THE INCIDENCE OF EYE DISEASES.

826 in France, and at present the proportion of immigrants under treatment is small. Undoubtedly a serious factor is that only a small proportion of infected women present themselves for treatment at the dis"Ne quid nimis." pensaries. In 1927, out of 611 new cases of syphilis,409 patients were men and 202 women. It is sugTHE INCIDENCE OF EYE DISEASES. gested that an intensive campaign should be undertaken among women and that better arrangements AT the Royal Society of Medicine last week Mr. for privacy should be made in the dispensaries. Cyril 11. Walker inaugurated his term of office as Unfortunately it is only too common for patients an President of the Ophthalmological Section by as soon as the external signs of to trrXaent give up address on Some Recent Changes in the Incidence of about a third the disease nave disappeared. Ophthalmic Diseases. Several diseases of the eyes, follow their treatment regularly, Only and more than half’ he said, which used to be extremely common are now it up after a few injections. Here social workers comparatively rare, at any rate in Bristol and the give can be of great help ; also the loss of time through surrounding district. One of these was blepharitis of the lids in both the squamous and pustular varieties ; attendance at the dispensary should be reduced to another was phlyctenular disease of the conjunctiva a minimum. Teanselme and Burnier consider that and cornea. The diminution of blepharitis was no many medical practitioners are not up to date in doubt due to the improvement in the cleanliness of their methods of diagnosis and treatment, so that children of the hospital class, and of phlyctenular valuable time is lost at the onset of the disease, whiledisease to an improvement in their nutrition, due the patient spreads infection. They urge that every to the general raising of the level of wages since medical student, without exception, should be the war. Even more encouraging was the drop in the obliged to take a course of training in a venereal incidence of ophthalmia neonatorum. The percentage diseases department, and that all dispensaries should of children in a Bristol blind school who have lost their be regarded as schools where practitioners may come improve their technique. They believe that sight owing to this disease is not more than a quarter to of what it was 50 years ago. In Bristol the number of clandestine prostitution is considerably increasing in Paris, and that this is contributing to the endemic cases notified fell from 137 in 1922 to 59 in 1927. This of syphilis. It will be remembered that France is decrease is and recent remarkable, may perhaps quite be attributed to more efficient prophylaxis by one of the few remaining countries where State midwives and the earlier treatment secured. In regulation of prostitution is still in force, but the Bristol the routine use of silver nitrate for prophy- number of women arrested for infringing the police laxis had been abandoned and a 1 per cent. solution regulations has regularly increased during the past, of mercurochrome substituted. Syphilitic iritis was five years. now becoming one of the uncommon affections of the RECENT WORK ON SPRUE. eye, and lamellar cataract, associated with defective enamel of the teeth and rickets, was now seldom seen. A DEFINITE and serious attempt has been made at Perhaps even more remarkable was the comparative the Haffkine Institute, Bombay, to unravel the rarity of cases of genuine primary acute glaucoma. mysteries of sprue. F. P. Mackie and his fellow Whether this was due to the fact that many cases workers have already published in the Indian Journal which would formerly have been diagnosed as primary of Medical Research a series of papers on the bioare now found to be secondary is a matter on which chemistry of this important and widespread disease, The idea and now in conjunction with G. D. Chitre, he has Mr. Walker did not express an opinion. that it had anything to do with the indiscriminate use once more tackled the vexed question of its exact of atropine by the general practitioner in former daysI to yeasts. In a profusely illustrated study’ relationship he rejected as a libel on his older colleagues in general they recount investigations showing that whilst the practice. yeast fungus, known as lllonilia psilosis, originally All this is very encouraging and the question may described by Ashford, can be found in 40 per cent. of be asked : Why, then, is the number of patients cases of sprue in Bombay, an identical organism is attending eye hospitals and eye departments as great I, present with equal frequency in other intestinal or greater than it ever was before ? The greater care ’, diseases as well as in healthy individuals and animals. which is now devoted to the correction of refractive The work have done gives no support to the they errors is doubtless the principal reason, but not view that 11-1. psilosis (so-called), or any other yeast-like the sole one. There are some serious eye diseases has any causative relationship to studied, organisms which show no sign of diminution. Though acute sprue. Their study of the structure and life-history primary glaucoma is rare, chronic glaucoma is as of intestinal yeasts leads them to think, moreover, common as ever. Certain forms of cyclitis associated that the value of the fermentative properties of these with keratitis punctata are even more common as a basis of classification has been much organisms than formerly. Although cases of lamellar cataract over-estimated and that really the human intestinal are seldom seen, senile cataract still afflicts a certain are relatively few in species and are much more yeasts proportion of the population over middle age, and so easily classified on broad lines into a few distinct far as its pathology and prevention go, presents types. The variability of strains on subculture is very problems which are as yet completely unsolved. great, and Mackie and Chitre urge that it is unscientific to create a large number of species on inconstant characters. The net result of their labour is wholly SYPHILIS IN PARIS. negative, but it has cleared the air for further investiTHE latest figures suggest that syphilis is on the gation and has definitely brought to an end much The venereal diseases dispensary work on the yeast theory of sprue which was unsound increase in Paris. at the H6pital Saint Louis, which receives patients and required refutal. At the same time it has borne from all over Paris and the surrounding districts, out the results of Manson-Bahr’s research in Ceylon in 1912-14, which was published in a report to the reports that the number of cases, after having fallen London School of Tropical Medicine in 1915.2 The regularly from 1920 to 1924, began to rise again in conclusions reached at that time were that the veast each the has risen number and since then 1925, year, of new cases registered in 1927 being almost exactly fungi found in sprue were indistinguishable from the what it was in 1920. Various possible explanations thrush fungus (M. albicans) and that their exact for this state of affairs are discussed by Jeanseime 1 Indian Medical Research Memoirs. No. 11. (Supplementary and Burnier.1 At one time, they point out, it was Series to the Indian Journal of Medical Research.) Yeasts and that the disease was being imported by Sprue. By Lieut.-Colonel F. P. Mackie, I.M.S., and G. D. Chitre, thought B.M.S. Published for the Indian Research Fund Association by immigrants, but it was found that 80 per cent. of Thacker, Spink, and Co., Calcutta. Pp. 39. Price Rs.3. 12 annas, the under treatment had become infected

Annotations.

____

foreigners

1 Bull. de l’Acad. de Méd., 1928, c., 749.

or

5s. 2 A Report

on Researches on Sprue in Ceylon. mbridge University Press, 1915.

1912-1914.