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PLANS OF CAMPAIGN AGAINST MALARIA.
1201
encephalitis lethargica and moral deterioration, the rest of the report of the Commissioners for England is not particularly informative as to criminal lunacy. The corresponding report for Scotland (available for the year 1929) gives rather fuller details, especially in respect of the type of insanity of each inmate admitted to the Department at Perth Prison, and in respect of the cost of maintenance. PLANS OF CAMPAIGN AGAINST MALARIA.
report of the Ross Institute length with the malaria policy of the Institute, and maintains that the proposals of the League of Nations Malaria Commission, as he believes to be advised for Europe, would result in leaving millions of malaria-stricken races in the tropics to struggle helplessly with the disease until they become strong and healthy. He characterises it as one of the most astounding proIN the latest annual
Sir Malcolm Watson deals at
positions
he has
ever
heard.
It should not be for-
gotten that there are two lines of attack in the antimosquito campaign, antilarval and anti-imaginal. Sir Malcolm, with immense experience of their benefits, naturally lays stress on antilarval measures. The Commission has laid stress on anti-imaginal measures, being, it is clear, convinced that actual infection takes place nearly always in the house. Some of the grounds for this conclusion must be experiences such as that of Watson himself-namely, that to remove the dwelling to half a mile from anopheline breeding grounds, without altering the locality of the daily work of its inhabitants, gives practical immunity from malaria. But if a house can by its very cleanness, lightness, and airiness be made distasteful to the adult anopheles, the same end is attained as if it were placed at a distance from the site of pupal emergence of these imagines ; and the possession of a home of this kind is rendered possible only by raising the human standard of life. That there are these two practical and supporting lines of approach to the antimosquito campaign few will question ; to determine which is the more useful in particular circumstances seems to give the strongest support to the policy of the Ross Institute, which is one of research and experiment in field and laboratory, undertaken in close cooperation with sanitation, medicine, and industry. Apart from all those considerations of duty and humanity which must bring many subscriptions to the Institute, the sums of money received form, as Sir Patrick Manson is quoted as saying of their like, " an investment yielding a most liberal return to the country that makes them." ____
THE GERSON DIET FOR DERMATOSES.
X raysand other means, had failed. The pruritus also relieved but relapsed three weeks later. A similar incomplete result was achieved in the case of seborrhceic dermatitis, but both the cases of chronic eczema were discharged cured after two months’ dieting-one of them having previously resisted almost every conceivable treatment, as an in-patient for 11 months. Some interesting investigations on the blood calcium, sodium chloride, sugar, and alkali reserve of the blood, and the pH of the urine were carried out at the same time as the salttree dieting. On the whole there was a slight rise in the calcium content, no change in the sodium chloride, and none that was at all noteworthy in the alkali reserve. The pH of the urine showed a definite movement to the acid side, although no such tendency of the whole organism as is posited by Hermannsdorfer could be demonstrated. In their conclusions the authors say that the Gerson salt-free diet is of considerable value in cases of tuberculosis cutis, and might be found even more helpful when combined with actinotherapy and other methods as is done by Jesionek and others. The main purpose of their investigation was to ascertain the constitutional effects, if any, on the organism as a whole, and in particular how the general change in environment affects the growth and persistence of the tubercle bacillus. They think that further progress awaits elucidation of the essential mechanism of the treatment-which may have some relation to the chloride and water content of the skin itself.
was
THE LEBANON
HOSPITAL.
Tms year sees the thirtieth anniversary of the Lebanon Hospital for mental diseases at Asfuriyeh, Beirut. Thirty years ago the state of the mentally afflicted in Syria was pitiable. Except for a collection of bare and wretched cells in Damascus, there was no provision for their care or treatment, and their fate was almost worse than that of the insane in this country in the Middle Ages. A Swiss missionary, Theophilus Waldmeier, decided in 1896 to retire from the Brummana Mission in order, at the age of 64, to set forth on a crusade to establish an asylum in Syria. He spent two years visiting asylums in England, Europe, and America, and in appealing to a wide public for funds. The hospital, which he opened in 1900, was an international venture. It began as an old farmhouse, amid a few sparse trees, with 15 beds, and untrained mountain girls as attendants. Now there are 219 beds, tended by capable nurses, amid groves of trees and gardens. The annual report1 shows that during last year 163 patients were admitted, and there were 219 in residence on March 31st, 1931. During the year
THE results recently recordeddo not support the more enthusiastic views of previous writers on the Gerson-Sauerbruch-Hermannsdorfer salt-free diet. The cases included four of lupus vulgaris, one of lupus verrucosus, two of varicose leg ulcer, two of chronic ulcer, one of seborrhceic dermatitis, and one of neurodermatitis. In none of the tuberculous cases was a cure achieved, although there was definite involution and inhibition of extension. The two leg ulcers remained in statu quo after four months of the treatment. In the neuroderma case the usual eosinophilia fell from 10 per cent. to 4 per cent., although all previous attempts to influence it, by
discharged relieved, 26 recovered, Syria there is a large proportion of voluntary patients, and the hospital consultingroom serves as a valuable out-patient department. There is considerable overcrowding and many applications have to be refused, despite the addition last year of an upper storey to one of the women’s pavilions and a new corridor of 11 single rooms for women. Open-air care and occupational therapy were practised at the Lebanon Hospital from the first. The patients are engaged in mattress-making, carpentry, gardening, laundry work, the olive oil soap industry-from the olive trees on the estate-and the making of leban, a form of sour milk. In the early days little or
1 Schlammadinger, J., and Szép, E. : Med. Klinik, April 2nd, p. 508.
London, N.W. 8.
48
patients
and 16 died.
1 Obtainable
were
Even in
from
the
Secretary,
55,
Wellington-road,
encephalitis lethargica and moral deterioration, the rest of the report of the Commissioners for England is not particularly informative as to criminal lunacy. The corresponding report for Scotland (available for the year 1929) gives rather fuller details, especially in respect of the type of insanity of each inmate admitted to the Department at Perth Prison, and in respect of the cost of maintenance. PLANS OF CAMPAIGN AGAINST MALARIA.
report of the Ross Institute length with the malaria policy of the Institute, and maintains that the proposals of the League of Nations Malaria Commission, as he believes to be advised for Europe, would result in leaving millions of malaria-stricken races in the tropics to struggle helplessly with the disease until they become strong and healthy. He characterises it as one of the most astounding proIN the latest annual
Sir Malcolm Watson deals at
positions
he has
ever
heard.
It should not be for-
gotten that there are two lines of attack in the antimosquito campaign, antilarval and anti-imaginal. Sir Malcolm, with immense experience of their benefits, naturally lays stress on antilarval measures. The Commission has laid stress on anti-imaginal measures, being, it is clear, convinced that actual infection takes place nearly always in the house. Some of the grounds for this conclusion must be experiences such as that of Watson himself-namely, that to remove the dwelling to half a mile from anopheline breeding grounds, without altering the locality of the daily work of its inhabitants, gives practical immunity from malaria. But if a house can by its very cleanness, lightness, and airiness be made distasteful to the adult anopheles, the same end is attained as if it were placed at a distance from the site of pupal emergence of these imagines ; and the possession of a home of this kind is rendered possible only by raising the human standard of life. That there are these two practical and supporting lines of approach to the antimosquito campaign few will question ; to determine which is the more useful in particular circumstances seems to give the strongest support to the policy of the Ross Institute, which is one of research and experiment in field and laboratory, undertaken in close cooperation with sanitation, medicine, and industry. Apart from all those considerations of duty and humanity which must bring many subscriptions to the Institute, the sums of money received form, as Sir Patrick Manson is quoted as saying of their like, " an investment yielding a most liberal return to the country that makes them." ____
THE GERSON DIET FOR DERMATOSES.
X raysand other means, had failed. The pruritus also relieved but relapsed three weeks later. A similar incomplete result was achieved in the case of seborrhceic dermatitis, but both the cases of chronic eczema were discharged cured after two months’ dieting-one of them having previously resisted almost every conceivable treatment, as an in-patient for 11 months. Some interesting investigations on the blood calcium, sodium chloride, sugar, and alkali reserve of the blood, and the pH of the urine were carried out at the same time as the salttree dieting. On the whole there was a slight rise in the calcium content, no change in the sodium chloride, and none that was at all noteworthy in the alkali reserve. The pH of the urine showed a definite movement to the acid side, although no such tendency of the whole organism as is posited by Hermannsdorfer could be demonstrated. In their conclusions the authors say that the Gerson salt-free diet is of considerable value in cases of tuberculosis cutis, and might be found even more helpful when combined with actinotherapy and other methods as is done by Jesionek and others. The main purpose of their investigation was to ascertain the constitutional effects, if any, on the organism as a whole, and in particular how the general change in environment affects the growth and persistence of the tubercle bacillus. They think that further progress awaits elucidation of the essential mechanism of the treatment-which may have some relation to the chloride and water content of the skin itself.
was
THE LEBANON
HOSPITAL.
Tms year sees the thirtieth anniversary of the Lebanon Hospital for mental diseases at Asfuriyeh, Beirut. Thirty years ago the state of the mentally afflicted in Syria was pitiable. Except for a collection of bare and wretched cells in Damascus, there was no provision for their care or treatment, and their fate was almost worse than that of the insane in this country in the Middle Ages. A Swiss missionary, Theophilus Waldmeier, decided in 1896 to retire from the Brummana Mission in order, at the age of 64, to set forth on a crusade to establish an asylum in Syria. He spent two years visiting asylums in England, Europe, and America, and in appealing to a wide public for funds. The hospital, which he opened in 1900, was an international venture. It began as an old farmhouse, amid a few sparse trees, with 15 beds, and untrained mountain girls as attendants. Now there are 219 beds, tended by capable nurses, amid groves of trees and gardens. The annual report1 shows that during last year 163 patients were admitted, and there were 219 in residence on March 31st, 1931. During the year
THE results recently recordeddo not support the more enthusiastic views of previous writers on the Gerson-Sauerbruch-Hermannsdorfer salt-free diet. The cases included four of lupus vulgaris, one of lupus verrucosus, two of varicose leg ulcer, two of chronic ulcer, one of seborrhceic dermatitis, and one of neurodermatitis. In none of the tuberculous cases was a cure achieved, although there was definite involution and inhibition of extension. The two leg ulcers remained in statu quo after four months of the treatment. In the neuroderma case the usual eosinophilia fell from 10 per cent. to 4 per cent., although all previous attempts to influence it, by
discharged relieved, 26 recovered, Syria there is a large proportion of voluntary patients, and the hospital consultingroom serves as a valuable out-patient department. There is considerable overcrowding and many applications have to be refused, despite the addition last year of an upper storey to one of the women’s pavilions and a new corridor of 11 single rooms for women. Open-air care and occupational therapy were practised at the Lebanon Hospital from the first. The patients are engaged in mattress-making, carpentry, gardening, laundry work, the olive oil soap industry-from the olive trees on the estate-and the making of leban, a form of sour milk. In the early days little or
1 Schlammadinger, J., and Szép, E. : Med. Klinik, April 2nd, p. 508.
London, N.W. 8.
48
patients
and 16 died.
1 Obtainable
were
Even in
from
the
Secretary,
55,
Wellington-road,