Soft sore or soft chancre produces a painful ulcer on the genitals.

The pain tenderness and soft feel of chancroid distinguish it from the painless hard chancre of primary syphilis. It responds well to tetracyclines and also the sulphonamides.

Granuloma inguinale or Donovanosis is rarely seen in temperate countries. It is endemic among the Aboriginals of central and northern Australia and is common around Port Moresby in Papua New Guinea. It has an incubation period of one to four weeks. It causes painless blisters or small papules on the skin of the genitals or thighs which then become raised and irregular and may break down and ulcerate. These lesions heal slowly and may leave marked scarring. Penicillin is not effective but the condition responds to the tetracyclines.

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The mature doctor will accept that death is inevitable, and will help his patients to approach it. But actively to push the patient across that threshold is another thing altogether.

Most doctors would accept the principle that one should not use extraordinary means to prolong life if that life has lost its “quality.”

But here the definition becomes obscure. For what is “quality” of life?

In the U.S. the medical profession has been confused by the always-present threat of a malpractice suit.

Fortunately, this is rare in Australia.

When you discuss euthanasia, either in support of it or not, you will need to consider who it is who makes the final decision — the patient, the patient’s family, the patient’s doctor, a panel of doctors or lay people, or perhaps a concensus of all of these.

But you will also need to discuss who will do the deed — the patient’s own doctor, or a specially licensed doctor — who carries out this procedure when requested.

God help him.

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Being a bacterial illness it responds to antibiotics, although the organism is resistant to penicillin.

Pertussis vaccine is present in the triple antigen and is given to children starting at eight weeks of age. The greatest threat to children from whooping cough is to those under 12 months old.

Older children tolerate whooping cough much better, but may be affected by severe side effects from the vaccine.

The whooping cough part of triple antigen is usually not given to those over 12 months old. When immunisation is necessary, the CDT (combined diphtheria and tetanus) vaccine is used instead.

Cough suppressants are of little use trying to control whooping cough, but the child will usually respond fairly quickly once antibiotics are given.

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The question arises: Is it true that the sympathetic nervous system registers in the iris as a square, as shown in several iris charts?

After studying the existing systems, I have come to the conclusion that the sympathetic trunk and the sympathetic ganglia have their proper place around the iris-wreath, but before giving my interpretation, I would like to outline the relevant observations given in these systems.

Irisdiagnosis has been greatly enriched by Anderschou’s location of the ganglionic plexi in the iris. He portrays the ganglionic plexus as a chainlike range of elevations between the nutritive organ areas (stomach and intestines) and the other organ areas of the body. Observation of it in the iris is rather difficult, and not possible in an iris of compact and dense texture.

On close examination with a lens, the small indications are found in conjunction with the organ-arcs. A part of the colon and intestines is to be found inside the sympathetic line, but all borders are dependent upon the mutual influences of the affected (diseased) parts. In this connection, I should like to point out that the medulla oblongata also has its place here.

In the Anderschou chart, the sympathetic line is indicated as a square around the iris-wreath, with arcs of different sizes directed inwardly and outwardly.

The solar plexus, a ganglionic plexus of the general nervous system, is also the control centre of the body-life, which through the umbilical cord has built up the whole body according to the three polar axes of the three dimensions. The animal nervous system, subject to consciousness and will, has its centre in the brain. The control centre of the vegetative nervous system corresponds in the iris with the central fibrous ring of the pupillary sphincter around the pupil.

The position of the solar plexus (plexus coeliacus) has been defined by only two or three investigators, who, however, are very vague in their exact location, and with whom I must completely disagree. According to the anatomical position, the solar plexus is found in front of the sympathetic trunk, in which case it is unquestionably a gastro-intestinal plexus. In spite of other opinion, it can only be placed with the sympathetic nervous system, whose location in the iris-wreath surrounding the digestive area, therefore the intestinal area, is quite definite. The sympathetic trunk shows as a ring-formation around the solar plexus in the region of the

iris-wreath.

He correlates the Vagus with the upper layer of the iris, the Sympathetic with the second layer, and the motor and sensory nerve fibres with the third layer. The correspondence with Hense’s view of the nerve layers is significant.

Kronenberger’s interpretation of the threefold arc-formation and the nerve rings is found in Hense in a different form. This interpretation of the three arc-formations has presumably also led to the introduction of the three major, six minor regions in the iris chart of Madaus-Flink.

However, that the sympathetic nervous system is not seen as a square, but that if signs such as black streaks or white lines go from the outer edge of the iris to the iris-wreath, or radiate out from the pupil and break through the iris-wreath, such signs always refer to the Sympathetic. It indicates that the complaints have a chronic character and would be difficult to cure.

Iris chart in which the sympathetic nervous system is indicated around the iris-wreath as a square, and on which he marks the lower line as the sympathetic ganglia, and the upper line as the sympathetic nervous system with connections to the head. Although the organ areas do not quite correspond with the modern chart, one must agree that even at that time a good understanding had been worked out. Everything is so arranged that it could be developed further, thus enabling later investigators to improve the existing system.

In the works of the more recent investigators, Maubach, Angerer and Deck, we find no localisation of the vegetative nervous system.

After concluding this review of different authors and of the anatomical relations, I think I can claim that the following key to the location of the vegetative nervous system in the iris is in accordance with the findings of many investigators.

The autonomic nervous system is described as a nervous system which functions according to its own laws. Anatomically considered, the autonomic nervous system, together with the glands of internal secretion and the body fluids, forms a functional unity.

The Vagus ( = Parasympathetic) is the 10th cranial nerve. It is also called the pneumogastric nerve. It consists of all those vegetative nerve fibres, including their origins and central connections, which arise in the mid-brain and the medulla oblongata, as well as in the sacral division. As the cranio-sacral system, it is functionally opposed to the thoracico-lumbar system (Sympathetic). The fibres of the parasympathetic do not run over the sympathetic trunk, but use true brain and spinal cord nerves as conductors.

The Sympathetic system, also known as the thoracico-lumbar system or the sympathetic trunk, has its cells of origin in the lateral horns of the thoracic and upper lumbar spinal cord. The spinal centres belonging to the vertebral column and spinal cord are subject to the influence of higher centres in the medulla oblongata, in the mid-brain, and in the cerebral cortex.

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