THE HEALTH OF MUNITION WORKERS.

197 there should be educated men and women of good standing who in this great national emergency will find in work among munition workers fit, scope for their energies and their patriotism.. No doubt the need for women welfare workers to help where women and girls are employed is the more urgently and generally felt, but the need exists also where the munition workers are men, and particularly where they are boys. For this reason the memorandum to which we have referred should provide interesting and suggestive reading on Jan, 1st, 1916. for many who are anxious to help their country, but who as yet have not found the niche best suited to them. The Committee responsible for it, having Sir George Newman as its chairman, includes Sir Thomas Barlow, Bart., Mr. G. Bellhouse (of the Factory Department, Home Office), Professor "Ne quid nimis." A. E. Boycott, Mr. J. R. Clynes, Dr. E. L. Collis (Factory Department, Home Office), Dr. W. M. Fletcher, Professor Leonard E. Hill, Mr. S. Osborn THE HEALTH OF MUNITION WORKERS. i (Sheffield), Miss R. E. Squire (Factory Department, Memorandum No. 2, submitted by the Health of Home Office), and Mrs. H. J. Tennant. Munitions Workers’ Committee to the Minister of Munitions, deals with those matters outside the "SOLDIER’S HEART." ordinary undertakings of factory management IN opening the discussion on the soldier’s heart which have to be considered if the full efficiency of any factory is to be maintained, and which at the Section of Therapeutics of the Royal present difficulties not easily to be overcome in Society of Medicine on Tuesday evening, Sir James connexion with the vast and rapidly organised Mackenzie dealt with a subject which he has made munition works now being carried on. The four peculiarly his own, and compressed into a brief half chief influences affecting industrial efficiency hour a complete account of the subject from a to which the memorandum calls attention are clinical and etiological standpoint. The condition those which raise questions of housing, transit, known as "soldier’s heartis best defined by stating canteen provision, and the individual welfare of what it is not. The life of the trenches is in every the employee. The sudden influx of workers in way a trying one for the soldier; it finds out his point certain districts has overtaxed housing con- of least resistance, which mav be an impaired heart, ditions beyond any limits that would be tolerated serviceable enough for the conditions of his everyin normal conditions of peace. Railways and other day life, but unequal to any severe and prolonged means of transit in many cases cannot provide for strain. Loss of compensation follows and the the men and women to be carried without imposing ordinary symptoms of heart failure. But this upon them overcrowding, waiting, delay, and loss of is not the subject of Sir James Mackenzie’s. time; the provision of suitable food in the factories, address. "Soldier’s heart" itself is something quite or in such lodgings as are available for the workers, different, and was first clearly described by is only arranged with difficulty and not always with American physicians during the Civil War as. satisfactory results; and those responsible for the a form of heart trouble to which soldiers were organisation of the factories, as such, have their particularly liable. It is a condition charactime fully occupied without being able to devote terised by exhaustion of the circulatory system, any appreciable part of it to the personal super- shown as regards the heart by breathlessness, a vision of the individual welfare of their workpeople. sense of suffocation and prascordial discomfort, To secure improvement in these four important and a frequency which if not raised during rest particulars is quite essential if the factory is to becomes unduly increased on slight exertion. be maintained at its highest efficiency, for the As regards the vessels, the condition is marked good health and content of the workers are by great vaso-motor instability, shown in pallor necessary to this end. In order to obtain better or flushing of the nose and extremities, attended conditions the recommendation made by the Com- with giddiness or fainting in the more severe. mittee is that " welfare supervisionshould be forms. But the symptoms are not confined to established by those responsible, such as is now the circulatory system, and in 90 per cent. at least receiving the attention of the more enlightened of the cases observed this system is not the one. employers, welfare supervision not being a new thing primarily affected ; the circulatory symptoms are but one the usefulness and desirableness of which of a general illness in which the central have suddenly been rendered conspicuous. The task nervous system has a large share. Apart from the of the "welfare worker" is no light one, requiring, vaso-motor disturbances there is an irritability of as it does, experience, if persons so endowed are temper, a depression of spirits, an inability to conobtainable, but in any case tact, good sense, under- centrate thought, a nervous tension liable to lead to. standing of industrial conditions, and sympathy. sudden outburst and a tendency to focus the attenThe memorandum refers to courses of social tion constantly on the condition of the heart, which study, as established at the University of London implies a profound influence on the nervous tissues. and the University of Birmingham, comprising The condition is reminiscent, indeed, of another lectures and practical work, and designed for condition of nervous exhaustion which has already persons seeking to qualify themselves for posts been described in these columns when dealing as welfare workers, as well as for other similar with special hospitals for officers with nervous. employment. Assuredly the recommendations of exhaustion. In both class of cases there is a. the Committee should secure the support of all marked disinclination for mental exertion. And who can help to render them effective, and there is this in common to the two states: both not certified practises in contravention of the Act. It is also ordered that the medical officer of every local supervising authority shall report annually to the authority on the administration of the Act, transmitting a copy of his report to the Board and to the Local Government Board for Scotland, and the Board is to present a report of its proceedings annually to the Privy Council. The Midwives (Scotland) Act, 1915, came into force

Annotations.

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