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PYORRHŒA ALVEOLARIS.
88 of his belief that this was the primary initial lesion. In the other 25 per cent. the first clinical manifestations were multiple macules appearing simultaneously or a generalised rash. The conunonest sites of the initial lesion were the buttocks, the cheeks, the posterior and lateral surfaces of the thighs, and the loins. The primary lesion was never seen on chest or abdomen, although these regions often showed lesions in the more advanced stages of leprosy. The initial lesion was a solitary pale or pinkish macule, and in three cases this primary macule started from a scabies scar. Rogers and -Nluir calculated incubation period by supposing susceptibility to be equal throughout the whole time of exposure ; taking half of this period as the average time of infection, they added the time which had elapsed between isolation and the appearance of the first sign of the disease. Using this method, Dr. Rodriguez calculates that the probable average incubation period among the segregated and unsegregated Culion children is three years and nine months. The period of observation of children of lepers segregated after 6 months of age should cover at least five years, for one child developed the first suspicious signs four years and two months after isolation. Segregation of the children of lepers delayed after the age of 6 months did not decrease the incidence of leprosy, nor did it delay the appearance of the disease. The removal of children of lepers from a leprous milieu immediately after birth is the only safe prophylactic measure. The experience of the Almona Settlement in India during 30 years, and of the Molokai Settlement in Hawaii during 15 years, has made it certain that such a measure is effective. In both these leper settlements but one child so removed has become a leper. Dr. Rodriguez and the Philippine Health Service are to be congratulated on a valuable contribution to our knowledge of leprosy. ____
RESEARCH IN ANIMAL BREEDING. THE Animal Breeding Research Department of the University of Edinburgh has gained an international reputation, and the sixth annual report of its director makes interesting reading, both because it deals with varied investigations and because it describes
extraordinarily rapid progress. Although projected as long ago as 1913, the department did not get seriously to work until 1921. Even then it was in very humble circumstances ; but it was under the of Dr. F. A. E. Crew, and within these few years the importance of its labours has so
directorship
prolific stock. During the course of the year several papers have been published on endocrinology, with special reference to the sexual glands, and Dr. Crew has two interesting contributions on the subject of rejuvenation. He has shown that in the fowl uni. lateral vasoligation does not cause rejuvenation in the senile male—a result which gives no support to the claims of those who recommend the operation On the for the restoration of mammalian youth. other hand, he finds that the feeding of desiccated thyroid to aged fowls of both sexes has definite rejuvenating effects, such as the resumption of egg. laying by the females. These are only examples of the interesting information contained in the director’s statement, and we note that reprints of published papers will be sent to any person interested. The unassuming format of the present report is becooming to an institute which is urgently in need of funds. PYORRHŒA ALVEOLARIS. THE treatment of pyorrhoea, alveolaris, with which Mr. G. B. Pritchard deals under another heading in our present issue, must wait on diagnosis, a truism which only needs emphasis because it is so liable to be overlooked in this condition. The diagnosis of pyorrhoea depends on the recognition of periodontal pockets around the necks of the teeth produced by a process of ulceration occurring in the periodontal men:. brane. The differential diagnosis lies between it ard gingivitis, and all gradations arc found between a simple superficial gingivitis and an advanced pyorrhoea existing either separately or together and running either an acute or chronic course. The symptoms are often identical-i.e., hæmorrhage from the gums— either spontaneously or after brushing. They botl may produce a purulent discharge from the gum margin, and both are most important causes of oral sepsis. Clinically the manifestations of a gingivitis are superficial, of pyorrhoea deep as well as superficial. An acute gingivitis may produce considerable sloughof the gingival margin and superficial parts of i ing the adjoining gum, but the alveolar gum cannot be separated to any extent from the necks of the teeth. A chronic gingivitis may produce considerable hypertrophy of the gum margin, which may ulcerate freely, but the pockets associated with it do not An acute descend below the necks of the teeth. pyorrheea alveolaris may produce paradental abscesses, but although deep-seated they are lateral to the roots and not apical. A clironic pyorrhoea of any length of standing destroys the normal festoon of gum at the necks of the teeth, and produces varying amounts of gum recession ; and further still the membrane deep to the receded gum margin is destroyed leaving the pockets between the root and the alveol s, which are diagnostic whether or not there is visible pus. Radiographically, the marginal absorptions of alveolus is little or absent in gingivitis. while in pyorrhœa a varying amount of absorption is always visible with destruction of the superficial compact bone.
scientific world that the Itockefeller International Education Board offered £30,000 for its development on condition that an equal stini The present report was raised from other sources.l contains, by way of postscript, the intimation of a gift of £10,000 from Lord Woolavington. The sphere of work is likely to be enlarged and its educational value increased, and already a number of foreign research workers have been attracted to the school. Much of what is done has an almost immediateE application to practical agriculture, but the temptation to be merelv utilitarian has been eschewed. To The suggestion that if such quote the director : and such problems were solved vast sums of money would be saved may be of profound economic interest to the economist and the statesman ; it will certainly interest the scientist as a citizen, but it does not constitute the kind of stimulus that provokes him to ardent investigation." Such problems, however, as fertility and fecundity in sheep and studies in the fleece qualities of various breeds and crosses have a great academic interest as well as an obvious economic application. The same holds good of a series of studies in sterility in the horse-studies which suggest that the mode of inheritance of a certain form
impressed the
"
of sterility is comparatively straightforward. In pigs these problems are being investigated from a different aspect—namely, the breeding of a more 1 THE
LANCET, 1926, ii., 341.
I
_____
THE COST OF DRUGS IN PANEL PRACTICE. THERE seem to be careless prescribers in Scotland as well as in other parts of Great Britain. The epithet is that of the Dundee Panel Committee which returns in its report for 1926 to the expense to the Drug Fund involved in careless prescribing. It might be more accurate as well as more courteous to use the term elaborate prescribers to indicate those who regard the taste and colour of a mixture as of equal importance with its active ingredients. Leaving out of account modern organic preparations with a few exceptions, such as potassium iodide, the commoner pharmacopoeial drugs which are well proved in private and hospital practice are inexpensive, while it is the newer forms of medication whose value may be in doubt which are costly. A consideration of prices, the report remarks, would almost lead one to conclude that the cost of a drug is inversely proportional to its therapeutic value. But it is mere
RESEARCH IN ANIMAL BREEDING. THE Animal Breeding Research Department of the University of Edinburgh has gained an international reputation, and the sixth annual report of its director makes interesting reading, both because it deals with varied investigations and because it describes
extraordinarily rapid progress. Although projected as long ago as 1913, the department did not get seriously to work until 1921. Even then it was in very humble circumstances ; but it was under the of Dr. F. A. E. Crew, and within these few years the importance of its labours has so
directorship
prolific stock. During the course of the year several papers have been published on endocrinology, with special reference to the sexual glands, and Dr. Crew has two interesting contributions on the subject of rejuvenation. He has shown that in the fowl uni. lateral vasoligation does not cause rejuvenation in the senile male—a result which gives no support to the claims of those who recommend the operation On the for the restoration of mammalian youth. other hand, he finds that the feeding of desiccated thyroid to aged fowls of both sexes has definite rejuvenating effects, such as the resumption of egg. laying by the females. These are only examples of the interesting information contained in the director’s statement, and we note that reprints of published papers will be sent to any person interested. The unassuming format of the present report is becooming to an institute which is urgently in need of funds. PYORRHŒA ALVEOLARIS. THE treatment of pyorrhoea, alveolaris, with which Mr. G. B. Pritchard deals under another heading in our present issue, must wait on diagnosis, a truism which only needs emphasis because it is so liable to be overlooked in this condition. The diagnosis of pyorrhoea depends on the recognition of periodontal pockets around the necks of the teeth produced by a process of ulceration occurring in the periodontal men:. brane. The differential diagnosis lies between it ard gingivitis, and all gradations arc found between a simple superficial gingivitis and an advanced pyorrhoea existing either separately or together and running either an acute or chronic course. The symptoms are often identical-i.e., hæmorrhage from the gums— either spontaneously or after brushing. They botl may produce a purulent discharge from the gum margin, and both are most important causes of oral sepsis. Clinically the manifestations of a gingivitis are superficial, of pyorrhoea deep as well as superficial. An acute gingivitis may produce considerable sloughof the gingival margin and superficial parts of i ing the adjoining gum, but the alveolar gum cannot be separated to any extent from the necks of the teeth. A chronic gingivitis may produce considerable hypertrophy of the gum margin, which may ulcerate freely, but the pockets associated with it do not An acute descend below the necks of the teeth. pyorrheea alveolaris may produce paradental abscesses, but although deep-seated they are lateral to the roots and not apical. A clironic pyorrhoea of any length of standing destroys the normal festoon of gum at the necks of the teeth, and produces varying amounts of gum recession ; and further still the membrane deep to the receded gum margin is destroyed leaving the pockets between the root and the alveol s, which are diagnostic whether or not there is visible pus. Radiographically, the marginal absorptions of alveolus is little or absent in gingivitis. while in pyorrhœa a varying amount of absorption is always visible with destruction of the superficial compact bone.
scientific world that the Itockefeller International Education Board offered £30,000 for its development on condition that an equal stini The present report was raised from other sources.l contains, by way of postscript, the intimation of a gift of £10,000 from Lord Woolavington. The sphere of work is likely to be enlarged and its educational value increased, and already a number of foreign research workers have been attracted to the school. Much of what is done has an almost immediateE application to practical agriculture, but the temptation to be merelv utilitarian has been eschewed. To The suggestion that if such quote the director : and such problems were solved vast sums of money would be saved may be of profound economic interest to the economist and the statesman ; it will certainly interest the scientist as a citizen, but it does not constitute the kind of stimulus that provokes him to ardent investigation." Such problems, however, as fertility and fecundity in sheep and studies in the fleece qualities of various breeds and crosses have a great academic interest as well as an obvious economic application. The same holds good of a series of studies in sterility in the horse-studies which suggest that the mode of inheritance of a certain form
impressed the
"
of sterility is comparatively straightforward. In pigs these problems are being investigated from a different aspect—namely, the breeding of a more 1 THE
LANCET, 1926, ii., 341.
I
_____
THE COST OF DRUGS IN PANEL PRACTICE. THERE seem to be careless prescribers in Scotland as well as in other parts of Great Britain. The epithet is that of the Dundee Panel Committee which returns in its report for 1926 to the expense to the Drug Fund involved in careless prescribing. It might be more accurate as well as more courteous to use the term elaborate prescribers to indicate those who regard the taste and colour of a mixture as of equal importance with its active ingredients. Leaving out of account modern organic preparations with a few exceptions, such as potassium iodide, the commoner pharmacopoeial drugs which are well proved in private and hospital practice are inexpensive, while it is the newer forms of medication whose value may be in doubt which are costly. A consideration of prices, the report remarks, would almost lead one to conclude that the cost of a drug is inversely proportional to its therapeutic value. But it is mere