JAMA

DANIELS, WORTH B.; SOLOMON, SYDNEY; JAQUETTE, WILLIAM A.

doi: 10.1001/jama.1943.02840360003001pmid: N/A

One hundred and twelve patients with meningococcic infection were studied at the Station Hospital at Fort Bragg, North Carolina, between Jan. 1, 1942 and April 17, 1943. Eighty of these patients had meningitis, and 32 had bacteremia without localization in the meninges. Our purpose in the present communication is to describe certain observations in connection with meningococcic infections, particularly as they relate to pathogenesis and to present data on the efficiency of the treatment of this infection with sulfadiazine. During 1942 at this post the disease occurred sporadically and there were only 16 cases in a large troop population. Beginning on Dec. 30, 1942 there was a decided increase in incidence. The weekly rate for the post as a whole reached 8 per thousand annually while the weekly rate for organizations composed of unseasoned troops went as high as 20 per thousand annually. Approximately one third of the soldiers at

HILL, LEWIS WEBB; LEVER, HASELTINE SMITH

doi: 10.1001/jama.1943.02840360011002pmid: N/A

During the period Jan. 1 to April 15, 1943, 68 patients with meningococcic infection were admitted to the Station Hospital at Camp Edwards, Massachusetts. Note that we do not say "meningitis," for many of these patients were admitted before the stage of meningitis had been reached. It is essential to bear in mind that infection with the meningococcus is divided into three stages: Nasopharyngeal infection, or sometimes even tonsillitis, clinically differing in no way from such conditions produced by other organisms.The stage of septicemia. The patient may die in this stage after a few hours, the infection may be overcome by proper treatment before meningitis has developed or in mild infections may be overcome by the patient himself without treatment, or the septicemia may progress in a few hours or in a day or two to meningitis. The last mentioned is the most common sequence of events.

MOCK, HARRY E.; MOCK, HARRY E.

doi: 10.1001/jama.1943.02840360015003pmid: N/A

This paper comprises a critical analysis of the literature on refrigeration anesthesia for amputations based on personal experience. To the 101 cases reported by Allen, Crossman and others1 we add observations on 17 cases of our own, eight amputations for peripheral vascular disease and nine amputations for trauma. What is meant by "refrigeration"? It is the chilling of tissues. It is not freezing. Freezing damages tissues as in frostbite; refrigeration does not. Water freezes at 0 C. (32 F.). Blood and tissues freeze at a slightly lower level. Refrigerating a limb with cracked ice or ice water lowers the temperature to somewhere between 0.5 and 5 above freezing. With a mechanical device the exact degree of refrigeration may be controlled. Hence there is a definite margin of safety. In no instance have we seen the tissues damaged. In an effort to determine the exact temperatures deep in the tissues

SHAFFER, BERTRAM; LENTZ, JOHN W.; McGUIRE, JAMES A.

doi: 10.1001/jama.1943.02840360019004pmid: N/A

Local sulfathiazole therapy is now a well established procedure in the treatment of superficial pyogenic disorders of the skin.1 Most authors considered this to be a relatively innocuous type of treatment, but experience has indicated that unfavorable reactions, some of them quite severe, may occur.2 This report details the types of reactions which have been described following local sulfathiazole therapy and also includes an account of 4 cases with allergic studies comprising our experiences with some of the more spectacular types of reactivity. Sams and Capland2 reported an example of recurrent contact dermatitis following repeated applications of sulfathiazole powder to the ears for a recurrent chronic dermatitis. Subsequent oral administration of the drug precipitated a severe dermatitis of the ears, followed shortly by a widely disseminate eruption. A patch test with the sulfathiazole powder gave negative results. Miller2 lists 5 cases of contact dermatitis due to

LIVINGOOD, CLARENCE S.; ROGERS, ARTHUR M.; FITZ-HUGH, THOMAS

doi: 10.1001/jama.1943.02840360025005pmid: N/A

When the personnel of the 20th General Hospital was first exposed to dhobie laundered clothes, soon after arrival in the C. B. I. theater, a small epidemic of patchy dermatitis made its appearance, which in all instances was distressing and in a few was temporarily incapacitating. The exact localization of the circumscribed patches of dermatitis on that part of the skin in contact with the dhobie mark and the course of the lesions made it quite obvious that this represented a contact dermatitis induced by the marking fluid which the native dhobies or washermen used in making their characteristic laundry marks (fig. 1). Having now completed identification of the causative agent, we make this report with a view of recording "dhobie mark dermatitis" as an entity which, to the best of our knowledge, has not been reported previously. We believe that our observations suggest a possible derivation of the term

GOLDSMITH, NORMAN R.

doi: 10.1001/jama.1943.02840360029006pmid: N/A

These cases are reported because of the novelty of the mode of spread of a contact dermatitis and to report a plant irritant uncommon to the Western Hemisphere. Dermatitis affecting 16 persons developed among employees of one of the large government departments in Washington, and the Dermatoses Investigations Section was requested to investigate. A bottle in a sealed mailpouch, shipped from India by air, had become partially opened and its contents, a thick black oil, had contaminated various pieces of mail. The contaminating substance was labeled "Bhilawanol Oil." REPORT OF CASES Three workers who were unpacking the pouch wiped the oil off the mail as well as they could. It was then distributed by a force of carriers and clerks numbering approximately 50. By evening a number of workers complained of itching and burning of their hands, arms and faces. Within twenty-four hours a vesicular eruption appeared on the exposed

ARIEL, IRVING; ABELS, JULES C.; PACK, GEORGE T.; RHOADS, C. P.

doi: 10.1001/jama.1943.02840360030007pmid: N/A

Immediate postoperative disturbances of water and electrolyte balance usually are corrected promptly by the adequate administration of isotonic solution of sodium chloride. Some instances of postoperative hypochloremia, however, are refractory to that procedure. This was noted first by Maddock as particularly common among patients with cancer of the gastrointestinal tract. He1 observed, furthermore, that when patients with this disorder began to eat an adequate diet the hypochloremia abated, but no explanation for this response was advanced. The existence of this type of hypochloremia now has been observed also in this hospital and appears to mark the postoperative course especially of patients with gastrointestinal disease. Attention first is directed to these patients usually because of their lethargy, anorexia, nausea and increasing abdominal distention. Blood studies reveal hypochloremia, alkalosis and hypoproteinemia. The intestine gradually becomes inactive. Flat roentgenograms of the abdomen are consistent with the picture of intestinal obstruction, and at

Tompkins, Victor N.

doi: 10.1001/jama.1943.82840360001008pmid: N/A

My purpose in this communication is to describe an aid in the diagnosis of meningococcic disease. This aid, the study of smears from purpuric skin lesions, while not new, is not widely used nor fully appreciated. It has particular application in outbreaks among military personnel in view of the high incidence of cutaneous lesions among them. In January 1943, during an outbreak of meningococcic disease, a patient was admitted to the infectious disease ward of this hospital in coma. She presented fever, leukocytosis, meningeal signs and a petechial type of cutaneous lesion over the extremities and axillary region. The cerebrospinal fluid was cloudy and contained neutrophils but no bacteria. Cultures of cerebrospinal fluid and blood were sterile. The patient was treated with sulfadiazine and made an uneventful recovery. In reviewing her case we were surprised to find that the organism believed to be responsible for her illness, namely the meningococcus,

OVERHOLSER, WINFRED

doi: 10.1001/jama.1943.82840360002010pmid: N/A

The interest of psychiatrists in physical therapy perhaps antedates that of any other medical specialty. This is particularly true of that form of physical therapy known as hydrotherapy; in hippocratic times baths were used for treating mental patients and during the Renaissance the noyade, a rather drastic form of hydrotherapy, was frequently employed. There is probably no mental hospital in the country today which does not have some hydrotherapeutic installation, and the continuous tub and the wet sheet pack have long been standard procedures in such hospitals. Perhaps too the earliest therapeutic uses of electricity were those in connection with psychiatric practice, even though the effects of the static spark and more recently of the faradic current in connection with the treatment of the neuroses were largely suggestive rather than primarily physical. Physical therapy and psychiatry have labored under rather similar difficulties in that they are both newly recognized specialties

doi: 10.1001/jama.1943.02840360034009pmid: N/A