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SUDAN MEDICAL SERVICE
800 from it. Again, situations can be contrived to break down self-doubt. Thus a girl who fancies herself unattractive will attend her first club meeting in apprehension ; the doctor arranges without her knowledge that one man after another asks her to dance. The CHAIRMAN in summing up mentioned the lack of opportunity for the sexes to meet in penal institutions. It can be partly alleviated, he said, by having a woman nurse on the male side of the institution. SUDAN MEDICAL SERVICE THE activities recorded in,the report of the Sudan Medical Service for 1941 would be creditable in times of peace and are doubly so under the stress of war-there is no evidence of restrictions either in performance or production. The general health of the Sudan remained satisfactory and the incidence of epidemic disease below the average. The small amount of malaria in the Northern Sudanis attributable to favourable climatic conditions. The strain of war and lack of leisure took their toll of British officials, who showed a higher incidence of sickness and consequently a greater number of deaths and invaliding than for some years past. Cerebrospinal fever topped the list of epidemic diseases, and some 1824 cases were reported with 459 deaths, which cornpares favourably witli 1936 when there were 13,440 cases and 8906 deaths. Diphtheria was not of major importance. Relapsing fever incidence was above the average, with 3028 cases and 110 deaths. The small amount of smallpox (46 cases with none fatal) bears testimony to the efficacy of the extensive vaccination campaigns of the last four years and to the lymph produced in the local Stack laboratories. For the first time, a case of tick typhus was reported in Equatoria Province. Yellow fever was absent during the year. Bilharziasis (B. hcematobia) constituted no real danger, but remains as a potential menace to the irrigated areas of the Gezira. The incidence of blackwater fever (28.cases with 9 deaths) is not great; Arab Sudanese provided the greater number-not a single European was affected. Guineaworm is prevalent in Equatoria Province, the Nuba Mountains and the Bor district of the Upper Nile Province, but now that anti-guineaworm wells have been constructed in many endemic areas, it is reasonably hoped that there will be ’a reduction in this disease. Regarding dysentery, it is rather surprising to read that of 3661 cases admitted to hospital 2924 were diagnosed as amcebic and only 737 as bacillary in origin, though the war must have considerably increased the incidence of the latter. On the other hand, the incidence of enteric fevers remained remarkably low, only some 129 cases being recorded. Among the 477 cases of kala-azar reported there was a remarkably high mortality, with 138deaths; these must be largely attributed to the recent campaigns in the very worst endemic centres. In spite of treatment with ’Stilbamidine’ many patients succumbed and the Sudan variety appears to be particularly resistant to any form of treatment. Under the heading of cutaneous leishmaniasis there was one example of espundia (mucocutaneous leishmaniasis) which has occasionally been recorded before from the Sudan. The 46 cases of oriental sore came mostly from the Kordofan Province. Of trypanosomiasis 125 cases were reported in Equatoria Province, 47 in a fresh outbreak in the Meridi district and 1 in the Kajo Kaju subdistrict. A pass system was organised between the Sudan and Belgian Congo, and between the Sudan and. French Equatorial Africa, in order to limit the spread of the disease and enable people to visit relatives. The section on public health-and hygiene, by Lieut.-Colonel H. A. Crouch, describes special measures for the control of yellow fever in view of the remarkable outbreak in the Nuba Mountains in 1940. There has been no recrudescence. Immunisation has been carried out on an extensive scale for all members of the Forces, all officials, police, railway and steamer personnel,. medical staff, school-children,missionaries and others going south of Khartoum. All guards and employees on aerodromes were included and mass inoculation was undertaken in vi]Jages,near aerodromes, posts and lines of communication. The campaign against aedes mosquitoes has been a feature of public health work, necessitating the employment of extra staff.
Reviews of Books of Natural Membranes H. ])A*SON, D sc, associate professor of physiology, Dalhousie University, Canada ; J. F. DANIELLI, D SC, AlC, Beit memorial research fellow and fellow of St. John’s College, Cambridge. (Cambridge Univ. Press. Pp. 361. 25s.)
Permeability
THE authors have undertaken a task long overdue in compiling the available evidence-for much of which they are personally responsible-on the fundamental question of permeability. They are not too technical for any medical reader who is willing to skip a little. Serious students of physiology and biochemistry, and teachers of these subjects, will find much valuable information and many new ideas. The behaviour of the various kinds of membrane encountered in the body is succeeded by a summary of modern views on the nature of the cell membrane. Equilibria, and partial or selective permeability of a membrane are discussed. Experimental methods are explained, and the tricks employed by the erythrocyte to deceive investigators are frankly exposed. The book is rounded off by chapters on haemolysis,. secretion, renal function, and the kind of theory of permeability which seems to be emerging from the available evidence. The authors claim no more than to draw attention to the transition from qualitative to quantitative studies of living membranes. They write critically and they neither oversimplify nor elaborate unduly on inadequate evidence.
Annual Review of Biochemistry. (Vol. XII.) Editors : J. M. LucK, J. University.
(Lewis.
Pp.
704.
318.
,
H. C.
SMITH, Stanford
6d.)
.
THE articles in this volume are well up to the standard we have come to expect. Lipman’s section on the biological oxidations and reductions gives a good summary of the present position, and contains some valuable notes on the dropping mercury electrode, and the use of polarography in the study of enzymes. The proteolytic enzymes are discussed by Herriott in a timely review of a subject about which biochemists tend to remain rather old-fashioned. Besides such usual subjects as the steroids, proteins and amino-acids, vitamins, and synthetic drugs ,the book covers the microclaemistry and electron microscope.
Hermaphroditos The’ Human Intersex. A. P. CAWADIAS, MD DURH., FRCP, physician, St. John Clinic and Institute of Physical Medi. cine, London. (Heinemann. Pp. 78. 15s.) Tms book is an extension of Dr. Cawadias’s Thomas Vicary lecture to the Royal College of Surgeons.’ It is
.
also an improvement on it, for some of the unduly optimistic claims for endocrine treatment then made have been wisely omitted. The author exposes and explains historically the fiction of the true hermaphrodite and proceeds to elaborate in detail and with ability his personal views. These rest upon certain premises with which all students would agree. A male is not a male because he has testes ; he has testes because he is a male, and a female is a female not because she has ovaries but has ovaries because "
similarly
she is "
a
"
female."
is a normal phenomenon. There is no absolute male nor absolute female." " The system of sex determination.... consists in an interaction of a biological field, a sexoformic impulse and a’ environment." biological " The biological field of the human embryo is bisexual. On this field the organising sexoformic impulse ... acts," always unisexually, through the genic sex organisers and the endocrines. But though this hypothesis is ably developed, there are curious omissions which deny to this book the rank of a classical monograph. The experiments of Greene and his associates in America, which are favourable to the thesis, are not mentioned. Goldschmidt is too cavalierly POSTWAR INTERNATIONAL COLLABORATION IN MEDICINE.— dismissed, although in many respects he too is a friend. Dr. Melville,Mackenzie has chosen this subject for theThere is,too, a tendency to describe at length the Harben lectures which he is to deliver to the Royal Institute patients who " fit " well, and to leave unmentioned of Public Health and Hygiene, 28, Portland Place, London,such awkward cases as Guldberg’s example of uniovular W.1, on Jan. 24, 25, and 26 at 3 rM. twins, one female and one gynandroid.
Intersexuality
...
...
’
’
,
Reviews of Books of Natural Membranes H. ])A*SON, D sc, associate professor of physiology, Dalhousie University, Canada ; J. F. DANIELLI, D SC, AlC, Beit memorial research fellow and fellow of St. John’s College, Cambridge. (Cambridge Univ. Press. Pp. 361. 25s.)
Permeability
THE authors have undertaken a task long overdue in compiling the available evidence-for much of which they are personally responsible-on the fundamental question of permeability. They are not too technical for any medical reader who is willing to skip a little. Serious students of physiology and biochemistry, and teachers of these subjects, will find much valuable information and many new ideas. The behaviour of the various kinds of membrane encountered in the body is succeeded by a summary of modern views on the nature of the cell membrane. Equilibria, and partial or selective permeability of a membrane are discussed. Experimental methods are explained, and the tricks employed by the erythrocyte to deceive investigators are frankly exposed. The book is rounded off by chapters on haemolysis,. secretion, renal function, and the kind of theory of permeability which seems to be emerging from the available evidence. The authors claim no more than to draw attention to the transition from qualitative to quantitative studies of living membranes. They write critically and they neither oversimplify nor elaborate unduly on inadequate evidence.
Annual Review of Biochemistry. (Vol. XII.) Editors : J. M. LucK, J. University.
(Lewis.
Pp.
704.
318.
,
H. C.
SMITH, Stanford
6d.)
.
THE articles in this volume are well up to the standard we have come to expect. Lipman’s section on the biological oxidations and reductions gives a good summary of the present position, and contains some valuable notes on the dropping mercury electrode, and the use of polarography in the study of enzymes. The proteolytic enzymes are discussed by Herriott in a timely review of a subject about which biochemists tend to remain rather old-fashioned. Besides such usual subjects as the steroids, proteins and amino-acids, vitamins, and synthetic drugs ,the book covers the microclaemistry and electron microscope.
Hermaphroditos The’ Human Intersex. A. P. CAWADIAS, MD DURH., FRCP, physician, St. John Clinic and Institute of Physical Medi. cine, London. (Heinemann. Pp. 78. 15s.) Tms book is an extension of Dr. Cawadias’s Thomas Vicary lecture to the Royal College of Surgeons.’ It is
.
also an improvement on it, for some of the unduly optimistic claims for endocrine treatment then made have been wisely omitted. The author exposes and explains historically the fiction of the true hermaphrodite and proceeds to elaborate in detail and with ability his personal views. These rest upon certain premises with which all students would agree. A male is not a male because he has testes ; he has testes because he is a male, and a female is a female not because she has ovaries but has ovaries because "
similarly
she is "
a
"
female."
is a normal phenomenon. There is no absolute male nor absolute female." " The system of sex determination.... consists in an interaction of a biological field, a sexoformic impulse and a’ environment." biological " The biological field of the human embryo is bisexual. On this field the organising sexoformic impulse ... acts," always unisexually, through the genic sex organisers and the endocrines. But though this hypothesis is ably developed, there are curious omissions which deny to this book the rank of a classical monograph. The experiments of Greene and his associates in America, which are favourable to the thesis, are not mentioned. Goldschmidt is too cavalierly POSTWAR INTERNATIONAL COLLABORATION IN MEDICINE.— dismissed, although in many respects he too is a friend. Dr. Melville,Mackenzie has chosen this subject for theThere is,too, a tendency to describe at length the Harben lectures which he is to deliver to the Royal Institute patients who " fit " well, and to leave unmentioned of Public Health and Hygiene, 28, Portland Place, London,such awkward cases as Guldberg’s example of uniovular W.1, on Jan. 24, 25, and 26 at 3 rM. twins, one female and one gynandroid.
Intersexuality
...
...
’
’
,