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THE CLIMATE OF DISCOVERY
1088 fibres become brittle and easily break, forming fragments that are scattered and may convey infection whenever the bedding is disturbed. Synthetic fibre (’ Terylene ’) blankets stand up well to washing and sterilisation by boiling in the laundry. They are warm and comfortable in use, but objection has been made that they generate static electricity and In are therefore dangerous in the operation theatre. our view this is no disadvantage since, on bacteriological grounds alone, blankets should never be taken into the theatre. Moreover, it is not sufficiently appreciated that even wool has appreciable powers of generating static electricity. There are also several kinds of woven cotton material suitable for use as hospital blankets. One of these is turkish towelling. They too may be sterilised by boiling. We are now giving these different types of blanket ward trials, but it is yet too early for us to say how they stand up to long use, repeated sterilisation, and laundering. Public Health Laboratory, General Hospital,
Middlesbrough.
ROBERT BLOWERS J. POTTER K. R. WALLACE.
SiR,-It is indeed encouraging to find appearing almost
Dr. Leonard Colebrook’s article of Oct. 29 and Dr. W. F. Wells’s textbook.! Dr. Colebrook adds another chapter to the large volume of evidence incriminating airborne organisms in infections of wounds and burns. Fortunately the picture need not be so black as he paints it, for there is also a large volume of published evidence showing that airborne bactericides could be a potent weapon for reducing cross-infections. It is somewhat surprising that Dr. Colebrook should have made only passing reference to American work on glycol aerosols and omitted all reference to British work on phenolic aerosols.
simultaneously,
Apart from our own published work on air disinfection the Medical Research Council2 recommended the trial of heatvolatilised hexylresorcinol. Dickson3 and McGrath4 offer good evidence of its efficiency in reducing morbidity from aerial infections, and we have had verbal reports of reduced contamination-rates in plasma and ampoule filling rooms of hospitals, blood-transfusion centres, and commercial premises. McGrath’s results in the Dublin Zoo monkey house are the most striking in that morbidity from upper-respiratory infections " almost disappeared, and there has been no case of tuberculosis " following the introduction of resorcinol and subsequently hexylresorcinol aerosols ; and the position remains unchanged to date. These trials, extending now over six and a half years, seem to have passed unnoticed by the majority of English doctors. We suggest that the conditions in hospital practice are similar in many respects to those in McGrath’s cases, and that hexylresorcinol aerosols would be equally effective. Dr. MacKay, in his letter last week, mentions his work5 on hexylresorcinol and reiterates that thermal aerosol generators are relatively cheap and simple compared with air-conditioning plant.6 A high rate of kill (90-95% in five minutes) is a common finding in the laboratory. Removal of bacteria at such a rate by air changes would necessitate one air change every two minutes. This would cause great discomfort from draughts, and such rapid air movement might even increase the number of organisms reaching an operation wound or uncovered burn. It is open to question whether it would be in the best interest of patients to remain for long periods in bacteria-free air. The presence of dead or attenuated organisms such as occur in aerosol-treated atmospheres may have a prophylactic value. Aerosols again come into the picture with regard to the control of flies. The continuous-flow aerosol has hitherto been installed in over 50 hospitals in this country, and has proved remarkably successful. It is particularly suitable for -
1.
2.
Wells, W. F. Airborne Contagion and Air Hygiene. Cambridge, Mass., 1955. Studies in Air Hygiene. Spec. Rep. Ser. med. Res. Coun., Lond.
1948, no. 262 ; p. 314. Dickson, C. Irish J. med. Sci. 1953, p. 337. McGrath, J. Ibid, p. 343. MacKay, I. J. Hyg., Camb. 1952, 50, 82. 6. See also Baker, A. H. Lancet, 1954, i, 518, 3. 4. 5.
fly-control in wards, since it is silent, and needs no labour (and is therefore immune from the possibility of human failure, a major factor in pest-control) ; and as it dispenses only the pure insecticide the irritation which commonly results from carriers and solvents does not
occur.
Finally Dr. Colebrook, in his otherwise admirable survey of the sources of contamination, omits an importa,nt one-the cockroach. While no species of cockroach has yet been implicated as a disease vector it is generally accepted that it may, at times, be an important agent in the mechanical transmission of infection on food. The eradication of these insects is extremely difficult, but the installation of continuous-flow-aerosol equipment has given excellent long-term results and has often eliminated cockroach populations of both Blatta orientalis and The same installations are also Blattella germanica. effective
against flies.
Avebury Research Laboratories, Goring-on -Thames, Oxon.
A. H. BAKER F. G. SAREL WHITFIELD.
THE CLIMATE OF DISCOVERY
SiR,-Einstein stated that the most important thing in scientific work is intuition. Is this where art comes into both Science and Medicine, and can the difference between Professor Arnott (Oct. 15) and Sir Francis Walshe (Oct. 29) be resolved in this way? London,
J. W.1..j.
M. ALSTON.
PSYCHOSOMATIC PROBLEMS IN POSTURAL RE-EDUCATION
SIR,-I wonder if the profession, generally, realises the importance of Dr. Barlow’s article of Sept. 24. If doctors could get patients to master the principles which he stresses, it would go a long way to minimise the effects of the strain of everyday life. " Good posture " can be taught to the student or patient only by learning the fundamentals of muscle action, called the anatomy of movement. For any action to be carried out
perfectly, the activating muscles must function just after the contraction of the synergists and both these sets of muscles must work on already alerted prime fixers. three fundamental postures that the body can and passive. We divide the human frame arbitrarily into eight mobile parts attached to eight fixed parts : (1) the head on the neck and trunk ; (2) and (3) the shoulder girdle suspended by muscles from the skull, the cervical and dorsal spine, and the chest wall; (4) the trimk and pelvis ; (5) and (6) the pelvis on the hip-joints ; (7) and (8) the whole body on the ankles and feet. In active posture all the mobile parts are firmly attached to the fixed levels by the prime fixing muscles. The position adopted is that of the ape, and is a position of alertness. If we consider it in detail, it is the position taken up in conditions of stress and strain. The matador and the trapeze artist both adopt this position and it is one in which the prime fixing muscles are in slight contraction but the other muscles are in balanced relaxation. Scandinavian countries are now teaching relaxed posture. This stipulates that in the-erect position the prime fixers are all fixed and the patient, as Dr. Barlow says, stands as tall as possible, so that he takes all the body-weight off his joints. The simile of the motor-car in which the tyres are pumped up, thus avoiding all strains on the rims of the wheels, chassis, and springs, is a good one. Inactive posture is completely the opposite and means that the person slumps, so that the weight of the mobile parts acts as a chronic strain on the fixed parts, and the symptoms of postural strain are produced. If we consider the eight levels at which this can occur, we can see that many of the ills of the body can be accounted for by incorrect posture or sudden movements performed off guard ; such symptoms may be headaches, pains in the neck, pains down the arms with brachial neuritis and capsulitis of the shoulders, low back pain with or without sciatica or pseudo-sciatica, pains in the buttock, and pains and aches in relation to flat feet. There
are
adopt-active, inactive,
Middlesbrough.
ROBERT BLOWERS J. POTTER K. R. WALLACE.
SiR,-It is indeed encouraging to find appearing almost
Dr. Leonard Colebrook’s article of Oct. 29 and Dr. W. F. Wells’s textbook.! Dr. Colebrook adds another chapter to the large volume of evidence incriminating airborne organisms in infections of wounds and burns. Fortunately the picture need not be so black as he paints it, for there is also a large volume of published evidence showing that airborne bactericides could be a potent weapon for reducing cross-infections. It is somewhat surprising that Dr. Colebrook should have made only passing reference to American work on glycol aerosols and omitted all reference to British work on phenolic aerosols.
simultaneously,
Apart from our own published work on air disinfection the Medical Research Council2 recommended the trial of heatvolatilised hexylresorcinol. Dickson3 and McGrath4 offer good evidence of its efficiency in reducing morbidity from aerial infections, and we have had verbal reports of reduced contamination-rates in plasma and ampoule filling rooms of hospitals, blood-transfusion centres, and commercial premises. McGrath’s results in the Dublin Zoo monkey house are the most striking in that morbidity from upper-respiratory infections " almost disappeared, and there has been no case of tuberculosis " following the introduction of resorcinol and subsequently hexylresorcinol aerosols ; and the position remains unchanged to date. These trials, extending now over six and a half years, seem to have passed unnoticed by the majority of English doctors. We suggest that the conditions in hospital practice are similar in many respects to those in McGrath’s cases, and that hexylresorcinol aerosols would be equally effective. Dr. MacKay, in his letter last week, mentions his work5 on hexylresorcinol and reiterates that thermal aerosol generators are relatively cheap and simple compared with air-conditioning plant.6 A high rate of kill (90-95% in five minutes) is a common finding in the laboratory. Removal of bacteria at such a rate by air changes would necessitate one air change every two minutes. This would cause great discomfort from draughts, and such rapid air movement might even increase the number of organisms reaching an operation wound or uncovered burn. It is open to question whether it would be in the best interest of patients to remain for long periods in bacteria-free air. The presence of dead or attenuated organisms such as occur in aerosol-treated atmospheres may have a prophylactic value. Aerosols again come into the picture with regard to the control of flies. The continuous-flow aerosol has hitherto been installed in over 50 hospitals in this country, and has proved remarkably successful. It is particularly suitable for -
1.
2.
Wells, W. F. Airborne Contagion and Air Hygiene. Cambridge, Mass., 1955. Studies in Air Hygiene. Spec. Rep. Ser. med. Res. Coun., Lond.
1948, no. 262 ; p. 314. Dickson, C. Irish J. med. Sci. 1953, p. 337. McGrath, J. Ibid, p. 343. MacKay, I. J. Hyg., Camb. 1952, 50, 82. 6. See also Baker, A. H. Lancet, 1954, i, 518, 3. 4. 5.
fly-control in wards, since it is silent, and needs no labour (and is therefore immune from the possibility of human failure, a major factor in pest-control) ; and as it dispenses only the pure insecticide the irritation which commonly results from carriers and solvents does not
occur.
Finally Dr. Colebrook, in his otherwise admirable survey of the sources of contamination, omits an importa,nt one-the cockroach. While no species of cockroach has yet been implicated as a disease vector it is generally accepted that it may, at times, be an important agent in the mechanical transmission of infection on food. The eradication of these insects is extremely difficult, but the installation of continuous-flow-aerosol equipment has given excellent long-term results and has often eliminated cockroach populations of both Blatta orientalis and The same installations are also Blattella germanica. effective
against flies.
Avebury Research Laboratories, Goring-on -Thames, Oxon.
A. H. BAKER F. G. SAREL WHITFIELD.
THE CLIMATE OF DISCOVERY
SiR,-Einstein stated that the most important thing in scientific work is intuition. Is this where art comes into both Science and Medicine, and can the difference between Professor Arnott (Oct. 15) and Sir Francis Walshe (Oct. 29) be resolved in this way? London,
J. W.1..j.
M. ALSTON.
PSYCHOSOMATIC PROBLEMS IN POSTURAL RE-EDUCATION
SIR,-I wonder if the profession, generally, realises the importance of Dr. Barlow’s article of Sept. 24. If doctors could get patients to master the principles which he stresses, it would go a long way to minimise the effects of the strain of everyday life. " Good posture " can be taught to the student or patient only by learning the fundamentals of muscle action, called the anatomy of movement. For any action to be carried out
perfectly, the activating muscles must function just after the contraction of the synergists and both these sets of muscles must work on already alerted prime fixers. three fundamental postures that the body can and passive. We divide the human frame arbitrarily into eight mobile parts attached to eight fixed parts : (1) the head on the neck and trunk ; (2) and (3) the shoulder girdle suspended by muscles from the skull, the cervical and dorsal spine, and the chest wall; (4) the trimk and pelvis ; (5) and (6) the pelvis on the hip-joints ; (7) and (8) the whole body on the ankles and feet. In active posture all the mobile parts are firmly attached to the fixed levels by the prime fixing muscles. The position adopted is that of the ape, and is a position of alertness. If we consider it in detail, it is the position taken up in conditions of stress and strain. The matador and the trapeze artist both adopt this position and it is one in which the prime fixing muscles are in slight contraction but the other muscles are in balanced relaxation. Scandinavian countries are now teaching relaxed posture. This stipulates that in the-erect position the prime fixers are all fixed and the patient, as Dr. Barlow says, stands as tall as possible, so that he takes all the body-weight off his joints. The simile of the motor-car in which the tyres are pumped up, thus avoiding all strains on the rims of the wheels, chassis, and springs, is a good one. Inactive posture is completely the opposite and means that the person slumps, so that the weight of the mobile parts acts as a chronic strain on the fixed parts, and the symptoms of postural strain are produced. If we consider the eight levels at which this can occur, we can see that many of the ills of the body can be accounted for by incorrect posture or sudden movements performed off guard ; such symptoms may be headaches, pains in the neck, pains down the arms with brachial neuritis and capsulitis of the shoulders, low back pain with or without sciatica or pseudo-sciatica, pains in the buttock, and pains and aches in relation to flat feet. There
are
adopt-active, inactive,