- Email: [email protected]
RETROGRADE SANITATION.
257 course, no panel must be formed anywhere until the rightful terms of the profession are accepted all over the country, but we shall not compromise our position by forming the local
RETROGRADE SANITATION. To the Editor of THE LANCET.
medical committees. (c) Much objection has been raised to the Act because of the inadequate representation of the medical profession on the various administrative bodies, but I think that with local Medical Committees safeguarding the interests of the profession it will only be necessary to have representatives on the committees. I believe that it will be difficult to get general practitioners to devote the time which will be involved in filling the posts now open to medical men on these committees, and it is a mistake to think that medical men could be found in large numbers to give the time that will be required to attend to the detail of these insurance com-
SIR,-In spite of the pressure of other business, last Session the Government found time to pass a "Factories and Workshops Act," 1911, and Mr. McKenna has just issued some "Regulations as to Humidity and Ventilation in Cotton Cloth Factories " (Statutory Rules and Orders, 1911, No. 120). It is headed "Health and Safety," but after careful petu al it is only safe to conclude that those portions of these regulations relating to ventilation can but tend to deterioration in the health of the operatives. It is true that these rules contain certain orders relating to humidity and the care of clothes, which had been previously in force, but which are now dealt with in more detail and with greater definiteness of language than had been done in previous regulations, and this is truly an excellent thing. When, however, it is seen that, in reference to ventilation, the standard of purity of the air is greatly reduced, the conclusion will be reached that a grievous mistake (or I would rather say a crime against the laws of health) has been there-
mittees. I trust that these matters may be taken into the most I am, Sir, yours faithfully, careful consideration. CHARLES F. HARFORD. Jan. 1912. 22nd, Leyton, E.,
To the Editor of THE LANCET.
SIR,-I
my friend Dr.
by committed. In Regulation 9
of this document it is enacted that " In every humid shed and in every dry shed the arrangements for ventilation shall be such that at no time during working hours shall the proportion of carbon dioxide in the air, in any portion of the shed, exceed the limit specified below for that
Greenwood will forgive me for not at present entering further into the controversy concerning the merits of the per capita or per attendance systems of payment for medical service. He and I are well aware how impossible it is to induce the enthusiasts for either method to look favourably upon the other. We both took part in formulating the compromise which is embodied in the local optionclause as to method of remuneration amongst the so-called six cardinal principles, and I am sure neither of us desires to interfere in any way with that compromise or to do anything that might for a moment be regarded as a weakening of the profession’s attitude towards its six-point programme. My recent intervention in your columns and elsewhere has been entirely due to the fact that two influential members of the profession, no doubt in ignorance of the difficulty with which the compromise had been arrived at, had written urging upon their colleagues a course which, if persisted in, must lead to the abandonment of one of the cardinal principles and cause serious dissension in our ranks. Until "local option"as to method of remuneration is firmly established in the Commissioners’ regulations it is unsafe for the medical profession to reopen their discussions on the merits of the respective systems. I am, Sir, yours faithfully, LAURISTON E. SHAW. Jan. 22nd, 1912. am
sure
Major
shed, namely :by volume parts in excess of the
for 7)Mm7 sheds or u’7/ shed
of carbon dioxide per 10,000 of air proportion in the outside air at the
11
fordry sheds11
time.
Now, in the regulations previously in force the amount of carbon dioxide allowed per 10,000 volumes of air had only been five volumes in the case of humid sheds, and the same standard was recommended by the then Home Office Committee for dry sheds as well. It will therefore be seen at a glance how great a fall in the purity of the air in all these sheds will follow this enactment. The history of the lastnamed standard is briefly as follows. In the year 1896-97 a Home Office Committee was appointed to inquire into the conditions of humid sheds. It consisted of Sir H. Roscoe, F. R S., the late Sir William Roberts, F. R S., and myself, and among other matters requiring attention we found that the amount of ventilation in these workplaces required by s’atute was insufficient. In our report to the Home Office we therefore recommended that as a measure of the respiratory impurity no greater proportion than nine volumes of carbon dioxide per 10,000 volumes of air (i.e., five volumes more than was contained in the outer air) should be allowed in the sheds, and that the ventilating arrangements should be sufficient to secure the general attainment of this standard. We pointed out that "this limit will secure an amount of ventilation corresponding to about 2000 c.f. per head per hour, and your committee believe that such a requirement would bring about a material improvement in the health and comfort of the workers." This proposal was accepted without protest by both masters and
-
To the Editor of THE LANCET. SiR,-It is with great dismay that I note so little protest is made concerning our independence, the most important point of all, under the Insurance Act. As the Act stands three-fifths of the Local Insurance Committee is composed of members of Friendly Societies and Post Office con-
tributors ; thus, technically, this seems to satisfy one cardinal point " ; but as a matter of actual practice and in workpeople. Two years later, in 1899, Mr. Williams, the inspector under effect is it not clearly evident that we are as badly off (or the Cotton Cloth Factories Acts, noted that the scientific as if we were under control of the worse) entirely Friendly Societies ?7 This point the council of the British tests had already led to a great improvement in the working Medical Association, if it claims to represent the pro- conditions of the operatives, and that it had also done much fession, must immediately and definitely insist on being to promote an intelligent interest and a more exact knowrectified. ledge on the subject of ventilation." He also drew up the table showing the results before and after the following of on the silence the Societies this Surely Friendly point speaks volumes, for they know full well that if we are fools improved means of ventilation had been installed. enough to work under the Act without a drastic alteration Table sh07ving .4pproxii?tate lYtl1nber ofT ol2cmes of Carbon on this particular point at least, no matter what our Dioxide per -ZO,000 dzce to Respiration. remuneration may be, they will be able to dictate to us. Before Before "
I
The newspapers may be full of accounts of medical men being hauled up before these tribunals. Are we content, on matters of discipline, to be subject to such bodies with only a right of appeal to the Commissioners ?7 Surely the deciding body should be the General Medical Council. Can anyone expect any self-respecting father to permit his son to enter our profession where service under such debasing conditions exists ? I believe this Act to be the"beginning of of the end" for our profession as an honourable calling. I am, Sir, yours faithfully, E T. T. LARKAM. LARKAM. Manchester, Jar. 22nd, 1912.
improvements. 8-0 6-8 10-7 11-3 6-9 g.O
.........
.........
.........
.........
.........
.........
After After.
2-1 42 31 2 6 3’0 4-2
improvements.
z i
z
9-2 111 7-7 1044 78
.........
.........
.........
.........
.........
After ’ 3-8 366 2-4 3-7 2-4
’
Mr. Williams further remarked that the health of the had greatly improved and the sickness-rate had been much smaller. All the evidence drawn from public health annals shows that this final result of improved ventilation is only what
operatives
’
258
might have been anticipated, and I greatly fear that the new harmony with the views of Dr. Head and Dr. Holmes as to and degraded standard will lead to more ill-health, to the r6le which the cerebral hemispheres play in sensation. The identification of feeling tone with the optic thalamus respiratory disease, and especially to an increase in the number of consumptives. helps us to understand the anatomico-physiological I am, Sir, yours faithfully, mechanism pertaining to moods and mental temperament. ARTHUR RANSOME. If these depend, as they undoubtedly largely do, on feeling Bournemouth, Jan. 22nd, 1912. tone, and if feeling tone is closely associated with the activity of the optic thalamus, then moods and temperament INTESTINAL MYIASIS. must be closely dependent upon the activity of this organ. Now feeling tone is profoundly influenced by the state of To the Editor of THE LANCET. 1 the blood (witness the change in the affective nature during SiR,-The addition of a few references to Dr. E. A.1the rutting time, and as the result of the action of such I as alcohol and morphine), and we therefore seem Cockayne’s bibliography in his interesting paper on Intestinalsubstances Myiasis would make it more complete. I have seen five such justified in assuming that temperament and moods depend cases in infants, in four of which the larvse were present in in large measure upon the manner in which that subtly the stools and in one they were found in the vomit. The complex and ever-changing fluid, the blood, plays upon a particular varieties were not identified. particular part of the mind instrument-to wit, the optic I am, Sir, yours faithfully, thalamus. EDMUND CAUTLEY. Park-street, W., Jan. 23rd, 1912. I may here remark parenthetically that there is strong
I
Additional bibliography.—1. Cohn: Deutsche Medicinische Wochen- evidence in favour of the conclusion that differences in schrift, March 24th, 1898; age 3 months; larvæ in vomit and fæces. mental temperament essentially depend, not upon differ2. Keenan: THE LANCET, 1903, vol. i., p. 200 ; infant; larvæ in vomit. 3. S. M. Lawrence: Brit. Med. Jour., 1910, vol. ii., p. 376. 4. A. E.ences in brain organisation, but upon differences in blood May: Brit. Med. Jour., 1906, vol. ii., p. 180. 5. A. B. Northgate: Brit. composition ; not upon differences in the structure of the Med. Jour., 1906, vol. ii., p. 180. 6. J. Smyth: THE LANCET, 1902, mind instrument, but upon differences in the way that vol. ii., p. 1487. The last four cases consisted of a girl, 9 years old, and instrument is played upon by the blood. three males, an adult, a boy, and an infant with larvæ in the stools. May I, Sir, in conclusion suggest that the authors of these remarkable articles might throw still more light on a subject To the Editor of THE LANCET. they have done so much to illuminate, by investigating the SIR,-Dr. E. A. Cockayne in his interesting article in THE effects on the various forms of sensibility of substances such LANCET of Jan. 20th on " Intestinal Myiasis " says : " There, as alcohol and morphine ?7 I am, Sir, yours faithfully, is still a little doubt as to how the larvae gain access to the, HARRY CAMPBBLL. CAMPBELL. intestinal tract," and then mentions various articles of food, Wimpole-street, Jan. 20th, 1912. milk is which its absence. I on have conspicuous by among
several occasions observed that the ovipositor of a fly drowned in milk has been extruded, and I have little doubt that the eggs I have were in the milk, though I did not search for them. recorded observations that when temperature conditions were favourable, fermentccteon of food stuffs was not an essential factor in the growth of the larvae of the house fly. In cases of intestinal myiasis the eggs or young larvas might easily be introduced in milk from which a drowned fly has been removed-a not infrequent incident in many homes in the " " fly months. Flies will live through the winter in a warm kitchen or bakehouse, and milk is frequently kept in such places. The colour of the milk prevents the ova or larvse being observed without careful straining and minute examination. Even the for extraordinary cases in which larvae have been months or years may also thus be explained. I am, Sir, yours faithfully, J. T. C. NASH. Norwich, Jan. 20th, 1912.
NON-TUBERCULOUS MILK GUERNSEY.
IN
To the Editor of THE LANCET.
report of the Royal Commission upon Tuberculosis has called attention to the fact that a large proportion of the tuberculosis of children and young people is due to the consumption of milk from cows affected with this disease. Until 1906 tuberculosis was apparently unknown amongst Guernsey cattle, but it was then introduced by cattle re-imported after having been to England for exhibition. This re-importation is now forbidden, and drastic laws have been passed compelling the slaughter of all infected cattle and granting State compensation. As a result the disease has been practically stamped out, and of the 1364 animals exported during the past three years, all of which were tested with tuberculin, only six were found to be affected. This gives tuberculosis a rate of under t per cent. compared with the estimate of Sir John McFadyean, principal of the Royal Veterinary College, London, of 20 per cent. of adult cows in SIR,-The
passed
I
recent
SENSORY DISTURBANCES AND CEREBRAL England. LESIONS. The forms To the Editor of THE LANCET. SIR,-Among the many conclusions arrived at by Dr. Henry Head and Dr. Gordon Holmes in their studies of the sensory disturbances resulting from cerebral lesions,l I find none more interesting than that which assigns to the optic thalamus, or rather the "essential organ " of this structure, a leading rÔle in the genesis of feeling (affective) tone. This element of feeling tone not only enters largely into the massive sensations of pleasure and discomfort, but also into emotional feelings, such as fear, joy, anger, gloom ; it constitutes, moreover, the essential ingredient of mental temperament and of moods. The suggestion that feeling tone is largely determined by the activity of a limited portion of brain tissue may to some appear somewhat startling. When, however, we call to mind that a creature with a brain no larger than a pea, such as a mouse or small bird, is capable of as highly developed affective tone as man himself, it becomes evident (1) thatti a diminutive mass of brain tissue suffices for the genesis ofE affective tone ; and (2) that the enormous development of thes cerebral hemispheres in the higher mammals is not for the3 purpose of adding to feeling capacity in its grosser aspects,’ but, on the contrary, is essentially bound up with intellectual development-a conclusion, needless to say, in entiree .
of human tuberculosis chiefly caused by bovine tuberculosis (tubercular glands of neck, abdominal tuberculosis, and lupus) are consequently exceedingly rare in the island of Guernsey. Channel Islands’ cows give the richest milk in the world, the average of fat for Guernsey cattle being over 60 per cent. above the English legal standard for fat. It is impossible to over-rate the importance, especially where children and delicate persons are concerned, of milk so rich in butter fat, and above all so free from the germs of the scourge of tuberculosis -I am, Sir, yours faithfully, HENRY DRAPER BISHOP, Health
Office,
Medical Officer of Health, States of Guernsey, Jan. 20th, 1912.
THE FINSBURY MEDICAL SOCIETY AND
TUBERCULOSIS DISPENSARIES. To the Editor of THE LANCET. meeting of the Finsbury Medical Society held Jan. 19th, the following resolution was unani-
SiR,—At Friday, mously passed:a
on
That the Finsbury Medical Society presents strenuous opposition to the establishment of a tuberculosis dispensary in Finsbury on the lines proposed by the Central Committee for the Establishment of Tuberculosis Dispensaries.
I am,
Sir,
yours
-
1
THE
LANCET, Jan. 6th (p. 1), 13th (p. 79),
and 20th
(p. 144), 1912.
Guernsey. Guernsey.
Northampton-square, E.C.,
Jan.
faithfully,
W. FRANCIS ROE, RoE, Hon. Sec. 20th, 1912.
RETROGRADE SANITATION. To the Editor of THE LANCET.
medical committees. (c) Much objection has been raised to the Act because of the inadequate representation of the medical profession on the various administrative bodies, but I think that with local Medical Committees safeguarding the interests of the profession it will only be necessary to have representatives on the committees. I believe that it will be difficult to get general practitioners to devote the time which will be involved in filling the posts now open to medical men on these committees, and it is a mistake to think that medical men could be found in large numbers to give the time that will be required to attend to the detail of these insurance com-
SIR,-In spite of the pressure of other business, last Session the Government found time to pass a "Factories and Workshops Act," 1911, and Mr. McKenna has just issued some "Regulations as to Humidity and Ventilation in Cotton Cloth Factories " (Statutory Rules and Orders, 1911, No. 120). It is headed "Health and Safety," but after careful petu al it is only safe to conclude that those portions of these regulations relating to ventilation can but tend to deterioration in the health of the operatives. It is true that these rules contain certain orders relating to humidity and the care of clothes, which had been previously in force, but which are now dealt with in more detail and with greater definiteness of language than had been done in previous regulations, and this is truly an excellent thing. When, however, it is seen that, in reference to ventilation, the standard of purity of the air is greatly reduced, the conclusion will be reached that a grievous mistake (or I would rather say a crime against the laws of health) has been there-
mittees. I trust that these matters may be taken into the most I am, Sir, yours faithfully, careful consideration. CHARLES F. HARFORD. Jan. 1912. 22nd, Leyton, E.,
To the Editor of THE LANCET.
SIR,-I
my friend Dr.
by committed. In Regulation 9
of this document it is enacted that " In every humid shed and in every dry shed the arrangements for ventilation shall be such that at no time during working hours shall the proportion of carbon dioxide in the air, in any portion of the shed, exceed the limit specified below for that
Greenwood will forgive me for not at present entering further into the controversy concerning the merits of the per capita or per attendance systems of payment for medical service. He and I are well aware how impossible it is to induce the enthusiasts for either method to look favourably upon the other. We both took part in formulating the compromise which is embodied in the local optionclause as to method of remuneration amongst the so-called six cardinal principles, and I am sure neither of us desires to interfere in any way with that compromise or to do anything that might for a moment be regarded as a weakening of the profession’s attitude towards its six-point programme. My recent intervention in your columns and elsewhere has been entirely due to the fact that two influential members of the profession, no doubt in ignorance of the difficulty with which the compromise had been arrived at, had written urging upon their colleagues a course which, if persisted in, must lead to the abandonment of one of the cardinal principles and cause serious dissension in our ranks. Until "local option"as to method of remuneration is firmly established in the Commissioners’ regulations it is unsafe for the medical profession to reopen their discussions on the merits of the respective systems. I am, Sir, yours faithfully, LAURISTON E. SHAW. Jan. 22nd, 1912. am
sure
Major
shed, namely :by volume parts in excess of the
for 7)Mm7 sheds or u’7/ shed
of carbon dioxide per 10,000 of air proportion in the outside air at the
11
fordry sheds11
time.
Now, in the regulations previously in force the amount of carbon dioxide allowed per 10,000 volumes of air had only been five volumes in the case of humid sheds, and the same standard was recommended by the then Home Office Committee for dry sheds as well. It will therefore be seen at a glance how great a fall in the purity of the air in all these sheds will follow this enactment. The history of the lastnamed standard is briefly as follows. In the year 1896-97 a Home Office Committee was appointed to inquire into the conditions of humid sheds. It consisted of Sir H. Roscoe, F. R S., the late Sir William Roberts, F. R S., and myself, and among other matters requiring attention we found that the amount of ventilation in these workplaces required by s’atute was insufficient. In our report to the Home Office we therefore recommended that as a measure of the respiratory impurity no greater proportion than nine volumes of carbon dioxide per 10,000 volumes of air (i.e., five volumes more than was contained in the outer air) should be allowed in the sheds, and that the ventilating arrangements should be sufficient to secure the general attainment of this standard. We pointed out that "this limit will secure an amount of ventilation corresponding to about 2000 c.f. per head per hour, and your committee believe that such a requirement would bring about a material improvement in the health and comfort of the workers." This proposal was accepted without protest by both masters and
-
To the Editor of THE LANCET. SiR,-It is with great dismay that I note so little protest is made concerning our independence, the most important point of all, under the Insurance Act. As the Act stands three-fifths of the Local Insurance Committee is composed of members of Friendly Societies and Post Office con-
tributors ; thus, technically, this seems to satisfy one cardinal point " ; but as a matter of actual practice and in workpeople. Two years later, in 1899, Mr. Williams, the inspector under effect is it not clearly evident that we are as badly off (or the Cotton Cloth Factories Acts, noted that the scientific as if we were under control of the worse) entirely Friendly Societies ?7 This point the council of the British tests had already led to a great improvement in the working Medical Association, if it claims to represent the pro- conditions of the operatives, and that it had also done much fession, must immediately and definitely insist on being to promote an intelligent interest and a more exact knowrectified. ledge on the subject of ventilation." He also drew up the table showing the results before and after the following of on the silence the Societies this Surely Friendly point speaks volumes, for they know full well that if we are fools improved means of ventilation had been installed. enough to work under the Act without a drastic alteration Table sh07ving .4pproxii?tate lYtl1nber ofT ol2cmes of Carbon on this particular point at least, no matter what our Dioxide per -ZO,000 dzce to Respiration. remuneration may be, they will be able to dictate to us. Before Before "
I
The newspapers may be full of accounts of medical men being hauled up before these tribunals. Are we content, on matters of discipline, to be subject to such bodies with only a right of appeal to the Commissioners ?7 Surely the deciding body should be the General Medical Council. Can anyone expect any self-respecting father to permit his son to enter our profession where service under such debasing conditions exists ? I believe this Act to be the"beginning of of the end" for our profession as an honourable calling. I am, Sir, yours faithfully, E T. T. LARKAM. LARKAM. Manchester, Jar. 22nd, 1912.
improvements. 8-0 6-8 10-7 11-3 6-9 g.O
.........
.........
.........
.........
.........
.........
After After.
2-1 42 31 2 6 3’0 4-2
improvements.
z i
z
9-2 111 7-7 1044 78
.........
.........
.........
.........
.........
After ’ 3-8 366 2-4 3-7 2-4
’
Mr. Williams further remarked that the health of the had greatly improved and the sickness-rate had been much smaller. All the evidence drawn from public health annals shows that this final result of improved ventilation is only what
operatives
’
258
might have been anticipated, and I greatly fear that the new harmony with the views of Dr. Head and Dr. Holmes as to and degraded standard will lead to more ill-health, to the r6le which the cerebral hemispheres play in sensation. The identification of feeling tone with the optic thalamus respiratory disease, and especially to an increase in the number of consumptives. helps us to understand the anatomico-physiological I am, Sir, yours faithfully, mechanism pertaining to moods and mental temperament. ARTHUR RANSOME. If these depend, as they undoubtedly largely do, on feeling Bournemouth, Jan. 22nd, 1912. tone, and if feeling tone is closely associated with the activity of the optic thalamus, then moods and temperament INTESTINAL MYIASIS. must be closely dependent upon the activity of this organ. Now feeling tone is profoundly influenced by the state of To the Editor of THE LANCET. 1 the blood (witness the change in the affective nature during SiR,-The addition of a few references to Dr. E. A.1the rutting time, and as the result of the action of such I as alcohol and morphine), and we therefore seem Cockayne’s bibliography in his interesting paper on Intestinalsubstances Myiasis would make it more complete. I have seen five such justified in assuming that temperament and moods depend cases in infants, in four of which the larvse were present in in large measure upon the manner in which that subtly the stools and in one they were found in the vomit. The complex and ever-changing fluid, the blood, plays upon a particular varieties were not identified. particular part of the mind instrument-to wit, the optic I am, Sir, yours faithfully, thalamus. EDMUND CAUTLEY. Park-street, W., Jan. 23rd, 1912. I may here remark parenthetically that there is strong
I
Additional bibliography.—1. Cohn: Deutsche Medicinische Wochen- evidence in favour of the conclusion that differences in schrift, March 24th, 1898; age 3 months; larvæ in vomit and fæces. mental temperament essentially depend, not upon differ2. Keenan: THE LANCET, 1903, vol. i., p. 200 ; infant; larvæ in vomit. 3. S. M. Lawrence: Brit. Med. Jour., 1910, vol. ii., p. 376. 4. A. E.ences in brain organisation, but upon differences in blood May: Brit. Med. Jour., 1906, vol. ii., p. 180. 5. A. B. Northgate: Brit. composition ; not upon differences in the structure of the Med. Jour., 1906, vol. ii., p. 180. 6. J. Smyth: THE LANCET, 1902, mind instrument, but upon differences in the way that vol. ii., p. 1487. The last four cases consisted of a girl, 9 years old, and instrument is played upon by the blood. three males, an adult, a boy, and an infant with larvæ in the stools. May I, Sir, in conclusion suggest that the authors of these remarkable articles might throw still more light on a subject To the Editor of THE LANCET. they have done so much to illuminate, by investigating the SIR,-Dr. E. A. Cockayne in his interesting article in THE effects on the various forms of sensibility of substances such LANCET of Jan. 20th on " Intestinal Myiasis " says : " There, as alcohol and morphine ?7 I am, Sir, yours faithfully, is still a little doubt as to how the larvae gain access to the, HARRY CAMPBBLL. CAMPBELL. intestinal tract," and then mentions various articles of food, Wimpole-street, Jan. 20th, 1912. milk is which its absence. I on have conspicuous by among
several occasions observed that the ovipositor of a fly drowned in milk has been extruded, and I have little doubt that the eggs I have were in the milk, though I did not search for them. recorded observations that when temperature conditions were favourable, fermentccteon of food stuffs was not an essential factor in the growth of the larvae of the house fly. In cases of intestinal myiasis the eggs or young larvas might easily be introduced in milk from which a drowned fly has been removed-a not infrequent incident in many homes in the " " fly months. Flies will live through the winter in a warm kitchen or bakehouse, and milk is frequently kept in such places. The colour of the milk prevents the ova or larvse being observed without careful straining and minute examination. Even the for extraordinary cases in which larvae have been months or years may also thus be explained. I am, Sir, yours faithfully, J. T. C. NASH. Norwich, Jan. 20th, 1912.
NON-TUBERCULOUS MILK GUERNSEY.
IN
To the Editor of THE LANCET.
report of the Royal Commission upon Tuberculosis has called attention to the fact that a large proportion of the tuberculosis of children and young people is due to the consumption of milk from cows affected with this disease. Until 1906 tuberculosis was apparently unknown amongst Guernsey cattle, but it was then introduced by cattle re-imported after having been to England for exhibition. This re-importation is now forbidden, and drastic laws have been passed compelling the slaughter of all infected cattle and granting State compensation. As a result the disease has been practically stamped out, and of the 1364 animals exported during the past three years, all of which were tested with tuberculin, only six were found to be affected. This gives tuberculosis a rate of under t per cent. compared with the estimate of Sir John McFadyean, principal of the Royal Veterinary College, London, of 20 per cent. of adult cows in SIR,-The
passed
I
recent
SENSORY DISTURBANCES AND CEREBRAL England. LESIONS. The forms To the Editor of THE LANCET. SIR,-Among the many conclusions arrived at by Dr. Henry Head and Dr. Gordon Holmes in their studies of the sensory disturbances resulting from cerebral lesions,l I find none more interesting than that which assigns to the optic thalamus, or rather the "essential organ " of this structure, a leading rÔle in the genesis of feeling (affective) tone. This element of feeling tone not only enters largely into the massive sensations of pleasure and discomfort, but also into emotional feelings, such as fear, joy, anger, gloom ; it constitutes, moreover, the essential ingredient of mental temperament and of moods. The suggestion that feeling tone is largely determined by the activity of a limited portion of brain tissue may to some appear somewhat startling. When, however, we call to mind that a creature with a brain no larger than a pea, such as a mouse or small bird, is capable of as highly developed affective tone as man himself, it becomes evident (1) thatti a diminutive mass of brain tissue suffices for the genesis ofE affective tone ; and (2) that the enormous development of thes cerebral hemispheres in the higher mammals is not for the3 purpose of adding to feeling capacity in its grosser aspects,’ but, on the contrary, is essentially bound up with intellectual development-a conclusion, needless to say, in entiree .
of human tuberculosis chiefly caused by bovine tuberculosis (tubercular glands of neck, abdominal tuberculosis, and lupus) are consequently exceedingly rare in the island of Guernsey. Channel Islands’ cows give the richest milk in the world, the average of fat for Guernsey cattle being over 60 per cent. above the English legal standard for fat. It is impossible to over-rate the importance, especially where children and delicate persons are concerned, of milk so rich in butter fat, and above all so free from the germs of the scourge of tuberculosis -I am, Sir, yours faithfully, HENRY DRAPER BISHOP, Health
Office,
Medical Officer of Health, States of Guernsey, Jan. 20th, 1912.
THE FINSBURY MEDICAL SOCIETY AND
TUBERCULOSIS DISPENSARIES. To the Editor of THE LANCET. meeting of the Finsbury Medical Society held Jan. 19th, the following resolution was unani-
SiR,—At Friday, mously passed:a
on
That the Finsbury Medical Society presents strenuous opposition to the establishment of a tuberculosis dispensary in Finsbury on the lines proposed by the Central Committee for the Establishment of Tuberculosis Dispensaries.
I am,
Sir,
yours
-
1
THE
LANCET, Jan. 6th (p. 1), 13th (p. 79),
and 20th
(p. 144), 1912.
Guernsey. Guernsey.
Northampton-square, E.C.,
Jan.
faithfully,
W. FRANCIS ROE, RoE, Hon. Sec. 20th, 1912.