Review of some of the recent advances in tropical medicine, hygiene and veterinary science, with special reference to their possible bearing on medical, sanitary and veterinary work in the Anglo-Egyptian Sudan : being a supplement to the Third Report of the Wellcome Research Laboratories at the Gordon Memorial College Khartoum / by Andrew Balfour and R. G. Archibald.

  • Balfour, Andrew.
Date:
1908
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Licence: Attribution 4.0 International (CC BY 4.0)

Credit: Review of some of the recent advances in tropical medicine, hygiene and veterinary science, with special reference to their possible bearing on medical, sanitary and veterinary work in the Anglo-Egyptian Sudan : being a supplement to the Third Report of the Wellcome Research Laboratories at the Gordon Memorial College Khartoum / by Andrew Balfour and R. G. Archibald. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    in primary cultures involution forms often occurred. The organism was found to ferment Cerebro- glucose and maltose, but not levulose. The diagnostic value of the agglutination test is Spinal Fever slight. The Biplococcus crassus which occurs along with the meningococcus is agglutinated —continued by meningococcus serum. A valuable and very practical paper is that by Eobertson^ of Leith, who deals specially with administrative control, and advocates the douching of the nasal cavities of all intermediaries with chlorine water. His method was to douche at intervals of two days, and three times in all. He also draws attention to the value of formamint lozenges, especially for children. He also recommends the isolation of all those living in infected houses. Thorough spraying of infected premises with formaldehyde was deemed useful, and, a point which might be missed, the confiscation and destruction of all foodstuffs found in lower class houses is stated to be a valuable preventive measure. As regards diagnosis, Birnie and Smith^* successfully isolated and cultivated the specific organism from the blood by the simple procedure of puncturing a vein and distributing 4 cubic centimetres of blood equally between two flasks containing 75 cubic centimetres of sterile bouillon. Kutscher^ finds an agar, made with human placental juice, an excellent medium for the growth of the first generation of the meningococcus. In the only case I have seen in the Sudan I was able to isolate and cultivate a diplococcus from the meninges, which answered in every respect to that of Weichselbaum. Chlorine water would probably be of little use as a nasal douche in this country, but the menthol wash recommended by the Germans might be tried. It would, I think, be comparatively easy, in the light of recent knowledge, to control an outbreak in Khartoum, where the people are amenable to sanitary control, and very thorough disinfection methods followed by compensation can often be adopted owing to the small value of native dwellings and belongings. [Note.—A recent outbreak has enabled one to prove the truth of this assertion.] Chicken-pox. In the Sudan, where one deals chiefly with black skins, the diagnosis of chicken-pox from small-pox is sometimes very difficult. The following points, which have served one as fairly trustworthy guides, and have been gathered from various sources, may be helpful. Rogers' suggests that the blood changes in the two conditions might well repay study:— 1. Prodromata. Often no prodromal period in chicken-pox. Usually present in small-pox. 2. Feeling of illness when rash appears in chicken-pox. The opposite is true in mild or modified small-pox. 3. Facial appearance. Nothing special in chicken-pox; heavy, anxious or stuporose in small-pox. Amongst the natives these three are of less value than the following:—■ 4. Frequently a rise in temperature accompanies appearance of rash in chicken-pox. In small-pox the temperature falls at this time. 5. Eash appears first on the trunk in chicken-pox, on the face in small-pox. 6. Distribution of rash. Trunk and proximal portions of extremities in chicken-pox. Face and distal portions in small-pox, together with back of trunk. (Sec, however, note under Small-pox, page 183). 7. If a so-called skin window be marked off, the irregularity of the rash is well seen in chicken-pox. i.e. vesicles and pustules together in the area. Not so in small-pox. 8. Eapid change from papule to vesicle in chicken-pox, frequently in a few hours and within 24 hours. At least 24 hours in small-pox, often 72 hours. 9. Centre of vesicle its highest point in chicken-pox; depressed in small-pox. 10. Papules of chicken-pox not so firm and shotty as those of small-pox. 11. Depth of skin involved. Less in chicken-pox than in small-pox. Hence seeds in palms and soles usually found only in the latter. 12. The character of the scales, thin in chicken-pox, thick in small-pox, is said to aid one, but I have not noticed this in native cases. Early cupped scabs in chicken-pox are, however, very characteristic. 13. The scars of chicken-pox are smooth and have irregular edges, while those of small-pox are pitted and as if punched out. The former are often wider as the vesicles tend to spread laterally. 1 Robertson, W. (July 27th, 1907), Remarks on the Outbreak of Epidemic Cerebro-Spinal Meningitis. British Medical Journal, p. 185. ^ Birnie, J. M., and Smith, M. T. (October, 1907). American Journal of Medical Science. ^ Kutscher, K. (November 9th, 1907), Ein Beitrag zur Ziichtung des Meningococcus. Cent. fUr Bakt. Abt., 1907, Vol. XLV., No. 3, p. 286. Rogers, L., Fevers in the Tropics, London, 1908.