Volume 63 · Issue 02 · 1944

Anemia in chronic nephritis is common and has long been recognized. In 1836, Richard Bright (1) in his classical description of Bright's disease remarked that "after a time the healthy color of the countenance fades." In 1850, Schmidt (2) found in several cases of nephritis a marked decrease in the volume of the cells in proportion to the Plasma. In 1878, Leichtenstern (3) demonstrated a reduction in the amount of hemoglobin in 3 cases of chronic Bright's disease.

The formation of intrapleural fibrin bodies following artificial pneumothorax is a not uncommon event, but their detection can only be made during life by X-ray examination, either by fluoroscopy or by filming. Fleischner was accredited to be the first to describe a case seen under fluoroscopy in 1922. In spite of the fact that a fair number of articles have appeared smce then, the condition is, apparently not well known as evidencgd by the fact that many text books make no mention of it, Graham, Singer and Ballon (1), however, gave quite a detailed account, and Davies (2) briefly, in their respective text books. Usually regarded as an incidental finding during the course of tuberculous hydropneumothorax of only academic value, they may yet, besides giving rise to some confusion in differential diagnosis, have some practical bearing on the prognosis when one comes to know more about the subject. They are liable to be missed during, screening unless they happen to be large and easily visualised or else exhibit free or peculiar quivering movements which happen to catch the observer's eye, or unless the examiner consciously keeps a watch out for them. As far as the writers are aware, there has been so far no report of this condition in China. They are therefore prompted to draw attention to this interesting condition by presenting this case report and at the same time reviewing the salient points.

During the past decade, great progress has been made in the control and prevention, the care and treatment of tuberculosis in general and phthisis in particular. Sadly, however, the specific cure for this disease is yet not in sight.

The first report of 84 cases of pulmonary tuberculosis treated by collapse therapy (1) was read before the first biennial conference of the Chinese Medical Association at Shanghai in 1932. Since then we have been able to continue the observation of artificial pneumothorax in the treatment of pulmonary tuberculosis. The present report comprises a clinical and statistical study. Of 410 cases treated at the First Hospital of The Red Cross Society of China, Shanghai, during the years of 1930-1936. This study as well as many others of the artificial pneumothorax treatment in pulmonary tuberculosis are constantly encountering the difficulty of the lack of a uniform classification of clinical forms of the disease, which vary so much that it is almost impossible to classify them. Therefore, the statistical result of every case of collapse therapy can only have a conditional value.

Ya-tan-tzu (鸦膽�?, which is probably Brucea javanica Merr. (1), has been reported to have some value as an anti-amebic drug (2). Mougeot (3) reported in 1903 that out of 879 cases of amebic dysentery treated by him, 799 were completely cured in from three to six days, while 57 of these cases required fifteen days. Since clinical results have been encouraging,it was believed desirable to determine the effect of aqueous infusions of oil-free portions of the kernels.

According to Chu (1) Yang-chiao-ou is the name of the poisonous seeds of a plant which botanically has been identified by Chun as Apocynaceae strophanthus diyaricatus (Lour), Hook and Arn. The chief active constituent of these seeds has been found to be an amorphous saponin, which on hydrolysis with acids, yields glucose and three well crystallized sapongenins, proyisionally named by Chu (1) as strophanthiline A (C 25H 36O 4, m.p. 205-6�?, B (C 39H 64O 4, m.p. 289-91�? and C (C 18H 26O 4, m.p. 305-7�?. As far as chemical investigations go, thus saponin is different from the known strophantnins; it would be thus interesting to see whether it is similar to the latter in its pharmacological actions. The results of some preliminary studies of this saponin are herewith communicated.

During recent years empyema thoracis is by no means a rarity and instead its incidence is probably on the increase. The introduction of artificial pneumothorax for the treatment of pulmonary tuberculosis undoubtedly brings in a number of cases of thoracic empyema which would not have occurred if our judgment and technique have been more perfect. Jones and Alexander (1) reported 70 cases of empyema with 28 cases complicated by pneumothorax. Vineberg and Aronovitch (2) reviewed 37 cases of tuberculous empyema, of which 30 cases are secondary to induced pneumothorax. Modern Warfare, of course, is to blame for many chest wound cases which are frequently complicated with thoracic empyema. Ranson (3) recently reported that out of 150 cases of chest injury, 35 patients had thoracic empyema. Since chemotherapy of sulfanilamide compound is available, theoretically postpneumonic empyema should be prevented if treatment is properly given at the early stage of the disease. However, there is yet a very high percentage of the people of this country who are denied this time-honored medicine. Hence, we should he still on the lookout for patients suffering from empyema complicating pneumonia as well as other types and be prepared to give the proper treatment. The following 5 cases are herewith reported.