filippo rho

1
764 summer than in winter. Generally no particular atten- tion was discovered to be paid to maintaining different rates of air movement and warmth according to the amount of physical exertion entailed by the work in progress. Sedentary work was being carried on in rooms too cold in winter and too hot in summer, and heavy manual work in rooms with unsatisfactory rates of cooling and temperatures in both season’s of the year. This report is the second of a series dealing with the boot and shoe industry, further additions to which are promised. It is a good piece of work, throwing valuable light on conditions of labour and on the way in which health and efficiency can be improved by attention to the human factor in industry. BROMISM THROUGH MATERNAL MILK. A CURIOUS case of bromism is reported from the pedi- atric department of the diagnostic clinic of the State Department of Health at Carthage, New York. 1 A breast-fed infant of 6 months presented an apparently painful papulo-pustular eruption. There was a history of a general " white " rash at birth, followed by the appearance of this papulo-pustular eruption at the age of 6 weeks. The diagnosis of bromism was made and was confirmed by the discovery of bromine in the mother’s milk. The origin of the bromine was not far to seek. The mother, a nervous individual, had been taking for two years a proprietary remedy called Miles’ Restorative Nervine, shown by the American Medical Association to contain bromides of ammonium, potassium, and sodium, along with chloride and benzoate of sodium. No record has been found in the literature of bromism acquired in this way, though it is noted that some American authors have observed the secretion of bromides in human milk. This is mentioned also in Hale White’s " Materia Medica," but we have found no allusion in accessible medical literature to the danger of producing bromism in the infant from administering bromides to the nursing ’, mother. ____ FILIPPO RHO. As we have already mentioned, Professor Filippo Rho, Medical Lieutenant-General of the Royal Italian Navy," its medical Director-General during the war, retired last September after 40 years of distinguished service. The Annali di Medicina Navale for December expresses the respect in which he was held in the department and the regret felt at his retirement, which is technically due to the reduction of the Naval Medical Service by the abolition of his, its highest, rank. Professor Rho joined the Italian Navy in 1880, and in the following year joined a ship, which took him round the world, as her zoologist. He early took up the study of tropical diseases, and was for ten years demonstrator of tropical disease at the University of Naples, where he, with others, built up a Post-graduate School of Naval and Colonial Medicine, and also established the 4.M.o[M, which budded off from the Italian Medical JoM)’?m in 1895. His was the foresight that, for the Italian Navy, decided in 1898 that there should be in action not one dressing-station but two, and planned the medical equipment of ships accordingly ; he also took an early share in the establishment of hospital ships. In January, 1912, he maintained the need for anti- typhoid inoculation and later for Castellani’s triple vaccine (T.A.B.). In 1913 he secured that Metchnikoff’s calomel ointment should be used in the navy prophy- lactically, and the practice spread to the army. It is also claimed that owing to his initiative and his methods it was that the naval brigade on the lower Piave in 1918 suffered far less from malaria than did the army generally, and he took a forward part in Italy, as the war advanced, in finding out how to feed the army with equal calories at less expense. He maintained that Rubner’s allowance of meat in his diet for heavy labour was excessive, and got the soldiers’ diet in Italy altered accordingly. That alteration certainly assisted Italy to remain in the war. He published his book on 1 Bromin Poisoning through Mother’s Milk. Frank van der Bogert, M.D. Am. Jour. of Diseases of Children, February, 1921. p. 167. tropical diseases in 1897. He has a long record of original work, and leaves the service followed by the regrets of all his brother officers and the respect of everyone who is acquainted with his original investigations. RESEARCH SCHOLARSHIPS AND GRANTS OF THE BRITISH MEDICAL ASSOCIATION. THE Council of the British Medical Association is prepared to receive applications for research scholar- ships as follows:- 1. An Ernest Hart illeiitorial Scholarship, of the value of E200 per annum, for the study of some subject in the department of State medicine. 2. Three Research Scholarships, each of the value of 1150 per annum, for research into some subject relating to the causation, prevention, or treatment of disease. Each scholarship is tenable for one year, commencing on Oct. lst next. A scholar may be reappointed for not more than two additional terms. The Council of the Association is also prepared to receive applications for grants for the assistance of research. Preference will be given, other things being equal, to members of the medical profession, and to applicants who propose as subjects of investigation problems directly related to practical medicine. Applications for scholarships and grants for the year 1921-22 must be made not later than Saturday, June 25th. Each application should be accompanied by testi- monials, including a recommendation from the head of the laboratory, if any, in which the applicant proposes to work, setting out the fitness of the candidate to con- duct such work, and the probable value of the work to be undertaken. This is not intended, however, to prevent applications for grants in aid of work which need not be performed in a recognised laboratory. The condi- tions of award and application forms will be supplied on application to the Medical Secretary of the Associa- tion, 429, Strand, London, W.C. 2. WAR RISK INSURANCE IN U.S.A. IN the Military 8nrgeon for February Surgeon J. G. Townsend, of the U.S. Public Health Service, tells how the War Risk Insurance of the United States is taking care of those disabled by the war. Every officer, man, or nurse, injured, or with disease contracted on duty, if insured against damage, has a claim against this insurance on account of the disability. Total and per- manent disability receives some C240 a year, temporary total disability about C200; 50 per cent. and so on dis- abilities receive in proportion. In addition the U.S. gives a further compensation quite independently of the insurance ; this latter compensation is not discussed in the article under notice. The examination and treat- ment of the ex-Service man has been turned over to the capable and ready hands of the valuable U.S. Public Health Service. Over 4,000,000 people have been dis- charged, all of whom are possible clients, and of them half a million have filed claims. The United States has been divided into 14 districts, each with a commissioned officer of the Public Health Service as district super- visor. He and his office hunt up and keep record of the disabled in the district, gather them in for examina- tion, sending passage warrants, meal vouchers, &c. ; patients with tuberculosis, if summoned, are sent packets with paper spittoons and paper napkins; doctors are appointed in large towns and at important railway junctions to examine the disabled and furnish reports, which are kept filed, each patient’s dossier by itself ; a pathological index of all cases in the district is kept up to date, so that the number of any sort in the district can be stated at any time; also there is an office personnel to deal with pay and leave, and an accounts section. 30,000 claims are examined monthly, and between 5 and 6 million dollars paid out every month in insurance. Disabilities are still developing, the tuberculosis maximum is expected in 1923, the mental and psychical in 1926. Of 3500 amputation cases, 11 had lost both arms, 68 both legs. Double total permanent disabilities such as these mentioned, or eyes, get f:500 a year. Of 82,000 hospital cases, 19,000 were tuberculous (23 per cent.). 1

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764

summer than in winter. Generally no particular atten-tion was discovered to be paid to maintaining differentrates of air movement and warmth according to theamount of physical exertion entailed by the work inprogress. Sedentary work was being carried on inrooms too cold in winter and too hot in summer, andheavy manual work in rooms with unsatisfactory ratesof cooling and temperatures in both season’s of the

year. This report is the second of a series dealing withthe boot and shoe industry, further additions to whichare promised. It is a good piece of work, throwingvaluable light on conditions of labour and on the wayin which health and efficiency can be improved byattention to the human factor in industry.

BROMISM THROUGH MATERNAL MILK.

A CURIOUS case of bromism is reported from the pedi-atric department of the diagnostic clinic of the StateDepartment of Health at Carthage, New York. 1 Abreast-fed infant of 6 months presented an apparentlypainful papulo-pustular eruption. There was a historyof a general " white " rash at birth, followed by theappearance of this papulo-pustular eruption at the

age of 6 weeks. The diagnosis of bromism was madeand was confirmed by the discovery of brominein the mother’s milk. The origin of the brominewas not far to seek. The mother, a nervous

individual, had been taking for two years a proprietaryremedy called Miles’ Restorative Nervine, shown bythe American Medical Association to contain bromidesof ammonium, potassium, and sodium, along withchloride and benzoate of sodium. No record has beenfound in the literature of bromism acquired in this way,though it is noted that some American authors haveobserved the secretion of bromides in human milk.This is mentioned also in Hale White’s " MateriaMedica," but we have found no allusion in accessiblemedical literature to the danger of producing bromismin the infant from administering bromides to the nursing ’,mother.

____

FILIPPO RHO.

As we have already mentioned, Professor Filippo Rho,Medical Lieutenant-General of the Royal ItalianNavy," its medical Director-General during the war,retired last September after 40 years of distinguishedservice. The Annali di Medicina Navale for Decemberexpresses the respect in which he was held in the

department and the regret felt at his retirement, whichis technically due to the reduction of the Naval MedicalService by the abolition of his, its highest, rank.Professor Rho joined the Italian Navy in 1880, and inthe following year joined a ship, which took him roundthe world, as her zoologist. He early took up the studyof tropical diseases, and was for ten years demonstratorof tropical disease at the University of Naples, wherehe, with others, built up a Post-graduate School ofNaval and Colonial Medicine, and also established the4.M.o[M, which budded off from the Italian MedicalJoM)’?m in 1895. His was the foresight that, for the ItalianNavy, decided in 1898 that there should be in actionnot one dressing-station but two, and planned themedical equipment of ships accordingly ; he also tookan early share in the establishment of hospital ships.In January, 1912, he maintained the need for anti-typhoid inoculation and later for Castellani’s triplevaccine (T.A.B.). In 1913 he secured that Metchnikoff’scalomel ointment should be used in the navy prophy-lactically, and the practice spread to the army. It isalso claimed that owing to his initiative and his methodsit was that the naval brigade on the lower Piave in1918 suffered far less from malaria than did the armygenerally, and he took a forward part in Italy, as thewar advanced, in finding out how to feed the armywith equal calories at less expense. He maintainedthat Rubner’s allowance of meat in his diet for heavylabour was excessive, and got the soldiers’ diet in Italyaltered accordingly. That alteration certainly assistedItaly to remain in the war. He published his book on

1 Bromin Poisoning through Mother’s Milk. Frank van der Bogert,M.D. Am. Jour. of Diseases of Children, February, 1921. p. 167.

tropical diseases in 1897. He has a long record of

original work, and leaves the service followed by theregrets of all his brother officers and the respect ofeveryone who is acquainted with his originalinvestigations. -

RESEARCH SCHOLARSHIPS AND GRANTS OFTHE BRITISH MEDICAL ASSOCIATION.

THE Council of the British Medical Association is

prepared to receive applications for research scholar-ships as follows:-

1. An Ernest Hart illeiitorial Scholarship, of the valueof E200 per annum, for the study of some subject in thedepartment of State medicine.

2. Three Research Scholarships, each of the value of 1150 perannum, for research into some subject relating to thecausation, prevention, or treatment of disease.Each scholarship is tenable for one year, commencingon Oct. lst next. A scholar may be reappointed for notmore than two additional terms. The Council of theAssociation is also prepared to receive applications forgrants for the assistance of research. Preference willbe given, other things being equal, to members of themedical profession, and to applicants who propose assubjects of investigation problems directly related topractical medicine.Applications for scholarships and grants for the year

1921-22 must be made not later than Saturday, June 25th.Each application should be accompanied by testi-monials, including a recommendation from the head ofthe laboratory, if any, in which the applicant proposesto work, setting out the fitness of the candidate to con-duct such work, and the probable value of the work tobe undertaken. This is not intended, however, to preventapplications for grants in aid of work which need notbe performed in a recognised laboratory. The condi-tions of award and application forms will be suppliedon application to the Medical Secretary of the Associa-tion, 429, Strand, London, W.C. 2.

WAR RISK INSURANCE IN U.S.A.IN the Military 8nrgeon for February Surgeon J. G.

Townsend, of the U.S. Public Health Service, tells howthe War Risk Insurance of the United States is takingcare of those disabled by the war. Every officer, man,or nurse, injured, or with disease contracted on duty,if insured against damage, has a claim against thisinsurance on account of the disability. Total and per-manent disability receives some C240 a year, temporarytotal disability about C200; 50 per cent. and so on dis-abilities receive in proportion. In addition the U.S.

gives a further compensation quite independently of theinsurance ; this latter compensation is not discussed inthe article under notice. The examination and treat-ment of the ex-Service man has been turned over to thecapable and ready hands of the valuable U.S. PublicHealth Service. Over 4,000,000 people have been dis-charged, all of whom are possible clients, and of themhalf a million have filed claims. The United States hasbeen divided into 14 districts, each with a commissionedofficer of the Public Health Service as district super-visor. He and his office hunt up and keep record of thedisabled in the district, gather them in for examina-tion, sending passage warrants, meal vouchers, &c. ;patients with tuberculosis, if summoned, are sent

packets with paper spittoons and paper napkins;doctors are appointed in large towns and at importantrailway junctions to examine the disabled and furnishreports, which are kept filed, each patient’s dossier byitself ; a pathological index of all cases in the district iskept up to date, so that the number of any sort in thedistrict can be stated at any time; also there is anoffice personnel to deal with pay and leave, and anaccounts section. 30,000 claims are examined monthly,and between 5 and 6 million dollars paid out everymonth in insurance. Disabilities are still developing, thetuberculosis maximum is expected in 1923, the mentaland psychical in 1926. Of 3500 amputation cases, 11had lost both arms, 68 both legs. Double totalpermanent disabilities such as these mentioned, or

eyes, get f:500 a year. Of 82,000 hospital cases, 19,000were tuberculous (23 per cent.).

1