Volume 56 · Issue 03 · 1939

The original purpose of this study was to determine the character of tuberculous lesions in the Chinese of Peking, with special consideration of the frequency of lesions of the type of first infection (childhood type) and of lesion of reinfection or adult type at different periods of life. The autopsy records and the organs from the autopsies that were available made it possible to compare in some detail the two types of infection.

In a large part of Chinese adults who died in Peking with pulmonary tuberculosis the disease had the usual character of the chronic pulmonary tuberculosis of adults found elsewhere (see preced ing paper (1). Slightly less than half of them had lesions of first infec tion or childhood type of tuberculosis. The number of these lesions in adults was so great that the attempt was made to determine if there was some factor which might explain their occurrence.

The treatment of dysentery is essentially dietary for it consists in replacing the water and minerals lost during diarrhoea and sweating before the effects of their withdrawal damage the tissues. Too often, the similarly depleted vitamins are neglected. In diarrhoea infections, attention to these metablic essentials is necessary for four reasons.

As far as the writers are aware, few studies on the changes of blood and cerebrospinal fluid sugar during hypoglycemia have been made in schizophrenic patients. While our work was in progress, two articles had come to our notice. In the paper by Dussik (1) the blood and cerebrospinal fluid sugar values at the time of insulm coma were determined, while in the communication by Day, Niver and Greenberg (2) the course of changes in blood and cerebrospinal fluid sugar after insulin was followed. The object of this paper is to report the results of a number of individual and serial determinations of both the blood and cerebrospinal fluid sugar in schizophrenic patients treated by insulin according to Sakel's method (3).

On August 4th, 1937, immediately after the outbreak of the Sino-Japanese conflict, the Chinese Red Cross requested that certain national Red Cross Societies should be informed of its most urgent needs in case they should feel inclined to offer assistance. A week later, it expressed the desire to have a delegate of the International Red Cross Committee sent to China, and announced the constitution of a central Relief Committee, requesting estimates for large quantities of medical supplies.

The occurrence of kala-azar in children in the first year of life presents certain unusual advantages for the study of the epidemiology of the disease. In the first place, the simple life of an infant with respect to diet, contact and whereabouts renders many of the possible channels of infection in an adult relatively unimportant in a young child, thus greatly reducing the epidemiological factors to be considered.

In the previous papers of this series (Winfield 1937, 1937a, 1937b, Winfield and Chin 1938) the study of the epidemiology of the nematode Ascaris lumbricoides has been used to indicate the fundamental aspects of the fecal pollution of the environment in West Shantung, as a part of a general program of study on the control of fecal-borne diseases. In order more completely to fill in the picture of sanitary conditions the main features of which have been disclosed by the Ascaris studies, concomitant studies on the parasitic amoebae have also been carried through. These investigations on the amoebae are also of value because they contribute to our specific knowledge of these protozoa.

It is not uncommon for typhoid to cause inflammations to the biliary system, but it is very rare for the gallbladder to perforate in typhoid. In going over the Quarterly Cumulative Index Medicus between 1927 and 1939, I have been able to find that Tongs (1) reported a case of perforation of gallbladder in a patient who had an attack of typhoid fever two months previously. Likewise Notti (2) reported a case of peritonitis due to perforation of gallbladder during typhoid, Bodnar (3) in the same year, a similar case in a boy of 7 years old, and Costa (4) another case in a child of 6 years of age.