Sphagnum
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1043 2. Greenwood BM, Greenwood AM, Bradley AK, Tulloch S, Hayes R, Oldfield FS. Deaths in infancy and early childhood in a well-nourished, rural, West African population. Ann Trop Paediatr 1987; 7: 91-99. 3. Harinasuta T, Bunnag D. The clinical features of malaria. In: Wemsdorfer WH, McGregor IA, eds. Malaria: principles and practice of malariology, Vol 1. Edinburgh: Churchill Livingstone, 1988: 721. 4. Rothe H. One hundred cases of cerebral malaria. E Afric Med J 1956; 33: 405-07. 5. Armengaud M, Louvain M, Diop-Mar L. Etude portant sur 448 cas de paludisme chez l’Africain de la region dakaroise. Bull Soc Med Afr Noire Langue Franc 1962; 7: 167-96. 6. Guignard J. Le Paludisme pernicieux du nourrisson et de l’enfant. Considerations cliniques, pronostiques, et therapeutiques. A propos de 130 cas observes en zone d’endemie palustre. Ann Pediatrie 1963; 43: 646-56. 7. Musoke LK. Neurological manifestations of malaria in children. E Afric Med J 1966; 43: 561-64. 8. Rey M, Nouhouayi A, Diap Mar I. Les expressions cliniques du paludisme a Plasmodium falciparum chez l’enfant noir african (d’apres une experience hospitaliere dakaroise). Bull Soc Pathol Exot 1966; 59: 683-704. 9. Lemercier G, Bert J, Nouhouayi A, Rey M, Collomb H. Le neuropaludisme: aspects electroencephalographiques, neuropatho- logiques, problemes physiopathologiques. Path Biol 1969; 17: 459-72. 10. Omanga V, Ngandu K, Disengomoka I, Badibanga B. Access pernicieux palustre chez l’enfant. Afrique Med 1977; 16: 507-16. 11. Commey JCC, Mills-Tetteh D, Phillips BJ. Cerebral malaria in Accra, Ghana. Ghana Med J 1980; 19: 68-72. 12. Stace J, Bilton P, Coates K, Stace N. Cerebral malaria in children: a retrospective study of admissions to Madang hospital. Papua New Guinea Med J 1982; 25: 230-34. 13. Omanga V, Ntihinyuwa M, Shako D, Mashako M. Les hemiplegies au cours de l’acces pernicieux a plasmodium falciparum de l’enfant. Ann Paediatr 1983; 30: 294-96. 14. Schmutzhard E, Gerstenbrand F. Cerebral malaria in Tanzania. Its epidemiology, clinical symptoms and neurological long-term sequelae in the light of 66 cases. Trans R Soc Trop Med Hyg 1984; 78: 351-53. 15. Ahmad SH, Meonis R, Kidwai T, Khan TA, Khan HM, Shahab T. Cerebral malaria in children. Indian J Paediatr 1986; 53: 409-13. 16. Thapa BR, Marwaha RK, Kumar L, Mehta S. Cerebral malaria in children: therapeutic considerations. Indian J Paediatr 1988; 25: 61-65. 17. Nouhouayi A. Les aspects neurologiques du paludisme a Plasmodium falciparum. Thessis. University of Dakar, Senegal, 1967. 18. Molyneux ME, Taylor TE, Wirima JJ, Borgstein A. Clinical features and prognostic indicators in paediatric cerebral malaria: a study of 131 comatose Malawian children. Quart J Med 1989; 71: 441-59. 19. Population and Housing Census 1983. General report Vol 1: Administrative and analytic procedures. Central statistics department, Banjul: The Gambia Government 1987. 20. World Health Organization. Bench aids for the diagnosis of malaria, set 2. 21. Teasdale G, Jennett B. Assessment of coma and impaired consciousness: a practical scale. Lancet 1974; ii: 81-83. 22. White NJ, Krishna S, Waller D, Craddock C, Kwiatkowski D, Brewster D. Open comparison of intramuscular chloroquine and quinine in children with severe chloroquine sensitive falciparum malaria. Lancet 1989; ii: 1313-16. 23. Menon A, Otoo LN, Herbage EA, Greenwood BM. A national survey of the prevalence of chloroquine resistant Plasmodium falciparum malaria in The Gambia, West Africa. Trans R Soc Trop Med Hyg (in press). 24. White NJ. Pathophysiology. In: Strickland GT, ed. Clinics in tropical medicine and communicable disease. London: Saunders, 1986. 25. White NJ, Krishna S. Treatment of malaria. Some limitations and considerations of the current methods of assessment. Trans R Soc Trop Med Hyg 1989; 83: 767-77. 26. Collomb H, Rey M, Dumas M, Nouhouayi A, Petit M. Les hemiplegies au cours du paludisme aigue. Bull Soc Med Afr Noire Langue Franc 1967; 12: 791-95. 27. Sanohko A, Dareys J-P, Charrean M. Etat encephalitique prolonge et acces pemideux palustres. Bull Soc Med Afr Noire League Franc 1968; 13: 662-69. 28. Grau GE, Fajardo LF, Piguet PF, Allet B, Lambert PH, Vassali P. Tumour necrosis factor (cachectin) as an essential mediator in cerebral malaria. Science 1987; 237: 1210-12. 29. Grau GE, Gretener D, Lambert PH. Prevention of murine cerebral malaria by low-dose cyclosporin A. Immunology 1987; 61: 521-25. 30. Kwiatkowski D, Itill AVS, Sambout I, et al. TNF concentrations in rural, cerebral, non-fatal cerebral, and uncomplicated P falciparum malaria. Lancet (in press). 31. Warrell DA, White NJ, Veall MA, et al. Cerebral anaerobic glycolysis and reduced cerebral oxygen transport in human cerebral malaria. Lancet 1988; ii: 534-38. 32. White NJ, Miller KD, Marsh K, et al. Hypoglycaemia in African children with severe malaria. Lancet 1987; i: 708-11. 33. Taylor TE, Molyneux ME, Wirima JJ, Fletcher KA, Morris K. Blood glucose levels in Malawian children before and during the administration of intravenous quinine for severe falciparum malaria. N Engl J Med 1988; 319: 1040-47. 34. Pukrittayakamee S, White NJ, Clemens R, et al. Activation of the coagulation cascade in falciparum malaria. Trans R Soc Trop Med Hyg 1989; 83: 762-66. 35. McGregor IA. The significance of parasitic infections in terms of clinical disease: a personal view. Parasitology 1987; 94: S159-78. 36. Bruce-Chwatt LJ. Malaria in African infants and children in Southern Nigeria. Ann Trop Med Parasitol 1952; 40: 173-200. 37. Trape JF, Quinet MC, Nzingoula S, et al. Malaria and urbanization in Central Africa: the example of Brazzaville. Part V: Pernicious attacks and mortality. Trans R Soc Trop Med Hyg 1987; 81 (Suppl 2): 34-42. 38. Greenwood BM, Greenwood AM, Bradley AK, et al. Comparison of two strategies for control of malaria within a primary health care programme in The Gambia. Lancet 1988; i: 1121-27. 39. Snow RW, Lindsay SW, Hayes RJ, Greenwood BM. Permethrin- treated bed nets (mosquito nets) prevent malaria in Gambian children. Trans R Soc Trop Med Hyg 1988; 82: 838-42. From The Lancet Sphagnum In the last war sphagnum moss was used fairly widely as an absorbent in wound dressings, and if casualties increase it may prove useful again. The large cells of the plant, which botanically lies between the true mosses and the liverworts, act as reservoirs and are perforated with small pores which allow the rapid absorption of water. Sphagnum is thus capable of taking up much more fluid than cotton-wool, in which the cellulose tubes are of small diameter, usually collapsed and twisted from drying, and incapable of filling by capillary attraction in the same way as the moss cells. A good sample of sphagnum will take up from 12 to 19 times its own weight in fluid and will hold up wound discharges until the whole mass becomes saturated. The conditions under which it is gathered and dried affect its absorptive powers considerably. It grows on damp moors and on lowland heaths and mosslands, and being easily recognised does not require experts to gather it. It is saturated with moisture when gathered and the natural impulse of the gatherers is to wring out the water before carrying the sack-load home, sometimes a distance of many miles; but this process is likely to damage the cellular structure and should be avoided if possible. The plants ought to be spread out in a sunny, airy place before the sack is filled but since this is a counsel of perfection more often than not gentle squeezing may be necessary. When the gatherers reach home the collection should be spread out on the floor of a spare attic or outhouse to dry; but if a large demand for sphagnum arises it would be better to arrange depots in which the sphagnum could be dried on wooden or canvas trays arranged in racks separated sufficiently to allow for free circulation of air. The trays could be covered with butter-muslin and their contents dried in the open. Oven-drying is quicker, but makes the sphagnum brittle and less easy to handle.... During the last war large quantities of sphagnum were pressed into thin sheets in a hydraulic press and though these were convenient to handle the absorptive power of the sphagnum was impaired. Moreover, dressings made from such sheets were apt to swell, sometimes when there was no chance of adjusting the bandages. Sphagnum is a more serviceable dressing in the form of loose pads. Nurserymen have long used it as a packing for plants, but it would have to be collected more carefully for use as dressings. The gathering sites chosen should be unpolluted by smoke fumes from industrial works or by brackish water; the slopes below buildings and farms should be avoided because they may be contaminated by sewage. Possibly botanical and natural history societies could combine to supply manufacturers with moss sponsored by their members. (Dec 14, 1940)
Transcript of Sphagnum
1043
2. Greenwood BM, Greenwood AM, Bradley AK, Tulloch S, Hayes R,Oldfield FS. Deaths in infancy and early childhood in a well-nourished,rural, West African population. Ann Trop Paediatr 1987; 7: 91-99.
3. Harinasuta T, Bunnag D. The clinical features of malaria. In:
Wemsdorfer WH, McGregor IA, eds. Malaria: principles and practiceof malariology, Vol 1. Edinburgh: Churchill Livingstone, 1988: 721.
4. Rothe H. One hundred cases of cerebral malaria. E Afric Med J 1956; 33:405-07.
5. Armengaud M, Louvain M, Diop-Mar L. Etude portant sur 448 cas depaludisme chez l’Africain de la region dakaroise. Bull Soc Med AfrNoire Langue Franc 1962; 7: 167-96.
6. Guignard J. Le Paludisme pernicieux du nourrisson et de l’enfant.Considerations cliniques, pronostiques, et therapeutiques. A propos de130 cas observes en zone d’endemie palustre. Ann Pediatrie 1963; 43:646-56.
7. Musoke LK. Neurological manifestations of malaria in children. E AfricMed J 1966; 43: 561-64.
8. Rey M, Nouhouayi A, Diap Mar I. Les expressions cliniques dupaludisme a Plasmodium falciparum chez l’enfant noir african (d’apresune experience hospitaliere dakaroise). Bull Soc Pathol Exot 1966; 59:683-704.
9. Lemercier G, Bert J, Nouhouayi A, Rey M, Collomb H. Leneuropaludisme: aspects electroencephalographiques, neuropatho-logiques, problemes physiopathologiques. Path Biol 1969; 17: 459-72.
10. Omanga V, Ngandu K, Disengomoka I, Badibanga B. Access pernicieuxpalustre chez l’enfant. Afrique Med 1977; 16: 507-16.
11. Commey JCC, Mills-Tetteh D, Phillips BJ. Cerebral malaria in Accra,Ghana. Ghana Med J 1980; 19: 68-72.
12. Stace J, Bilton P, Coates K, Stace N. Cerebral malaria in children: aretrospective study of admissions to Madang hospital. Papua NewGuinea Med J 1982; 25: 230-34.
13. Omanga V, Ntihinyuwa M, Shako D, Mashako M. Les hemiplegies aucours de l’acces pernicieux a plasmodium falciparum de l’enfant. AnnPaediatr 1983; 30: 294-96.
14. Schmutzhard E, Gerstenbrand F. Cerebral malaria in Tanzania. Its
epidemiology, clinical symptoms and neurological long-term sequelaein the light of 66 cases. Trans R Soc Trop Med Hyg 1984; 78: 351-53.
15. Ahmad SH, Meonis R, Kidwai T, Khan TA, Khan HM, Shahab T.Cerebral malaria in children. Indian J Paediatr 1986; 53: 409-13.
16. Thapa BR, Marwaha RK, Kumar L, Mehta S. Cerebral malaria inchildren: therapeutic considerations. Indian J Paediatr 1988; 25: 61-65.
17. Nouhouayi A. Les aspects neurologiques du paludisme a Plasmodiumfalciparum. Thessis. University of Dakar, Senegal, 1967.
18. Molyneux ME, Taylor TE, Wirima JJ, Borgstein A. Clinical features andprognostic indicators in paediatric cerebral malaria: a study of 131comatose Malawian children. Quart J Med 1989; 71: 441-59.
19. Population and Housing Census 1983. General report Vol 1:
Administrative and analytic procedures. Central statistics department,Banjul: The Gambia Government 1987.
20. World Health Organization. Bench aids for the diagnosis of malaria, set 2.21. Teasdale G, Jennett B. Assessment of coma and impaired consciousness:
a practical scale. Lancet 1974; ii: 81-83.22. White NJ, Krishna S, Waller D, Craddock C, Kwiatkowski D, Brewster
D. Open comparison of intramuscular chloroquine and quinine inchildren with severe chloroquine sensitive falciparum malaria. Lancet1989; ii: 1313-16.
23. Menon A, Otoo LN, Herbage EA, Greenwood BM. A national survey ofthe prevalence of chloroquine resistant Plasmodium falciparum malariain The Gambia, West Africa. Trans R Soc Trop Med Hyg (in press).
24. White NJ. Pathophysiology. In: Strickland GT, ed. Clinics in tropicalmedicine and communicable disease. London: Saunders, 1986.
25. White NJ, Krishna S. Treatment of malaria. Some limitations andconsiderations of the current methods of assessment. Trans R Soc TropMed Hyg 1989; 83: 767-77.
26. Collomb H, Rey M, Dumas M, Nouhouayi A, Petit M. Les hemiplegiesau cours du paludisme aigue. Bull Soc Med Afr Noire Langue Franc1967; 12: 791-95.
27. Sanohko A, Dareys J-P, Charrean M. Etat encephalitique prolonge etacces pemideux palustres. Bull Soc Med Afr Noire League Franc 1968;13: 662-69.
28. Grau GE, Fajardo LF, Piguet PF, Allet B, Lambert PH, Vassali P.Tumour necrosis factor (cachectin) as an essential mediator in cerebralmalaria. Science 1987; 237: 1210-12.
29. Grau GE, Gretener D, Lambert PH. Prevention of murine cerebralmalaria by low-dose cyclosporin A. Immunology 1987; 61: 521-25.
30. Kwiatkowski D, Itill AVS, Sambout I, et al. TNF concentrations in rural,cerebral, non-fatal cerebral, and uncomplicated P falciparum malaria.Lancet (in press).
31. Warrell DA, White NJ, Veall MA, et al. Cerebral anaerobic glycolysis andreduced cerebral oxygen transport in human cerebral malaria. Lancet1988; ii: 534-38.
32. White NJ, Miller KD, Marsh K, et al. Hypoglycaemia in African childrenwith severe malaria. Lancet 1987; i: 708-11.
33. Taylor TE, Molyneux ME, Wirima JJ, Fletcher KA, Morris K. Bloodglucose levels in Malawian children before and during the
administration of intravenous quinine for severe falciparum malaria. NEngl J Med 1988; 319: 1040-47.
34. Pukrittayakamee S, White NJ, Clemens R, et al. Activation of the
coagulation cascade in falciparum malaria. Trans R Soc Trop Med Hyg1989; 83: 762-66.
35. McGregor IA. The significance of parasitic infections in terms of clinicaldisease: a personal view. Parasitology 1987; 94: S159-78.
36. Bruce-Chwatt LJ. Malaria in African infants and children in SouthernNigeria. Ann Trop Med Parasitol 1952; 40: 173-200.
37. Trape JF, Quinet MC, Nzingoula S, et al. Malaria and urbanization inCentral Africa: the example of Brazzaville. Part V: Pernicious attacksand mortality. Trans R Soc Trop Med Hyg 1987; 81 (Suppl 2): 34-42.
38. Greenwood BM, Greenwood AM, Bradley AK, et al. Comparison of twostrategies for control of malaria within a primary health care
programme in The Gambia. Lancet 1988; i: 1121-27.39. Snow RW, Lindsay SW, Hayes RJ, Greenwood BM. Permethrin-
treated bed nets (mosquito nets) prevent malaria in Gambian children.Trans R Soc Trop Med Hyg 1988; 82: 838-42.
From The Lancet
SphagnumIn the last war sphagnum moss was used fairly widely as anabsorbent in wound dressings, and if casualties increase it mayprove useful again. The large cells of the plant, which botanicallylies between the true mosses and the liverworts, act as reservoirs andare perforated with small pores which allow the rapid absorption ofwater. Sphagnum is thus capable of taking up much more fluid thancotton-wool, in which the cellulose tubes are of small diameter,usually collapsed and twisted from drying, and incapable of fillingby capillary attraction in the same way as the moss cells. A goodsample of sphagnum will take up from 12 to 19 times its own weightin fluid and will hold up wound discharges until the whole massbecomes saturated. The conditions under which it is gathered anddried affect its absorptive powers considerably. It grows on dampmoors and on lowland heaths and mosslands, and being easilyrecognised does not require experts to gather it. It is saturated withmoisture when gathered and the natural impulse of the gatherers isto wring out the water before carrying the sack-load home,sometimes a distance of many miles; but this process is likely todamage the cellular structure and should be avoided if possible. Theplants ought to be spread out in a sunny, airy place before the sack isfilled but since this is a counsel of perfection more often than notgentle squeezing may be necessary. When the gatherers reach homethe collection should be spread out on the floor of a spare attic orouthouse to dry; but if a large demand for sphagnum arises it wouldbe better to arrange depots in which the sphagnum could be driedon wooden or canvas trays arranged in racks separated sufficientlyto allow for free circulation of air. The trays could be covered withbutter-muslin and their contents dried in the open. Oven-drying isquicker, but makes the sphagnum brittle and less easy to handle....During the last war large quantities of sphagnum were pressed intothin sheets in a hydraulic press and though these were convenient tohandle the absorptive power of the sphagnum was impaired.Moreover, dressings made from such sheets were apt to swell,sometimes when there was no chance of adjusting the bandages.Sphagnum is a more serviceable dressing in the form of loose pads.Nurserymen have long used it as a packing for plants, but it wouldhave to be collected more carefully for use as dressings. Thegathering sites chosen should be unpolluted by smoke fumes fromindustrial works or by brackish water; the slopes below buildingsand farms should be avoided because they may be contaminated bysewage. Possibly botanical and natural history societies couldcombine to supply manufacturers with moss sponsored by theirmembers.
(Dec 14, 1940)
