Volume 49 · Issue 01 · 1935

In a previous communication(1), the data of a patient with relatively early osteomalacia were presented, showing very striking and prolonged response to the corrective influence of vitamin D in calcium and phosphorus metabolism. Since then we have studied four other patients with osteomalacia whose clinical features were more complicated, and whose response to vitamin D therapy showed further points of interest. It seems worthwhile to report these cases for comparison. The methods employed in the metabolism ward and laboratory are the same as those given in our previous paper.

Cleft palate is the result of the failure to unite, during early fetal life, of the various parts which join in the formation of the normal palate. The upper lip and alveolar process develop from three separate processes, namely, a central premaxillary process and two lateral maxillary processes.

Experience shows that in many cases of Schistosomiasis the presence of ova in the stools is not detected by the ordinary means of examination, such as direct smear and saline concentration. But when these methods.are supplemented by others the ova can be demonstrated in the faeces. Schistosomiasis is a problem of major importance in China, and if reliable information as to its incidence is to be obtained, it is essential that some standard method of diagnosis should be adopted in the various laboratories doing this work. It is in the hope that this may be done that the following methods are here described, and they have the advantage that no elaborate apparatus is required and they can be used in any hospital laboratory.

Of late years one has heard much of China's external enemies, but it is often forgotten that her internal enemies, such as tuberculosis, the infectious fevers, and osteomalacia kill far more persons every year, than have been killed in war during the last ten years.

During the past three years the increasing number of cardiac patients admitted to the Hsiang-Ya hospital, the large proportion of women among them, and the pitiableness of their plight as a group, has made the staff search among the literature for accounts of cardiac disease in China. Such accounts are very meagre indeed. In fact articles on heart disease in publications in China are very scarce. Dieuaide gives a general review of care of heart disease, but the work on which it is based was done chiefly in the United States. Statistics on incidence and classification are practically non-existent. It seems likely from our experience that as digitalis and other drugs become known, more and more patients will enter hospitals for treatment of cardiac disease and that opportunities for observation win increase. This article is merely an enumeration and classification of a comparatively small number of cases, which will have to be checked elsewhere and many times over before being of statistical value.

Malignant tumours occurring at the limbus of the eye are usually classified into epitheliomata and sarcomata. An epithelioma takes origln from a papilloma and a sarcoma from a naevus. According to Fuchs, (1) "the pigmented mole (naevus pigmentosa) occurs especially in the bulbar conjunctiva close to the cornea in the spot whcre the pinguecula develops." The origin of the cells of naevi iB not agreed upon. Some claim they are derived from the endothelial cells of the lymph vessels, while others assert that they arise from the surface epithelium or from the chromatophores. Some men classify all tumours at the limbus as epitheliomata. Veil, (2) for instance, argues that all limbal tumours described as melano-sarcomata originate in naevi and are therefore naevicarcinomata because both pigmented and unpigmented naevi take origin from the basal epithelium.

Amebiasis of the uterine cervix is a rare parasitic infection of the female genital tract. A survey of accessible literature discloses only one report on such condition. This was by Lee (1) who first described two cases of carcinoma of cervix invaded by Entameba histolytica. The rarity of this condition warrants the addition of the following case to the literature.

Patients with urological disorders from a fair proportion of the surgical cases one is called upon to deal with in Shanghai. We wish to record the following cases, which illustrate certain important points in this branch of surgery.

One of the early problems that faces the small country hospital, rural health centre or private practitioner is that of reliable high pressure steam sterilization. The ordinary pattern. Of autoclave usually runs by a primus stove which easily gets out of order and at best is expensive in fuel. Then again the autoclave itself frequently proves too complicated for the junior assistant to manage and the doctor himself cannot take time off to run it. Any steam boiler to be safe should easily withstand a test of double its working pressure. We have tried several of the autoclaves now on the market in this manner and found that very few would even stand up to their full working pressure.

With the first of this year's issues some changes are being made in the form of the Journal to meet the desires of those who are asking for a larger amount of clinical and general material.

The report of the sessions of the Commission on Medical Education held in Nanking on September 6th and 7th, 1934, cannot but impress the reader with the devoted labor of those who prepared the very detailed outlines of courses accompanying the curriculum discussed at those meetings. Since it was decided that there should be further discussion by groups at Peiping and Shanghai with a view to the final elaboration by the Commission of definite recommendations to the Ministry of Education, it may not be out of place to submit for general consideration some fundamental principIcs which if sound might affect the nature of the requirements to be adopted.