The American Journal of Tropical Medicine and Hygiene - Volume s1-2, Issue 2, March 1922

• 1.  In 1916, when the survey by the Rockefeller Foundation was made, Guayaquil was the key to the yellow fever situation of the West Coast of South America. It was a permanent endemic focus, from time to time infecting the coast both north and south of itself.
  
  The elimination of yellow fever from Guayaquil at this time would have eliminated it from this entire coast and probably in perpetuity. It was therefore planned.
• 2.  This was postponed on account of the war and before it was accomplished yellow fever had been introduced (in early 1919) from Guayaquil into northern Peru, where it spread rather widely during that year and the next, threatening both to reinfect Guayaquil, now free of it, and to spread into the populous districts to the south where there was a good chance of its forming a more or less permanent focus.
• 3.  In the campaign against this epidemic the ultimate dependence was exclusively on the control of Stegomyia by elimination of their breeding places, isolation of the sick and fumigation of infected premises being disregarded.
• 4.  This was pressed only at certain places of strategic importance, key places, and little attention paid to outbreaks elsewhere. The prime object was to prevent further extension of infection rather than the elimination of that already existing, except as a means to prevent extension.
• 5.  It was urged that the same measures—Stegomyia control—be extended to healthy places in the south exposed to infection, key places, so as to render them incapable of propagating yellow fever should it be introduced.
  
  This was not done efficiently, reliance being placed on a military Cordon Sanitaire and the natural defence furnished by a waterless desert about 60 miles wide to the south.
• 6.  Yellow fever was eliminated from the northern department, where the above campaign was undertaken, the last (doubtful) cases occurring in September, but passed the Cordon Sanitaire and was found in epidemic form in Janurary, 1920, well to the south, where it had been some months.
• 7.  General outline of plan of campaign for 1921, now being carried on by Hanson.
• 8.  Importance of this work: It should free the entire Pacific coast of South America from yellow fever—and permanently.

• 1.  In three different sets of experiments four guinea-pigs, five rabbits and one monkey (Macaccus rhesus) were inoculated directly into the blood stream, with blood containing P. falciparum.
• 2.  The plasmodia were proved to be living and viable at the time they were injected into the animals, by the fact that cultures put up at the same time grew and segmented.
• 3.  The animals remained apparently well and repeated blood examinations extending beyond the incubation period of malaria in man failed to show plasmodia in any of the animals except in one guinea-pig twenty-four hours after the inoculation. These plasmodia did not seem to have grown, although those in the corresponding culture in human serum had practically all grown beyond the ring stage found in the animal.
• 4.  The plasmodia in cultures in serum from the different animals failed to grow, although those in the corresponding cultures in human serum grew in the usual way.

• 1.  Alcoholic extracts of the pigment of yellow corn, rye, oats, and buckwheat possess fluorescent properties.
• 2.  Aqueous suspensions of these pigments produce photodynamic hemolysis in vitro.
• 3.  These data are not inconsistent with the theory of photodynamic action in pellagra. Obviously these experiments cannot be regarded as offering any substantial support of this theory unless successful experiments in animals are obtained.

On April 6, 1911, there was admitted into my service at the John Sealy Hospital at Galveston, a negro, Joe Bardy, from Kingsville, Texas. He was a brakeman on the Brownsville Railroad and brought a letter to me from Drs. M. E. and Amy B. Miles. The letter stated that he was referred because of an unusual and obscure infection and requested my assistance in diagnosing and treating the disease.

The patient was thirty-nine years of age, appeared quite ill, somewhat emaciated and weak.

Family history. Negative.

Previous illness. Yellow fever in childhood, rheumatism affecting the joints twelve years before, Neisserian infection several times, the last attack being eight months previously.

Habits. Were usual to his race and station and he was a heavy consumer of alcohol in the form of whiskey, beer and gin.

Present illness. Three months before he had observed a warty projection on the forehead just above the left eye.

The case, which forms the subject of this paper, was under the care and treatment of Dr. John M. McCleery, American Mission, Doleib Hill, Malakal, and I am indebted to him for the material sent for histopathological examination, as well as for the photographic figures 1 and 2 and the notes on the clinical history of the case.

The patient was that of a male, approximately thirty-five years of age, a native of the Southern Sudan, who came to the American Mission for treatment. This mission station is about 500 miles south of Khartoum, and obtains a number of patients from the various Nuer, Dinka and Shilluk tribes who frequent that district.

On examination, the patient was found to have a large indurated ulcerated area involving the lower part of the right nipple. The ulcer had existed for a period of nearly a year and was relatively painless. There was no previous history of trauma connected with the lesion.

INFECTION BY MONILIA PSILOSIS The writer has had to date over one thousand cases of typical sprue in the Island of Porto Rico. The cases were studied in four periods:

• 1.  A purely clinical series, 1908–1913.
• 2.  A clinical series, checked upon by mycological study of tongue, scrapings and feces, 1914–1917.
• 3.  A clinical series, checked upon by serologic study of patients' blood, 1920.
• 4.  An unfinished series, 1921.

The work upon the statistical data is not yet complete, but in general it can be stated that of 350 cases in the first two series, of which about one-half received in treatment one-sided diets, there were 29 deaths, 4 of which were due to complications. In these cases sugar of commerce and cereals were prohibited but the treatment was, in general, that recommended in standard works of that epoch on tropical medicine.

It is not my purpose on this occasion to deal with filariasis in itself, but mainly with its relation to other lymphatic conditions in tropical countries. There exists, in fact, a close connection, from a pathogenic viewpoint, between the various lymphopathies of warm countries, and it is my deliberate opinion that this has not been given due consideration.

In 1916, I published a work devoted to the peculiar action that the climatic factor performs upon the people living in said countries, and discussed therein other writers' views on the subject (1). I find however, that despite such contributions, certain erroneous concepts are still prevalent among physicians in and out of the tropics, and it is for that reason that I presently wish to insist upon some fundamental ideas on the matter.

It is not my desire now to treat such an important subject fully, since I have done so in the work already mentioned, but simply to confine myself exclusively to two of the different lymphopathic processes I have referred to.

Since the last annual meeting of this Society, it has suffered the loss of its most illustrious member, Major-General William Crawford Gorgas.

General Gorgas will be known to future generations as the Great Sanitarian of his age. History will emphasize the fact that he applied practically, on a large scale, the knowledge of the transmission of yellow fever by one particular species of mosquito which fact had been so thoroughly and so completely demonstrated by the Board of Medical Officers of the United States Army headed by Walter Reed; that through his initiative as a practical sanitarian yellow fever was banished from Cuba in an astoundingly short period of time; that his broad vision, comprehensive knowledge and practical application of the sanitary principles required in the prevention of disease made possible the construction of the Panama Canal. At the time of his death he was waging a contest with yellow fever in its final remaining strongholds in South and Central America.

Isadore Dyer was born in Galveston, Texas, November 2, 1865, and received his early education at private schools in that city. From 1880 to 1884, he attended the Bellevue High School, Bellevue, Virginia. He entered the Sheffield Scientific School of Yale University in October, 1884, and graduated with the degree of Bachelor of Philosophy in 1887; studied medicine for one year at University of Virginia and while there helped to found “Corks and Curls,” an annual which has a national reputation; entered the Medical Department of Tulane in November, 1888, and graduated in May, 1889.

From January, 1890, to June, 1892, he studied in New York City and was an interne in the New York Skin and Cancer Hospital from December, 1890, to June, 1892, and then spent several months in Europe, returning to Tulane in October, 1892, to become lecturer on skin diseases in the Tulane Medical Department, and in March, 1893, was appointed professor of diseases of the skin in the New Orleans Polyclinic.

Howard Benjamin Cross, eldest son of Mr. and Mrs. John K. Cross, of Waukomos, was born July 31, 1889, near Conway Springs, Kansas. In childhood he moved with his parents to Lamont, Oklahoma, where he later received his public school education. Later he entered the Tonkawa preparatory school. After graduation he taught two terms in a rural school near Lamont. In 1911 he entered the University of Oklahoma, from which he graduated in 1915, receiving the degree of Bachelor of Science. He taught biology in the Southwestern State Normal at Weatherford one year and zoölogy as assistant to Dr. Lane, University of Oklahoma, for three years. He was a graduate student at the University of Chicago and Johns Hopkins University, receiving the degree of Doctor of Philosophy from the latter institution in June, 1921.

In 1918 he enlisted in the United States army and was sent to Baltimore to assist in the work of the Johns Hopkins Army Medical School.

The eighteenth annual meeting of the American Society of Tropical Medicine will be held May 2 and 3, 1922, at the Hotel Washington, Washington, D. C., in conjunction with the twelfth triennial congress of American Physicians and Surgeons. Announcements as to details of the meeting of the Society and of the Congress will be duly mailed to members. Titles of papers received later than March 31 will not appear on the printed program.

The meeting this year promises to be of unusual interest and also affords an excellent opportunity for members to attend the meetings of a considerable number of other national medical societies which together with this Society constitute the Congress, namely, American Ophthalmological Society, American Otological Society, American Neurological Association, American Gynecological Society, American Dermatological Association, American Laryngological Association, American Surgical Association, American Climatological and Clinical Association, Association of American Physicians, American Association of Genito-Urinary Surgeons, American Orthopedic Association, American Pediatric Society, American Association of Pathologists and Bacteriologists, and American Society of Tropical Medicine.