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Most of the studies on pressures within the craniovertebral cavity have been conducted on adult human beings or on full-grown animals. Obviously, the adult cranium and spinal column are relatively fixed in shape and in capacity and can probably be considered as a closed box completely filled with various soft or fluid substances to which the rules of physics concerning the transmission of pressure where fluids completely fill rigid, communicating containers will apply. We do not propose to challenge the approximate accuracy of such a conception of transmission of pressure in adults, but we feel that the rigid box idea is unsound in theory and in fact frequently invalid in the human infant. In the first place, under every-day stresses the skull and the spinal column of the infant are subject to expansion, contraction and distortion to a degree which makes any such phrase as "closed box of constant volume"

The majority of 13 cases of Rocky Mountain spotted fever from an endemic focus of the disease in the Cape Cod area of Massachusetts were diagnosed late, and two patients died. However, earlier diagnosis, earlier initiation of specific therapy, and prevention of fatalities should have been possible. Clinical, epidemiologic and laboratory data highly suggestive of the disease were almost all available early in the first week of illness to help in the diagnosis. There was high fever, severe headache, toxicity, mental confusion and myalgia. A generalized measles-like rash involved the palms and soles in almost all cases. Cases occurred seasonally between April and September, sharply restricted geographically to a known endemic focus, and predominantly in children. Complement-fixing and Weil-Felix antibodies rose late in the second week and were of no help in early diagnosis. Thrombocytopenia was surprisingly frequent, occurring in seven of 11 patients tested.

Summary An infant with maple syrup urine disease was placed on a basically synthetic diet at age 4 1/2 months. The diet was different from those originally described in that a proprietary vitamin preparation was substituted for the vitamin mixture. The infant developed megaloblastic anemia with folate deficiency within a few months. The anemia and folate deficiency ceased following oral folic acid supplementation. Coincident with the folate deficiency was a severe malabsorption syndrome which also cleared after folic acid was administered.