deaths of eminent foreign medical and scientific men

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704 substantiated. In your editorial you do not question the con- tinued usage of thalidomide in leprosy patients in spite of the fact that the side-effects of the drug on the peripheral nerves are still being ignored by leprologists. Alternative drugs, such as clofazimine and possibly rifampicin, are available for the management ofE.N.L. University College London, Department of Anatomy and Embryology, London WC1E 6BT. C. L. CRAWFORD CHROMOSOMAL ABERRATIONS IN PROTEIN-CALORIE MALNUTRITION SIR,-It is still uncertain whether protein-calorie mal- nutrition (P.c.M.) causes chromosomal damage. Armendares et al. and Betancourt et al. reported a significantly higher proportion of chromosomal abnormalities in malnourished infants as compared with the controls. Khouri and Mc- Laren 3 observed a similar increase in the frequency of aberrations but found no correlation between the degree of malnourishment and the rate of chromosomal lesion. They concluded that P.c.M. per se might not induce chromosomal aberrations. Betancourt et al. in a subsequent report concurred with this suggestion and suggested that the high aberration frequency previously reported 1,2 might have been due to other causes, such as specific deficiency of methionine, vitamin B12, or folate. They discounted an aetiological role of ionising radiation, for addition of 3H-thymidine to, and X-irradiation of, lymphocyte cultures did not show any significant difference in aberra- tion frequencies between the malnourished and control groups. Similarly, Thornburn et al,5 concluded that chro- mosomal aberrations in malnourished Jamaican children might be due to some toxic factors like " bush tea " rather than P.c.M. We examined the chromosomes in eleven children with moderate-to-severe malnutrition and in eight healthy infants. All the patients except one had weight below 60 percentile of the reference standard. 6 Peripheral-blood leucocytes were cultured in all cases, except one in which bone-marrow was processed. Most of the aberrations were either chromatid breaks, isochromatid breaks, or acentric fragments. No rings, dicentrics, or exchange configurations were noticed. The frequencies of chromosomal abnormalities in the malnourished and control children are shown in the table. The difference in the mean frequencies between the two groups was significant (p < 0-05). However, five out of the eleven patients had the same frequency range as that of the healthy group. Therefore, to take these variations into consideration, the x2-test was done, and the computed value of x2 was not significant (P>0-05). Details of this investigation will be published elsewhere.’ It was noticed that children with P.C.M. invariably had some sort of infection. However, the effect of the associated infection or disorder did not seem to be reflected in the frequency of aberrations in the individual patients in our study. It is likely that although P.c.M. per se may not cause chromosomal lesions, the cumulative effect of P.c.M. and associated ailments and infections may result in increased 1. Armendares, S., Salamanca, F., Frenk, S. Nature, 1971, 232, 271. 2. Betancourt, M., DeLa Roca, J. M., Sa&eacute;nz, M. E., Di&aacute;z, R., Cravioto, J. Lancet, 1974, i, 168. 3. Khouri, F. P., McLaren, D. S. Am. J. hum. Genet. 1973, 25, 465. 4. Betancourt, M., DeLa Roca, J. M., Carvioto, J. Lancet, 1974, ii, 1332. 5. Thornburn, M. J., Hutchison, S., Alleyene, G.A.O. ibid. 1972, i, 591. 6. Stuart, H. C., Stevenson, S. S. in Textbook of Pediatrics (edited by W. E. Nelson); p. 42. Philadelphia, 1969. 7. Upadhyaya, K. C., Verma, I. C., Ghai, O. P. Indian Pediat. (in the press). CHROMOSOME ABERRATIONS IN MALNOURISHED AND HEALTHY CHILDREN frequency of chromosomal aberrations. As it is not possible to control and monitor all the factors in man’s environment which directly or indirectly may cause some of these abnormalities, animal studies are more likely to resolve this question. The solitary report by Sadasivan and Raghuram 8 involved too small a number of animals to be definitive. Genetics Unit, Department of P&aelig;diatrics, All India Institute of Medical Sciences, New Delhi 110016, India. KAILASH C. UPADHYAYA ISHWAR C. VERMA O. P. GHAI MATERNAL NUTRITION AND LOW BIRTH-WEIGHT S!R,&mdash;Try as I will I am unable to comprehend the editorial activities of The Lancet. The Sept. 6 issue contains a full-page editorial on an analogy of lymph to cerebrospinal fluid fol- lowed by only a half page on maternal nutrition and low birth- weight, affecting as it does hundreds of millions of mal- nourished and starving individuals. This latter editorial compares two studies which find that prenatal nutrition does affect birth-weight with two that report no association. Only one is older than 1959 and that is not the best available. As an example, you ignore the almost definitive experimen- tal study of Bacon Chow in Taiwan-not a particularly deprived country-demonstrating the linear relationship of protein and caloric intake with birth-weight and, thus, the worldwide devastating effect of prenatal malnutrition upon the lifelong functioning of the surviving offspring. As a counter- posing study, you draw upon the 1947 report of Smith of a biased sample who underwent the short-lived Dutch famine in the last months of World War II in German-occupied Amster- dam and Rotterdam. Smith’s survey contained a lethal flaw, ignoring the glaring fact that the available food was not distn- buted randomly. Stein and Susser’s much more sophisticated study on the effects of the Dutch famine comes to the same in- excusable conclusion, on the same population as did Smith-i.e., birth-weight did not fall very much--despite their acknowledgement in at least two papers that the highest socio-economic stratum obtained more food and the total number of births dropped drastically. It is tragicomic to con- template that it was Thomson, whose negative findings make up the remaining argument in the editorial, in reviewing Stein and Susser’s 1974 book in Science, failed to see the totallv ’%, flawed assumption and lavished praise on a study in which the control population was at times nutritionally in almost as bad 8. Sadasivan, G., Raghuram, T. C. Lancet, 1973, ii, 574.

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Page 1: DEATHS OF EMINENT FOREIGN MEDICAL AND SCIENTIFIC MEN

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son, and daughters. The account referred to shows on theface of it that the attack was certainly not hydrophobic,and that its nature may be more readily understood by con-sidering the great part which imagination and imitationoften play in the production of paroxysmal nerve affections,as illustrated in Hecker’s Epidemics of the Middle Ages.Nearer to our day and more to the point are the records ofcases of "psudo-hydrophobia" such as that given by Dr.Broadbent five years ago (Clin. Soc. Trans., vol. xvi.), whotook occasion to point out to how great a degree the higheremotional centres may operate in exciting into action thelower centres; how, in fact, real disease may be simulatedclosely by functional disturbance, as in hysteria.

THE PARKES MEMORIAL PRIZE.

IT may be useful to remind our naval and military readersthat the triennial Parkes Memorial Prize of one hundred

pounds in money, and a gold medal value fifteen guineas, isto be awarded at the close of the present year. The com-

petition for the prize is open to all medical officers of the

Army, Navy, and Indian Services of executive rank. The

subject, as previously announced,is the "Etiology of YellowFever, to be illustrated, as far as practicable, from thepersonal experience of the writer"; and the essays, eachbearing a motto, and accompanied by a sealed envelope withthe same motto and containing the name of the competitor,are to be sent to the Secretary of the Parkes Memorial Fund,Royal Victoria Hospital, Netley, on or before Dec. 31st, 1888.

THE LATE PROFESSOR DE BARY.

IN the lamented death, on the l9th ult., of Prof. de Bary,of the University of Strassburg, at the age of fifty-seven,the botanical world loses one of its most illustrious

members. Prof. de Bary is perhaps best known for hisresearches in mycology and the lowest forms of vegetablelife. His " Lectures on Bacteria," of which a translation byMr. Garnsey, edited by Prof. J. B. Balfour, has recentlybeen issued by the Clarendon Press, Oxford, supplied amuch-felt want. Prof. de Bary was born at Frankfort; hefirst studied medicine, but in 1854 became a teacher of botanyat Tiibingen. After holding professorships at Freiburg and IHalle, he was in 1872 appointed to the chair at Strassburg.

AUDITORY ALLOCHIRIA.

ALLOCHIRIA, first described by Obermeister in 1882,consists in the perception of a sensation in the opposite sideof the body to that on which the excitation was made.Tabes dorsalis and other spinal diseases afford the most

frequent examples of it. )1. Gel]6 has observed in a youngperson affected with chronic hyperplastic otitis and audi-tory hyperasstbesia of the left side, but not presenting anysign of paralysis, hysteria, or tabes, an auditory allochiria,consisting in the fact that the patient heard on the left sidea piping sound produced in the right carotid artery underthe influence of the least effort or of the slightest emotion !

THE SALFORD INFECTIOUS HOSPITAL.

THE proposal to provide a new infectious hospital forSalford is meeting with considerable opposition on the

ground of the unsuitability of the intended site, and protestshave been made against it, both in the public press and bymeans of a deputation to the Local Government Board. Thewhole subject will probably be thoroughly threshed out ata public inquiry, and in the meantime we would onlyexpress our gratification that some hospital provision otherthan that now existing in the borough is in contemplationfor Salford.

THE CROWN PRINCE.

THE recent rumours and reports as to the condition of theCrown Prince of Germany have been conflicting, but the tele-gram from San Remo received by us on Thursday announces,we deeply regret to state, that the breathing of the dis-tinguished patient is not nearly so good, and that ’reliefby means of a surgical procedure will very soon be neces-sary. From all the information at present available, itwould appear that the larynx is the seat of perichondritiswith necrosis of cartilage; but that fact does not materiallymodify the grave prognosis given some time ago. Shouldthe perichondritis prove to be the sole disease, its greatextent must cause serious permanent deformity of the

larynx, with corresponding impairment of its function. Oathe other hand, the steadily progressive nature of the

perichondritis-its spread from one side to the other,and from cricoid to thyroid-offers strong grounds for thefear that it is but a secondary result of a more gravemalady. Tracheotomy in itself, in an adult, is an extremelysimple operation, devoid of all the difficulties surroundingit in young children, and the gravity of it is solely derivedfrom the conditions rendering its performance necessary.But the recent development of the case will excite renewedanxiety for the Crown Prince, and we shall anxiously awaitfurther news of the distinguished patient.

Just on going to press we learn that the operation of

tracheotomy has been successfully performed on Ilis

Imperial Highness by Dr. Bramann, the other medicalattendants being present. -

LAPAROTOMY FOR INTESTINAL OBSTRUCTIONDUE TO GALL-STONE.

WE learn that Mr. Charles Stonham has recently performedlaparotomy in a case of intestinal obstruction, and found agall-stone firmly impacted in the ileum, about twenty inchesabove the ileo-meal valve. The stone was removed by alongitudinal incision about one inch in length, and the woundclosed with a double row of fine silk sutures. There was

recent peritonitis of the gut above the stone, but none below., The patient, a lady aged sixty-six, who was very prostrateat the time of the operation, died fifteen hours later.

Symptoms of obstruction had lasted forty-eight hours.

DEATHS OF EMINENT FOREIGN MEDICAL ANDSCIENTIFIC MEN.

THE deaths of the following foreign eminent medical andscientific men are announced :-Dr. Hyaciathe Sauveur,Emeritus Professor in the University of Li&eacute;ge, and lastsurvivor of the old Faculty of Medicine reorganised in

1835.-Dr. Shaitanoff, Medical Inspector of Yaroslarlt.

FEES FOR COMPULSORY NOTIFICATION.

THE Sanitary Committee of the Oldham Corporation havehad a lengthened discussion on the question of payment forcertificates for the compulsory notification of infectiousdiseases ; the point in dispute being whether the fee for asingle certificate should cover notification of all cases in thehouse or not, and whether it should also be made to includean opinion as to the fitness of the patient for removal. The

difficulty of certifying as to multiple cases is often as greatwhen they are in one house as when they are in separateones, and this especially where houses are tenanted by morethan one family; and it is certain that the fee decided on inthe Act did not comprehend the inclusion of informationas to other matters than the notification of disease. By some

, members of the committee the increased demands were

regarded as unjustifiable, and it is quite certain that themedical profession will be within their rights if they decline