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STREPTOCOCCUS IN RHEUMATIC FEVER.
620 to lead to the final tragedy. The description was evidence of a mind that would have grasped at any object upon which to project its inner troubles, but the uncritical publicity given to the case fostered the idea that noise can serve as a primary cause of insanity or suicide-an idea which, in view of the contagiousness of emotional states, would be wisely omitted from anti-noise propaganda. Such arguments are not needed. It is sufficient that many nervous people are peculiarly susceptible to all kinds of stimuli, and they have at least the right to be protected from those unnecessary noises that the ordinary man i resents. This resentment may well serve as our i standard, for our unsophisticated likes and dislikes are reasonable guides to conduct, and did not, for example, await the progress of science to tell us that butter was a better food than margarine, or fresh air and sunshine healthier than the smoke of the town. We need not wait for scientific proofs of ill-effects from modern din ; our desire for peace and quiet is the justifiable foundation of the campaign against noise.
as
STREPTOCOCCUS IN RHEUMATIC FEVER. IT is perhaps nothing more than a coincidence that the production of highly plausible evidence incriminating the streptococcus in scarlet fever has been followed by a recrudescence of the old theory that rheumatic fever is caused by an analogous organism. There is, however, a considerable difference between the two cases. In scarlet fever there is found a streptococcus which produces an exotoxin which kills rabbits and behaves like other exotoxins. In rheumatic fever a remarkably neutral organism is held responsible ; and whatever toxin it produces is certainly of small virulence to animals. Three strains of this organism are discussed in the annual raportl of the Metropolitan Asylums Board. These
normal as among abnormal children, that it is of small animal virulence, and that evidence of antitoxin formation is scanty. Allowance must be made for variations in technique, but in the main Small’s technique was followed by Dr. R. G. White at theBelmont laboratories of the M.A.B. THE PREVALENCE OF GALL-STONES. review of cholelithiasis, based on a. scrutiny of the records of 9531 consecutive autopsies on patients of all ages performed in the General Infirmary at Leeds, is given by Dr. D. M. B. Gross,. of the Department of Pathology of the University of: Leeds. The basis of this review is the sounder forthe fact that an autopsy is made on nearly every patient who dies in the infirmary. Taking the figures,. then, as representing some 10,000 unselected individuals it appears that 6 per cent. of all men and 12 per cent.. of all women have gall-stones. The age-incidence shown in the charts which Dr. Gross has drawn does not differ materially from what is commonly assumed,. except for the demonstration that the solitary cholesterol stone is quite rare until the sixth and seventh decades. An entirely new fact, however, emerges from the statistics in regard to latency. In the 800 autopsies in which cholelithiasis was. present the corresponding clinical notes and history gave no suggestion of their presence in 576 cases;.;. in other words, cholelithiasis was latent and symptomless, so far as could be judged from the records, in about three cases out of four. The widely accepted notion that pregnancy contributes to cholelithiasis is negatived by this study ; it offers no support to the view that gall-stones are more frequent in married than in single women. The conclusion Dr. Gross draws is that " the factors influencing gall-stone formation are common to both sexes, A
STATISTICAL
Small’s Streptococcus cardioarthi-itidis, Birkhaug’s strain, and that of Lazarus-Barlow isolated in England. to the are
butmorepotent in the caseofwomen.Inaddition
common factors there is a sexual one, other Dr. Lazarus-Barlow has described in an earlier than pregnancy, acting in women alone." Thecommunication how he extracts from these organisms survey provides confirmation of the current opinion an endotoxin which, when injected into* rabbits, causes that faceted stones and pigment concretions area slight rise of temperature and ill-defined lesions. associated with cholecystitis, whereas the solitary He now relates an attempt to produce antisera to cholesterol and mulberry stones are not. The assothese three strains, and finds the rise in temperature ciation between the " strawberry " gall-bladder and! diminished (but not prevented) when it isadministered. the ’’ mulberry " calculus is established on statistical But the antisera were strictly specific, each to its own grounds, apparently for the first time. There appears strain. He concludes that the lesions produced in to be a definite relationship between diabetes and no way resemble those of rheumatic fever, and though cholelithiasis, and also between athercma and chole-. he considers there is evidence of some endotoxin, lithiasis. But no association between cholelithiasisthis is no more virulent than that obtained from many as distinct from cliolecystitis-and peptic ulceration strains held to be saprophytic. Of exotoxin there is can be seen in the data here given. In a companion paper2 Dr. N. no evidence at all. Gray Hill is unfeignedly sceptical of any advantages following the administration of antisera prepared THE DISCOVERY OF TWO DIFFERENT FORMS from these strains in acute rheumatism. Rheumatic OF HYDROGEN. fever, he remarks, is a disease running an uncertain WiTHiN the past two years a discovery of more and complex course, not to be compared with that of scarlet fever. Improvement following injections needs than ordinary importance was made in Germany,. careful analysis and control, and in the 15 cases and excited great interest in scientific circles. The he describes he could find no evidence of improve- discovery consists in the theoretical prediction, ment although serum rash was troublesome. An followed by the experimental proof, that in ordinary attempt was made to discover the frequency of hydrogen gas the molecules are of two kinds instead of being all alike. The new work led to much discuss occurrence of this type of organism in rheumatic and control cases. Fifty throat swabs in each series were sion at the recent meeting of the American Chemical forwarded, unidentified, to Dr. Lazarus-Barlow ; ’, Society at Minneapolis, and thus arose an impressioru 34 per cent. of the rheumatic and 42 per cent. of the in uninstructed circles that it had its origin in the control cases showed the organism. During the last United States. The discovery does not in any way three years Dr. J. C. Small, of Philadelphia, has upset present-day views upon the intimate atomic recorded a remarkable series of cases showing the structure of matter, according to which the ultimate advantages of serum treatment with his specific atoms of any element are composed of a positively antisera. The smaller series at Carshalton must be charged nucleus inside a surrounding shell of negaweighed in the balance on the other side of the scale. tive electrons which annul the central charge. The This series seems to show quite clearly that the atom of hydrogen consists of the simplest possible incriminated organism is as widely spread among nucleus carrying a simple unit of positive charge,. with one neutralising electron outside. Irl 1 Further Investigations into the Ætiology of Acute Rheumatic together Fever. By P. Lazarus-Barlow, M.D., assistant bacteriologist, the atoms of elements other than hydrogen the. Queen Mary’s Hospital for Children. Annual report for 1928-29, nucleus itself has a definite structure, being built up p. 379. of a number of hydrogen nuclei together with a. 2 The Relationship of Streptococcus Cardioarthritidis to Acute lesser number of electrons intimately welded together Rheumatism. By N. Gray Hill, M.C., M.B., B.S., D.P.H., assistant medical officer at the same hospital, ibid., p. 385. by forces whose nature is not yet understood. The
as
STREPTOCOCCUS IN RHEUMATIC FEVER. IT is perhaps nothing more than a coincidence that the production of highly plausible evidence incriminating the streptococcus in scarlet fever has been followed by a recrudescence of the old theory that rheumatic fever is caused by an analogous organism. There is, however, a considerable difference between the two cases. In scarlet fever there is found a streptococcus which produces an exotoxin which kills rabbits and behaves like other exotoxins. In rheumatic fever a remarkably neutral organism is held responsible ; and whatever toxin it produces is certainly of small virulence to animals. Three strains of this organism are discussed in the annual raportl of the Metropolitan Asylums Board. These
normal as among abnormal children, that it is of small animal virulence, and that evidence of antitoxin formation is scanty. Allowance must be made for variations in technique, but in the main Small’s technique was followed by Dr. R. G. White at theBelmont laboratories of the M.A.B. THE PREVALENCE OF GALL-STONES. review of cholelithiasis, based on a. scrutiny of the records of 9531 consecutive autopsies on patients of all ages performed in the General Infirmary at Leeds, is given by Dr. D. M. B. Gross,. of the Department of Pathology of the University of: Leeds. The basis of this review is the sounder forthe fact that an autopsy is made on nearly every patient who dies in the infirmary. Taking the figures,. then, as representing some 10,000 unselected individuals it appears that 6 per cent. of all men and 12 per cent.. of all women have gall-stones. The age-incidence shown in the charts which Dr. Gross has drawn does not differ materially from what is commonly assumed,. except for the demonstration that the solitary cholesterol stone is quite rare until the sixth and seventh decades. An entirely new fact, however, emerges from the statistics in regard to latency. In the 800 autopsies in which cholelithiasis was. present the corresponding clinical notes and history gave no suggestion of their presence in 576 cases;.;. in other words, cholelithiasis was latent and symptomless, so far as could be judged from the records, in about three cases out of four. The widely accepted notion that pregnancy contributes to cholelithiasis is negatived by this study ; it offers no support to the view that gall-stones are more frequent in married than in single women. The conclusion Dr. Gross draws is that " the factors influencing gall-stone formation are common to both sexes, A
STATISTICAL
Small’s Streptococcus cardioarthi-itidis, Birkhaug’s strain, and that of Lazarus-Barlow isolated in England. to the are
butmorepotent in the caseofwomen.Inaddition
common factors there is a sexual one, other Dr. Lazarus-Barlow has described in an earlier than pregnancy, acting in women alone." Thecommunication how he extracts from these organisms survey provides confirmation of the current opinion an endotoxin which, when injected into* rabbits, causes that faceted stones and pigment concretions area slight rise of temperature and ill-defined lesions. associated with cholecystitis, whereas the solitary He now relates an attempt to produce antisera to cholesterol and mulberry stones are not. The assothese three strains, and finds the rise in temperature ciation between the " strawberry " gall-bladder and! diminished (but not prevented) when it isadministered. the ’’ mulberry " calculus is established on statistical But the antisera were strictly specific, each to its own grounds, apparently for the first time. There appears strain. He concludes that the lesions produced in to be a definite relationship between diabetes and no way resemble those of rheumatic fever, and though cholelithiasis, and also between athercma and chole-. he considers there is evidence of some endotoxin, lithiasis. But no association between cholelithiasisthis is no more virulent than that obtained from many as distinct from cliolecystitis-and peptic ulceration strains held to be saprophytic. Of exotoxin there is can be seen in the data here given. In a companion paper2 Dr. N. no evidence at all. Gray Hill is unfeignedly sceptical of any advantages following the administration of antisera prepared THE DISCOVERY OF TWO DIFFERENT FORMS from these strains in acute rheumatism. Rheumatic OF HYDROGEN. fever, he remarks, is a disease running an uncertain WiTHiN the past two years a discovery of more and complex course, not to be compared with that of scarlet fever. Improvement following injections needs than ordinary importance was made in Germany,. careful analysis and control, and in the 15 cases and excited great interest in scientific circles. The he describes he could find no evidence of improve- discovery consists in the theoretical prediction, ment although serum rash was troublesome. An followed by the experimental proof, that in ordinary attempt was made to discover the frequency of hydrogen gas the molecules are of two kinds instead of being all alike. The new work led to much discuss occurrence of this type of organism in rheumatic and control cases. Fifty throat swabs in each series were sion at the recent meeting of the American Chemical forwarded, unidentified, to Dr. Lazarus-Barlow ; ’, Society at Minneapolis, and thus arose an impressioru 34 per cent. of the rheumatic and 42 per cent. of the in uninstructed circles that it had its origin in the control cases showed the organism. During the last United States. The discovery does not in any way three years Dr. J. C. Small, of Philadelphia, has upset present-day views upon the intimate atomic recorded a remarkable series of cases showing the structure of matter, according to which the ultimate advantages of serum treatment with his specific atoms of any element are composed of a positively antisera. The smaller series at Carshalton must be charged nucleus inside a surrounding shell of negaweighed in the balance on the other side of the scale. tive electrons which annul the central charge. The This series seems to show quite clearly that the atom of hydrogen consists of the simplest possible incriminated organism is as widely spread among nucleus carrying a simple unit of positive charge,. with one neutralising electron outside. Irl 1 Further Investigations into the Ætiology of Acute Rheumatic together Fever. By P. Lazarus-Barlow, M.D., assistant bacteriologist, the atoms of elements other than hydrogen the. Queen Mary’s Hospital for Children. Annual report for 1928-29, nucleus itself has a definite structure, being built up p. 379. of a number of hydrogen nuclei together with a. 2 The Relationship of Streptococcus Cardioarthritidis to Acute lesser number of electrons intimately welded together Rheumatism. By N. Gray Hill, M.C., M.B., B.S., D.P.H., assistant medical officer at the same hospital, ibid., p. 385. by forces whose nature is not yet understood. The