Congenital Hepatic-duct Malformation

BIUTISH I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ME JOURNALof his blood count elsewhere had given no signs of hyper- eosinophiUa, I had it re-exatnined in October, when a "hyper- coslnophil phase" of 11% was found.t. R. Rugeley publihsed a paper on allergic causes of prutitus ani recently (Annals df Allergy, 1946, 4, 374 and 396) and reported about 14 cases of pruritus ani in which a connexion with allergic causes was revealed and rapid imtprovement achieved by' treatment on these lines, whereas the conven- tional treatment, tried befote, had proved to be unsuccessful.He holds the opinion that excoriationis, oedema of the skin, thickening, or exudation vary in intensity, and that papillitis, fissures, and other changes thought to be causative factors are often secondary and not pritnary changes.He recotnends strongly that allergic causes of prutitus ani should be investi- gated before radical procedures are suggested, such as surgical interference, x-ray treatment, local injections, diisions of nerves, or tattooing of the anal margins with anaesthetics.-I am, etc., London, W.1.E. M. FRAENktL.Congenital Hepatic-duct Malformation Sitt,-Length of survival nmay warrant recording the follow- ing case.A female child 10 months old had been jaundiced since her normial birth.Weight records were: 7 lb.(3.1 kg.) at birth, 9 lb.(4 kg.) at 6 nionths, 12 lb. (5.4 kg.) at 10 months.Absence of breast milk had resulted in cows' milk feedings.Three older children were healthy.The child was lively and profoundly jaundiced.Her spleen