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HEALTH IN FACTORIES AND WORKSHOPS

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27 not readily accessible, for the text-books of veterinary I pathology deal with the subject only from the clinical point of view and give but little general information on the distribution of cancer, even in the restricted field of the domesticated animals. The appearance of two publications dealing with the subject compre- hensively from somewhat different points of view is therefore opportune. A book by Dr. W. H. Feldman, entitled " Neoplasms of Domesticated Animals," is reviewed elsewhere in this issue. An essay by Dr. W. Cramer on the comparative study of cancer 1 is concerned with the general aspects of the problem and summarises the important information which has been gained from the study of malignancy. The fact that all species of vertebrates are subject to the disease, including non-domesticated animals living in their natural habitat, shows that such external factors as diet and environment and civilisation cannot be of fundamental importance in the aetiology of cancer. Another significant fact to which attention is drawn is that the different species show constant differences both in the type of tissue (epithelium or connective tissue) and in the organs most frequently affected by the development of malignancy; but wherever malignancy occurs it shows the phenomenon of age-incidence characteristic of the disease in man. This, in the light of recent work on experimental carcinogenesis, indicates that throughout the verte- brate kingdom the development of malignancy requires a long preparatory period amounting to a considerable fraction of the span of life of the individual. This is true even for the spontaneous occurrence of those fowl sarcomas which can be transmitted by a cell-free filtrate. This means, as Dr. Cramer points out, that for our understanding of the setiology of cancer this slow preparatory process is at least as important as the actual change which takes place when a normal cell is transformed into a malignant one. The nature of the actual change is still unknown, but we already know a good deal about the preparatory process, and it is in this direc- tion that cancer research is making active progress. BERNHARD BANG VETERINARY medicine has lost one of its most distinguished exponents by the death of Prof. B. L. F. Bang, of Copenhagen, in his eighty-fifth year. Graduating in 1880, two years before Koch’s announce- ment of the discovery of the tubercle bacillus, Bang was early made a convert to the newly born science of bacteriology, and as one of the pioneer workers in this subject he carried out researches into many of the most important infectious diseases of domestic animals. Though his name is written large on many pages of the history of veterinary bacteriology, he will be remembered chiefly for his work on tuber- culosis and contagious abortion of cattle. His plan for the eradication of bovine tuberculosis, known as the Bang method, was first put forward in 1894. It rested on the observation that the immense majority of calves were healthy, even when they were born of tuberculous parents, and that, provided they were separated from the infected herd and fed on pasteur- ised milk or on the milk of healthy cows, they would remain healthy indefinitely. The essential feature of the method consists in the formation of a clean herd housed apart from the original infected herd, and recruited from calves which have been separated from their mothers within two days of birth. The old animals, whether infected or not, are prevented 1 The Cancer Review, June, 1932, p. 241. from coming into contact with the new herd, and are gradually sold or killed off. The new herd is tested with tuberculin every six months, and any positive reactors are transferred to the old herd. If the necessary precautions to avoid the occurrence of cross-infection are faithfully carried out, it is not infrequently possible in this way to eradicate tuber- culosis in four to six years. Though not as successful as the more drastic " accredited herd plan," which has been used so largely in the United States of America and in Canada, it has the great merit of being relatively inexpensive and being applicable by any intelligent farmer. The discovery of the causative agent of contagious abortion was the joint work of Bang and Stribolt, who succeeded in demonstrating, a minute bacillus in the infected membranes and in the stomach of the feetus. Though Bang’s bacillus, as this organism was generally called, was described in 1897, and the bacillus of Malta fever was isolated by Bruce ten years previously, it was not till 1918. that, owing to the work of Alice Evans, the close relationship of these two organisms was established. Since that date Bang’s bacillus, now dignified by the name of Brucella abmiu8, has attracted increasing. attention, particularly amongst the medical profession, on account of its ability to give rise to undulant fever in man. Prof. Bang, who was born at Soro, in Zealand, and was educated there and at Copenhagen, was appointed professor of internal diseases at the Royal Veterinary College in Copenhagen in 1892, and held this chair until 1914. His son, Dr. Oluf Bang, who is now professor of pathology and therapeutics at the college, has made several contributions to the study of animal diseases, and is well known to members of the veterinary profession in this country. HEALTH IN FACTORIES AND WORKSHOPS THE signs of the times appear in the latest -report of the senior medical inspector of factories.! The bad state of the labour market is reflected in the low incidence of notifiable industrial disease, while the mechanisation of industry shows itself in an increase of " nervous disabilities " due to the boredom of the machine hand-a condition almost unknown to the craftsman. One of the pressing problems in industrial health to-day is the control of this vague, ill-defined, but no doubt very real disability due to ennui ; s vastly more days are lost from this than from all the recognised industrial diseases put together. An economic problem is that of the woman worker who undertakes home duties both before and after work, thus expending energy which in the interests of her health would be better conserved. Of the special industrial diseases, silicosis and asbestosis have received much attention. Many visits have been paid to factories with the object of estimating the risk and advising preventive measures, and the health of packers in the asbestos industry has been specially investigated. The department has obtained much information from the presence of one of their inspectors at inquests on suspected cases of silicosis or asbestosis. The Registrar-General received 785 certificates of death from fibrosis of the lungs ; 319 were due to silicosis, compared with 241 last year. The cases of silicosis occurred in a great variety of industries, the most affected being sandstone (69), pottery (57), coal-mining (47), grinding (36). During the year nine deaths from asbestosis, or asbestosis 1 See Report of the Chief Inspector of Factories and Workshops for 1931. H.M. Stationery Office. 1932. Pp. 155. 2s. 6d.
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not readily accessible, for the text-books of veterinary Ipathology deal with the subject only from the clinicalpoint of view and give but little general informationon the distribution of cancer, even in the restrictedfield of the domesticated animals. The appearanceof two publications dealing with the subject compre-hensively from somewhat different points of view istherefore opportune. A book by Dr. W. H. Feldman,entitled " Neoplasms of Domesticated Animals,"is reviewed elsewhere in this issue. An essay byDr. W. Cramer on the comparative study of cancer 1is concerned with the general aspects of the problemand summarises the important information which hasbeen gained from the study of malignancy. Thefact that all species of vertebrates are subject to thedisease, including non-domesticated animals living intheir natural habitat, shows that such externalfactors as diet and environment and civilisationcannot be of fundamental importance in the aetiologyof cancer. Another significant fact to which attentionis drawn is that the different species show constantdifferences both in the type of tissue (epithelium orconnective tissue) and in the organs most frequentlyaffected by the development of malignancy; butwherever malignancy occurs it shows the phenomenonof age-incidence characteristic of the disease in man.This, in the light of recent work on experimentalcarcinogenesis, indicates that throughout the verte-brate kingdom the development of malignancyrequires a long preparatory period amounting toa considerable fraction of the span of life of theindividual. This is true even for the spontaneousoccurrence of those fowl sarcomas which can betransmitted by a cell-free filtrate. This means, asDr. Cramer points out, that for our understandingof the setiology of cancer this slow preparatory processis at least as important as the actual change whichtakes place when a normal cell is transformed into amalignant one. The nature of the actual change isstill unknown, but we already know a good dealabout the preparatory process, and it is in this direc-tion that cancer research is making active progress.

BERNHARD BANG

VETERINARY medicine has lost one of its most

distinguished exponents by the death of Prof. B. L. F.Bang, of Copenhagen, in his eighty-fifth year.Graduating in 1880, two years before Koch’s announce-ment of the discovery of the tubercle bacillus, Bangwas early made a convert to the newly born scienceof bacteriology, and as one of the pioneer workersin this subject he carried out researches into manyof the most important infectious diseases of domesticanimals. Though his name is written large on manypages of the history of veterinary bacteriology, hewill be remembered chiefly for his work on tuber-culosis and contagious abortion of cattle. His planfor the eradication of bovine tuberculosis, known asthe Bang method, was first put forward in 1894. Itrested on the observation that the immense majorityof calves were healthy, even when they were born oftuberculous parents, and that, provided they wereseparated from the infected herd and fed on pasteur-ised milk or on the milk of healthy cows, they wouldremain healthy indefinitely. The essential feature ofthe method consists in the formation of a clean herdhoused apart from the original infected herd, andrecruited from calves which have been separatedfrom their mothers within two days of birth. Theold animals, whether infected or not, are prevented

1 The Cancer Review, June, 1932, p. 241.

from coming into contact with the new herd, and aregradually sold or killed off. The new herd is testedwith tuberculin every six months, and any positivereactors are transferred to the old herd. If the

necessary precautions to avoid the occurrence ofcross-infection are faithfully carried out, it is not

infrequently possible in this way to eradicate tuber-culosis in four to six years. Though not as successfulas the more drastic " accredited herd plan," whichhas been used so largely in the United States ofAmerica and in Canada, it has the great merit ofbeing relatively inexpensive and being applicable byany intelligent farmer. The discovery of the causativeagent of contagious abortion was the joint work ofBang and Stribolt, who succeeded in demonstrating,a minute bacillus in the infected membranes and inthe stomach of the feetus. Though Bang’s bacillus,as this organism was generally called, was describedin 1897, and the bacillus of Malta fever was isolatedby Bruce ten years previously, it was not till 1918.that, owing to the work of Alice Evans, the closerelationship of these two organisms was established.Since that date Bang’s bacillus, now dignified by thename of Brucella abmiu8, has attracted increasing.attention, particularly amongst the medical profession,on account of its ability to give rise to undulant feverin man.

Prof. Bang, who was born at Soro, in Zealand,and was educated there and at Copenhagen, wasappointed professor of internal diseases at the RoyalVeterinary College in Copenhagen in 1892, and heldthis chair until 1914. His son, Dr. Oluf Bang, whois now professor of pathology and therapeutics at thecollege, has made several contributions to the studyof animal diseases, and is well known to members ofthe veterinary profession in this country.

HEALTH IN FACTORIES AND WORKSHOPS

THE signs of the times appear in the latest -reportof the senior medical inspector of factories.! Thebad state of the labour market is reflected in the lowincidence of notifiable industrial disease, while themechanisation of industry shows itself in an increaseof " nervous disabilities " due to the boredom of themachine hand-a condition almost unknown to thecraftsman. One of the pressing problems in industrialhealth to-day is the control of this vague, ill-defined,but no doubt very real disability due to ennui ; svastly more days are lost from this than from all therecognised industrial diseases put together. An

economic problem is that of the woman worker whoundertakes home duties both before and after work,thus expending energy which in the interests of herhealth would be better conserved. Of the specialindustrial diseases, silicosis and asbestosis havereceived much attention. Many visits have beenpaid to factories with the object of estimating therisk and advising preventive measures, and thehealth of packers in the asbestos industry has beenspecially investigated. The department has obtainedmuch information from the presence of one of theirinspectors at inquests on suspected cases of silicosisor asbestosis. The Registrar-General received 785certificates of death from fibrosis of the lungs ; 319were due to silicosis, compared with 241 last year.The cases of silicosis occurred in a great variety ofindustries, the most affected being sandstone (69),pottery (57), coal-mining (47), grinding (36). Duringthe year nine deaths from asbestosis, or asbestosis

1 See Report of the Chief Inspector of Factories and Workshopsfor 1931. H.M. Stationery Office. 1932. Pp. 155. 2s. 6d.

Page 2: HEALTH IN FACTORIES AND WORKSHOPS

28

with tuberculosis, came to the notice of the department,bringing the total of which particulars are availableto 35. It is of interest that the average lengthof employment in the fatal cases of silicosis is morethan twice as long as in the fatal cases of asbestosis.Dr. Bridge says, "the unenviable position of sand-blasting and ocscupations in the asbestos industryat the present time is evident." The effective controlof the dust in sandblasting is said to be a matter of;extreme difficulty, though progress has been madein abolishing the risk by the use of steel shot as theabrasive instead of sand. The Asbestos IndustryRegulations came into force on March 1st, 1932,but already a noticeable improvement in exhaustventilation and suppression of dust had taken placein a number of factories. The decrease in dermatitisseems to be maintained and the incidence of someof the more readily controlled causes has been reduced,notably oil. Increased knowledge of the value ofcoating the exposed skin with a film of ointment islargely responsible for reducing dermatitis amongpainters. An examination of cellulose sprayers,which is being continued, has shown a definite rela-tion between conditions of ventilation and ill-health;the signs and symptoms of local irritation, depression,and fatigue seem to be due to the solvents of celluloseand not to the diluent hydrocarbons. A small

group of experienced workers showed no apparentinjury to health, even in the absence of localisedexhaust ventilation, when xylol was used as a

diluent. Two cases of cadmium poisoning are

recorded in men working on welding electrodes whichcontained a fiftieth of an ounce of cadmium ; fumeswere given off when the electrode was heated above315° C. Five men employed in sinking a caisson

cylinder in marshy ground near the Thames becamefatally asphyxiated. Death was due to anoxaemiafrom exposure to an atmosphere incapable of support-ing life ; this atmosphere was found to consist ofoxygen, 0-12 per cent. ; carbon dioxide, 14-36 percent.; methane, 4’ 59 per cent. ; and the rest

nitrogen. Considerable attention has been devotedby the department to the " safety first " campaignagainst accidents. Accidents are no longer attributedto machinery alone, and educational organisationfor dealing with the human factor is now almostuniversally accepted as a practical and business-likedevelopment in industry.

THE NATIONAL PHYSICAL LABORATORY

THE annual inspection of the National PhysicalLaboratory at Teddington took place on June 28th,when a large number of visitors were present andwere received by Sir Frederick Gowland Hopkins,Sir Joseph Petavel the director, and Sir RichardGlazebrook. The numerous visitors had oppor-tunities of watching demonstrations illustratingprogress in engineering, aero-dynamics and metal-lurgy, in physics with special application to optics,electricity and wireless mechanisms, and metrology-nor does this exhaust the menu of the feast set beforethem. It is interesting to reflect that any or all ofthese developments of exact knowledge, however

widely separated from clinical medicine they appearto be, may have to-day a direct application to practice.All science is to-day more or less directly reflected inmedicine, so many are the boundaries which havebeen removed. No man can say exactly, for example,where chemistry stops and physiology begins, whatfamiliarity with electricity can rightly be demanded ’,of the medical man, or what knowledge of physics orof statistics he. will require. But with a medical man

the sciences outside his apparent range have to bebrought into action not in the ideal conditions of thestudy, the laboratory, or the workshop, but in allvarying environments with application to subjects ofevery kind of make-up. When we attempt to estimatethe progress of scientific medicine by statistics, wehave to show that the figures have been properlycorrected and properly used. But the workingdoctor often has to rely on experts to explain anddefend figures he may himself have collected, beforehe can direct his energies in accordance with theirevidence. A similar humble attitude must beadopted when, for example, he has to employdiscoveries in the realms of electricity or physics forapplication in therapeutics. The lesson of such anexhibition as that provided by the National PhysicalLaboratory is that as medicine is directed to thebenefit of all sorts and conditions of men, so allsorts and conditions of knowledge will find their

place in its development. The medical laboratorydepends for much of its work on investigations suchas are directed by the metrology department of theNational Physical Laboratory. That department is

responsible for the maintenance of our standards oflength, mass, and time, and verification is carried onhere of all types of precise measuring instruments.In this department there was on view a new wave-length comparator for measuring length in terms ofwaves of light, with a view to establishing a waveof light as the universal unit in place of the Imperialstandard yard and the metre. Another apparatus, aone-kilogramme vacuum balance, has been constructedat the laboratory for weighing to the highest precisionin air or in vacuum ; the instrument will probablygive an accuracy greater than that attainable by thepresent balance-namely, one part in a hundredmillion. There is a vibration clock by which observa-tions can be made to within one five-thousandth ofa second. Such standardisation may at first glanceappear far removed from anything which clinicalmedicine needs. But if we judge what our develop-ments in exact science may become by comparisonwith the pathological routine of a generation ago,and if we see no reason -why the rate of progressshould not be maintained, it is clear that no

standardisation can be too accurate for what our

needs may be. Such is the message to us of thisgreat technical show.

ROCKEFELLER MEDICAL FELLOWSHIPS. — TheMedical Research Council announce that, on-behalf of theRockefeller Foundation, they have awarded travellingFellowships for 1932-33 as follows: Colin Panton Beattie,M.B., of the Bacteriology Department of EdinburghUniversity; William Donald Wykeham Brooks, M.R.C.P.,of St. Mary’s Hospital, London; Eleanor Mildred Creak,M.R.C.P., of the Maudsley Hospital, London; Ian GeorgeWilson Hill, M.B., of the Royal Infirmary, Edinburgh;William Arthur Mackey, M.B., of the Department of Surgeryof Glasgow University; David James Macmyn, M.B., ofKing’s College Hospital, London; and John Chassar Moir,M.D., of University College Hospital, London. Dr. Brooksand Dr. MacMyn have been appointed on modified conditionswhile receiving emoluments from other sources.

These Fellowships are awarded to graduates who have hadsome training in research work either in the primary sciencesof medicine or in clinical medicine or surgery, and who arelikely to profit by a period of work at a chosen centre inAmerica, or, in special cases, in Europe, before takingup positions for higher teaching or research in the BritishIsles. In view of the high qualifications of so many of thecandidates on this occasion, the Council greatly regretthat it has not 1been possible for them to make a larger numberof awards.


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