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TROPICAL MEDICINE.
311 THURSDAY, JULY 24TH. The section
discussion
was
occupied during
the whole
sitting
with
a
on
Dysentery. Captain S. R. DOUGLAS, I.M.S. (ret.), introduced the discussion by reading a paper in which he gave an epitome of the work done in recent years by investigators on this subject, more particularly on the amoebic form of the disease, including the life-history of the entamoebse causing dysentery in man, the cultivation of pathogenic amoebas, experimental work on animals, the occurrence of the disease in Europe among persons
who had
never
been outside
their own
complications of the malady, and the treatment of amoebic dysentery. As regards the treatment by emetine, recently advocated by Major L. Rogers, I.M.S., it had the advantage of being as effective as that by ipecacuanha without giving rise to any disagreeable effects such as vomiting or depression of the heart. Mr. J. GRAHAM WILLMORE and Mr. H. SAVAGE (Egypt) contributed jointly a paper, which was read by Mr. Savage, country, the
on
rarer
the
Effects of the Serum
Treatment of the
Bacillary Form of Dysentery. briefly discussed and the danger
at epidemiology was present existing of the introduction of the infection into Western Europe and elsewhere by Mohamedan pilgrims returning from Mecca was pointed out. The authors urged that dysentery should be added to the list of diseases respecting which international regulations have been framed (cholera, plague, and yellow fever). The authors’ experience was gained chiefly at the quarantine station of El Tor, where clinical and bacteriological examination of cases was made
The
that the geographical distribution of the niarias had received considerable attention, as also had morphology and the points of distinction between the different species of embryos. But it appeared that little had been done to elucidate the pathology of the disease, though it was admitted that something had been done as regards chyluria and as to various obscure suppurative conditions originated by the presence of the parasites in the human tissues. With respect to elephantiasis several new operations had been proposed for the cure or relief of that distressing condition. Leiper had succeeded in discovering the intermediate host of filaria loa, the embryos of which were found by him to undergo their developmental cycle in the salivary glands of biting fleas of the genus Chrysops (C. dimidiata and C. silacea). The stages of their development are much like those that occur in the embryos of F. bancrofti in the mosquito. One of the most promising lines suggested for future investigation is that of the epidemiology of the disease. Such. questions as hyperfilariation, the duration of the life of the embryos in the blood, and the pathology and pathological anatomy of the diseased conditions produced, are also of equal interest. Though several theories have been put forward, it is not yet definitely known how the so-called "Calabar swellings"are produced. The general question of eosinophilia is also suggested as a subject for further research. Df. Low concluded by pointing out that there is yet a fruitful source of investigation awaiting anyone who likes to take up the subject of human filariasis. Dr. BAHR gave an account of his special investigations of filariasis in Fiji, and described some microscopical specimens he had prepared and which he invited the members of the section to examine in the Pathological Museum at the close of the meeting. He said that when a filaria died in the human tissues it acted like a foreign body, causing irritation and giving rise to production of toxins. Filaiial abscesses were common in Fiji. He suggested a It is number of points needing further investigation. as of that Dr. Bahr well as an assistant mention worthy contracted filariasis while conducting the inquiry in Fiji. The discussion was continued by Professorv. WASIELEWSKI, Dr. DUNCAN WHYTE, Dr. R. FLEMING JONES (British New Guinea), Dr. CAMERON BLAIR, Dr. MALCOLM WATSON, Dr. CHARLES FORSYTH (Hong-Kong), and the PRESIDENT. After Dr. Low and Dr. BAHR had replied, a paper was read on
and treatment carried out. The Turks appear to be the race which is the most susceptible to bacillary dysentery, but the Turkish authorities take no precautions whatever against it, permitting on all sides fsecal contamination of water and food. The authors recognised three forms of dysentery- the amoebic, the bacillary, and a combination of the two. The serum treatment was applied in bacillary cases. Agglutination experiments were carried out and serum was tested against four main types of bacilli. Shiga’s bacillus did not appear to be very common at El Tor. Massive doses of serum were recommended twice daily and continued for ten days to prevent relapses. Improvement was, as a rule, quickly observed as soon as the serum treatment had been Dengue and PAletootom?ts Fever begun. A number of tables were shown giving the results by Lieutenant-Colonel CECIL BIRT, R.A.M.C., in which the of the authors’ observations and experiments. and causation of the Dr. C. M. WENYON (London School of Tropical Medicine) symptoms, geographical distribution, two diseases were compared. There appeared to be some contributed a paper, which was in his absence read by Dr. similarity in several respects between dengue and phleboF. W. O’CONNOR, one of the secretaries, on tomus or sandfly fever, and the same might be said also of The Morphology of the Intestinal Ammb&-, yellow tever. mere were certain grounds ior grouping the and which was of a highly technical nature. Description three diseases in one and the same class ; they were caused was given in detail of the various stages through which by distinct but closely related kinds of virus. amoebas, pathogenic and non-pathogenic, pass. Explanation This paper was discussed by the PRESIDENT, Dr. Low, and was offered of the differing forms and stages of development Dr. FLEMING JONES, and Colonel BIRT then briefly replied. which these parasites undergo and how they are affected by Before adjourning to the Pathological Museum to attend the existing contents of the intestines of the host. the demonstration of filaria promised by Dr. BAHR, the In the important discussion which followed the reading PRESIDENT, in a short speech, summed up the proceedings of of the three papers the following members took part- the three days, and in a few concluding remarks spoke namely, Major HARRISON, Major HOUGHTON, R. A. M. C., Lieu- of the help given by the two sectional secretaries, Dr. E. tenant-Colonel W. MOLESWORTH, I.M.S., Dr. M. CAMERON Curwen (Hove) and Mr. F. W. O’Connor (London School of BLAIR (Northern Nigeria), Major R. W. JACKSON, R.A.M.C. Tropical Medicine). Dr. CAMERON BLAIR then proposed a vote of thanks to (ret.) (Weymouth), Lieutenant-Colonel H. W. D. LEAHY, I.M.S. (ret.), Dr. MALCOLM WATSON (Federated Malay the President, and this, after being seconded by Dr. DUNCAN States), Professor v. WASIELEWSKI (Heidelberg), and the WHYTE, was carried by acclamation. The demonstration PRESIDENT. of niarise by Dr. Bahr concluded the proceedings of the After Captain DOUGLAS and Dr. SAVAGE had briefly section. replied, the section adjourned to the Pathological Museum, where a demonstration was given of amoebse by Professor v. LARYNGOLOGY, RHINOLOGY, AND OTOLOGY. WASIELEWSKI (Leiter der Wissenschaftlichen Abteilung des WEDNESDAY, JULY 23RD. Instituts fiir Krebsforschung und a.o. Professor von Hygiene an der Universitat, Heidelberg). President, Dr. A. J. HUTCHISON (Brighton). Specimens of entamoebas were also exhibited by Dr. P. H. BAHR (Ceylon). This conDr. WILLIAM MILLIGAN (Manchester) opened a discussion cluded the business for the day. on the Technique and After-Treatment of the Radical Mastoid FRIDAY, JULY 25TH. Operation. A discussion was opened by Dr. G. C. Low, of the of the Dr. importance of a detailed examinaMilligan spoke Diseases on Tropical Bureau, London, tion of the functional activity of the labyrinth prior to the 1 zlariccsis. performance of the radical mastoid operation and of the He briefly reviewed the literature on human of a "radical"operation in cases of diffuse purulent risks published during the past- two years. It was mentioned (latent) labyrinthitis, and the possibility of converting a 1 THE LANCET, Oct. 19th, 1912, circumscribed into a diffuse serous or purulent labyrinthitis. p. 1062.
filariasisI
discussion
was
occupied during
the whole
sitting
with
a
on
Dysentery. Captain S. R. DOUGLAS, I.M.S. (ret.), introduced the discussion by reading a paper in which he gave an epitome of the work done in recent years by investigators on this subject, more particularly on the amoebic form of the disease, including the life-history of the entamoebse causing dysentery in man, the cultivation of pathogenic amoebas, experimental work on animals, the occurrence of the disease in Europe among persons
who had
never
been outside
their own
complications of the malady, and the treatment of amoebic dysentery. As regards the treatment by emetine, recently advocated by Major L. Rogers, I.M.S., it had the advantage of being as effective as that by ipecacuanha without giving rise to any disagreeable effects such as vomiting or depression of the heart. Mr. J. GRAHAM WILLMORE and Mr. H. SAVAGE (Egypt) contributed jointly a paper, which was read by Mr. Savage, country, the
on
rarer
the
Effects of the Serum
Treatment of the
Bacillary Form of Dysentery. briefly discussed and the danger
at epidemiology was present existing of the introduction of the infection into Western Europe and elsewhere by Mohamedan pilgrims returning from Mecca was pointed out. The authors urged that dysentery should be added to the list of diseases respecting which international regulations have been framed (cholera, plague, and yellow fever). The authors’ experience was gained chiefly at the quarantine station of El Tor, where clinical and bacteriological examination of cases was made
The
that the geographical distribution of the niarias had received considerable attention, as also had morphology and the points of distinction between the different species of embryos. But it appeared that little had been done to elucidate the pathology of the disease, though it was admitted that something had been done as regards chyluria and as to various obscure suppurative conditions originated by the presence of the parasites in the human tissues. With respect to elephantiasis several new operations had been proposed for the cure or relief of that distressing condition. Leiper had succeeded in discovering the intermediate host of filaria loa, the embryos of which were found by him to undergo their developmental cycle in the salivary glands of biting fleas of the genus Chrysops (C. dimidiata and C. silacea). The stages of their development are much like those that occur in the embryos of F. bancrofti in the mosquito. One of the most promising lines suggested for future investigation is that of the epidemiology of the disease. Such. questions as hyperfilariation, the duration of the life of the embryos in the blood, and the pathology and pathological anatomy of the diseased conditions produced, are also of equal interest. Though several theories have been put forward, it is not yet definitely known how the so-called "Calabar swellings"are produced. The general question of eosinophilia is also suggested as a subject for further research. Df. Low concluded by pointing out that there is yet a fruitful source of investigation awaiting anyone who likes to take up the subject of human filariasis. Dr. BAHR gave an account of his special investigations of filariasis in Fiji, and described some microscopical specimens he had prepared and which he invited the members of the section to examine in the Pathological Museum at the close of the meeting. He said that when a filaria died in the human tissues it acted like a foreign body, causing irritation and giving rise to production of toxins. Filaiial abscesses were common in Fiji. He suggested a It is number of points needing further investigation. as of that Dr. Bahr well as an assistant mention worthy contracted filariasis while conducting the inquiry in Fiji. The discussion was continued by Professorv. WASIELEWSKI, Dr. DUNCAN WHYTE, Dr. R. FLEMING JONES (British New Guinea), Dr. CAMERON BLAIR, Dr. MALCOLM WATSON, Dr. CHARLES FORSYTH (Hong-Kong), and the PRESIDENT. After Dr. Low and Dr. BAHR had replied, a paper was read on
and treatment carried out. The Turks appear to be the race which is the most susceptible to bacillary dysentery, but the Turkish authorities take no precautions whatever against it, permitting on all sides fsecal contamination of water and food. The authors recognised three forms of dysentery- the amoebic, the bacillary, and a combination of the two. The serum treatment was applied in bacillary cases. Agglutination experiments were carried out and serum was tested against four main types of bacilli. Shiga’s bacillus did not appear to be very common at El Tor. Massive doses of serum were recommended twice daily and continued for ten days to prevent relapses. Improvement was, as a rule, quickly observed as soon as the serum treatment had been Dengue and PAletootom?ts Fever begun. A number of tables were shown giving the results by Lieutenant-Colonel CECIL BIRT, R.A.M.C., in which the of the authors’ observations and experiments. and causation of the Dr. C. M. WENYON (London School of Tropical Medicine) symptoms, geographical distribution, two diseases were compared. There appeared to be some contributed a paper, which was in his absence read by Dr. similarity in several respects between dengue and phleboF. W. O’CONNOR, one of the secretaries, on tomus or sandfly fever, and the same might be said also of The Morphology of the Intestinal Ammb&-, yellow tever. mere were certain grounds ior grouping the and which was of a highly technical nature. Description three diseases in one and the same class ; they were caused was given in detail of the various stages through which by distinct but closely related kinds of virus. amoebas, pathogenic and non-pathogenic, pass. Explanation This paper was discussed by the PRESIDENT, Dr. Low, and was offered of the differing forms and stages of development Dr. FLEMING JONES, and Colonel BIRT then briefly replied. which these parasites undergo and how they are affected by Before adjourning to the Pathological Museum to attend the existing contents of the intestines of the host. the demonstration of filaria promised by Dr. BAHR, the In the important discussion which followed the reading PRESIDENT, in a short speech, summed up the proceedings of of the three papers the following members took part- the three days, and in a few concluding remarks spoke namely, Major HARRISON, Major HOUGHTON, R. A. M. C., Lieu- of the help given by the two sectional secretaries, Dr. E. tenant-Colonel W. MOLESWORTH, I.M.S., Dr. M. CAMERON Curwen (Hove) and Mr. F. W. O’Connor (London School of BLAIR (Northern Nigeria), Major R. W. JACKSON, R.A.M.C. Tropical Medicine). Dr. CAMERON BLAIR then proposed a vote of thanks to (ret.) (Weymouth), Lieutenant-Colonel H. W. D. LEAHY, I.M.S. (ret.), Dr. MALCOLM WATSON (Federated Malay the President, and this, after being seconded by Dr. DUNCAN States), Professor v. WASIELEWSKI (Heidelberg), and the WHYTE, was carried by acclamation. The demonstration PRESIDENT. of niarise by Dr. Bahr concluded the proceedings of the After Captain DOUGLAS and Dr. SAVAGE had briefly section. replied, the section adjourned to the Pathological Museum, where a demonstration was given of amoebse by Professor v. LARYNGOLOGY, RHINOLOGY, AND OTOLOGY. WASIELEWSKI (Leiter der Wissenschaftlichen Abteilung des WEDNESDAY, JULY 23RD. Instituts fiir Krebsforschung und a.o. Professor von Hygiene an der Universitat, Heidelberg). President, Dr. A. J. HUTCHISON (Brighton). Specimens of entamoebas were also exhibited by Dr. P. H. BAHR (Ceylon). This conDr. WILLIAM MILLIGAN (Manchester) opened a discussion cluded the business for the day. on the Technique and After-Treatment of the Radical Mastoid FRIDAY, JULY 25TH. Operation. A discussion was opened by Dr. G. C. Low, of the of the Dr. importance of a detailed examinaMilligan spoke Diseases on Tropical Bureau, London, tion of the functional activity of the labyrinth prior to the 1 zlariccsis. performance of the radical mastoid operation and of the He briefly reviewed the literature on human of a "radical"operation in cases of diffuse purulent risks published during the past- two years. It was mentioned (latent) labyrinthitis, and the possibility of converting a 1 THE LANCET, Oct. 19th, 1912, circumscribed into a diffuse serous or purulent labyrinthitis. p. 1062.
filariasisI