1. Three cases of situs inversus are described and the clinical and aetiological factors are discussed briefly.
2. This abnormality occurring in father and son whose family history indicates a great degree of consaguinity seems to support the view held by Cockayne that it is a recessive inheritance.
3. Situs inversus when complete seems to cause no disability. When incomplete as in examples of isolated dextrocardia, congenital heart diseases are commonly seen in association with it. Other congenital malformations may also co-exist. Recently the syndrome of hypertrophic rhinitis, nasal polyposis and sinusitis and bronchiectasis have been encountered in association with transposition of the viscera.
Lower Perak, an alluvial plain, much of it below spring tide levels, lies between tidal reaches of the large Perak and Bernam rivers. It has a mixed rural population, about 40 per cent. being Malaysians. Inspection, with individual card records, was made of 2, 388 boys in vernacular schools aged 6 to 16 years, local prejudice exempting girls. The diet, largely rice, of these children appears deficient in animal protein, and probably in calcium, iron, phosphorus, and vitamin B. They show few signs of deficiency diseases, have a dental caries rate of about 70 per cent., and one-third had poor muscular development. They suffer mainly from fever, anaemia and skin infections. * An asterisk denotes that the paper dealt with is thought to be of more than ordinary interest to tropical readers. As ages were quite unreliable, only the 513 presenting birth certificates were grouped to the nearest birthday. [img 1T161260A.tif] Comparisons are made with the Baldwin-Wood scale for American medium type boys, who at every age are of superior weight. Full correlation tables are given for the 513 and 2, 388 boys. To eliminate doubtful ages the, Baldwin-Wood tables were used to calculate the mean weights of Americans at the height of the Perak boys, and now the Americans only [img 1T161260B.tif] come out slightly higher than these. The essential difference therefore seems to be more a matter of size and physical development in relation to age, than any significant change in-ratios at different ages. Comparison was made with Kedah measurements. This is a similar district 120 miles north of Lower Perak. Curves are used which are not strictly comparable, as some girls were included, but Dr. J. H. STRACHAN took out the figures of 1, 018 Kedah boys. These are compared with the 2, 388 Perak boys, in weight for inches in height. Although the conditions and districts seem in all respects similar the Kedah boys are significantly lighter for all heights. No explanation has been found for this. The authors insist on the usefulness of correlation tables. " It is obvious that the medium American boys are much heavier than the Malaysian children. But the second American weight/height curve seems to show that if one selects for comparison boys of the same stature at each age, the American boys would be on the whole only slightly heavier than the Lower Perak boys." This investigation has got the utmost value from rather unpromising materials. Any school worker will gain some new viewpoints from its careful perusal. James Kerr.