tolerance, and have -made similar observations in
Annotations. "Ne quid nimis."
during the present war. The. of diabetes is perhaps of greater interest than the disappearance of obesity, of gout, and of chronic constipation noted during the same period and the increasing rarity of eclampsia in pregnant women. The balance is not equalised by the alleged increase in the frequency of peptic ulcer. Any observations of a similar character made in this country would be of interest and might throw useful light on the relation between habit and metabolic disorder. enemy countries cure
MUCH stress has been put, and rightly, on war diseases. That way progress has lain. But there have also been war cures, and of these we have heard less. The disappearance of functional nervous disease among the civil population during the last four years is, however, a matter of general comment. In Berlin we understand that migraine BRONCHO-SPIROCHÆTOSIS. disappeared completely from the month of August, THANKS to the work of G. A. Lurie, Galli- Valerio/ 1914, and, without doubt, the work of general H. and the subject of broncho-spirochsetosis Violle,3 in this has been country mitigated practitioners by the fact that they have seen fewer minor ail- has received considerable light. The condition - ments. Many of these, while real enough, are until recently was only of interest to the tropical such as the patient communicates only to his or practitioner, but lately it has become a serious her (generally her) family doctor, and the particular matter to medical men in Europe, cases of the family doctor has generally been away. Minor malady having been reported from Serbia and the The ailments cannot be assessed in actual figures, but Balkanic zone, Switzerland, and France. there is a certain amount of evidence accumulat- condition and its etiological agent were first ing in regard to definite morbid conditions described in Ceylon in 1905 by Castellani, who which have become numerically less frequent later named the causal agent SpoctsbfOMCHs. during the war. Dr. Herbert Elias and Dr. His researches were confirmed by S. Branch in Richard Singer laid before the Vienna Medical 1907 in the West Indies, by Jackson in the same 1 Society on Oct. 18th last a therapeutic study year in the Philippine Islands, and by several of the influence of war diet upon diabetes. Their other observers, whilst H. G. Waters in 1909 The conconclusion is based upon figures, and it is recorded numerous cases from India. later found in dition was All a remarkable one. practically every degrees of diabetes as it occurred in Vienna were favourably influenced part of the tropics, of special importance by the altered circumstances of war, in males being the work of Chalmers and O’Farrell, who almost without exception, in females frequently succeeded in reproducing the disease in monkeys, but by no means universally. The chart which we and the thorough investigation of Fantham on the morphology of the organism. Spirochaeta bronchi1&bgr;12,1,f I iOtA/I!:’.. I 1Ulh.1’-=. I 1UII.t’7 I 1017/1Q alis, according to the description given by all these authors, is so markedly polymorphic that the suggestion arises whether the term does not cover more than one species or variety of spirochsete. The classical investigation of Fantham4 seems to prove, however, that the various forms found belong, in reality, to only one species, differing from the spirochaates occurring commonly in the mouth. Fantham discovered the coccoid stage of the parasite, which he believes to be of fundamental significance in the dissemination of the malady. Clinically, three types of the condition are to be distinguished-the acute, the subacute, and the The acute chronic. develops abruptly ; reproduce here shows the decreasing number of the patient complains type of headache and rheudiabetics dying in the Vienna General Hospital matoid pains all over the body; he feels chilly during the last five years, the thick line indicating and coughs much, though there is but very scanty total deaths, the interrupted line the deaths occuror mucoid muco-purulent expectoration. The ring in coma. The authors express regret that they lasts from 3-6 days. This influenzagenerally cannot give the result in percentages, inasmuch as like of type broncho-spirochaetosis has given rise to the total diabetic admissions to hospital could not a suggestion that true influenza may be a form be ascertained, but of the general lesson to be of spirochoetosis. The subacute and c7wonic types drawn from the chart there appears to be no doubt. of broncho-spirochaetosis are of practical relevance, The better war prognosis in males as distinguished as they may closely simulate pulmonary tuberfrom that in females is a fact claimed by these culosis. In these types the patient often spits up observers as a new observation, coinciding with and this, together with wasting, an evening blood, their pre-war experience, for which they venture to rise of temperature, and, on examination, the preadvance no explanation. In the case of patients with sence of of dullness and crepitations, may slight glycosuria the difference between war and pre- suggest patches a diagnosis of phthisis. In a certain war experience was very striking. Whereas not one number of cases, however, the general condition of 29 slight diabetics before the war could be regarded remains good. The first patient seen by Castellani as cured, 33 out of 39 became sugar-free under war in Ceylon in 1905 was still alive in 1915, and Violle conditions. The experience -of Bouchardat during a number of cases in which the general the siege of Paris in 1870-71 is quoted as having quotes 1 Journal of been similar. G. Klemperer, P. F. Richter, and Tropical Medicine, Dec. 1st, 1915. 2 fur Schweizer-Aerzte, February, 1917. Correspondenzblatt others have noted the increased carbohydrate 3 Presse Médicale, July 11th, 1918; THE LANCET, 1918, ii., 775. 4 Annals of Parasitology, July. 1915. 1 Wiener klin. Wochenschr., Nov. 21st, 1918. 5 De Verbizier: Bull. Académie de Médecine, Séance 8 Octobre, 1918. ____