Volume 47 · Issue 06 · 1933

Lobar pneumonia is caused by majority of cases. Organisms thus known are classified into four types according to their immunological reactions (1, 2). The first three groups are fixed types each with distinct characteristics and are highly parasitic in nature, while Type IV is composed of a number of strains which, according to the more recent studies (3) can be reclassified into several serological subgroups. As a causative agent of lobar pneumonia the three fixed types are the most important. Diagnosis of lobar pneumonia according to the type of the causative organism is no longer only of academic and bacteriological interest but has now assumed some practical importance in view of the recent development of the specific serum therapy, a subject at present commanding wide interest, especially in America.

Chronic appendicitis without acute exacerbation may present such vague gastro-intestinal and local symtoms and signs that a definite clinical diagnosis is often difficult to make. In such cases, the help of roentgenologists is often sought, either to rule out other gastro-intestinal lesions or to contribute roentgenologic evidence that may justify the diagnosis and treatment.

The diagnosis of a typical case of acute appendicitis constitutes no problem. Its classical symptoms and physical signs are too well known to the profession to merit repetition here. Unfortunately, only fifty-percent of the patients suffering from acute appendicitis possess symptomatology favoring an early diagnosis. The other fifty-percent of cases which may be atypical throughout their course or which may not assume the text-book picture untiL very late, form the problem of the day. The problem becomes more serious when it is realized that every hour of delay in the surgical interference of the disease yields higher mortality. Surgeons generally agree that if appendectomy is performed within the first twenty-four hours, the operative mortality should not exceed one percent. In our own small series which gives an operative mortality of a little over 6 percent, there was no death in the thirty-two cases operated upon during the first twenty-four hours of their illness.

The injection treatment of varicose veins is by no means a new method. In recent years, however, so many new chemicals have been introduced and the technique has been so greatly modified and improved, that a comprehensive review of the subject may not be amiss. A careful search of the medical literature reveals that, as early as 1353, Chassaignac (1) suggested the obliteration of varicose veins by the injection of perchIoride of in:n and in 1855, Degranges (1) used an iodotannic solution. Later, English (1) of Vienna used a five per cent alcohol solution for injection. Weinhemere (1) used ferriC chloride and reported 32 cases with go d results.

Syphilis and yaws, though distLnctly differing in regard to their clinical, pathological and epidemological phenomena respectively, be- long to the group of treponematous diseases. Their respective clinical efflorescences and pathological changes are entirely different due to the different organotropism of the respective Treponema. Both infections may be co-existent in the same animal or person. Yet, both yaws and syphilis belong to one group just as tuberculosis and leprosy belong also to a single group. It is in this sense that the term "treponematoses" has been used.

While a nation-wide school health program is lacking in China, work has been developed in a few cities including Peiping. The writer has had opportunity to review some of the records showing the causes of morbidity as observed during the five years 1927-1932 in the school clinics under the administration of the First Health Station.

The development of industrial hygiene is largely dependent upon the contributions of improved health conditions of workmen to the prosperity of industry itself. Likewise, the success of a school health program is closely related to the extent to which educators appreciate the value of upholding children's health for the sake of general education itself. The first important duty of health workers in industrial and educational circles is to win the confidence of the leaders in these fields. This is true today and probably will hold true for many years to come.

The Peiping Child Health Institute planned a five year program when it was established in 1930, which included the investigation of conditions in Peiping relating to maternity and child health. The Institute in 1931 created a committee on the investigation of infant mortality under Dr. C Fang of the Metropolitan Hospital. The general purpose of the investigation was similar in principle to the recent international inquiry of the Health Organization of the League of Nations (1), a though at the same time it was hoped the results would serve as a future yardstick for the progress of infant health in Peiping as well as a guide to the training of local workers.

The two chief factors in the estabIishment of adequate community medical protection are personnel and funds. The relatively low economic standard of this country constitutes a problem in the introduction of modern medical methods developed in countries which are more advanced economically. Consequently, the question of the cost of the various types of medical services is a matter of paramount interest. There is also another aspect of interest to any country on the point of initiating medical services and that is the principle involved as to whether it should be along the same lines of evolution as occurred in the Occident where private preceded public medical protection or whether there should be adoption of the policy from the beginning of state medicine. Decision as to the latter must also take into consideration the economic factors. In China, there has been little published data on this subject. The present paper is presented with the idea of arousing public interest toward this important problem. It is hoped that similiar data elsewhere may be made available for comparison.

We take great satisfaction to comment and draw the attention of our readers to a reduction of import duty on certain medicinal preparations. Last August when the duty on all medicines, drugs and medicinal compounds were raised from fifteen to twenty per cent to meet the decreased revenue resulting from the loss of Manchuria, we voiced a strong protest as most of these products are not being manufactured locally and cannot be classed in the some category as luxuries on which the increase was then directed. It is gratifying, therefore, to note that under the new tariff which went into effect from May 22nd, although considerable increases in rates are shown in many cases, the rates on quinine (item 461) and serums and vaccines (item 464) have been decreased from twenty to five per cent ad valorem; duty for other medicines and drugs remains unchanged.

The trend of the times seems to indicate that society is in the initial stage of evolution from an antiquated regional civilization to that of a uniform scientific international one. In fact, so initial is the change that it is doubtful whether as yet more than one quarter of the world's population is utilizing any appreciable part of the scientific knowledge now available. And, hitherto the introduction of scientific knowledge in the fields of education, agriculture, transportation, economics, medical protection, and other channels, has been fragmentary, individual and uncoordinated.

The six regular meeting of the Chinese Ophthalmological Society was held on Friday, January 20, 1933 in the Peiping Union Medical College, when the following demonstrations were presented.