SURRA IN THE PHILIPPINE ISLANDS
1
690 of her sex would feel themselves placed in an embarrassing position by the admission of a man suffering from an extreme degree of retention of urine or bleeding profusely from a recent laceration of the external genitals. It is neither necessary nor desirable to elaborate this argument, but it is manifest that if the lady does not deal with such cases as part of her ordinary work it is hardly in the interest of a patient suffering in the way we have suggested that she should have to treat him in an emergency. SURRA IN THE PHILIPPINE ISLANDS. THE existence of surra in the Philippine Islands is definitely announced and is causing considerable mortality among the transport animals and cavalry horses of the United States army of occupation, some 2000 animals having died from it during the last six months of 1901. The disease has proved almost invariably fatal and has caused some alarm owing to the possibility of its introduction into the United States. Captain Curry, M.D, reports that the carrier of surra in the Philippines is a biting fly, the S’tomoxys calcitrans1 He has examined a large number of flies and mosquitoes but has found the trypanosome only in this species, in which it may remain alive for 24 hours after biting an infected animal. This fly is very abundant in and about Manila, especially in the stables and corrals, and it lays its eggs in the dung, in which the larvse and pupae thrive. As a prophylactic measure, all remedial agents having failed, the destruction or disinfection by lime or rebroleum of animal excrement in all stables and corrals is recommended. DURHAM COUNTY CONSUMPTION SANATORIUM. WE have received a copy of the third annual report of the Society for the Prevention and Cure of Consumption in the county of Durham. We cordially agree with the general tone of the report. We have frequently urged that it is the duty of medical men to educate their patients as to the danger of infection which may arise from the improper disposal of tuberculous sputum. The committee of the Durham Society has been adopting this principle. Addresses have been given to meetings of workmen, members of the Sunderland board of guardians, and the Cooperative Society, and letters have been sent to the various local authorities asking them to adopt preventive measures. Several authorities now offer the free disinfection of rooms vacated by consumptives and distribute leaflets showing the great danger of indiscriminate spitting, of breathing close and vitiated air, and the need for the better ventilation and lighting of cow-byres, as well as the more stringent supervision of the milk-supply. It is interesting to note that voluntary notification of cases of consump- tion has been in force in Sunderland for a year and the medical officer of health states that 96 cases have been reported. Sunderland has a population of over 146,000, so that the number notified cannot be stated to be large. Further, the borough of Gateshead has also adopted voluntary notification, so that this measure is now in force amongst over a quarter of a million of the population in the county. We shall await with interest I further intelligence of the result of this experiment. The report of the medical officer (Dr. J. Gray) as to the results of the sanatorium treatment ia certainly satis- factory and we trust that the necessary funds will be forth- coming to provide more beds. Attached to the report is an article on " Consumption : Its Prevention and Cure." It is intended for the use of sanitary authorities, boards of guardians, consumptives, and the general public." Informa- tion is given in a popular manner of the methods by which 1 American Medicine July 19th, 1902, p. 95. tuberculosis is spread and the means which may be adopted to diminish its dissemination. ON THE "INTENSIVE" MERCURIAL TREAT- MENT OF GENERAL PARALYSIS AND TABES DORSALIS. PROFESSOR LEMOINE of Lille has contributed to the Revue Neurologique of July 30th last an important practical paper on the treatment of general paralysis and tabes dorsalis by the hypodermic injection of an organic salt of mercury in large doses and for prolonged periods. He refers to the view generally entertained by many physicians that general paralysis and tabes dorsalis are but little capable of improvement under the so-called "intensive" form of mercurial treatment, and publishes a number of cases where the results of treatment, especially as regards general paralysis, are so strikingly beneficial as to suggest that the question requires re- consideration. 12 cases are recorded by him at some length, six being cases of general paralysis and six of tabes dorsalis submitted to treatment. Two out of the six cases of general paralysis are recorded below as typical and illus. trative. Case 1. The patient was a man, aged 29 years, with a history of syphilitic infection. He had been well treated with mercury after he had contracted the disease and had married subsequently and begotten two apparently healthy children. He developed general paralysis later. On then coming under observation he was submitted to the form of mercurial treatment alluded to at the heading of this annotation. He was given daily hypodermic injections of benzoate of mercury to the extent of two centigrammes (three-tenths of a grain) per dose, from Oct. 10th to Dec. 25th, 1897. The treatment was carried out uninterruptedly with the following results. Speech and memory, which had hitherto been impaired and defective, were much improved but the general mental weakness remained the same. From time to time since then, up to February, 1902, treatment was continued. The mental and physical conditions improved further and only a slight pupillary inequality remained. He had since 1897 begotten four children, all of whom appeared to be healthy. Case 2. The patient was a man, aged 27 years, of alcoholic habits, neuropathic predisposition, and impulsive temper. He had had syphilis when a youth, and some years afterwards he developed symptoms of general paralysis with grandiose delusions and megalomania. He was then admitted into an asylum and treated with daily injections of benzoate of mercury to the extent of two centigrammes (three-tenths of a grain) per dose, as in Case 1. The injections were given for 15 days continuously and then discontinued for a similar period. The dose was then raised to three centigrammes (about half a grain), the intervals of treatment and discon- tinuance being as before, the whole period of treatment extending from May to the end of September. During October considerable amelioration was seen both mentally and physically. The treatment was now reduced to two centigrammes (three-tenths of a grain) per dose, and this was continued for seven months. A slight apoplectiform seizure occurred once during this period. At the end of the time it was noticed that the disease (dementia) was arrested, though! the patient’s original character and disposition-viz., those of a neuropath-were clinically unmistakeable. Professor Lemoine gives detailed accounts of four other cases of general paralysis treated as mentioned. In all the six cases he observed marked improvement of symptoms both mental and physical, but, as he points out, longer periods of observa- tion are necessary before it can be conclusively established that the disease has been definitely arrested in such cases. The excellent results obtained, however, in these cases oi general paralysis he regards as justifying publication. Oi
Transcript of SURRA IN THE PHILIPPINE ISLANDS
690
of her sex would feel themselves placed in an embarrassingposition by the admission of a man suffering from an extremedegree of retention of urine or bleeding profusely from arecent laceration of the external genitals. It is neither
necessary nor desirable to elaborate this argument, but it ismanifest that if the lady does not deal with such cases aspart of her ordinary work it is hardly in the interest of apatient suffering in the way we have suggested that sheshould have to treat him in an emergency.
SURRA IN THE PHILIPPINE ISLANDS.
THE existence of surra in the Philippine Islands is
definitely announced and is causing considerable mortalityamong the transport animals and cavalry horses of the
United States army of occupation, some 2000 animals
having died from it during the last six months of 1901.The disease has proved almost invariably fatal and has
caused some alarm owing to the possibility of its introductioninto the United States. Captain Curry, M.D, reports thatthe carrier of surra in the Philippines is a biting fly, theS’tomoxys calcitrans1 He has examined a large number offlies and mosquitoes but has found the trypanosome only inthis species, in which it may remain alive for 24 hours afterbiting an infected animal. This fly is very abundant in andabout Manila, especially in the stables and corrals, and itlays its eggs in the dung, in which the larvse and pupaethrive. As a prophylactic measure, all remedial agentshaving failed, the destruction or disinfection by lime orrebroleum of animal excrement in all stables and corrals is
recommended.
DURHAM COUNTY CONSUMPTION SANATORIUM.
WE have received a copy of the third annual report of the
Society for the Prevention and Cure of Consumption in thecounty of Durham. We cordially agree with the generaltone of the report. We have frequently urged that it
is the duty of medical men to educate their patientsas to the danger of infection which may arise from the
improper disposal of tuberculous sputum. The committeeof the Durham Society has been adopting this principle.Addresses have been given to meetings of workmen,members of the Sunderland board of guardians, and theCooperative Society, and letters have been sent to the variouslocal authorities asking them to adopt preventive measures.Several authorities now offer the free disinfection of rooms
vacated by consumptives and distribute leaflets showing thegreat danger of indiscriminate spitting, of breathing closeand vitiated air, and the need for the better ventilationand lighting of cow-byres, as well as the more stringentsupervision of the milk-supply. It is interesting to
note that voluntary notification of cases of consump-tion has been in force in Sunderland for a yearand the medical officer of health states that 96 cases
have been reported. Sunderland has a population of
over 146,000, so that the number notified cannot bestated to be large. Further, the borough of Gatesheadhas also adopted voluntary notification, so that this measureis now in force amongst over a quarter of a million of thepopulation in the county. We shall await with interest Ifurther intelligence of the result of this experiment. The
report of the medical officer (Dr. J. Gray) as to theresults of the sanatorium treatment ia certainly satis-
factory and we trust that the necessary funds will be forth-coming to provide more beds. Attached to the report is anarticle on " Consumption : Its Prevention and Cure." It isintended for the use of sanitary authorities, boards of
guardians, consumptives, and the general public." Informa-tion is given in a popular manner of the methods by which
1 American Medicine July 19th, 1902, p. 95.
tuberculosis is spread and the means which may be adoptedto diminish its dissemination.
ON THE "INTENSIVE" MERCURIAL TREAT-MENT OF GENERAL PARALYSIS AND
TABES DORSALIS.
PROFESSOR LEMOINE of Lille has contributed to the
Revue Neurologique of July 30th last an important practicalpaper on the treatment of general paralysis and tabes
dorsalis by the hypodermic injection of an organic saltof mercury in large doses and for prolonged periods.He refers to the view generally entertained by manyphysicians that general paralysis and tabes dorsalis are
but little capable of improvement under the so-called"intensive" form of mercurial treatment, and publishesa number of cases where the results of treatment,especially as regards general paralysis, are so strikinglybeneficial as to suggest that the question requires re-
consideration. 12 cases are recorded by him at some
length, six being cases of general paralysis and six of tabesdorsalis submitted to treatment. Two out of the six casesof general paralysis are recorded below as typical and illus.trative. Case 1. The patient was a man, aged 29 years,with a history of syphilitic infection. He had been welltreated with mercury after he had contracted the diseaseand had married subsequently and begotten two apparentlyhealthy children. He developed general paralysis later.
On then coming under observation he was submitted to theform of mercurial treatment alluded to at the heading ofthis annotation. He was given daily hypodermic injectionsof benzoate of mercury to the extent of two centigrammes(three-tenths of a grain) per dose, from Oct. 10th to Dec.25th, 1897. The treatment was carried out uninterruptedlywith the following results. Speech and memory, which hadhitherto been impaired and defective, were much improvedbut the general mental weakness remained the same. Fromtime to time since then, up to February, 1902, treatment wascontinued. The mental and physical conditions improvedfurther and only a slight pupillary inequality remained. Hehad since 1897 begotten four children, all of whom appearedto be healthy. Case 2. The patient was a man, aged 27years, of alcoholic habits, neuropathic predisposition, andimpulsive temper. He had had syphilis when a youth, andsome years afterwards he developed symptoms of generalparalysis with grandiose delusions and megalomania. He
was then admitted into an asylum and treated with
daily injections of benzoate of mercury to the extent
of two centigrammes (three-tenths of a grain) per dose,as in Case 1. The injections were given for 15 dayscontinuously and then discontinued for a similar period.The dose was then raised to three centigrammes (abouthalf a grain), the intervals of treatment and discon-
tinuance being as before, the whole period of treatment
extending from May to the end of September. DuringOctober considerable amelioration was seen both mentallyand physically. The treatment was now reduced to two
centigrammes (three-tenths of a grain) per dose, and this wascontinued for seven months. A slight apoplectiform seizureoccurred once during this period. At the end of the time itwas noticed that the disease (dementia) was arrested, though!the patient’s original character and disposition-viz., thoseof a neuropath-were clinically unmistakeable. ProfessorLemoine gives detailed accounts of four other cases of
general paralysis treated as mentioned. In all the six caseshe observed marked improvement of symptoms both mentaland physical, but, as he points out, longer periods of observa-tion are necessary before it can be conclusively establishedthat the disease has been definitely arrested in such cases.The excellent results obtained, however, in these cases oi
general paralysis he regards as justifying publication. Oi
