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THE BOOKS GO ROUND
570 Even the work-shy student, with ears like the deaf adder’s for the lecturer’s drone and eyes revolted by the sight of type, might be stimulated by cinematic tuition. Young men and maidens have been known to cut lectures ; they seldom miss the flicks. The movie has one priceless perquisite. Time is no object : a thousand years is as a day, and a day as a thousand years, just a function of the’ speed of the clockwork. Fifty years ago Muybridge’s slow-motion pictures taught us how we run and jump ; the name of Canti stands for the quick-motion solution of the solemn process of tissue culture. The film is not just an adjuvant to the news story, it is the only way of the home bringing rhythm of life. THE -
BOOKS GO
ROUND
THE International Guild of Hospital Librarians is not to be put off by a mere blitz. Some hospitals have lost the better part of their libraries along with much else ; others have been more fortunate’. Book Trolley for October tells of volumes repaired, librarians appointed, patients giving a capable hand, and service steadily maintained. There are stories of resource, too-of the librarian who met the needs of two Polish airmen with seven Polish books and a dictionary, and trained a oneauthor man (the author was Nat Gould) to nibble at Zane Grey and then by gradual degrees to swallow most of John Buchan and a stiff dose of Cronin. This reading habit grows on us with war. Nor are the troops forgotten. The Red Cross and St. John Hospital Library has been developing into a vigorous and widespread service since the war began. Bales of books are being sent out regularly to the depots and hospitals in the Middle East, Kenya, Iraq, Iceland, West Africa and Gibraltar, as well as the sick quarters of the Navy and R.A.F. During the summer books and magazines have been sent out at home and abroad at the rate of more than twenty thousand a month. The books which come in from donors have to be sifted, for many people anxious to be of service have sent along all manner of books, regardless of aptness for the purpose. Thus " A Treatise on Elephants " has been known to arrive cheek by jowl with " Better Bed Manners." At home war has made for useful decentralisation; book depots have been established in every county of England and Wales and in many provincial cities. They collect and distribute, sort and mend books. Voluntary librarians sometimes helped by professionals have been appointed who have been able to meet the needs of patients methodically, thanks to the experience gained in the library service during the past twenty years.
examination of the
lungs gave very misleading primary pulmonary’ infection could not be diagnosed by stethoscopy, and tuberculous could not be distinguished from non-tuberculous pneumonia. As a general rule a high erythrocyte-sedimentation rate was Physical
results;
found to indicate an exudative lesion, whereas a low one pointed either to a healing lesion or to a caseous or advanced tuberculous focus with bad prognosis. An analysis of the source of infection in 38 cases, most of them under 5, showed that the father was the source of infection in 12 and the mother in 9. In attempting to correlate the housing conditions with the incidence of tuberculosis it was noted that the tuberculinisation of the childhood community appeared to be evenly distributed among all classes of dwelling, but that the slum child had much greater difficulty in healing his tuberculous lesion. The word " slum " is used in the report to indicate " one room in a tenement house, basement, The report tabulates a number or dilapidated cottage." of possible measures for meeting the situation. Excluding as impracticable the removal of a child exposed to infection under some sort of Grancher system, or the removal of the infecting adult by compulsory segregation, Dr. Price considers that the best method of prevention is early diagnosis, combined with prophylactic vaccination, increased institutional accommodation, and educational propaganda. PNEUMOCOCCAL
MENINGITIS
ALTHOUGH
pneumococcal meningitis is comparatively rare-only 7% of Neal’s3131 collected cases of acute and chronic meningitis were pneumococcal-it was until the introduction of the sulphonamides almost invariably fatal. Perhaps more often secondary than primary, with otitis media and pneumonia the commonest primary infections, pneumococcal meningitis affects young children and elderly people more than it does other age-groups, having in this respect some resemblance to bronchopneumonia. While any one of the 30-odd pneumococcus types may be the infecting agent, type in pneumococcus is the most common single type in this infection and is particularly associated with meningitis in older patients as a sequel to an insidious otitis media or mastoiditis. Since sulphanilamide is effective against this type, determination of the pneumococcus type in meningitis is probably always worth while, for some patients do not easily tolerate sulphapyridine. Indeed the good results obtained with sulphanilamide in the treatment of pneumococcal meningitis (including types other than type in) have prompted Steele and Gottlieb2 in a recent review to rank it alongside sulphapyridine, which besides being more toxic is less uniformly TUBERCULOSIS IN DUBLIN CHILDREN absorbed. Howard3 in his report of the recovery of a THE tuberculosis mortality of the child population of child aged 1 year-a very rare occurrence at this age even Dublin City for the years 1930-36 was 8 per 10,000 in these sulphonamide days-suggests that sulphachildren in the age-groups 0-15, and for 1937-39, 7 per thiazole is the drug of choice. If so, it must be given at 10,000. These figures led the Irish Paediatric Association regular four-hourly intervals for its rapid excretion to make a tuberculin survey in the hospitals of the city makes a constant concentration in the tissues difficult to and a report compiled by Dr. Dorothy Price has now been maintain. No-one will now deny that all three of these issued.l Six hospitals participated in the survey, and sulphonamides can miraculously save patients with the tuberculin test employed throughout the investigation pneumococcal meningitis, but it is not easy to say what was the Hamburger percutaneous ointment. The proportion of treated cases do actually recover, for it is association are well satisfied with this as an initial test, inevitable that successes will be published more often finding it reliable, simple and painless. A group of 1121 than failures, and an analysis of the published cases is children were tested in the age-groups 0-14, -of whom 230 not a fair criterion of the case-fatality under sulphonreacted. The reactors at all ages were thus 20-5% of amide therapy. This point is exemplified in the series the total tested, the percentage increasing from 4-6 in of 14 cases with only one recovery recorded by Cooke.4
the 0-1 year group to 46-1 in the 10-14 year group. Sex-incidence showed a slight preponderance of female positive reactors (4%). No less than 22 unsuspected cases of active tuberculosis were diagnosed by means of the test. The radiological findings in 116 of the children with positive reactions showed -that 67 were suffering from active lesions which required treatment ; 6 died. 1. Irish J. med.
Sci. July, 1941, p. 241.
It will be noted that of his fourteen cases nine were over 45 years of age land two under 2 years which from the prognostic viewpoint are the unfavourable age-groups with sulphonamide therapy : the recovered patient was aged 22. Apart from age, probably the most important 1. Neal, J. B. J. Amer. med. Ass. 1935, 105, 568. 2. Steele, C. A. and Gottlieb, J. Arch. intern. Med. 1941, 68, 211. 3. Howard, S. J. Lancet, Nov. 1, 1941, p. 512. 4. Cooke, W. T. Ibid, p. 510.
BOOKS GO
ROUND
THE International Guild of Hospital Librarians is not to be put off by a mere blitz. Some hospitals have lost the better part of their libraries along with much else ; others have been more fortunate’. Book Trolley for October tells of volumes repaired, librarians appointed, patients giving a capable hand, and service steadily maintained. There are stories of resource, too-of the librarian who met the needs of two Polish airmen with seven Polish books and a dictionary, and trained a oneauthor man (the author was Nat Gould) to nibble at Zane Grey and then by gradual degrees to swallow most of John Buchan and a stiff dose of Cronin. This reading habit grows on us with war. Nor are the troops forgotten. The Red Cross and St. John Hospital Library has been developing into a vigorous and widespread service since the war began. Bales of books are being sent out regularly to the depots and hospitals in the Middle East, Kenya, Iraq, Iceland, West Africa and Gibraltar, as well as the sick quarters of the Navy and R.A.F. During the summer books and magazines have been sent out at home and abroad at the rate of more than twenty thousand a month. The books which come in from donors have to be sifted, for many people anxious to be of service have sent along all manner of books, regardless of aptness for the purpose. Thus " A Treatise on Elephants " has been known to arrive cheek by jowl with " Better Bed Manners." At home war has made for useful decentralisation; book depots have been established in every county of England and Wales and in many provincial cities. They collect and distribute, sort and mend books. Voluntary librarians sometimes helped by professionals have been appointed who have been able to meet the needs of patients methodically, thanks to the experience gained in the library service during the past twenty years.
examination of the
lungs gave very misleading primary pulmonary’ infection could not be diagnosed by stethoscopy, and tuberculous could not be distinguished from non-tuberculous pneumonia. As a general rule a high erythrocyte-sedimentation rate was Physical
results;
found to indicate an exudative lesion, whereas a low one pointed either to a healing lesion or to a caseous or advanced tuberculous focus with bad prognosis. An analysis of the source of infection in 38 cases, most of them under 5, showed that the father was the source of infection in 12 and the mother in 9. In attempting to correlate the housing conditions with the incidence of tuberculosis it was noted that the tuberculinisation of the childhood community appeared to be evenly distributed among all classes of dwelling, but that the slum child had much greater difficulty in healing his tuberculous lesion. The word " slum " is used in the report to indicate " one room in a tenement house, basement, The report tabulates a number or dilapidated cottage." of possible measures for meeting the situation. Excluding as impracticable the removal of a child exposed to infection under some sort of Grancher system, or the removal of the infecting adult by compulsory segregation, Dr. Price considers that the best method of prevention is early diagnosis, combined with prophylactic vaccination, increased institutional accommodation, and educational propaganda. PNEUMOCOCCAL
MENINGITIS
ALTHOUGH
pneumococcal meningitis is comparatively rare-only 7% of Neal’s3131 collected cases of acute and chronic meningitis were pneumococcal-it was until the introduction of the sulphonamides almost invariably fatal. Perhaps more often secondary than primary, with otitis media and pneumonia the commonest primary infections, pneumococcal meningitis affects young children and elderly people more than it does other age-groups, having in this respect some resemblance to bronchopneumonia. While any one of the 30-odd pneumococcus types may be the infecting agent, type in pneumococcus is the most common single type in this infection and is particularly associated with meningitis in older patients as a sequel to an insidious otitis media or mastoiditis. Since sulphanilamide is effective against this type, determination of the pneumococcus type in meningitis is probably always worth while, for some patients do not easily tolerate sulphapyridine. Indeed the good results obtained with sulphanilamide in the treatment of pneumococcal meningitis (including types other than type in) have prompted Steele and Gottlieb2 in a recent review to rank it alongside sulphapyridine, which besides being more toxic is less uniformly TUBERCULOSIS IN DUBLIN CHILDREN absorbed. Howard3 in his report of the recovery of a THE tuberculosis mortality of the child population of child aged 1 year-a very rare occurrence at this age even Dublin City for the years 1930-36 was 8 per 10,000 in these sulphonamide days-suggests that sulphachildren in the age-groups 0-15, and for 1937-39, 7 per thiazole is the drug of choice. If so, it must be given at 10,000. These figures led the Irish Paediatric Association regular four-hourly intervals for its rapid excretion to make a tuberculin survey in the hospitals of the city makes a constant concentration in the tissues difficult to and a report compiled by Dr. Dorothy Price has now been maintain. No-one will now deny that all three of these issued.l Six hospitals participated in the survey, and sulphonamides can miraculously save patients with the tuberculin test employed throughout the investigation pneumococcal meningitis, but it is not easy to say what was the Hamburger percutaneous ointment. The proportion of treated cases do actually recover, for it is association are well satisfied with this as an initial test, inevitable that successes will be published more often finding it reliable, simple and painless. A group of 1121 than failures, and an analysis of the published cases is children were tested in the age-groups 0-14, -of whom 230 not a fair criterion of the case-fatality under sulphonreacted. The reactors at all ages were thus 20-5% of amide therapy. This point is exemplified in the series the total tested, the percentage increasing from 4-6 in of 14 cases with only one recovery recorded by Cooke.4
the 0-1 year group to 46-1 in the 10-14 year group. Sex-incidence showed a slight preponderance of female positive reactors (4%). No less than 22 unsuspected cases of active tuberculosis were diagnosed by means of the test. The radiological findings in 116 of the children with positive reactions showed -that 67 were suffering from active lesions which required treatment ; 6 died. 1. Irish J. med.
Sci. July, 1941, p. 241.
It will be noted that of his fourteen cases nine were over 45 years of age land two under 2 years which from the prognostic viewpoint are the unfavourable age-groups with sulphonamide therapy : the recovered patient was aged 22. Apart from age, probably the most important 1. Neal, J. B. J. Amer. med. Ass. 1935, 105, 568. 2. Steele, C. A. and Gottlieb, J. Arch. intern. Med. 1941, 68, 211. 3. Howard, S. J. Lancet, Nov. 1, 1941, p. 512. 4. Cooke, W. T. Ibid, p. 510.