SIDEROCYTES IN MAN

770 done so. Inone of the cities there had been much latter group, but only 30% in the drug-treated series, The average amount of were under 60 years of age. evacuation, in another there had been little, and " shelter drug given was 18-4 g. per case, and McClure notes that life " was common in two but absent in a third. Yet the not only was there a tendency to give too little drug but scabies graphs are nearly similar for all three. The also to stop the drug too soon. As for the distribution of cause of this rising epidemic of scabies is unknown. pneumococcus types in this series, it is noteworthy that Mellanby suggests that the increase in dancing and only 83 out of 386 (21.5%) belonged to types i and 11, a cinema-going between 1930 and the outbreak of war may striking difference from the usual distribution in towns. be in part responsible for it. Some will not accept his Similar investigations could be organised in this country thesis that the incidence of scabies in the general populaand would Drobablv vield much interesting information. tion is similar to that in patients admitted to fever but there can be little doubt that the trends hospitals, INTRAMUSCULAR BLOOD IN CŒLIAC DISEASE will be much the same. Attention was called to the ARGUING that some disturbance of the internal secre- increase in scabies by many school medical officers in tions is the cause of coeliac disease, J. Wickstromi of their 1938 reports, so the beginning of the epidemic Helsingfors advocates its treatment by intramuscular can be dated. injections of whole blood. The blood, from healthy THORACIC SURGERY AT LEEDS adults, usually relatives of the patient, was injected into Mr. P. R. Allison has taken over the direction of a the gluteal region in doses of 15-20 c.cm. without any department of thoracic surgery at Leeds General Inadditions at intervals of 2-5 days for a series of 10-30 his appointment as hon. assistant injections. During this treatment all other measures firmary, relinquishing This surgeon. department is breaking new teaching mixed suitable for An were suspended. diet, average ground ; the London Hospital and the Newcastle the child’s age, was given with generous milk and milk mixtures, porridge and so forth-in fact a diet which General Hospital have such units, and there are thoracic would usually be considered quite unsuitable for patients surgeons at many large hospitals, but Leeds claims to with coeliac disease. Several cases were treated at have the first thoracic department to be opened in a teaching hospital. At present there are training hospitals for nurses with frequent changes of provincial 10 surgical beds=5 for women and 5 for men-reserved staff so that the good results obtained cannot be attributed to expert nursing care. Five children with for thoracic cases, which will form a war-time nucleus ; different combinations of symptoms, but all undoubtedly later, when the hospital has its normal complement of is hoped to have more. Mr. Allison, to whose examples of coeliac disease, were treated. No sudden beds, itand energy foresight the department is largely due, will in and to with the stools occurred change symptoms begin be assisted an anaesthetist and a resident surgical officer. by remained unchanged. But after a injections the to rise and this continued weight began improvement SIDEROCYTES IN MAN steadily throughout the course of injections with a NOT long ago Griinebergfound that granules of corresponding bettering of the appetite. After 2-3 " free " iron could be detected by the prussian-blue months the weight had risen by between 1 and 4 kg. and test in the red blood-cells of mice suffering from an the whole picture of the child had changed. The extra inherited disease typified by " flexed-tail and bellyweight gave the limbs a better-proportioned appearance, spot." A few such cells also appeared in embryo and the abdomen became less distended, muscle tone rats, and Gruneberg newly born normal mice improved and the child’s general behaviour, including thought that they might also#nd be found in man, if they temper, showed a striking change for the better. The were looked for. He now reports2 that small percentstools tended to remain of the coeliac type for some time ages of siderocytes have been found in the blood of when normal stools began to appear, often alternating human fcetuses ; the figures varied from 0-10 to 4-45%, with coeliac stools. The blood-sugar curves, however, and the amount of siderotic material was usually small. retained their low characteristics and a tendency to low has tried to link up the presence of siderocytes Griineberg blood-phosphorus was also unchanged. It is not with the change from megaloblastic to normoblastic claimed, therefore, that coeliac disease is cured by whole- erythropoiesis ; this is unlikely since in man the blood injections, but it seems clear that the general takes place at an early stage, being complete at about condition is so much improved that other treatment is the 8th week whereas the age of the fcetuses whose unnecessary. Wickstrom urges that this form of treatblood was examined for siderocytes ranged from 33 to ment is indicated when the general state of the child with 40 weeks. The significance of the siderocytes is not cceliac disease is bad, with much wasting and loss of known ; present theory points to iron being transported appetite. In fact it is during the worst phases of the in the plasma and combined with hsemoglobin in the disease that good results can be obtained by whole blood, bone-marrow, nor does it normally become " free " and thus a big step towards final cure can be taken just again until the haemoglobin is liberated by the break. when other therapeutic measures have failed. It might down of the red cell. Their presence in normal embryos equally be argued that- it is just at such a stage that a favours the suggestion that the free iron represents a dramatic turn for the better often takes place without hitherto unknown mode of haemoglobin synthesis rather any special method of treatment, so that Wickstrom’s than a disturbed haemoglobin metabolism. modest claims will have to be confirmed. Sir ALFRED WEBB-JOHNSON, P.R.C.S., has been INCREASE OF SCABIES elected a vice-president of the Middlesex Hospital. USING as his material the patients admitted to This is we believe the first time this honour has been infectious -diseases hospitals in five English cities during conferred on a member of the active staff. the past ten years, Kenneth Mellanby2 deduces that the Dr. R. DAwsorr RUDOLF, emeritus professor of theraincidence of scabies from 1931 to 1937 was low and peutics in the University of Toronto, died on Nov. 2 regular in distribution but in 1938 began to rise briskly after a short illness. He was a graduate of Edinburgh and since that year the rise has accelerated. Roughly, University and was elected to the fellowship of the before 1938 the incidence in fever patients was 3 per Royal College of Physicians of London in 1910. He renewed old associations on the European battlefield had 1941 risen to 25 The it 1000. whereas 1000, by per in 1917-18, taking special interest in trench fever, and incidence varied in the five hospitals but the upward his popular little book on the Medical Treatment of trend was the same in all. The rise started before the Disease had the critical outlook which marks the war, and though war conditions have probably helped scientific observer. the spread of the disease they cannot be proved to have

few

change

.

1. Nord. Med. 1941, 12, 2889.

2. Med.

Offr, Nov. 1, 1941, p. 141.

1. See Lancet, Aug. 16, 1941, p. 195. 2. Grüneberg, H. Nature, London, Oct 18, 1941, p. 469.