Volume 49 · Issue 06 · 1935

In the West, in countries where many serious infectious diseases have been eliminated or brought under control, cardiovascular disease has become the most frequent cause of death among adults(I). Illness from heart failure causes an enormous loss of time and money, so that the economic aspects of heart disease loom large(2). Its prevention is, therefore, a most important problem of public health, taking rank next after tuberculosis (3) Realization of this need is growing rapidly, as is shown by the formation of national associations with the principal purpose of attacking the problem. State public health, administrations have hardly entered the field as yet, but they must soon do so.

In a series of infection experiments with Culex pipiens in Shanghai area by Hu and Yen (1933), the larvae of Wuchereria barcrofti were found to be able to survive for quite a while after they had developed to the matured stage in the mosquito host. The filarial larvae in some of the Culex pipiens were found to be still very active when examined after 32 days of incubation. With the present series of observations, a longer time was allowed to elapse after the Culex pipiens were experimentally infected before they were dissected for examination, in order to obtain further ideas concerning the duration of life of the infective filarial larvae in their mosquito host.

As cystostomy is a surgical procedure these may be considered as mechanical, namely to rest (a) the kidneys, (b) the bladder, (c) the urethra.

Salmonella enteritidis infection in man other than that of acute gastro-enteritis is uncommon. It usually takes the form of septicemia, though local infection of the gall bladder, and of the meninges has been reported. Dean (1) reported a case in which S. enteritidis was isolated from the gall-bladder, the feces and from the gall-stones in a case of chronic cholecystitis with cholelithiasis. Stuart and Krikorian (2) claimed it to be the cause of meningitis.

Among the many complications which may occur during labour, pulmonary embolism is one of the most tragic, and against which we are more or less helpless. The condition carries with it a very high mortality, and attack is usually so sudden and dramatic, that it gives an extreme shock to both the family and the accoucheur. Fortunately, it is of rare occurrence, and many obstetricians have never seen a case. Because of this rarity, it is considered desirable to report a case which came under observation in October, 1933.

Through the help of a fellowship given by the League of Nations and the permission of Dr. J. Heng Liu, director of the Central Field Health Station, the writer had been able to attend the Malaria Course at Singapore from April 30th to June 27th, 1934. As appeared elsewhere this course was arranged and supported by the Health Organization of the League of Nations. There were two distinct stages to the course, namely: (1) A theoretical and laboratory study with practical demonstration, and (2) Practical field study. The course was well attended by 27 candidates representing g different countries: Australia, China, French Indo-China, Federated Malay States, Unfederated Malay States, Straits Settlements, Japan, Siam, and India. The theoretical and laboratory study was held in the King Edward VII College of Medicine at Singapore with the support of the whole staffs of the college as well as experts from Java, Indo-China, and Malaya, and it laSted from the 30th of April to the 2nd of June. Field study commenced immediately after the end of the theoretical and laboratory study. The candidates were divided into two parties, one to take field study in Malaya and the other in Java. The writer was assigned to the Java party. The writing of this report is based on his personal experiences gathered in both Singapore and Java, which he hopes might interest others who have not had the chance to attend the course.

In 1924-28, Faust(1) found 25-26 per cent incidence of intestinal parasites infestation among 14,000 persons examined in North China. Cart and Stall (2) in 1923-24, examined 4,000 persons, divided into five groups, namely, the Chefoo group, the Nantungchow group. the rice-cultivation group and the mulberry-tree cultivation group from Soochow, and the Canton group, with the result that they found a very high incidence of intestinal helminths in the Canton group and a low percentage in the mulberry-tree cultivation group from Soochow, (hookworm being the highest), and a heavy infestation in the children. S. L. Hung (3) reported that 37.6 per cent out of 1,000 persons examined in Peiping were infected with intestinal parasites.

In our self-appointed task of discovering, testing and applying modern equipment for rural medical work one of the most interesting and satisfactory has been the problem of X-ray equipment.

The problem of the distribution of physicians is vitally related to the medical profession as well as to the public. The recent report of the Committee on the Costs of Medical Care for the American People (6) reveals that the medical facilities in the United States are not distributed primarily according to needs, but rather according to real or supposed ability of patients to pay for service. As a result, many cammunities in that country are undersupplied with practitioners, hospitals and other facilities, while others have a surplus. For example, in 1929 there was one physician to every l,431 persons in South Carolina, as contrasted with one to every 571 in California and one to every 621 in New York State. Furthermore, the same report shows that there is also a maldistribution by type, as indicated by the fact that approximately 45 per cent of the physicians in America have completely or partially limited their practice to a specialty, although, in the opinion of the Committee, apparently the needs of the people could be met adequately if not more than 18 per cent of physicians were specialists.

It is well known among clinicians, that tuberculosis is very prevalent among all classes of the Chinese population. It is one of the most common causes of disease as recorded in the out-patient departments of hospitals in China. It constitutes an important problem for the authorities in charge of secondary schools and colleges. The presence of tuberculosis infection among various groups of society has been studied in many parts of the world during the past few years. The work among school children furnishes a satisfactory field for study. It was, therefore, thought worth while to study the incidence of tuberculous infection among a group of Chinese middle school students. The following report gives the result of such a study.

Those who study the reports of hospitals in China must have been struck by the steady increase in returns of this disease. This does not mean that many cases are shown in the returns of any one hospital but that whereas a few years ago such a diagnosis was very rare, now most large hospitals from time to time report a case. Of course we realise that this may only imply more exact diagnosis and the recognition of a comparatively new disease, but on the other hand the mortality of the disease is so high and the lesions so striking that we should judge ourselves that the increase of victims is real and not only apparent.

It has been generally held that the character of the fluid obtained by lumbar puncture in cases of tuberculous meningitis is of diagnostic importance. The transparency of the fluid and the number and type of the cells are all useful means of distinguishing the tuberculous form from some of the other forms of meningitis. The typical fluid in tuberculous meningitis is clear, occasionally it is slightly cloudy, and only very rarely turbid. The cellular content of the fluid is generally increased, 120 to 200 cells per cubic millimeter being an average count. The mononuclear cells are very greatly in excess