Page:The Journal of Tropical Medicine, volume 6.djvu/216

184 THE JOURNAL OF TROPICAL MEDICINE. [June 1, 1903.

then repeated in 20 to 30-grain doses every four to six days, until five or six weeks have passed without a paroxysm. Attention to liver and bowels was em- phasised, with the ingestion of large doses of very hot water.

Pes Gigas.

CoNGENITALE PARTIELLE HyPERTROPHIE DES FussEs [Congenital Partial Hypertrophy of the Foot]. (La Revue Médicale de l'Afrique du Nord).—Legrand ob- served this condition in a European. The right foot only was affected. The X-rays demonstrated the fact that the three inner metatarsi were hypertrophied. The second and third phalanges were united and exhi- bited a bony substance. The termination of the toes was club-like in form. Radiography also demonstrated that the three inner metacarpal bones and the first phalanges of the right hand were also hypertrophied. The hypertrophy only affected the breadth, not the length of the bones. Raynaud reports hypertrophy of the left foot in a Cabyl, the big toe being the size of an orange, the second toe was enlarged, but to a less degree, the third toe was slightly hypertrophied, and the two others were normal.

In the Journat or Tropica Mepicine, January, 1900, a plate of what is evidently a similar affection to those described above is given under the name of

Pes Gigas.

Plague.

Tur SprEAD AND Proprynaxis oF Piacun. Med. Record, May 16th, 1903.—In the discussion on plague during the American Medical Association Meeting, May 5th to 9th, 1903, Dr. W. J. Calvert stated that so long as such plague centres as Canton and Hong Kong existed, the disease was likely to appear in the Pacific coast of North America.

Dr. J. J. Kinyoun said that the sine qua non in pro- phylaxis was the accurate diagnosis of the first case, and that the clinical forms were so varied that errors in diagnosis of first cases were the tule. Plague might resemble anthrax, tonsilitis, mumps, diphtheria, ery- sipelas, pneumonia, acute pleurisy, malignant peri- carditis, endocarditis, typhoid, typhus, relapsing and malarial fevers, acute dysentery, miliary tubercle, septicemia, pyemia, and syphilis. These forms ot plague and its insidiousness and the inexperience of the profession rendered plague one of the most difficult to recognise. For diagnosis a bacteriological examina- tion was essential.

Dr. F. G. Novy emphasised the fact that plague was essentially a disease of animals and primarily was not a human disease. The disease was transmitted by the bites of animals, such as the rats or rodents of China. How the disease was communicated to the human being, what was the portal of entry, was a very difficult question to answer and possibly never would be answered satisfactorily. The virulency of the germ decreased. the longer it was kept in artificial culture. The organism he did not consider to be very resistent and could be

easily destroyed. Besides isolation of the sick, disinfec- tion, segregation, &c., he said we have a powerful method of controlling the disease, 7.e., by serum inoculation.

Yellow Fever.

Tue Mopre or TRANSMISSION or YELLOW Fever. Med. Record, May 16th, 1903.—In a discussion on this subject before the American Medical Association, May 5th to 9th, 1903, Dr. James Carroll claimed that yellow fever could be produced by the mosquito only.

Dr. Stamford E. Chaillé stated that he had never secured satisfactory evidence of the proof of a single case of yellow fever either by direct contagion or of infection by fomites.

Dr. C. W. Stiles, of Washington, said there were certain biological facts in the consideration of yellow fever. The cause of the disease belonged to one of three different groups: (1) Bacterium, (2) flagellata, and (3) sporozoa. The entire history of the disease, with its short incuba- tion period, &c., shows that the organism was probably reproduced by non-sexual methods. The bacterium seemed to be excluded by the history of incubation in the mosquito. Regarding the flagellata, nothing was known regarding its sexual development. He thought the parasite which was the cause of the disease possibly

was a sporozoite. ES

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