514

TUB ANTISEPTIC)

[VOL,. 4 1 , MJ ft-* AI O 'Li) A C A S E O f L U U K ^ E M I A I N A HABIT O F 3 M O N T H S M . C11ANDA 515

genitals, each reaching its maximum relative importance in that ord^K^^p time of development. Ultimately in the normal course of. event'a8f|||pll genital area predominates. SADGER added the hypothesis that ' " - ^ I ^ ^ ^ S life, regressive processes may lead to reanimation of interest in the1?ff|f||f|i region and accounts for the tendency to pruritus ani in later life;; s . ' S | l | p ; ^ (4) Skin is an organ of appreciation of pain. In some individual^^S becomes of special importance in relationship to deep-seated emdti"^. trends such as feelings of guilt. 'S^^^B-. (5) Skin at a vehicle of hypochondriacal tendencies-hypochoridrj.^^^S preoccupation with the skin. It is very commonly seen amongst WOVMBSS*" who never feel clean until they wash many tiines either their hands or plates. DR. GiULEsriE saw once an interesting family group|<^Ktf illustrates a variety of the ways in which the skin may become the*HH||I| of hypochondriacal trends in the personality. Father, mother and d a u S ^ ^ all believed themselves to suffer from a parasitic affection of the s k i i f j j ^ ! continually washed and disinfected with lysol. sWy

'J As regards treatment the patients were advised complete rest. Khesari dal was stopped in the diet. Vitamin B was administered paren'torally as well as orally. Fresh fruits and green vegetables were given. Calcium and Bromide were also given. After the administration of vitainin B it was found that the lumbar p pain \yaa much decreased and the p patients re able gradually to lk b t f l i h h frere able gradually to walk about freely without any help, but spastic gait was still present on close observation.
I flm g r a t e f u l t o tlio Civil S u r g e o n , J ^ a y a , l o r h i s kiiiil p e r m i s s i o n t o p u b l i s h t h i s a t i i u l e .

A Case of Leukaemia in a Baby of 3 Months

tit

MANOHANJAN CHANDA, " Chanda Niketun ". Munikganj (Dacca).

i|fJSeptember last 1 was called in to see a baby (male) patient 3 months |||>ld for bronchitis from which he had been suffering then for the last llgays. The baby was found to be fairly well developed, well nourished ljp;,of mild disposition (not irritable), but slightly ansernic. The throat iSyas:congested, one tonsil was slightly enlarged. The spleen was 3", liver Cases and Comments Sl^below the costal margin. No abnormality was noticed in the heart, lllttrigs, digestive system or in urinary or central nervous system. The Lathyrism |gl|[|by was somewhat constipated. Temperature was 98'2 F. Next day of S. K. AHMAD, . :;' feyj.visit the patient vomited a considerable quantity of yellow liquid in Medical Officer, Safdar Memorial Hospital, P.O. Milaky (Oaya), tiihar.-. ihe'morning and temperature rose upto 10()'F in the evening. 1 suspecfeS.it to be a case of malaria which was prevalent at the time in an epiATHYKISM IS a deficiency disease but fortunately it is not so ilmic form. I prescribed him Quinine Ethyl-carp, Seroline, Calcium, as rickets or beri-beri. Its .'etiology is not definitely known.,; ijfllk of Magnesia and a mild throat paint but no improvement was believe that it is a chronic food poisoning caused by the ingestion of m ^ p ^ Noticed. On the third day of treatment it struck me that it could not he and others claim that it is d^ue to the too frequent use of khesari ; ,^B@ Infattaek of malaria or K.A. but some other ailment. diet. Maize and khesari may be the causative agents but the diseijjjgipi j | | : ; I advised the relatives of the patient to get the blood examined. No also found in places where maize and khesari are not used by thepfe^^K? at all. Some authorities say, that it is caused by the deficieny of v i t ^ ^ S |||||ialarial parasite was found in the blood ; in diff. count, there was indicaP|||priof K.A. The patient was sent to Calcutta for further treatment B and it affects only those whose diet is deficient in vitamin B. Khesr||pl| ^^d' there the attendant physician decided to push Neostibosan. Before is a very common food in this locality but so far I have come aorosjp||||| ""ffiection the blood was again examined and from the result of examinafew cases of lathyrism. ;v5Sfft : Jjfon'the disease was diagnosed to be a case of leukaemia. Many eminent Lately, I have come across six cases of this disease, threer.froM ijlpy'sfiiaris were consulted in Calcutta but with no satisfactory result, village abd the rest from three different villages. All gave a W s t | ^ | | | | jpjfe.patient died in the latter part of November, 1943. The fever ranged having taken khesari dal (not maize) for months together. All;cas*e|i: !& 98 F to 101" F (irregular, intermittent). Spleen was enlarged upto from the poorer classes and they were males below the age of r.2QijlI| ijppjPel and was hard and not tender. No anorexia was present. The None gave any history of venereal diseases. The patients are v ^ r J | ^ ^ S jlitient was somewhat constipated from the beginning of the attack. their food lacking inmost vitamins. They could not afford to tak"e||l||| ssJlBroiichitis was increased at the time of death and patient was emaciated : or fresh fruit. . / . -^^M g^fd'aneemicl'' Diet was breast milk and lactose. The main signs and symptoms resembled those of lateral Bcleroli||||L |The treatment was Ferr et ammon citras, Liq. Arsenicalis, Glycerine, the spinal cord. The patients first feel weakness of the legs.'1"."T|^^d^^ hvtab. with liver powder, etc. Deep X-ray exposures were given. The pain in the girdle and difficulty in walking and getting up from be<p|li| Srwas diminished (3 fingers) after X-ray therapy. On the whole 8 foot feels heavy on walking. In a full developed case there iS^gj^-rag Jiosures wore given. lumbar pain, the lower extremity is rigid, the gait spastic, the k n ^ ^ ^ g S/Blood report:Before X-ray exposure. exag"erated and the patient cannot stand erect. Later he is unajfifl JL~7-1'0-'43. Total leukocyte count 44,450 per emin. ; total erythrocyte stand up or walk about without the help of others. The upper ex'tf rant 2,030.000 per cram.; haemoglobin 40% ; diff. leukocyte count Polywas found normal in all cases. Sphincters were not involved in an|? ipi'rphonuclear neutrophils 13%; lymphocytes 85%; polymoiphonudcar There was general debility in all cases, and complaint of insomnia^d^i Sinophils 1% ; blast cells 1%; plenty of normoblasts and evidence of acute pain. No other abnormality was detected except irregularit|||p|||| Inisocytosis and poikilocytosis. b,owels and. loss, qf appetite, ;^I^S llp-'Routine blood report:After X-ray exposure,