Steady Addition to Knowledge Realized: Relation Between Benefactions and Medical Research G¢J THINK it has not been sume public that the Lester bene! an opportunity which has incre responsibility of the community director of the Henry Lester Inst issued.
The annual report contains full records of the year's working among the various departments of the Institute, the three chief ones being the Divisions of Clinical Research and Experimental Surgery, of Physiotogical Sciences, and of Pathological Solences, and is illustrated with photographs of some of the senior members of the staff and of various Important items of equipment used in the various laboratories, Dr. Earle's introduction to the report reads in part og follows:—Diseases are not specific entities Uke plants and animals. and there a change In the incidence and character of diseases going on, nob only in different parts of the world, but' also in the "same parts of the world at different times. This iso important that T have" asked Dr. James L, Maxwell to allow. me to publish some extracts from the last Tecture he gave at the Institute, 'These extracts, of course, express the personal views of the lecturer, Dut "coming as they do from one who has played an important part the "development of -modern medicine in China, they should surely challenge our' attention, In Retrospect "1m my hospital days, three diseases were outstandingly common. Typhoid fever was the curse of the medical wards on account of its prevalence, severity, and the enormous amount of heavy nursing it entailed. So many patients suffering from typhoid came to the hospital that a rule had fo be made that no more than five were to be in any one ward at once, owing to the strain it Imposed on the nursing staff, 'Twenty-five years Tater, one of my daughters nursed for a year in the same hospital, and mostly in the medical wards, with 'Out ever seeing a case of typhoid. A few years ago, the Secretary of the International Nurses' Council was asked to secure training in typhoid ursing for a group of nurses. going out to India, and had to reply that Dractieal training in typhoid nuts was almost impossible to got in Et and, as only when an occasional small and Isolated outbreak occurred were there enough cases in any one place to secure the necessary practi cal teaching. The disease has dis appeared largely as a result of the improvement. in public health laws, especially in regard to water and milk On the women's side of our outpatient department, one of the commonest diseases was chlorosis, a form of anglia. that. was extraordinarily prevalent among girls working in factories and workshops. AS a common disease it has now completely disappeared, and this is undoubtedly dug to better conditions in factories, shorter hours, more hygienic clothing,
and open-alr games. and' the alttacton of the open air "The third disease to which 1 should like to refer is_ tuberculosis. If mot as frequent in England then fas "it is in China now, it was appollingly common, and' took a heavy toll of lives. Inthe past seventy years, it has decreased by more than 'T5 per cent. and this, again, has been due not so much to' treatment, as to health education, and to improved economic conditions.
Leprosy Treatment "Leprosy treatment was absolutely In Ils Infancy and of knowledge of the causes favouring the dovelopment of this discase there was none, Sogrogation was the only form of treatment suggested and was obsession of physicians and govern-monte alike, an obsession which unhappily has noy even yet disappeared.
'Singe those days the treatment of leprosy has rapidly advanced, _not only through the use of the' more modern chaulmoogra preparations, but still more by' the recognition that concurrent diseases, unhealthy living habits, and" probably nutritional defects are most important factors in the development of the disease.
"The uso of emetine in dysentery was unknown. T well remember the coming of emetine, for T said to myself, if this drug is going to do al that it claims, it ought to be able to do it even though no attempt is made to control the diet, T therefore gave my first injection to a woman hospital while leaving her to eat the full hospital diet. The case was happily a very favourable one, and the result. in rapid clearing up of the disease was so striking that T have never forgotten it, ig a striking thing that the history of ciently recognized by the Shanghai faction to medical science presents sassed rather than diminished the for the maintenance and future development of its voluntary hospitals," says Dr. H. G. Earle, stitute: of Medical R arch, in his introduction to the annual report for 1936, which has just been with one or two exceptions, been covered by my period of time in the East. Hookworm was practically, unknown, schistosomiasis had. never been heatd of, the lung fluke was supposed to be absent, and fasclolopsis confined to the Shaoshing area. It so happened that when I was appointed Chairman of the first Research Commitee of the China Medical Association in 1907, we took as our main investigation the distribu-lon of the common helminths, and were thus able to establish the prevalence of these parasites.
Typhola "Rare" came out before there were any of the modern laboratory. tests fF ge tpohova, but as 1 have already me Aleaied, with 'a considerable eerie nce, the dzesse, while my wife the tad been a ister at St. Barthes Iemew' odad) a mich wider ex. Deroncs sill of the nurning se of Uphold: yet in twenty years in Fors rosa, doubt "whether Tsay Sweaty Gases! Of typhoid: fever, tu Amy Where °t Knew the. hospitals Iyphold among foreigners wat very femmon, yet the alme. doctors who Siagnovea the disease eatly in for. lamers, failed to find it in there Came Sse" alien 'Peat was, say, tiety Sears ago. Of recent years' Inthe Same place, typhoid fever forms one the Target causes for admisten of Chinese patients to the same: Nesp tal "and" easly, the largest number
Blong the coast of China and In man eats. "The same story is tural inland cities, "The extraordinary fact is also true that whereas when T rt came abroad dAmay had the reputation "of cing the vairtiest ity in China, and tulle deserved it, it now Bids fir for ing' one of the finest" of the Gun "cotst, and' hor an nsialled Supply of pire water. f'ean, myst, fee, No exeape "from the nelson that "hoid is enormousiyon the Increase in lrcumstances: where one would have naturally predicted the Dppoate tobe the exe"
Text read from the printed page and cleaned; old type leaves the occasional error.