Colour-Blindness and the Board of Trade.

312 obvious that occasionally this does happen, and the question arises first what ought the dispenser to do. As an example, if an unusually large dose of some drug is ordered without any statement or indication that the dose is unusual, should the dispenser merely take a careful note of the prescription, with a special comment, dispense the drug as ordered, and

Colour-Blindness and the Board of Trade. FOR long past there has been agitation in the medical world against the methods adopted by the Board of Trade in the examination in colour vision of candidates for certificates as master or mate in the Mercantile Marine. Most of the strictures have been passed upon the scientific methods

await what may prove to be a catastrophe ? Undoubtedly, if possible, the druggist should communicate with the prescriber, even at the risk of exciting suspicion in the mind of the patient or his friends, for it is unquestionable

adopted. Whether these are fundamentally erroneous or wrongly applied may be left out of discussion for

prescriber should indicate in some way that he has a good reason for ordering an unusual dose. This may be done in various ways, as by underlining the drug and dose, or by adding "(sic)"in brackets or by a footnote. It would undoubtedly be better if some uniform practice in this respect were adopted, and no better method could be employed than a short footnote. The dispenser may not be able to communicate with the physician-he may not even know the latter’s name. Many prescriptions are only signed with initials, and have no address stating where the prescriber lives. Both these omissions ought to be avoided ; all prescriptions should, in our opinion, be signed in full and the address of the signer given, unless the paper bears the patient’s address, when, of course, the prescriber can be readily traced. All pharmacists will probably agree with us that when it is absolutely necessary to modify a prescription the dispenser should exercise his own judgment in doing so, but that he should, if possible, communicate with the writer of it. We think that in most cases the medical practitioner will welcome that the

moment. an

TRATTLES is

TRATTLES, of which we give present issue of THE LANCET, proves

of Mr. JOHN

that there is serious fault somewhere. Mr. of exceptional ability, who has proved

a seaman

his

superior capacity in the technical details of his profession by passing the examinations for second and first mate after serving in the forecastle as an ordinary sailor. His colourvision has been examined on six occasions during the last six years ;

on

three occasions he

he failed. As the

passed and on three occasions Shipping Gazettesays : I Any system which

keeps a man on tenterhooks for four years as to whether he will be flung out of his profession and made to join the

in the interests of everyone concerned. dispenser must, however, be carefully and there is no doubt that this point is clearly

prudent

case

account in the

conclusively

this attention to his interests rather than resent it as an The prescriber should remember that the interference. pharmacist who refers back a prescription is following a safe and

The

are

the

course

The discretion of the

restricted, and honourably recognised by pharmacists. On the other hand, all medical practitioners should recognise with equal

crowd that loafs on the Thames Embankment stands wholly condemned. We clearly ought not to ffing a man about from tribunal to tribunal, until, declaring him first to be colourblind, then to be otherwise, and then to be colour-blind again, we run the risk of throwing him off his mental balance altogether." The Skipping Gazette goes on to discuss, or rather to ridicule in highly sarcastic fashion, the scientific evidence given by Sir WILLIAM ABNEY and others before It accepts as infallible Sir FRANCIS the special court. MOWATT’S opinion that the selection of wools by daylight, as he saw the test applied, does not afford a conclusive test. It records its respect for the lantern test if properly applied, but not for Sir WILLIAM ABNEY’S method of application. Much stress is naturally laid upon the "practical test " conducted by Commander WILSON-BARKER. We should have thought that the expense of this test might have been avoided in the face of the overwhelming evidence that Mr. TRATTLES had for many years acted as lookout man and second mate without mishap. As those

force the fact that the responsibility for a prescription rests ultimately with them, and that if a prescription presents doubt or difficulty that doubt or difficulty should be cleared up at the time of writing the prescription. competent to judge realise quite well, such a test is Serious mistakes in prescriptions are rare, but possibly no of no value unless carried out in atmospheric condiI tions which would render it one is such a good judge of their frequency as the dishighly dangerous to many The Gazette draws two conclusions from lives. a and is discreet holds Shipping person usually pensing chemist, who is that the One it I I sounds the death-knell of the inquiry. his tongue. In Mr. McEwAN’S paper is a collection of vicious of in itsimproved’ form." even system instances which have come under his personal cognisance, wool-testing, credit on the devisers of The other is that ’’the whole question of sight-testing must and do not reflect

certainly

great

these instances

be put on a higher plane." The first conclusion is controversial and need not be discussed at present. With the gist of the second we are in cordial agreement, though will be found that the weak spot is we think that it rather the system of examination and the mode in which it is conducted than the actual tests themselves. The Shipping Gazette very rightly says° ° What is obviously

sufficiently numerous to be alarming, though individually they would We can only cause embarrassment when they occurred. of pre what we have said above-the responsibility repeat a is serious and no one, scribing very practitioner should ever forget this. and when Hurry flurry prescribing should the

be

prescriptions ;

but

avoided, and carelessness is

a

are

not

crime.

medical subject must, at least to some extent, be regarded as such. Mr. CHURCHILL admits that no oculist or medical " man is included among the officers conducting these tests. a

THE WATER-SUPPLY

OF

WARMINSTER

(WILTS).

-The new water-supply for Warminster was formally on Jan. 20th in the presence of a large gathering.

opened ,

1 Shipping Gazette

and

Lloyds’ List,

Jan.

12th, 1910

313 paper was to throw light on this startling increase in the number of those reported accidents during the 18 years dealt with in this table. It was pointed out that the provisions dealing with such accidents in the involving the safety of numberless lives, the present Factory Acts of 1891, 1895, and 1906 were far more comanomalies cannot be permitted to endure. Like so many prehensive than those in the preceding Act of 1878. Not physiological problems, those presented by colour-blindness only were many additional non-fatal classes of accidents demand an extensive knowledge of physical facts, and made reportable by the more recent Acts, but reports were it is imperative that those who conduct the examina- also, for the first time, required from the occupiers of docks, tions, whether primarily physiologists or physicists, must wharves, quays, warehouses, and certain laundries; the reof such accidents was also made compulsory on the have acquired that competent knowledge of physiology porting occupiers of factories, workshops, &c., with liability to and physics which is more likely to be found in the penalty for omission to report. The number of factory physiologist than in the physicist, but even then only after inspectors was increased, moreover, from 88 in 1894 to 200 the devotion of special study to the particular subject. in 1908, and prosecutions for failure to notify accidents were In our opinion the whole question should be referred to a frequently instituted throughout the period under notice. The Royal Commission or to a committee of the Royal Society, increasing liberality and general extension of the provisions in successive Workmen’s Compensation Acts, more especially upon which physiologists and ophthalmologists who have in the Act of 1897, have without doubt also greatly tended given special attention to the subject should be adequately to increase the number of reported accidents. During the represented. Among the duties of such a committee would be period under review there was, too, a marked increase of the re-investigation of tests for colour-blindness with a view activity in trade, and of both the number and the proportion to selecting those most appropriate to the end in view, and of the population exposed to risk of accident in factories, the reorganisation of the examinations to ensure the efficient workshops, &c., through the decline of home industries and the of machine for hand labour. These were substitution carrying out of the tests. It would then be seldom, if ever, some of the causes referred to in Mr. Verney’s paper in necessary to have recourse to a court of law to adjudicate on explanation of the great increase in the number of reported what is a purely scientific question. accidents in factories and workshops between 1890 and 1907. If these several causes do not entirely account for the increase of reported accidents, it is at any rate obvious that the official crude figures, which served as the basis of this paper, should not be accepted as affording trustworthy of real increase in the proportional number of evidence "Ne quid nimis." preventable accidents, and still less of any increasing neglect of due care for the safety of workers in factories and

of far greater difficulty and complexity and laymen in general realise, but Gazette Shipping the feeling must be unanimous that in so serious a question,

The

subject

is

one

than the

Annotations. "

THE RESEARCH

DEFENCE SOCIETY.

in another column a letter signed by Lord Cromer, the Hon. Sydney Holland, Dr. F. M. Sandwith, and Mr. Stephen Paget, respectively President, chairman of committee, honorary treasurer, and honorary secretary of the Research Defence Society, which sets out briefly the work accomplished by the society during the past 12 months. We hope the medical profession will read this studiously moderate communication, for it proves the established position of the society and its activity in the defence of scientific workers upon whose efforts much of our medical progress will depend in the future, as it has depended in the past. Weknow from frequent communications which we receive on the subject that members of the medical profession deeply resent the accusations of cruelty which are brought against many of those engaged in scientific research. All these should support the Research Defence Society by their subscriptions, and use their voices among their patients to increase the large number of persons, medical and lay, who are resolved to defend the cause of science from the malice or inaccuracy of the faddist, never more difficult to deal with than when reinforced by the amiable convictions of the

WE

workshops.

-

publish

humane sentimentalist. ____

ACCIDENTS IN

FACTORIES AND WORKSHOPS.

AT the meeting of the Royal Statistical Society on Jan. 18th a paper was read by Mr. H. Verney, one of H.M. factory inspectors, on the reported accidents involving fatal or’ bodily injury to workers in factories and workshops. It appears from a table in the appendix to the annual report of the chief inspector of factories for the year 1907 that the annual reported number of this class of accidents increased from 8211 in 1890 to 124,325 in 1907 ; of the latter number 1179 were fatal accidents. The main object of the

A MEDICAL EXAMINER

IN

PHYSICS.

THE coordination of the pre-clinical and clinical studies of me dical curriculum is the order of a day which is in revolt against the multiplication of special studies in our medical schools. When it has been finally decided that the student cannot be turned into a complete chemist, physicist, biologist,

the

pharmacist, anatomist, physiologist, obstetrician, physician, and surgeon within the space of five years, the question at once is raised whether it is desirable that the preliminary subjects should be taught by specialists, each convinced of the supreme virtue of his own particular brand of "leather," or whether they should be handed over to practitioners of medicine having special knowledge of one or other of the preliminary studies and able to judge of its application to the main business of the medical student’s labours. Not so very many years ago it was almost the invariable custom at the hospital schools for one of the physicians to take charge of the physiological department in the same way as in most schools the study of anatomy is still presided over by one of the surgeons, although in the universities the professors of anatomy and physiology have usually specialised exclusively in their own sciences. The advantage of using the special teacher with full knowledge of his subject, able to demonstrate the principles of that subject with assurance and a ripe faculty of illustration, is very considerable, but the old plan of science teaching by men actively engaged in clinical work had its merits. The advantages of such teaching must at any rate be very great when it is given by a practitioner really competent to undertake it, and knowing at first hand the exact principles which will have most bearing upon the after-studies of the men under his charge. But there

I