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painful manifestations of rheumatoid disease. Acourse of spa treatment may modify the terrain tosuch an extent that the body recovers its equilibrium.And to the patient this equilibrium is the essence ofhealth. It has been contended, again with someshow of justice, that the unsiiccessfiil results of spatreatment are not reported. In a country villagcethe doctor’s failures go about the only street on

crutches ; the failures of spa treatment, like thoseof fashionable quacks, are scattered far and wideand have no means of speaking with a common voice.Still. in the long run, it must be on actual concreteresults that success depends, as may be seen fromthe fact that within the larger resorts there arc alwayssmaller units which enjoy continuous patronagewhile success waxes or wanes around them, and thissuccess must depend on a good report handed onfrom patient to patient by word of mouth. Afrescoed notice in an Upper Engadine batli runs :

"The scientific individual adaptation of the prescrip-tion increases the efficiency of the cure uncommonly,"and several Engadine resorts have scientific workersof university standard among the practising doctors.At St. Moritz Bad Dr. S. HEDiGER is working outthe effect of baths upon the volume of the pulse,using the sphygmovolumeter designed under Prof.0. VERAGUTH at the Zurich Institute for PhysicalTherapy. At Tarasp Dr. E. LENZ, who lectures onpharmacology at Berne, has shown by exact observa-tion that a week in a subalpine climate may actprecisely like a digitalis cure.Health resorts have been known to cry up their own

wares and decry those of others, but there need, wethink, be no jealousy as between spa and spa. Thereis a mass of relievable chronic ill-health which doesnot necessarily show on any monthly mortalityreturn, and which yet reduces in large measure theefficiency and happiness of the community. Muchof this can be mitigated or relieved by spa treatment,and there must be resorts for many different tastes.Some undoubtedly possess such wealth of natural

advantage that it is hardly human to expect anequally high standard of art: others less favoured byNature have built up a substantial and sufficient repu-tation by performing well all the adjuvants of treat-ment. It may be recalled that the mere climate of theBlack Forest, in which the late OTTO WALTHER madethe name of Nordrach world-famous, has little enoughto recommend it. As between home and abroad, alittle competition is good for both spa and patient,and it is open to our own resorts to cater for theoutlander just as they do for us. The captain ofthe Syrian host in lauding the virtues of his ownhome waters over the Jordan apparently was notspeaking from actual personal experience of them.We can hardly bring to the Welsh or Yorkshire

uplands the blue sky and pellucid air of the south,yet the Aix massage, the Plombieres douche, or

the Nauheim bubbly-bath may be equally effectivewherever they are individually and skilfully applied.

A NEW HOSPITAL AT COLNE.-On Sept. 3rd SirWilliam P. Hartley, of Southport, laid the foundation-stoneof the new hospital which he and Lady Hartley havepresented to their native town of Colne. Some years agoSir William Hartley gave to the town a cottage hospitaland the Hartley Homes, in which aged natives of thetown live rent-free. The new hospital is arranged for 50patients and stands in grounds covering over four acres.Sir William Hartley said the financial position of the hos-pital was assured by the adoption of a scheme of weeklycontributions by the workpeople, in addition to annualsubscriptions. Mr. Wilson Hey, F.R.C.S., of Manchester,also a native of Colne, opened the subscription list vitha gift of 100 guineas.

Annotations.

LIGHTING IN KINEMA STUDIOS.

"Ne quid nimis."

THE effect of ult,ra-violet radiation on the eyes hasinterested ophthalmologists for many years ; it wasdiscussed at the International Congress of Medicine in1913 and papers on the subject have appeared atintervals since. Now the matter has again come intoprominence owing to the results of the use of powerfularc lamps of American make in British kinematographstudios during last year. Some of the actors andactresses developed a form of conjunctivitis afterworking in this intense light, and the matter wasreferred by the Minister of Health to the Committeeon the Causes and Prevention of Blindness. Thiscommittee has now issued an interim report.Each division of the spectrum is associated with

certain characteristic effects-radiant heat with theinfra-red, light with the visible part, and chemicaleffects with the ultra-violet-but the visible parthas thermal and chemical properties too, as well asthat of light. Radiant heat induces erythema of theskin, which reacts and thereby protects itself bysweating. The moist eyeball is similarly protected andthe fluid media of the eye act as an absorbent screen.Heat rays seldom reach the retina although they arerefracted in the eye exactly as are light rays. Theydo reach the lens when the eye is subjected to prolongedexposure ; cataract in glass-blowers is sufficient con-firmation of this. Visible rays in excess induce anotherprotective measure-blepharospasm, which is a

characteristic feature of the typical albinotic facies.The kinema actress, however, must usually voluntarilydispense with this protection; so many emotions areassociated with sympathetic nerve stimulation andinduce a wide palpebral aperture. The most familiarprotective result is a contracted pupil and the ocularpain complained of probably results from stimulationof sensory nerve-endings in the iris.

Dazzling is an interesting, if distressing, phenome-non. Its usual cause is a corneal or lenticular opacitywhich scatters instead of refracting the rays of light.But the normal cornea is not quite transparent andsome diffusion occurs in the eye with ordinary illumina-tion. Under conditions of excessive illumination thisincreased diffusion will cause dazzling. Excessivelight also may enter the eye through less transparentstructures such as the iris. Indeed, the position ofthe normal man in relation to intense light is that ofthe albino in relation to ordinary light. Erythropsiais associated with a large pupil and with aphakia. Itis due to the visible rays, but the ultra-violet rays, ifnot essential to its production, materially assist. It isa common accompaniment of snow-dazzling, and lightreflected from snow is rich in ultra-violet rays. Thelens absorbs ultra-violet rays and it also convertsthem into waves of greater wave-length, producingthe phenomenon of fluorescence of the lens. A largepupil is a sign of sympathetic stimulation and in thebusiness of acting must be an almost habitual occur-rence. Erythropsia should be a familiar after-effectof kinema acting in intense light ; it might almost betaken as an index of the emotionalism of individualactors and actresses.The symptoms attributed to the intense lights used

for the production of films are exactly those of snow-blindness and electric ophthalmia, and, like erythemaof the skin after exposure to unusual amounts ofsunlight, are due to the actinic or ultra-violet rays.After a latent period of half or one day follow rednessof the lids, injection and chemosis of the conjunctiva,photophobia, and pain. Erosions of the cornea havebeen described after exposure to light from the arcused in electric welding and stress is usually laid oncontraction of the pupils. This is not due, however,to the stimulus of light, for congestion miosis is commonin all corneal and conjunctival inflammations. Thesymptoms pass off in a few days. The latent period

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is of interest. In the effects of X rays and of radiumit is longer still-maybe some weeks.

The committee has established that these powerfulsearchlights are not less efficient when used withdiffusion screens, and it is gratifying to learn that theAssociation of Kinematograph Manufacturers on itsown initiative has given an undertaking to the Ministerof Health that its members will not permit the use ofopen arc lights without filters in their studios. TheCommittee has accepted this undertaking, but wiselypoints out that research is needed as to the best typeof lamp required. -

A CONTROVERSY ON INDUSTRIAL ACCIDENTS.

THE publication in the United States of a PublicHealth Bulletin1 dealing with the comparison of aneight-hour plant and a ten-hour plant has arousedconsiderable interest on account of the conclusionsdrawn from a mass of data carefully collected.Further, the authors have unexpectedly steppedout of their way to attack the conclusions come toin an investigation, made on behalf of the Healthof Munition Workers’ Committee in this country byDr. H. M. Vernon.2 into the causation of industrialaccidents. The conclusions arrived at by Dr. Vernonwere, briefly, that industrial accidents dependprimarily upon industrial risk ; in other words, varyingspeed of production is the factor largely responsiblefor variations in accident rates. Nevertheless, if thework is so unduly heavy, or gb prolonged-as to produceover-fatigue, the accident rate rises out of proportionto production, but still the variations in accident ratefrom hour to hour are in the main governed byvariations in output. The American authors con-sidered they had found evidence to justify them inplacing greater stress upon the influence of fatigueand less upon risk. Hence the attack. But thosewho live in glass houses should not throw stones ;and immediately the Bulletin reached this country,errors were pointed out in these columns vitiating thepossibility of relying upon the deductions drawn bythese authors, or of accepting the attack on Dr.Vernon as otherwise than unjustified. We pointed outthat curves representing the hourly output of all I,classes of workers were compared with curves repre-senting the hourly occurrence of accidents among thesame workers ; while data given elsewhere in theBulletiyz showed that approximately 50 per cent. ofthe accidents occurred among 34 per cent. of theworkers with less than six months’ service ; " thelevel of the accident rate varied inversely with theexperience of the workers." In other words, outputwhich was mainly contributed to by the 66 per cent.of workers with a service longer than six months-the level of output rate varies directly with theexperience of workers-is compared with accidentswhich are equally contributed to by this 66 per cent.and the 31 per cent. with less than six months’ servicewhose output, being less in absolute amount per man,cannot have materially influenced the general outputcurve ; yet the hourly variations of output amongthe two groups cannot be expected to have tallied,indeed there is every probability of disagreement.No attempt to explain this fallacy has been made,

and, possibly for this reason, Dr. Vernon has wiselyrefrained from embarking upon a considered reply.The cudgels have, however, now been taken up inAmerica, and a controversy has appeared in theApril number of the Journal of Industrial Hygiene 3 :

this controversy may have been occupying the fullattention of the authors of the Bulletin. HereDr. A. H. Ryan deals at considerable length with thestatistical methods employed by the authors. Hiscriticism is keen, but just. He clearly shows that

1 Comparison of an Eight-hour Plant and a Ten-hour Plant.Public Health Bulletin, No. 106. 1920. Washington.2 An Investigation of the Factors Concerned in the

Causation of Industrial Accidents. H. M. Vernon. Healthof Munition Workers’ Committee. Memo. 21. 1918. Cd. 9046.

3 Discussion of Public Health Bulletin, No. 106. By Dr.A. H. Ryan. And Reply by Mr. P. S. Florence. Journal ofIndustrial Hygiene. April, 1921.

fallacies have into the output and accidentindices, substantial enough to invali(ltte the deduc-tions drawn. Ite hold" that " in view of the objectionsto the output and accident indices, neither can beaccepted as valid, either for the plant as a whole,or for a sunicient part of cither plant to be trulyrepresentative " : and, further, declares the evidenceon lost time not to be conclusive, and the comparisonbetween the two plants to be fallacious. Dr. Ryandisclaims being associated with the bulk of theBulletin, and appears to regret that some of his ownwork, dealing with rhythm in industry, is includedin this publication. Mr. P. S. Florence, one of theauthors of the l3nlletin,, to whom this stringentcriticism was suhmitted, essays a reply. But it begsthe question and is consequently ineffective. Heis driven to accept the criticism as well founded, andhas to fall back upon being

" doubtful whether therefinements which Dr. Ryan suggests would havemade any material difference in the conclusions to bedrawn." The authors of this l3ulletirz, which hasreceived much notice, would have done well tosubmit it to much more careful examination beforepublication. The Joiti-ital of Industrial Hygiene hasdone good service in publishing this discussion.

IN DEFENCE OF THE BACILLUS BULGARICUS.

ALTHOUGH Metchnikoff’s teaching as to the valueof the lactic acid ferment in the large intestine hasstill many devoted apostles among laymen-especiallyon the continent—the results obtained and publishedby medical men who have used preparations ofB. bulqaricus in their practice have brought littlecredit on this method of treating intestinal putrefac-tion. Prof. E. Doumer, of Lille, while he accepted thepractical failure of this treatment, was not able toforget that Metchnikoff had to his credit some con-vincing experiments carried out in vitro. Why, then,did the same experiments inside the human intestineend so differently ? His answer, 1 formulated aftercareful research, is that the bacillus is provided witha nourishing diet in the test tube, while in the intestinehe finds himself deprived of all food in the midst ofhis enemies. Metchnikoff, it seems, had made themistake of assuming that some starch would survivethe action of both ptyalin and diastase, whereas infact no starch does. Prof. Doumer therefore coatsa proportion of starch with paraffin melting at44°—45 C. Analysis shows that such a mixture providesavailable starch in the large intestine and the recordedclinical experience tends to indicate that the bacillusis not slow to take advantage of it.

OUTLOOK FOR PHYSICAL RESEARCH.

IMPETUS is being given to physical research inCalifornia by an annual grant of 230,000 made bythe Institute of Technology for the current expensesof a new laboratory, the equipment of which is beingprovided by a private donor, at a cost of no less than60,000. That manufacturers are keenly alive to thebenefit accruing to them from physical researches isshown by the participation of the Southern CaliforniaEdison Company in some of the new activities, forthey are bearing the cost of apparatus required forinvestigations in the transmission of electrical powerat high voltages.

Prof. R. A. Millikan has been appointed directorof the new institute. A novel feature of the personnelis that Prof. Lorentz of Leiden is to be one of the stafffor the winter months, and it is expected that someBritish experts will be invited to similar temporaryappointments. This seems to be an extension of theidea of travelling professorships, and if a galaxy oftalent is thus to be made available to the institutefar-reaching results may be anticipated. Physicalresearch has an ever-widening range of action and of

1 Le Scalpel, August 13th, 1921.