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Digitized by the Internet Archive in 2016 https://archive.org/details/journalofiowasta4611iowa mm Strep sore throat responds readily to OTYCIN (Erythromycin, Lilly) Temperature normal, throat culture negative, usually within twenty-four hours. The chance, therefore, of marriage between two heterozygous individuals is very remote, and even if such a mating occurs, the odds are 4: 1 against a homozygous or defective child being bom to them. Atten- tion has been called to the fact that the clinical material at the world’s largest hospital, Eloise, in Detroit, is not being used for teaching purposes. With each advancing decade, in short, the American people (and the world) are receiving better and better medical care.

DILANTIN Sodium is supplied in a variety of forms— including Kapseals® of 0.03 Gm. If one takes into considera- tion the rarity of the disease, he can see that the incidence of heterozygousity must be extremely low. The University of Michigan and Wayne Univer- sity educated no more than 38.3 per cent of the physicians now practicing in the state, and a year- ly average of 266 are coming from outside. MAQUOKETA In this day and age, fewer people are dying from acute illnesses, and more and more are living long enough to become the victims of the heart diseases, cancer, arteriosclerosis and strokes, both large and small, or the progressive entity of senil- ity.

37 Cooperation Among Professions 38 Hitherto Unrecognized Talent 38 Attention, G-P’s 39 Erythroblastosis 39 American Heart Association Reaches Maturity .... xxxix Six-Day Course for G-P’s at Denver xxxix American Academy of Allergy xxxix COPYRIGHT, 1955, BY THE IOWA STATE MEDICAL SOCIETY EDITORS Everett M. Except for hemophilia and possibly the newly discovered entity variously called plasma thrombo- 1 2 Journal of Iowa State Medical Society January, 1956 plastin component (P. C.), Christmas disease or hemophilia B, all the known hereditary bleeding diseases are transmitted as non sex-linked.

D., Iowa City 21 State University of Iowa College of Medicine Clinical Pathologic Conference 28 EDITORIALS Happy New Year! In none of them is there valid evidence that the bleeding is caused by an in- hibitor or by an excess of an anticoagulant.

The discovery of the labile factor in 1943 1 initiated a new development which has led to the discovery that prothrombin activity requires at least two accessory and additional factors, the la- bile and the stable factors, and that the formation of thromboplastin depends on platelets and two or more plasma constituents, one of which, thrombo- plastinogen, is deficient in hemophilia.

The disease undoubtedly has been confused with mild hemophilia on occasion, and von Willebrand had some justification in referring to it as “pseudohemophilia.” HEMATOLOGIC HEREDITARY BLEEDING DISEASES (hematostaxis) According to the classical theory, thromboplastin and calcium react with prothrombin to form throm- bin.

Rather, they are important sources of information not only in regard to hemorrhage but also in regard to the nature of heredity. 2 In all of the known hereditary diseases, a clotting factor is lacking. The reality of these new factors has been conclusively proved by the discovery of congenital clinical conditions in which a particular factor is markedly depleted.In the same family group, one of the other children, a boy, and one of the grandfathers were heterozygous. My own experience in general practice has been short, but since it has yielded me several ideas that appear valuable, I am sure that the minds of other gen- eral physicians must be well-filled storehouses of technics and information from which the medical profession might benefit, were it not for their reluctance to write for the journals.It is highly probable that con- genital labile-factor deficiency has a similar heredi- tary pattern. This hesitancy, I am sure, is due to a feeling of humility on the part of the general practitioner.

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Whether the abnormality in von Wil- lebrand’s disease is intrinsically in the vessel or whether it is in the blood remains undetermined. It is particularly confusing that the bleeding time may at times be normal and at other times be marked- ly prolonged.

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