Volume 46 · Issue 09 · 1932

The patient, male, age 33, was admitted to the Lester Chinese Hospital on May 27th, J932. He gave a six weeks' history of stabbing pain in the right upper quadant. For ten days prior to admission the pain bad been more intense and persistent. It was associated with obstinate constipation, the appetite had been poor, and there was a history of attacks of fever and chilliness without any actual rigor.

Patient walked into consulting room complaining of fever and general malaise for 12 days or more. He looked well nourished, but flaby. He stated he had had no previous illness or injury within 3 years, no haemorrhages, and was feeling well until onset of present illness. Present illness presented the usual features of relapsing fever. The history indicated it was probably a first relapse. The diagnosis was confirmed microscopically.

The first case of bacteriologically confirmed cholera in Shanghai this year was reported on April 26, when a laborer, age 40, was taken with the disease in Chapei, according to the first cholera bulletin of the season issued by Dr. Wu Lien-teh, director of the National Quarantine Service.

The very considerable prevalence of Relapsing Fever in Shanghai amongst the Chinese population and those who were refugees during the period of hostilities presented a unique opportunity for a combined clinical and laboratory investigation into the various features of this disease. A team of research workers was organised under the auspices of the Division of Pathology of the Henry Lester Institute to undertake the laboratory investigations.

Lobar pneumonia is considered as a deadly disease, second only to tuberculosis in its toll of human mortality. In China this disease is comparatively infrequent judging from the experience of our general hospital work. In glancing over our hospital records from 1924-1931 inclusive, we have a record on 74 cases of acute lobar pneumonia with 15 deaths, i. e. a mortality of 20.2 per cent. The cause of death in lobar pneumonia is generally due to toxemia, anoxemia and cardiac failure. But despite the various therapeutic measures aiming at controlling these symptoms, the results of even the most modern treatment, whether specific or non-specific, are still disappointing.

Cyst of the urachus is a rare and interesting condition. In 1921 Thomson reported that of 64,938 operative procedures performed upon inpatients in the Canton Hospital, patent urachus occurred only three times. In Maxwell's "Diseases of China" this condition is not referred to. Lubash states that at the Brady Urological Foundation only two cases were seen in a service of over 20,000 admissions. MacFarland states that Weiser in 1906 was able to collect 86 cases of the large cysts some of which were not authentic. Cullen reports that large cysts of the urachus are more frequent in women than men.the proportion being 16 to 5. The largest cyst on record was reported by Rippman. It contaTned 52 liters of fluid.

By great effort of the Nationalist Government general and professional education in China has made considerable progress within the last few years. The medical schools, particularly, have shown a marked improvement. It is now entirely possible for the Chinese youth to receive an adequate modern medical education at home without the necessity of spending a period of four to six years abroad.

This brief report is presented with hope that it will increase the amount of medical help that is given China's great country population and that it may help simplify some doctor's problem in preparing for a clinic away from his hospital.

The choice of a medical bag presents some difficulty to the doctor working in the interior of the country, and more so to the one who is preparing to go inland for the first time. Two objections may be made to the bags and cases which are available from firms supplying medical requisites. First, the fittings include many articles one would not choose, together with a few that meet with one's approval. Second, there is no spare room for the addition of diagnostic instruments and dressings. The high cost of the ready-to-use article constitutes a third and very real objection.

Various attempts have been made in recent years to regulate the practice of modern medicine in this country by the central, provincial and city governments through the registration of medical practitioners, but so far there has been littIe coordination in their effort.s. There is a wide range of difference even in the fees charged for registration; some of the local governments are known to levy a higher fee for registration than the central government in order to create an additional source of income.

Largely arising from the necessity of meeting the loss of revenue due to the developments in Manchuria, the government has since last month increased the import tariff on certain luxuries among which are included medicines and drugs, the duty on which has been raised from 15 to 20 per cent plus a surtax of ten per cent.

In psychiatric practice in Korea the old is still with us: the old tragedy of human suffering physical privation and mental pain; the old causes still working, the old results still appearing; the old ignorance, callousness and cruelty; the old hopelessness; the old mis- conceptions; the old stigma which makes it well nigh impossible for a patient once the victim of mental derangement ever to be accepted into and restored to normal social relations and responsibilities.