an ingenious truss

1
312 NOTES, COMMENTS, AND ABSTRACTS. TREATMENT OF ITCHING DERMATOSES. ACCORDING to M. Friedlander/ Lebedjew was the first to try intravenous injections of a 10 per cent. sodium bromide solution in pruriginous affections, and his results led to a scientific enquiry in Vienna, where the advantages of the method were confirmed. Ekzebrol, which is a 10 per cent. solution of strontium bromide in 20 per cent. glucose solution, was the direct outcome of these investifgations, and is prepared for the market by the firm of Tosse (Hamburg.) The drug is administered exclusively by the intravenous route, and during the injection gives rise to a feeling of warmth, which spreads rapidly over the whole body, and of which the patient must be warned. Friedlander has never noted any ill-effects, and in one or two cases without promi- nent veins he has even ventured to inject the drug deeply into the glutei. This route, however, is painful, and the patients did not submit to more than two injections. The usual procedure is to administer a 10 c.cm. ampoule three times a week. The results are described as variable. Sometimes the pruritus was controlled after three injections, in other cases as many as 16 had to be given before the symptom disappeared. Ekzebrol, it is stated, can be used both in primary general pruritus of unknown or obscure setiology, and in that which follows or is associated with psoriasis, lichen ruber planus and eczema. Failures of course occur with this, as with all other methods, if the cause cannot be ascertained and removed. PUBLIC HEALTH IN KENYA. A REPORT on the Colony and Protectorate of Kenya, recently issued, states that the land area is 221,800 square miles in extent, and the water area, which includes the larger portion of Lake Rudolf and the eastern waters of the Victoria Nyanza, 4011 square miles. Mount Kenya, after which the colony is named, is 17,040 feet in height, and is capped by perpetual snow and ice. There are no marked seasonal changes such as winter and summer. At high altitudes the diurnal variation of temperature is high, being as much as 30°F. in some places, but the mean temperature varies little from month to month. The range of temperature between different parts of Kenya is very wide. At Lamu, on the coast, the mean shade temperature is 80 ° F. At Mom- basa it is 77°F. In Kisamu, on the Victoria Nyanza it is 72’5°F. In the Rift Valley and highland areas the mean temperature is normally between 58OF. and 65°F. The rain- fall is generally well distributed. Precipitation varies considerably with the physical configuration of the colony. According to a census taken in 1926, the number of Euro- peans in the colony was 12,529, of Asiatics (excluding Arabs), 30,583, and of Arabs 10,577, whilst the estimated African population in 1927 was 2,847,632. In the section of the report devoted to public health it is stated that after the visit to the colony of Dr. J. B. Orr, of the Rowett Research Institute, in 1926, in connexion with the proposed pasture investigation, the subcommittee of the Civil Research Committee decided to extend the scope of the investigation to problems of human as well as animal nutrition. With funds provided by the Empire Marketing Board, two special research officers have been employed in the country, not as independent investigators, but working in closest collaboration with the local people. During 1927 two new centres, namely Kitui and Teita, were opened in the Native Reserves. A medical officer of health has been appointed to Nakuru, on account of the considerable develop- ment which is taking place in the township, and also because of the urgent necessity of instituting sanitary measures at this centre of the grain trade. Besides his duties at Nakuru, the medical officer has been responsible for both Eldoret and Kitale. The first appointment of a medical officer of health to a Native Reserve took place in the latter half of the year, and has proved a complete success. Local native councils have taken an increasing interest in health matters, and large sums of money are being voted by the councils for medical and other objects. On the coast useful measures are being taken against hookworm infestation. The willing cooperation of the people holds out great promise of definite results. Throughout the Reserves generally work is being organised, so that information about diseases, and instruc- tion in simple hygiene, is given, as well as treatment, while at the same time information about the pathological con- dition of the population is being collected. The country has been free from epidemics of serious disease. Plague requires watching, but no outbreaks of any magnitude occurred during 1927. Small-pox was introduced into Nairobi from India, and uneasiness was caused from the fact that cases came under notice from a considerable area, extending as far out as the Fort Hall Reserve. Original 1 Derm. Woch., June 6th, p. 810. cases had remained concealed. Probably owing to the wholesale vaccination campaign conducted two years ago, the outbreak did not assume any magnitude. The epidemic of malaria experienced in 1926 did not recur, possibly owing to the fact that the rains generally were on the short side. The problem is to be tackled energetically in Nairobi; the Government made av Table a sum of £20,000, to be expended during 1928, the municipality and railway authorities sharing in the expense. The International Sleeping Sick- ness Commission, part of whose labours were conducted in Kenya, has completed its work. It was possible during 1927 to conduct a comprehensive population survey of the lake shore. Over 200,000 individuals were examined, and only 380 cases of trypanosomiasis were detected, these mostly being found in three well-defined areas. In one small location, consisting of a population of 800 odd, over 100 cases were found. Measures to deal with the most thickly infested areas are being undertaken. The small area referred to as being especially heavily infected is to be evacuated. Other steps will include clearing of the lake shore and the construction of watering-places. All cases which were found were adequately treated, in order to render them non-infective. Progress of the scheme for the provision out of loan funds of hospitals in various parts of the country has not been as rapid as was hoped, but a small hospital at Kiltui is practi- cally completed, while work has been commenced on a hospital and other medical buildings at Kakamega Station. AN INGENIOUS TRUSS. THE " Colquhoun " truss for hernia consists of a steel spring, to which is fitted a pneumatic appliance consisting of a back pad situated at the centre of the spring, with air connexions communicating with the front pad or pads, which cover the site of the hernia. The pads are inflated by the wearer to the extent he finds most comfortable ; the valve is then closed, and the pressure in the appliance remains even. The back pad serves a double purpose: (1) it substitutes a soft air cushion for the hard spring, and (2) transfers the pressure to the front pads in conformity with the movements of the wearer. The pads are con- structed to include some of the well-known product " Sorbo." While rendering them practically immune from puncture, this does not interfere with the automatic movement of the air, and makes it possible to use a much softer pad than can be employed with nearly all steel spring trusses. The softness of these pads allows them to conform readily to the contour of the body, while the action of the spring, combined with the automatic pressure exercised, gives a soft yet firm holding. This pressure, which owing to the construction of the spring occurs only directly under the pads, has a natural lifting tendency on the front pad or pads, instead of a direct inward action. Any cough or sudden movement is resisted first by the air cushion and then by the spring of the truss. Owing to the special construction, it is claimed that perineal straps are unnecessary The principle on which this appliance is designed is distinctly ingenious, and the truss should prove comfortable to wear. It is manufactured by the Uterpress Co., 65, Atlantic-road, Brixton, London, S.W., and a patent has been applied for. NEW WOMEN’S WARDS AT GRAVESEND.-The Marchioness of Carisbrooke last week opened new women’s wards at the Gravesend and North Kent Hospital. PRESTON ROYAL INFIRMARY.—The sum of :610,000 has been allocated to the building fund of Preston Royal Infirmary by the trustees of the estate of the late Alderman T. Parkinson, who was thrice mayor of Preston. NORTHAMPTON GENERAL HOSPITAL.—Mrs. J. G. Sears, of Collingtree Grange, Northamptonshire, has given £5000 to the Northampton General Hospital, £3000 of which is to be allocated to the purchase of radium. A NEW OR.THOPwDrc HOSPITAL.—A new hospital for cripples was opened on August 3rd at Harlow Wood, near Mansfield, on a site given by the Duke of Portland. There are two wards of 40 beds each, and the total cost of building and equipment was £35,000. NEW HOSPITAL AT BOGNOR.—It is proposed to erect at Bognor a county hospital to commemorate the King’s convalescence in the neighbouring hamlet of Aldwick. A site, together with a promise of £5250, has been given by an anonymous donor, and a committee has been appointed to further the scheme.

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312 NOTES, COMMENTS, AND ABSTRACTS.

TREATMENT OF ITCHING DERMATOSES.

ACCORDING to M. Friedlander/ Lebedjew was the first totry intravenous injections of a 10 per cent. sodium bromidesolution in pruriginous affections, and his results led to ascientific enquiry in Vienna, where the advantages of themethod were confirmed. Ekzebrol, which is a 10 per cent.solution of strontium bromide in 20 per cent. glucose solution,was the direct outcome of these investifgations, and isprepared for the market by the firm of Tosse (Hamburg.)The drug is administered exclusively by the intravenousroute, and during the injection gives rise to a feeling ofwarmth, which spreads rapidly over the whole body, andof which the patient must be warned. Friedlander has nevernoted any ill-effects, and in one or two cases without promi-nent veins he has even ventured to inject the drug deeply intothe glutei. This route, however, is painful, and the patientsdid not submit to more than two injections. The usualprocedure is to administer a 10 c.cm. ampoule three timesa week.

The results are described as variable. Sometimes thepruritus was controlled after three injections, in other casesas many as 16 had to be given before the symptomdisappeared. Ekzebrol, it is stated, can be used both inprimary general pruritus of unknown or obscure setiology,and in that which follows or is associated with psoriasis,lichen ruber planus and eczema. Failures of course occurwith this, as with all other methods, if the cause cannot beascertained and removed.

PUBLIC HEALTH IN KENYA.

A REPORT on the Colony and Protectorate of Kenya,recently issued, states that the land area is 221,800 squaremiles in extent, and the water area, which includes thelarger portion of Lake Rudolf and the eastern waters of theVictoria Nyanza, 4011 square miles. Mount Kenya, afterwhich the colony is named, is 17,040 feet in height, and iscapped by perpetual snow and ice. There are no markedseasonal changes such as winter and summer. At highaltitudes the diurnal variation of temperature is high, beingas much as 30°F. in some places, but the mean temperaturevaries little from month to month. The range of temperaturebetween different parts of Kenya is very wide. At Lamu,on the coast, the mean shade temperature is 80 ° F. At Mom-basa it is 77°F. In Kisamu, on the Victoria Nyanza it is72’5°F. In the Rift Valley and highland areas the meantemperature is normally between 58OF. and 65°F. The rain-fall is generally well distributed. Precipitation variesconsiderably with the physical configuration of the colony.According to a census taken in 1926, the number of Euro-peans in the colony was 12,529, of Asiatics (excluding Arabs),30,583, and of Arabs 10,577, whilst the estimated Africanpopulation in 1927 was 2,847,632.

In the section of the report devoted to public health itis stated that after the visit to the colony of Dr. J. B. Orr,of the Rowett Research Institute, in 1926, in connexionwith the proposed pasture investigation, the subcommitteeof the Civil Research Committee decided to extend the scopeof the investigation to problems of human as well as animalnutrition. With funds provided by the Empire MarketingBoard, two special research officers have been employed inthe country, not as independent investigators, but workingin closest collaboration with the local people. During 1927two new centres, namely Kitui and Teita, were opened inthe Native Reserves. A medical officer of health has beenappointed to Nakuru, on account of the considerable develop-ment which is taking place in the township, and also becauseof the urgent necessity of instituting sanitary measures atthis centre of the grain trade. Besides his duties at Nakuru, themedical officer has been responsible for both Eldoret andKitale. The first appointment of a medical officer of healthto a Native Reserve took place in the latter half of the year,and has proved a complete success. Local native councilshave taken an increasing interest in health matters, andlarge sums of money are being voted by the councils formedical and other objects. On the coast useful measuresare being taken against hookworm infestation. The willingcooperation of the people holds out great promise of definiteresults. Throughout the Reserves generally work is beingorganised, so that information about diseases, and instruc-tion in simple hygiene, is given, as well as treatment, whileat the same time information about the pathological con-dition of the population is being collected. The countryhas been free from epidemics of serious disease. Plaguerequires watching, but no outbreaks of any magnitudeoccurred during 1927. Small-pox was introduced intoNairobi from India, and uneasiness was caused from thefact that cases came under notice from a considerable area,extending as far out as the Fort Hall Reserve. Original

1 Derm. Woch., June 6th, p. 810.

cases had remained concealed. Probably owing to thewholesale vaccination campaign conducted two years ago, theoutbreak did not assume any magnitude. The epidemic ofmalaria experienced in 1926 did not recur, possibly owing tothe fact that the rains generally were on the short side. The

problem is to be tackled energetically in Nairobi; theGovernment made av Table a sum of £20,000, to be expendedduring 1928, the municipality and railway authoritiessharing in the expense. The International Sleeping Sick-ness Commission, part of whose labours were conducted inKenya, has completed its work. It was possible during1927 to conduct a comprehensive population survey of thelake shore. Over 200,000 individuals were examined, andonly 380 cases of trypanosomiasis were detected, thesemostly being found in three well-defined areas. In onesmall location, consisting of a population of 800 odd, over100 cases were found. Measures to deal with the mostthickly infested areas are being undertaken. The smallarea referred to as being especially heavily infected is to beevacuated. Other steps will include clearing of the lakeshore and the construction of watering-places. All caseswhich were found were adequately treated, in order torender them non-infective.

Progress of the scheme for the provision out of loan fundsof hospitals in various parts of the country has not been asrapid as was hoped, but a small hospital at Kiltui is practi-cally completed, while work has been commenced on a

hospital and other medical buildings at Kakamega Station.AN INGENIOUS TRUSS.

THE " Colquhoun " truss for hernia consists of a steelspring, to which is fitted a pneumatic appliance consistingof a back pad situated at the centre of the spring, with airconnexions communicating with the front pad or pads,which cover the site of the hernia. The pads are inflated bythe wearer to the extent he finds most comfortable ; thevalve is then closed, and the pressure in the applianceremains even. The back pad serves a double purpose:(1) it substitutes a soft air cushion for the hard spring, and(2) transfers the pressure to the front pads in conformitywith the movements of the wearer. The pads are con-

structed to include some of the well-known product " Sorbo."While rendering them practically immune from puncture,this does not interfere with the automatic movement of theair, and makes it possible to use a much softer pad than canbe employed with nearly all steel spring trusses. Thesoftness of these pads allows them to conform readily to thecontour of the body, while the action of the spring, combinedwith the automatic pressure exercised, gives a soft yet firmholding. This pressure, which owing to the construction ofthe spring occurs only directly under the pads, has a naturallifting tendency on the front pad or pads, instead of a directinward action. Any cough or sudden movement is resistedfirst by the air cushion and then by the spring of the truss.Owing to the special construction, it is claimed that perinealstraps are unnecessaryThe principle on which this appliance is designed is

distinctly ingenious, and the truss should prove comfortableto wear. It is manufactured by the Uterpress Co., 65,Atlantic-road, Brixton, London, S.W., and a patent hasbeen applied for.

NEW WOMEN’S WARDS AT GRAVESEND.-TheMarchioness of Carisbrooke last week opened new women’swards at the Gravesend and North Kent Hospital.

PRESTON ROYAL INFIRMARY.—The sum of :610,000has been allocated to the building fund of Preston RoyalInfirmary by the trustees of the estate of the late AldermanT. Parkinson, who was thrice mayor of Preston.

NORTHAMPTON GENERAL HOSPITAL.—Mrs. J. G.Sears, of Collingtree Grange, Northamptonshire, has given£5000 to the Northampton General Hospital, £3000 of whichis to be allocated to the purchase of radium.

A NEW OR.THOPwDrc HOSPITAL.—A new hospitalfor cripples was opened on August 3rd at Harlow Wood,near Mansfield, on a site given by the Duke of Portland.There are two wards of 40 beds each, and the total cost ofbuilding and equipment was £35,000.

NEW HOSPITAL AT BOGNOR.—It is proposed toerect at Bognor a county hospital to commemorate theKing’s convalescence in the neighbouring hamlet of Aldwick.A site, together with a promise of £5250, has been given byan anonymous donor, and a committee has been appointedto further the scheme.