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SCHOLARSHIPS FOR SONS OF MEDICAL MEN
198 for the offence of playing football in the street. This offence is punishable by fine ; but, where the lads and their fathers are unemployed, imprisonment is liable to follow in default of payment. The punishment is therefore in effect a sentence of imprisonment without the option of a fine. PERICARDIAL INJECTION OF LIPIODOL ALTHOUGH lipiodol has so far been used principally for diagnostic purposes in the radiography of the lungs, there is reason to think that it may have a therapeutic value in chronic pulmonary disease. The It has been same applies to its injection elsewhere. seldom in cases of but pericarditis since it employed cannot be expected to give information of much diagnostic value, but the few recorded cases do suggest that its injection may in itself bring about in the clinical condition. In some 1 the Dr. Paul W. Fritsch possibilities, reviewing reports in detail a case of his own.
improvement
A girl, 10 years old, with a previous history of articular rheumatism and carditis, was admitted to hospital with a left basal pleurisy and clinical and radiographic evidence of an extensive pericardial effusion. There were subsequently physical signs elicited which were interpreted as indicating a left lower lobe pneumonia, and 130 c.cm. of greenish-yellow fluid were aspirated from the left base. Pericardial puncture was carried out in the fifth interspace ’outside the radiographic shadow of the heart, the needle being directed obliquely inwards towards the heart. At the second attempt, 75 c.cm. of slightly blood-stained exudate were removed, which contained flakes of pus and pneumococci. Two cubic centimetres of lipiodol were injected, after which radiographic examination showed a fine deposit of opaque substance in the basal and lateral regions of the pericardial sac. The general condition of the patient gradually improved, and the dyspnoea and precordial pain diminished. Four weeks after the injection the patient was free from symptoms, and clinical and radiographic examination showed evidence of mitral disease uncomplicated by effusion ; the signs at the left base had also cleared.
Whilst
the immediate amelioration of urgent symptoms may be attributable in this case to the withdrawal of fluid from the pericardial sac, it is not unreasonable to suppose that the lipiodol may have been responsible to some extent for the subsequent absorption of exudate and for preventing adhesions. This is the more significant since the fluid had contained pus and pneumococci. The method of treatment appears at any rate to be harmless if small
quantities
are
employed.
PUBLIC HEALTH IN SHANGHAI Dr. J. H. Jordan’s report to the Shanghai Municipal Council for 1932 has just been published, and, having consideration to its bulk and the amount of information which it contains, the publication is prompt. The document is of great interest, as showing how many are the avenues of health to be safeguarded in a great city on the edge of the tropics, for Shanghai, standing approximately at sea level, is at the latitude 31’N. The population of Shanghai proper is made up of a little over a million of Chinese and 44,000 of other nations, but in the area of greater Shanghai, as estimated in October, 1932, the population is over three millions. Throughout the year the SinoJapanese conflict dislocated the work of the health department, as all sick in the municipal hospitals, which were in the fighting area, had to be removed to new quarters. The evacuation was completed in three days, but the work put a heavy burden on the staff, who had to arrange at short notice for 85 camps housing 44,000 refugees. The incidence of mortality 1 Acta Pædiat., 1933,
xiv., 412.
from the communicable diseases is the subject of close tabular statement. The chief cause of death was tuberculosis, and here the figures of the Chinese and the foreigner are more comparable than in the case of other diseases, the natives being proportionately the greater sufferers, even when their preponderance in number may warrant the larger total mortality. In the case of diphtheria, 59 cases were notified among the foreign residents with two deaths, while among the Chinese there were 350 cases with 73 deaths. Of influenza, 11cases were notified among the foreign population, and there were 157 cases among the Chinese with 69 deaths. There was an outbreak of cholera during the year, and measles was prevalent to an extent which the report acknowledges to be not indicated by the figures, identification of cases being very difficult. Other evidence of the strict sanitary conscience exhibited by the municipal authorities is supplied in the inspections of foodstuffs, bakeries and markets, and the visiting of slaughterhouses and, to a certain extent, the dwelling-places. Slums are being cleared in Shanghai, but it is delicate work to improve conditions where the population shows no interest in reforms or resists them. SCHOLARSHIPS FOR SONS OF MEDICAL MEN By the generosity of Sir Milsom Rees two scholarships will be awarded annually to the sons of medical men. Each scholarship will be of the annual value of E100, to be deducted from the fees, and the scholars will be educated at Port Regis Preparatory School, Broadstairs. At the moment the school contains 50 boys, but further accommodation has. now been built, so that there will be ample accommodation for this addition. Boys at entry must be between 8 and 9 years of age, and they may hold the scholarship for some five years. They will be selected at an interview from those boys who have done best in some simple examination conducted in or near their own homes. The first examination will be held in March, 1934, and the scholars will join the school at the commencement of the following summer term. Full particulars may be obtained on application to
the
headmaster, Port Regis School, Broadstairs. Mr. D. P. D. Wilkie, professor of surgery in the University of Edinburgh, has been appointed a
member of the Medical Research Council in succession to Mr. Wilfred Trotter, F.R.S., who retires in rotation on Sept. 30th, after four years’ service. INDEX TO " THE LANCET," VOL. I., 1933 THE Index and Title-page to Vol. 1., 1933, which was completed with the issue of June 24th, is now in preparation. A copy will be sent gratis to subscribers on receipt of a post-card addressed to the Manager of THE LANCET, 7, Adam-street, Adelphi, W.C.2. Subscribers who have not already indicated their desire to receive Indexes regularly as published should do so now. BRITISH DENTAL HOSPITAL.-The report for 1932 expresses regret at the resignation of Mr. George Thomson, who has been chairman since the establish-ment of the hospital in 1911. He has been succeeded by Mr. E. E. Turner, the honorary treasurer. The’ scheme for treating adolescents at reduced fees bridges the interval between the school-leaving age and that at which eligibility for dental benefit under the Insurance Acts begins. The facilities provided by the hospital, in cooperation with a number of metropolitan borough councils, for the dental treatment of expectant and nursing mothers and their young children at special clinics have been largely made use of. During the year 5637 children from the London County Council schools attended the clinic at the Lewisham treatment centre.
improvement
A girl, 10 years old, with a previous history of articular rheumatism and carditis, was admitted to hospital with a left basal pleurisy and clinical and radiographic evidence of an extensive pericardial effusion. There were subsequently physical signs elicited which were interpreted as indicating a left lower lobe pneumonia, and 130 c.cm. of greenish-yellow fluid were aspirated from the left base. Pericardial puncture was carried out in the fifth interspace ’outside the radiographic shadow of the heart, the needle being directed obliquely inwards towards the heart. At the second attempt, 75 c.cm. of slightly blood-stained exudate were removed, which contained flakes of pus and pneumococci. Two cubic centimetres of lipiodol were injected, after which radiographic examination showed a fine deposit of opaque substance in the basal and lateral regions of the pericardial sac. The general condition of the patient gradually improved, and the dyspnoea and precordial pain diminished. Four weeks after the injection the patient was free from symptoms, and clinical and radiographic examination showed evidence of mitral disease uncomplicated by effusion ; the signs at the left base had also cleared.
Whilst
the immediate amelioration of urgent symptoms may be attributable in this case to the withdrawal of fluid from the pericardial sac, it is not unreasonable to suppose that the lipiodol may have been responsible to some extent for the subsequent absorption of exudate and for preventing adhesions. This is the more significant since the fluid had contained pus and pneumococci. The method of treatment appears at any rate to be harmless if small
quantities
are
employed.
PUBLIC HEALTH IN SHANGHAI Dr. J. H. Jordan’s report to the Shanghai Municipal Council for 1932 has just been published, and, having consideration to its bulk and the amount of information which it contains, the publication is prompt. The document is of great interest, as showing how many are the avenues of health to be safeguarded in a great city on the edge of the tropics, for Shanghai, standing approximately at sea level, is at the latitude 31’N. The population of Shanghai proper is made up of a little over a million of Chinese and 44,000 of other nations, but in the area of greater Shanghai, as estimated in October, 1932, the population is over three millions. Throughout the year the SinoJapanese conflict dislocated the work of the health department, as all sick in the municipal hospitals, which were in the fighting area, had to be removed to new quarters. The evacuation was completed in three days, but the work put a heavy burden on the staff, who had to arrange at short notice for 85 camps housing 44,000 refugees. The incidence of mortality 1 Acta Pædiat., 1933,
xiv., 412.
from the communicable diseases is the subject of close tabular statement. The chief cause of death was tuberculosis, and here the figures of the Chinese and the foreigner are more comparable than in the case of other diseases, the natives being proportionately the greater sufferers, even when their preponderance in number may warrant the larger total mortality. In the case of diphtheria, 59 cases were notified among the foreign residents with two deaths, while among the Chinese there were 350 cases with 73 deaths. Of influenza, 11cases were notified among the foreign population, and there were 157 cases among the Chinese with 69 deaths. There was an outbreak of cholera during the year, and measles was prevalent to an extent which the report acknowledges to be not indicated by the figures, identification of cases being very difficult. Other evidence of the strict sanitary conscience exhibited by the municipal authorities is supplied in the inspections of foodstuffs, bakeries and markets, and the visiting of slaughterhouses and, to a certain extent, the dwelling-places. Slums are being cleared in Shanghai, but it is delicate work to improve conditions where the population shows no interest in reforms or resists them. SCHOLARSHIPS FOR SONS OF MEDICAL MEN By the generosity of Sir Milsom Rees two scholarships will be awarded annually to the sons of medical men. Each scholarship will be of the annual value of E100, to be deducted from the fees, and the scholars will be educated at Port Regis Preparatory School, Broadstairs. At the moment the school contains 50 boys, but further accommodation has. now been built, so that there will be ample accommodation for this addition. Boys at entry must be between 8 and 9 years of age, and they may hold the scholarship for some five years. They will be selected at an interview from those boys who have done best in some simple examination conducted in or near their own homes. The first examination will be held in March, 1934, and the scholars will join the school at the commencement of the following summer term. Full particulars may be obtained on application to
the
headmaster, Port Regis School, Broadstairs. Mr. D. P. D. Wilkie, professor of surgery in the University of Edinburgh, has been appointed a
member of the Medical Research Council in succession to Mr. Wilfred Trotter, F.R.S., who retires in rotation on Sept. 30th, after four years’ service. INDEX TO " THE LANCET," VOL. I., 1933 THE Index and Title-page to Vol. 1., 1933, which was completed with the issue of June 24th, is now in preparation. A copy will be sent gratis to subscribers on receipt of a post-card addressed to the Manager of THE LANCET, 7, Adam-street, Adelphi, W.C.2. Subscribers who have not already indicated their desire to receive Indexes regularly as published should do so now. BRITISH DENTAL HOSPITAL.-The report for 1932 expresses regret at the resignation of Mr. George Thomson, who has been chairman since the establish-ment of the hospital in 1911. He has been succeeded by Mr. E. E. Turner, the honorary treasurer. The’ scheme for treating adolescents at reduced fees bridges the interval between the school-leaving age and that at which eligibility for dental benefit under the Insurance Acts begins. The facilities provided by the hospital, in cooperation with a number of metropolitan borough councils, for the dental treatment of expectant and nursing mothers and their young children at special clinics have been largely made use of. During the year 5637 children from the London County Council schools attended the clinic at the Lewisham treatment centre.