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SYPHILIS IN THE NEGRO.
523
light
as
as
ordinary
coal gas.
Helium is very widely
distributed in nature, it is present in minute proportion in the atmosphere, and occurs to the extent of 1.5r per cent. or more in the natural gas of Kansas.
It is vastly safe as a buoyant agent, for it is not ,only non-inflammable, but it has hitherto resisted every effort to make it combine with other elements. The terrible disaster will not sound the knell of the airship or prevent men from risking their lives in its further development, but it should and must turn the minds of our rulers to insist on every avenue of safety being explored, even if helium has to be
fetched from America and
to
consume
new
engines designed
heavier fuel.
SYPHILIS IN THE NEGRO. Dr. Ernest L. Zimmermann, of Baltimore, has undertaken a comparative study of syphilis in whites and negroes for the purpose of emphasising inherited racial differences in response to syphilitic infection. ’The paper is based on the study of 1843 cases in the Johns Hopkins Dispensary, a charitable clinic in which approximately 60 per cent. coloured and 40 per cent. white patients are treated. The race and sex distribution of the cases was as follows : .596 white males, 521 coloured males, 297 white females, and 429 coloured females. It was found that in negroes a much greater number of infections occur before the twentieth year than in whites. Over 50 per cent. of the female patients become infected before their twenty-first year, a, fact explained by their early indulgence in promiscuous sexual intercourse, the greater frequency of syphilis in the negro Tace, and the sexual indulgence of the negro male in spite of the presence of primary or secondary lesions. No differences were noted in the character of the chancre in the two races, the more pronounced induration described by Morrison in the negro not being observed. Dr. Zimmermann’s experience confirms that of other writers as to the rarity of extragenital chancres in the negro, only 5 out of 27 such chancres in this series being found in coloured patients. Secondary syphilis in the negro was characterised by marked polyadenitis, frequent and severe osteoarthritic symptoms, by the frequency of iritis, and by the high incidence of follicular and pustular syphilides. Though secondarv lesions of the mouth and pharynx exclusive of diffuse erythema were commoner among the white patients, moist papules and condylomata were much commoner in the coloured race, especially in the female. The annular papular syphilide first described by Atkinson in 1882 under the name of syphiloderma papulatum circiwas unusually frequent in the negro. Tertiary syphilis in the black race was characterised by the predominance of osseous lesions which were twice as frequent as in white patients in whom neurosyphilis
natum
much commoner, and constituted about half of the late manifestations. Cardio-vascular syphilis, as had also been found by Osler and Janeway at the Johns Hopkins Hospital, was relatively more frequent in Dr. Zimmermann’s negro patients with an incidence of two to one in coloured and white males respectively. Cerebro-spinal syphilis, including both the meningitic and endarteritic forms, was approximately of equal frequency in both races. Cerebral endarteritis was particularly frequent in black patients, being observed in 20 negroes and in only 9 whites. Tabes was diagnosed in 94 white and in 14 coloured patients, and general paresis in 24 white and only 4 coloured patients. Dr. Zimmermann concludes that there are inherited biological differences between white and negro patients as regards syphilitic infection. The negro develops intense reactions in the cutaneous and osseous structures, and is relatively free from tabes and paresis. In white patients absence of, or only slight development of, skin manifestations is more frequent than in the negro, but there is a greater tendency to tabes and general paresis. was
1 Archives of Dermatology and Syphilology, July, 1921.
THE
MAUDSLEY
HOSPITAL.
THE third course of instruction for the diploma in psychological medicine opens at the Maudsley Hospital on Monday. Oct. 3rd. On that day, at 2.:30 P.M.,
Sir Frederick Mott gives the first of a series of six lectures on the Pathology of Mental Diseases, and at 5 P.M. Dr. Bernard Ilart clelivers the first of eight On Wednesday, lectures on the Psychoneuroses. Oct. Gth, at 2.30 P.M., Dr. F. C. Shrubsall lectures on the Practical Aspect of Mental Deficiency, and at 4.30 P.M., Dr. W. C. Sullivan commences a series on Crime and Insanity. On Thursday, Oct. 6th, at 2.30 P.M., Dr. C. 11. Bond takes up the Differential Diagnosis and Treatment of Mental Disorders, and at 4.:30 P.M. Dr. E. Mapother lectures on the Symptoms of Mental Disease. Six clinical demonstrations will be given on Tuesdays, 2.30 P.M., at the Maida Vale Hospital for Paralysis and Epilepsy, by Dr. F. Golla, commencing Oct. 1th, Sir F. Mott continuing the series. It should hardly be necessary to call attention to the importance of the Maudsley Hospital as a school of psychological medicine. In line as it is with the forward movement in mental medicine on its preventive side, this institution cannot be allowed to fall a victim to the very natural spirit of economy at present prevailing at the London County Council. Medical men in London will lose no opportunity of making their opinion effectively known in this regard. EXPERIMENTS ON
LIVING ANIMALS.1
UNDER this title a return has been issued over the of Sir George Thane for England and Scotland, and of Dr. M. C. McKenna for Ireland. Full details are tabulated of the places registered for vivisection, of the licensees with their qualifications, and of the number and nature of the experiments performed. Sir George Thane in his report makes it clear that the utmost precautions must be taken by investigators to avoid pain and sepsis, not only in the interests of the animals, but in order to ensure successful results. It is unnecessary here to set out the limitations imposed on licensees working under the various certificates issued, as medical men are well aware of the strict supervision of all biological research. Most workers will have received unexpected visits from inspectors, and the tribute paid to licensees for their attention, not only to the actual requirements of the Act but to the suitable lodging and general well-being of the animals, will be received with satisfaction. Seven technical irregularities only are noted, six due to inadvertence or misapprehension, and in the seventh case only, where experiments needing Certificate B were performed by a licensee holding only Certificate A, was the outstanding application for the required certificate refused. Distortion of the true facts relating to experimental medicine can best be refuted by reference to official statements, and an accessible copy of the current report might well be on the medical man’s bookshelf.
signatures
Sir Walter Fletcher will preside over the Section of Physiology of the British Association to be held at Edinburgh next week and will speak on the part played by physiology in the war. 1
H.M. Stationery Office.
Price 6d.
RADCLIFFE INFIRMARY, OXFORD.-The successful course held in October last year is being year from Oct. 3rd-8th. The subjects for discussion include the Cause of Diseases of Joints (Sir A. Garrod), Modern Views of Heart Disease (Dr. W. Collier), Some Cases in the Later Stages of Syphilis (Dr. E. Mallam), while the surgeons will operate at stated times, and demonstrations will be given in the wards and special departments. Dinner in Queen’s College Hall on Saturday evening completes the week. Further information from Dr. Hugh Whitelocke, Secretary to the Committee, 0, Banbury-road, Oxford.
post-graduate repeated this
light
as
as
ordinary
coal gas.
Helium is very widely
distributed in nature, it is present in minute proportion in the atmosphere, and occurs to the extent of 1.5r per cent. or more in the natural gas of Kansas.
It is vastly safe as a buoyant agent, for it is not ,only non-inflammable, but it has hitherto resisted every effort to make it combine with other elements. The terrible disaster will not sound the knell of the airship or prevent men from risking their lives in its further development, but it should and must turn the minds of our rulers to insist on every avenue of safety being explored, even if helium has to be
fetched from America and
to
consume
new
engines designed
heavier fuel.
SYPHILIS IN THE NEGRO. Dr. Ernest L. Zimmermann, of Baltimore, has undertaken a comparative study of syphilis in whites and negroes for the purpose of emphasising inherited racial differences in response to syphilitic infection. ’The paper is based on the study of 1843 cases in the Johns Hopkins Dispensary, a charitable clinic in which approximately 60 per cent. coloured and 40 per cent. white patients are treated. The race and sex distribution of the cases was as follows : .596 white males, 521 coloured males, 297 white females, and 429 coloured females. It was found that in negroes a much greater number of infections occur before the twentieth year than in whites. Over 50 per cent. of the female patients become infected before their twenty-first year, a, fact explained by their early indulgence in promiscuous sexual intercourse, the greater frequency of syphilis in the negro Tace, and the sexual indulgence of the negro male in spite of the presence of primary or secondary lesions. No differences were noted in the character of the chancre in the two races, the more pronounced induration described by Morrison in the negro not being observed. Dr. Zimmermann’s experience confirms that of other writers as to the rarity of extragenital chancres in the negro, only 5 out of 27 such chancres in this series being found in coloured patients. Secondary syphilis in the negro was characterised by marked polyadenitis, frequent and severe osteoarthritic symptoms, by the frequency of iritis, and by the high incidence of follicular and pustular syphilides. Though secondarv lesions of the mouth and pharynx exclusive of diffuse erythema were commoner among the white patients, moist papules and condylomata were much commoner in the coloured race, especially in the female. The annular papular syphilide first described by Atkinson in 1882 under the name of syphiloderma papulatum circiwas unusually frequent in the negro. Tertiary syphilis in the black race was characterised by the predominance of osseous lesions which were twice as frequent as in white patients in whom neurosyphilis
natum
much commoner, and constituted about half of the late manifestations. Cardio-vascular syphilis, as had also been found by Osler and Janeway at the Johns Hopkins Hospital, was relatively more frequent in Dr. Zimmermann’s negro patients with an incidence of two to one in coloured and white males respectively. Cerebro-spinal syphilis, including both the meningitic and endarteritic forms, was approximately of equal frequency in both races. Cerebral endarteritis was particularly frequent in black patients, being observed in 20 negroes and in only 9 whites. Tabes was diagnosed in 94 white and in 14 coloured patients, and general paresis in 24 white and only 4 coloured patients. Dr. Zimmermann concludes that there are inherited biological differences between white and negro patients as regards syphilitic infection. The negro develops intense reactions in the cutaneous and osseous structures, and is relatively free from tabes and paresis. In white patients absence of, or only slight development of, skin manifestations is more frequent than in the negro, but there is a greater tendency to tabes and general paresis. was
1 Archives of Dermatology and Syphilology, July, 1921.
THE
MAUDSLEY
HOSPITAL.
THE third course of instruction for the diploma in psychological medicine opens at the Maudsley Hospital on Monday. Oct. 3rd. On that day, at 2.:30 P.M.,
Sir Frederick Mott gives the first of a series of six lectures on the Pathology of Mental Diseases, and at 5 P.M. Dr. Bernard Ilart clelivers the first of eight On Wednesday, lectures on the Psychoneuroses. Oct. Gth, at 2.30 P.M., Dr. F. C. Shrubsall lectures on the Practical Aspect of Mental Deficiency, and at 4.30 P.M., Dr. W. C. Sullivan commences a series on Crime and Insanity. On Thursday, Oct. 6th, at 2.30 P.M., Dr. C. 11. Bond takes up the Differential Diagnosis and Treatment of Mental Disorders, and at 4.:30 P.M. Dr. E. Mapother lectures on the Symptoms of Mental Disease. Six clinical demonstrations will be given on Tuesdays, 2.30 P.M., at the Maida Vale Hospital for Paralysis and Epilepsy, by Dr. F. Golla, commencing Oct. 1th, Sir F. Mott continuing the series. It should hardly be necessary to call attention to the importance of the Maudsley Hospital as a school of psychological medicine. In line as it is with the forward movement in mental medicine on its preventive side, this institution cannot be allowed to fall a victim to the very natural spirit of economy at present prevailing at the London County Council. Medical men in London will lose no opportunity of making their opinion effectively known in this regard. EXPERIMENTS ON
LIVING ANIMALS.1
UNDER this title a return has been issued over the of Sir George Thane for England and Scotland, and of Dr. M. C. McKenna for Ireland. Full details are tabulated of the places registered for vivisection, of the licensees with their qualifications, and of the number and nature of the experiments performed. Sir George Thane in his report makes it clear that the utmost precautions must be taken by investigators to avoid pain and sepsis, not only in the interests of the animals, but in order to ensure successful results. It is unnecessary here to set out the limitations imposed on licensees working under the various certificates issued, as medical men are well aware of the strict supervision of all biological research. Most workers will have received unexpected visits from inspectors, and the tribute paid to licensees for their attention, not only to the actual requirements of the Act but to the suitable lodging and general well-being of the animals, will be received with satisfaction. Seven technical irregularities only are noted, six due to inadvertence or misapprehension, and in the seventh case only, where experiments needing Certificate B were performed by a licensee holding only Certificate A, was the outstanding application for the required certificate refused. Distortion of the true facts relating to experimental medicine can best be refuted by reference to official statements, and an accessible copy of the current report might well be on the medical man’s bookshelf.
signatures
Sir Walter Fletcher will preside over the Section of Physiology of the British Association to be held at Edinburgh next week and will speak on the part played by physiology in the war. 1
H.M. Stationery Office.
Price 6d.
RADCLIFFE INFIRMARY, OXFORD.-The successful course held in October last year is being year from Oct. 3rd-8th. The subjects for discussion include the Cause of Diseases of Joints (Sir A. Garrod), Modern Views of Heart Disease (Dr. W. Collier), Some Cases in the Later Stages of Syphilis (Dr. E. Mallam), while the surgeons will operate at stated times, and demonstrations will be given in the wards and special departments. Dinner in Queen’s College Hall on Saturday evening completes the week. Further information from Dr. Hugh Whitelocke, Secretary to the Committee, 0, Banbury-road, Oxford.
post-graduate repeated this