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Atelectasis, congenital heart disease, intracranial hemorrhage and several other diseases are now recognized as producing cyanotic attacks in newly born infants, but little attention has been given to hypoplasia of the mandible as an etiologic entity in producing such attacks. During the past two years, four patients have been admitted to our wards on account of this condition. REPORT OF CASES Case 1.—E. K., a white female infant, aged 6 weeks, was admitted to the hospital on account of failure to gain weight and frequent attacks of cyanosis. The family history was unimportant. The child was born at full term, with a normal delivery, weighing 8¼ pounds (3.7 Kg.). She was never breast fed but was given a formula on which she did not gain, though the formula was adequate. Soon after birth it was noticed that the infant had frequent and severe attacks of cyanosis, which could be relieved

In any disease in which the mortality rate is unusually high, numerous and not altogether successful methods of treatment are likely to be advocated. This has been true of erysipelas in infants. Morse1 reported 90 per cent mortality in infants; Erdman2 reported 39.7 per cent; while Schaffer and Rothman3 gave the following results: infants under 1 month of age, 80 per cent; under 6 months, 53 per cent; from 6 to 12 months, 47 per cent, and from 1 to 2 years, 14 per cent. As regards the influence of different forms of therapy, Knox4 reported a mortality rate of 60 per cent in infants under 6 months of age treated by local measures; Robertson5 quoted 65 per cent in infants under 12 months of age treated by exsanguination-transfusion; Borovsky,6 29 per cent by the use of a 2 per cent solution of mercurochrome-220

It is evident from the numerous inquiries that are received at the Willard Parker Hospital that the true value of scarlet fever antitoxin is not generally known; with this in view, the following observations are presented.The series presented consists of 465 consecutive and unselected cases, in which 250 of the patients did not receive antitoxin. I feel, therefore, that the real value of the antitoxin can be obtained.All patients with scarlet fever who were admitted to the hospital did not receive antitoxin, for it was apparent that in the moderately severe and in the mild cases the patients did not show sufficient toxemia to warrant the treatment. Furthermore, the serum rash that may appear often causes more subjective symptoms than the disease per se. Therefore, it was decided that the temperature and the clinical observations should govern the administration of the antitoxin. As a rule, patients who had

Vines,1 in 1920, while treating a patient with hemophilia observed that following the development of a local skin reaction to horse serum, not only did the bleeding cease, but there was also a reduction in the coagulation time of the capillary blood.In 1926, Mills2 repeated the observations of Vines. He found that patients with hemophilia, when treated by protein sensitization, with a local cutaneous reaction, generated a normally reacting prothrombin. In two patients so treated the clotting time was reduced from twenty to four and one-half minutes in one, and from ten to two and one-half minutes in the other.Since 1928 we have treated eight children suffering from hemophilia according to the method of Vines and Mills. We soon discovered that the treatment did not completely remove the bleeding tendency, but we did find sufficient improvement in the patients, as evidenced by clinical and laboratory observations,

Recently a child in the wards developed varicella. It was desirable to safeguard all exposed children in order to shorten the period of quarantine and to protect the several very ill children from the additional strain incident to chickenpox.Greenthal's1 report states that of thirty-six exposed persons who were vaccinated from the vesicle fluid of a patient suffering from varicella, nineteen gave positive reactions and sixteen negative reactions. In his series of cases, varicella did not develop in those persons who were vaccinated, successfully or unsuccessfully. With his observations in mind, it seemed probable that there might be equal success in preventing the spread of varicella in the wards. After a negative Wassermann reaction was obtained on the original patient, twenty-three exposed persons were vaccinated in the following manner: A vesicle was first cleansed with a solution of boric acid and then with a saline solution, and the content

American Academy of Pediatrics Postgraduate Course to Be Held in Boston, Dec 9-11.—The American Academy of Pediatrics is sponsoring a postgraduate course on "Advances in Diagnosis and Treatment" at the Children's Hospital Medical Center, Boston, on Dec 9-11, 1963. The course has been arranged by Dr. R. Cannon Eley, Associate Professor of the Department of Pediatrics, Harvard Medical School, and will deal with newer aspects of congenital cardiac diseases, tumor therapy, seizures, streptococcal infections, anesthesia, and pancreatic fibrosis. Registrants are invited to attend the meeting of the New England Pediatric Society which will be held the afternoon of Dec 11.For a complete program and registration information, write to the American Academy of Pediatrics, PO Box 1034, Evanston, Ill.Hold Postgraduate Course in Diseases Due to Immune Mechanisms Oct 14-18.—The Allergy Sections of the Veterans and the Montefiore Hospitals, Pittsburgh, will offer a comprehensive course on "Diseases