i6 



NATURE 



[June 20, 19 18 



Medicine. Of in oflicers interrogated on the pro- 

 phylactic value of quinine in lo-grain doses twice 

 weekly, their opinions were divided, the majority 

 holding that it was of little or no value, and some even 

 saying that it was detrmiental. For treatment in an 

 advanced dressing station for three days, one officer 

 considered that quinine should be given in 8o-grain 

 doses daily. The majority (about 63 per cent.) were 

 in favour of 30 grains daily. 



For treatment after return to duty subsequent to 

 the above, nine officers advised stoppage of all quinine ; 

 seventy-three considered that the drug should be con- 

 tinued for from one to three and a half months in 

 daily doses, according to different opinions, of 10, 20, 

 or 30 grains. Some recommended gradual reduction 

 of the amount of daily quinine during the same 

 period. 



In treating cases following discharge from hospital 

 the treatment advised was much the same, the medical 

 officers expressing the same opinions practically as for 

 cases leaving dressing stations. Subsidiary treatment 

 was recommended by some. Continuance of quinine 

 until the end of the malarial season had also some 

 supporters. 



Both these papers include an account of a large 

 amount of work done by many skilled officers, and 

 should serve as a valuable guide to officers an3 medical 

 men who have charge of malarial cases or intend 

 carrying out further investigation work on this very 

 important subject. It is desirable that an effort be 

 made to ascertain definitely why quinine, so success- 

 ful in the majority of cases, should fail in others. 



An interesting addendum to the first report deals 

 with the excretion of quinine in the urine. It seems 

 that there is a tendency for the excretion of quinine 

 to reach a concentration of 7-1 1 grains per litre of 

 urine. These results obtained no. matter- what salt 

 was given or how administered, except, perhaps, in 

 the case of the lactate. F. W. O'Connor. 



SCIENTIFIC PROBLEMS OF DISABLED 

 SOLDIERS. 



\irE commend to the attention of our readeis the 

 ''* April issue of Recalled to Life, a journal edited 

 by Lord Charnwood, and devoted to " the care, re- 

 education, and return to civil life of disabled sailors 

 and soldiers." Its articles are written by men who 

 are seeking for practical solutions of the problems 

 presented by disabled soldiers— problems which are 

 both medical and sociological. Half of the men who 

 are wounded require special treatment for the restora- 

 tion of movement to damaged Ijmbs. Great military 

 hospitals have been, and are being, established in 

 various centres throughout the country for the treat- 

 ment of these orthopaedic cases. The establishment 

 of these great "orthopaedic" centres has been accom- 

 panied by a real educative movement, in which surgeon 

 and soldier have been equally involved. It is true 

 that no new principle of treatment has been intro- 

 duced; the old methods have been adapted to new 

 conditions and applied on a scale which no one had 

 ever anticipated. 



Sir Robert Jones, who contributes an article on 

 "The Problem of the Disabled," was the first to 

 realise that success in the treatment of orthopeedic 

 cases was largely a problem of education— to teach 

 soldiers how to bring back lost movements to damaged 

 joints by voluntary and natural movements of the 

 limbs. The introduction of " curative workshops " to 

 rnilitary hospitals is one of the most profitable innova- 

 tions of the war. Of the men treated in orthopedic 

 hospitals about three-fourths return again to military 

 NO. 2538, VOL. lOl] 



service ; the remaining fourth is discharged as unfit 

 for further service. It is now the business of the 

 Ministry of Pensions to look after the welfare of that 

 discharged fourth. 



Various writers describe the organisations which 

 are being brought into existence to meet the needs, 

 not only of the men discharged from orthopaedic 

 hospitals, but also of the large numbeVs rejected by 

 the Army on account of a permanent breakdown 

 in health due to exposure in the field, resulting 

 in rheumatism, tuberculosis, disordered action of the 

 heart or of the brain. To meet the needs of the dis- 

 charged unfit the Ministry of Pensions is establishing 

 throughout the country centres of treatment and super- 

 intendence. An ideal form of " village centre " for the 

 cure and training of discharged men is described by 

 Mr. Warwick Draper. Major Dundas Grant contri- 

 butes an article on the training of the deaf soldier. 

 Everywhere the importance of "self-help" is em- 

 phasised. Capt. Wilbur C. Lowry, of the Canadian 

 Army Medical Service, while giving an account of the 

 "remedial exercises" practised in the orthopaedic 

 gymnasium Granville Canadian Special Hospital, 

 Buxton, mentions the fact that the best teachers are 

 to be found amongst 'the men who themselves have 

 undergone gymnastic treatment. 



M 



CLIMATOLOGY OF PARISA 



FLAMMARION, in the comprehensive report 

 referred to below, not cnly gives a summary of 

 the meteorological conditions in Paris during the 3ears 

 19 15 and 19 1 6, but also carries the comparison of the 

 seasonal variations of the principal climatic elements 

 back to 1886. The year 1915 had a mean temperature 

 equal to 10-4° C, or 02° above the normal, while 1916 

 was in even closer accordance with the average. The 

 rainfall of 1915 was 574 mm., and of 1916 698 mm.,, 

 or respectively 3 per cent, and 22 per cent, above 

 the average. The author concludes that "in spite of 

 the frightful intensity of the cannonades; they have 

 exerted no influence on tlae rainfall in the region of 

 Paris." In 1915 less than half the average fell in the 

 months of March, May, and October, the only month 

 showing an excess being December, when, however, 

 the rainfall was more than double the average. This 

 was followed by a very dry January (19 16), with 

 less than a quarter of the average. Although some- 

 what wetter than 1915, no month in 1916 had 

 an excess of rain greater than one-third of the 

 average. 



Some remarkably low barometric pressures are re- 

 ferred to, the most notable being those of November 

 12-13, 1915, and November 18, 1916. On the former 

 occasion pressure fell to 723 mm. (2846 in.), the rise 

 after the minimum being extremely rapid, amounting 

 to 25 mm. (099 in.) in fifteen hours. On the latter 

 date pressure descended to 713 mm. (28-07 i"-)» ^^is 

 being the lowest reading in the vicinity of Paris since 

 December 24, 182 1. In 1915 temperature was some- 

 what abnormal, the coldest month, November, 

 having a mean temperature 4° C. lower than that 

 of December. In 19 16 the lowest temperature occurred 

 as late as March 8, while the month of June was 

 colder than May. An interesting diagram is given 

 for each year of the daily variations of the various 

 elements of climate, the phases of the moon being 

 also shown, as the author remarks that "the ignorant" 

 still continue to associate weather phenomena with the 

 lunar period. 



1 "Rapports suf les Travaux de la Station de Cli i ato!ogie agricole de 

 Tuvisy pendant les Annies 1915 et 1916." Par M. Camille Flammarion 

 Directeur de la Station. Pp. 41. 



