1236

and workshop, approaches it from one angle ; the

paediatrician from another, for as BAUDOUIN 2

remarks, the faulty adaptation shown by manychildren should throw light on the means ofdefence against external stimuli and the way theycan best be utilised. For many morbid statesthere is a " climate "’ which we should seek topromote, and it is almost ridiculous, for example,that at this time of day we should still be uncertainwhether children with pneumonia should not afterall be nursed out of doors.3 Dr. GEORGE DAy 4

lately mentioned that he was trying to discoverthe effect of certain types of weather on tuber-culous patients and had reached the tentativeopinion that they do best when it is positively

2 Baudouin, G. (1936) Rev. Physiothér. 12, 370.3 See, for example, Wallace, H. L. (1937) Brit. med. J.

March 27th, p. 657.4 J. State Med. March, 1937, p. 157.

vile. Much information on such subjects has beengathered by W. F. PETERSEN in the United Statesand published in his " The Patient and theWeather." Hitherto it has been customary mostlyto rely on impressions ; but better even thanthe best impressions are measurements, and the

systematic studies made during the last twentyyears on non-tuberculous children in the island ofF6hr near Heligoland are an example of seriouseffort to introduce precision where it is badlyneeded. We may be unable to guess whether the" climate " we recommend-be it at the seaside orin a bedroom with closed windows-will benefitour patient, but we should at least try to find outwhat effect, if any, it has upon his bodily functionsand the course of his illness. This is a partof clinical science where we want facts.

5 Kestner, O. (1937) Brit. med. J. March 13th, p. 555.

ANNOTATIONS

MALARIA AND SYPHILIS

THOSE responsible for the mental hospitals of theLondon County Council are anxious that the

opportunities afforded at Horton for the treatment ofneurosyphilis and general paralysis should be betterknown. A special unit for the treatment of syphilisof the nervous system was established there in 1925by the L.C.C. and Ministry of Health jointly and some800 cases have been treated. The unit has serveda second purpose, because the malariotherapy givenhas allowed of valuable studies of induced malaria.The methods developed by the Institute for breedingand infecting mosquitoes have been copied in otherparts of Europe: Wagner-Jauregg’s clinic in Viennahas adopted the Horton technique for examiningblood films, and the plans of the insectarium havebeen reproduced in Germany, Roumania, and Holland.The research on malaria, which has attracted visitorsand investigators from all parts of the world, has beenmade possible only by team-work. The cases havehad medical care from one of the medical officers ofHorton Hospital; the laboratory is in charge ofMr. P. G. Shute with two assistants ; the Ministryof Health, besides giving clerical aid, have allowedColonel S. P. James, F.R.S., to direct the malariawork and establish a research centre. Since ColonelJames’s recent retirement, Horton has formed a

liaison with the London School of Hygiene andTropical Medicine, and Prof. J. G. Thomson is carryingon the work. A whole-time investigator, Colonel J. A.Sinton, I.M.S., with a malaria research fellowshipfrom the Royal Society, is now at the hospital, andwe are glad to learn that another whole-time worker,Dr. E. L. Hutton, with a clerical assistant, is under-taking work from the neurdsyphilitic aspect, undersupervision from Dr. W. D. Nicol, the medical

superintendent, who last November visited Wagner-Jauregg’s clinic as well as hospitals and institutionsin Germany. The records of cases already treatedwill furnish much good material; the incidenceof syphilis in families of general paralytics is now

being inquired into. The hospital is also keen totreat more and earlier cases, particularly as it ishoped that advantage will be taken of the facilitiesfor treating patients on a voluntary basis at a stagelong before the necessity for certification. In this

type of case very favourable results are to be

anticipated, and the duration of the patients’ stay

in hospital should be considerably curtailed, beingin suitable cases as short as 3-4 weeks. It is hopedthat the opportunities for studying neurosyphiliswill attract to Horton as many inquirers as theopportunities for studying malaria have attracted

during the past ten years.

SILICOSIS

OBSERVATIONS on the chemistry of some dan-

gerous dusts made by a group of workers at theImperial College under the leadership of Prof.H. V. A. Briscoe and summarised in two letters inNature (May 1st, 1937, p. 753) may throw usefullight on some of the perplexities of human silicosis.Briefly their discovery is that freshly made dust

may be quite different chemically and mineralogicallyfrom the rock from which it has been derived: it

quickly takes up water from damp air and readilyyields alkali and soluble silica on extraction withwater, much in excess of the solubility of naturalquartz. The same dust when it has lain some time incontact with air is much less reactive, and thisaccumulated dust has often been used for experi-ments on animals whereas in actual practice men areof course exposed to dust immediately it has beenmade by rock-drilling or blasting. A natural inorganicparticle is so arranged molecularly that, rather likean animal, it is coated with a relatively inert skin,and when it is mechanically broken its molecules aredisarranged and it may become by comparison anactive chemical agent. It has also been discoveredthat the solubility of silica from quartz dust is muchreduced by mixing with finely divided charcoal,anthracite, ordinary coal, or lime, from which variouspossibilities in the way of prevention arise as wellas some explanation of the difficulties about silicosisin some coal-miners.

MUSICOGENIC EPILEPSY

IT has long been known that auditory stimulimay bring on epileptic attacks, the commonest formof stimulus being a loud and unexpected noise.Music may, rarely, be a determining cause of fits,and Dr. Macdonald Critchley has collected notesof 20 cases illustrating this sequence of events.Of these, 4 were under his own care, 7 were reportedto him by colleagues, while the remaining 9 are

1 Brain, 1937, 60, 13.