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EYE-STRAIN IN RELATION TO GENERAL HEALTH.
839
prevalence
of such
a
deadly
disease
as
pneumonia
so
electricity
is obtained the cost for power should not be
more
1½d. per unit, and to avoid another risk also mentioned that we should at least have some very definite statistical -viz., failure of ventilation by breakdown of motor working evidence as to the effect of the open-window system in the the fans-the motors and fans should be in duplicate.
frequently following some of the diseases referred to indicates
than
treatment of these diseases during cold and damp weather. Of course, I am not suggesting that efficient ventilation by night as well as by day is not desirable, nor that there may not be more chance of infection for others in the same room,
As in my experience there are very few places where drains and sewers are sound, the value is seen of adopting some such system of sewer ventilation so nobly tried by the advanced town of Leicester, and so ably explained by your Sanitary Commissioner, and the wide publication of your report should tempt some of our good philanthropists who have the good health of the nation one of their objects. I am, Sir, yours faithfully, D. T. BOSTEL. Ebury-street, London, S.W., March 8th, 1911.
if the windows are kept closed, nor even that in good health it is not desirable to become hardened as far as possible to the ordinary climatic variations which are likely to have to be encountered. My point is, that when any of the diseases mentioned is present that is not the time, in the majority of cases at least, for anything but sheltering the patient from certain climatic vicissitudes. Open windows A DISCLAIMER. are particularly objectionable in all probability when a child To Editor of THE LANCET. the is ill and has hitherto not been habituated to the pouring in a SIR,-Mr. Dixon, Christian Scientist, lately said in the of cold and damp air through the open window. It would -Revie7v that I Ideclared openly, a few months ago, that one of the first Satitrday which be however, appear, things may that is such a mania for the removal of the appendix." there done, immediately a nurse for a sick child has been procured, is to open, and keep open, the windows dav and night Let me say that I never said anything of the kind, nor wrote anywhere. Mr. Dixon isattributing to me what somebody regardless of the nature of the disease, the kind of weather it, else to which the child hitherto been may have said.-I am, Sir, yours faithfully, or the conditions have may STEPHEN PAGET. I am. Sir, yours faithfully, Ladbroke-square, W., March 21st, 1911. accustomed. J. SIM WALLACE. Wimpole-street, W., March 7th, 1911. "
MUSCULAR SPASM IN CARIES OF THE SPINE. EYE-STRAIN IN RELATION TO GENERAL To M6 Nattor or THE LANCET. HEALTH. SIR,-While being naturally gratified at the appreciation To the Editor of THE LANCET. of my work, which so well-known an authority on spinal SIR,—It is not easy to grasp the point of Mr. Kenneth curvatures as Mr. Roth has been kind enough to express, Campbell’s letter in THE LANCET of March 18th. I take it I must confess some surprise at his protest against my be admits the possibility of local cerebral congestion, though suggestion that muscular spasm is a factor of importance in contradicted by experimental research, and denies that such the production of deformity in spinal caries. a factor could cause the symptoms usually attributed to Mr. Roth’s assertion that I have assumed the action "eye-strain "in view of the fact that the brain is insensi- of a whole group oF muscles which do not exist is tive." Headache is one of the commonest results of so-called unwarranted ; his appeal to you to admit that such "eye-strain," it is also the result of many other conditions- muscles exist only in my imagination is almost pathetic ; If then the sensitiveness of the brain while his toxic, traumatic, &c. sneer at an eminent orthopaedic surgeon. whose has anything to do with the subject I would be glad to hear views may not coincide with his own, is undignified. in what way. I am, Sir, yours faithfully, Mr. Roth has not appreciated the fact that an anterior spinal A. A. BRADBURNE. Manchester, March 20th, 1911. EXPERIMENTS IN SEWER VENTILATION AT LEICESTER. To the Editor
SIR.—The report of
oj THE LANCET.
Sanitary Commissioner in THE LANCET of March 4th, p. 618, points once more to the efforts of THE LANCET in continually making publicly known anything likely to assist in improving the health and comfort of the people all over the world in general The truly and of the United Kingdom in particular. scientific system of sewer and drain ventilation of Shones cannot be questioned by any practical man, and it is a great pity it is not more largely adopted throughout the kingdom, especially in so-called health towns, which should be compeiled by Act of Parliament to have every drain and sewer fitted or a similarly effectual system. Your Commissioner in his very thorough report calls attention to the difficulties encountered at Leicester after the system had been put in operation, especially when it was found that air was drawn into the drains and sewer through unsound and leaky joints and not through the down-cast ventilation pipes. To my mind, this is evidence of one of the valuable points of the system, because it exhibits a serious weakness that under the present system of sewer or drain ventilation would never be discovered, especially as now there are methods of making drain and pipe sewer joints sound (air and water tight) without greatly disturbing the surface ground under which drains and sewers are laid at a reasonable cost. The very great health advantage would be added to the district of having sound sewers and drains scientifically ventilated, with the advantage, as your Commissioner also points out, of having all foul smells drafted away from the town and district where they can be filtered, cremated, or destroyed. Another great advantage also accrues in that the sewage is continually being aerated, and in places where sewers have slight gradients the flow would be doubtlessly accelerated. Your Commissioner mentions cost of electric current at 3d. per with but now in most places where an efficient installation of your
muscle is by no means synonymous with a muscle anterior to the spine. In the paper he refers to, which you honoured me by printing in the columns of THE LANCET, I was dealing essentially with the mechanical treatment of spinal caries during recumbency. I indeed prefaced my description of the apparatus I employ by a short allusion to the factors which produce deformity, and emphasised the influence of muscular spasm. That it is a factor in the production of deformity of extreme importance I am convinced, but that its action is very complex, I think, cannot be doubted. I hope indeed later to be able tn publish a separate paper on this subject, but to have dealt with it at length in the original paper was an impossibility. Mr. Roth has deigned to criticise my remarks somewhat hastily and without due consideration. If he will dispassionately consider the factors which produce deformity in spinal caries in any particular case, he should, in the light of the suggestion I have made as to the importance of muscular spasm, soon grasp the importance of the action of the anterior spinal muscles-i e., the anterior of the muscles investing the spine-which act to the greatest mechanical advantage in the dorsal region, and not, as he conceives they should, in the cervical or lumbar. Mr. Roth has betrayed a lack of comprehension of muscular action about the spine. Perhaps his kindly hint that I should examine the cadaver might be amicably reciprocated by me. I did not venture to advance my views until I had anticipated his advice and supplemented the information I thus gained by extensive clinical observation. In any case, even if Mr. Roth is unable to appreciate the effects of muscular spasm in spinal caries, yet still he may care to adopt the mechanical methods I have advocated, methods which are the outcome of a study of muscular spasm in this condition. In that case I can promise him with confidence that the cases of spinal caries under his care will not become more deformed, that deformity which has not commenced will not appear, and that that portion of deformity which may be present which is due to existing muscular spasm may be safely and certainly corrected. I am, Sir, yours faithfully, H. J. J. GAUVAIN. Alton, Hants, March 20th, 1911.
prevalence
of such
a
deadly
disease
as
pneumonia
so
electricity
is obtained the cost for power should not be
more
1½d. per unit, and to avoid another risk also mentioned that we should at least have some very definite statistical -viz., failure of ventilation by breakdown of motor working evidence as to the effect of the open-window system in the the fans-the motors and fans should be in duplicate.
frequently following some of the diseases referred to indicates
than
treatment of these diseases during cold and damp weather. Of course, I am not suggesting that efficient ventilation by night as well as by day is not desirable, nor that there may not be more chance of infection for others in the same room,
As in my experience there are very few places where drains and sewers are sound, the value is seen of adopting some such system of sewer ventilation so nobly tried by the advanced town of Leicester, and so ably explained by your Sanitary Commissioner, and the wide publication of your report should tempt some of our good philanthropists who have the good health of the nation one of their objects. I am, Sir, yours faithfully, D. T. BOSTEL. Ebury-street, London, S.W., March 8th, 1911.
if the windows are kept closed, nor even that in good health it is not desirable to become hardened as far as possible to the ordinary climatic variations which are likely to have to be encountered. My point is, that when any of the diseases mentioned is present that is not the time, in the majority of cases at least, for anything but sheltering the patient from certain climatic vicissitudes. Open windows A DISCLAIMER. are particularly objectionable in all probability when a child To Editor of THE LANCET. the is ill and has hitherto not been habituated to the pouring in a SIR,-Mr. Dixon, Christian Scientist, lately said in the of cold and damp air through the open window. It would -Revie7v that I Ideclared openly, a few months ago, that one of the first Satitrday which be however, appear, things may that is such a mania for the removal of the appendix." there done, immediately a nurse for a sick child has been procured, is to open, and keep open, the windows dav and night Let me say that I never said anything of the kind, nor wrote anywhere. Mr. Dixon isattributing to me what somebody regardless of the nature of the disease, the kind of weather it, else to which the child hitherto been may have said.-I am, Sir, yours faithfully, or the conditions have may STEPHEN PAGET. I am. Sir, yours faithfully, Ladbroke-square, W., March 21st, 1911. accustomed. J. SIM WALLACE. Wimpole-street, W., March 7th, 1911. "
MUSCULAR SPASM IN CARIES OF THE SPINE. EYE-STRAIN IN RELATION TO GENERAL To M6 Nattor or THE LANCET. HEALTH. SIR,-While being naturally gratified at the appreciation To the Editor of THE LANCET. of my work, which so well-known an authority on spinal SIR,—It is not easy to grasp the point of Mr. Kenneth curvatures as Mr. Roth has been kind enough to express, Campbell’s letter in THE LANCET of March 18th. I take it I must confess some surprise at his protest against my be admits the possibility of local cerebral congestion, though suggestion that muscular spasm is a factor of importance in contradicted by experimental research, and denies that such the production of deformity in spinal caries. a factor could cause the symptoms usually attributed to Mr. Roth’s assertion that I have assumed the action "eye-strain "in view of the fact that the brain is insensi- of a whole group oF muscles which do not exist is tive." Headache is one of the commonest results of so-called unwarranted ; his appeal to you to admit that such "eye-strain," it is also the result of many other conditions- muscles exist only in my imagination is almost pathetic ; If then the sensitiveness of the brain while his toxic, traumatic, &c. sneer at an eminent orthopaedic surgeon. whose has anything to do with the subject I would be glad to hear views may not coincide with his own, is undignified. in what way. I am, Sir, yours faithfully, Mr. Roth has not appreciated the fact that an anterior spinal A. A. BRADBURNE. Manchester, March 20th, 1911. EXPERIMENTS IN SEWER VENTILATION AT LEICESTER. To the Editor
SIR.—The report of
oj THE LANCET.
Sanitary Commissioner in THE LANCET of March 4th, p. 618, points once more to the efforts of THE LANCET in continually making publicly known anything likely to assist in improving the health and comfort of the people all over the world in general The truly and of the United Kingdom in particular. scientific system of sewer and drain ventilation of Shones cannot be questioned by any practical man, and it is a great pity it is not more largely adopted throughout the kingdom, especially in so-called health towns, which should be compeiled by Act of Parliament to have every drain and sewer fitted or a similarly effectual system. Your Commissioner in his very thorough report calls attention to the difficulties encountered at Leicester after the system had been put in operation, especially when it was found that air was drawn into the drains and sewer through unsound and leaky joints and not through the down-cast ventilation pipes. To my mind, this is evidence of one of the valuable points of the system, because it exhibits a serious weakness that under the present system of sewer or drain ventilation would never be discovered, especially as now there are methods of making drain and pipe sewer joints sound (air and water tight) without greatly disturbing the surface ground under which drains and sewers are laid at a reasonable cost. The very great health advantage would be added to the district of having sound sewers and drains scientifically ventilated, with the advantage, as your Commissioner also points out, of having all foul smells drafted away from the town and district where they can be filtered, cremated, or destroyed. Another great advantage also accrues in that the sewage is continually being aerated, and in places where sewers have slight gradients the flow would be doubtlessly accelerated. Your Commissioner mentions cost of electric current at 3d. per with but now in most places where an efficient installation of your
muscle is by no means synonymous with a muscle anterior to the spine. In the paper he refers to, which you honoured me by printing in the columns of THE LANCET, I was dealing essentially with the mechanical treatment of spinal caries during recumbency. I indeed prefaced my description of the apparatus I employ by a short allusion to the factors which produce deformity, and emphasised the influence of muscular spasm. That it is a factor in the production of deformity of extreme importance I am convinced, but that its action is very complex, I think, cannot be doubted. I hope indeed later to be able tn publish a separate paper on this subject, but to have dealt with it at length in the original paper was an impossibility. Mr. Roth has deigned to criticise my remarks somewhat hastily and without due consideration. If he will dispassionately consider the factors which produce deformity in spinal caries in any particular case, he should, in the light of the suggestion I have made as to the importance of muscular spasm, soon grasp the importance of the action of the anterior spinal muscles-i e., the anterior of the muscles investing the spine-which act to the greatest mechanical advantage in the dorsal region, and not, as he conceives they should, in the cervical or lumbar. Mr. Roth has betrayed a lack of comprehension of muscular action about the spine. Perhaps his kindly hint that I should examine the cadaver might be amicably reciprocated by me. I did not venture to advance my views until I had anticipated his advice and supplemented the information I thus gained by extensive clinical observation. In any case, even if Mr. Roth is unable to appreciate the effects of muscular spasm in spinal caries, yet still he may care to adopt the mechanical methods I have advocated, methods which are the outcome of a study of muscular spasm in this condition. In that case I can promise him with confidence that the cases of spinal caries under his care will not become more deformed, that deformity which has not commenced will not appear, and that that portion of deformity which may be present which is due to existing muscular spasm may be safely and certainly corrected. I am, Sir, yours faithfully, H. J. J. GAUVAIN. Alton, Hants, March 20th, 1911.