Volume 58 · Issue 02 · 1940

Osteomalacia is a frequent disease in the northern parts of China. Maxwell's papers (1-5) contain good clinical descriptions of the disease as it occurs here, particularly in relation to the practice of obstetrics. Our metabolic studies (6-11) have confirmed and amplified the concept that deficiency of vitamin D through its lack in the diet and through in adequate exposure to sunlight plays a primary role in the etiology of the disease. The low calcium intake in the usual Chinese dietaries and the drain incidentaI to frequently repeated pregnancies and prolonged lactation serve to accentuate the rate of skeletal demineralization. While osteomalacia has been a subject of intensive clinical and metabolic study here, pathological material is rather scanty. The following case seems worth recording in view of the Advanced picture it presents, the finding of parathyroid hyperplasia as a probable aggravating factor in the bone decalcification, and the presence of thoracic deformity and vitamin B 1 deficiency which are contributory to the cardiac embarrassment and fatal termination.

Sulfanilamide is known to be a very diffusible substance and its ability to penetrate the tissues of the body has been considered an important factor in its therapeutic efficacy in combating infection. Marshall and his co-workers (1) have demonstrated that sulfanilamide readily enters various tissues and body fluids. Rambo (2) found it in the aqueous and vitreous humors and lens, and Bellows and Chinn (3) detected it in all ocular tissues and fluids after oral administration. With the exception of the studies of Bellows and Chinn on two patients and those of Mengel (4), who determined the concentration of sulfanilamide in the aqueous and vitreous humors in three patients, all determinations have been made on the eyes of animals.

Three Chinese infants with severe anemia and marked erythrobla-starmia have recently been seen in the Pediatric Service of the Peiping Union Medical College Hospital. The clinical, hematological and roentgenological findings of these cases are reported here. It is hoped that the publication of this kind may stimulate more interest and further investigation on the mechanism of the production of abnormal blood pictures in such cases.

In a previous communication (1) a micro-sedimentation method was described. The normal Sedimentation rate according to this method ranges from 0.5 to 15 mm at the end of one hour. Figures between 15 and 17 mm.are regarded as border line values, and they may be considered as increased or normal depending upon other clinical and laboratory findings in a given case. Any value above 17 mm is taken as an increased sedimentation rate.

The usual conception of the alteration in the hemopoietic system in pellagra is that it closely simulates that of pernicious anemia. Huck (1923) and Turner (1933) (and particularly the latter) having studies the blood picture in pellagrins in great detail and with careful control of cases, concluded that the anemia, when present, was definitely of the chlorotic, normocytic, or microcytic type and in no instance of the macrocytic type.

A recent report by Cochrane tells of his efforts in transmitting human leprosy to splenectomized monkeys. Adler has reported on the transmission of leprosy to Syrian hamsters, and Balfour Jones the transmission of rat leprosy to the hamster. It is quite evident that if there was a laboratory animal available for the study of leprosy, its mode of infection and various methods of treatment, we might expect much more rapid progress in the study of this disease which has been so baffling for many hundreds of years. It is also self-evident that a method of infection which follows actual conditions found in humans, is highly desirable. In the following experiments the animals were fed with a diet which is common to a great many people through- out the world as suggested by Oberdoerffer.

Rat-bite fever, called "sodoku" meaning "rat-poison" (1) in Japan, is usually considered a rare and interesting disease contracted from the bite of an infected rat. In regions where careful investigations have been made, the causative organism, Spirillum minus, has been found in a high percentage of rats (2). It is primarily a disease of rats, transmissible to other rats, to cats, dogs (3) and other rodents (4) and to man by their bite.

The Province of Yunnan has hitherto received scant attention as regards its mosquito fauna. This has been chiefly due to the difficulties of travel in the Province up to the establishment of the new Bur ma highway in 1939. Such surveys as have taken place in the past have been chiefly along previously established routes of travel. Gaschen (1934) conducted an entomological survey along the French railway from Lao-Kay to. Yunnanfu (Kunming) and found nine species of anophelinesin the region he visited. Yao and Ling (1937) made a study of the mosquito fauna of South-western China and gave a list of fifteen species of Anopheles for the Province of Yunnan. The regions visited comprised the southern section of the province and some stations along the Yunnan Railway.

Scarlet fever is generally considered to be a prevalent and severe disease in North China. As early as 1890 Coltman (1) gained this impression from his correspondents. In 1934 Yang and Shih (2), from the replies of medical practitioners to their questionnaire, concluded that scarlet fever was absent or mild in South China, not unduly severe in the central provinces, and severe in the North. These reports were based mainly upon personal impressions of various observers. Recently Davis et al (3) and Hsu (4) by Dick test, and Gear (5) and Hsu and K'e (6), by analysing special hospital reports from many parts of the country, confirmed this general impression. As there is yet lacking a published account on the epidemiology of scarlet fever in a particular Chinese community, it seems desirable to present certain epidemiological observations on the disease in Peiping.

The problem of the oral health of the Chinese people is of the greatest national importance. It concerns not only the dental and medical professions, but also about four hundred million Chinese citizens. Its successful solution involves attitudes and procedures which must be attained and developed by those now responsible for establishing the national health program. This leadership now rests upon the shoulders of the medical profession. The still largely unorganized dental profession of China can scarcely be held accountable for its present apathy in the matter.