JAMA

MADDOCK, WALTER G.; COLLER, FREDERICK A.

doi: 10.1001/jama.1937.02780010003001pmid: N/A

The importance of water to the human organism is greater than that of any other substance. It normally comprises 65 per cent of the total body weight and is fundamentally concerned with every physiologic process. For centuries the intake and output of fluids have been investigated by man, the observations of Sanctorius,1 published in 1614, on the perspiratio insensibilis of water from the skin and lungs being classics of early scientific endeavor. Rowntree2 and, more recently, Underhill3 have presented reviews of the literature on water metabolism. Basic studies on an accurate measurement of the water balance of human beings have been carried out by Newburgh and his associates4 and we acknowledge the inspiration and counsel given by this investigator. From the surgical aspect, water balance becomes most important in dealing with the patient who, because of his disease or treatment, cannot take in sufficient fluids by

WOLBACH, S. B.

doi: 10.1001/jama.1937.02780010009002pmid: N/A

Descriptive accounts of the pathologic changes resulting from each vitamin deficiency would make a voluminous report, dry and nonstimulative. The subject will be presented with the attitude that each deficiency causes distinctive functional disturbances and is accompanied by distinctive morphologic changes which together may reasonably be regarded as primary effects. In consequence, it is assumed that some of the general disturbances in nutrition, blood formation and growth, common to several of the vitamin deficiencies, are in all probability secondary nonspecific effects. The primary morphologic effects, as far as known, when analyzed all prove to be manifestations of retardation or suppression of normal processes. In recovery from a vitamin deficiency following restoration of the vitamin to the diet, normal morphologic sequences are resumed and proceed for a brief period at a rate exceeding the normal, until repair is completed. Possibly physiologic activities of certain types may be suppressed without demonstrable tissue

BILLS, CHARLES E.

doi: 10.1001/jama.1937.02780010015003pmid: N/A

Certain facts about vitamin D are widely known. It occurs only rarely in foodstuffs. It is formed in the skin by exposure to ultraviolet rays from the sun or from artificial sources. It is developed in some foodstuffs by their being briefly irradiated. It is produced by irradiating ergosterol, the sterol of fungi. From irradiated ergosterol it can be isolated and crystallized. The fact that vitamin D is not a single chemical substance has only recently been recognized. The erroneous view still commonly held is that ergosterol is the parent substance, or provitamin, from which all vitamin D arises. Ergosterol exhibits four spectral absorbtion bands in the ultraviolet region. These bands were observed in the unsaponifiable fraction of the various materials that become antiricketic on irradiation. Since it is rare that even one band, not to mention such a series of bands, is exactly duplicated by different chemical substances, the

YOUMANS, JOHN B.

doi: 10.1001/jama.1937.02780010017004pmid: N/A

It is becoming better and better recognized that the mild or latent forms of the vitamin deficiencies are more important in practice at present than the fully developed cases. The latter are uncommon, are easily recognized and are usually promptly and adequately treated. On the other hand there is reason to believe that minimal or mild forms of these diseases are much more frequent, often escape recognition and, because of their insidious effect on large numbers of people, constitute a more serious problem than the occasional advanced cases. It is true that the diagnosis of these mild forms is often difficult and uncertain. Nevertheless, there is available today much new knowledge of the vitamins which is applicable to the diagnosis and study of the milder forms of their deficiencies in patients. It is my purpose in this paper to describe the present means of diagnosis of the mild or early

SABIN, ALBERT B.; OLITSKY, PETER K.

doi: 10.1001/jama.1937.02780010023005pmid: N/A

It has been repeatedly shown by many investigators1 that when the virus of poliomyelitis is instilled intranasally in rhesus monkeys it enters the central nervous system by way of the olfactory nerves and bulbs. Our purpose in the present communication is to describe the pathologic changes produced by the virus in its passage through the olfactory bulbs and to present evidence that these changes occur only when the virus has reached the bulbs from the periphery by way of the olfactory nerves and not when the invasion of the central nervous system is by other pathways. Experimental poliomyelitis in rhesus monkeys was produced almost constantly by instilling 1 cc. of a 10 per cent virus suspension (M. V. strain) into each nostril on one day and repeating the process forty-eight hours later. With this procedure the first rise of temperature occurs between the fourth and sixth days and paralysis

BLAIR, VILRAY P.; BROWN, JAMES BARRETT; BYARS, L. T.

doi: 10.1001/jama.1937.02780010026006pmid: N/A

Foot discomfort may vary from an intermittent annoyance to a real calamity, depending on its intensity and also on the occupational and social status of the individual. A nail or a pebble inside the shoe can make normal walking next to impossible; likewise can a plantar wart or a residual hard scar if located at a bearing point. Further, prolonged use of an unnatural stance can apparently lead to secondary changes, which may be persistently annoying long after the primary cause has been removed. After successful treatment of the wart or its local sequelae, the patient may still remain crippled. An antecedent static fault has been suggested as one, or a contributing, cause, but in our limited experience the static changes appeared to be secondary rather than primary. Plantar warts are not of rare occurrence, and their clinical behavior and therapeutic response might suggest that they are not all of

WIEN, MAX S.; PERLSTEIN, MINNIE OBOLER

doi: 10.1001/jama.1937.02780010029007pmid: N/A

Ulceration of the skin as a part of the syndrome of lymphogranuloma inguinale has not received much notice in the discussion of the clinical manifestations of this disease. Huguier1 in 1848 described esthiomene as a chronic hypertrophy and ulceration of the vulva which may be associated with similar involvement of the vulvo-anal area, rectal ulceration or stricture. In the majority of his cases there was also infiltration of the inguinal lymph glands. He subdivided his entity into four main clinical groups: a hypertrophic vegetative type, an elephantiasic type, a type characterized by the formation of fistulas, and an ulcerative type. Fournier2 in 1873 described the occurrence of a syndrome of indolent edema of the vulva which was frequently associated with inguinal lymphopathy. He believed that it was syphilitic in origin but distinct from his "syphilome anorectale." Ulceration of the vulva is not mentioned in his description. In 1896

LONG, PERRIN H.; BLISS, ELEANOR A.

doi: 10.1001/jama.1937.02780010034008pmid: N/A

The recent observations of numerous European investigators1 that para-amino-benzene-sulfonamide and certain of its chemical derivatives exert a specific chemotherapeutic effect in beta-hemolytic streptococcic infection are of great interest. It will be our purpose in this preliminary communication to offer confirmatory observations to certain of the results already obtained by the aforementioned observers and to add new observations regarding the mode of action of these substances. In the course of our investigations we have used two samples of para-amino-benzene-sulfonamide, one supplied to us by the Jackson Laboratory of E. I. DuPont de Nemours and Company, the other in tablet form under the name of "Prontylin" by the Winthrop Chemical Company. Two derivatives of para-amino-benzene-sulfonamide have also been studied. The first of these, the hydrochloride of 4'-sulfamido-2, 4 diaminoazo-benzene, was labeled "Prontosil tablets," while the second, the disodium salt of 4'-sulfamido-phenyl-2-azo-7-acetylamino-1 hydroxy naphthalene-3, 6-disulfonic acid, was sent to us in a

BRINDLEY, G. V.

doi: 10.1001/jama.1937.02780010039009pmid: N/A

Several facts pertain to cancer of the rectum which favorably influence the prognosis. A more optimistic view with regard to malignant conditions here should prevail. Practically all patients with carcinoma of the rectum can be cured when adequate surgery is instituted in the early stages of the disease. Rectal cancers can be diagnosed easily and with certainty while the lesion is early and curable. This ideal falls far short of attainment. Lahey1 believes that one patient in four with this condition can be relieved by surgery. Miles2 reports 21 per cent of five-year cures for all cases seen presenting a rectal malignant growth. Fansler3 writes that not more than 40 or 50 per cent of those patients are suitable for radical operation. Dixon,4 reviewing a large series at the Mayo Clinic, states that in more than 50 per cent of the cases the growths were inoperable.

Smith, William A.

doi: 10.1001/jama.1937.92780010001010pmid: N/A

Wolf1 has recently reported striking benefit obtained by the use of quinine in four cases of myotonia and has concluded that quinine is a specific for this disorder, which has shown practically no response to all previous methods of therapy. I have had an opportunity to confirm this remarkable discovery in three cases, which will be briefly reported. The familial disease known as myotonia congenita was first described in 1876 by Thomsen, a Danish physician. He himself and twenty members of his family were affected. The disease is characterized by tonic muscular spasms occurring at the start of a movement, which greatly restrict further action. With repeated attempts at movement the spasms relax and the movement gradually becomes more free, until there is no difficulty. After a period of inactivity, however, the spasm occurs on attempted activity. The condition is usually worse when the patient is cold or