John R. Williams

HAZARD OF METAL FOIL ON CANDY AND TOBACCO

To the Editor:— Your answer to the letter of inquiry from Dr. Charles Stover (The Journal, May 2, p. 1590) regarding the hazards of metal foil on chocolate is timely. Probably the hazard from the use of tobacco packed in foil is quite as great. Recently a bookkeeper, aged 60, consulted me, complaining of self-diagnosed gout. The symptoms and signs were pain in both legs, swelling of the base of the right great toe, and deposits suggesting tophi at the base of the great toe and the second toe. Other symptoms were loss of appetite, extreme nervousness, muscle twitching and mild weakness. According to Peters and Van Slyke, lead poisoning has long been recognized as a cause of gout. They cite Magnus-Levys thirty-six cases of gout, thirteen of the patients having definite lead poisoning and six others presumably having it. With this in mind the patient was questioned closely as

PROBABLE PLACENTAL TRANSMISSION OF TUBERCULOSIS.

Because of the scarcity of data on the subject of placental transmission of tuberculosis, the following is deemed worthy of report: Patient. —Mrs. K., aged 30, American housewife, eight months pregnant. History. —Patient complained of cough, night sweats, failing appetite and loss of weight; she gave a family history of tuberculosis, one sister who had lived and slept with her having died of the disease a short time previously. Examination. —The chest anteriorly and posteriorly revealed typical signs of tuberculosis in apices of both lungs. There was a loss of weight of 20 pounds in ten weeks in spite of pregnancy. The sputum contained both elastic tissue and tubercle bacilli. Subsequent History. —One month later, patient in normal labor, gave birth to a full-term, apparently healthy, 7-pound boy. The placenta and cord were immediately placed in 4 per cent. formalin solution and sent to Dr. A. S. Warthin, Ann Arbor,