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THE TRAGEDY OF LEWIS.
SUNLIGHT.-THE TRAGEDY OF LEWIS.
88
economical than Mrs. Glasse, who, in her famous and it rather looks as if future numbers will contain " Art of Cookery," published at the end of the a reiteration of the same material. This will not eighteenth century, gives as the proportions for a matter as long as it has the desired effect of driving "plain custard " a quart of new milk sweetened to home to the public the great importance of sunlight as taste to eight eggs with half their whites omitted. our best " preventive medicine ": the fear is that the She would add a little nutmeg and rose-water forhealth authorities will be tempted to buy artificial flavouring. For a richer " almond custard," she daylight lamps rather than deal with the real problem prescribes a pint of cream, a quarter of a pound of of smoke abatement. almond::; "beaten fine," two spoonfuls of rose-water, THE TRAGEDY OF LEWIS. the yolks of four eggs, and sugar to taste. What Mrs. Glasse would have said to the description of coloured LAST year the report of the school medical officer maize flour as "cream custard" can hardly be for the Lewis division of Ross-shire made pitiful imagined. reading, and this year again Dr. Agatha E. Miller has a dreary tale to tell of hardship and privation, and SUNLIGHT. the struggle for life of a sturdy seafaring race large of THE Sunlight League was founded in May of last stature, strong of muscle, born with a heritage of and it has recently published the first number of health to be found nowhere else on these islands, year, " Sunlight: a Journal of Light and Truth."1 In an rapidly deteriorating and slowly dying out from editorial foreword it is stated that the purpose of this ’, poverty and its privations. Dr. Miller reports whole " to work for the restoration of the i schools of these children with hardly an unsound tooth new publication is light of the sun to all who live in cities, and to affirm between them, and she has never seen a case of rickets the principles and applications of light for health, and on the island. But the story of deterioration is told in the prevention and cure of disease." In the pages clearly enough in the tables of comparative weights which follow there are congratulatory messages from for the children of Lewis and of the mainland of Rosseminent men and women, and articles by experts shire who come of similar stock. There is a loss of dealing with the various problems which affect the weight among the Lewis children at all ages during Sunlight League. Sir Oliver Lodge writes on Sun- school life, and there is noticeable, too, a deterioration light for Health ; Dr. Leonard Hill emphasises the since 1921, which was the last fairly normal year as importance of the skin through which the sun, wind, far as weather and economic conditions are conand rain can do so much to influence the activities of cerned. These Ross-shire children " have inherited," the body ; Mrs. M. A. Cloudesley Brereton deals with writes Dr. Miller, " a fine physique second to none, the question of the modern woman’s dress and health, but in Lewis we have to stand by and see their and she advocates in a restrained yet emphatic manner steady deterioration, robbed of the fish they depend the value of " clothes light in weight, warm enough to on for their staple food, dependent only on the very conserve the body’s natural heat but porous enough limited amount of land developed on the island and to let in light and air, loose enough to allow of free sinking into ever deeper poverty." Comparisons of active movement." The Smokeless City is the title of heights and weights of English children with those of an interesting article by E. D. Simon and Marion these Lewis children are valueless. They belong to a Fitzgerald, and the question of housing and sunlight different race, almost the tallest in Europe, and are is dealt with by A. Trystan Edwards under the title of comparable with children of the taller Northern races the Sun-Trap House. The smoke nuisance is attacked of Europe. Their height, as may be seen from the from several points of view, and it is interesting to table which we reproduce, is second only to that of learn from an article on this subject by Colonel Swedish children, who are tallest of all. Thwaites that in 1307 a man was executed in England for burning " sea-cole " to the detriment of his neighComparative Amerage Height Table-in Centimetres. bour’s health ! What has actually been achieved in Boys of National Free Schools Only. the way of " sun cures " in this country is described under the title of Days in the Sun : the Story of Ken Wood, and Miss Margaret McMillan shows both what tremendous damage absence of sunlight does to the children of our big cities, and also what encouraging possibilities lie ahead of us in an extension of the open-air nursery school system. A page has been reserved for book-reviews, but there is strangely no -reference either to the publishers or to the prices of the ,books mentioned. Further matter includes an account of the objects of the Sunlight League, and an appeal .for " Lamps " by Miss McMillan, and this brings us rather to the heart of the problem which is well presented in an article entitled Artificial Sunlight, by Dr. C. W. Saleeby, reprinted in this journal from .the New Statesman. " The inevitable has happened," .’he says. We have had to attack the problem of sunlight and health not by abolishing smoke and letting the sun shine down upon the rich and poor alike, but ,by the introduction of artificial sunlight-" the makers What is going to happen to these people, or rather are racing one another to produce as many lamps as what is to be done about the problem they set us? possible." While this seems all to the good, judging They are entirely dependent on the natural produce of by the results of the treatment of rickets, for example, the land and of the sea. Their clothing is made of by artificial sunlight, there are certain dangers to be homespun wool or tweed. The majority of the cotton faced in the use of this method, and Dr. Hill wisely garments worn are made out of old flour-bags, and states that " the carrying out of artificial light Dr. Miller says flour-bags make strong garments, treatment requires to be controlled by the medical costing only 3d. each. They are literally being starved the harm be done for great may by profession, out of existence, and although at the end of 1923 there injudicious use of powerful sources of ultra-violet were signs of somewhat better prospects, " the school rays." This new journal has objects with which all year had opened with increasing rain, cold, and wind, those working for the health of the community must wet fuel, a damaged harvest, much of it blown away. be in sympathy, but there is no indication as to The minimum of straw and hay for the cattle meant whether it is to be a monthly or a quarterly publication, the minimum of milk, and it is difficult to exaggerate the importance of milk when fish, the staple diet, 1 Sunlight. Vol. I., No. 1. December, 1924. The Sunlight had become so scarce. There was only a small quantity League, 37, Russell-square, W.C. 1s. more
,
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PAROXYSMAL TACHYCARDIA.-GLANDULAR THERAPY.
89
In of diseased potatoes available from the harvest." another became aphasic during a paroxysm. " I never saw in school," Dr. Miller adds, " so many 40 cases in which the date of onset was noted, the children who were not fit to be there, either tempted out average time during which the attacks had occurred by the provision of a midday meal or forced out for was 12 years. In three cases the attacks had recurred want of a sick certificate.... It is not recommended over a period of 40 years or more, the longest period to Lewis being 43 years. that gymnastics be taught In considering prognosis, the after-histories of 84 country children. Many of the children are fit to take part and would greatly benefit; on the other cases of the 102 seen in the clinic were obtained. hand, many have too far to walk to school, and are This large number is noteworthy, as unless the tired. The exertion of the school day takes a good deal percentage of after-histories is high, they are of little out of under-nourished children." Various relief prognostic value. From the data furnished by the funds came to the help of the islanders last year, , circularised questionnaire, the authors conclude that giving a midday meal and clothing to necessitous attacks of paroxysmal tachycardia do not appear to children, and offers of help have been renewed this year, have contributed much to cardiac failure or to but the trouble, though immediately relieved by such incapacity. The death-rates were high in cases of kindly measures, calls for deeper remedy. They are a paroxysmal tachycardia associated with aortic and proud people, too, and require careful handling, but coronary disease (57 per cent.) and with endocarditis even so, it should not be past the wit of man to (46 per cent.). The final conclusion is that the estimadevise some practical and acceptable means of tion of the prognosis of paroxysmal tachycardia helping them to help themselves. We must not forget depends very largely on the estimation of the type that Lewis responded as one man to the call to arms and degree of the underlying cardiac damage. This at the very beginning of the late war. Many of conclusion is a reasonable one which might command the men were killed, and in her report Dr. Miller draws general acceptance. attention to the fact that the best-fed and best-clothed children are the children of war widows. GLANDULAR THERAPY. ECONOMISTS are fond of talking about the laws of PAROXYSMAL TACHYCARDIA. supply and demand and, within certain limits, an demand produces an increased supply. Paroxysmal tachycardia is often regarded as a increased the last few years the tremendous increase in During functional disorder of the heart. Dr. John Parkinson described it as the best example of such at the Ottawa glandular therapy has led to a demand for preparathe various ductless glands, and the huge meeting last year1 and was taken to task for doing so tions ofwhich has resulted shows no signs of the supply A. Dr. and in Graham-Stewart others our own by " which shortage economically one would be led to columns. Can a functional " disease kill ? was the when with animal products. It has dealing burden of this correspondence. A valuable paper on expect been said that if the parathyroid glands of all the Paroxysmal Tachycardia, with Special Reference to animals in the world were added together they would A. Dr. F. Willius Dr. Arlie R. and Prognosis, by Barnes, not the equal of the Mayo Clinic, Rochester, Minnesota, affords the quantity in opportunity of returning to the subject. The the market, authors give the results of observations on a series of 102 cases which were seen in the cardiac department but this is of the Mayo Clinic between 1914 and 1923.2 The probably a n authors define simple paroxysmal tachycardia as a exaggerated condition in which, from time to time, the normal statement mechanism is interrupted by a series of rapid irregular which in any beats varying in rate between 100 and 200 each case would be difficult to minute, the series starting and ending abruptly. The If we 102 cases were divided into four groups as follows : prove. insulin, except 1) 36 cases of nodal tachycardia which were sub- pituitary divided into five cases in which the P.-R. interval was extracts diminished, 28 cases in which the P.-R. interval gland reprobably was zero, and 3 cases in which there was an E,.-P. the present 7 cases of auricular interval ; (2) tachycardia ; most success(3) 6 cases of ventricular tachycardia ; and (4) 53 cases ful and satisAll the cases were carefully of auricular flutter. of the preparations of the ductless glands. examined, and were all verified by electrocardiographic factory Now the anterior lobe of the human pituitary the attacks. The clinical taken tracings during in an adult weighs on an average about one-third picture of the condition is well known, the most of a gramme. The usual weight given for the its sudden onset characteristic and being important whole gland is 0-5 g., and the anterior lobe forms abrupt cessation. In the symptomatology, the authors about two-thirds of this. The usual preparations of give prominence to vertigo, which was associated with the anterior lobe contain five grains, " representing the attacks in 18 cases, 15 of which were male patients this weight of fresh glandular substance," or almost and 3 female. Eleven of the patients were over the weight of the whole anterior lobe in the exactly 49 years of age and the incidence of arterio-sclerosis human The quotation given above is taken subject. on Stress is laid the and hypertension was high. strong from a pamphlet recently issued Oxo, Ltd., on the probability of cerebral arterio-sclerosis acting as a pituitary gland, and a picture inbythis pamphlet of a of occurrence vertigo bottle .determining factor in the 100 tablets, each consisting of 5 gr. .associated with paroxysmal tachycardia-a point of the containing of the ox, makes it of interest to know pituitary it is that has hitherto received little attention-and the size and of the bovine pituitary gland. urged that a history of attacks of tachycardia should It is perhaps weight to dispel the distrustful suggestions be carefully excluded in dealing with an elderly contained in the above remarks that the pamphlet patient who complains of vertigo, especially if includes a picture of the pituitary gland of man evidences of arterio-sclerosis are present. Besides compared with that of the common hump-backed vertigo there were other manifestations of cerebral whale. The endocrine sceptic would probably prefer anæmia. Five patients had syncope during attacks, to see the gland of an ox used for comparison purposes, two were delirious, one had epileptiform seizures, three and in future editions of these interesting perhaps had spells of unconsciousness in their paroxysms, and booklets in the " Oxoid" series, dealing with the three said that everything became black before their various of this reputable firm, glandular products One patient complained of numbness and ,eyes. pictures of the ductless glands of the bovine species The guarantee of " quality, 1 will be introduced. THE LANCET, 1924, ii., 481. and 2 Boston Medical and Surgical Journal, 1924, cxci., 666. uniformity, reliability " of these prepa,rapotency,
indiscriminately
____
88
economical than Mrs. Glasse, who, in her famous and it rather looks as if future numbers will contain " Art of Cookery," published at the end of the a reiteration of the same material. This will not eighteenth century, gives as the proportions for a matter as long as it has the desired effect of driving "plain custard " a quart of new milk sweetened to home to the public the great importance of sunlight as taste to eight eggs with half their whites omitted. our best " preventive medicine ": the fear is that the She would add a little nutmeg and rose-water forhealth authorities will be tempted to buy artificial flavouring. For a richer " almond custard," she daylight lamps rather than deal with the real problem prescribes a pint of cream, a quarter of a pound of of smoke abatement. almond::; "beaten fine," two spoonfuls of rose-water, THE TRAGEDY OF LEWIS. the yolks of four eggs, and sugar to taste. What Mrs. Glasse would have said to the description of coloured LAST year the report of the school medical officer maize flour as "cream custard" can hardly be for the Lewis division of Ross-shire made pitiful imagined. reading, and this year again Dr. Agatha E. Miller has a dreary tale to tell of hardship and privation, and SUNLIGHT. the struggle for life of a sturdy seafaring race large of THE Sunlight League was founded in May of last stature, strong of muscle, born with a heritage of and it has recently published the first number of health to be found nowhere else on these islands, year, " Sunlight: a Journal of Light and Truth."1 In an rapidly deteriorating and slowly dying out from editorial foreword it is stated that the purpose of this ’, poverty and its privations. Dr. Miller reports whole " to work for the restoration of the i schools of these children with hardly an unsound tooth new publication is light of the sun to all who live in cities, and to affirm between them, and she has never seen a case of rickets the principles and applications of light for health, and on the island. But the story of deterioration is told in the prevention and cure of disease." In the pages clearly enough in the tables of comparative weights which follow there are congratulatory messages from for the children of Lewis and of the mainland of Rosseminent men and women, and articles by experts shire who come of similar stock. There is a loss of dealing with the various problems which affect the weight among the Lewis children at all ages during Sunlight League. Sir Oliver Lodge writes on Sun- school life, and there is noticeable, too, a deterioration light for Health ; Dr. Leonard Hill emphasises the since 1921, which was the last fairly normal year as importance of the skin through which the sun, wind, far as weather and economic conditions are conand rain can do so much to influence the activities of cerned. These Ross-shire children " have inherited," the body ; Mrs. M. A. Cloudesley Brereton deals with writes Dr. Miller, " a fine physique second to none, the question of the modern woman’s dress and health, but in Lewis we have to stand by and see their and she advocates in a restrained yet emphatic manner steady deterioration, robbed of the fish they depend the value of " clothes light in weight, warm enough to on for their staple food, dependent only on the very conserve the body’s natural heat but porous enough limited amount of land developed on the island and to let in light and air, loose enough to allow of free sinking into ever deeper poverty." Comparisons of active movement." The Smokeless City is the title of heights and weights of English children with those of an interesting article by E. D. Simon and Marion these Lewis children are valueless. They belong to a Fitzgerald, and the question of housing and sunlight different race, almost the tallest in Europe, and are is dealt with by A. Trystan Edwards under the title of comparable with children of the taller Northern races the Sun-Trap House. The smoke nuisance is attacked of Europe. Their height, as may be seen from the from several points of view, and it is interesting to table which we reproduce, is second only to that of learn from an article on this subject by Colonel Swedish children, who are tallest of all. Thwaites that in 1307 a man was executed in England for burning " sea-cole " to the detriment of his neighComparative Amerage Height Table-in Centimetres. bour’s health ! What has actually been achieved in Boys of National Free Schools Only. the way of " sun cures " in this country is described under the title of Days in the Sun : the Story of Ken Wood, and Miss Margaret McMillan shows both what tremendous damage absence of sunlight does to the children of our big cities, and also what encouraging possibilities lie ahead of us in an extension of the open-air nursery school system. A page has been reserved for book-reviews, but there is strangely no -reference either to the publishers or to the prices of the ,books mentioned. Further matter includes an account of the objects of the Sunlight League, and an appeal .for " Lamps " by Miss McMillan, and this brings us rather to the heart of the problem which is well presented in an article entitled Artificial Sunlight, by Dr. C. W. Saleeby, reprinted in this journal from .the New Statesman. " The inevitable has happened," .’he says. We have had to attack the problem of sunlight and health not by abolishing smoke and letting the sun shine down upon the rich and poor alike, but ,by the introduction of artificial sunlight-" the makers What is going to happen to these people, or rather are racing one another to produce as many lamps as what is to be done about the problem they set us? possible." While this seems all to the good, judging They are entirely dependent on the natural produce of by the results of the treatment of rickets, for example, the land and of the sea. Their clothing is made of by artificial sunlight, there are certain dangers to be homespun wool or tweed. The majority of the cotton faced in the use of this method, and Dr. Hill wisely garments worn are made out of old flour-bags, and states that " the carrying out of artificial light Dr. Miller says flour-bags make strong garments, treatment requires to be controlled by the medical costing only 3d. each. They are literally being starved the harm be done for great may by profession, out of existence, and although at the end of 1923 there injudicious use of powerful sources of ultra-violet were signs of somewhat better prospects, " the school rays." This new journal has objects with which all year had opened with increasing rain, cold, and wind, those working for the health of the community must wet fuel, a damaged harvest, much of it blown away. be in sympathy, but there is no indication as to The minimum of straw and hay for the cattle meant whether it is to be a monthly or a quarterly publication, the minimum of milk, and it is difficult to exaggerate the importance of milk when fish, the staple diet, 1 Sunlight. Vol. I., No. 1. December, 1924. The Sunlight had become so scarce. There was only a small quantity League, 37, Russell-square, W.C. 1s. more
,
____
____
PAROXYSMAL TACHYCARDIA.-GLANDULAR THERAPY.
89
In of diseased potatoes available from the harvest." another became aphasic during a paroxysm. " I never saw in school," Dr. Miller adds, " so many 40 cases in which the date of onset was noted, the children who were not fit to be there, either tempted out average time during which the attacks had occurred by the provision of a midday meal or forced out for was 12 years. In three cases the attacks had recurred want of a sick certificate.... It is not recommended over a period of 40 years or more, the longest period to Lewis being 43 years. that gymnastics be taught In considering prognosis, the after-histories of 84 country children. Many of the children are fit to take part and would greatly benefit; on the other cases of the 102 seen in the clinic were obtained. hand, many have too far to walk to school, and are This large number is noteworthy, as unless the tired. The exertion of the school day takes a good deal percentage of after-histories is high, they are of little out of under-nourished children." Various relief prognostic value. From the data furnished by the funds came to the help of the islanders last year, , circularised questionnaire, the authors conclude that giving a midday meal and clothing to necessitous attacks of paroxysmal tachycardia do not appear to children, and offers of help have been renewed this year, have contributed much to cardiac failure or to but the trouble, though immediately relieved by such incapacity. The death-rates were high in cases of kindly measures, calls for deeper remedy. They are a paroxysmal tachycardia associated with aortic and proud people, too, and require careful handling, but coronary disease (57 per cent.) and with endocarditis even so, it should not be past the wit of man to (46 per cent.). The final conclusion is that the estimadevise some practical and acceptable means of tion of the prognosis of paroxysmal tachycardia helping them to help themselves. We must not forget depends very largely on the estimation of the type that Lewis responded as one man to the call to arms and degree of the underlying cardiac damage. This at the very beginning of the late war. Many of conclusion is a reasonable one which might command the men were killed, and in her report Dr. Miller draws general acceptance. attention to the fact that the best-fed and best-clothed children are the children of war widows. GLANDULAR THERAPY. ECONOMISTS are fond of talking about the laws of PAROXYSMAL TACHYCARDIA. supply and demand and, within certain limits, an demand produces an increased supply. Paroxysmal tachycardia is often regarded as a increased the last few years the tremendous increase in During functional disorder of the heart. Dr. John Parkinson described it as the best example of such at the Ottawa glandular therapy has led to a demand for preparathe various ductless glands, and the huge meeting last year1 and was taken to task for doing so tions ofwhich has resulted shows no signs of the supply A. Dr. and in Graham-Stewart others our own by " which shortage economically one would be led to columns. Can a functional " disease kill ? was the when with animal products. It has dealing burden of this correspondence. A valuable paper on expect been said that if the parathyroid glands of all the Paroxysmal Tachycardia, with Special Reference to animals in the world were added together they would A. Dr. F. Willius Dr. Arlie R. and Prognosis, by Barnes, not the equal of the Mayo Clinic, Rochester, Minnesota, affords the quantity in opportunity of returning to the subject. The the market, authors give the results of observations on a series of 102 cases which were seen in the cardiac department but this is of the Mayo Clinic between 1914 and 1923.2 The probably a n authors define simple paroxysmal tachycardia as a exaggerated condition in which, from time to time, the normal statement mechanism is interrupted by a series of rapid irregular which in any beats varying in rate between 100 and 200 each case would be difficult to minute, the series starting and ending abruptly. The If we 102 cases were divided into four groups as follows : prove. insulin, except 1) 36 cases of nodal tachycardia which were sub- pituitary divided into five cases in which the P.-R. interval was extracts diminished, 28 cases in which the P.-R. interval gland reprobably was zero, and 3 cases in which there was an E,.-P. the present 7 cases of auricular interval ; (2) tachycardia ; most success(3) 6 cases of ventricular tachycardia ; and (4) 53 cases ful and satisAll the cases were carefully of auricular flutter. of the preparations of the ductless glands. examined, and were all verified by electrocardiographic factory Now the anterior lobe of the human pituitary the attacks. The clinical taken tracings during in an adult weighs on an average about one-third picture of the condition is well known, the most of a gramme. The usual weight given for the its sudden onset characteristic and being important whole gland is 0-5 g., and the anterior lobe forms abrupt cessation. In the symptomatology, the authors about two-thirds of this. The usual preparations of give prominence to vertigo, which was associated with the anterior lobe contain five grains, " representing the attacks in 18 cases, 15 of which were male patients this weight of fresh glandular substance," or almost and 3 female. Eleven of the patients were over the weight of the whole anterior lobe in the exactly 49 years of age and the incidence of arterio-sclerosis human The quotation given above is taken subject. on Stress is laid the and hypertension was high. strong from a pamphlet recently issued Oxo, Ltd., on the probability of cerebral arterio-sclerosis acting as a pituitary gland, and a picture inbythis pamphlet of a of occurrence vertigo bottle .determining factor in the 100 tablets, each consisting of 5 gr. .associated with paroxysmal tachycardia-a point of the containing of the ox, makes it of interest to know pituitary it is that has hitherto received little attention-and the size and of the bovine pituitary gland. urged that a history of attacks of tachycardia should It is perhaps weight to dispel the distrustful suggestions be carefully excluded in dealing with an elderly contained in the above remarks that the pamphlet patient who complains of vertigo, especially if includes a picture of the pituitary gland of man evidences of arterio-sclerosis are present. Besides compared with that of the common hump-backed vertigo there were other manifestations of cerebral whale. The endocrine sceptic would probably prefer anæmia. Five patients had syncope during attacks, to see the gland of an ox used for comparison purposes, two were delirious, one had epileptiform seizures, three and in future editions of these interesting perhaps had spells of unconsciousness in their paroxysms, and booklets in the " Oxoid" series, dealing with the three said that everything became black before their various of this reputable firm, glandular products One patient complained of numbness and ,eyes. pictures of the ductless glands of the bovine species The guarantee of " quality, 1 will be introduced. THE LANCET, 1924, ii., 481. and 2 Boston Medical and Surgical Journal, 1924, cxci., 666. uniformity, reliability " of these prepa,rapotency,
indiscriminately
____