- Email: [email protected]
A SUPER DUST MAN
738
Bullough of Essex, was that the building for the sick must in future be a part of a local centre for preventive Such a scheme, in which as well as curative medicine. the hospital itself would be merely a necessary detail of . the whole, had been worked out at Grantham but postponed owing to the war. A new idea was embodied in the Harvard Hospital (somewhere in Wessex) which was a base for a field unit with its laboratories, combined with a hospital for infectious diseases. Mr. Elcock favoured the policy of using hospitals for education in healthful living ; the building was as important as what happened inside it. As regards size it seems clear that the day of small, scattered special hospitals is over. For historical reasons, as Dr. Harkness pointed out, the isolation hospital, sanatorium, maternity hospital and so on had risen independently ; there was no reason why they should not now be grouped and the isolation of their medical and nursing staffs ended. This would accentuate the importance of circulation ; as many as 20 traffics might have to be considered in a modern general hospital. Mr. Elcock claimed that his continuous veranda type of ward, with beds parallel to walls, ensured a far larger amount of sunlight per patient ; this had been shown experimentally at the Building Research Station and in practice at the Hertford County Hospital. On one point both architects and doctors were agreed-the need for specialisation in hospital construction by both professions. The day of the benevolent amateur is over. The local architect’s plans, adapted by clinicians with the matron called in as an afterthought, produce a building which is often more cottage than hospital. The Emergency Hospital Service has revealed the need for specialist hospital officers. The effective coroner is- a blend of lawyer and doctor ; should not the central authority, at least, have on its staff a doctor who is qualified in architecture ?
.
RISKS OF PARACHUTE-JUMPING NEw methods of warfare tend to produce new types of injury as missiles and machines change, and to some extent treatment changes accordingly, although basic surgical principles remain unaltered. The pathology of parachute-jumping is the latest offspring of aviation medicine, itself so recently a lusty infant, and in what must be one of the first reviews of these injuries in English, Tobin, Cohen and Vandoverhave surveyed the accidents occurring during the first year of parachutetraining in the United States. They note that the four phases of a jump are each associated with a special group of injuries. The first arise at the time of leaving the plane and are due to entangling of equipment or failure of the parachute to open, and these are usually fatal, although in one case where the jumper got hooked to the tail of the plane he escaped with a dislocated hip. In the second phase, when the parachute opens, the shock may produce serious abdominal or thoracic injuries, a danger that may be lessened by distributing the shock over as wide an area of the body as possible. During the third stage of actual descent, diverse lesions may occur, and in this connexion Boothby, Benson and Lovelace2 have pointed out the risk of fatal anoxia when the pilot has bailed out from over 30,000 ft. during his descent to sufficiently oxygenated air at 18,00020,000 ft. The injuries on impact compose the fourth and by far the largest group, consisting mainly of more or less complicated injuries to the lower extremities ; and fortunately these can be minimised by intensive ground-training in alighting before actual jumping is begun. In all, 2-4% of the jumps made were associated with some injury, but only a quarter required hospitalisation ; 80% of these major injuries were fractures, none of them compound, half of which were malleolar,, though Tobin, W. J., Cohen, L. J. and Vandover, J. T. J. Amer. med. Ass. 1941, 117, 1318. 2. Boothby, W. M., Benson, O. O. and Lovelace, W. R. J. Aviat. Med. 1940, 11, 59. 1.
fractures of every bone of the lower limb were recorded. Rather unexpectedly the os calcis was fractured only once. Falls on the outstretched hand resulted in an occasional fracture of the clavicle, humerus, or radial head. The frequency of malleolar fractures must be ascribed to uneven landing associated with cross-currents, unskilled guidance of the parachute, and irregular terrain, these factors combining to produce a violent temporary shearing force across the ankle-joint. The incidence of these injuries, which are of the type that tend to unfit a man for further jumping, is small, and Tobin and. his colleagues attribute this to careful preliminary training in the art of jumping. This paper leads to the reflection that parachute-troops are one of the few groups of fighting-men separated from their medical services during active warfare ; but perhaps this problem, too, will be solved in time. DRIED AND CONDENSED MILKS THE deficit of liquid milk for the main body of the public owing to its welcome increased intake by children and pregnant and nursing mothers, and the large import ofdried and condensed milks from the U.S.A. and Canada naturally raise the question of the relative nutritive values of these commodities. How far does condensation and drying lower the food values of milk ? People who have heard that cooking destroys vitamin C rush to the conclusion that heat treatment of milk destroys all its nutritive value. They may take comfort from an article by S. K. Kon1 of the National Institute for Research in Dairying in which he gives a comprehensive table of the constituents of various forms of milk and the loss of them, if any, in manufacture. The loss is remarkably small, except in vitamins Band C, and since milk is of small value in supplying these vitamins it matters hardly at all from a dietetic point of view whether milk is taken pasteurised, sterilised, condensed or dried. Milk is valuable mainly for its first-class protein, its calcium and its vitamin A. It makes a substantial contribution of riboflavin but its values for vitamins C and D are low. Fortunately vitamin A and riboflavin are not reduced atall even by drying, nor is the calcium rendered less available. There is possibly some small reduction of the biological value of the proteins, but it is negligible. Even the drastic treatment of milk in spray drying destroys only 10% of its Bl and 20% of its C. Dried and condensed milks are therefore not to be despised by anyone, and there are hygienists who look forward to the day when milk will bepurchasable only at the grocers. A SUPER
John Switzer
DUST
MAN
Owens, whose death is announced,
qualified at Trinity College, Dublin, in 1892 and took his M.D. four years later. He played truant from the Medical Directory to reappear in 1912 with high engineering qualifications as hon. secretary of the Committee for the Investigation of Atmospheric Pollution under the chairmanship of Sir Napier Shaw, director of the Meteorological Office. Of this committee our Mr. Vasey was also a member ; much of the work was done in THE LANCET laboratories, and the reports appeared as supplements in our columns. Owens had the bonhomie and the drive to make any collective investigation a success, he had a vision of what England might be without smoke, and his agile mind was constantly devising new and better methods for trapping and measuring the particles of dust in the air. He was also the instigator of the Coal Smoke Abatement Society and wherever linen can now be hung out to dry without getting grimy, or the reader in a city garden can turn over the page of his novel without first blowing the smuts off it, the name of Owens should be held in honoured memory. 1. Nature, Lond. 1941, 148, 607.
‘
Bullough of Essex, was that the building for the sick must in future be a part of a local centre for preventive Such a scheme, in which as well as curative medicine. the hospital itself would be merely a necessary detail of . the whole, had been worked out at Grantham but postponed owing to the war. A new idea was embodied in the Harvard Hospital (somewhere in Wessex) which was a base for a field unit with its laboratories, combined with a hospital for infectious diseases. Mr. Elcock favoured the policy of using hospitals for education in healthful living ; the building was as important as what happened inside it. As regards size it seems clear that the day of small, scattered special hospitals is over. For historical reasons, as Dr. Harkness pointed out, the isolation hospital, sanatorium, maternity hospital and so on had risen independently ; there was no reason why they should not now be grouped and the isolation of their medical and nursing staffs ended. This would accentuate the importance of circulation ; as many as 20 traffics might have to be considered in a modern general hospital. Mr. Elcock claimed that his continuous veranda type of ward, with beds parallel to walls, ensured a far larger amount of sunlight per patient ; this had been shown experimentally at the Building Research Station and in practice at the Hertford County Hospital. On one point both architects and doctors were agreed-the need for specialisation in hospital construction by both professions. The day of the benevolent amateur is over. The local architect’s plans, adapted by clinicians with the matron called in as an afterthought, produce a building which is often more cottage than hospital. The Emergency Hospital Service has revealed the need for specialist hospital officers. The effective coroner is- a blend of lawyer and doctor ; should not the central authority, at least, have on its staff a doctor who is qualified in architecture ?
.
RISKS OF PARACHUTE-JUMPING NEw methods of warfare tend to produce new types of injury as missiles and machines change, and to some extent treatment changes accordingly, although basic surgical principles remain unaltered. The pathology of parachute-jumping is the latest offspring of aviation medicine, itself so recently a lusty infant, and in what must be one of the first reviews of these injuries in English, Tobin, Cohen and Vandoverhave surveyed the accidents occurring during the first year of parachutetraining in the United States. They note that the four phases of a jump are each associated with a special group of injuries. The first arise at the time of leaving the plane and are due to entangling of equipment or failure of the parachute to open, and these are usually fatal, although in one case where the jumper got hooked to the tail of the plane he escaped with a dislocated hip. In the second phase, when the parachute opens, the shock may produce serious abdominal or thoracic injuries, a danger that may be lessened by distributing the shock over as wide an area of the body as possible. During the third stage of actual descent, diverse lesions may occur, and in this connexion Boothby, Benson and Lovelace2 have pointed out the risk of fatal anoxia when the pilot has bailed out from over 30,000 ft. during his descent to sufficiently oxygenated air at 18,00020,000 ft. The injuries on impact compose the fourth and by far the largest group, consisting mainly of more or less complicated injuries to the lower extremities ; and fortunately these can be minimised by intensive ground-training in alighting before actual jumping is begun. In all, 2-4% of the jumps made were associated with some injury, but only a quarter required hospitalisation ; 80% of these major injuries were fractures, none of them compound, half of which were malleolar,, though Tobin, W. J., Cohen, L. J. and Vandover, J. T. J. Amer. med. Ass. 1941, 117, 1318. 2. Boothby, W. M., Benson, O. O. and Lovelace, W. R. J. Aviat. Med. 1940, 11, 59. 1.
fractures of every bone of the lower limb were recorded. Rather unexpectedly the os calcis was fractured only once. Falls on the outstretched hand resulted in an occasional fracture of the clavicle, humerus, or radial head. The frequency of malleolar fractures must be ascribed to uneven landing associated with cross-currents, unskilled guidance of the parachute, and irregular terrain, these factors combining to produce a violent temporary shearing force across the ankle-joint. The incidence of these injuries, which are of the type that tend to unfit a man for further jumping, is small, and Tobin and. his colleagues attribute this to careful preliminary training in the art of jumping. This paper leads to the reflection that parachute-troops are one of the few groups of fighting-men separated from their medical services during active warfare ; but perhaps this problem, too, will be solved in time. DRIED AND CONDENSED MILKS THE deficit of liquid milk for the main body of the public owing to its welcome increased intake by children and pregnant and nursing mothers, and the large import ofdried and condensed milks from the U.S.A. and Canada naturally raise the question of the relative nutritive values of these commodities. How far does condensation and drying lower the food values of milk ? People who have heard that cooking destroys vitamin C rush to the conclusion that heat treatment of milk destroys all its nutritive value. They may take comfort from an article by S. K. Kon1 of the National Institute for Research in Dairying in which he gives a comprehensive table of the constituents of various forms of milk and the loss of them, if any, in manufacture. The loss is remarkably small, except in vitamins Band C, and since milk is of small value in supplying these vitamins it matters hardly at all from a dietetic point of view whether milk is taken pasteurised, sterilised, condensed or dried. Milk is valuable mainly for its first-class protein, its calcium and its vitamin A. It makes a substantial contribution of riboflavin but its values for vitamins C and D are low. Fortunately vitamin A and riboflavin are not reduced atall even by drying, nor is the calcium rendered less available. There is possibly some small reduction of the biological value of the proteins, but it is negligible. Even the drastic treatment of milk in spray drying destroys only 10% of its Bl and 20% of its C. Dried and condensed milks are therefore not to be despised by anyone, and there are hygienists who look forward to the day when milk will bepurchasable only at the grocers. A SUPER
John Switzer
DUST
MAN
Owens, whose death is announced,
qualified at Trinity College, Dublin, in 1892 and took his M.D. four years later. He played truant from the Medical Directory to reappear in 1912 with high engineering qualifications as hon. secretary of the Committee for the Investigation of Atmospheric Pollution under the chairmanship of Sir Napier Shaw, director of the Meteorological Office. Of this committee our Mr. Vasey was also a member ; much of the work was done in THE LANCET laboratories, and the reports appeared as supplements in our columns. Owens had the bonhomie and the drive to make any collective investigation a success, he had a vision of what England might be without smoke, and his agile mind was constantly devising new and better methods for trapping and measuring the particles of dust in the air. He was also the instigator of the Coal Smoke Abatement Society and wherever linen can now be hung out to dry without getting grimy, or the reader in a city garden can turn over the page of his novel without first blowing the smuts off it, the name of Owens should be held in honoured memory. 1. Nature, Lond. 1941, 148, 607.
‘