Volume 47 · Issue 05 · 1933

Typhus fever is endemic throughout the whole of North China, and every year claims many victims. It is impossible to determine the number of deaths annually from this disease; but from the fear of the disease in the minds of the common people, and form the frequency with which one meets cases of it, we know that the disease is very prevalent in these regions.

In a previous article the writer bas described a method for culture of tubercle bacilli using semipermeable containers which confined the organism and yet allowed the culture medium to soak through from outside.

Tuberculosis of the mesenteric lymph glands is a common disease in childhood and early adult life. It may be the primary focus or the only tuberculosis in the body. Its symptomat logy is protean and often not characteristic. The diagnosis is not easy and is frequently delayed until one of the complicating features calls for an abdominal operation. Among these complications may be mentioned acute and chronic intestinal obstruction (1, 2), pressure o.n the blood vessels (3) and the ureters (4), and the right lower quadrant syndromes, the so-called pseudo-appendicitis (5, 6, 7). It is beyond the scope of this article to dwell upon at length the clinical features of this disease for which the reader may be referred to the bibliography (1, 8, 9). The purpose of the present report is to emphasize the impOftance of a group of gastric symptoms associated with mesenteric lymphadenitis. As will be shown later these symptoms are by no means rare, but they have not received the attention they deserve.

One of the procedures used to test sensory loss consists of tracing various figures on the skin of the patient, --whose eyes are closed through-out, --and then asking him to describe what he felt. This sense of tactile recognition of outlines drawn on the skin is particularly suited to Chinese who can read and write, since their script allows a familiar progression from a single line to complex characters. This paper presents a trial of that principle made on Chinese soldiers who received head-wounds involving the brain during the Sino-Japanese hostilities at Shanghai in the first part of 1932.

Dr. R. L. Cecil of the Cornell Medical School has pointed out, in a paper on "The Relation of Medicine to Dentistry" (1) that one of the most serious problems that faces the medical profession today is the maintenance of some sort of connection between general medicine and the various rapidly developing specialties.

This study comprises 120 women about whom information was collected in 1931 through questionnaires prepared by the writer and sent out by women college students to some of their married friends and relatives. Answers were made anonymously, but even so the very personal nature of some of the questions made some women unwilling to answer, with the result that some forms were returned perfectly blank thus perhaps rendering a mild rebuke at the perpetrators of so daring a venture.

This case is reported because of its comparative infrequency. DeLee mentions the collected reports (by Freund) of seventeen authors, in which rupture, both spontaneous, and traumatic, varied from l in 234 cases to 1 in 6100 cases. This case of spontaneous rupture is the only rupture of either sort in a series of 350 cases.

The very clear and illuminating, article on Spinal Anaesthesia in the January 28th number of the J. A. M. A. this year has come to me with special emphasis because of the case which I now report.

This case is presented showing certain points in the diagnosis and treatment that may be of interest.

Typhus fever has an unfortunate pre-eminence among infectious diseases in this country in being the one that causes the greatest loss among physicians and other social workers. Further, nothing but the most assiduous nursing keeps the mortality among its victims within reasonable bounds and such nursing is seldom available. In a sense it is something of a reflection on our profession that neither preventive nor curative measures have so far greatly affected its mortality. True, we know that the disease is louse-borne and to that extent should be easily prevented. It can be and is prevented by properly organized systematic measures for delousing and special clothing for those knowingly brought into contact with infected louse-carrying patients. Unfortunately such measures are impossible for the individual worker among a famine stricken population and the risks of entering lousy dwellings and using public vehicles in endemic areas are ever present.

In times of national distress relief work in various forms plays an important part in the mitigation of human sufferings. Medical relief for such occasions along modern lines in this country is of a comparatively recent origin and may be traced back to the Red Cross Society of China founded thirty years ago upon the principles and policies advovated by the League of Red Cross Societies.

For facilitating serological work such as Wassermann's reaction and all kinds of agglutination etc. requiring very small fractions of cubic centimeter, the work must be sufficiency accurate with no waste of time and materials.