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VENEREAL INFECTION IN RHINE ARMY.
826
experience this influence was both beneficial and well marked. The bacteriology can be done more cheaply by an assistant medical officer of health because he is not paid much-if at all-for the work, but the advocates of this procedure do not always seem to realise that something more than a microscope and appropriate stains are necessary. It is in the preparation and accurate standardisation of media that the central laboratory has the advantage. I am, Sir, yours faithfully, A. KNYVETT GORDON, M.B.
experience. It is to be hoped that his article will be read by the lay enthusiasts who have been misled by the lay press, and especially by members of county councils and insurance committees, who can hardly listen to a suggestion that sanatoriums have failed to do a tithe of what was promised. I cannot help thinking that if much of the money which has been spent on sanatoriums had been used to enforce by-laws regarding fresh air and sunlight in cottages we should have had better results. I am,
Sir, yours faithfully, S. NOY SCOTT.
THE FIGURES OF VENEREAL DISEASE. To the Editor of THE LANCET. I am sorry. The increase of 23,000 fault. SIR,-My V.D. cases was ’’ at the London hospitals," not " at the London Hospital." I misread my brief. I am, Sir, yours faithfully, KNUTSFORD.
A FATAL CASE OF CŒLIAC INFANTILISM. l’o the Editor
of
THE LANCET.
SIR,-Dr. R. Miller, in presenting
in your issue of
April 9th the view of caeliac disease that he supports, might, I think, have referred to the fatal case published by Dr. Hugh Paterson and myself in THE LANCET, 1914, i., p. 1533, under the title- ’’The Occurrence of Ascites of a Non-tuberculous Origin in Chronic Recurrent
I believe it to be in this Diarrhoea in Childhood." VENEREAL INFECTION IN RHINE ARMY. the first complete proof by necropsy of a country 1’o the Editor of THE LANCET. clinical sign which is well recognised in the eoeliac SIR,—In a letter of mine you recently published affection, though perhaps hardly yet generally appreI showed how much better the
(March 26th) very ciated. Ascites is so intimately associated in our minds American Forces in Germany were in their control of with abdominal tuberculosis in childhood that its venereal infection than were the British Forces. The occurrence in a wasting disease with diarrhoea tempts American rate I quoted was for the period January- us to decide that the condition must be strongly October, 1920-viz., 142 per 1000 per annum. This rate tuberculous. The completion of the proof of its nonhas now been considerably reduced, and for the period tuberculous nature is thus, I think, worth a reference Nov. lst, 1920, to April 1st, 1921, the American rate is in a paper dealing with the necropsies upon cases of 114 per 1000 per annum. The lowest rate officially cœliac disease. It is of some interest that a widestated for the British Forces is 168 per 1000 per annum infiltration -of the intestinal walls and spread leucocytic for the period Jan. lst, 1920, to Jan. 31st, 1921, and the pancreas was found in this case as in the one criticised ,highest rate, quoted semi-officially, is that given by by Dr. Miller in his paper. There is no doubt that Dr. Dr. E. B. Turner in November last-viz., 500 per 1000 ’Miller has made a valuable contribution to the subject per annum.-I am, Sir, yours faithfully, his case, which was investigated by a by publishing ETTIE A. ROUT, skilled pathologist; whether his conclusion that the Late Hon. Secretary, New Zealand disease is " a digestive fault " independent of organic Volunteer Sisters. affection is correct the future must decide, though in my opinion he does not gain by ruling out cases THE VALUE OF THE QUASI-CONTINUOUS described by others which he had no opportunity of TEMPERATURE RECORD. seeing himself. My experience of cceliac disease has To the Edito1’ of THE LANCET. been that it may appear suddenly in classical type or SIR,-Since our paper on the Value of the Quasi- follow upon a definite entero-colitis; it may- be comContinuous Temperature Record in the Early Diagnosis plicated by a subsequent entero-colitis or by serious Is it and Prognosis of Tuberculosis appeared in THE LANCET constipation with great atony of the bowel. " of March 19th we have received a number of inquiries independent " of organic change ? Possibly. but I still think we require more research upon the subject, as to how we take these temperatures-one as to whether it is not very disturbing to the patient to have and prefer to suspend my judgment. I am, Sir, yours faithfully, his temperature taken at such short intervals. May we F. JOHN POYNTON, M.D. the of these out that method taking temperatures point was described in THE LANCET of Feb. 5th and 12th, 1916, and that the records published in our last paper are LUNACY IN EGYPT. simply in continuation of work begun some eight years ago ?*? The thermometer used-a rectal thermometerTo the Editor of THE LANCET. is left in position for 24 hours or more (the patient SIR,—I notice that in THE LANCET of March 12th, lying in bed), except when the patient has to use the p. 553, under this heading there appears the statement night-stool. One of us lay in bed with the thermometer that ’’ at Khanka are received the more quiet patients in position for the greater part of six weeks. All aver and no women, a rather special class." As this statethat they experience no inconvenience even when the ment may give a wrong impression of the type of cases The thermometer is left in situ for several days. admitted nowadays to Khanka Hospital for the Insane, process of recording the temperature is purely may I point out that the classes of cases received at the mechanical and automatic. two Egyptian hospitals for the insane are as stated on We are, Sir, yours faithfully, 3 of the under review:G. SIMS WOODHEAD.
P. C. VARRIER-JONES. A CONTROLLED STUDY OF SANATORIUM
RESULTS. To the Editor of THE LANCET. SIR,-If all investigations and trial of new methods of treatment were carried out with such patience and control as Dr. E. Ward has shown in his article in your issue of March 12th, it would be better for all concerned -viz., the patients, the doctors, and the State. Dr. Ward, who may be supposed to have begun his work with a prejudice in favour of sanatorium methods, has published his conclusions with a candour that is con-
vincing. ’ My
own
experience distinctly supports his
p. report "Abbassia Asylum receives all female cases, all criminal cases, all paying cases, and male cases arising in Cairo. Khanka Asylum receives all non-criminal pauper male cases arising in Egypt except in Cairo."
-
Hospital include all of insanity among men. Prior to 1917, owing to deficient means of communication, Khanka Hospital only received cases transferred from Abbassia Hospital, but since that date patients are received direct from their homes. The admissions at Khanka Hospital, therefore, comprise all types of insanity occurring amongst the population of Egypt similar to male asylums in other countries. I am, Sir, yours faithfully, H. W. DUDGEON, Director, Khanka Hospital for the Insane. Thus the
types
cases
admitted to Khanka
experience this influence was both beneficial and well marked. The bacteriology can be done more cheaply by an assistant medical officer of health because he is not paid much-if at all-for the work, but the advocates of this procedure do not always seem to realise that something more than a microscope and appropriate stains are necessary. It is in the preparation and accurate standardisation of media that the central laboratory has the advantage. I am, Sir, yours faithfully, A. KNYVETT GORDON, M.B.
experience. It is to be hoped that his article will be read by the lay enthusiasts who have been misled by the lay press, and especially by members of county councils and insurance committees, who can hardly listen to a suggestion that sanatoriums have failed to do a tithe of what was promised. I cannot help thinking that if much of the money which has been spent on sanatoriums had been used to enforce by-laws regarding fresh air and sunlight in cottages we should have had better results. I am,
Sir, yours faithfully, S. NOY SCOTT.
THE FIGURES OF VENEREAL DISEASE. To the Editor of THE LANCET. I am sorry. The increase of 23,000 fault. SIR,-My V.D. cases was ’’ at the London hospitals," not " at the London Hospital." I misread my brief. I am, Sir, yours faithfully, KNUTSFORD.
A FATAL CASE OF CŒLIAC INFANTILISM. l’o the Editor
of
THE LANCET.
SIR,-Dr. R. Miller, in presenting
in your issue of
April 9th the view of caeliac disease that he supports, might, I think, have referred to the fatal case published by Dr. Hugh Paterson and myself in THE LANCET, 1914, i., p. 1533, under the title- ’’The Occurrence of Ascites of a Non-tuberculous Origin in Chronic Recurrent
I believe it to be in this Diarrhoea in Childhood." VENEREAL INFECTION IN RHINE ARMY. the first complete proof by necropsy of a country 1’o the Editor of THE LANCET. clinical sign which is well recognised in the eoeliac SIR,—In a letter of mine you recently published affection, though perhaps hardly yet generally appreI showed how much better the
(March 26th) very ciated. Ascites is so intimately associated in our minds American Forces in Germany were in their control of with abdominal tuberculosis in childhood that its venereal infection than were the British Forces. The occurrence in a wasting disease with diarrhoea tempts American rate I quoted was for the period January- us to decide that the condition must be strongly October, 1920-viz., 142 per 1000 per annum. This rate tuberculous. The completion of the proof of its nonhas now been considerably reduced, and for the period tuberculous nature is thus, I think, worth a reference Nov. lst, 1920, to April 1st, 1921, the American rate is in a paper dealing with the necropsies upon cases of 114 per 1000 per annum. The lowest rate officially cœliac disease. It is of some interest that a widestated for the British Forces is 168 per 1000 per annum infiltration -of the intestinal walls and spread leucocytic for the period Jan. lst, 1920, to Jan. 31st, 1921, and the pancreas was found in this case as in the one criticised ,highest rate, quoted semi-officially, is that given by by Dr. Miller in his paper. There is no doubt that Dr. Dr. E. B. Turner in November last-viz., 500 per 1000 ’Miller has made a valuable contribution to the subject per annum.-I am, Sir, yours faithfully, his case, which was investigated by a by publishing ETTIE A. ROUT, skilled pathologist; whether his conclusion that the Late Hon. Secretary, New Zealand disease is " a digestive fault " independent of organic Volunteer Sisters. affection is correct the future must decide, though in my opinion he does not gain by ruling out cases THE VALUE OF THE QUASI-CONTINUOUS described by others which he had no opportunity of TEMPERATURE RECORD. seeing himself. My experience of cceliac disease has To the Edito1’ of THE LANCET. been that it may appear suddenly in classical type or SIR,-Since our paper on the Value of the Quasi- follow upon a definite entero-colitis; it may- be comContinuous Temperature Record in the Early Diagnosis plicated by a subsequent entero-colitis or by serious Is it and Prognosis of Tuberculosis appeared in THE LANCET constipation with great atony of the bowel. " of March 19th we have received a number of inquiries independent " of organic change ? Possibly. but I still think we require more research upon the subject, as to how we take these temperatures-one as to whether it is not very disturbing to the patient to have and prefer to suspend my judgment. I am, Sir, yours faithfully, his temperature taken at such short intervals. May we F. JOHN POYNTON, M.D. the of these out that method taking temperatures point was described in THE LANCET of Feb. 5th and 12th, 1916, and that the records published in our last paper are LUNACY IN EGYPT. simply in continuation of work begun some eight years ago ?*? The thermometer used-a rectal thermometerTo the Editor of THE LANCET. is left in position for 24 hours or more (the patient SIR,—I notice that in THE LANCET of March 12th, lying in bed), except when the patient has to use the p. 553, under this heading there appears the statement night-stool. One of us lay in bed with the thermometer that ’’ at Khanka are received the more quiet patients in position for the greater part of six weeks. All aver and no women, a rather special class." As this statethat they experience no inconvenience even when the ment may give a wrong impression of the type of cases The thermometer is left in situ for several days. admitted nowadays to Khanka Hospital for the Insane, process of recording the temperature is purely may I point out that the classes of cases received at the mechanical and automatic. two Egyptian hospitals for the insane are as stated on We are, Sir, yours faithfully, 3 of the under review:G. SIMS WOODHEAD.
P. C. VARRIER-JONES. A CONTROLLED STUDY OF SANATORIUM
RESULTS. To the Editor of THE LANCET. SIR,-If all investigations and trial of new methods of treatment were carried out with such patience and control as Dr. E. Ward has shown in his article in your issue of March 12th, it would be better for all concerned -viz., the patients, the doctors, and the State. Dr. Ward, who may be supposed to have begun his work with a prejudice in favour of sanatorium methods, has published his conclusions with a candour that is con-
vincing. ’ My
own
experience distinctly supports his
p. report "Abbassia Asylum receives all female cases, all criminal cases, all paying cases, and male cases arising in Cairo. Khanka Asylum receives all non-criminal pauper male cases arising in Egypt except in Cairo."
-
Hospital include all of insanity among men. Prior to 1917, owing to deficient means of communication, Khanka Hospital only received cases transferred from Abbassia Hospital, but since that date patients are received direct from their homes. The admissions at Khanka Hospital, therefore, comprise all types of insanity occurring amongst the population of Egypt similar to male asylums in other countries. I am, Sir, yours faithfully, H. W. DUDGEON, Director, Khanka Hospital for the Insane. Thus the
types
cases
admitted to Khanka