Volume 58 · Issue 05 · 1940

Studies on the incidence of tuberculosis among apparently healthy persons in China have been made by several authors. Korns (1925) performed tuberculin test on 2,049 individuals in Peiping between 8 and 20 years of age, with the Pirquet technic. Lai and his associates (1934) did the same on 4,703 persons of all ages under 25 years in and near Shanghai, using one-thousandth dilution of old tuberculin in tracutaneously as the final testing dose. Wylie (1935) tested 600 middle school students in Paoting using one to one-thousandth dilution of old tuberculin. Fan (1937) tested 274 children in a rural district in Shantung with one to ten-thousandth dilution of old tuberculin. Hall and Chang (1934) reported on the incidence of pulmonary tuberculosis among l,007 employees and students of the Peiping Union Medical College between 20 and 40 years of age, based on roentgeno-graphical findings. So far there is no published study in which a sufficiently large group of persons were tuberculin-tested, the tuberculin reactors were fluoroscopically examined and diagnosis was ascertained by x-ray films and follow-up examinations. The present communication deaIs with the results of (a) tuberculin testing of 8,282 individuals between 5 and 20 years of age, (b) fluoroscopic examination of 3,167 tuberculin reactors between 10 and 25 years of age and (c) roentgeno-graphic examination of the suspects thus found, and whenever possible, periodical follow up of all who showed lesions to ascertain the diagnosis.

Information regarding incidence and intensity of parasites of the intestinal tract of man in West China is meaget and fragmentary. While undertaking a series of investigations to determine the sources and modes of transmission of human intestinal parasites in Chengtu (the results of these studies will be published soon) it was felt necessary to secure some more specific knowledge of the prevalence of the intestinal parasites of man in the district concerned. For this reason the present investigation was carried out.

Up to the present there ha not been recorded a large series of Cantonese babies' full term birth weights. Series, all of them small. have been published for Northern and Central Chinese, by Lee (1930), King & Tang (1937), and Eno (1933). Lee included 270 Southern Chinese in his series.

During the past two years many clinicians in various large centers have noted an increased prevalence of an unusual form of pneumonia. Previous efforts directed toward the isolation of etiological agent from this disease were uniformly unsuccessful. The evidence seemed fairly conclusive that the pneumonia was not due to any known bacterium, and certain features both in the clinical syndromes and in the various laboratory findings led numerous investigators to suspect that the disease might be caused by a hitherto unknown virus. Numerous attempts were made in this laboratory during 1939 to isolate a virus from throat washings obtained from thirteen cases clinically diagnosed as primary atypical pneumonia." Although eight different species of animals were used in these attempts, no success was attained. Despite these failures filtered throat washings from some cases were passed in series on the chorio-allantoic membrane of the developing chick. Frozen and dried chick membrane passage material was taken to Jamaica and this material was used for the inoculation of the wild mongoose. The results in the mongoose were sufficiently suggestive to warrant the continuation of the studies in this remarkably intractable species. Somewhat over 240 mongooses have now been used. Results suggest that a filtrable agent has been isolated from throat washings. This agent is capable of producing transmissible consolidation of variable extent in the mongoose lung. The agent appears to have been neutralized by the convalescent serum obtained from patients with the disease but not by the acute phase serum from the same patients. The evidence now available strongly suggests that this agent may be etiologically related to the human disease, but additional studies will be necessary before this bypothesis can be adequately defended.

It has long been known that dogs with high intestinal obstruction live only for short periods of time. The cause of death, however, still remains obscure even, though a vast amount of experimental work has been carried out in attempts to explain this phenomenon. The toxemia theory sponsored by earlier workers has fallen more or less into disrepute as the recent literature has given increasing importance to the profound alterations in the chemical constituents of the blood which occur in this condition. The vital role played by chlorides was first realized by Haden and Orr and subsequently emphasized by other investigators. It has been shown that the lowering of the blood chlorides is brought about chiefly by the loss of electrolytes through repeat.ed vomiting, and the beneficial action occasioned by the administration of saline is believed by many, natably Gamble and Ross, and Wangensteen and Chunn, to be due not to a detoxifying process but to the replacement of a definite loss.

The use of sulfanilamide in the treatment of trachoma was first described by Heinemann (1) in 1937. Subsequently many reports have appeared in the literature, dealing with its therapeutic effect in this disease. Favorable results have been obtained by Heinemann (1), Lian (2), Loe (3), Gradle (4), Dik (5), Kirk, McKelvie and Hussein (6), Hirschfelder (7), Guyton (8) and Richards, Forster and Thygeson (9). Theseinclude rapid cessation of lacrimation, photophobia, blepharospasm and secretion, paling and thinning of the hyperemic and thickened conjunctiva, flattening followed by disappearance of the conjunctival hypertrophy and follicles. clearing of active pannus and recent corneal opacities, and improvement of vision. According to Loe, sulfanilamide can effect an arrest of trachoma in about three weeks. Gradle stated that "the results of three weeks of treatment with sulfanilamide approximated those with from three to six months of local treatment although there was no scar formation". Richards, Forster and Thygeson observed that the trachoma virus disappeared from the conjunctiva during treatment. The results of these workers tend to show the great therapeutic efficacy of sulfanilamide in trachoma and that it produces far more rapid and extensive healing than any other antitrachomatous remedy so far available.

Gonococcal vulvo-vaginitis is a very distressing disease from many points of view. Those who have had experience along this line can not but notice the anxiety it produces in the minds of parents. From the beginning they feel humiliated and concerned as to the source of infection, its possible spread to other children and the consequence on the child in later life. The infected children receive mental injury as well as physical trauma. It is a serious social problem and a worry to those in charge of children's institutions.

A correlated study of the drug levels in the blood of the patients on sulfapyridine therapy with the clinical response was difficult and inaccurate, because of the irregularity in absorption of the orally administered sulfapyridine (1, 2, 3), nausea and vomiting in sensitive individuals and to deIirium and dysphagia in serious cases. Suspensions of sulfapyridine in oil (7) and in sodium hydroxide (4) had been used to overcome some of these difficulties. But in critical cases with massive infection and overwhelming toxemiain which a prompt action of the drug through a rapid rise to therapeutic blood level and its proper maintenance is desirable, these methods were found to be inad equate. Sodium sulfapyridine (soludagenan) was therefore used for this study. It is an aqueous soluble sodium salt of sulfapyridine in 33'/a% solution, each ampoule of 3 cc containing one gram of sulfapyridine.

Bacillary dysentery is essentially a localized disease of large intestine and in severe cases the inflammatory process may extend to the terminal ileum and mesenteric glands.

On August 24, 1938, two trematode specimens, belonging to the genus Euparyphium, were found at autopsy in the small intestine of a Chinese male, who had died of chrome myelogenous leukemia in the Peiping Union Medical College Hospital. The morphoIogical characters of these two trematodes as described below, are identical with those of Euparyphium jassyense Leon and Ciurea, 1922, which has been recorded only from man and was obtained only once from a Roumanian of Persian origin in Jassy. As the present case represents the second report of the occurrence of this parasite, it seems desirable to have a full description of the specimens so that future investigators may compare the morphological variations of this species collected from different localities.

Foreign bodies in the appendix are often mentioned in text-books on medicine, surgery, and pathology. Pins, fish-bones, nails, buttons, date-stones, cherry stones and grape seeds have been recorded as having entered this organ.

To follow every case of cholera during a rapidly spreading epidemic until the stool culture becomes negative is virtually impossible.