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Rockefeller Foundation seeks to be true to its chartered purpose, which is to promote, not the exclusive prosperity of any one nation, but the well-being of mankind throughout the world.'”

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The relief of a disabling malady prevalent throughout areas inhabited by 900,000,000 people of the world is sufficiently important in itself. But the control of hookworm infection has another and even more significant value. It is an effective means of educating people in the meaning of public health work, and of persuading them to support more comprehensive measures for preventing other diseases as well. For the facts about hookworm disease are fairly simple and easy to understand. Experience with antihookworm campaigns in many countries has proved that the disease can readily be used as a means of educating the public in the possibilities of preventive medicine.

In the year 1922 the International Health Board had a part in hookworm-control activities in 22 governmental areas in the United States, the West Indies, Central America, South America, and the Far East. Since 1911 the board has cooperated in 69 States and countries. In 54 control measures were carried out; in 15 others only surveys were made. The policy of the board in this work has been: (1) To undertake control measures only on the invitation of a government which (2) bore from the first at least a small part of the expense and agreed (3) to take on each year an increasing proportion of the cost until it finally (4) assumed entire responsibility for the continuance of the project. In order to measure the progress of control the board in the last three years made reexaminations of school children in 66 counties in the Southern States and compared results with those of the original surveys, which were made between 1910 and 1914. On the average a reduction of 47.5 per cent was shown. In one county a decrease of 94 per cent had taken place; in several, over 80 per cent; in only one was an increase disclosed.

Simple and well understood as hookworm control may seem to be, the fact is that new knowledge is constantly leading to the adoption of new methods. The board's staff in the field constitutes in a true sense a body of research workers who are always on the alert for information and improved methods. From time to time experts are sent out to make special studies which throw new light on the problems of sanitation, treatment, and education. Important field studies in Trinidad and Porto Rico show that hookworm larvæ can not travel far through the soil and do not live more than six weeks. This localizing of infection and self-sterilizing of the soil have a fundamental bearing on the problem of sanitation.

Outbreaks of illness following the consumption of cheese are of great rarity, says a writer in the Nation's Health for May 15, 1923. An epidemic attributable to this cause was recorded in London in 1901, but the majority of outbreaks recorded have been in America. The main features of cheese poisoning resemble those of poisoning from other infected foods, but one or two minor points of difference are brought out by Dr. H. M. Cameron Macaulay in the Lancet in his study of an outbreak of cheese poisoning at Dover in July,

1922.

Doctor Macaulay does not find evidence of a single fatal case in any outbreak where the circumstances incriminating the cheese have been at all conclusive, whereas in other food-poisoning epidemics the case mortality is in the neighborhood of 1.5 per cent. Another point of difference is that the period of incubation appears to be shorter in cheese poisoning, and the usual food-poisoning organisms are hardly ever found in epidemics due to cheese.

The nature of cheese as a food affords an explanation for these differences. Cheese occupies the unique position of being practically the only article of food prepared many weeks or months before it is intended for consumption and not subjected to any process of preservation during that period. Moreover, bacterial action, so far from being inhibited, is encouraged along definite channels in order to bring about ripening.

This very fact makes it unlikely that in the event of a pathogenic organism being introduced in process of manufacture would remain. alive at the time of consumption, the growth of the saprophytic bacteria and molds associated with the ripening process being unfavorable to the growth of the usual pathogenic organisms.

It is usual, therefore, in the rare instances when food poisoning has been attributed to cheese to find the Gaertner organisms present, a group almost invariably associated with an extremely stable toxin, capable of withstanding a temperature of 100° C. for five minutes. Care was taken to exclude the food handlers as carriers. Cheese poisoning, therefore, Doctor Macaulay considers to be a pure intoxication and infection with Gaertner organisms.

Dental officers will be interested in the following note contributed by the Navy Dental School:

The use of the Howe silver-reduction method for the sterilization of root canals is occasionally followed by severe pain of many hours' duration which dressings placed in the canals seem unable to alleviate. This pain is no doubt caused by the presence of the solutions in the apical area. Indeed, such severe pain often results that extraction is resorted to for relief. Prevention is better than a cure.

The silver solution should never be pumped in the canals with a broach, preferably carried a little distance into the canals with glass pipettes or gelatin tips and permitted to find its way to all diseased tissue by diffusion, allowing as long as 30 minutes to insure thorough penetration before adding the formalin. All excess formalin should be removed with cotton points and a dry point inserted as a dressing. Laboratory experiments indicate that the silver solution will penetrate wherever tissue disintegration has occurred to but not through the apex unless force is used. When severe pain follows the use of this treatment it is recommended that an injection of novocain for anaesthesia be used, preferably conduction. This injection will, of course, immediately relieve the pain, and usually permanently; however, if it returns after the effect of the novocain wears off it is with much less severity. The use of this simple means will obviate the necessity of extraction for relief.

BOOK NOTICES.

Publishers submitting books for review are requested to address them as follows:

The Editor,

United States Naval Medical Bulletin,

Bureau of Medicine and Surgery, Navy Department,

Washington, D. C.

(For review.)

Books received for review will be returned in the absence of directions to the contrary.

PRACTICAL BACTERIOLOGY, BLOOD WORK AND ANIMAL PARASITOLOGY, INCLUDING BACTERIOLOGICAL KEYS, ZOOLOGICAL TABLES, AND EXPLANATORY CLINICAL NOTES, by E. R. Stitt, A. B., Ph. G., M. D., Sc. D., LL. D., Rear Admiral, Medical Corps and Surgeon General, United States Navy. Seventh edition. P. Blakiston's Son & Co., Philadelphia, 1923.

This work needs no introduction to the naval medical officer or to the medical profession at large. The fact that seven editions have passed through the press in a few years testifies to its usefulness and popularity. The book has been noted for the large amount of practical information it presents in concise form. The new edition is similar in plan to those preceding it. In the revision the author has eliminated all material that has become obsolete or of questionable practical value and has added much to bring the book strictly up to date; as he states in the preface," the advances in internal medicine during the two years that have elapsed since the appearance of the previous edition have made it necessary to increase the volume of the book by 132 pages." Many of the illustrations used in former editions have been replaced in this edition by others that are more instructive. A large number of new tables have been added, among which those dealing with the classification of mosquitoes and those giving the vitamine content and the constitution of various foodstuffs are noteworthy.

The importance of dietetic faults in the production of disease and in lowering the resistance of the body to bacterial invasion has become clearly recognized and it is pleasing to note that the author has inserted a summary of the subject of nutrition for the convenience of those who may not have ready access to recent literature dealing with this question.

In connection with the flocculation tests for syphilis, it is noted that the Sachs-Georgi, Meinicke's third modification, and the Kahn methods have been substituted for the less dependable modifications of the Wassermann test formerly described.

The Jansky classification of blood groups has been adopted in view of the recommendation of the special committee representing the American Association of Immunologists, the Society of American Bacteriologists, and the Association of Pathologists and Bacteriologists, but the author has retained the Moss classification used in former editions for the benefit of those preferring it.

The section on the Noguchi modification of the Wassermann reaction was prepared by Doctor Noguchi; Doctor McCoy, of the Public Health Service, has reviewed the "Bacteriology of water" and written the section on "Toxin and antitoxin unit "; Dr Edward Francis of the same service has prepared the paragraphs on Bacterium tularense, indicating the care the author has taken to have the work authoratative.

NON-SURGICAL DRAINAGE OF THE GALL TRACT. A TREATISE CONCERNED WITH THE DIAGNOSIS AND TREATMENT OF CERTAIN DISEASES OF THE BILIARY AND ALLIED SYSTEMS, IN THEIR RELATION TO GASTRO-ENTEROLOGY AND GENERAL CLINICAL MEDICINE, by B. B. Vincent Lyon, A. B., M. D., chief of clinic, gastrointestinal department of the Jefferson Hospital; associate in medicine in the Jefferson Medical College, attending physician to the Methodist Episcopal Hospital, Philadelphia, Lea Febiger, Philadelphia, Pa., 1923.

Much of the advance in medical knowledge has been due to the discovery of technical methods of examination and treatment. In April, 1917, a paper was published by Dr. S. J. Meltzer, of the Rockefeller Institute, which carried at the end this footnote:

"In experiments with magnesium sulphate I observed that the local application of a 25 per cent solution of that salt on the mucosa (of the duodenum) causes a completely local relaxation of the intestinal wall. It does not exert such an effect when the salt is administered by mouth-that is, when it has to pass through the stomach before it reaches the intestines. The duodenal tube, however, apparently has reached an efficient practical stage. I make, therefore, the suggestion to test in jaundice and biliary colic the local application of a 25 per cent solution of magnesium sulphate by means of the duodenal tube. It may relax the sphinctor of the common duct and permit the ejection of bile, and perhaps even permit the removal of a calculus of moderate size wedged in the duct in front of the papilla of Vater.”

This observation was the basis of the practical method of drainage of the biliary tract by way of the duodenum evolved and described in various medical journals by the author of this book.

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