Volume 60 · Issue 02 · 1941

Hemolytic streptococcus as an important cause of puerperal sepsis. has long been recognized. However, early studies on the bacterial flora of the vagina of parturient women revealed facts which seemed hard to explain at the time. Thus, Taylor and Wright (1) did vaginal cultures on l,123 parturient women immediately prior to delivery and found 32 to be positive for hemolytic streptococci. Of this number only three had fever during their puerperium. Rose (2) in 1933 reported results of a similar study on 3,774 delivery cases. Of 75 cases who showed hemolytic streptococci in the vagina during the Antenatal period 4 per cent developed fever during puerperium, of 71 who showed streptococci at the time of admission 7 per cent developed fever and of 129 cases showing the organisms during puerperium 10 per cent had fever. Thus, it was clearly shown that only a relatively small proportion of the parturient women who harboured hemolytic streptococci in the vagina developed sepsis. The reason for this was not clear at that time.

The relationship between sex and immunity to syphilis has engaged our attention for a number of years. That the female is more resistant to syphilis than the male has been amply shown in the case of human beings by Turner (1) and other investigators. Our own experience in the syphilis clinic of the Peiping Union Medical College supports this conclusion. In the rabbit (an animal used extensiveIy in experimental syphilis) the same difference between the sexes has been found to exist (2, 3). Our observations, which have been presented in part elsewhere (4, 5), as well as some unpublished data, also indicate that experimental syphilis is distinctly milder in the female than in the male rabbit, following either intracutaneous or intravenous inoculation of the virus. However, the explanation of this difference in immunity is not clear, at least so far as the mechanism of its development is concerned. In this laboratory we have carried out experiments showing that the primary sex hormones, among other factors, are capable of influencing the course of the disease in experimental animals.

Since Kline first introduced the slide precipitation test for syphilis in 1926 (1, 2), many modifications have been described in at tempting to simplify the technique or to increase its sensitivity. As each modification is claimed by its author to be superior to the others, it is apparent that the choice of a suitable method for the serodiagnosis of syphilis is neither simple nor easy.

During the fall of 1935, CheeIoo University Medical School accepted responsibility for the medical care of 19,000 refugees from the flooded farming districts of south-western Shantung, They were cared for in Tsinan at government expense, in 30 groups or "camps", of from 200 to 1,400 persons each, and were provided with two meals a day, consisting of steamed bread, made of 4th grade wheat flour and millet flour, a thin millet congee and pieces of salt turnip. Many individuals supplemented this diet from time to time with small quantities of vegetables, such as raw onion, red pepper sauce and boiled cabbage bought from vendors. This was more common in the early fall than later in the winter, when their small private funds had, in many cases, been exhausted. Later in the winter, the ingredients of the bread were changed to include corn meal, 4th class wheat flour and millet flour.

It has been recognized that the best opportunity to control pulmonary tuberculosis lies in the finding of early cases by means of tuberculin test and X-ray examination and the treatment of minimal lesions. Yet, today, even in the centers most actively engaged in the management of this disease, about 80 per cent of the patients are suffering from advanced lesions when first seen. To treat these advanced cases is just as important a measure as the treatment of early minimal ones, otherwise they would be a serious menace to the community.

Tuberculosis of the mandible has been considered a rare disease. Before 1922, according to Chapotel (1), only 50 cases were recorded in the literature, and since that time, reports of tuberculosis. of this bone have been very infrequent. Nevertheless, the seeming rarity of the Condition may have been exaggerated somewhat by the fact that tuberculosis has not been considered regularly in the differential diagnosis of apparent osteomyelitic lesions of the mandible. The following case abstracts are illustrative of this fact.

Soybean.milk (vegetable milk), prepared by grinding soybeans with water, has properties resembIing cow's milk, and this has prompted its use as an adulterant. A simple device for estimating the amount of adulteration is needed. Previous methods proposed by Nakayasu (1921), using a color test, and by Adolph and Yang (1933), based on estimation of the iodine number, have not been altogether satisfacWry. LaWall and Harrison (1935) list a number of qualitative methods for detecting the presence of soybean flour in manufactured foods. Glynn (1939) makes use of an immunological method for estimating soybean protein in meat-soybean mixtures. There are differences between the proteins of soybean milk and those of cow's milk. Glycinin, the principal protein of the soybean is a globulin, which under certain conditions is more readily coagulated by sodium chloride than is the casein of cow's milk. We have made use of this fact in the following procedure.

In 1922 Stephens described Plasmodium ovale, a new malaria parasite in the blood films taken in 1918 from a British soldier who contracted malaria in East Africa (1). Since then cases due to this species, though not many, have been now and then observed and reported in Africa by Stephens and other workers (2, 3). In 1932, James, Nicol and Shute succeeded in infecting A. maculipennis with this parasite and in transmitting the infection to patients through the bites of these mosquitoes. They concluded that the morphological characters of this parasite were unaltered in the human and insect hosts through the experiments (4). These findings justify in regarding P. ovale as a distinct species and in the malarial infection due to this species.

In recent years much stress is being laid upon pre-operative treatment for reducing operative risk, and rightly so. Feeding the patient with a full regimen of vitamins and nutritious food is no doubt a very important means of doing this, but frequently one is confronted with a patient who by reason of gangrene or infection is so toxic that it is impossible to give much nourishment by mouth. While for such patients intravenous administration of nutrient fluids, including blood transfusion,is an important adjunct, no doubt a simpler method is to be welcomed to either repIace or supplement it.

Abscess of the sclera is not mentioned in most of the textbooks of ophthalmology (Fuchs, Parsons, Gifford, May, etc.), while in a few only a brief reference is made. The rarity of this condition is testified by de Schwemitz (1) Scnoenberg (2), Duke-Elder (3), and others. Its rarity is explained on the ground that the scleral tissue has a powerful resistance against the invasion of bacteria.

Since its first publication in 1887, this JOURNAL has tried with certain limitations to record the progress of medicine made in this country in particular and in the rest of the world in general. That, despite the state of unrest prevailing in the Far East in recent years, the JOURNAL has been able to carry on this work is a testimony of the courage and devotion of the medical profession to its advancement.