 in London.