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This book consists of the papers and discussions presented at a symposium held in Dundee during September 1964. The five sessions were devoted to (1) the requirements for normal nidation, (2) the influence of drugs on embryogenesis, (3) trophoblast as homograft, (4) the cytogenetics of fetal maldevelopment, and (5) clinical and pathological aspects of abnormal trophoblast—quite an assortment of topics. The theoretical and practical problems dealt with concern the life, survival, and well-being of early conceptuses, though as one discussant admitted, it may sometimes seem that studies of fertility and reproduction are chiefly aimed at reducing the first and interfering with the second. But the recent spate of human plural births attests that contrary efforts are also being made. Seen from whatever angle you please, the early embryo is coming in for an ever bigger share of the attention of many individuals and institutions whose diverse interests otherwise seldom

Recent work on the basal metabolism of infants and adults has revived interest in Rubner's law that heat production in different individuals and species of animals is proportional to the surface area. This law was first definitely formulated by Rubner 1 in 1883, although suggested by Bergman 2 many years before. At the time the experimental work in support of this theory was done no record was kept of body movements and men and animals were allowed to move during the periods of investigation. The average heat production per square meter of body surface was about 1,000 calories per day. In modern work, where the influence of muscular activity is absolutely excluded, the figure is in the neighborhood of 830 calories per square meter per day, as has been shown in Paper 4 of this series. With these new figures it is not unnatural that many

To the Editor:— At the hospital staff meeting we were informed that, owing to pressure from government boards controlling the use of raw materials, certain form sheets used in our case histories will no longer be furnished. For example, "progress" and "follow-up" notes will, for the duration, go on the same sheet. This may not be a vital change, but the hospital is making a definite sacrifice. The histories will be less easily digested and abstracted when somebody wishes to tabulate a number of them. Yet if this trifling change can be of the slightest use in the war effort, it has our wholehearted approval. Here is the rub. After that meeting, I visited my mail box in the hospital and abstracted sixteen pieces of mail that made a mass of paper weighing 1 pound 9 ounces. Many folders consisted of numerous pages, some printed in brilliant colors. Many, many

The relatively inexpensive mark-sense paper-and-pencil technique for administering a computer-generated and computer-processed health questionnaire is easy for patients to understand, simple to revise, and permits large-scale testing at low cost. The total questionnaire is designed to be administered in two or more portions or levels. Because each level after the first is a more detailed inquiry into positive responses made to questions of preceding levels, this multilevel approach permits the inquiry to be individualized to the patient. The questionnaires are generated from a question library, and the completed forms are read by an optical scanner. A summary of the patient's responses is printed for the physician's use.

A computer-generated and computer-processed health questionnaire has been evaluated for patient acceptance and reliability of content. Various formats have been tested and it was concluded that a mark-sense paper-and-pencil questionnaire offered significant advantages over a cardsort questionnaire. Studies of administration techniques showed that administration by a specially trained clerk is advantageous.

This volume consists of 30 papers which were presented in December, 1960, at a symposium sponsored jointly by the American Association for the Advancement of Science, the American Physiological Society, and the Society of General Physiologists. Primary emphasis is given to current concepts of the electrical and ionic events associated with nerve and muscle excitability. Active transport and membrane selectivity in elementary systems such as red blood cells are discussed first; the more complex problems presented by nerves, voluntary striated muscle, cardiac muscle, and smooth muscle are then dealt with successively. Junctional transmission and the contractile mechanism in muscle receive special attention and the probable energy supply for the various activity processes is discussed. The mechanism of action of certain pharmacologic agents is considered in terms of their effect on membranes. Numerous models, conceived in the light of recent experimental data, are presented. Throughout, the illustrations are of good quality.

The McKenzie and Stoughton (1962) method for evaluating the vasoconstrictive properties of corticosteroids has been modified as follows: test compounds are incorporated into coded, glassine backed 1-cm squares of thin absorbent paper which are applied to forearm surfaces at 5-mm intervals according to a predetermined plan. Results are (1) improved experimental design, (2) avoidance of error inherent in applying alcoholic solutions directly to convex skin surfaces, (3) increased numbers of test sites per subject, (4) increased ease and accuracy of recording reactions and (5) decreased test subject discomfort during the test. Four new difluoroprednisolone diesters were found by this method to be significantly more active than the reference standard betamethasone 17-valerate.

METHODS FOR DETECTING HEATED MILK Numerous methods have been proposed to test quickly and simply whether or not a given sample of milk has been heated. The methods suggested fall into three main groups: Those based on the changes which the protein undergoes when milk is heated. These have not proved applicable in practice. Those which depend on the presence of oxidizing enzymes in milk. Of these, Storch's test is generally regarded as most satisfactory. This, however, as is well known, can be used only on milk heated from 78 to 80 C. (172.4 to 176 F.). It cannot, therefore, be applied to milk heated to the temperatures employed for pasteurization in this country. A microscopic test devised by myself and described in a paper by Frost and Ravenel in 1911 (A Microscopic Test for Heated Milk, Proc. Am. Assn. Med. Milk Commissions, May, 1911, p. 127). Two features of

The title of this paper may seem rather an ambitious one, since the study of vital and social statistics, and their application to the comparative study of races and nations, is almost too new to furnish many principles that may serve as bases of induction. However, I purpose to state in a fragmentary way a few notes and observations bearing on the subject. More than usual experience as a traveller has brought me in contact with various races of men under different mesological conditions. Experience and observation in this line show that, in spite of physical and moral varieties, there exists practically, for the physician, but one people, since there are no wide differences, biologically or medically speaking, in the human species; and the infirmities of men, notwithstanding their physical inequalities and the extensive range of the nosological table, are much the same the world over, no matter whether they

Ridgway, Pa., Sept. 20, 1902. To the Editor: —This last summer I drafted and presented to the official board of the First M. E. Church of this place, being a member of the board, a set of resolutions, drawing attention to the falseness of statements and dishonesty of purpose of various advertisers of "patent" medicines, and condemning the publication of such advertisements by the publishers of our church periodicals. The resolutions were passed, but two members of the official board voting against them. I took the ground that it was detrimental to the interests of the church that the papers should receive a profit from so false a business. Copies of the resolutions were sent to the various church publications circulating in this district. If necessary this move can be followed up to the annual and general conferences.

Mr. President and Gentlemen of the Association of Medical Colleges:—The paper of Dr. Vaughan, which has interested us so much, suggests great changes in medical education. During the past year my attention has been called to some of the details of laboratory work which must be faced by every one of you. Allow me to very briefly speak of some of the results of my thoughts and studies.Laboratory rooms must be light and roomy. Forty square feet of floor is the least amount which will accommodate a single student, and then only in the chemical laboratory. In all other laboratories at least sixty square feet of floor space, not including aisles, must be allowed each student. In the chemical laboratory students' desks may be placed twenty feet from the windows; in laboratories in which microscopes are to be used, fourteen feet is a maximum.The ordinary medical class in

The immense amount of scholarship as well as the complex voluminous paraphernalia required to make a comprehensive collection of all the papers given and gotten by someone as prolific and active as Thomas Jefferson is appreciated best by those who have followed the production of the Jefferson Volumes. The first one appeared nearly 20 years ago. The cost, even to those who subscribed to the whole series, has gone up. The speed of producing them has gone down far below the glad hopes at the beginning. The quality and excellence of the books as well as the profoundly important story are illustrated vividly time and again. The most recent volume, number 17 in the series, brings matters up almost to the end of 1790. In the four or more years which elapsed between the publication of volumes 16 and 17, Congress passed enabling legislation to support a far reaching and

Arsenic as a cause of exfoliative dermatitis was recognized soon after the advent of arsenical preparations in the treatment for syphilis. It is the opinion of Throne, Van Dyck, Marples and Myers 1 that arsenic is either a contributing or an exciting cause in at least 30 per cent of all cases diagnosed as eczema. The sources of arsenic in exfoliative dermatitis due to arsenic poisoning are: medication, food contamination, absorption through the skin of susceptible persons and contact with the drug either in surroundings or through occupation. The industrial preparations containing arsenic are: arsenic trioxide (as 206), often called arsenous acid or white arsenic, which forms the basis of most of the industrial preparations; liquid or solid weed killers, wood preservers, sprays containing arsenic and arsenical sheep dips in solid or liquid preparations; fly paper, flykilling solution (arsenic trioxide), arsenical powders, pastes and various liquids for destroying insects and

To the Editor : The tendency to incriminate certain drugs for adverse reactions without exploring all other possibilities is to be deplored. In this respect we read with great interest Jarkowski's and Martmer's account (Amer J Dis Child104:669, 1962) of a fatal case of toxic epidermal necrolysis occurring in a 12-year-old girl and would like to make the following comments. The disease, startling in its symptomatology, appearing much like a severe scalding over a large area, may be a new entity or a more severe form of erythema multiforme or Stevens Johnson syndrome. The child had received a sulfonamide for an upper respiratory infection, and the reaction was attributed to the drug. It was not stated whether she had ever received sulfonamides previously. The paper makes no mention of questioning the patient's family about other drugs which she might have taken. Acetylsalicylic acid (aspirin) was given as an antipyretic. While most

This book is the 42nd in a series of public health papers published by the World Health Organization. In summary fashion it deals with the collection of perinatal epidemiological and statistical data, specific perinatal medical problems, the organization of care, and the required directions of perinatal training and research. Reading this book reacquaints one with the painful process of making decisions and recommendations by committee and the rapidity with which our technical world moves, dating some of the statements in this relatively recent publication. Most of the recommendations made in this book will find wide agreement among working perinatologists. There is even a recommendation that in the basic training of every physician "the time allocated to neonatology should be between a quarter and a third of that devoted to pediatrics." There are some portions of the book that are not particularly helpful. The discussion of the clinical terminology surrounding hyaline

In the course of other work on metabolism in typhoid fever it became advisable to analyze the feces of the patients. While these analyses constitute only a part of the problem in hand, the paucity of studies on the absorption of food in the febrile state appears to warrant publication of the results as a separate communication. For a complete discussion of the absorption of food in typhoid fever the reader is referred to the paper of Du Bois. 1 Seven cases in all have been studied. The diets administered were modifications of the high calory diet employed in this clinic, that is, the proportions of fat and carbohydrate were varied to satisfy the requirements of the problem under investigation. METHODS OF CHEMICAL ANALYSIS Urine and feces were collected in the manner described by Gephart and Du Bois. 2 The analysis consisted in the determination of fat and

Jackson, Parkinson, Holmes, Sherrington, Horsley, and Walshe are names chosen more or less at random to illustrate the high quality of the English school of neurology. The task of selecting papers to celebrate the eightieth birthday of Sir Gordon Holmes presented to Sir Francis Walshe an extremely difficult task, for in neurology his name is written large. Clinical neurology has always held a fascination for those with keen analytical minds. Good observers, with the infinite patience to do careful and repeated neurological examinations and follow the natural history of disorders of the nervous system to their final outcome, have deciphered the relationship between lesions and abnormal signs and symptoms. One of the few useful medical by-products of recent wars has been the multitude of patients with a great variety of penetrating wounds of the head. Information from such sources, pieced out from careful studies, has clarified a great many puzzles

Schizophrenia is a ubiquitous condition. When you consider that 50% of all hospital beds, not merely psychiatric beds, are filled with patients with this diagnosis, you become aware of the horrendous problems faced by the medical community. In spite of the immensity of this problem, few books are published in this area. Dr. Searles has published a series of illuminating papers on various facets of this illness. Pathological aspects of early mother-infant relationships, the subjective experience of the patient's suffering, modes of communication and impairment of thinking, the changes which take place in the course of therapy, and concepts concerning aspects of healthy ego formation are cogently analyzed and further clarified with clinical gems. The uniqueness of this text is Dr. Searles' richness of empathic observations. He is able to communicate these remarkable perceptive contributions in simple terms, devoid of the polysyllabic jargon of psychiatry. His candid remarks about his

Aseptic technic in the dressing of wounds is of prime importance, and is often poorly executed. For use in a surgical clinic, office or where sterile instruments and dressings are kept in bulk, the use of an "individual service sterile towel" is an excellent method. The employment of the usual linen towel is expensive, and demands considerable laundry work and renewal from the constant washing. The ordinary paper towels of rather coarse fiber are excellent and inexpensive substitutes. They can be separated from one another and stacked with one corner of the closed side folded, so as to form an easy method for extraction later. The towels are then put in a hospital towel envelop and sterilized under steam pressure. When they are needed, one end of the envelop is unpinned and opened, as shown in the illustration. Each sterile towel may then be withdrawn, opened, and the sterile dressings

CONTENTS Previous investigations. 2. Methods used. 3. Case histories. 4. Experimental data. 5. Discussion of results. A. The law of the conservation of energy in fever. B. The basal metabolism in typhoid fever. C. The specific dynamic action of food in typhoid fever. D. The relationship of heat production and heat elimination. E. A comparison of caloric intake and caloric output. F. Summary and conclusions. PREVIOUS INVESTIGATIONS In a previous communication 1 the respiratory metabolism of typhoid patients as determined by means of the small Benedict respiration apparatus was discussed in detail. The literature of the subject was also reviewed, making repetition here unnecessary. Following this earlier work it was possible to continue the study of the typhoid patients by using the respiration calorimeter of the Russell Sage Institute of Pathology in Bellevue Hospital. In the immediately preceding papers of the series 2 the calorimeter and

At the meeting of the Southern Section of The Triological Society in Naples, Fla, Drs Christopher P. Dehan and James Jerger, Houston, Tex, presented their work on the analysis of gender differences in the auditory brain-stem response. Specifically, the authors found that in young female subjects there was a variation in the latency of the auditory brain-stem response compared with young male and postmenopausal female subjects. While head size and increased temperature postovulatorily can explain some of this difference, the authors hypothesized that the effect of progesterone in increasing nerve excitability is the primary cause of the decrease in latency.—

Sir Aubrey Lewis, LLD, DSc, MD, FRCP, FRCPsych, lately emeritus professor of psychiatry, University of London, formerly of the Institute of Psychiatry, was a distinguished and important English psychiatrist. Two volumes of his collected works were published shortly after his retirement in 1966. This group of 24 articles was written between his retirement and his death in 1975. They are primarily essays in the history of psychiatry and are characterized by superb erudition and a deep understanding of his profession and its roots, written in elegant English. He once wrote, "The humanities cannot, by definition, be classified as sciences but history and ethics and, in the long run, philosophy are branches of knowledge from which medicine draws sustenance. This is particularly true of their relation to psychiatry." The articles are introduced by Michael Shepherd, and there is a bibliography of Sir Aubrey's articles for 1926 to 1978. It will not

Somerset Maugham once remarked that he could think of no better training for an aspiring writer than to spend a few years in medicine. Nowadays, more and more voices are heard claiming that a medical education and a few years in practice are certain to squelch, or more likely to ruin, any creative talent, particularly the talent to write. Medicine, preoccupied as it has become with science and technology, may no longer be the same territory where Maugham found human nature without disguise and was creatively stimulated by the experience. Yet with its strict demands for observation and precise description, medicine is still a profession uniquely suited for cultivating the skills fundamental to the art of self-expression. Contemporary scientific literature is not lacking in the exceptional piece that reflects the art of medicine without being short on science and that shows that smoothness of style, depth of perception, and elegance

In exchange for freedom of inquiry, scientists are obliged to explain their work. CARL SAGAN It is clever, of course, to be clever And good, of course, to be good But when you're so frightfully clever As seldom to be understood It's sad, though if anything sadder Not to be quite as good as you should. LEWIS CARROLL As you record your experiments, do you compose your manunscript as a murder mystery waiting until the last paragraph of the discussion section for the denouement? Do you clutch to your breast the fine details of your experimental technic so your colleagues cannot reproduce them? Do you write in the text each and every detail of the tables in the event that they are not read properly? Do you imply the fact that the results of your study on five rats will be a turning point in your field or, conversely, are

The Archives is the first volume of what will become an annual collection of original articles and abstracts reviewing the clinical, educational, and research developments of the new specialty of family practice. In the past, this specialty has lacked its own traditions of literature, education, and research because the other specialties have provided this information and training for the generalist. This collection of articles is broken up into three distinct sections. The first section considers the development of family practice as a specialty in its historical progression as a unique field of study with a well-defined body of knowledge. This includes articles that were instrumental in the philosophic evolution of family practice in the early 1960s and more recent evaluations showing how family practice contributes a novel and valuable approach to clinical research. The second section deals with the development of undergraduate education programs in family medicine during the past

This book is a series of 27 chapters by almost as many authors dealing with the various aspects and interpretations of the Oedipus complex. As is fitting, it begins with a part of Freud's Interpretation of Dreams. Freud himself as well as others felt that the Oedipus complex formed the cornerstone of the foundations of psychoanalysis itself. Evidence of this view actually arose when Freud wrote to Fleiss about a year and a half after the death of Fleiss' father and subsequently wrote about it in the Interpretation of Dreams in 1900. In his readings Freud had come across Sophocles' three works on Oedipus, Antigone, Oedipus Tyrannus, and Oedipus at Colonus. The main thrust of Freud's thinking was on Oedipus Tyrannus.To most people the story of Oedipus is simple. He was an infant who was abandoned by his parents, was adopted into another family, reached manhood, and subsequently killed

Author Taro Takemi is one of the most remarkable physicians of this or any other century. Consider these factors: 1. Fundamentally educated as a physician, he functioned as a research scientist in prewar and wartime Japan. 2. Selected by Emperor Hirohito, he visited Hiroshima within 24 hours after the atomic bomb blast on Aug 6, 1945, to investigate the circumstances. Because of his advice to the Emperor, Japan's involvement in the Second World War was ended. 3. After the war, when research in Japan was abolished by the unconditional surrender and subsequent occupation, he became a practicing physician/internist. 4. He served as personal physician to six postwar prime ministers of Japan. 5. He served as President of the Japan Medical Association for 25 consecutive years, retiring in 1982. 6. Now 78 years old, Dr Takemi will be a visiting professor at the Harvard School of Public Health beginning in May

The randomized clinical trial (RCT) is well established among research methodologies, especially in the evaluation of new drugs. Its use for other problems is often more controversial. Advocates point out the theoretical advantages that make positive results obtained by this method so convincing. They stress the doubtful reliability of clinical observation and of descriptive studies, and, to support their position, they keep a list of harmful practices that have been perpetuated for lack of timely RCTs. Detractors emphasize the expense, the attendant time lags, the unrealistic rigidity of protocols, the lack of representativeness of volunteers, potential ethical problems, and the inability of modest-sized trials to detect important effects. They point out that most of the major advances in 20th-century medicine have not been subjected to randomized trials. Indeed, the more substantial the breakthrough, the less the need for an RCT to document its value. This slim volume is written by

The rationale for this book appears to be the editor's conviction that medicine should "rediscover" therapeutic uses of marihuana. In an attempt to buttress this thesis, he compiled 25 of the "better professional journal articles" from the past 133 years that pertain to various medicinal or scientific aspects of the drug. Most articles describe personal experiences, therapeutic applications with patients, acute clinical studies, or chemical and pharmacological endeavors. Only Musto's excellent review of the 1937 Marihuana Tax Act is not directly concerned with medical or pharmacological effects of cannabis. After O'Shaughnessy introduced marihuana into the Western pharmacopoeia in 1839 (his report is the first in this book), the drug was promptly recommended for an utterly endless list of disorders. Despite utopian claims, however, wide acceptance never evolved. The editor's primary explanation for this is that recent "recreational" use and the "resultant restrictive federal legislation" functionally ended medical applications of marihuana.

In presenting the subject of non-absorbent gauze for your consideration I am not offering a new topic for discussion; non-absorbent gauze takes its origin contemporaneously with the antiseptic dressings of Lister. Lister's 1 earlier dressings were distinctly non-absorbent; the manner of their production secured it, for muslin was soaked in a heated mixture of paraffin 16 parts, resin 4 parts and carbolic acid crystal 1 part; while still warm the excess of the compound was wrung out. Lister 2 shortly thereafter even suggested an 8 per cent. carbolic gauze made in the same manner. The paraffin counteracted the adhesiveness of the resin, and together they precluded a capillarity in gauzes thus treated. The faults of this carbolized gauze were early recognized and were its non-absorbence and its tendency to cake into a solid mass. In turn, Lister 2 experimented with corrosive sublimate and cyanid of mercury; the former, he found, combined

HISTORICAL A respiration calorimeter is an apparatus designed for the measurement of the gaseous exchange between a living organism and the atmosphere which surrounds it, and the simultaneous measurement of the quantity of heat produced by that organism. The first contrivance of this nature was described by Lavoisier in 1780. It will be remembered that Lavoisier was the first to comprehend the significance of the then newly discovered oxygen. Primitive though the apparatus, yet intellectually inspiring was the mind which so early grasped the principles and understood many of the difficulties. Apparatus for the measurement of the respiratory exchange was perfected before that for the measurement of heat production. Thus, Regnault and Rieset 1 in 1850 designed an air-tight apparatus in which an animal was placed; the carbonic acid formed in it was removed by pumping the air into flasks filled with potash, and oxygen was added

Twenty substantial chapters by as many authors make up this inconspicuous but important book. They are grouped into 5 sections. The first 4 deal with the medical, physiological, nutritional, and psychological aspects of fitness and exercise and the fifth relates exercise and fitness to physical education. Much fundamental scientific work is critically summarized in some chapters; in others, the applications are described in commendable detail. Renewed efforts are made to crystallize the concept of fitness, to define it in operational terms, to make concrete recommendations about food and drink before and during athletic competition, and to appraise present-day programs of physical activity in schools and YMCA's. This book illustrates the advantages of bringing together experts from various fields for systematic consideration of a common area of interest. Several instances of muddled thinking and incongruous practices can be found in it, and the reader can console himself with the thought that

CONTENTS Previous descriptions of calorimeters. The calorimeter room. The wooden frame. The copper walls and the insulating wall. The absorber table, spirometer and heat absorbing system. Rheostat board and observer's table. Electric thermometers. Telephone, fan and bed. Electric and alcohol control experiments. Limits of error in measuring heat, carbon dioxid and oxygen. Determination of water elimination. Adaptability of calorimeter to varying conditions. Summary and conclusions. During the short time in which the Sage calorimeter has been in operation there have been several requests for the technical details of the construction of the apparatus. It has therefore seemed advisable to publish a brief article for those interested in calorimeters. A complete description of the Atwater-Rosa-Benedict type of apparatus will be found in the monograph by Benedict and Carpenter. 1 A number of valuable improvements are

With the transition from the anatomic to the physiological era in the investigation of the brain, it seemed appropriate to von Bonin to cull from history some of the outstanding contributions concerning the cerebral cortex as a basis for the appreciation of more modern concepts. The problem of choice was prodigious, but the selections are judicious and of historical importance. In translation there are now made available the studies of Flourens, the structure of the cerebral cortex by Baillarger, Broca's report on aphemia and the seat of the faculty of articulate language, the research of Fritsche and Hitzig on the electrical excitability of the cortex, and the studies of the functions of the cerebral hemispheres by Munk and Meyner. There are also reports by Brodmann on comparative localization in the cerebral cortex, by von Monakow on localization of brain functions, and by Cajal on anatomic and physiological features of the

Mr. President and Fellow-members of the Ohio State Medical Society: The subject of fever—in its general aspect—has been deemed worthy of so much labor and study on the part of the physiologist, the pathologist and the clinician, and is of such practical import to all who practice our art in any of its branches, that no apology is necessary, I trust, for bringing one of its numerous phases before this society for consideration. Looking at its most constant and evident symptom—the pyrexia—the physiologist points out, and the pathologist, and clinician confirm the probable •existence of heat-producing, heat controlling and heat dissipating areas, situated in the central nervous system, and influencing by their abnormal action the production of this particular symptom. That the pyrexia, however, does not constitute the disease is quite evident, since, it may be absent, controlled or even eliminated, and yet the patient be far from well. While

Of those who have achieved eponymic "immortality," very few deserve this boon of fickle fate more than James Parkinson. This book was brought out in 1955, on the occasion of the bicentenary of Parkinson's birth. In addition to reproducing in facsimile "An Essay on the Shaking Palsy," the editor has brought together a very perceptive biographical essay on Parkinson, by McMenemey; a review of the pathology of Parkinson's disease, by Greenfield, and a clinical analysis of the paralysis agitans syndrome, by Sir Francis Walshe, whose firm critical strokes have done so much to keep English neurology centered on clinical experience, corrected and refreshed by an appeal to natural history as well as the fancier but sometimes more fanciful formulations of the electroneurophysiologists. Before reading this book my ignorance of the man James Parkinson was complete, in fact, a perfect thing. This has all been changed by reading his "Essay" and

Francis L. Black, Ph.D., Yale University School of Medicine, New Haven, Conn.: Dr. McCarthy has given us an excellent review of what is known of strain variation in measles, and I would like to take this opportunity to compliment him on his helpful presentation. Without in any way disagreeing with Dr. McCarthy's analysis of the production of different types of cytopathic effects (CPE) under comparable conditions as manifestations of differences in virus strain, it might be worth noting again the importance of the cell in determining the outcome. The cytopathic changes which we observe are changes in the cell as well as on the virus. While the strains developed by Oddo and his co-workers1gave a consistent type of CPE in 3 types of culture, other examples have been quoted, notably the work of Dr. Milovanovic, in which a virus preparation gave distinctly different effects in different cultures. It

Chronic catarrhal laryngitis is a continuous passive inflammation of the laryngeal mucous membrane. Its etiology is multifarious. The most influential causes are nasal stenosis, liquor drinking, tobacco smoking, vitiated air, and an intemperate use of the vocal organs. Nasal stenosis necessitates mouth breathing—an abnormal respiration, by which we have carried into the laryngeal cavity an air pregnant with dust, that soon begets an inflammatory process. Chronic alcoholism produces an abnormal activity of the mucous glands of the mouth and fauces, which, during sleep, drops depraved excretions into the larynx, thereby producing a permanent inflammation. Tobacco smoking causes to be deposited daily in the air passages the liquid alkaloid nicotina, which produces partial paralysis of the vasomotor nerves of this locality, and a resultant permanent injury to the mucous texture. Vitiated air, in illy ventilated apartments, is one of the commonest causes of chronic laryngitis. Air reeking with noxious vapors poisons

A child, about 10 years of age, was referred to me by the principal of a school with the tentative diagnosis of infection of the face. At first appearance this seemed a possibility, the right cheek of the child, from the corner of the mouth to the sulcus in front of the ear and from the ramus of the lower jaw to the zygoma presenting a uniformly bright red appearance, with a definitely defined border. It was distinctly an inflammation of some kind, the child's face resembling the wind-beaten face of a person who rarely indulges in outdoor sport, after long exercise in a strong gale. Careful examination of the throat and teeth revealed no possible cause. I thought an ulcerated tooth might be the etiology, for the cheek was generally tender and slightly swollen. However, the edema was uniform. There was no particular tenderness over the antrum, and the

Nowadays, we hear a lot about stress. Recently, Asher wrote a delightful comment upon the relationship between stress and organic disease. I quote from his Lettsomian lecture, published in the Lancet 2:417, 1959: "Consider the ubiquitous stress factor, now accepted as the origin of many modern diseases—peptic ulcer, asthma, and ulcerative colitis. Here is a particularly well-written passage of this subject, from the pen of a distinguished physician: 'Peptic ulcer—one of the pestilent camp followers of civilization—one of the penalties we pay for our boasted progress, seems to be more than keeping pace with our advancement, and to be attaching itself especially to certain forms and phases of civilization. There is reason to believe that it is, if not of modern origin, at least of modern growth, and that modern habits and modern modes of life have something to do with its propagation. This is essentially a feverish and fidgetty

Recent reports of considerable variation in the serum levels, and therefore in the probable biological activities, of equal doses of certain drugs marketed by different manufacturers, focus attention upon an important determinant of drug efficacy. These variations indicate that therapeutic equivalence, or equal biological activity, cannot necessarily be inferred from equivalence in the chemical constitution of different formulations of the same drug. In the Drug Efficacy Study, it has been found that, in many cases, no data bearing on biological activity of chemically equivalent drugs are available other than those submitted by the manufacturer who originally filed a New Drug Application for his product. For this reason, the following qualifying addendum was approved by the Policy Advisory Committee of the Drug Efficacy Study and was forwarded to the Food and Drug Administration with each of the 26 groups: Drugs of identical chemical composition (so-called generic drugs) formulated and marketed by

[Your attention is invited to a subject which from the humanitarian standpoint is of the greatest importance and of practical value to us as surgeons. Much of the effort of our profession is directed toward the relief or prevention of pain. Distinct advances in our art followed the introduction of the various narcotics, and the science of surgery took a long step forward when the use of sulphuric ether for anesthesia was discovered Sept. 30, 1846, by Dr. Wm. T. G. Morton, of Wellesley, Mass., and chloroform by Sir James Simpson, of Edinburgh, on Nov. 4, 1847; and these names will ever live in our memory. But the great boon of narcosis is not unalloyed. Thousands have died from the effects of the volatile anesthetics, and every time we administer them we take upon ourselves the responsibility of a human life. Ether kills once in 15,000 administrations; chloroform once in

To the Editor: —There is no specialty in medicine that may be excused from its obligation to the bedside point of view. Administrative medicine as one of the more important public health activities has a clinical aspect which, in a peculiar sense, is the final reason for its existence as a specialty. The successful hospital constructionist is the man with the bedside point of view. Hospital equipment is more obviously related to the bedside. Professional and business staff organization, if it is not planned and later adjusted to the needs of the patient, defeats its own purposes. Hospital administration, which provides the experience on which construction, equipment and organization are finally based, must concern itself primarily with the bedside, for in the last analysis the hospital exists for the benefit of the patient, all other benefits that may be derived in connection with his care coming in the nature of

In a spirit that cannot be too highly commended, Dr. E. S. Kilgore has submitted to me the first draft of his manuscript together with a letter stating that "it would be decidedly to the advantage of the truth-seeking medical public if, after reading my manuscript, you would present your criticism in the form of an article to appear in the same journal number. . . . If you will do this I should like to have the privilege of reading your manuscript and, if indicated, altering my own, and we would then exchange manuscripts again until there were no further changes to make." Convinced by my experience as well as that of others, with the graphic oscillatory method of determining the blood pressure; by the satisfactory check to which it has been subjected by the experiments on animals, performed by myself and others, and by observations made both by

The history of an institution is said to resemble the lengthening shadow of a great man. Certainly the vital element in the history of a country or a part of it is biographical. The Monticello Association is a family group of descendents of Thomas Jefferson. It is asking too much for lightning to strike twice in the same spot. There has been no second Mr. Jefferson. The Jefferson family can be proud of the fact that a very considerable number of Jefferson's descendents have been and continue to be citizens of talent and, indeed, distinction; still there is no one whose stature anywhere nearly approaches that of the patriarch of the clan. But there has been a sprinkling of governors, senators, cabinet members, and other citizens of character; for the most part they do not stand forth very high above their fellows in the generality of mankind. One of the