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A COMPACT NEUROLOGICAL INSTRUMENT
836
through routine health examinations accompanied by radiography of the chest. For working girls coming
I does not appear to be of much importance, and Sir Henry Bashford inclines to the view that the majority of new cases are due to the reactivation of some earlier or childhood focus of infection, to intercurrent illness or strain, or to anxiety. In the discussion that followed Dr. G. T. HEBERT emphasised that mass X-ray examinations must be
from rural districts to industrial areas where the incidence of tuberculosis might be high such routine examinations should be repeated at intervals. Mass radiography has been made much easier and cheaper by the introduction of miniature fluoro-photography. From experience of large schemes of health examinations now in operation he thought that there would be little or no opposition by the workers themselves to examinations made by factory medical officers. Dr. CHARLES SUTHERLAND discussed the risks of tuberculosis in industries involving exposure to silica. He pointed out that a new worker entering a silicarisk industry may be tuberculous on entering, may have a quiescent lesion which becomes active, or may become infected within a few years of starting work. Having become infected, the worker may develop the condition known as silico-tuberculosis which usually becomes open tuberculosis after a number of years. Such a man probably is only infectious to’other workmen for a short period, as he quickly becomes unfit In certain occupations with intense for work. exposure, as in sandblasting, a worker with quiescent tuberculosis has his focus reactivated. In other industries the focus remains quiescent for years, but ultimately becomes active after simple silicosis has developed. As a prophylactic measure, in addition to continuing with improvements in the hygiene of working conditions, Dr. Sutherland urged the importance of medically selecting the workers entering the silica industries. Silico-tuberculosis could be greatly reduced by preventing, through initial and repeated medical examinations, any tuberculous person being employed in a silica-risk industry and so infecting fellow workers possibly rendered more susceptible by their previous exposure to silica. Silico-tuberculosis can be minimised by reducing the risk of infection with tuberculosis as well as by measures directed to eliminating silicosis. He protested against the view that all adult tuberculosis was due to the reactivation of a childhood infection. Sir HENRY BASHFORD spoke about the experience of tuberculosis among Post-Office workers. The Post Office, he said, is the largest and probably the most varied industrial unit in the country, but its employees are to some extent a selected group, since the majority have been examined medically at least once, and in most cases twice, before establishment. All new cases of respiratory tuberculosis are seen by Post-Office doctors, and after periodical reports from sanatoria or hospitals every case is re-examined by a Post-Office doctor before being allowed to resume duty. The incidence of respiratory tuberculosis, which compares favourably with that of the community, has declined steadily for the last 20 years. It is highest, both for men and women, between the ages of 20 and 30. With Dr. W. L. Scott Sir Henry Bashford published in 1936 an analysis of the after-histories of 3755 cases arising between 1914 and 1926. Although, in addition to the usual Civil Service sickpay allowances, the Post Office permits very liberal sick absence in cases of respiratory tuberculosis as long as medical reports are favourable, it is a constant finding that half of all new cases do not recover sufficiently to return to duty. Of those who return nearly half are invalided within ten years for recurrence of the disease or for other forms of ill health, although every effort is made to provide them with suitable employment. After ten years the prospects are much better, and the loss in the next five years is only 14 per cent. In the experience of the Post Office over many years the personal contact factor
as a sieve for separating suspicious cases. Such cases must be re-examined from time to time in order to detect any progressive changes in their earliest stages. Dr. E. J. KING described the structure of silicotic nodules and the criteria for their recognition. Dr. DONALD STEWART pointed out the difficulties now existing in the examination of new entrants to industry both on account of the shortage of qualified 8taff and the great and rapid movements of workers to war-time industries. Dr. JOHN CRAW said that mass radiography has proved of great value in the haematite mining industry both by preventing the employment of tuberculous men and by facilitating the earlier detection of tuberculosis amongst men actually engaged in mining. Dr. E. L. MIDDLETON expressed the hope that adequate arrangements would be made for the care of those found to be affected should mass diagnosis on the lines proposed by Dr. Hart and other speakers be attempted.
regarded
New Inventions A COMPACT NEUROLOGICAL INSTRUMENT
THIS instrument, the combination of several pocket instruments, will be found useful in summing up the effects of wounds on the nervous system. It weighs 3 oz., measures 7 in. long, and easily fits into a military pocket. The handles are calibrated up to 20 cm. and can be used in measuring the diameter of the heart and other objects. The ends are designed for testing two-point discrimination, and the lock has a sharp point for testing pain sensation. A 3 mm. object
be enamelled in white on this lock for roughly testing visual fields. The head, made of duralumin, is in two parts: the lower section has a soft-rubber percussion tip of standard (door-stop) size, and a compartment for cotton-wool; the upper section, with a fine steel pin-wheel for testing pain sensation, screws into the lower compartment. This " hammer"" was constructed by a group in the graduate school of McGill University, aided by the department of can
mechanical engineering. HAROLD
ELLIOTT, M.D.
through routine health examinations accompanied by radiography of the chest. For working girls coming
I does not appear to be of much importance, and Sir Henry Bashford inclines to the view that the majority of new cases are due to the reactivation of some earlier or childhood focus of infection, to intercurrent illness or strain, or to anxiety. In the discussion that followed Dr. G. T. HEBERT emphasised that mass X-ray examinations must be
from rural districts to industrial areas where the incidence of tuberculosis might be high such routine examinations should be repeated at intervals. Mass radiography has been made much easier and cheaper by the introduction of miniature fluoro-photography. From experience of large schemes of health examinations now in operation he thought that there would be little or no opposition by the workers themselves to examinations made by factory medical officers. Dr. CHARLES SUTHERLAND discussed the risks of tuberculosis in industries involving exposure to silica. He pointed out that a new worker entering a silicarisk industry may be tuberculous on entering, may have a quiescent lesion which becomes active, or may become infected within a few years of starting work. Having become infected, the worker may develop the condition known as silico-tuberculosis which usually becomes open tuberculosis after a number of years. Such a man probably is only infectious to’other workmen for a short period, as he quickly becomes unfit In certain occupations with intense for work. exposure, as in sandblasting, a worker with quiescent tuberculosis has his focus reactivated. In other industries the focus remains quiescent for years, but ultimately becomes active after simple silicosis has developed. As a prophylactic measure, in addition to continuing with improvements in the hygiene of working conditions, Dr. Sutherland urged the importance of medically selecting the workers entering the silica industries. Silico-tuberculosis could be greatly reduced by preventing, through initial and repeated medical examinations, any tuberculous person being employed in a silica-risk industry and so infecting fellow workers possibly rendered more susceptible by their previous exposure to silica. Silico-tuberculosis can be minimised by reducing the risk of infection with tuberculosis as well as by measures directed to eliminating silicosis. He protested against the view that all adult tuberculosis was due to the reactivation of a childhood infection. Sir HENRY BASHFORD spoke about the experience of tuberculosis among Post-Office workers. The Post Office, he said, is the largest and probably the most varied industrial unit in the country, but its employees are to some extent a selected group, since the majority have been examined medically at least once, and in most cases twice, before establishment. All new cases of respiratory tuberculosis are seen by Post-Office doctors, and after periodical reports from sanatoria or hospitals every case is re-examined by a Post-Office doctor before being allowed to resume duty. The incidence of respiratory tuberculosis, which compares favourably with that of the community, has declined steadily for the last 20 years. It is highest, both for men and women, between the ages of 20 and 30. With Dr. W. L. Scott Sir Henry Bashford published in 1936 an analysis of the after-histories of 3755 cases arising between 1914 and 1926. Although, in addition to the usual Civil Service sickpay allowances, the Post Office permits very liberal sick absence in cases of respiratory tuberculosis as long as medical reports are favourable, it is a constant finding that half of all new cases do not recover sufficiently to return to duty. Of those who return nearly half are invalided within ten years for recurrence of the disease or for other forms of ill health, although every effort is made to provide them with suitable employment. After ten years the prospects are much better, and the loss in the next five years is only 14 per cent. In the experience of the Post Office over many years the personal contact factor
as a sieve for separating suspicious cases. Such cases must be re-examined from time to time in order to detect any progressive changes in their earliest stages. Dr. E. J. KING described the structure of silicotic nodules and the criteria for their recognition. Dr. DONALD STEWART pointed out the difficulties now existing in the examination of new entrants to industry both on account of the shortage of qualified 8taff and the great and rapid movements of workers to war-time industries. Dr. JOHN CRAW said that mass radiography has proved of great value in the haematite mining industry both by preventing the employment of tuberculous men and by facilitating the earlier detection of tuberculosis amongst men actually engaged in mining. Dr. E. L. MIDDLETON expressed the hope that adequate arrangements would be made for the care of those found to be affected should mass diagnosis on the lines proposed by Dr. Hart and other speakers be attempted.
regarded
New Inventions A COMPACT NEUROLOGICAL INSTRUMENT
THIS instrument, the combination of several pocket instruments, will be found useful in summing up the effects of wounds on the nervous system. It weighs 3 oz., measures 7 in. long, and easily fits into a military pocket. The handles are calibrated up to 20 cm. and can be used in measuring the diameter of the heart and other objects. The ends are designed for testing two-point discrimination, and the lock has a sharp point for testing pain sensation. A 3 mm. object
be enamelled in white on this lock for roughly testing visual fields. The head, made of duralumin, is in two parts: the lower section has a soft-rubber percussion tip of standard (door-stop) size, and a compartment for cotton-wool; the upper section, with a fine steel pin-wheel for testing pain sensation, screws into the lower compartment. This " hammer"" was constructed by a group in the graduate school of McGill University, aided by the department of can
mechanical engineering. HAROLD
ELLIOTT, M.D.