- Email: [email protected]
SERUM TREATMENT OF SPORADIC MENINGOCOCCAL MENINGITIS
1410 is to shatter the nucleus ; perhaps a refinement in method will allow a gentler but no less
knowledge sure
approach. SERUM TREATMENT OF SPORADIC MENINGOCOCCAL MENINGITIS
MENINGOCOCCAL meningitis in non-epidemic periods and areas is most often due to infection with strains of meningococci of the serological Group II. This group comprises the Types 2 and 4 of Gordon as well as other types, perhaps many, which possess serological relationship, but not complete identity, with Types 2 and 4 and with each other. In the basal meningitis of infants, which is the chief contributor to mortality from meningococcal meningitis in inter-epidemic periods, meningococci of Group II. are especially Serum therapy in infections with Group II. common. is often, and particularly in infants, much less successful than in infections with Group I., the usual cause of cerebro-spinal fever in epidemic form. It is possible that one reason, among others, for this is’B an inadequate amount of antibody for Group II. in the usual polyvalent anti-meningococcus therapeutic serum. The serum department of the Lister Institute has, therefore, prepared a special Group II. serum by immunising horses solely with Group II. strains recently isolated from sporadic cases in various parts of the country. This serum has been subjected to a concentration process in which a large proportion of the inactive protein is removed so that one volume of the concentrated serum is roughly equivalent in antibody content to three volumes of the original serum from which it was derived. The usual small quantity of tricresol has been added to the finished product. It is suggested that this serum, obtainable from Messrs. Allen and Hanburys Ltd., might be employed in the treatment of infants with meningococcal meningitis unless and until serclogical tests of the infecting strain have shown, as they will in a small minority of cases, that it belongs to Group I. Records are kept at the Ministry of Health of the serum treatment of meningococcal meningitis in every case in which information is available, and it is much to be desired that such information should be as complete as possible, since there is as yet no means of arriving at an assessment of the value of antimeningococcus sera except the compilation of clinical findings. In reporting cases treated by concentrated anti-meningococcus serum, the actual quantity used, in cubic centimetres of the serum, should be stated and not the presumed equivalent amount of the natural serum.
which appeared at the time in our columnsand was reprinted2 when the centenary of his birth was celebrated. It was at that time a portent for a dirty compound fracture to heal by first intention and Macfee was accessory to an act of historical interest. After completing his housesurgeoncy he left Glasgow for London, where he spent the remainder of his long life. His death severs what must be the last link between our time and the house surgeons of Lister’s Glasgow days.
LISTER’S HOUSE SURGEON
Dr. John Macfee, who died last Saturday at the age of 92 years, was house surgeon in 1864-65 at the Royal Infirmary in Glasgow. It was on that a of 11 was admitted 12th, 1865, August boy to the Infirmary after the wheel of an empty cart had passed over his left leg, breaking both the bones and causing a wound, 2inches long and 4 inch broad, over the fracture into which a probe could be passed for some inches. Macfee, acting under Lister’s instruction, dipped a piece of lint in liquefied phenol, laid it on the wound, and immobilised the limb with pasteboard splints, the dressing being left undisturbed for four days. When Lister then examined it there were some superficial sloughs caused by the phenol, but no signs of suppuration. The wound healed within six weeks and the boy’s recovery was complete. Lister recorded this case in an article entitled " On of treating compound fracture, a new method
abscess, &c.,"
SINOGRAPHY
meeting of the section of otology of the Royal Society of Medicine on Dec. 4th, with Dr. Douglas Guthrie in the chair, Dr. Paul Frenckner of Stockholm read a paper on sinography, a method of radiography in the diagnosis of sinus thrombosis. This method of investigation aims at determining AT
a
the existence of an obstruction to the blood stream in the dural sinuses or in the jugular vein, and is accomplished by taking an X ray picture during the injection of a Rontgen-opaque substance into the sinuses. The technique is as follows : by means of specially made trepanning instruments the superior longitudinal sinus is exposed, and into this vessel a Rontgen-opaque substance is injected and, simultaneously, X ray photographs are taken. If there is any obstruction to the blood stream in any of the evacuary" sinuses, the picture of the Rontgenopaque substance shows where it is to be found. Anatomical variations and anomalies must be carefully taken into consideration in assessing the value of the radiograms. An objection to the procedure is that it involves exposure of a cranial sinus for the purpose of establishing the diagnosis of disease in another sinus. The commonest affection of a cranial sinus is infective thrombosis of a lateral sinus secondary to suppurative otitis, and here the diagnosis is usually sufficiently clear to warrant direct operative exploration of the diseased region. In rare cases, where there is bilateral aural suppuration, there may be a doubt as to which side is the cause of the symptoms. "
THE following trustees have been appointed to administer Lord Nuffield’s gift for medical research at Oxford: Mr. W. M. Goodenough, vice-chairman of Barclays Bank (chairman); Mr A. D. Lindsay, vice-chancellor of the University; Sir Farquhar Buzzard, regius professor of medicine; Prof. T. B. Johnston, dean of Guy’s Hospital medical school; Mr. R. W. Thornton, chartered accountant; Mr. Douglas Veale, registrar of the University; Prof. Edward Mellanby, F.R.S., secretary of the Medical Research Council; Mr. Andrew Walsh, solicitor; Major R. S. Rowell, member of the Radcliffe Infirmary’s board of guardians; and Mr. A. H.
Wood, representing the Wingfield-Morris Orthopaedic
Hospital. 1 THE LANCET, 1867, i., 326. 2 Ibid., 1927, i., 773.
LONDON HOSPITAL--The
sum
of 280,000 is wanted
this hospital for essential improvements, and a dinner was held at Claridge’s Hotel on Dec. 3rd in support of the appeal when donations amounting to over JE4000 were received. The chief items of expenditure are 25,000 for a domestic servants’ hostel, 21,000 for an extension to the nurses’ home, and 15,000 for the ear, nose, and throat wards. A sum of at least E42,000 must be collected before an effective start with work can be made. The hospital has already received an anonymous gift ofill,000 towards the appeal.
by
knowledge sure
approach. SERUM TREATMENT OF SPORADIC MENINGOCOCCAL MENINGITIS
MENINGOCOCCAL meningitis in non-epidemic periods and areas is most often due to infection with strains of meningococci of the serological Group II. This group comprises the Types 2 and 4 of Gordon as well as other types, perhaps many, which possess serological relationship, but not complete identity, with Types 2 and 4 and with each other. In the basal meningitis of infants, which is the chief contributor to mortality from meningococcal meningitis in inter-epidemic periods, meningococci of Group II. are especially Serum therapy in infections with Group II. common. is often, and particularly in infants, much less successful than in infections with Group I., the usual cause of cerebro-spinal fever in epidemic form. It is possible that one reason, among others, for this is’B an inadequate amount of antibody for Group II. in the usual polyvalent anti-meningococcus therapeutic serum. The serum department of the Lister Institute has, therefore, prepared a special Group II. serum by immunising horses solely with Group II. strains recently isolated from sporadic cases in various parts of the country. This serum has been subjected to a concentration process in which a large proportion of the inactive protein is removed so that one volume of the concentrated serum is roughly equivalent in antibody content to three volumes of the original serum from which it was derived. The usual small quantity of tricresol has been added to the finished product. It is suggested that this serum, obtainable from Messrs. Allen and Hanburys Ltd., might be employed in the treatment of infants with meningococcal meningitis unless and until serclogical tests of the infecting strain have shown, as they will in a small minority of cases, that it belongs to Group I. Records are kept at the Ministry of Health of the serum treatment of meningococcal meningitis in every case in which information is available, and it is much to be desired that such information should be as complete as possible, since there is as yet no means of arriving at an assessment of the value of antimeningococcus sera except the compilation of clinical findings. In reporting cases treated by concentrated anti-meningococcus serum, the actual quantity used, in cubic centimetres of the serum, should be stated and not the presumed equivalent amount of the natural serum.
which appeared at the time in our columnsand was reprinted2 when the centenary of his birth was celebrated. It was at that time a portent for a dirty compound fracture to heal by first intention and Macfee was accessory to an act of historical interest. After completing his housesurgeoncy he left Glasgow for London, where he spent the remainder of his long life. His death severs what must be the last link between our time and the house surgeons of Lister’s Glasgow days.
LISTER’S HOUSE SURGEON
Dr. John Macfee, who died last Saturday at the age of 92 years, was house surgeon in 1864-65 at the Royal Infirmary in Glasgow. It was on that a of 11 was admitted 12th, 1865, August boy to the Infirmary after the wheel of an empty cart had passed over his left leg, breaking both the bones and causing a wound, 2inches long and 4 inch broad, over the fracture into which a probe could be passed for some inches. Macfee, acting under Lister’s instruction, dipped a piece of lint in liquefied phenol, laid it on the wound, and immobilised the limb with pasteboard splints, the dressing being left undisturbed for four days. When Lister then examined it there were some superficial sloughs caused by the phenol, but no signs of suppuration. The wound healed within six weeks and the boy’s recovery was complete. Lister recorded this case in an article entitled " On of treating compound fracture, a new method
abscess, &c.,"
SINOGRAPHY
meeting of the section of otology of the Royal Society of Medicine on Dec. 4th, with Dr. Douglas Guthrie in the chair, Dr. Paul Frenckner of Stockholm read a paper on sinography, a method of radiography in the diagnosis of sinus thrombosis. This method of investigation aims at determining AT
a
the existence of an obstruction to the blood stream in the dural sinuses or in the jugular vein, and is accomplished by taking an X ray picture during the injection of a Rontgen-opaque substance into the sinuses. The technique is as follows : by means of specially made trepanning instruments the superior longitudinal sinus is exposed, and into this vessel a Rontgen-opaque substance is injected and, simultaneously, X ray photographs are taken. If there is any obstruction to the blood stream in any of the evacuary" sinuses, the picture of the Rontgenopaque substance shows where it is to be found. Anatomical variations and anomalies must be carefully taken into consideration in assessing the value of the radiograms. An objection to the procedure is that it involves exposure of a cranial sinus for the purpose of establishing the diagnosis of disease in another sinus. The commonest affection of a cranial sinus is infective thrombosis of a lateral sinus secondary to suppurative otitis, and here the diagnosis is usually sufficiently clear to warrant direct operative exploration of the diseased region. In rare cases, where there is bilateral aural suppuration, there may be a doubt as to which side is the cause of the symptoms. "
THE following trustees have been appointed to administer Lord Nuffield’s gift for medical research at Oxford: Mr. W. M. Goodenough, vice-chairman of Barclays Bank (chairman); Mr A. D. Lindsay, vice-chancellor of the University; Sir Farquhar Buzzard, regius professor of medicine; Prof. T. B. Johnston, dean of Guy’s Hospital medical school; Mr. R. W. Thornton, chartered accountant; Mr. Douglas Veale, registrar of the University; Prof. Edward Mellanby, F.R.S., secretary of the Medical Research Council; Mr. Andrew Walsh, solicitor; Major R. S. Rowell, member of the Radcliffe Infirmary’s board of guardians; and Mr. A. H.
Wood, representing the Wingfield-Morris Orthopaedic
Hospital. 1 THE LANCET, 1867, i., 326. 2 Ibid., 1927, i., 773.
LONDON HOSPITAL--The
sum
of 280,000 is wanted
this hospital for essential improvements, and a dinner was held at Claridge’s Hotel on Dec. 3rd in support of the appeal when donations amounting to over JE4000 were received. The chief items of expenditure are 25,000 for a domestic servants’ hostel, 21,000 for an extension to the nurses’ home, and 15,000 for the ear, nose, and throat wards. A sum of at least E42,000 must be collected before an effective start with work can be made. The hospital has already received an anonymous gift ofill,000 towards the appeal.
by