births, marriages, and deaths

1
289 were adhered to by all expectant mothers, the result would certainly be drastic reductions in the numbers of maternal deaths, stillbirths, and neonatal deaths, in the number of toxsemic patients occupying hospital beds, and in the number of babies filling the cots of premature-baby units. It would save many lives, much expense, and much domestic upheaval; and obstetricians would be spared many grey hairs. Reading. K. DOUGLAS SALZMANN. K. DOUGLAS SALZMANN. 1. Senn, A., Lundsgaard-Hansen, P. Helv. med. acta (in the press). LEPTOSPIROSIS AMONG BRITISH TROOPS IN MALAYA LEWIS CLEIN. SiB,ŅDr. Fairburn and Dr. Semple (Jan. 7) suggest that penicillin and chloramphenicol play no useful part in the treatment of leptospirosis. Having just returned from Malaya, where I was in charge of the medical wards in the third military hospital there at Kluang, Johore, may I state briefly my opinions on treatment of this disease ? In one year, during which time approximately two cases of leptospirosis a month were admitted, penicillin therapy in no case failed to give dramatic amelioration of symptoms and prompt (within forty-eight hours) reduction in pyrexia and other signs. The dosage employed was 600,000 units four- hourly for five days. I hope this letter may dissuade others from following the non-antibiotic regime suggested by Dr. Fairburn and Dr. Semple. Dublin. LEWIS CLEIN. THE HOSPITAL STAPHYLOCOCCUS A. SENN P. LUNDSGAARD-HANSEN. SiR,-In your issue of Jan. 7 Dr. Brodie and his colleagues report finding that the carrier-rate of staphylococci was doubled as a result of admission to hospital, and suggest that pseudomembranous enterocolitis in the first eight days after partial gastrectomy may be explained by the frequency of antibiotic-resistant (serotype ac/-) staphylococci. That the hospital reservoir of staphylococci, rather than the strains carried by patients on admission, is in fact the main source of infection in staphylococcal enterocolitis is strongly suggested by evidence recently obtained at the Surgical University Clinic in Berne. In 10 out of 17 cases seen between June and December, 1955, a complete investigation was done, consisting of nose- and-throat swabs with tests for antibiotic sensitivity on admission, examination of the faeces at the onset of the disease, and (thanks to the kind assistance of Dr. R. E. 0. Williams, of Colindale) bacteriophage typing. The results showed that 2 cases were due to endogenous superinfection of the gastro-intestinal tract from the nose with strains resistant to penicillin, streptomycin, and tetracyclines. The remaining 8 cases were, however, caused by cross-infection-in 7 cases with the same " house type " (phage combination 7/47/54/77, with minor deviations in some cases). This " house type " was encountered altogether 9 times over a period of four and a half months on three different wards. 1 case was traced directly to a member of the nursing staff harbouring this strain in the nose. We were fortunate enough not to lose any patients in this series. 5 cases were treated with erythro- mycin, and 12 with the new antibiotic ’ Rovamycin (’ Spira- inycin’).’ A. SENN Berne, Switzerland. P. LUNDSGAARD-HANSEN. THE MUNDESLEY SANATORIUM : A DISCLAIMER E. C. WYNNE-EDWARDS GEORGE DAY. The Sanatorium, Mundesley, Norfolk. SIR,-As Mark Twain said on a similar occasion, " Report of demise greatly exaggerated." Like all private sanatoria and most National Health Service sanatoria we have had to close whole blocks from lack of patients, and the prospects of survival as an establishment for the treatment of pulmonary tuberculosis are by no means rosy ; but we have every intention of carrying on a bit longer. Mundesley was one of the first British private sanatoria to open 57 years ago, and we rather hoped to be among the last to close. Obituary JOHN GEORGE FOSTER O.B.E., B.A., M.B. Dubl. Colonel Foster, who died on Jan. 13 at the age of 83 in Queen Alexandra’s Military Hospital, London, had served in the Royal Army Medical Corps for nearly forty years. His retirement in 1937 he regarded only as an opportunity for service of a different kind, and as secretary of the Corps’s charitable funds and as its historian he continued to work for it with devotion, kindliness, and scholarship. He was born in Athlone and graduated M.B. from Trinity College, Dublin, in 1896. Four years later he joined the R.A.M.C. During the South African war he saw active service in Cape Colony, Orange River Colony, and the Transvaal. In the first world war he served in Mesopotamia till 1920. He was three times mentioned in despatches and received the brevet rank of lieut.- colonel. He was appointed o.B.E. in 1919. In 1929 he took over the secretaryship of the R.A.M.C. Benevolent Society and the R.A.M.C. Fund, and he continued this work throughout the second world war, visiting his office daily, whatever the state of the blitz might be. An operation for the removal of an eye in 1944 he allowed to be only a temporary handicap. " It causes errors in typing," he wrote, " but I hope I shall surmount this very quickly." As a historian he was responsible for part of the roll of the Army Medical Services which goes back to 1666. Foster’s Roll, which covers the years from 1898 to 1933, will be a fitting memorial to its compiler. From the records which he had gathered for this work and from his own wide knowledge of the Corps, he had for many years helped us in preparing obituaries of serving officers. He was also an authority on military medals and decorations, and he had lately given his own fine collection to the R.A.M.C. historical museum. A colleague writes : "By the death of Colonel Foster all ranks of the R.A.M.C. have lost a real friend. For the 20 years he was secretary of the R.A.M.C. Benevolent Society and the R.A.M.C. Fund, I was closelv associated with him on their committees and I would like to record what a devoted secretary he was and how deeply interested in his work. He would spare no trouble in seeking information which might enable officers, other ranks, or their families who were found to be in distress or in need to receive such help as could be granted to them. Each case became his personal interest. He possessed in a remarkable degree the faculty of detecting an applicant for help whose case was not genuine. How great a friend he was to the R.A.M.C. may not, I fear, be fully realised, because he was a quiet and unassuming man, very kindly and considerate, who shunned the limelight and worked unobtrusively. He showed his interest in the Army generally by his knowledge of its history, which he implemented by a magnificent collection of British war medals." A Scandinavian correspondent informs us of the death last month in Sweden of Dr. IVAN BRATT, well known for his system of alcohol control known as Bratt’s system. Soon after qualifying in medicine at the age of 25 he threw himself into the discussions raging over the abuse of alcohol in Sweden. His system of alcohol control hinged on the right of every individual to a certain amount of alcohol, but only eo much and no more for each. Sweden has only recently abandoned this system in favour of greater freedom of alcohol consumption. Bratt also made his mark as director of Svenska Kullager Fabriken and in this post he showed great administrative ability. He retired during the war, and he spent his last years on his estate in Sodermanland, Sweden. His life was saddened in 1940 by the death of his wife in a German air attack outside Paris, during which he himself was also wounded by a bomb splinter. He was 77 years of age. Births, Marriages, and Deaths BIRTHS DICKINSON.-On Feb. 6, at University College Hospital, London, to Elizabeth, wife of Dr. C. J. Dickinson, son-Mark John.

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289

were adhered to by all expectant mothers, the result wouldcertainly be drastic reductions in the numbers of maternaldeaths, stillbirths, and neonatal deaths, in the number oftoxsemic patients occupying hospital beds, and in the numberof babies filling the cots of premature-baby units. Itwould save many lives, much expense, and much domesticupheaval; and obstetricians would be spared many greyhairs.

Reading. K. DOUGLAS SALZMANN.K. DOUGLAS SALZMANN.

1. Senn, A., Lundsgaard-Hansen, P. Helv. med. acta (in the press).

LEPTOSPIROSIS AMONG BRITISH TROOPS IN

MALAYA

LEWIS CLEIN.

SiB,ŅDr. Fairburn and Dr. Semple (Jan. 7) suggest thatpenicillin and chloramphenicol play no useful part in thetreatment of leptospirosis. Having just returned from Malaya,where I was in charge of the medical wards in the thirdmilitary hospital there at Kluang, Johore, may I state brieflymy opinions on treatment of this disease ?In one year, during which time approximately two cases of

leptospirosis a month were admitted, penicillin therapy in nocase failed to give dramatic amelioration of symptoms andprompt (within forty-eight hours) reduction in pyrexia andother signs. The dosage employed was 600,000 units four-hourly for five days.

I hope this letter may dissuade others from following thenon-antibiotic regime suggested by Dr. Fairburn and Dr.Semple.

Dublin. LEWIS CLEIN.

THE HOSPITAL STAPHYLOCOCCUS

A. SENNP. LUNDSGAARD-HANSEN.

SiR,-In your issue of Jan. 7 Dr. Brodie and his colleaguesreport finding that the carrier-rate of staphylococci wasdoubled as a result of admission to hospital, and suggest thatpseudomembranous enterocolitis in the first eight days afterpartial gastrectomy may be explained by the frequency ofantibiotic-resistant (serotype ac/-) staphylococci.That the hospital reservoir of staphylococci, rather than

the strains carried by patients on admission, is in fact the mainsource of infection in staphylococcal enterocolitis is stronglysuggested by evidence recently obtained at the SurgicalUniversity Clinic in Berne.In 10 out of 17 cases seen between June and December,

1955, a complete investigation was done, consisting of nose-and-throat swabs with tests for antibiotic sensitivity on

admission, examination of the faeces at the onset of the disease,and (thanks to the kind assistance of Dr. R. E. 0. Williams,of Colindale) bacteriophage typing. The results showedthat 2 cases were due to endogenous superinfection of thegastro-intestinal tract from the nose with strains resistantto penicillin, streptomycin, and tetracyclines. The remaining8 cases were, however, caused by cross-infection-in 7 caseswith the same " house type " (phage combination 7/47/54/77,with minor deviations in some cases). This " house type

"

was encountered altogether 9 times over a period of four anda half months on three different wards. 1 case was traced

directly to a member of the nursing staff harbouring thisstrain in the nose. We were fortunate enough not to loseany patients in this series. 5 cases were treated with erythro-mycin, and 12 with the new antibiotic ’ Rovamycin (’ Spira-inycin’).’

A. SENN

Berne, Switzerland. P. LUNDSGAARD-HANSEN.

THE MUNDESLEY SANATORIUM : A DISCLAIMER

E. C. WYNNE-EDWARDSGEORGE DAY.

The Sanatorium,Mundesley,Norfolk.

SIR,-As Mark Twain said on a similar occasion, " Report ofdemise greatly exaggerated." Like all private sanatoria andmost National Health Service sanatoria we have had to closewhole blocks from lack of patients, and the prospects ofsurvival as an establishment for the treatment of pulmonarytuberculosis are by no means rosy ; but we have everyintention of carrying on a bit longer.Mundesley was one of the first British private sanatoria to

open 57 years ago, and we rather hoped to be among the lastto close.

ObituaryJOHN GEORGE FOSTER

O.B.E., B.A., M.B. Dubl.

Colonel Foster, who died on Jan. 13 at the age of 83 inQueen Alexandra’s Military Hospital, London, hadserved in the Royal Army Medical Corps for nearly fortyyears. His retirement in 1937 he regarded only as anopportunity for service of a different kind, and as

secretary of the Corps’s charitable funds and as itshistorian he continued to work for it with devotion,kindliness, and scholarship.He was born in Athlone and graduated M.B. from

Trinity College, Dublin, in 1896. Four years later hejoined the R.A.M.C. During the South African war hesaw active service in Cape Colony, Orange River Colony,and the Transvaal. In the first world war he served inMesopotamia till 1920. He was three times mentionedin despatches and received the brevet rank of lieut.-colonel. He was appointed o.B.E. in 1919.

In 1929 he took over the secretaryship of the R.A.M.C.Benevolent Society and the R.A.M.C. Fund, and hecontinued this work throughout the second world war,visiting his office daily, whatever the state of the blitzmight be. An operation for the removal of an eye in1944 he allowed to be only a temporary handicap. " Itcauses errors in typing," he wrote,

" but I hope I shallsurmount this very quickly."As a historian he was responsible for part of the roll

of the Army Medical Services which goes back to 1666.Foster’s Roll, which covers the years from 1898 to 1933,will be a fitting memorial to its compiler. From therecords which he had gathered for this work and from hisown wide knowledge of the Corps, he had for many yearshelped us in preparing obituaries of serving officers. Hewas also an authority on military medals and decorations,and he had lately given his own fine collection to theR.A.M.C. historical museum.A colleague writes : "By the death of Colonel Foster

all ranks of the R.A.M.C. have lost a real friend. For the20 years he was secretary of the R.A.M.C. BenevolentSociety and the R.A.M.C. Fund, I was closelv associatedwith him on their committees and I would like to recordwhat a devoted secretary he was and how deeplyinterested in his work. He would spare no trouble inseeking information which might enable officers, otherranks, or their families who were found to be in distressor in need to receive such help as could be granted tothem. Each case became his personal interest. Hepossessed in a remarkable degree the faculty of detectingan applicant for help whose case was not genuine. Howgreat a friend he was to the R.A.M.C. may not, I fear,be fully realised, because he was a quiet and unassumingman, very kindly and considerate, who shunned thelimelight and worked unobtrusively. He showed hisinterest in the Army generally by his knowledge of itshistory, which he implemented by a magnificent collectionof British war medals."

A Scandinavian correspondent informs us of the death lastmonth in Sweden of Dr. IVAN BRATT, well known for hissystem of alcohol control known as Bratt’s system. Soonafter qualifying in medicine at the age of 25 he threw himselfinto the discussions raging over the abuse of alcohol in Sweden.His system of alcohol control hinged on the right of everyindividual to a certain amount of alcohol, but only eo muchand no more for each. Sweden has only recently abandonedthis system in favour of greater freedom of alcohol consumption.Bratt also made his mark as director of Svenska KullagerFabriken and in this post he showed great administrativeability. He retired during the war, and he spent his lastyears on his estate in Sodermanland, Sweden. His life wassaddened in 1940 by the death of his wife in a German airattack outside Paris, during which he himself was also woundedby a bomb splinter. He was 77 years of age.

Births, Marriages, and DeathsBIRTHS

DICKINSON.-On Feb. 6, at University College Hospital, London, toElizabeth, wife of Dr. C. J. Dickinson, son-Mark John.