Cardio-splanchnic phenomenon of Abrams / by Albert Abrams.

  • Albert Abrams
Date:
1911
Catalogue details

Licence: Public Domain Mark

Credit: Cardio-splanchnic phenomenon of Abrams / by Albert Abrams. Source: Wellcome Collection.

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    in 10. During the year 2 were discharged as recovered, 2as relieved, 5 were transferred, and 8 died, the deaths all being from natural causes. Reception Houses. Up to the present the reception houses in Queensland have been merely resting places where patients from outlying districts could be temporarily detained until a sufficient number had been collected to be sent to one of the hospitals for the insane. Now, however, Dr. Ellerton proposes to submit certain amendments of the existing Lunacy Act whereby the reception houses will be done away with and sanctioning the admission of early cases of insanity into mental wards in general hospitals for a limited period on the authority of two medical certificates only, without any magistrates’ or justices’ orders. Cost. The net cost per patient per week at Goodna was 8s. 2d., at Toowoomba 8s. 3d., and at Ipswich 6s, 4d., or an average of 7s. 7d. per week. / Straits Settlements. (FROM OUR SPECIAL CORRESPONDENT.) THE WORK OF THE MEDICAL DEPARTMENT. THE Principal Civil Medical Officer, Dr. W. Gilmore Ellis—who succeeded Dr. McDowell—has just issued his first annual report. It covers the year 1909. The mean population, which for 1901, calculated from the census returns, was 572,249, is estimated at 636,691 for 1909. ‘The estimated increase is based entirely on the increase between the census figures of 1891 and 1901, the better means of estimating from the number of births and deaths and immigration and emigration not being practicable as records for the latter are not reliable. The birth-rate has declined in all the Settlements, being 26.69 per 1,000 as against 28.75 in the previous year. The death-rate is the lowest registered since 1899; in 1908 it was 46.78 per 1,000; in 1909 it was only 38.56. Of the number of deaths registered in 1909, 4,714 were among infants under 1 year of age, which represents a percentage of 19.7 of the total. It was hoped that the Government would bring in a Midwives Bill during the year, but nothing was done in that direction. During the year, however, some native women were being trained in the maternity wards of the General Hospital. These wards are slowly increasing in favour amongst the Chinese, and with more cases it is hoped the work will progress satisfactorily and bear fruit in the future. ° There were fewer cases of plague during 1909 in the several Settlements, only 5 cases occurred, all of which were fatal. Cholera also showed a marked decrease— 84 cases with 76 deaths, as against 198 with 178 deaths during 1908. Beri. beri still claimed a number of victims, no less than 1,506 persons dying from that disease in 1909 out _ of a total of 2,118 cases. The results from the use of parboiled rice continue to give satisfaction, and the native patients at the several hospitals are exclusively fed on cured rice. Work on the etiology of this disease has been in progress throughout the year at the Research Institute, Kuala Lumpur, under Dr. Fraser. Dr. Ellis remarks that a dispatch had been sent through the High Commissioner to the Secretary of State transmitting a report recording the results. In the present state of knowledge, however, it has not been found feasible to advise Government as to any legislative measures of a preventive nature, although the results of work at many different laboratories seem to promise that this must soon be possible. As in other parts of the world, the death-rate from phthisis is high, no less than 2,659 deaths being registered. This serious mortality, the report states, is likely to continue until some practical measures are put in force in the larger towns to lessen over- 22500894155 Mezpican JournNaL crowding, improve ventilation, and remove advar ged cases. 0. The number of cases of ankylostomiasis amounted to 535. compared with 192 in 1908, 80 cases being fAtal. Over 30,000 cases were treated in the various hospitals throughout the Settlements, with a percentage af 12.01 deaths to the total treated. The total number of vaccinations performed throughout the colony in was 12 854, In connexion with the Medical School there are now 72 full-course students, compared with 58 in 1908, studying for the L.M.S. diploma, cf whom 17 are in their fitth year. Much good work is being done in connexion with the pathological department of the colony. Correspondence. PARATYPHOID FEVER. Siz,—Permit me, as one familiar with the scientific work being done in India by officers of the Royal Army Medical Corps.and also conversant with the statistical facts relating to both the European and Indian armies, to enter a plea for clear thinking as to the use of the term “ paratyphoid fever.” From recent literature on this sub- ject there appears to be a definite tendency at home to apply the term “ paratyphoid fever” to cases of infection by the micro-organism known as Bacillus paratyphosus B. Concurrent with this, there is a tendency to overlook the infection by the closely allied micro-organism known as Bacillus paratyphosus A. This latter attitude may be due to the apparent infrequency of paratyphoid A infection in England or Europe. Before the nomenclature becomes crystallized and passes into general use by the profession, in the sense suggested by the recent literature published, if would be as well for the profession to realize that, in India and also in South Africa, there is recognizable a definite clinical entity caused by the Baciilus para- typhosus A. This clinical entity is a fever or pyrexia of the continued type. This view is worth bearing in mind, that itis to this continued fever, often of comparatively short duration and marked by a low case-mortality rate, caused by the Bacillus paratyphosus A, that the term “paratyphoid fever” should be applied, and applied only, at least for the present. Practically all the Indian cases are instances of infection by the A bacillus, and so far no case is diagnosed in the army unless the incriminating micro-organism has been isolated from the case. Without going into the question of what is meant by a Bacillus paratyphosus B, or discussing how confusion has arisen, or the methods by which confusion can be avoided, as to whether a given micro organism is Bacillus para- typhosus B or Bacillus swipestifer, it appears desirable to recognize that infections by these micro-organisms are really not “fevers” as ordinarily understood, but rather explosive infections of the nature of an acute enteritis, commonly the outcome of what is called “food poisoning.” As explained, the infection by the A bacillus conforms to quite a different type, and is best described as “ para- typhoid fever.” From this point of view, it seems desirable that a confusion of ideas be avoided and that, failing better terms of expression, we limit the use of the expression ‘‘ paratyphoid fever ” to cases of fever in which the causative micro-organism is the Bacillus para- typhosus A, and describe as ‘‘food poisoning” those in which the causative micro-organism is either the Bacillus paratyphosus B, or the Bacillus swipestifer, or the other closely allied organism, the Bacillus enteritidis of Gaertner. It must be admitted that we have still much to learn regarding all these infections, and subsequent investigation may compel us to modify our conceptions as to the whole group, but speaking in the light of our present knowledge, it is submitted that the views here outlined afford the safer and the wiser attitude to adopt. A considerable mass of evidence is accumulating, and much knowledge is being acquired in India as to the prevalence, symptoms, epidemio- logy, and identity of the causative micro-organism of para- typhoid fever. In fact—may I he pardoned for saying so —there is a small group of officers of the Royal Army Medical Corps working in India who probably know more
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