JAMA

GRAY, ALBERT S.

doi: 10.1001/jama.1935.02760410001001pmid: N/A

My discussion of industrial hygiene will be concerned principally with the effect of industrial environment on health. The effect of an unhealthful working environment was recognized by some of the fathers of medicine even before the beginning of the modern factory system. But the most impressive evidence of the effect of an unhealthful working environment is probably the morbidity and mortality statistics developed by Dublin in 1929 as the result of a study of three and a quarter million wage earners. Although his results have been presented before and are doubtless familiar to many, they show such a clear picture of the widespread effects of an industrial environment on the health of the worker that a few of the more significant conclusions are presented. Dublin's figures include a wide variety of industries, both those which are especially productive of occupational disease and also those which present no outstanding health hazard.

CECIL, RUSSELL L.; FRIESS, CONSTANCE; NICHOLLS, EDITH E.; THOMAS, WARREN K. STRATMAN

doi: 10.1001/jama.1935.02760410005002pmid: N/A

Malarial fever was first used therapeutically in 1917 by Wagner-Jauregg1 in the treatment of dementia paralytica. This investigator had previously tried tuberculin and typhoid vaccine in the treatment of this disease and had obtained very good results with both these agents. By 1928 he had treated 2,000 dementia paralytica patients with malarial fever, as reported by his co-worker Gerstmann,2 and in 1931 Wagner-Jauregg3 summarized the results of malarial therapy in 3,000 cases of cerebrospinal syphilis that had been studied in the Vienna Psychiatric Clinic. Wagner-Jauregg was convinced that malarial therapy was much superior to other pyrogenic agents in the treatment of dementia paralytica, and this view is now quite widely held by neurologists. In view of the excellent results that are often obtained in rheumatoid arthritis by the intravenous injection of typhoid vaccine, it occurred to us that arthritis, like dementia paralytica, might respond well to malarial

McBRIDE, EARL D.

doi: 10.1001/jama.1935.02760410008003pmid: N/A

The surgical treatment of hallux valgus or "bunions" carries with it an unusual responsibility. End results that appear excellent to the surgeon are often not

BEARDWOOD, JOSEPH T.

doi: 10.1001/jama.1935.02760410012004pmid: N/A

Diabetes mellitus has definitely increased during the last decade. With the increasing incidence of this disease there has come a greater appreciation of its symptoms and the symptoms of its complications. The disease as well as some of its complications has been named from syndromes which are merely terminal manifestations. In most instances, long before the development of the advanced stages, symptoms have been present which if properly interpreted will enable one to make an earlier diagnosis and in many cases prevent a development of serious and even fatal sequelae. Thus the symptoms of polyuria and polydipsia from which diabetes has derived its name have developed in only a relatively small percentage of cases when first seen. It is now realized that diabetic gangrene in the vast majority of cases is a terminal condition, the result of definite arterial changes, which many years before the development of gangrene give premonitory

McKENNA, CHARLES M.; EWERT, EARL

doi: 10.1001/jama.1935.02760410016005pmid: N/A

When the final chapter is written on the subject of cryptorchidism, it will be divided in our opinion into two distinct chapters. One will have to do with the embryology, histology and physiology of undescended testicle, and the second with the anatomy, technic of operation and end results. In the former the name of Dr. Carl Moore1 of the University of Chicago will stand out prominently, while in the latter the names of Bevan,2 Torek,3 Meyer,4 Cabot,5 Cunningham, Keyes, Wangensteen,6 Eccles and others will be noted. Bevan was a pioneer in this work and deserves particular attention, because he has continued to perfect his orginal operation so that at the present time his technic is more generally accepted than any other. To date there have been more than forty different operations described in the literature. That is the best evidence that no one technic

MINOT, GEORGE R.

doi: 10.1001/jama.1935.02760410020006pmid: N/A

The development of information concerning anemia during the past decade has permitted the clear recognition that this condition often may be dependent on defective or deficient nutrition. This idea, however, is not new; for example, in 1651 was written by an anonymous author "[Chlorosis is] chiefly found in young maidens who... foolishly feed upon trash." Wide gaps in our knowledge remain and complete information concerning the mechanism of producing anemia associated with nutritional deficiency must be obtained in the future, but at present one can recognize that anemias may arise because of a lack or nonavailability in the body of at least three classes of dietary substances: (1) iron, (2) vitamin C and (3) a mysterious substance contained abundantly in liver and, to a less extent, in certain other organs which, if absent, makes normal blood formation impossible, and anemias of the so-called pernicious type ensue. ETIOLOGY The anemias due

FINLAND, MAXWELL; RUEGSEGGER, JAMES M.; FELTON, LLOYD D.

doi: 10.1001/jama.1935.02760410024007pmid: N/A

The investigations of Bailey and Shorb1 and of Jamieson, Powell, Bailey and Hyde2 have prompted the addition of heterophile antibody, produced in rabbits, to the usual antipneumococcus serum in the treatment of human cases of pneumococcic lobar pneumonia. The justification for the use of such a mixture and the alleged claims for the superiority of such a product may be summarized briefly: 1. In human cases of pneumonia, just as in rabbits injected with cultures, the pneumococcus is said to exhibit the properties of a heterophile antigen. 2. The patient's pneumococci and the injected horse serum (which is known to be an active heterophile antigen) are said to combine with the natural heterophile antibody and render the latter inactive with regard to its alleged protective action against invasion by the pneumococcus. 3. This antigen-antibody combination may account for the "primary toxicity" of therapeutic horse serum and the untoward

HEALEY, CLAIRE E.

doi: 10.1001/jama.1935.02760410026008pmid: N/A

Since 1929 diphtheria toxoid has been used in the immunization of nurses at the Cook County Hospital. Many of the nurses in this group are either in the post-graduate school or come from affiliated schools for the contagious or pediatric service. The time for immunizing them is therefore limited. It is important also that the immunization interfere as little as possible with their training school courses. Because of reactions observed at times in adults on the administration of toxoid, it has been found advisable to give an initial dose of 0.1 cc. followed at weekly intervals by 0.25 cc., 0.5 cc., 1 cc. and from 1.5 to 2 cc. The small initial doses probably in most instances confer little immunity but may serve to desensitize the individual to the proteins contained in the toxoid mixture so that the larger doses can be tolerated with less reaction. Retests are made after

NESBIT, REED M.; McDONNELL, C. H.

doi: 10.1001/jama.1935.02760410027009pmid: N/A

The value of ketonuria in the treatment of certain types of infections of the urinary tract has become widely recognized and utilized. Although the ketogenic diets recommended by Clark1 have proved their worth as a therapeutic agent, it has been constantly observed that a considerable proportion of patients placed on this regimen find it unpalatable, and many are completely unable to tolerate it. In a series of fifty cases treated by this method at the University Hospital, it was observed that practically every patient was upset by the diet at one time or another. The gastric upsets produced by its high fat content were so objectionable to some that they refused to continue on this regimen. Modifications of the diet were therefore made in an effort to remove this objectionable feature. It has long been recognized as a fundamental principle of metabolism that the organism is not dependent on

CREED, JOHN P.

doi: 10.1001/jama.1935.02760410029010pmid: N/A

This case of hemochromatosis was discovered quite by accident during an abdominal operation. Later I made a survey of the literature and will attempt here to give a short summary of the established facts and the consensus of the theories of this disease. The disease was first described in 1882 by Hanot and Chauffard and called bronze diabetes. They described the classic triad of cirrhosis, pigmentation of the skin, and diabetes. Von Recklinghausen in 1889 showed that the pigmentation of skin and viscera was due to a deposit of hemosiderin and hemofuchsin in the tissues. He called the disease hemochromatosis and, appropriate or not, this name has persisted down to the present time. INCIDENCE It is a rare disease. Only three cases occurred in 106,000 admissions to the Johns Hopkins Hospital and only four cases were found in 5,000 autopsies at the Bellevue Hospital. The only other case reported in