American journal of diseases of children

KUGELMASS, I. NEWTON; BANCROFT, FREDERIC W.; STANLEY-BROWN, MARGARET

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150003001

Hemorrhagic diatheses in childhood constitute a variety of disorders with a common tendency to bleed. They may be manifested in the form of petechial spots, purpuric extravasations or ordinary loss of blood from free surfaces. These clinical expressions of a disorder of the blood represent active hemorrhagic disease in all grades of severity. But there is a comparable group of disturbances of the blood in which a tendency to bleed or clot representing potential hemorrhagic disease may be precipitated by a sudden change in the vascular system. These latent aspects of hemorrhagic disease have thus far been neglected. Hemorrhagic disease, latent or active, results from an alteration in either the vascular system or its blood content. An understanding of the mechanism must be based first on knowledge of the normal formative tissue. The reticulo-endothelium is the common hematopoietic tissue which is capable of giving rise to different varieties of blood

GERSTLEY, JESSE R.; WANG, CHI CHE; WOOD, AGNES A.

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150019002

In previous communications,1 we compared the volatile acid output of infants fed on breast milk with the output of those fed on diluted cow's milk plus lactose. It was found that the volatile acid output and the total titratable acidity were relatively constant when breast milk was employed and were extremely variable on the diluted cow's milk mixtures. Changing the diet had no great influence on the total quantity of acid excreted. A change from breast milk to cow's milk invariably caused the appearance of propionic acid in the stool. We showed that many factors other than diet influenced the number of stools and the excretion of acid. The present study deals with the comparison of the acid output of infants on breast milk with that of infants on whole cow's milk. As in our previous studies, this investigation embraces clinical considerations such as temperature, weight curve, number and

GREENWALD, HARRY M.; PENNELL, SAMUEL

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150025003

In a previous paper we reported observations on the blood sugar values during fasting in normal new-born infants.1 In this paper we report the results of studies on the dextrose, saccharose, lactose and dextrimaltose tolerance in new-born infants. In addition, the blood sugar curve after a breast feeding was determined in eighteen infants. We found a number of reports2 in the literature on carbohydrate tolerance in infants ranging in age from 1 month to 2 years, but a careful search failed to reveal any studies on new-born infants. TECHNIC In all the work done, the values of the blood sugar were estimated on blood from the great toe, according to the technic described in a previous paper.1 Three hours after a feeding, the blood was taken and the sugar content was determined. Immediately after the blood was taken, 2 Gm. of dextrose, saccharose, lactose or dextrimaltose per

SCHWARTZ, A. B.; JANNEY, F. R.

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150036004

The incidence and mortality of diphtheria have been effectively reduced by the extended introduction of immunization against the disease. In the popularization of such a procedure, the fine work of Park and his associates deserves a place as a distinctly outstanding achievement for public health. The procedure has been adopted in the public schools of hundreds of communities. Through these agencies tangible statistical evidence of its benefits has been recorded. The complete effectiveness of the immunization program has been lessened by the difficulty of reaching the preschool child, among which group the highest incidence of diphtheria prevails, and by the imperfections of methods and materials used. To eradicate diphtheria completely, immunization must become as routine a medical practice for the preschool child as is the administration of orange juice a dietetic measure for the infant. Such custom, however, must be made secure by perfecting methods and materials now available. Errors

KOHN, JEROME L.; FELSHIN, GERTRUDE

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150044005

In a previous paper we1 have shown that in children after the cessation of a ketosis induced by a ketogenic diet, the carbohydrate metabolism does not return to normal at once but passes through a transitory stage. During this stage, there appears to be an excessive ability to utilize carbohydrates. This is shown by the occurrence of only a slight rise in the blood sugar curve in a dextrose tolerance test. The same low type of blood sugar tolerance curve is also seen following recovery from ketosis caused by cyclic vomiting. Often during an acute lobar pneumonic infection in children acetone is found in the urine. According to Binger, Hastings, Sendroy, Neill and Morgan,2 there is not a true ketosis during lobar pneumonia. They based their conclusions on the presence of normal blood reaction and normal blood gases. The constant occurrence of acetonuria in many acute infections of

SCHOENTHAL, LUDWIG; BURPEE, CLAUDE

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150049006

In recent years, considerable attention has been paid to a peculiar combination of chronic renal disease and deformity of the bones, known as "renal infantilism," renal dwarfism" or "renal rickets." Shipley and his co-workers and1 Lathrop,2 Hunt,3 Parsons4 and Duken5 have reviewed the literature on this subject and contributed additional case reports. Parsons, who has made the most extensive chemical study of this condition, has stated that the bone deformities are those of true low calcium rickets, which, according to the x-ray picture, should be classified into three types: (a) atrophic type, (b) florid type and (c) "woolly" type. The decrease of the calcium level of the blood may be absolute, as in one case reported by Parsons4 in which it was diminished to 3.95 mg. per hundred cubic centimeters, or only relative; that is, the calcium value is normal but low as compared

ELEY, R. CANNON

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150061007

In any disease in which the mortality rate is unusually high, numerous and not altogether successful methods of treatment are likely to be advocated. This has been true of erysipelas in infants. Morse1 reported 90 per cent mortality in infants; Erdman2 reported 39.7 per cent; while Schaffer and Rothman3 gave the following results: infants under 1 month of age, 80 per cent; under 6 months, 53 per cent; from 6 to 12 months, 47 per cent, and from 1 to 2 years, 14 per cent. As regards the influence of different forms of therapy, Knox4 reported a mortality rate of 60 per cent in infants under 6 months of age treated by local measures; Robertson5 quoted 65 per cent in infants under 12 months of age treated by exsanguination-transfusion; Borovsky,6 29 per cent by the use of a 2 per cent solution of mercurochrome-220

MARPLES, ELEANOR; CRUMP, ENID

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150068008

Infantile tetany has been recognized as a clinical entity for many years, but Howland and Marriott1 in 1918 were the first to describe its characteristic blood chemistry. They showed that the calcium content of the serum was greatly reduced in the active stages of tetany. Kramer, Tisdall and Howland2 found that electrical reactions typical of tetany (the cathodal opening contraction less than 5 milliamperes and the anodal opening contraction less than the anodal closing contraction) were present when the calcium content of the serum was less than 7.5 mg. per hundred cubic centimeters. Little attention has been paid to the inorganic phosphorus content of the serum in tetany, as that has generally been reported to be at or slightly below the normal level. Thus in 1921 Kramer, Tisdall and Howland2 reported normal values in seven cases of infantile tetany. Hess3 and his co-workers in 1923 determined

SCHOWALTER, R. P.

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150076009

As whooping cough causes many more deaths than diphtheria, measles or scarlet fever,1 it is important to know whether prophylactic injections of vaccine do or do not prevent the disease. The use of convalescent serum to control and prevent whooping cough was reported as early as 1901, as quoted by Griffith and Mitchell,2 and whooping cough vaccine has been in use for more than sixteen years. Fresh vaccine and stock vaccine have been used. While Huenekens3 believed that stock vaccines some months old are valueless, Mishulov, Oldenbusch and Scholl4 claimed that eight different stored preparations were tested at the end of four and one-half years and found to be highly potent, as measured by their power to stimulate specific antibodies in rabbits. Sauer and Hambrecht,5 in their excellent study of the problem, stated that as a prophylactic measure vaccines are lauded more by the practicing

SCHWARTZ, SIDNEY P.

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150081010

It is generally agreed that digitalis finds its greatest use and value in its slowing of the ventricular rate during established auricular fibrillation. That digitalis may, however, initiate and be responsible for the development of this arrhythmia in children with heart disease has been questioned on the ground that other factors responsible for the onset of this irregularity could not be ruled out.1 Since the rational use of digitalis depends in a great measure on a recognition and appreciation of its toxic manifestations, I have considered it worth while to call particular attention to the fact that digitalis in adequate doses can produce both the transient and the permanent forms of auricular fibrillation in children with heart disease. Moreover, the development of this arrhythmia is an early toxic manifestation during the course of digitalis therapy, and in some instances may result fatally. The close relationship of administration of digitalis

HINES, EDGAR A.

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150092011

Tetanus neonatorum has in past years been given a diversity of names, having been known as the "scourge of St. Kilda," "seven day sickness," "nine day fits," "trismus," "trismus nascentium" and other names of uncertain significance. For many years this disease was a "will-o-the-wisp" for the medical profession, puzzling many of the great scientists. Even to the present day, the pathology and treatment remain in the realms of the uncertain. It is a common belief that the disease is a great rarity. Johnston, in 1928, began his case report by saying, "Tetanus Neonatorum must be an extremely rare disease today." Statistical investigation, however, shows that tetanus neonatorum yet flourishes in some parts of the world, including the United States. The statistical data in this study were obtained from individual correspondence with each State Bureau of Vital Statistics and through the U. S. Bureau of Census. The assimilation of these data

BATY, JAMES M.

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150105012

A small group of cases has come to light during the past fifteen years of a condition originally described as Gaucher's disease and more recently established as a distinct clinical and pathologic entity, variously called Niemann's disease, Niemann-Pick's disease, lipoid cell splenohepatomegaly and lipoid histiocytosis. This condition occurs almost entirely in infants of Jewish parentage and affects females more commonly than males, in the ratio of 6:1. It is characterized by slowly progressing emaciation, enlargement of the spleen and liver and death before the age of 2 years from inanition or an intercurrent respiratory infection. Physical and mental retardation are commonly noted, and there are often characters suggesting mongolism or amaurotic family idiocy. Slight enlargement of the lymph nodes and brownish pigmentation of the skin may be present. There is a slight progressive anemia and moderate leukocytosis. Pathologically, the spleen is firm with rounded borders, and the cut surface is

BENJAMIN, L.

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150118013

Abscesses of the thymus gland were first described by Dubois in 1850 as a product of congenital syphilis. However, twenty-one years earlier, Cruveilhier reported cysts in the thymus gland of infants. Chiari believed that the Dubois abscess was a cyst formed by the thymus tissue invading Hassall's corpuscles, the result of pronounced syphilitic changes. While Schlesinger accepted this view, Tuve held the opinion that the Dubois abscess resulted from necrosis of the medulla of the thymus produced by a syphilitic disturbance in the development of the blood vessels supplying this region. Simmonds and Schridde demonstrated Spirochaeta pallida in this lesion. Eberle was not in accord with the opinion of its being a true abscess, but thought that they were dilated epithelial channels, which were remnants of the thymus anlage brought about by a syphilitic vascular disturbance during the development, with subsequent collection of pus in these channels. This explanation was

MALNEKOFF, B. J.

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150123014

Acute abscess of the mediastinum is exceedingly rare in infancy and in childhood. Müller1 quoted Hare, who reported a series of sixty-six cases gathered from the literature, in which only six patients were in the first decade of life and nine patients in the second decade. Cook2 reported four cases, in which the patients were 8 months, 8 years, 11 years, and 16 years of age, respectively. Achenbach3 reported a case in an infant, aged 3 weeks, following sepsis from thrombo-enteritis of the left umbilical artery and grip. Von Dehn4 reported a case of bilateral empyema with abscess of mediastinum in a child, aged 3 years. I have not found one case of pure mediastinal abscess in the records of the Milwaukee Children's Hospital, although the records of two cases showed acute generalized mediastinitis with death, following tracheotomy and acute retropharyngeal abscess. The following report may

GASUL, BENJAMIN M.

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150127015

The term diffuse cerebral sclerosis was long applied to a group of diverse diseases characterized by diffuse glial hyperplasia, admittedly the end-result of varied pathologic conditions including inflammatory, degenerative and developmental lesions. In 1912, Schilder1 isolated from this broad group what he termed a new disease entity, encephalitis periaxialis diffusa, or as it is more commonly termed, Schilder's disease. His original case was that of a child who presented a confusing clinical picture and died after operation for a presumed cerebral tumor. On the basis of this case and of four other cases that he chose from the literature (those of Ceni,2 Rossolimo,3 Beneke,4 and Haberfield and Spieler5), Schilder characterized the new pathologic entity as a sharply delimited but diffuse subcortical symmetrical involvement of the white matter. The myelin sheaths were destroyed with relative preservation of axones, and secondary hyperplasia of the fibrillary glia took

RUHRÄH, JOHN

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150142016

Nils Rosén von Rosenstein was born near Gothenburg on Feb. 1, 1706 (old style). His father was Erich Rosenius, at the time an army chaplain, and his mother Anna Wekander, who came out of an exemplary family of clergymen. One of his brothers, Eberhard, became professor of medicine at Lund and was subsequently ennobled and took the name Rosenblad. An anecdote on von Rosenstein's childhood, with which he used to entertain his friends, was that at the age of 4 he was stricken with plague and that he lay over twenty-four hours as dead. His mother, arranging his burial clothes, noticed signs of life and fainted. In 1718, he attended the Gymnasium in Gothenburg, and two years later the Academy in Lund. His father intended him to enter the ministry, but from his early years he was inclined to the study of medicine. One of his early teachers in medicine

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150147017

SOCIETY NEWS Second International Pediatric Congress, Stockholm, August, 1930 (Second Announcement).—Their Royal Highnesses, the Crown Prince and the Crown Princess of Sweden have graciously promised the convention their patronage. On special request from several quarters, the date of the convention has been put forward one day, and the new dates are thus Aug. 18 to 21, 1930. Acting on the suggestions received from the national committees of the different countries, the Swedish organization committee has chosen the following subjects for discussion: (a) the biologic effect of direct and indirect ultraviolet irradiation; (b) the physiologic and pathologic significance of the thymolymphatic system; (c) the psychology and pathopsychology of childhood; their significance as a branch of pediatric research and teaching, and their application in medicosocial work. The names of the speakers on these subjects will be announced in the near future, as well as the names of those announced in advance

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150149018

In the article by Dr. Kutsuji Kato (Congenital Transposition of Cardiac Vessels: A Clinical and Pathologic Study, Am. J. Dis. Child. 39:363 [Feb.] 1930) footnote 2 is incomplete. It should read: "2. There seems to be confusion on the part of the author who prints an autopsy picture of a case of complete visceral dextroposition describing it as a case of complete transposition of cardiac vessels. See Griffith, J. P. C., and Mitchell, A. G.: The Diseases of Infants and Children, ed. 2, Philadelphia, W. B. Saunders Company, 1926, vol. 2, p. 381."

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150149019

"The Relations of Weight, Height and Age in Negro Children" (American Journal of Diseases of Children 38:1222 [Dec.] 1929), the headings for the third and fourth columns in tables 4 and 5 were given incorrectly. These should read: Height in Inches Colored (R and H) Height in Inches White (B and W)

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150150020

TYSON, RALPH M.

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150195021

Blatt, Maurice L.

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150200022

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150211023

This book of twelve chapters (with seven illustrations) is essentially a grouping of lectures delivered by Dr. Wallace on various occasions before British and American Dental Societies and college students. The various chapters are skilful, forceful and repeated expositions of the author's ideas regarding the cause of dental caries, the comparative value of research in this field by various investigators and methods available in preventing dental disease. He emphatically questions the importance of vitamin deficiency in the diet as a factor in susceptibility to caries, and presents many good arguments in refutation of the theories of susceptibility so frequently promulgated by dietary investigators. Dietary habits, rather than the chemical constituents of foods, are the suggested cause of dental caries, and the author would prevent it by education in avoiding soft, mushy and starchy foods, especially the carbohydrates, and finish each meal with a food that would cleanse the teeth, carrying

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150211024

When one takes up this book he is struck in looking through it by the painstaking and methodical way in which the subject is treated. The book is not exhaustive, nor is it intended to be, but there is sufficient data to cover all the points that are necessary for the practical consideration of the subject. The preliminary chapters on the physiology of the infant and on milk with digestion and metabolism are well considered and adequately treated. Breast feeding is considered in detail. The material on artificial feeding of the healthy child is most enlightening in view of the distorted ideas that some American students seem to have brought back from Germany. The ideas conform closely to those held by conservative pediatricians in this country. There is a chapter on the nourishment of the premature and debilitated child which is well worth reading. Possibly no part of the book,

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150212025

This monograph is the reproduction of a review which appeared in a recent number of the Ergebnisse der inneren Medizin und Kinderheilkunde, vol. 36. It is a careful consideration of the subject by one who for many years has been actively engaged in its investigation, both in the laboratory and in the clinic. It considers not only the prophylactic and curative treatment for rickets and tetany, but also its diagnosis, etiology and pathogenesis. The bibliography is exceptionally full, including more than 1,500 references. The monograph can be recommended to all who wish to read or refer to an account that comprises the newer points of view of rickets and tetany. The indications for direct and indirect irradiation therapy are carefully outlined, and the question of "hypervitaminosis" is adequately discussed.

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150212026

This is a well written booklet, which can be understood by lay people. It contains many illustrations of the more common conditions, which are selfexplanatory. Considering the size of the volume, many of the ordinary disabilities of the feet are thoroughly discussed in simple terms. The most important phase of the work throughout the volume is prophylaxis, in that the author emphasizes and constantly gives specific directions for the prevention of minor foot troubles.

1930 American journal of diseases of children

doi: 10.1001/archpedi.1930.01930150213027