bluuebunny/crossref_metadata_2025_split huggingface dataset:
Round Table Discussion
Authors: SMYTH FRANCIS SCOTT 
Published: December 2021

Chairman Smyth: It is our purpose at this Round Table Discussion to discuss asthma in children with special emphasis on the practical aspects of such care.
A literal interpretation of the word asthma is "to breathe hard." This is the symptom in labored respiration after violent exercise, with oxygen lack in high altitudes, so also the lack of oxygen caused by circulatory and cardiac disturbances. Such usage of the term, "labored breathing" also implies a primary obstructive phenomena in the lungs, or a pneumonia. Thus, we find our differential definition requires further limitation. Asthma is really a symptom with many possible causes. So, for our own purposes of definition, we are going to limit the subject of asthma to those patients whose labored breathing is due to edema, secretions, and smooth muscle spasm induced by allergic sensitivity.
No element in the diagnosis is more important than the history of the patient. A good history cannot be obtained in one interview but is the result of persistence by the physician and of cooperation and understanding by the parents. A diary-like history kept by the mother will be invaluable. Many times we have interviewed anxious parents when the child was having an acute asthmatic attack, and got nowhere on the family history. You suspect there may be a bilateral allergy inheritance but you can elicit no information as to a constitutional inherited factor. This is equally true of the initiation of symptoms. The parents may deny any other allergic symptomatology, but as they begin to understand the problem, you will obtain further information extremely valuable for your study. The physician wants to know the season of the year in connection with the onset of symptoms, the locus of the first attack, has the child had repeated colds, any dermatitis of an allergic nature, etc. Once the intelligent mother has understood the problem, her observations can be as accurate as those of the physician, and in several instances, I have seen her come up with a solution of certain phases of the problem which has been very apt.
It seems unnecessary to mention the importance of the physical examination. In a sense, it is the clinician's scientific approach, i.e., accurate observation which not only clarifies the differential diagnosis to a great extent, but also brings to light the nutritional status, contributing infections, and the general make-up of the child. These are often of the utmost significance in any program designed to bring relief from the asthma, as well as to assure robust health.
TRENDS IN HEALTH LEGISLATION AND ADMINISTRATION
Authors: ALLEN RAYMOND E. , BLOEDORN WALTER L. , ANDERSON DONALD G. , JOHNSON JOSEPH L. , RUTSTEIN DAVID D. , REED LOWELL 
Published: December 2021

DURING the first four days of May, the National Health Assembly met in Washington. The Assembly which was called by Federal Security Administrator Ewing, at the request of President Truman, opened in a charged atmosphere. As expressed by one observer: some of the delegates came to Washington with eyebrows at top mast, freely airing suspicions that the four-day conference was a Democratic political expedient. That the Assembly avoided many of the pitfalls lying in its path was a notable achievement. Evidence of its success appears in an editorial of the Journal of the American Medical Association which credits Mr. Ewing and his associates for having dispelled the doubts and anxieties which had originally existed.
May 1, not only marked the opening of the Assembly, it was also, by Presidential proclamation, "Child Health Day." The subject of child health was therefore the central theme of the opening luncheon which was presided over by one of the past presidents of the Academy, Dr. Lee Forrest Hill, Dr. Hill reviewed for the Assembly the Academy's nation-wide survey of the existing medical facilities and services available to children. He also described briefly the formation of the continuing committee—the Committee for Improvement of Child Health—charged with the responsibility of analyzing the hardwon facts and translating them into an action program.
The Assembly's assignment was a formidable one: to review the whole field of health and to set forth the feasible goals which might be realized in the next decade. In order to cover as much ground as possible, 14 sections were formed. The subjects assigned to these groups and a list of their Chairmen are an interesting array:
Section 1. What is the Nation's Need for Health and Medical Personnel? Algo D. Henderson, Chairman.
Section 2. What is the Nation's Need for Hospital Facilities, Health Centers and Diagnostic Clinics? Charles F. Wilinsky, Chairman.
Section 3. What is the Nation's Need for Local Health Units? Haven Emerson, Chairman.
Section 4. Chronic Disease and the Aging Process. James R. Miller, Chairman.
Section 5. A National Program for Maternal and Child Health. Leona Baumgartner, Chairman.
CLINICAL USE OF ALCOHOL-REFINED TOXOIDS
Authors: RUEGSEGGER J. M. , LOOSER G. K. 
Published: December 2021

Alcohol-refined toxoids of diphtheria and tetanus were inoculated into 31 adults and 550 children.
These alum-precipitated toxoids are associated with many fewer and less severe reactions, both in adults and children, than those following the use of ordinary toxoids.
Within the limits of a year's observation after inoculation, such toxoids appear to be able to stimulate an adequate and durable immunity as adjudged by serial antitoxin titrations.
GUIDANCE IN MATERNAL AND INFANT CARE TWO MONTHS BEFORE AND AFTER THE BIRTH OF THE FIRST-BORN
Authors: CLAY AUGUSTA STUART 
Published: December 2021

THIS study was made in the belief that family living and growth can be healthier if parents understand how mother and baby develop and what they need.
Eleven mothers were visited weekly for two months before and after the birth of their firstborn to discover what guidance they wanted, what was offered, and what additional guidance was needed. The writer secured their cooperation by agreeing to work with them as a consultant, to interpret their point of view to the doctor, to explain medical instructions when permitted, and to teach the normal growth processes of mother and baby.
Ten mothers were registered in the prenatal clinics of the New Haven Hospital; the eleventh had a private physician. They had no recorded problems beyond the needs of healthy pregnancy and they wanted to participate. Eight husbands agreed to take part in the study. The other three were overseas, but their wives reported for them. Backgrounds varied; 20 of the 22 had had college or high school education; all were between 18 and 32. None dropped out, and after the four months all asked for continued guidance.
Cases were too few and the study too brief for statistical evidence. But problems were uncovered which needed to be considered and which have largely been neglected in routine obstetric and pediatric care.
These parents wanted to learn—not in classes, but in the privacy of home—how to care for mother and baby without disrupting their accustomed way of living. All wanted the care and interest of one doctor for mother and one for baby. However, six women and five men preferred to talk with a consultant who was not a doctor, but who was affiliated with their doctors. The doctors seemed too busy for "little things" and "family affairs," and they saw so many doctors that they all seemed strangers. Once they felt sure that the consultant's interest was in themselves rather than in teaching them, they set the pace and pattern in the conference. There was no questionnaire, no probing, no set procedure. If they had any immediate interests or problems: job, move, presents, trips, in-laws, illness—these were discussed before they talked of pregnancy and baby.
REPORT OF THE MEETING OF THE ACADEMY EXECUTIVE BOARD
Authors: GRULEE CLIFFORD G. 
Published: December 2021

A special meeting of the Executive Board of the American Academy of Pediatrics was held at Hotel Statler, Buffalo, N.Y., on Thursday, April 29, 1948. The meeting was called to order at 7:50 P.M. by the President, Dr. John A. Toomey. There were present Drs. Toomey, Sisson, Pease, Martmer, Grulee, Stringfield, Beaven, Barba, London, Wishropp, Munns, McElhenney, Spickard, McLendon, Snedeker, and by invitation, Drs. Joseph S. Wall, Coursen B. Conklin and John P. Hubbard.
It was moved, seconded and carried that when speakers are asked to appear on programs at meetings, they should receive 7½¢ for travel, and ten dollars a day for the time in service at the meeting. When they ask to appear on programs at meetings, they should not be reimbursed.
The Board went into executive session and after due deliberation the following resolution was adopted: "A committee of three members of the Executive Board shall be appointed to confer with the Board of Trustees of the American Medical Association and place before them the proposal, which has been passed by the Executive Board of the Academy, that there should be Federal subsidy for the teaching of pediatrics in the medical schools."
The President appointed the following Committee: Drs. Beaven, Sisson and Munns. Dr. Harvey F. Garrison, representing the Academy as liaison officer to the American Medical Association, was added to this Committee.
The meeting recessed at 11:50 P.M. and was called to order at 9 A.M. April 30, 1948, by the President.
It was moved, seconded and carried that any statements being made public by the Committee for Improvement of Child Health should be reviewed and approved by Drs. Wilson, Hill and Webb.
It was moved, seconded and carried that a representative of the Academy be empowered to place before the House of Delegates of the American Medical Association our resolution opposing S-1290 as written in the action taken at the February 1948 meeting.
It was moved, seconded and carried that the Committee to the American Medical Association be empowered to ask Dr. Harold H. Mitchell, Chairman of the Academy Committee on School Health, to accompany the Committee as an adviser during the conference with the Trustees.
A motion was made and seconded that Dr. Hubbard, as Director of the Committee for Improvement of Child Health, be encouraged and empowered to go ahead and seek funds for the Committee.
THE PEDIATRICIAN AND THE PUBLIC
Authors: HARPER PAUL 
Published: December 2021

The recommendations that federal tax funds be used for the support of pediatric education which were prepared by the Committee for Improvement of Child Health and approved by the Executive Board of the American Academy of Pediatrics are supported with the following reservations:
a. The recommendations of the Academy should acknowledge the need to strengthen the entire field of medical education while maintaining the Academy's qualification to speak for the pediatric aspects.
b. The recommendations should more clearly emphasize the desirability of extending medical training by an affiliation between outlying hospitals and medical centers. The purpose is more and better training in pediatrics for general practitioners as well as for pediatricians.
c. The recommendations should be amended to strengthen the position of the proposed advisory council on medical education and to require that there shall be no interference with academic freedom to develop medical education and to investigate disease.
Give Your Child A Chance
Authors: ALDRICH C. ANDERSON 
Published: December 2021

This book adds another volume to the many already published on the subject of child care. Its preface and foreword are written by Donovan J. McCune, M.D., and Norvelle C. LaMar, M.D., respectively, who endorse the author's statements.
There is little in the way of advice to which I would not subscribe. In fact it is remarkable that So many pages can be filled with so much advice which is highly acceptable. Miss Turner has done a masterful job of summarizing the liberal ideas of our times. However, one begins to doubt the efficacy of any book so full of instructions without an adequate discussion of the "whys" of liberal ideas.
MULTIPLE CYSTIC TUBERCULOSIS OF BONE
Authors: KREIDBERG MARSHALL B. , DOWNING DANIEL F. 
Published: December 2021

Cystic tuberculosis of bone is an uncommon but by no means rare disease. It is often confused with syphilis, pyogenic osteomyelitis, malignant tumor, polyostotic fibrous dysplasia, eosinophile granuloma and other disorders which affect the skeleton. The diagnosis depends, first, on familiarity with the condition; second on the histologic features of material removed by biopsy; and, finally, on the demonstration of tubercle bacilli by guinea pig inoculation or by culture in the purulent discharge or in the excised tissues of the sinus.
A report of an exemplary case is presented.
AN OUTBREAK OF NAUSEA, VOMITING AND DIARRHEA ON A MATERNITY SERVICE; TRANSMITTED TO A CHILD CARING INSTITUTION AND TO PRIVATE HOMES
Authors: ABRAMSON HAROLD , FUERST HAROLD T. 
Published: December 2021

An outbreak of epidemic nausea, vomiting and diarrhea in newborn infants is described. The communicability of the disorder is demonstrated by its direct spread to the residents of a child caring institution and to the occupants of a nearby tenement house. We are in agreement with the observations of Brown, Crawford and Stent and those of Cook and Marmion that the condition is a relatively mild one in newborn infants and that it should not be confused either clinically or epidemiologically with the syndrome epidemic diarrhea of the newborn.
A differential diagnosis should be made between this disorder and epidemic diarrhea of the newborn, salmonella infection of the newborn, and the diarrhea accompanying stomatitis in young infants, and should be based on clinical and epidemiologic factors.
Outbreaks in nurseries for newborn infants should be studied carefully and indiscriminate grouping of cases avoided. Distinctive and constant clinical and epidemiologic features should be sought in each outbreak to separate it from the general group of diarrheal disorders of the newborn.
Round Table Discussion
Authors: PETERSON J. C. 
Published: December 2021

Chairman Peterson: In this discussion we will attempt to clarify concepts concerning the use of skin testing material in the diagnosis of these two fungus infections. We will also attempt to show the relationship of minimal mild infections to the more serious infections.
Until the recent past, most of us have considered fungus infections to play a very minor or unimportant role in the production of disease process in children. All of us have been more or less aware of the fact that thrush and certain dermatomycoses are commonplace in early infancy and childhood respectively but serious infections are so rare that they are of little significance. In general, fungus infections have seemed to play an unimportant role in the spectrum of disease processes; only occasional rare severe infections being recognized.
In recent years we have been forced to the realization that fungus infection—generalized fungus infections—are much more common than we had previously suspected and that many of these infections have remained unrecognized or they have masqueraded under false pretenses and have been classified as other diseases.
The study of coccidiomycosis in California first pointed out the fungus infections, which have been recognized only as a generalized serious infection, might also exist in a much more benign form and might have a course which is entirely asymptomatic or nearly asymptomatic. In most of the fungus infections the recognition of the severe form of infection has antedated the recognition of the benign forms of infection. That is true of both of the fungus infections which we will discuss today.
The discussion of coccidioidomycosis will be led by Dr. Russel Mapes of Beverly Hills, Calif., who—though he is a practicing pediatrician—has had extensive experience with coccidioidomycosis in his work in the Army.
Dr. Mapes: Coccidioidomycosis is an infection caused by the fungus Coccidioides immitis. It may occur as a mild, even inapparent infection, or in the more common pulmonary form which is self-limited and without sequalæ, or it may appear as the progressive disseminated disease known as coccidioidal granuloma. The history and background of this disease is interesting.
THE PEDIATRICIAN AND THE PUBLIC
Authors: HARPER PAUL 
Published: December 2021

OUR attention has been called to two corrections which should be made in the letter of Dr. Thomas O. Gamble as it appeared in this column in the September issue of Pediatrics Dr. Gamble writes:
"On page 365 I quoted the first objective of the Association of American Physicians and Surgeons. Quotation marks should have been placed at the end of the two sentences which are enclosed in parentheses. Anyone reading my letter might assume that the last two sentences represented my interpretation of the first objective. So, while I agree entirely with the objective and its interpretation, I should not be given credit for something which belongs to the A.A.P.S."
The second correction is made in the letter from Dr. William J. Orr, Buffalo, New York, which is published below.
Dr. Myron E. Wegman and Dr. Ralph V. Platou, Professor and Head, Department of Pediatrics, respectively of Louisiana State University of Medicine and Tulane University School of Medicine have polled the professors of pediatrics throughout the country to ascertain their experience with federal funds. The results of this survey are summarized in their letter.
AUTHOR'S REPLY
Authors: BIRDSONG MCLEMORE 
Published: December 2021

Your letter of July 26 was received and I will be glad to reply to Dr. Smyth's letter.
For your own enlightenment, we have reviewed the slides on this case and not only were the organisms found, but on two occasions about six months apart the biopsy showed typical pathologic changes of tuberculosis. The negative tuberculin that we experienced in this child can be explained on an overwhelming infection in that the child was quite toxic in the hospital and died within a couple of weeks after being discharged.
SALMONELLA OSTEOMYELITIS AND ABNORMAL HEMOGLOBIN DISEASE
Authors: Silver Henry K. , Simon Jimmy L. , Clement David H. 
Published: December 2021

Two cases of salmonella osteomyelitis and abnormal hemoglobin disease are reported; the first in a white boy with combined sickle cell-Mediterranean anemia and the second in a Negro girl with hemoglobin C-D disease.
One case represents the first reported instance of salmonella osteomyelitis occurring in a patient with a mixed heterozygous hemoglobin disease while the other is the first observed in a patient with a hemoglobinopathy without sickling.
A complete review of the literature is presented.
ON THE ACCEPTANCE OF SOLID FOODS, AND OTHER FOOD PATTERNS, OF INFANTS AND CHILDREN
Authors: Beal Virginia A. 
Published: December 2021

Serial nutrition histories have been taken since 1946 on 65 children enrolled in the Child Research Council series. As the age of introduction of solid foods into the diet has become progressively earlier over a 10-year period, the number of infants refusing to accept these solid foods when first offered has increased. The average age of willing acceptance of cereal is 2½ to 3½ months, of vegetables 4 to 4½ months, of meat and meat soups 5½ to 6 months; fruit has been accepted at progressively earlier ages and is now accepted at 2½ to 3 months. The age of transition from prepared baby foods to the family's diet has decreased from approximately 2 years to 13 months. No benefit, as reflected by concentration of hemoglobin, mean corpuscular volume or mean corpuscular hemoglobin concentration, was observed with high intakes of iron from prepared infant cereals.
The curve of intake of nutrients rises rapidly and smoothly in early infancy. During the preschool period there is a marked decrease in appetite and while calorie intake continues to rise slowly, protein intake reaches a plateau and calcium intake decreases markedly. Median milk intake between 2 and 3 years of age is 16 ounces daily. After 3 years the intake of all nutrients rises.
NONADRENAL FEMALE PSEUDOHERMAPHRODISM AFTER ADMINISTRATION OF TESTOSTERONE TO MOTHER DURING PREGNANCY
Authors: Grunwaldt Edgar , Bates Talcott 
Published: December 2021

THE DIAGNOSIS of nonadrenal female pseudohermaphrodism should be based on the following criteria: (1) the external genitalia should show hypertrophy of the clitoris and some degree of labial fusion; (2) in infants, measurement of 17-ketosteroids or pregnanetriol should be performed to rule out the adrenogenital syndrome; in older patients this syndrome can be ruled out clinically by the lack of precocious puberty and progressive masculinization; (3) laparotomy should reveal a female internal genital apparatus, and (4) adequate biopsies of both gonads should show normal ovaries, excluding the possibility of ovotestes and true hermaphrodism.
The subject of pseudohermaphrodism is adequately covered by Wilkins et al. in a recent article in which 12 cases of nonadrenal female pseudohermaphrodism are mentioned; however, not all of these meet the four conditions described above. There are two in the literature in which pseudohermaphrodism followed the occurrence of masculinizing tumors (arrhenoblastoma) during pregnancy, but no mention was found of a case in which testosterone had been administered to the mother.
CASE REPORT
History
This infant was the first born of a 28-year-old white woman who consulted her obstetrician because of nausea and vomiting 10 weeks after the onset of the last menstrual period. On that day 100 mg of testosterone propionate was administered intramuscularly, and 10 mg of methyl testosterone three times a day was prescribed. Three days later another 100 mg of testosterone propionate was administered. She had taken 30 mg of testosterone by mouth daily for 51 days when administration was discontinued because of deepening voice.
MECHANISMS CONCERNED WITH APPETITE
Authors: Brobeck John R. 
Published: December 2021

THE TITLE given to this paper is a bit inappropriate for a discussion in physiology, since the word "appetite" has a psychologic rather than physiologic meaning. Both hunger and appetite, as well as satiety, refer to sensations or affective states, and none of the three words has an accurate or precise definition. In the following discussion they are used only for convenience, and with only their common English meanings. They cannot be studied directly in human infants nor in laboratory animals, but only indirectly by simple observation as to whether food is or is not accepted, or by noting the amount of food eaten or the rate of eating. Perhaps a better title is "Mechanisms that regulate intake of food," using the word, "regulate," as it is used in the case of respiration. For example ventilation of the lungs is said to be regulated through the interaction of respiratory centers, reflexes, stretch receptors and chemoceptors. Analogous mechanisms doubtless serve to regulate feeding.
Like the regulation of respiration, the control of intake of food is one of the important functions of the central nervous system. The digestive apparatus is concerned only in a limited way and that as a system regulated, rather than as the regulator. Sherrington noted as early as 1900 that feeding persists after operations upon the stomach, including nearly complete removal of the organ. If such an operation leaves the tract adequate for digestion, it does not lead to any primary, quantitative disturbance of feeding behavior. Similar conclusions may be drawn from observations upon patients who have undergone the several types of operation upon nerves supplying the stomach and intestine, including patients subjected to vagotomy.