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DRY LUMBAR PUNCTURE.
399 average increase for them being roots and the common ligaments respectively. The in the control classes it was only fourth obstacle to drawing off fluid is usually described Critics familiar with the technique of as the presence of nerve roots floating against the about 7. von Fleischel’s method might suggest that this needle, but here again he finds the suggestion unacceptdifference is not significant, but in view of the able, because the constituents of the cauda equina The fifth and newly recognised scientific and judicial way in which the research was lack mobility. carried out, these figures must be taken to mean a impediment, which he describes in the present note, real difference in favour of the special glass. On the is an abnormal persistence of three considerable whole, however, it is impossible to deny that the masses of film subarachnoid connective tissue in the benefit to the school-children from the vita-glass theca. The chief masses are lateral and the small windows was very slight, the reason probably being one is in the middle line. By the presence of these that children sitting upright in a class-room with masses in the theca the cavity from which fluid is their clothes on have very little of their skin exposed usually obtained may be reduced to one-third of its to the light. When, as in special establishments, normal width. A needle is apt to be thrust into one they can be recumbent and unclothed with the light of the lateral masses, and Dr. Carter suggests that in falling on them from above, the benefit is generally cases where " dry " lumbar puncture can be attriaccepted as considerable, and the effect would doubt- buted to this cause the needle should be withdrawn less also be more marked in places where there is and redirected so that it passes into the theca, not clear air and much sunshine. The daily average of exactly in the middle line, but not far from it. The sunshine at Smethwick was only 2 hours 45 minutes. large lateral and small mesial masses should thus be and for two hours (noon to 2 P.M.) of the sunniest avoided. The dissections on which the note is based part of the day the children were not in school. were made on children, but it is possible that the
glass classes, the nearly 13, whereas
These factors would more or less hold good for English schools in general, and considering that vita-glass tends to lose its special penetrability with time and is a good deal more expensive than ordinary glass, it scarcely seems sound policy to reglaze all class-rooms. Certainly it would be undesirable to do so if such a step were thought a satisfactory alternative to the establishment of adequate open-air schools where sunlight can act under much more favourable conditions and in company with many other healthful
influences.
____
A NEW VACCINATION ORDER. THE Minister of Health has adopted the four first recommendations of the Committee appointed by his predecessor in 1926 to consider, inter alia, " the practical methods which are available in the light of modern knowledge to remove any risks which may result from vaccination." An Order issued this week gives effect to the change of policy, and an account of its provisions will be found on p. 411 of our present issue. It instructs public vaccinators to make single insertions of lymph instead of the four
abnormally persistent subarachnoid fibrous tissue a certain proportion of adults.
may be found in ON
Tuesday evening, August 20th, the following
bulletin
was
issued from
Buckingham
Palace
:-
The progress of His Majesty the King towards restoration of health continues. The wound is steadily diminishing in size, and is healing satisfactorily. His Majesty has derived benefit from breathing and other physical exercises. Both bodily and mental activity are now undertaken without undue fatigue. The King will be able to leave London for Sandringham in a few days.
This bulletin, which is the first to appear since July 3rd, was signed by Sir Stanley Hewett, Sir Hugh Rigby, and Lord Dawson. MORE than 700 people have enrolled as members of the Thirteenth International Ophthalmological Congress which is to be held at Amsterdam and The Hague from Sept. 5th to 13th, and nearly 250 communications covering the branches of ophthalmology have been promised. The principal subjects of discussion will be the aetiology and non-operative treatment of glaucoma ; the geographical distribution of, and international social campaign against, trachoma; and the diagnosis of suprasellar tumours. Committees will present reports on the examination of visual acuity, perimetry, the notation of the cylinder axis, the examination of light sense, the standardisation of the visual examination of railwaymen and others, and ophthalmological education. The representative of England on the International Ophthalmological Council is Mr. Leslie Paton, whilst the secretary is Dr. E. Marx, of Holland.
which were previously required ; multiple insertions will be available for those who wish to gain maximal immunity at one operation. As a corollary to the smaller dosage the rule is altered by which the Ministry did not allow revaccination, by public vaccinators, below the age of 10. Revaccination will be encouraged at the age of entering school (5 to 7 years), and again on leaving (14 to 16). In a covering letter to local authorities the Minister emphasises the importance of primary vaccination in infancy. " Recognising that post-vaccinal nervous disease has occurred mainly in children of school age or in adolescents who have never been vaccinated, he expresses the opinion that in the present state of knowledge, and so long as the small-pox prevalent WE have to record the death of Dr. Fletcher Beach, in this country retains its mild character, it is not consulting physician to the West End Hospital for for the vaccination of to generally expedient press and at one time medical superinNervous Diseases, such persons unless they have been directly exposed to infection. The new Order makes no reference to tendent of Darenth Asylum, on August 18th, in his eighty-fifth year. the use of less potent lymph. "
DRY LUMBAR PUNCTURE. THE difficulties occasionally encountered in securing a sample of cerebro-spinal fluid, although the needle has been correctly passed, are examined by Dr. H. Carter in a short note contributed to the annual report of the Metropolitan Asylums Board for 1928 (p. 289). In the first place, he points out, the fluid I may be pathologically thick or may be liable to cloti in the needle. Secondly, there may for some reason be low local intrathecal fluid pressure. Neither of these explanations admits of much discussion. A third possible impediment-namely, lateral displacement of the theca by the needle-is set aside by Dr. Carter as improbable in view of the strong lateral and anterior attachment of the theca by the nerve
CENTRAL ASSOCIATION
FOR
MENTAL WELFARE.-
The annual conference of this Association, which was held in London at the end of last April, was described in our columns on May 4th (p. 921 et seq.). A complete report of the proceedings has now been issued and can be obtained from the Central Association for Mental Welfare, 24, Buckingham Palace-road, London, S.W., price 3s. 6d. The conference met under the presidency of Sir Leslie Scott, M.P., and was attended by a large number of people specially interested in mental welfare and the effect of the Local Government Act, 1929, on the work of local authorities under the Mental Deficiency Acts. Among the papers read was one on the report of the special investigation carried out on behalf of the joint committee of the Board of Education and the Board of Control, contributed by Dr. A. F. Tredgold, and an address on the recommendations of that committee was given by Dr. R. H. Crowley, senior medical officer to the Board of Education.
glass classes, the nearly 13, whereas
These factors would more or less hold good for English schools in general, and considering that vita-glass tends to lose its special penetrability with time and is a good deal more expensive than ordinary glass, it scarcely seems sound policy to reglaze all class-rooms. Certainly it would be undesirable to do so if such a step were thought a satisfactory alternative to the establishment of adequate open-air schools where sunlight can act under much more favourable conditions and in company with many other healthful
influences.
____
A NEW VACCINATION ORDER. THE Minister of Health has adopted the four first recommendations of the Committee appointed by his predecessor in 1926 to consider, inter alia, " the practical methods which are available in the light of modern knowledge to remove any risks which may result from vaccination." An Order issued this week gives effect to the change of policy, and an account of its provisions will be found on p. 411 of our present issue. It instructs public vaccinators to make single insertions of lymph instead of the four
abnormally persistent subarachnoid fibrous tissue a certain proportion of adults.
may be found in ON
Tuesday evening, August 20th, the following
bulletin
was
issued from
Buckingham
Palace
:-
The progress of His Majesty the King towards restoration of health continues. The wound is steadily diminishing in size, and is healing satisfactorily. His Majesty has derived benefit from breathing and other physical exercises. Both bodily and mental activity are now undertaken without undue fatigue. The King will be able to leave London for Sandringham in a few days.
This bulletin, which is the first to appear since July 3rd, was signed by Sir Stanley Hewett, Sir Hugh Rigby, and Lord Dawson. MORE than 700 people have enrolled as members of the Thirteenth International Ophthalmological Congress which is to be held at Amsterdam and The Hague from Sept. 5th to 13th, and nearly 250 communications covering the branches of ophthalmology have been promised. The principal subjects of discussion will be the aetiology and non-operative treatment of glaucoma ; the geographical distribution of, and international social campaign against, trachoma; and the diagnosis of suprasellar tumours. Committees will present reports on the examination of visual acuity, perimetry, the notation of the cylinder axis, the examination of light sense, the standardisation of the visual examination of railwaymen and others, and ophthalmological education. The representative of England on the International Ophthalmological Council is Mr. Leslie Paton, whilst the secretary is Dr. E. Marx, of Holland.
which were previously required ; multiple insertions will be available for those who wish to gain maximal immunity at one operation. As a corollary to the smaller dosage the rule is altered by which the Ministry did not allow revaccination, by public vaccinators, below the age of 10. Revaccination will be encouraged at the age of entering school (5 to 7 years), and again on leaving (14 to 16). In a covering letter to local authorities the Minister emphasises the importance of primary vaccination in infancy. " Recognising that post-vaccinal nervous disease has occurred mainly in children of school age or in adolescents who have never been vaccinated, he expresses the opinion that in the present state of knowledge, and so long as the small-pox prevalent WE have to record the death of Dr. Fletcher Beach, in this country retains its mild character, it is not consulting physician to the West End Hospital for for the vaccination of to generally expedient press and at one time medical superinNervous Diseases, such persons unless they have been directly exposed to infection. The new Order makes no reference to tendent of Darenth Asylum, on August 18th, in his eighty-fifth year. the use of less potent lymph. "
DRY LUMBAR PUNCTURE. THE difficulties occasionally encountered in securing a sample of cerebro-spinal fluid, although the needle has been correctly passed, are examined by Dr. H. Carter in a short note contributed to the annual report of the Metropolitan Asylums Board for 1928 (p. 289). In the first place, he points out, the fluid I may be pathologically thick or may be liable to cloti in the needle. Secondly, there may for some reason be low local intrathecal fluid pressure. Neither of these explanations admits of much discussion. A third possible impediment-namely, lateral displacement of the theca by the needle-is set aside by Dr. Carter as improbable in view of the strong lateral and anterior attachment of the theca by the nerve
CENTRAL ASSOCIATION
FOR
MENTAL WELFARE.-
The annual conference of this Association, which was held in London at the end of last April, was described in our columns on May 4th (p. 921 et seq.). A complete report of the proceedings has now been issued and can be obtained from the Central Association for Mental Welfare, 24, Buckingham Palace-road, London, S.W., price 3s. 6d. The conference met under the presidency of Sir Leslie Scott, M.P., and was attended by a large number of people specially interested in mental welfare and the effect of the Local Government Act, 1929, on the work of local authorities under the Mental Deficiency Acts. Among the papers read was one on the report of the special investigation carried out on behalf of the joint committee of the Board of Education and the Board of Control, contributed by Dr. A. F. Tredgold, and an address on the recommendations of that committee was given by Dr. R. H. Crowley, senior medical officer to the Board of Education.