SUPRARENAL CORTEX IN ADDISON'S DISEASE

.84 admission to medical, against 1543 to surgical beds. of extraction which they have found to bo the most The great majority (77 per cent.) of waiting patients effective after extensive trials, and by their various suffer from diseases such as hernia, haemorrhoids, clinical collaborators. There seems still to bo con. appendicitis, gastric and duodenal ulcers (52 bound siderable difficulty in obtaining an adequate supply for surgical, only eight for medical wards), cataract, of the extract and treatment has had to bo discon. chronic diseases of the ear, nose, and throat, and tinued in urgent cases for lack of it. Dr. L. G. endocervicitis and allied disorders. It is in the relief Rowntree recorded the use of this treatment in 20 cases of such patients, for whom voluntary hospitals will of Addison’s disease, with five deaths. Two patients always find it difficult to provide enough accommoda- who had adequate treatment did not respond. Those tion, that Dr. Picken sees one of the main functions who improved showed gain in weight and strength, of the municipal hospitals, for in the widest connota- disappearance of anorexia, nausea, and vomiting, tion of the word such treatment is preventive, if decrease of pigmentation, gain in sleep, change of only of more acute disorders. If all medical officers of outlook, and desire to go back to work. The hormone health advise their authorities in this sense, cooperation was administered intravenously, the dosage being between the two kinds of hospital should lead to the 3-5 c.cm. in a day. The preparation used by him foundation of a science of preventive medicine on had some tendency to sensitise the patients to a broader basis than has hitherto been possible and to adrenalin. Dr. G. A. Harrop (Baltimore) reported its speedy development. definite improvement with the extract in three cases, Dr. Allbright (Boston) in one case, while Dr. T. R. Boggs (Baltimore) described his success in one case THE JEWISH DENTAL CLINIC. with the whole gland, administered in a capsule THE annual report of the work of the Jewish Health insoluble in the stomach. The patient was a Scotch Organisation appears under the title " Public Health woman living in Jamaica, and her pigmentation Work in the Jewish Community." It includes many had been so deep as to cause social embarrassment interesting activities such as public lectures, inspection to her husband. Within four weeks after beginning of evening schools, and the well-known child-guidance treatment, which also included large doses of calcium, - clinic. It is satisfactory to learn that the society has the blanching of her skin was considerable and a report been restored to solvency and even provided with a received after her return to Jamaica was satissurplus. The most recent development is a dental factory. Dr. Rowntree reiterated his belief that the clinic for adolescents, which was opened on Nov. 20th extract from the cortex is a potent remedy for last. The committee felt that much of the valuable Addison’s disease, specific though not infallible, but work of the school dental service failed in its object he emphasised the need for many more records of owing to the lack of supervision for adolescents. cases before this form of treatment can be evaluated. Even when the young person is old enough to join the National Health Insurance scheme, dental EMBRYONIC INJURIES. benefit is only provided by some approved societies, .and then after an interval of several years. The THE late Dr. T. S. P. Strangeways evidently had Jewish dental clinic, called the " Prunella Treatment a sure instinct when he saw towards the end of his ’Centre," holds sessions in the evening after normal life that tissue culture was likely to be a valuable working hours in an attempt to fill this gap in the weapon in experimental pathology. Under the health service of the country. Patients are seen by guidance of Dr. H. B. Fell a number of valuable appointment, and every member under the scheme researches on normal growth and the mechanism of is inspected at least once a year. Inspection and calcification have come from the laboratory which treatment are combined with dental hygiene educa- he founded. One of these is a interesting singularly tion. The clientele is obtained through societies and contribution Dr. Janet S. F. Niven on the healing 1 by clubs, the affiliation fee being provisionally fixed at a of wounds in the rudiments of bones, isolated from shilling a year, with a minimum of jE2 per institution. the embryo and allowed to grow and differentiate in The clubs are visited by the dentists to give talks on tissue cultures ; what the tissues do is therefore oral hygiene and to make inspections and arrange determined by themselves and is not subject to any appointments for those requiring treatment. Already influence from the rest of the embryo. If the femur seven clubs have been visited and 166 young people from a five-day chicken embryo is cut across and the examined. Of these no fewer than 161 required ends left in apposition, the wound is healed at once treatment, thus indicating the need for the service. by proliferation of the cartilage cells and in 24 hours no trace of the cut can be seen or found in histological preparations ; later on, normal differentiation of the SUPRARENAL CORTEX IN ADDISON’S DISEASE cartilage occurs and bone begins to form in the usual THE discussion on hormones and the diseases of the way. In the early stages, therefore, cartilage cells ductless glands at the recent meeting of the Association have a remarkably high capacity for repair. But of American Physicians centred largely on the effect this is soon lost. If a femur rudiment from a sixin Addison’s disease of the potent hormone extracted day embryo is similarly divided across the shaft, from the suprarenal cortex. Attempts to elucidate the cartilage immediately adjacent to the cut underthe inter-relation of the adrenal and the thyroid glands goes some change which makes it opaque instead of by giving the extract to patients with Graves’s semi-translucent, and although the two halves of the disease were also described. So far, however, the rudiment go on differentiating normally the cartilage effect on these patients seems to have been mainly does not unite. The site of the cut remains obvious subjective-i.e., they felt better but their metabolic and is outlined on either side by a zone of degenerated rate was unchanged. With regard to Addison’s disease cartilage cells. The fragments are united and an not much progress seems to have been made since we effective mend made by proliferation of the periosteal last commented on this interesting work.1 Papers cells and the neighbouring connective tissue, aided were contributed by Dr. W. W. Swingle and Dr. sometimes by an ingrowth of the osteoblastic layer J. J. Pfiffner, of Princeton, who described the method of the periosteum and the production of osteoid 1 See THE LANCET, 1930, i., 652.

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Jour. Path. Bact., 1931, xxxiv., 307.