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THE PROGNOSTIC SIGNIFICANCE OF SCARLATINAL NEPHRITIS.
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nephritis developed orthostatic albuminuria was no FIGHT AGAINST MALARIA. greater than the frequency with which this condition LAST summer the Malaria Commission of the League occurs in the general population at the same age. of Nations Health Organisation undertook a tour of Besides, there was no relation between the severity three months for the study of the incidence of malaria of the scarlatinal and the frequency of nephritis in Eastern Europe, visiting Italy, the Balkans, and the subsequent orthostatic albuminuria. Additional Russia, and much valuable information was obtained. value would be given to Dr. Hansborg’s investigations This year, from May to September, the Commission and reassuring conclusions if the former were to be is extending on similar lines its inquiry into malaria repeated on the same material some score of years conditions prevailing in Egypt, Palestine, Syria, hence. eventually Turkey and Asia Minor, Sicily, Corsica, and Spain. At a session now in progress the CommisACTIVATED CARBON. sion, which consists of experts from Great Britain ORDINARY charcoal, and especially bone black, (represented by Colonel S. P. James, of the Ministry is well known to possess considerable properties of of Health), France, Germany, Italy, Poland, Rumania, liquids, absorbing gases, and promoting and Holland, is considering a final report on malaria decolorising chemical reactions. Of recent years a modification in Albania prepared at the request of the Albanian of the element has-been prepared known as activated Government, a request from the Turkish Government in which these properties are very highly for the appointment of an expert to help in organising developed as compared with the best bone black or an anti-malaria campaign in Turkey, and a note from other hitherto known variety of carbon. In the French Government asking for a special inquiry carbon the pores are of almost incredible in Corsica. Finally, the Commission will smallness in size and haveentirely porous walls the appointment of additional corresponding members which are not clogged up with impurities, so that the from British India, the United States, and France, chemical reactivity of the material, on the principle and a report on the question of the employment of of what the chemist terms surface action," is quinine and other cinchona alkaloids against malaria. improvpd out of all proportion. The methods of Owing to the depreciated exchanges, this question of manufacture are complicated and require great the cheapest and most effective drugs to use against experience, one general process, for example, being malaria is of fundamental importance in the work of to carbonise under regulated and definite conditions the Health Organisation on this subject. carefully prepared carbonaceous mixtures, followed by an elaborate purification and extraction. In connexion with the manufacture it is right to mention THE PROGNOSTIC SIGNIFICANCE OF the firm of Sutcliffe, Speakman, and Co., Ltd., of SCARLATINAL NEPHRITIS. Leigh, Lancashire. An important technical application of activated OUR knowledge is still very incomplete as to the duration of the damage inflicted by an attack of carbon is the extraction and purification of gases, espescarlatina on kidneys which, through the acute stage cially the direct separation of motor spirit from the of the disease, have reacted with albuminuria. Is, crude gases evolved in the carbonisation of coal, shale, for example, the small granular kidney, with which and other carbonaceous material, by the use of a bed of the material. When this is saturated steam is blown we are so familiar in the post-mortem room, the final of a of events a series with bout of through, and the motor spirit recovered in an extremely stage beginning scarlatina ? And how long do most cases of scarla- pure condition, thus eliminating a considerable amount tinal nephritis last before albumin disappears from of expensive fractionating plant. In the same way the urine, and what effect, if any, does scarlatinal solvent naphtha and other solvents can be recovered nephritis have on the development of orthostatic and purified, and another valuable outlet is the absorpalbuminuria ? These are some of the questions tion of obnoxious smells and vapours. The decolorwhich Dr. H. Hansborg, of the Blegdam Fever Hospital ising of oils and fats on these lines is almost entirely in Copenhagen, attempts to answer in a paper published a new field and important developments are pending, in Acla Medica Scal1dinavica for Feb. 12th. In the the method being of considerable advantage for the 10-year period, 1911-1920, his hospital admitted purification of tallow, coconut oil, linseed oil, peanut 75 per cent. of all the cases of scarlatina notified in and corn oil, cotton-seed oil, and castor oil. In the Copenhagen. Among the 14,339 cases of scarlatina latter case, for example, fuller’s earth is at present admitted in this period, there were 612 complicated used, but the addition of activated carbon, about by hsemorrhagic nephritis. After subtraction of the 5 per cent. by weight, gives far superior results. For solutions the material is finding the most extensive cases which proved fatal in the acute stage of the disease, there remained 588 patients, 284 of whom application, especially for cane-sugar, glucose, were re-examined from one to ten years after discharge, brewing sugars (maltose and lactose), tartaric acid, the heart and blood pressure as well as the urine cream of tartar, citric acid, lactic acid, and organic being investigated. Dr. Hansborg made a point of compounds used as intermediates in dyestuff examining the morning urine in those cases in which manufacture, together also for the extraction of gold orthostatic albuminuria was suspected, and he found from excessively dilute solution 1 part per 10,000,000 that among the 284 ex-patients there were 23 who in the cyanide process. The purification of ordinary alcohol and the extraction of higher toxic alcohols were suffering from albuminuria which was merely orthostatic. There was one patient found to be (fusel oil) is another similar application. In applying suffering from chronic nephritis, the characters of the treatment to liquids generally the activated which distinguished it from that of scarlatina, and carbon is as a rule simply stirred up with the heated there was only one patient whose albuminuria, which liquid for a short period and then blown through had lasted for five years, could be reasonably regarded filter presses, the product being subsequently revived As many as by various methods after acting for a number of as a sequel to the scarlatinal nephritis. 259 of the re-examined ex-patients showed no evidence times. Thus it may be boiled with water, re-burnt, of renal disease. Of these 259 patients, as many as or treated with acids or alkalies, and the method is 235 were already albumin-free when discharged capable of almost endless applications, especially, from the fever hospital. Several of the remaining as already indicated, different carbons may be sup24 patients took more than a year after discharge to plied for absorbing different materials, whether get rid of their albuminuria. With regard to the 23 from liquids or gases. Activated carbon possesses patients found on re-examination to be suffering considerable interest from a medicinal point of view from orthostatic albuminuria, Dr. Hansborg raises since it is used in the tablet or powder form for the the question, May this condition be the result, of a correction of flatulence, dyspepsia, and diarrhoea, and is haemorrhagic nephritis developing during an attack said to be much superior in this respect to ordinary of scarlatina ? One of his reasons for answering this powdered charcoal. Indirectly it is of great value question in the negative is that the frequency with also in many different directions in the manufacture which patients who had suffered from scarlatinal of pharmaceutical products, both for decolorising THE
____
Icarbon I any B consideractivated
I
nephritis developed orthostatic albuminuria was no FIGHT AGAINST MALARIA. greater than the frequency with which this condition LAST summer the Malaria Commission of the League occurs in the general population at the same age. of Nations Health Organisation undertook a tour of Besides, there was no relation between the severity three months for the study of the incidence of malaria of the scarlatinal and the frequency of nephritis in Eastern Europe, visiting Italy, the Balkans, and the subsequent orthostatic albuminuria. Additional Russia, and much valuable information was obtained. value would be given to Dr. Hansborg’s investigations This year, from May to September, the Commission and reassuring conclusions if the former were to be is extending on similar lines its inquiry into malaria repeated on the same material some score of years conditions prevailing in Egypt, Palestine, Syria, hence. eventually Turkey and Asia Minor, Sicily, Corsica, and Spain. At a session now in progress the CommisACTIVATED CARBON. sion, which consists of experts from Great Britain ORDINARY charcoal, and especially bone black, (represented by Colonel S. P. James, of the Ministry is well known to possess considerable properties of of Health), France, Germany, Italy, Poland, Rumania, liquids, absorbing gases, and promoting and Holland, is considering a final report on malaria decolorising chemical reactions. Of recent years a modification in Albania prepared at the request of the Albanian of the element has-been prepared known as activated Government, a request from the Turkish Government in which these properties are very highly for the appointment of an expert to help in organising developed as compared with the best bone black or an anti-malaria campaign in Turkey, and a note from other hitherto known variety of carbon. In the French Government asking for a special inquiry carbon the pores are of almost incredible in Corsica. Finally, the Commission will smallness in size and haveentirely porous walls the appointment of additional corresponding members which are not clogged up with impurities, so that the from British India, the United States, and France, chemical reactivity of the material, on the principle and a report on the question of the employment of of what the chemist terms surface action," is quinine and other cinchona alkaloids against malaria. improvpd out of all proportion. The methods of Owing to the depreciated exchanges, this question of manufacture are complicated and require great the cheapest and most effective drugs to use against experience, one general process, for example, being malaria is of fundamental importance in the work of to carbonise under regulated and definite conditions the Health Organisation on this subject. carefully prepared carbonaceous mixtures, followed by an elaborate purification and extraction. In connexion with the manufacture it is right to mention THE PROGNOSTIC SIGNIFICANCE OF the firm of Sutcliffe, Speakman, and Co., Ltd., of SCARLATINAL NEPHRITIS. Leigh, Lancashire. An important technical application of activated OUR knowledge is still very incomplete as to the duration of the damage inflicted by an attack of carbon is the extraction and purification of gases, espescarlatina on kidneys which, through the acute stage cially the direct separation of motor spirit from the of the disease, have reacted with albuminuria. Is, crude gases evolved in the carbonisation of coal, shale, for example, the small granular kidney, with which and other carbonaceous material, by the use of a bed of the material. When this is saturated steam is blown we are so familiar in the post-mortem room, the final of a of events a series with bout of through, and the motor spirit recovered in an extremely stage beginning scarlatina ? And how long do most cases of scarla- pure condition, thus eliminating a considerable amount tinal nephritis last before albumin disappears from of expensive fractionating plant. In the same way the urine, and what effect, if any, does scarlatinal solvent naphtha and other solvents can be recovered nephritis have on the development of orthostatic and purified, and another valuable outlet is the absorpalbuminuria ? These are some of the questions tion of obnoxious smells and vapours. The decolorwhich Dr. H. Hansborg, of the Blegdam Fever Hospital ising of oils and fats on these lines is almost entirely in Copenhagen, attempts to answer in a paper published a new field and important developments are pending, in Acla Medica Scal1dinavica for Feb. 12th. In the the method being of considerable advantage for the 10-year period, 1911-1920, his hospital admitted purification of tallow, coconut oil, linseed oil, peanut 75 per cent. of all the cases of scarlatina notified in and corn oil, cotton-seed oil, and castor oil. In the Copenhagen. Among the 14,339 cases of scarlatina latter case, for example, fuller’s earth is at present admitted in this period, there were 612 complicated used, but the addition of activated carbon, about by hsemorrhagic nephritis. After subtraction of the 5 per cent. by weight, gives far superior results. For solutions the material is finding the most extensive cases which proved fatal in the acute stage of the disease, there remained 588 patients, 284 of whom application, especially for cane-sugar, glucose, were re-examined from one to ten years after discharge, brewing sugars (maltose and lactose), tartaric acid, the heart and blood pressure as well as the urine cream of tartar, citric acid, lactic acid, and organic being investigated. Dr. Hansborg made a point of compounds used as intermediates in dyestuff examining the morning urine in those cases in which manufacture, together also for the extraction of gold orthostatic albuminuria was suspected, and he found from excessively dilute solution 1 part per 10,000,000 that among the 284 ex-patients there were 23 who in the cyanide process. The purification of ordinary alcohol and the extraction of higher toxic alcohols were suffering from albuminuria which was merely orthostatic. There was one patient found to be (fusel oil) is another similar application. In applying suffering from chronic nephritis, the characters of the treatment to liquids generally the activated which distinguished it from that of scarlatina, and carbon is as a rule simply stirred up with the heated there was only one patient whose albuminuria, which liquid for a short period and then blown through had lasted for five years, could be reasonably regarded filter presses, the product being subsequently revived As many as by various methods after acting for a number of as a sequel to the scarlatinal nephritis. 259 of the re-examined ex-patients showed no evidence times. Thus it may be boiled with water, re-burnt, of renal disease. Of these 259 patients, as many as or treated with acids or alkalies, and the method is 235 were already albumin-free when discharged capable of almost endless applications, especially, from the fever hospital. Several of the remaining as already indicated, different carbons may be sup24 patients took more than a year after discharge to plied for absorbing different materials, whether get rid of their albuminuria. With regard to the 23 from liquids or gases. Activated carbon possesses patients found on re-examination to be suffering considerable interest from a medicinal point of view from orthostatic albuminuria, Dr. Hansborg raises since it is used in the tablet or powder form for the the question, May this condition be the result, of a correction of flatulence, dyspepsia, and diarrhoea, and is haemorrhagic nephritis developing during an attack said to be much superior in this respect to ordinary of scarlatina ? One of his reasons for answering this powdered charcoal. Indirectly it is of great value question in the negative is that the frequency with also in many different directions in the manufacture which patients who had suffered from scarlatinal of pharmaceutical products, both for decolorising THE
____
Icarbon I any B consideractivated
I