Volume 60 · Issue 06 · 1941

During my stay in Yenan (Northern Shensi) February to May, 1938, I had the opportunity of investigating the incidence of rinder-pest in this cattle-raising country. Just at the beginning of that period a severe outbreak occurred in this district.

Previous studies in this laboratory have revealed the presence of natural Brucella infections among the human population of Peiping. This conclusion was reached firstly by finding of patients from whom Brucella organisms have been identified (1, 2) and secondarily by a study of the specific agglutinin of over 2000 specimens of normal human serum (3). However, it was pointed out that in spite of the apparently relatively frequent contact to the Brucella antigen as manifested by the comparatively high percentage of serum giving positive agglutination, no clue as to the sources of this infection has so far been disclosed. Continued efforts have been made in attempting to discover possible reservoirs in some animal hosts as this disease is well known to be prevalent among cattle, goats, and pigs. We are now able to report in a preliminary way the occurrence of Brucella infection among several dairy herds, which may be as considered as one of the sources of local infection.

After a comprehensive review of the literature on syphilitic aortitis, Longcope, (1) stated in 1913; "....the presence of spirochetes in these lesions, as might be expected, cannot by any means be constantly demonstrated with Levaditi stain....... That these organisms are Treponema pallidum seems almost certain though actual proof of such by culture from the arterial lesions, a most difficult task, or direct inoculation into animals, has not as yet been accomplished."

It is common knowledge that colostrum and milk of lactating mothers suffering from certain infectious diseases contain specific antibodies.

Bone meal, which is essentially calcium phosphate, is being used to an increasiug extent in China to replace the more expensive calcium lactate to meet dietary deficiencies in calcium. A question however has occasionally been regardiug the availability of the calcium in bone meal.

The carotid sinus is a bulbous dilatation of the proxmial part of the internal carotid artery (1,2,3,4). Histologically it is characterized by a thinning-out of the muscle fibers of the media and an increase of the collagen fibers of the adventitia, in the deeper layers of the latter there are numerous sensory receptors (1,2,4,5).

There is no doubt that primary carcinoma of the gall bladder is more common in Europe and America than in China. This is perhaps due to the greater frequency of gall stones in Western Countries.

Colloid carcinoma is usually found in the gastro-intestinal tract where the mucous secreting cells are abundant, but only rarely in the mammary glands. The earliest description if colloid carcinoma of the female breast is credited to Otto in 1816 (quoted by Gaabe, 6).

The recent publication of a report (1) of facial paralysis as a rare symptom of tetanus made us take special interest in a case recently under our care.

Pylephlebitis (thrombophlebitis of the portal vein) is a much dreaded complication of acute appendicitis, chiefly because of its high mortality rate. Owing to earlier disgnosis and to earlier and more adequate treatment of the latter condition, however, the incidence of this complication has been gradually diminishing in the last fifty years. In 1886, Fitz (1) cited 11 cases of pylephlebitis observed among 257 autopsies of patients dying from perforating appendicitis. Armstrong (2), in 1897, noted 5 deaths from mesenteric pytephlebitis and abscess of the liver among 67 mortalities from acute appendicitis. He reviewed a total of 517 cases. In 1929, Colp (3) analyzed a series of 2841 cases of acute appendicitis, and found that the diagnosis of pylephlebitis had been made only nine times.

Periostitis of the os calcis, until recently listed under the misnomer of gonorrheal spur, is a common disease of young Chinese males. Its importance generally has been under-estimated, largely because of a lack of understanding of the true nature of the disease. The literature concerning this subject is scarce and most of the papers which have been published deal with some form of local therapy and give little consideration to the systemic character of the malady. It is not surprising, therefore, to find that treatment has not proved satisfactory and more and more radical types of therapy have been devised.

After the discovery that sulfanilamide is the active principle responsible for the chemotherapeutic action of prontosil, over a thousand compounds have been studied. There are, however, only four, which are widely used today, namely sulfanilamide, sulfapyridine, sulfathiazole and neo-prontosil. In common with any drug to be used in therapy the acute and chronic toxicity of thin group of drugs have been thoroughly explored. For instance, sulfapyridine was thought to be Jess toxic than suWnilamide but this is probably due to the poorer absorption of the former drug. By the use of sodium salt which is equally absorbed as sufanilamide, it is found to be dicidedly more toxic. Sulfathiazole, on the other hand, is definitely less toxic. It is also found that sulfonamide compounds are partly acetylated into inactive compounds in the body, and some of them, especially acetyl sulfapyridine and acetyl sulfathiazole are relatively insoluble in the mine hence resulting in the formation of stone in the urinary tract after their administration.

The chance observation that a given chemical produces a specific desirable pharmacologic reaction which may have therapeutic possibilities may be the first step in any progress in chemotherapy. It is then the duty of the first members of the chemotherapeutic team consisting of chemists, pharmacologists and clinicians, to prepare chemically related agents for comparative pharmacologic study in order to determine the most promising derivative. The goal is the discovery of a substance quantitatively less toxic for mammals, without significant untoward or side-actions, which may be safely used in effective amounts. The theme of chemotherapy is chemical structure, biologic action, therapeutic effect. Such endeavors require nice coordination, with the object of finding beneficial agents which will not kill man more often than once in 10,000 times, if therapy is controlled by physicians, or more often than once in a million times if uncontrolled mass application by laymen is attempted.