South African Medical Journal - Volume 27, Issue 29, July 1953

1. Much blindness in the Bantu results from corneal lesions for which there are 2 main causes. The first of these is trachoma, an infective disease: and the second is leucoma of which the principal cause is bacterial conjunctivitis. 2. Trachoma alone was responsible for a blind rate of 781 per 100,000. On a previous survey a blind rate of 1,190 per 100,000 was found from leucoma alone. The blind rate for Europeans in South Africa is 91 per 100,000 (all causes). 3. Poleff's stain for trachoma inclusion bodies gave unsatisfactory results. In our experience the basophil mast cells are clearly defined by this method but the true Halberstaedter-Prowazek bodies remain unstained.

The middle lobe syndrome is being studied extensively nowadays. The anatomy of the middle lobe and its bronchus with lymph gland arrangement, soft bronchial walls and the presence of infection, predispose to this syndrome. Diagnosis is confirmed by X-ray studies, especially the lordotic projection, where the typical triangular shadow is seen more easily. Tomography and bronchography are of value, the latter especially for the demonstration of bronchiectasis. Bronchoscopy is valuable not only as a diagnostic procedure, but also for therapeutic purposes. This paper reports a study of 25 cases of middle lobe syndrome. Symptoms of chronic cough, haemoptysis, pyrexial attacks and loss of weight are indications for the above-mentioned special investigations. Proved pulmonary tuberculosis was found in near contacts of most cases although Koch's infection was not proved in the majority of the cases studied. Sometimes the middle lobe syndrome was discovered acidentally in the absence of symptoms. A few cases cleared up spontaneously. Others remained unchanged, or became worse in spite of antibiotic treatment. In the latter group of cases, because of continuous bronchial obstruction, resection is indicated. It is as yet uncertain for how long conservative treatment should be continued before deciding on surgery.

A case of exenteration of the orbit is descriptionbed, in which convalescence was considerably shortened by the application of a skin graft, and an excellent cosmetic result obtained by a satisfactory prosthesis.

*A report presented to the South African Medical and Dental Council in March 1952.