The in vitro production of ammonium and amines by intestinal bacteria in relation to nitrogen toxicity as a factor in hepatic coma.


The chemical basis of the virulence of Bacillus anthracis.  VII.  Two components of the anthrax toxin:  their relationship to known immunising aggressins.


Acanthomata appearing after eczema.

Acanthomata appearing after eczema.


The neurotoxin of Shigella shigae; a comparative study of the effects produced in various laboratory animals.


The use of cortisone in lichen planus.

The use of cortisone in lichen planus.


Tinea capitis in East London and Essex, 1944-1955.


Myocardial necrosis in the potassium-depleted rat:  a reassessment.


The basis of virulence in Pasteurella pestis:  the development of resistance to phagocytosis in vitro.


A study of the immunity against tetanus toxin following the use of a combined typhoid-tetanus vaccine.


The long term survival and reaction to methylthiouracil of thyroid auto-implants in the rat.


Plasma, tissue and urinary radioactivity after oral administration of 56Co-labelled vitamin B12.


Extragenital forms of cutaneous bilharziasis.


Results of splenectomy in auto-immune haemolytic anaemia.


Polymorphic light eruptions:  relation to ultraviolet light intensity and hours of sunshine.


The assay of antihaemophilic globulin (AHG) in plasma.


Congenital familial deficiency of factor V (parahaemophilia) combined with deficiency of antihaemophilic globulin.


The anticoagulant action of chlorazol fast pink.


Biological interaction between lymphocytes and other cells.


Variability of the rhesus antigen D.

Variability of the rhesus antigen D.


A hitherto undescribed human blood group Am.


A new coagulation defect.

A new coagulation defect.


A sex difference in the response to titrated irradiation therapy (32P) of patients with chronic granulocytic leukaemia.


Differences in the agglutinability of human red cells by the high-titre cold antibodies of acquired haemolytic anaemia.


Sixty years of industrial medicine in Great Britain.


Occupational medicine as a vocation.

Occupational medicine as a vocation.


The relationship between ventilatory capacity and simple pneumoconiosis in coalworkers; the effect of population selection.


Factors influencing the radiological progression rate of progressive massive fibrosis.


Pneumoconiosis in Central Indian coal-mines.


A study of dust toxicity using a quantitative tissue culture technique.


A quantitative technique for studying the effect of dust on phagocytic cells in vitro.


The use of a size selector for dust sampling with the thermal precipitator.


The use of the Pulheems system of medical classification in civilian practice.


Determination of atmospheric benzene concentration by displacement following adsorption on silica gel.


Two cases of poisoning with di-isopropylfluorophosphonate.  (D.F.P.).


Arsine poisoning.

Arsine poisoning.


The prescription of industrial disease.

The prescription of industrial disease.


Mobile home treatment unit for rheumatism and arthritis.


Progress in the treatment of fractures.

Progress in the treatment of fractures.


The role of weight training in a neuropsychiatric hospital.


Issues in rehabilitation:  does rehabilitation pay?


Homogenous bone grafts.

Homogenous bone grafts.


The distribution of radioactive sulphur in homografts of epiphyseal cartilage.


A mucosal cross-lip flap.

A mucosal cross-lip flap.


A method of reconstructing the whole abdominal wall.


Direct inguinal hernia:  plastic surgery applied to a general surgical problem.


Fractures of the mandible in children under the age of six years.


A removable wire suture for internal fixation of mandibular fractures.


Fracture of the midline of the mandible associated with complete unilateral dislocation of the jaw.


External ear malignancy.

External ear malignancy.


A method of reconstructing the breast.

A method of reconstructing the breast.


A paramount card for hare lip and cleft palate surgery.


Surface areas of body parts and their possible implications in treating burns.


THE INTRODUCTION of the rad in radiotherapy practice; a symposium.


Radiation units in use in Great Britain.


The transition from röntgen to rad.

The transition from röntgen to rad.


The use of the rad in clinical dosage.

The use of the rad in clinical dosage.


Conversion of röntgens to rads.

Conversion of röntgens to rads.


Measurement of energy absorption by ionization chambers.


An experimental study in microcholangiography; preliminary report.


Duodeno-colic fistula.

Duodeno-colic fistula.


A study of the variable angle as a measuring device of linear dimension.


Intubation in carcinoma of the oesophagus.


Pulmonary artery occlusion demonstrated by angiography.


Ureteric calculus with unusual radiographic features.


Foreign bodies in the appendix.

Foreign bodies in the appendix.


The rapid reconstruction of radium implants; a new technique.


An interlock system for a superficial x-ray set.


A comparative study of the effects of different arterial clamps on the vessel wall.


Squamous-cell cysts of the thyroid with special reference to the aetiology of squamous epithelium in the human thyroid.


Hypothermia as an aid to surgery.

Hypothermia as an aid to surgery.


Gastric tuberculosis associated with gastric carcinoma.


The negative X-ray report in cancer of the colon.


Metastasizing insulinoma with hypoglycaemia.


Chemodectoma of an aortic body.

Chemodectoma of an aortic body.


Acute volvulus of the stomach.

Acute volvulus of the stomach.


Gangrene of venous origin.

Gangrene of venous origin.


Atypical head injuries illustrating general therapeutic principles.


Fracture-dislocation of the talus in childhood; a report of two cases.


The anatomy of the intrarenal arteries in health and disease.


A clinico-pathological study of thyroid carcinoma.


Conjoined twins.

Conjoined twins.


Missile head wounds in the Korean campaign; a survey of British casualties.


Tumours of the diaphragm.

Tumours of the diaphragm.


Granuloma of the neck following thorotrast angiography.


Perforated peptic ulcer:  the immediate and long-term sequelae.


A case of spontaneous left ureterocolonic fistula associated with an abscess in the left loin and faecal fistula.


Prevention of the late complications of ureterocolostomy by methods of faecal exclusion.


Gas gangrene of the colon in a newborn infant; report of a case successfully treated by total colectomy.


A carcinoma of the third part of the duodenum.


Meckel's diverticulum with mesenteric abscess.


A case of unsuspected arterial disease.

A case of unsuspected arterial disease.


A case of faecal contamination of the pleura and gastrocolic communication following gunshot injury.


The value of bronchography in diagnosing peripheral primary lung carcinoma.


Massive collapse of the lung with acute respiratory infection.


Spontaneous haemopneumothorax.

Spontaneous haemopneumothorax.


Chlorpromazine in asthma, chronic bronchitis and emphysema.


The unusual occurrence of an acid-fast saprophyte and Salm. typhi-murium in association with a pulmonary lesion.


Peptic ulcer and pulmonary tuberculosis.


Thrombocytopenic purpura in tuberculosis.


Impressions of chemotherapy in the out-patient treatment of pulmonary tuberculosis in Singapore.


Domiciliary treatment of pulmonary tuberculosis.


Pulmonary tuberculosis under long-term treatment with corticotrophin and chemotherapy; a report on three cases.


Tuberculosis and syphilis; a record of four cases.


Cortisone and chemotherapy in pulmonary tuberculosis.


The congenital anomalies of the lower urinary tract.  II.


Acute pancreatitis following administration of isonicotinic acid hydrazide; report of a case.


Sensations associated with micturition.

Sensations associated with micturition.


Adenocarcinoma of the kidney in childhood:  report of a case and a review of the literature.


Primary tumours of the ureters and renal pelves:  survey and analysis of twelve cases.


Unilateral renal chyluria.

Unilateral renal chyluria.


Renal infarct as space-occupying lesion.


Enuresis in bilateral complete renal duplication treated by heminephrectomy and chemotherapy.


Vesico-ileal fistulae due to Crohn's disease.


Genito-urinary tuberculosis:  a progress chart.


The surgical spread of cancer in urology.


Summary of currently employed prostatic biopsy methods, with comments concerning combined transrectal biopsy and radical retropubic prostatectomy.


Adenomatoid tumours of the epididymis and tunica albuginea; two cases.


Fibrosarcoma of the spermatic cord.

Fibrosarcoma of the spermatic cord.


Bladder involvement in a case of herpes zoster.


Vesical schistosomiasis.

Vesical schistosomiasis.


The nature of genius.

The nature of genius.


Amnion implantation in peripheral vascular disease.


Shoe-fitting X-ray fluoroscopes; radiation measurements and hazards.


Technique for bypass operations in femoral arterial disease.


Nitrofurantoin in chronic urinary infection associated with renal calculi.


Urinary sympathin excretion of normal infants and of infants with pink disease.


Hyperthyroidism developing during P.A.S. therapy.


Gonadal agenesis with tetany and severe osteoporosis.


Haemolytic anaemia in sickle-cell trait.


Perforating wound of the portal vein.

Perforating wound of the portal vein.


Intestinal obstruction as a late complication of fibrocystic disease of pancreas.


GLUCAGON.

GLUCAGON.


Medical blood preparations.

Medical blood preparations.


Problems of Salmonella food-poisoning.

Problems of Salmonella food-poisoning.


Inhaled foreign bodies.

Inhaled foreign bodies.


Tracheostomy, and management of the unconscious patient.


Maintenance of high sickling rate in an African community.


Familial agamma-globulinaemia.

Familial agamma-globulinaemia.


Aetiology of juvenile diarrhoea; laboratory investigation of specimens referred from general practices in North-East London.


A family history of uterine and gastro-intestinal cancer.


Trendelenburg tilt; an obsolete position.


Leukoplakia of the bladder.

Leukoplakia of the bladder.


PREVENTION of tetanus.

PREVENTION of tetanus.


CO-OPERATIVE research in the common-wealth.


Blood substitute solutions.

Blood substitute solutions.


Hypothalamic syndromes.

Hypothalamic syndromes.


Surgical treatment of children with coarctation of the aorta.


Coarctation of the aorta.

Coarctation of the aorta.


Outbreak of food-poisoning from bread made of chemically contaminated flour.


Treatment of megaloblastic anaemia of pregnancy and the puerperium with vitamin B12.


Operative parathyroid arteriography for location of parathyroid tumour.


Macroglobulinaemia of Waldenström.

Macroglobulinaemia of Waldenström.


Anterior tibial syndrome after acute arterial occlusion, treated by decompression.


Enteritis and polyarthritis following partial gastrectomy.


ATTENUATED poliomyelitis viruses.

ATTENUATED poliomyelitis viruses.


PULMONARY embolism by amniotic fluid.

PULMONARY embolism by amniotic fluid.


CRYOGLOBULINAEMIA and macroglobulinaemia.


SPREAD of bacillary dysentery.

SPREAD of bacillary dysentery.


SIR HAROLD SCOTT.

SIR HAROLD SCOTT.


T. BATTERSBY JOBSON.

T. BATTERSBY JOBSON.


R. Scot Skirving.

R. Scot Skirving.


Hypoglycaemic and anti-diabetic sulphonamides.


A clinical trial of BZ 55.

A clinical trial of BZ 55.


Trial of an oral hypoglycaemic agent in diabetes.


Clinical trial of the new oral hypoglycaemic agent BZ 55.


BZ 55 in diabetes.

BZ 55 in diabetes.


Hypoglycaemic sulphonamides in treatment of diabetes.


The value of BZ 55 in control of diabetes.


VACCINATION against whooping-cough; relation between protection in children and results of laboratory tests; a report to the Whooping-cough Immunization Committee of the Medical Research Council and to the medical officers of health for Cardiff, Leeds, Leyton, Manchester, Middlesex, Oxford, Poole, Tottenham, Walthamstow, and Wembley.


Repeated delayed splenic bleeding into the lesser sac.


Some principles and methods of international health work.


[Douglasitis syndrome caused by a foreign body].


Medical research in contemporary society.


[Distribution by age and severity of cancers in function of embryological origin and site of the organ on which they develop].


[Endometriosis and pregnancy; two case reports].


A comparison of the toxoplasmin skin tests, the Sabin-Feldman dye tests, and the complement fixation tests for toxoplasmosis in various forms of uveitis.


Jonas S. Friedenwald:  in memoriam.

Jonas S. Friedenwald:  in memoriam.


Jonas S. Friedenwald; his contribution to medical education in Israel.


Personal recollections of Jonas S. Friedenwald.


Medical care among the North Carolina Moravians.


The adrenal cortex in diabetic retinopathy:  urinary 17-hydroxycorticosteroid excretion studies.


Library research and new drug development and promotion.


The library of the College of Medicine of the National Taiwan University.


Notes on the Medical Museum of the Armed Forces Institute of Pathology.


A detailed subject classification for cardiovascular reprint libraries based on the Standard Nomenclature of Diseases.


Research libraries in 1955.

Research libraries in 1955.


Differences in the behaviour of normal and allergic sera in the induction of paraspecific shock; studies on the mechanism of allergic dysreaction.


A galaxy of old Japanese medical books with miscellaneous notes on early medicine in Japan.  IV.  Ophthalmology, psychiatry, dentistry.


Medical references in The Arabian Nights.


Effects of cholic acid on cholesterol deposits and on plasma lipids and lipoproteins.


Episodic dyscontrol:  a third order of stress adaptation.


Motive and style in reality contact.

Motive and style in reality contact.


A contribution to the psychological understanding of the character of Don Juan.


Reflections on the wish of the analyst to break or change the basic rule.


Further studies on the phenomenon of toxialepsy to alloxan.


Activity of arterial wall enzymes on experimental arterial hypertension in rats.


Fechner and Freud.

Fechner and Freud.


Surgery in the aged.

Surgery in the aged.


Everyday problems in the care of the aged; transcription of a panel meeting.


Appendicitis is still dangerous.

Appendicitis is still dangerous.


Manuel Garcia's contribution to laryngology.


Manuel Garcia; the artist and scientist.


Renal function in man during acute hydronephrosis.


Gastrointestinal exfoliative cytology; its contribution to the diagnosis of gastrointestinal neoplasms.


A scheme for intracranial venous circulation.


Giant fibroadenoma of the breast.

Giant fibroadenoma of the breast.


Venous angioma as the cause of cerebellar apoplexy:  report of a case.


Obstetrical case study:  placenta accreta.


HUGH R. SPENCER; a tribute.

HUGH R. SPENCER; a tribute.


Role of pathology in the training of a surgeon.


The importance of training in pediatric pathology.


Pathology as an avocation.

Pathology as an avocation.


Admission to your medical school.

Admission to your medical school.


The use of the proteolytic enzymes in surgery.


A new vascular instrument for repair of saccular aneurysms.


SUMMARY of admissions and perinatal mortality, Department of Obstetric and Gynecology.


The problem of cerebral phlebothrombosis; an analysis of 22 cases.


The medical library, past and future.

The medical library, past and future.


Obstetrical case report.

Obstetrical case report.


[Clearly delimited infiltrating pruriginous melanoderma, with generalized adenopathy, but without evident giant blood cells; malignant reticulosis of pigmentogenous erythroderma type].


[Tuberculous manifestations in the course of prolonged cortisone therapy].


The reaction of the liver to intra-abdominal cooling.


Hypothermia in the surgical treatment of aortic aneurysms.


Hypothermia by venous cooling.

Hypothermia by venous cooling.


The value of transbronchial pressure measurement in the left auricle in the diagnosis of mitral disease.


The chemical composition of the blood in hypothermia.


A histochemical study of the pre-osseous stage of healing of experimental fractures.


Principles and indications for treatment of ventilatory insufficiency.


[Hypereosinophilia connected with an experimental parasitic impasse of Strongyloides fulleborni in the guinea pig].


[Studies on infectious jaundice viruses in tissue culture.  I.  Searching for viruses of infectious jaundice in material taken from patients].


[Attempted detection of infectious jaundice viruses in allantoic fluids of chick embryo and in tissue culture fluids by electron microscopic method].


[Studies on infectious jaundice viruses in tissue culture.  II.  Attempted culture of the laboratory strain NMG of infectious hepatitis virus in various tissues].


[Preservation of the reserve tissue material for investigations with poliomyelitis virus].


[Effect of cerebral autolysates on infection titer of Lansing poliomyelitis virus].


[Studies on infectious jaundice virus.  III.  Attempted preservation of virulence of the strain NMG of infectious jaundice virus for chick embryo].


[Affinity of poliomyelitis virus to fatty tissue].


[Determination of variations of adsorption properties of influenza viruses by various types of erythrocytes].


[Comparative studies on nucleic acids content in complete and incomplete forms of influenza virus; preliminary communication].


[Immunizing properties of strains of Pasteurella tularensis with low virulence].


[Isolation and properties of cereine B12, an antibiotic from Bacillus cereus phi].


[Studies on the resistance of Micrococcus to sulfonamides and to four antibiotics].


[Further studies on the appearance of toxoplasmosis in Poland].


[Sabin-Feldman test as a method of investigation of the resistance mechanism].


[Weigl's test; a new method of investigation of toxocity of chemotherapeutic agents].


[Characteristics of sewage in fishing industry].


[Modification of sodium nitrite content in nitrite ice].


The effect of a salt-free diet on the maximal concentrating ability of the kidney as measured by specific gravity.


The effect of pH, on the sickling phenomenon and its therapeutic possibilities.


Immunological studies in sarcoidosis.

Immunological studies in sarcoidosis.


A critical evaluation of the psyche as an etiologic agent in infantile eczema.


A study of C-reactive protein in tuberculosis.


Parergon.

Parergon.


Synthetic substances with morphine-like effect; relationship between analgesic action and addiction liability, with a discussion of the chemical structure of addiction-producing substances. For compounds of the morphine, morphinan, pethidine, hexamethyleneimine, methadone, and dithienylbutenylamine groups, the analgesic and physical-dependence-producing properties are compared. On the basis of a parellelism in intensity of these properties, conclusions are drawn regarding their interrelationship and the chemical features common to substances with morphine-like addiction liability.


Bilharziasis survey in south-western Asia; covering Iraq, Israel, Jordan, Lebanon, Sa'udi Arabia, and Syria:  1950-51. This paper describes a limited survey of bilharziasis and its vectors carried out during 1950 and 1951 in some countries of south-western Asia. Lack of time and of full facilities prevented the survey from being as comprehensive and systematic as would have been wished, but enough data were obtained to provide a general estimate of the situation.Information already available from the literature was supplemented by collecting unpublished records, questioning the inhabitants, examining random samples of stools and urine, and investigating rivers, wells, and springs. Bilharziasis haematobia is already heavily endemic in the irrigated areas of Iraq and is also present, in comparatively smaller foci, in northern Syria, Israel, and Sa'udi Arabia. In the opinion of the senior author (M. A. A.), the envisaged extension of irrigation is likely to create a serious health problem in Mesopotamia and to introduce the disease into the Jordan region unless the spread of the molluscan vector, Bulinus sp., is checked. Intensification of infection and further spread are possible in Israel and in the Syrian Jezire, while the remainder of Syria and Lebanon are not considered to be endangered. Bilharziasis mansoni is widespread in the fertile areas of Sa'udi Arabia and also occurs in one minor focus in Israel. The industrialization of Sa'udi Arabia which is planned to exploit its oil resources, with its inevitable concentration of population, equally presents a danger in the intensification of bilharziasis. It is considered that, unless prompt measures are undertaken to break the link between the agricultural and industrial expansion and the spread of the disease, the debilitation of large groups of the population and the economic loss which may well result over most of the inhabited parts of the area discussed will be significant.


The Arizona group of enterobacteriaceae in animals and man; occurrence and distribution. A summary of the occurrence and distribution of serotypes of the Arizona group of Enterobacteriaceae among animals and man is presented. In all, 1308 cultures have now been isolated and 96 serotypes identified. In the 75 cultures obtained from man, 21 serotypes have been found. Organisms of the Arizona group have been discovered in epizootic infections of animals in which the mortality was high. In man they have appeared both in sporadic cases and in well-defined outbreaks of disease. The bacteria have been found in blood cultures and localized infections as well as in the stools of persons affected with gastro-enteritis. The opinion that bacteria of the Arizona group are primary excitants of disease is stressed and evidence to support this view is presented.


Recommended laboratory methods for the diagnosis of plague.


Effect of preservation on the viability and allergenic potency of dried BCG vaccine. Although many studies have been made on the lyophilization of BCG vaccine, few reports on its stability have appeared. The amount of living bacilli present in the vaccine and its allergenic potency can be considered to be an indication of the stability of the vaccine. The authors have already reported on the change in viability of vaccines preserved for 17 months; in this paper two experiments on lots of vaccines preserved for three years are discussed. The authors determined changes in viability after storage and examined tuberculin reactions one to eighteen months after vaccination. It was observed that the vaccines which had a relatively high potency at the time of lyophilization maintained their ability to induce allergy for at least two years.


The Second International Standard for Corticotrophin. The authors describe the steps taken to establish the Second International Standard for Corticotrophin and discuss the results of the collaborative assay in which it was compared with the First International Standard. Sixty-one assays of the blended material from two batches of crude corticotrophin prepared by the Astwood procedure, but not subjected to oxycellulose purification, were carried out by 12 laboratories in 5 countries. Almost exclusively, the assay methods used were the thymus involution method and the subcutaneous and intravenous Sayers methods. It was estimated from the statistical analysis of the results that the new standard is 1.14 times as potent as the existing standard, and the International Unit has therefore been re-defined as 0.88 mg of the new standard.


The alpha antitoxin content of the international reference preparations of Clostridium welchii types B and D antitoxins. The alpha antitoxin contents of the International Reference Preparations of Clostridium welchii Types B and D Antitoxins were assayed against two type A test toxins-Cl. welchii (perfringens) test toxin P2, issued by the Statens Seruminstitut, Copenhagen, and Cl. welchii test toxin AGX 1373, issued by the Wellcome Research Laboratories, England-the alpha toxin contents of which were first determined against the International Standard Alpha Antitoxin. Three methods of assay were used: mouse killing (the L+ test); haemolysis of red blood cells (the Lh test); and production of turbidity in egg-yolk solution (the lecithinase or Lv test).Taking the mean of all tests, it was found that the International Reference Preparation of Cl. welchii Type B Antitoxin contained 282 units of alpha antitoxin per ml, while the International Reference Preparation of Cl. welchii Type D Antitoxin contained 93 units of alpha antitoxin per ml.


Use of synthetic, crystalline, L-alpha-dimyristoyl lecithin in cardiolipin antigens. Experiments were carried out by the authors to determine whether synthetic, crystalline, L-alpha-dimyristoyl lecithin could replace natural purified lecithins in the preparation of cardiolipin antigens. These experiments were designed specifically to find out whether it was possible to obtain the same serological reactions, qualitatively and quantitatively, with the test antigen as with a reference antigen containing natural lecithin, and whether the test antigen had the same keeping qualities as the reference antigen.The tests used were the quantitative complement-fixation test as modified by Mørch in 1933, and the VDRL slide flocculation test.The results showed that synthetic, crystalline, L-alpha-dimyristoyl lecithin could replace natural lecithin in the preparation of cardiolipin antigens, but that the antigens prepared with the synthetic lecithin were significantly less sensitive than those prepared with an equimolar amount of natural lecithin. The authors consider that further investigation is required before the use of synthetic lecithin is finally adopted.


Aldosteronism associated with adrenal cortical adenoma. An electrolyte-regulating corticoid has been identified and given the name aldosterone. This hormone may be produced in amounts above normal in adrenal cortical tumors in hyperplastic adrenal glands and in normal appearing adrenal glands. Overproduction of aldosterone is accompanied by certain characteristic clinical manifestations which should suggest the diagnosis. The diagnosis may be supported by examinations available in most well equipped clinical laboratories. Bioassay of aldosterone in the urine and estimation of exchangeable body sodium and potassium, using radioactive salts, are necessary for confirmation of the diagnosis.Since the description of this salt-retaining hormone by Simpson and Tait and the discovery of its chemical structure by Reichstein in 1954, reports of 14 cases have been published. Surgical removal of the offending tissue gives spectacular relief from the very distressing symptoms.


Electrocardiograms and vectorelectrocardiograms; an appraisal of their value in subendocardial and in transmural myocardial infarction. By vector methods quantitative differences can be shown to be present between subendocardial and transmural myocardial infarction. In acute transmural infarction the vector shift occurs later, the degree of shift is greater, the return to normal is later in time and an abnormal vector shift remains more frequently than in subendocardial infarction. In acute anteroseptal transmural infarction the degree of vector shift was closely correlated with the severity of the acute illness.


Massive and recurrent hernias; use of dermal grafts in carrying out repair. Graft of dermis is clinically and experimentally superior to graft of whole skin for use as reinforcement at the site of repair of hernia, for gross cysts do not form and it fuses better with the surrounding tissues than does whole skin. Placing either dermis or skin under tension helps prevent cyst formation and aids fusion with surrounding tissues. Dermal grafts are less liable to infection than are whole skin grafts, either at the time of operation or later.A split-split flap dermatome technique is presented as a preferred technique for obtaining a dermal graft from the thigh in cases of ventral hernia in which the abdominal skin is stretched, attenuated and inelastic because of the massive size of the hernia. This technique was used in 27 cases of massive hernia. There was infection in one case of the 27 and subsequent healing was satisfactory. One patient died of spontaneous rupture of an intracranial carotid aneurysm. Hernia did not recur in any patient.A split-split free graft dermatome technique is presented for use in cases in which an elliptical segment of normal skin can be removed adjacent to an inguinal or thoracic incision for repair of a hernia or other use. This technique was used in seven cases of inguinal hernia and in one of diaphragmatic hernia with satisfactory results.


Clinical recognition of chronic pyelonephritis. In five cases of chronic pyelonephritis herein described, fulfilling the pathologic criteria established by Weiss and Parker, the diagnosis was not established until autopsy or until the patient had reached a terminal uremic state. Improvement in the clinical recognition of pyelonephritis at all stages would be of value in improving the results of specific therapy, in clarifying the relation of pyelonephritis to hypertension, and in establishing what conditions, in addition to urinary stasis, may predispose to pyelonephritis. The clinical situations in which pyelonephritis should be suspected are discussed, and diagnostic criteria based upon examination of the urine, pyelograms, renal function studies, and renal biopsy are described and their limitations discussed.


Melanoma-simulating nodules due to capillary aneurysms. Six cases of a lesion simulating a melanoma clinically but due to an aneurysmal dilatation of a capillary with thrombosis are presented. The necessity of distinguishing these tumors from malignant melanomas is stressed. The thesis that every black, flat, growing lesion is not a melanoma is emphasized. Therefore, it follows that wanton sacrifice of adjacent normal tissue is not indicated in such lesions unless there is histologic proof or indisputable clinical evidence of malignancy. This is not to be construed as advocating that one should minimize the growing flat black nodule nor that histologic examination is not essential in such cases.


Parotid tumor operations; the case against enucleation. So-called mixed "encapsulated" parotid tumors are best managed by surgical procedures which avoid contact with the "capsule." Enucleation is often a hazardous and incomplete procedure. Subtotal or total parotidectomy with exposure of the facial nerve to avert accidental damage to it is the treatment of choice. Microscopic study of the periphery of such tumors reveals that the "capsule" does not fully encapsulate; hence, enucleation and lesser procedures may leave neoplastic tissue behind.Surgical procedures to achieve complete excision without endangering the facial nerve were carried out in 123 cases. There was local recurrence in one case.


Serologic diagnosis of syphilis; the use of Treponema pallidum immobilization and immune adherence tests. TPI tests were carried out on 4,060 sera. Among 3,934 patients with reactive STS and no history of syphilis, 2,148 or 54.6 per cent had negative reaction to TPI tests, 1,695 or 43.1 per cent had positive reaction and 91 or 2.3 per cent had doubtful reaction. Two hundred and ninety-two or 73.0 per cent of 400 pregnant women with reaction to STS in the absence of a history of syphilis showed negative results by TPI test, 103 or 25.8 per cent had positive results and five or 1.2 per cent had doubtful reaction.Ninety-five or 75.4 per cent of 126 patients with a history of treated syphilis had positive reaction to TPI tests, 20 or 20.2 per cent had negative reaction and nine or 9.1 per cent had doubtful reaction.TPI and TPIA tests were done on 143 sera carefully selected for the study. Among 102 sera subjected to the TPI test, 46 or 100 per cent of these positive were also positive by TPIA tests, while 52 or 94.5 per cent of 55 TPI-negative sera were also nonreactive by TPIA test. One serum gave doubtful TPI test reaction and positive TPIA test reaction.


The San Francisco earthquake and fire; public health aspects.


Allergic bronchial asthma and rhinitis; the importance of studies for sensitivity to foods. The authors consider sensitivity to foods and sensitivity to inhalants about equal in importance in bronchial asthma, allergic rhinitis and allergic bronchitis. Food allergens are the sole cause of bronchial and nasal allergic disease in 20 to 40 per cent of cases throughout life, including old age; inhalants are the sole cause in approximately an equal number; and sensitivity to foods and to inhalants are often associated. THEIR FREQUENT RECOGNITION OF SENSITIVITY TO FOODS AS A CAUSE OF DISEASE, THE AUTHORS BELIEVE, DEPENDS ON: (1) The recognition of the fallibility of skin testing and the usual negative skin reactions to allergenic foods in chronic and recurrent bronchial asthma and allergic rhinitis. (2) The adequate use of trial diets, especially cereal-free elimination diet. (3) The realization that ingested foods remain in the body usually for two to four weeks and that the diet must be continued until symptoms have been relieved for two to three times as long as preceding relief between attacks.


Congenital hepatomegaly; report of a case.


Coexistent coccidioidomycosis of the meninges and pulmonary cavitation due to Coccidioides.


Paraffinoma of the penis.

Paraffinoma of the penis.


The management of postpartum hemorrhage.


Diagnosis of rheumatic fever and like conditions; evaluation of certain of the acute phase reactants in a single specimen of blood. CERTAIN OF THE ACUTE PHASE REACTANT TESTS WERE PERFORMED ON THE SAME SPECIMEN OF BLOOD FROM PERSONS WITH THE FOLLOWING STATES: Normal, acute respiratory disease, streptococcosis, acute rheumatic fever, acute glomerulonephritis, acute rheumatoid arthritis, inactive rheumatic fever, lupus erythematosus, malignant disease, obesity, asthma, and allergic rhinitis. Of the tests performed, the mucoprotein-tyrosine and the antistreptolysin-0 titer when done together appeared to be the most discriminating. It is suggested that the performance of such tests on the same sample of blood might aid in differentiating mild acute rheumatic fever and acute rheumatoid arthritis from each other and also from other disease states.


Systemic toxic reactions to local anesthetics. The topical use of anesthetic agents involves an element of risk. Systemic toxic reactions are rare, but they do occur and may result in death. When a reaction occurs from a topical application, it usually progresses rapidly to respiratory and cardiovascular collapse, and thus therapy must be instituted with more haste to avoid deaths. Fatal systemic toxic reactions from topically administered anesthetic drugs are, in effect, usually not due to well informed use of the drug but to misuse owing to less than complete understanding of absorption. Emphasis is placed on the causes, prophylaxis and treatment of severe systemic toxic reactions which follow the topical application of local anesthetic drugs. If systemic toxic reactions resulting from a safe dose of a local anesthetic agent are correctly treated, there will usually follow an uneventful recovery rather than a catastrophe.


Stress incontinence in women; treatment by retropubic urethrovesical suspension. Twenty-four retropubic urethrovesical suspension operations were performed in a five-year period. Twenty-one of the patients were satisfied with the results, although the objective success of the operation did not always correlate with subjective relief of symptoms. The commonest apparent cause for failure was the coincidence of urgency with stress incontinence, and the few true failures, due to secondary relaxation of the paraurethral supports, were often mitigated by compensatory learning on the part of the patients, many of whom remain blissfully unaware of the underlying weakness. The retropubic urethrovesical suspension operation is simple, effective, and free of complications. It is indicated as a primary procedure whenever a vaginal operation has failed to cure (or, worse, has caused) stress incontinence. It is advised as a complementary procedure for women with a secondary complaint of stress incontinence who must undergo laparotomy for other cause.


Poliomyelitis vaccine; epidemiologic observations on the safety and effectiveness in California in 1955. During the past year California has participated with other states in a nationwide field evaluation of the safety and effectiveness of poliomyelitis vaccine. Among 227,000 children who received Cutter vaccine, and the household contracts of these children, the incidence of poliomyelitis was higher during the early postvaccinal period than in comparable age groups of the population at large. Among 238,000 children who received poliomyelitis vaccine made by other manufacturers early in 1955 no increase in poliomyelitis was observed in the inoculated children or their household contacts. Subsequent observation on over 500,000 additional children vaccinated in California alone since September 1955 with vaccine that was made under revised safety standards has uncovered no evidence of unsafe vaccine. In children who received a single inoculation of vaccine prior to the onset of the poliomyelitis season in 1955 the incidence of paralytic poliomyelitis was about 60 per cent less than in unvaccinated children. Among those who received two inoculations an 85 per cent reduction was observed. The average reduction in paralytic poliomyelitis for the entire vaccinated group was approximately 75 per cent. Data thus far on children vaccinated since September 1955 with poliomyelitis vaccine made by methods now approved indicate that a similar overall effectiveness is still being maintained.


Use of tranquilizers in diseases of the skin; a preliminary report. Tranquilizing agents such as chlorpromazine and reserpine were used in various diseases of the skin in which the psychogenic factors were considered important etiologic agents. While a tranquilizing effect was obtained in the majority of instances, the side reactions and variation in response were so great as to render these agents unsatisfactory for routine use as tranquilizers. Meprobamate (marketed under the trade names Miltown and Equanil) was then used on a group of dermatologic patients with more consistent tranquilizing effect and comparatively little unpleasant side reactions. It is felt that further study of the use of meprobamate as a tranquilizing agent in dermatology is worth while.


Acute perforated appendicitis in childhood; analysis of management, including the use of hypothermia. From an analysis of a recent series of 99 cases of acute perforated appendicitis in childhood several conclusions appeared valid.1. The majority of infants and young children with acute perforated appendicitis do not exhibit the signs of localization of peritoneal irritation so characteristically seen in older children and adults. Hence if a history compatible with acute perforated appendicitis is present and there is evidence of peritoneal irritation on repeated examinations, patients of this age group may be assumed to have the disease and should be prepared and operated upon with minimal delay. Early operation after a maximum of several hours of preparation with parenteral hydration, nasogastric suction and antibiotics is the treatment of choice.2. In nine patients in the present series with temperature and rapid pulse that did not fall to safe levels with the usual preoperative preparation, mild hypothermia appeared to reduce the risk of anesthesia and operation.3. The use of intraperitoneal drains in children with acute perforated appendicitis is associated with a definite reduction in the incidence of postoperative intraperitoneal abscesses and with a probable reduction in the number of serious wound infections.


Pulsating lesions metastatic from renal cancer. The differential diagnosis of a pulsatile mass found on physical examination should include metastasis from a carcinoma of the kidney. If the mass occurs in the region of the sternum with no abnormality noted in the thyroid gland upon examination, the primary tumor is most frequently in the kidney even though there may be no symptoms referable to the urinary tract.


The use of blood at a large Red Cross center; an evaluation of various aspects of utilization. During the past ten years over 1,000,000 pints of blood have been collected at the Los Angeles Regional Red Cross Blood Center. In addition to the progressive increase in the number of whole blood transfusions there has been a greater use of specific blood elements which results in purposeful and economical hemotherapy. With the increased use of blood there has also been a growing awareness of transfusion reactions and dangers. Serious transfusion complications reported have been due to bacterial contamination, to hemolytic reactions, to homologous serum jaundice, and to a mistake in cross-matching. Surgeons and anesthetists must pay strict attention to the use of blood since anesthesia masks severe hemolytic transfusion reactions. At present there is no way of eliminating the danger of the transmission of virus disease (infectious hepatitis and homologous serum jaundice) in blood transfusions.


Reserpine and chlorpromazine, their use in alcoholic and geriatric patients. Although reserpine and chlorpromazine had tranquilizing effect on a number of geriatric and alcoholic patients in a state hospital, several complicating results were noted, some with a bearing on the patients' health and others that might affect the assignment of personnel. Lipoprotein studies carried out on patients receiving reserpine seemed to indicate that a reduction in the blood levels of the denser lipoprotein molecules took place during therapy. Several elderly patients receiving chlorpromazine died of diseases that were not as sharply manifest by symptoms as they might be expected to be. Hence the need for closer observation than a limited staff could afford seemed a matter for consideration. Another consideration of the same order was the possible need for increased personnel for psychotherapy in light of the more receptive condition of the patients.


Posterior surgical approach to the rectum. A posterior approach to the rectum that has been used by the authors and others recently in treating premalignant lesions at the 8 to 14 cm. level has a number of advantages. Previous objections to it have been largely overcome by present-day methods of attaining a sterile operative field and also improvements in techniques of preoperative preparation and postoperative care. There are several special situations in which this approach may theoretically be of value.


Primary squamous cell carcinoma of the false vocal cord. Primary squamous cell carcinoma of the false vocal cord may arise on the surface mucosa or may arise beneath it and continue to grow deeply, presenting only a smooth tumescence of the area. These lesions may not cause hoarseness until late in the course of development. Diagnosis of submucosal primary lesions may present difficulty. Widefield laryngectomy is recommended for small primary lesions of the surface mucosa of the false vocal cord. Such lesions do not show edema of the tissues or deep ulceration and do not cause limitation of motion of the false or true vocal cords. For advanced lesions of the false vocal cord which arise on the surface mucosa and cause edema, ulceration and limitation of motion without enlargement of cervical nodes, widefield laryngectomy and elective block dissection of the neck should be done at the primary operation. Patients with such a primary lesion and metastasis to cervical lymph nodes, which are resectable, should be treated in a like manner.Patients with submucosal primary squamous cell carcinoma of the false vocal cord should be treated with widefield laryngectomy and block dissection of the neck, whether or not palpable resectable lymph nodes are noted in the neck. Apparently these lesions metastasize early and widely.


Cobalt tumor of the thyroid gland.

Cobalt tumor of the thyroid gland.


Acute urinary retention in pregnancy; report of a case.


Fractured styloid process of the temporal bone; report of a case.


The continuing battle against staphylococcus aureus, Saskatchewan 1955.


Time and motion study.

Time and motion study.


Lethbridge Municipal Hospital.

Lethbridge Municipal Hospital.


Keeping the trustee informed.

Keeping the trustee informed.


A medical challenge to the social sciences.  II.


The metabolism of gamma-hydroxyglutamic-alpha-C14 acid in the intact rat.


The action of factor I on certain invertebrate organs.


Parotid secretion of iodide.

Parotid secretion of iodide.


The effects of convulsant agents on partially isolated regions of the central nervous system.


Lipotropic dose-response studies in rats; comparisons of choline, betaine, and methionine.


Maintenance of body temperature of restrained adrenalectomized rats exposed to cold; effect of adrenal cortical hormones.


The occurrence of acetylcholine in the housefly, Musca domestica L.


Some observations concerning the biochemical inertness of methylphosphonic and isopropyl methylphosphonic acids.


Cardiovascular effects of pentolinium bitartrate in dogs.


The extractable heparin in different animal tissue.


The effect of insulin administration on arteriovenous glucose differences in the alloxan-diabetic dog.


Studies of lignin biosynthesis using isotopic carbon.  V.  Comparative studies on different plant species.


Regional differences in the glucagon content of pancreas from alloxanized dogs.


Further studies on the metabolism of urocanic-alpha-C14 acid.


Hemodynamic changes following aortic constriction in normal and in hypophysectomized rats.


Heparinase.  III.  Preparation and properties of the enzyme.


Glucosuria in rats receiving British anti-lewisite (BAL).


The role of the occupational therapist in the rehabilitation of speech.


Occupational therapy; work tests and assessment.


Rehabilitation of the aged.

Rehabilitation of the aged.


Prepaid dental care for Social Service recipients.


Progress of public health in Canada.

Progress of public health in Canada.


Robin Aids.

Robin Aids.


Recent trends in pertussis mortality and morbidity in Ontario.


Industrial rehabilitation.

Industrial rehabilitation.


The education of food handlers.

The education of food handlers.


An experiment in continuing in-service education for health officers.


Oral treatment of diabetes.

Oral treatment of diabetes.