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THE HEALTH OF THE MAORI.
564
covering collects the products of distilla- Sir Maui Pomare is now Minister of Health in the revapourised and absorbed as the New Zealand cabinet, Dr. Hiroa is director of Maori cigarette burns down to the end. The smoker who hygiene, and the rescue from extinction of one of the re-lights a pipe or cigar, it is stated, probably absorbs finest races in the world substantiates New Zealand’s more poison than he would from ten straightforward claim to have a sensitive health conscience. smokes, whilst chewing and snuff-taking are regarded as not nearly so harmful as smoking, because only a little nicotine is absorbed. There is hardly a single THE PREVENTION OF POST-MORTEM pathological condition, Prof. Kionka says, that INFECTIONS. tobacco cannot cause or aggravate, It sets up sclerotic WE have been sadly reminded in the opening weeks and necrotic changes in the heart and large vessels, examinations are not causes colour-blindness and scotoma, damages the of this year that post-mortem in this branch of those risk to without engaged the hearing by causing swelling and congestion in inner ear, and, in specially disposed subjects, will professional work, for two pathologists have recently died as the direct result of infected fingers due to produce a toxic psychosis or any of the minor psychic minor injuries received in the course of a routine and nervous troubles that go with cumulative poisonThe gravity of the position cannot beautopsy. habitof the all other Like ing sympathetic system. from sensational headlines of the correctly gauged forming drugs, he continues, it produces worse effects when it is a psychological factor. The ordinary lay press in such cases, nor does it seem possible at
for its paper tion, which
are
smokes because he likes it and cuts down his consumption when he has the familiar symptoms of over-smoking, but the nervous man who uses it to tone his nerves up for brain-work, when he should have learned to control them otherwise, may find himself in a bad way. Provided the poisoning has not continued so long that there are organic changes, says Prof. Kionka, the damage in all cases of chronic nicotinism is largely reparable by stopping all tobacco and purging the system by a course of exercise, baths, and medicine. Iodide of potash is also useful. If nicotine is harmful to adults, he concludes, it is deadly to adolescents, and most civilised countries enforce stringent laws against smoking by young man
people.
____
THE
HEALTH
OF THE MAORI.
LAST year a series of articles appeared in the Post of Wellington, New Zealand, on various aspects of public health activities. These attracted some attention, and the Dominion Department of Health decided to republish them in booklet form under the title of " Striking Facts and Figures " for the information of the general public. The articles and fulfil this are a form of official propaganda purpose well, although unsigned. New Zealand does not appear to admit the claim that to be attractive to the public an article on health must be signed with a famous name. The health of New Zealand has of recent years frequently been held up as an example to other nations. Of the health of the native population little is heard, and it might, perhaps, be thought that this was not so much a subject for pride. Such an idea is, however, shown to be erroneous by the final article which treats of Maori hygiene. Although at first in the hands of the Native Department, in 1901 certain important changes took place, and amongst them was the appointment of Dr. (now Sir Maui) Pomare, the first native graduate in medicine, as medical officer of health under the Health Department. He set in motion at once sanitary reforms among the Maori population which have negatived the pessimistic prediction of the extinction of this fine race. Soon after Dr. Pomare’s appointment nine Maori sanitary inspectors began their work, and in 1905 another Maori health officer, Dr. Te Rangi Hiroa, There are now was appointed to assist Dr. Pomare. over 20 native health nurses at work in the more populous Maori districts, lecturing to the women on the feeding of infants, the care of the sick, and other practical matters. Pamphlets in the native language have been prepared on the feeding of infants, tuberculosis, typhoid, influenza, scabies, among other subjects, and there is a good demand for them. Not mentioned in the booklet is the remarkably low death-rate from cancer among the Maori community discovered by Mr. J. W. Butcher in a statistical study Linked to which attention will later be called. up with preventive work is a certain amount of anthropological research. The social and physical improvement that has taken place since 1900 is attributed to the various measures thus briefly set out.
Evening
the moment to arrive at accurate statistical information of the incidence of infections following post-mortem examinations. The Registrar-General rarely reports more than one death per million in any year from all the injuries due to cutting or piercing instruments. In view of the very large number of autopsies. performed annually, there can be little doubt that disaster follows in an extremely small proportion of cases. Indeed, this is so well recognised in the profession that a feeling of false security is engendered, and small injuries are regarded of no moment. Even if the accident is recognised as potentially serious, there seems to be uncertainty as to what prophylactic measures should be adopted. Among these who work in the pathological departments of the big metropolitan and provincial hospitals familiarity is apt to breed contempt, and often insufficient care is taken to provide facilities for protection and for prompt and adequate treatment. Moreover, any medical man in practice is liable to be called on to perform an autopsy, though he may have but little experience in the technique. Therefore, we commend to the serious attention of all our readers the analysis of the causes of post-mortem injuries and advice as to their prevention, which forms the subject of this week’s article in the Modern Technique in Treatment series. ____
MORBID CHANGES IN PELLAGRA. OPPORTUNITIES for the careful post-mortem examination of the subjects of pellagra are rare in this country. Such an opportunity in the shape of the death of two patients, one suffering from undoubted pellagra and the second a probable case, presenting itself at the Royal Hospital, Edinburgh, has enabled Dr. William Susman, working with a from the Queen’s University, Hoffman toScholarship make a very full and complete report1 Canada, upon the pathological changes in this condition. Dr. Susman finds the oldest and most pronounced lesions in the thyroid gland which shows proliferation of the vesicular epithelium into the vesicles together with fibrosis and a generalised round-celled infiltration, indicating the spread of a toxic product by the lymphatics. Other organs also showing evidence of irritation by some toxic product are the liver, kidneys, and pancreas. The liver is markedly affected, the irritative process resulting in a fibrosis. In the pancreas the degenerative process affects principally the zymogen cells ; the islets of Langerhans are numerous and large, and the cells contain many alpha granules ; many of the islets give evidence of damage in the shape of haemorrhages. The kidneys show peritubular degeneration and fibrosis which, in the opinion of the author, indicates that the causativetoxic product is excreted through these organs. The spinal cord shows a degeneration of the dorsospino-cerebellar tract of a type similar to that described some years ago by Batten and Sandwith. Examination of the faeces by section failed to reveal the presence of amoebae and presumably, since no mention is made 1
Edinburgh Medical Journal, February, 1926, p. 58.
covering collects the products of distilla- Sir Maui Pomare is now Minister of Health in the revapourised and absorbed as the New Zealand cabinet, Dr. Hiroa is director of Maori cigarette burns down to the end. The smoker who hygiene, and the rescue from extinction of one of the re-lights a pipe or cigar, it is stated, probably absorbs finest races in the world substantiates New Zealand’s more poison than he would from ten straightforward claim to have a sensitive health conscience. smokes, whilst chewing and snuff-taking are regarded as not nearly so harmful as smoking, because only a little nicotine is absorbed. There is hardly a single THE PREVENTION OF POST-MORTEM pathological condition, Prof. Kionka says, that INFECTIONS. tobacco cannot cause or aggravate, It sets up sclerotic WE have been sadly reminded in the opening weeks and necrotic changes in the heart and large vessels, examinations are not causes colour-blindness and scotoma, damages the of this year that post-mortem in this branch of those risk to without engaged the hearing by causing swelling and congestion in inner ear, and, in specially disposed subjects, will professional work, for two pathologists have recently died as the direct result of infected fingers due to produce a toxic psychosis or any of the minor psychic minor injuries received in the course of a routine and nervous troubles that go with cumulative poisonThe gravity of the position cannot beautopsy. habitof the all other Like ing sympathetic system. from sensational headlines of the correctly gauged forming drugs, he continues, it produces worse effects when it is a psychological factor. The ordinary lay press in such cases, nor does it seem possible at
for its paper tion, which
are
smokes because he likes it and cuts down his consumption when he has the familiar symptoms of over-smoking, but the nervous man who uses it to tone his nerves up for brain-work, when he should have learned to control them otherwise, may find himself in a bad way. Provided the poisoning has not continued so long that there are organic changes, says Prof. Kionka, the damage in all cases of chronic nicotinism is largely reparable by stopping all tobacco and purging the system by a course of exercise, baths, and medicine. Iodide of potash is also useful. If nicotine is harmful to adults, he concludes, it is deadly to adolescents, and most civilised countries enforce stringent laws against smoking by young man
people.
____
THE
HEALTH
OF THE MAORI.
LAST year a series of articles appeared in the Post of Wellington, New Zealand, on various aspects of public health activities. These attracted some attention, and the Dominion Department of Health decided to republish them in booklet form under the title of " Striking Facts and Figures " for the information of the general public. The articles and fulfil this are a form of official propaganda purpose well, although unsigned. New Zealand does not appear to admit the claim that to be attractive to the public an article on health must be signed with a famous name. The health of New Zealand has of recent years frequently been held up as an example to other nations. Of the health of the native population little is heard, and it might, perhaps, be thought that this was not so much a subject for pride. Such an idea is, however, shown to be erroneous by the final article which treats of Maori hygiene. Although at first in the hands of the Native Department, in 1901 certain important changes took place, and amongst them was the appointment of Dr. (now Sir Maui) Pomare, the first native graduate in medicine, as medical officer of health under the Health Department. He set in motion at once sanitary reforms among the Maori population which have negatived the pessimistic prediction of the extinction of this fine race. Soon after Dr. Pomare’s appointment nine Maori sanitary inspectors began their work, and in 1905 another Maori health officer, Dr. Te Rangi Hiroa, There are now was appointed to assist Dr. Pomare. over 20 native health nurses at work in the more populous Maori districts, lecturing to the women on the feeding of infants, the care of the sick, and other practical matters. Pamphlets in the native language have been prepared on the feeding of infants, tuberculosis, typhoid, influenza, scabies, among other subjects, and there is a good demand for them. Not mentioned in the booklet is the remarkably low death-rate from cancer among the Maori community discovered by Mr. J. W. Butcher in a statistical study Linked to which attention will later be called. up with preventive work is a certain amount of anthropological research. The social and physical improvement that has taken place since 1900 is attributed to the various measures thus briefly set out.
Evening
the moment to arrive at accurate statistical information of the incidence of infections following post-mortem examinations. The Registrar-General rarely reports more than one death per million in any year from all the injuries due to cutting or piercing instruments. In view of the very large number of autopsies. performed annually, there can be little doubt that disaster follows in an extremely small proportion of cases. Indeed, this is so well recognised in the profession that a feeling of false security is engendered, and small injuries are regarded of no moment. Even if the accident is recognised as potentially serious, there seems to be uncertainty as to what prophylactic measures should be adopted. Among these who work in the pathological departments of the big metropolitan and provincial hospitals familiarity is apt to breed contempt, and often insufficient care is taken to provide facilities for protection and for prompt and adequate treatment. Moreover, any medical man in practice is liable to be called on to perform an autopsy, though he may have but little experience in the technique. Therefore, we commend to the serious attention of all our readers the analysis of the causes of post-mortem injuries and advice as to their prevention, which forms the subject of this week’s article in the Modern Technique in Treatment series. ____
MORBID CHANGES IN PELLAGRA. OPPORTUNITIES for the careful post-mortem examination of the subjects of pellagra are rare in this country. Such an opportunity in the shape of the death of two patients, one suffering from undoubted pellagra and the second a probable case, presenting itself at the Royal Hospital, Edinburgh, has enabled Dr. William Susman, working with a from the Queen’s University, Hoffman toScholarship make a very full and complete report1 Canada, upon the pathological changes in this condition. Dr. Susman finds the oldest and most pronounced lesions in the thyroid gland which shows proliferation of the vesicular epithelium into the vesicles together with fibrosis and a generalised round-celled infiltration, indicating the spread of a toxic product by the lymphatics. Other organs also showing evidence of irritation by some toxic product are the liver, kidneys, and pancreas. The liver is markedly affected, the irritative process resulting in a fibrosis. In the pancreas the degenerative process affects principally the zymogen cells ; the islets of Langerhans are numerous and large, and the cells contain many alpha granules ; many of the islets give evidence of damage in the shape of haemorrhages. The kidneys show peritubular degeneration and fibrosis which, in the opinion of the author, indicates that the causativetoxic product is excreted through these organs. The spinal cord shows a degeneration of the dorsospino-cerebellar tract of a type similar to that described some years ago by Batten and Sandwith. Examination of the faeces by section failed to reveal the presence of amoebae and presumably, since no mention is made 1
Edinburgh Medical Journal, February, 1926, p. 58.