Document jm5M6KXMzDXedXvkoO36XVbDk

\ c\ 4 4 2 V 3 r po.-terior lobe. the reaction negative, furthermore, the injection of 0.2 c.c. of the hormone of the anterior lobe of the pituitary body, tvhen injected into the skin of a pregnant woman, produces no reaction, whereas, when injected in the same way in the non.-pregr.cr.: woman a distinct red circle is produced in a few hours, which persists from twenty-four to thirty-six hours. The accumulated evidence, therefore, goes to show that the hormone responsible for the Zondek-Ascheim reaction is derived from the anterior lobe of the pituitary body; that the reaction is positive quite early in pregnancy, at a time when vuch positive evidence is most needed; and that the re liability of the test is very high. It is regrettable that from its nature the test cannot be made generally available. Jt requires the assistance of a laboratory where a Large stock of young female mice is cocstantlv at hand, and where mere are trained observers. The test, as a consequence, is expensive. It may prove, however, that the skin test referred to may overcome the difficulty. Recently, Drs. Otto Pollatschek and R. Porges; of Vienna, have made some valuable observations on this phase of the subject, and report that in their hands the skin test has proved to be reliable, except in one patient who had a hypophyseal tumour. Should these observations be confirmed we shall have at last a simple and reliable method of determining the existence of early pregnancy. ASBESTOSIS ASBESTOS is a mineral of interest to in England, but four cases in. Southern Canadian physicians, particularly to Rhodesia were reported by R. VC. Simson in physicians practising, in the Province o1f928. The latest publication on the subject Quebec, for a very considerable part of the is by W. E. Cooke, in the British Mediae! world's supply of asbestos is rained in the Journal tor September 28th, 1929. This Black Lake District between Quebec City article is in the nature of a review. and Sherbrooke. If work with asbestos Asbestos occurs in nature as a fibrous form presented a hazard to the worker it would be of serpentine. Its analysis varies somewhat reasonable to suppose that cases of in different parts of the world, but it is would be reported from time to time, but essentially a magnesium silicate. There may so far as can be determined no 'eases of or may not be iron present, and some forms specific disease have been reported among contain aluminum. The Canadian asbestos asbestos workers in the Province of Quebec. is said to contain about 41 per cent of silica This does not mean, however, that a hazard and 2.8 per cent of iron oxide. does not exist; it merely means that no Clinically, asbestos affects two tissues. hazard has been recognized. Tint, it may produce small warty growth; Mortality and morbidity records of in the skin,--the so-called "asbestos corns." asbestos workers are not available. In Secondly, it may give rise to a fibrosu of fact, information as to the effect of such the lungs, somewhat similar to that produced work on the worker is extremely limited. by silica. Investigation of the "asbestos The death of an asbestos worker which corns " indicates that they are granulomatous occurred in 1900 was reported by Dr. Murray in nature and have for their eore a tiny m England to the Department on Industrial spicule of asbestos fibre. Evidently asbestos Diseases, and the evidence suggested that is mildly irritating to the body tissues. The the death was due to an occupational disease. manner of the formation of the pulmonary This ease was not reported in the medical lesion is of great interest to students of literature. No further reports appeared until pneumoconiosis, for there is a widespread 1924, when Dr. W. . Cooke, of the TTigan .impression that silica is necessary to the Infirmary, published the history of a ease of formation of pulmonary fibrosis. Nor can pulmonary asbestosis. Since'then a number it be said at -present that this view is of isolated cases have been reported, mostly definitely disproved by the occurrence of in the manufacture of asbestos, and mostly pulmonary asbestosis, since asbestos in itself (Iolk.\L`M 2Z AAO- t  a silicate. To our knowledge no analyses of pulmonary tissue for silica have been made in eases of nsbestosis. It might be thought that the lesion in this condition was essentially the same as that of ordinary silicosis, i; it were not for the fact that certain very characteristic bodies are reported unlike those seen in ar.v other pathological picture. 'We refer to the socalled "curious bodies." Microscopic sections of lungs of asbestos workers show large elongated bodies varying in length from 10 to 100 microns. They may have single clubbed ends or may appear as elon gated dumb-bells, and sometimes single eoceal or streptococcal forms are seen. These bodies do not stain with the ordinary aniline dyes, but are themselves pale yellow or yellowish brown. The "curious bodies'* may he isolated from lung tissue by digesting portions of the lung with trypsin.' They may then be teased out, and in this wav some idea of their structure may be obtained. Apparently they are composed of a central core, which is probably an asbestos spicule, upon which cohiidal aggre gates of blood proteins have been ansorbti. These "curious bodies'' have been reported in different places in England and South Africa; in fact every published report cl pulmonary asbestosis has described them. `It is the opinion of Dr. Cooke that the 4 curious bodies "are diagnostic of pulmonary asbestosis. Since the reported cases of this disease have occurred largely among weavers and spinners it is possible that the mining and crushing of asbestos does not present a hazard. The failure to recognize the disease m however, is no evidence of this, for is other occupations experience has shown that large groups of men may suffer serious occupational effects, which go un recognized for years. mass c. ?mlxt. EMiorlal Comments Lx Mil. BES extents The problem of the ereche or foundling hos pital is how to lessen the relatively high rate of mortality that so often exists among the chil dren eared for is these institutions. The death rate, formerly nothing less than appalling, has been of late much improved through a fuller appreciation of the value of pasteurization of milk and of the derisive par. played by vitamins, but it is still too high. The outstanding fea tures of the affection that carries off ao many infants, as is well known, are athrepsia and diarrhoa. This affection can hardly be termed a disease, as it is not a (ingle entity and the causes are multiple. Tet many names have been applied to it----1 mal des creches, summer diarrhaa, infantile eholera, milk - injury (Czerny), disturbance of equilibrium (Finkelstein), and some others. Actually, what is called by these, various names is a symptomatic condi tion with a varied etiology. Drs. Loagprf and Panneton, in a helpful article that appears in the present issue of the Journal, have done good service in emphasizing one important eatue at least, namely, infection to the nose, throat, and car. ah infection, more over, which may be diphtherial and. as such, unsuspected. These authors jloint out that the problem involved, in many eases at least, is one of infection rather then alimentation. Careful examination, of tbe nose, throat, and ears, both clinical and bacteriological, should be carried out in all infants that are not thriving, for lesions of these organs mar be overlooked or, on account of their relative benignity, may bt passed over as of little account. Dn Loagpre and Panneton give tome strik ing figures as a result of their investigations in a ereche with which they arc connected, though they do not elaim that their findings are neces sarily applicable to other similar institutions. In sixty autopsies conducted on children dying with the "mal des crtches" only, two infants were found to have intestinal lesions. The out standing conditions found were otitis and mas toiditis. wbieh were present in fifty cases. 'With out eliminating completely frank gastro-enteritis. their experience leads them to think that the mgns manifested in the digestive tract In cases of athrepsia ara nek primary but aeeondary to eseptiewmia, usually due to infection in the ear. Furthermore, the authors have examined, in 151 earn, the eecmiona from the aaae and throat in patients manifesting ao local symptoms, and the pus in eases of otitis, and were surprised to obtain k. diphtheria m 85, or 562 per cent. Of course, the discovery of k. diphtheria in noses and throats that do not manifest the typical signs of diphtheria, or, indeed, any signs at all, is not new, but Drs. Loagprt and Panneton hare performed useful service in pointing out au important eause of trouble in hospitals lor children, where the diets prescribed are proper, and the care is otherwise bevond reproach. A-CJf.