348 BIRTHS, MARRIAGES, AND DEATHS

THE DIONNE QUINTUPLETSALTHOUGH the appearance and daily life of these

five attractive sisters has been made familiar to theworld at large by the screen and daily press, consider-able interest attaches to Dr. Allan R. Dafoe’s moretechnical account of their early life and feeding.He has already (Jour. Amer. Med. Assoc., 1934,ciii., 673) given an account of their birth and immediatetreatment, and in the January issue of the CanadianMedical Association Journal he carries their medicalhistory to the end of their first year.

Shortly after birth, the five infants were placedin a laundry basket and kept warm by means ofblankets heated in the oven ; later in the day itwas possible to obtain a hot-water bottle, and on thethird day an incubator was presented. Finally,there was a separate incubator for each infant ;the temperature was at first kept between 87 and90° F., and then at 84°, and by means of spongessoaked in hot water the humidity was maintainedat between 50 and 55. Being born two months beforeterm, the infants had the typical appearance of pre-maturity, breathed feebly and irregularly, and hadfrequent attacks of cyanosis and apncea. Withinthe first week a cylinder of 95 per cent. oxygen and5 per cent. CO2 was obtained, and the gas administeredas an

" aperitif " before feeds and whenever therewas cyanosis. This treatment was continued untilthey were three months old, by which time14 cylinders, containing 80 gallons of the gas, hadbeen used ! Dafoe gives details of the feeding, andincludes a set of weight charts that reflect everycredit on all concerned. The Hospital for SickChildren, Toronto, supplied breast milk from thefourth day until the fourth to fifth month, in amountsfinally reaching nearly a gallon a day. It is interestingthat at one point one of the infants was getting110 calories per pound body-weight, the daily caloricintake subsequently being gradually reduced to40 per pound. So far they have been free from infectionexcept for one attack of upper respiratory infectionand otitis media, and an attack of gastro-enteritiswhich affected all five patients. After removal ofthe infants to the Dafoe Hospital, built across theroad from their home in September, 1934, gown-and-mask technique was used continuously by allattendants.

Dr. Dafoe gives a humorous account of the recom-mendations for feeding and treatment that havereached him from all parts of the world-varyingfrom burnt rye whiskey to sheep’s dung in water.He does not emphasise the inevitable difficulties withwhich he must have been faced in a back-woodshome of the type in which the infants were born,nor the continual intrusion of pressmen and sight-seers. One cannot fail to be impressed, however,with the patient, ingenious, and successful way inwhich the medical care of the infants has been applied.

BILATERAL ECT OPIC PREGNANCY

A case of simultaneous bilateral tubal pregnancyis reported by S. J. de Vletter (Nederland. tijdschr.v. geneesk., 1935, lxxix., 5564). The patient,35 years of age, had had two other children andfour abortions. She was admitted to hospital com-plaining of acute abdominal pain and slight vaginalbleeding, the menstrual period being a fortnightoverdue. The uterus was found to be slightlyenlarged and the right tube could be felt as a distinctswelling. The left tube could not be felt. Thediagnosis was made of a right tubal pregnancy, andas there were no urgent symptoms immediate opera-tion was not undertaken. Next day there was anotherattack of pain, with signs of anaemia, and operationwas therefore performed. Laparotomy disclosed aruptured right Fallopian tube, with the extendedovum (measuring about 1’5 cm.) lying outside thetube in a mass of blood clot. The rupture was in theisthmus of the tube, which was removed. Theleft tube was seen to be ruptured at the same spotand was also removed. The patient made an

uneventful recovery. Histological examination con-firmed the presence of a bilateral ectopic pregnancy,both ova being apparently of the same age.

CERTIFICATION OF BLINDNESS

A CIRCULAR (No. 1520, ld.) issued by the Ministryof Health to those responsible for the administrationof the Blind Persons Act contains a warning that themethod of testing visual acuity by cards is liable togive varying results according to the degree of illu-mination. Acting on the advice of the Council ofBritish Ophthalmologists, they suggest that artificialillumination should be used in preference to day-light, and that the degree of illumination should benot less than 10 foot candles, setting out a methodof obtaining this degree. This is however not oneof the main difficulties with which the certifyingsurgeon is confronted. More important in doubtfulor borderline cases of blindness than small differencesin the acuity of central vision are defects in thevisual field, already restricted when one eye is blind,the presence of nystagmus, and the question whetherthe blindness is progressive, stable, or capable ofbeing improved by operation, treatment, or time.When all these have been considered, there maystill be room for difference of opinion in the inter-pretation of the phrase " unable to perform anywork for which eyesight is essential."

Births, Marriages, and DeathsBIRTHS

BAMFORD.-On Jan. 28th, at Ely, Cambs, the wife of Dr. BrianBamford, of a daughter.

BUCKTON.—On Jan. 29th, the wife of Dr. P. R. Buckton, ofWymondham, Norfolk, of a daughter.

CATTERALL.-On Jan. 27th, at Devonshire-place, the wife ofDr. R. C. F. Catterall, of a son.

GARLAND.-On Jan. 23rd, at Leeds, the wife of Dr. HughGarland, of a daughter.

HENSMAN.-On Jan. 29th, at Devonshire-place, W., the wifeof Dr. Stuart Hensman, Buckingham-street, S.W., of adaughter.

MARRIAGESKENNEDY—SHEPHERD.—On Jan. 25th, quietly, at Woodford,

Essex, Michael Leo Kennedy, M.B. N.U.I., F.R.C.S. Eng.,of Huddersfield, to Winifred Pearl Shepherd, of Highftelds,Chigwell.

DEATHSBATTLE.-On Feb. 2nd, at Horsell Common, Woking, William

Henry Battle, F.R.C.S. Eng., Consulting Surgeon, St.Thomas’s Hospital, late of Harley-street, London, in hisSlst year.

CHRISTMAS.—On Jan. 30th, at Bozeat, Northamptonshire,Major R. W. S. Christmas, M.R.C.S. Eng., late R.A.M.C.,B.E.F.

FABQUHARSON.—On Jan. 30th, at Chelsea, Stewart Farquharson,M.B. Lond., aged 41.

FORSBROOK.-On Feb. 3rd, 1936, at Victoria-street, London,S.W., William Henry Russell Forsbrook, M.D.

LUNN.—On Jan. 27th, at Olton, Birmingham, Cyril R. Lunn,M.B. Birm.

MACRAE.-On Feb. 2nd, at Newmill, St. Andrews, FarquharMacrae, M.B. Glasg., consulting surgeon, Western Infir-mary, Glasgow.

MARNOOH.—On Feb. 2nd, 1936, at 28, Albyn-place, Aberdeen,Sir John Marnoch, K.C.V.O., D.L., LL.D., EmeritusProfessor of Surgery in the University of Aberdeen.

PEARSE.—On Jan. 25th, the result of an accident, FrederickEdward Pearse, M.R.C.S. Eng., L.R.C.P. Edin., of Ripley,Surrey, aged 76. ’

PBIDHAM.—On Jan. 27th, at Burgh, Lincolnshire, CharlesFortescue Pridham, B.Chir. Camb., M.R.C.S. Eng.

ROB.-On Feb. 1st, 1936, in London, Joseph William Rob,O.B.E. M.D., of Oatlands Park, Weybridge, aged 59.

WAUGH.—On Jan. 29th, at Prenton, Birkenhead, AlexanderWaugh, M.B. Glasg., aged 71.

N.B.-A fee of 7s. 6d. is charged for the insertion of Notices ofBirths, Marriages, and Deaths.

GREENOCK HOSPITAL.—Provost Bell, on Jan. 27th,cut the first sod on the site of the Rankin MemorialMaternity and Children’s Hospital at Greenock. Thehospital is being given to the town by Miss M. D.Rankin at a cost of £40,000 and it is expected to befinished within eighteen months. It will have room

, for 56 beds.