Volume 67 · Issue 10 · 1949

Although peptic ulcer is a common disease and pain is its most important and characteristic symptom, yet there is still no unanimity of opinion regarding the exact mechanism of ulcer pain. Bonney and Pickering (1) in 1946, found that ulcer pain was relieved by aspiration of. the stomach contents and could be induced by reintroduction of these contents. Pain was not produced if the contents were neutralized prior to injection. Pain nearly always occurred when the gastric contents attained a certain degree of acidity for a sufficient time and was nearly always absent or subsiding when gastric.acidity fell below a certain level for a sufficient time. In the pain-free periods and in normal subjects, the introduction of acid did not induce pain. The threshold of acidity necessary to evoke pain varied greatly from one patient to another. In general, patients with duodenal .ulcer manifested the highest threshold and anastomotic ulcer the lowerest, with gastric ulcer intermediate. The pH necessary to evoke pain was about l.5 in patients with duodenal and gastric ulcer and as low as pH 2.75 in anastomotic ulcer. Their findings tend to confirm the acid theory advanced by Palmer (2) and other investigators.

The past literature on pernicious and allied anemias in infancy was rather confused and the conditions had not been properly recognised and classified. True addisonian pernicious anemia in infancy is undoubtedly an extreme rarity. In 1946 Peterson and Dunn (1) accepted, according to their criteria, only 3 reported cases as genuine and added one of their own. Other cases, similar but not true pernicious anemia, had been reported under various titles, such as "macrocytic hyperchromic anemia in early infancy" (2), "severe functional anemia resembling pernicious anemia of adults" (3), "nutritional anemia in infants responding to purified liver extract," (4) etc. Zuelzer and Ogden in 1946 attempted to define, on pathogenetic basis, an anemia which they termed "Megaloblastic Anemia in Infancy" (5). Later, the same group of workers have contributed further articles (6, 7, 8) dealing with the various clinico-pathological aspects of this syndrome. Since this condition has not gained wide recognition and has not as yet been reported from this country, we consider the following case worthy of communication.

Congenital stenosis of intestine is considered as a very rare condition and not a single case has yet been reported in the Chinese literature as far as we are aware. Drs. W. E. Ladd and R. E. Gross of the Children's Hospital in Boston reported twenty-one cases of congenital stenosis of intestine including two cases of jejunal stenosis, of which one recovered and the other died.

Although typhoid fever has practically disappeared from Western countries, in China it remains a common disease, and intestinal perforation due to typhoid ulcer still is all too frequently observed. In the past five years, we have encountered over thirty such cases in the Chung Ho Hospital, an average of 5 or 6 cases during each typhoid season.

In the year of 1945, it was reported from Chengtu (1) that Chinese soy-bean sauce has the bearing of transmitting the gastro-intestinal bacterial infections. The author found positive cultures in as many as 35% of the samples examined. If this finding can be confirmed, it seems to be quite a serious problem in the field of public health especially in China, because uncooked soy-bean sauce is frequently employed in the Chinese diet.

Primary pneumonic plague is almost always a rapidly fatal disease. As far as the writer is aware, there is no other ailment which runs such a rapid course and high mortality comparable to this disease. Wu Lien-teh (4) in 1926 reviewed the literature on recovery in primary pneumonic plague and stated "That recovery from pneumonic plague, though exceedingly rare, is not impossible. For all practical purposes, however, the prognosis of primary pneumonic plague may be considered as well- nigh hopeless." During the period from 1925 to 1944, there had been reports of recoveries in 8 cases of pneumonic plague in the world, (1, 2, 3, 6). Of these 8 recovered cases, not all were proved to be pneumonic plague by laboratory diagnosis.

As the pathogenic agent of trachoma has not yet been discovered, methods of treatment used up to now have been purely symptomatic. During the last twelve years, the attention of research workers and especially biologists has been drawn to sulphonamides because of their specific action on bacteria, particularly on protoplasm.

Blood transfusion is an important therapeutic measure which is being employed in an ever widening variety of pathologic conditions. Its use in all too many hospitals, however, still remains an emergency procedure which it is desirable to carry out with the least possible delay. If time then is required to locate willing friends and relatives and to await the search for compatible blood, particularly in those instances in which the patient belongs to one of the rarer blood groups, many lives may be forfeited. Increasing attention therefore has been focused on the development of adequate ways and means for the safe and satisfactory preservation and storage of blood. During the past ten years blood banks have been developed in many hospitals (8-10, 12, 14, 16, 18, 23) in an attempt to solve this difficulty. Their primary function is to facilitate the prompt and safe infusion of whole human citrated blood of the type needed at the time needed, and so to avoid unnecessary delay. Another important result of such an arrangement is that ample time is provided for careful, accurate laboratory examination of the blood to be infused, in contradistinction to the hurried and abbreviated procedures formerly so often employed.