Volume 48 · Issue 08 · 1934

The first report of pellagra in China was that of Jouvean-Dubreuil (1), who in 1920 observed four cases in Szechuan. In 1923 six cases were observed by Tyau in Shanghai (2), one case by Wu in Wuhu (3). Four years later Lambert (4) described one case of undoubted pellagra he saw in Honan. This was in a girl who had suffered from a recto-vaginal fistula and dysentery since 1925, the skin eruption appeared from that date. Foster and Anderson commenting on the above paper, mentioned this disease they saw in Hunan and Hong Kong. In the same year Mu (5) gave an account of the thirteenth authentic case observed in Peiping. In 1930 0ne of us (C.S.Y.) (6) described three cases which were associated with diseases of the gastro-intestinal tract. It was discussed that the organic lesions of the digestive system may interfere with adequate assimilation of food and absorption of nutrition and therefore they are of causative importance in the development of this deficiency disease. Many similar cases have been previously noted by other writers, and O'Leary (7) coined the term "secondary pellagra", in contrast to those in which the condition developed in absence of organic lesions of the digestive system.

Pellagra has been reported from nearly every country in Europe, notably Rumania (1), and Italy (2), from northern, central and south Africa, from India, Straits Settlements, Japan, Australia, Hawaii, some parts of South America, Panama, Central America, Mexico, the United States, Canada and the West Indies (3). R. W. Wilson (4) first reported several cases he had come across in Korea and in 1925 and 1933 R. M. Wilson (5) reported many cases he had seen in leper settlements in the same country.

Traumatic dislocation of the hip joint is very rare in children. In a review of the literature Choyce (1924) was able to collect only fifty-eight cases, to which he added one of his own. Since that time additional cases have been reported by Clarke (one case, 1929) and by Glynn (two cases, 1932). The following two cases were treated in the Peiping Union Medical College Hospital.

In recent years, the relation of calcium, potassium, and the calcium-potassium ratio of blood to various diseases has been studied with considerable interest, as these electrolytes are regarded as an autonomic regulator of cell function. In a number of cases with Parkinsonian disease, we have found vagotonic syndrome: slow pulse, excessive salivation, history of gastric hyperacidity, and marked resistance to atropin. Usually, the prescriptions consisting of 14 or 21 tablets of 1/1O0 grain (0.0006 gm) hyoscin hydrobomide, were given to these patients with instruction to take 2 or 3 tablets daily for a period of 7 days. On several occasions, the patients took all of the tablets in a few days without untoward results.

Some years ago Dr. Modinos of Java, treated opium addicts by injecting serum derived from the patients. The method is simple and in our hands worked very successfully.

It is well known that a slight amount of obliquity and rotation of the pregnant uterus is physiological. This fact is easily demonstrable at Caesarean section, when it may be observed that the adnexa on one side usually lie nearer the mid-line incision than those on the other.

In a previous paper (1) I brought forward several cases where the Fallopian tubes had been tied in continuity and pregnancy had supervened, and where unsuccessful attempts had been made to terminate pregnancy by a diIatation of the cervix and a curettage.

It is commonly observed that tuberculosis is prevalent in China, but there are no reliable statistics as regards the incidence of the disease in the general population. Before we are able to secure them, it is of interest to review some of the available local reports on this subject.

In the September number of the JOURNAL (1) appeared an account of the initiation and preliminary organisation of the Chinese Medical Association Survey of hospital patients undertaken by the Council on Medical Research in an attempt to collect data on the distribution and incidence of disease in China. In that account was outlined the method adopted of a simple card survey--one card being returned for each new patient seen by the hospitals agreeing to cooperate. Further, at the Conference of the Association held at Nanking in April this year, a report of the analysis of the case records from January to June 1933 was presented, the material of which is included in the present account of the case records of 1933.

The gravity of the opium evil has long been recognized by the Government which has from time to time enacted stringent laws prohibiting and penalizing the indiscriminate sale and habitual use of the drug and its derivatives. Due to the operation of a number of factors the law has been honoured more in the breach than in the observance.