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59 Notes, Comments and Abstracts FIRST AID IN THE FACTORY Now that industry has gone to it with a vengeance minor injuries in factories are bound to increase. In a fourth edition of their pamphlet. " First Aid and Ambul- ance for Factories," (H.M. Stationery Office. Is.) the Home Office have set out again a plan for protecting the worker against serious late results of trivial wounds. The notable common sense of the pamphlet makes it easy reading. It recommends that first-aid boxes should be placed in different parts of the works, in the ratio of at least one box to 150 workers ; that the box should be kept in the workroom itself, and preferably in the middle of the workers it is intended to serve ; and that a notice should be posted in every workroom giving the name of the person responsible for the box. The boxes contain simple dressings so packed that it is possible to remove one from its envelope without touching the pad which goes on the wound. Illustrative photographs show how this is done. No attempt is to be made to cleanse the wound on the spot, and the injured worker is sent to the ambulance-room for any additional treatment. This ruling does not apply to burns with acids or caustics ; in factories where such injuries are likely to occur workers are told that their first action must be to flood the burn with water, and suitable neutralising agents should be kept in the first-aid boxes. In large factories an ambul- ance-room has to be provided. At the end of the pamphlet there are some photographs of existing ambulance-rooms as superlative as any hospital in an American film, which show what can be done by firms of strong social conscience and large financial resources. The pamphlet advises that the room should have impervious walls and floor which can be flushed with water, washable enamel woodwork, rounded corners and good lighting. The equipment enumerated includes, besides the obvious instruments and dressings, such things as a sling stretcher for transporting a patient who has been injured in the hold of a ship or at a height above ground. A fully trained nurse should be in charge of the ambulance-room when possible, or failing that a person holding a first-aid certificate. Similarly the people in charge of the first-aid boxes in the workrooms should have had first-aid training. In any case it is desirable that a trained nurse should visit daily to see casualties and receive reports. Some large firms have engaged a full-time medical officer, and others arrange for a local doctor to attend two or three times a week. These are systems which might be extended with advantage. AUSTRALIAN HOSPITALITY FOR DOCTORS’ CHILDREN AUSTRALIAN doctors have offered to take into their homes up to 500 children under sixteen, either un- accompanied or accompanied by their mothers, and selection is being undertaken by the British Medical Association. Parents will be responsible for the passage money, and individual arrangements will be made about the cost of education and maintenance. This is essent- ially a private scheme to place doctors’ children in doctors’ homes and is quite separate from the official scheme. The B.M.A. will try to arrange for transport, although it cannot guarantee to do so, and it will also act as a medium for obtaining the necessary passports and exit permits. Further particulars and application forms may be obtained from the secretary of the B.M.A., B.3LA. House, Tavistock Square, W.C.I. An announcement about Canada’s offer will be made as soon as details are known. ON KEEPING WELL Dr. Harry Roberts is an old hand at combining advice about health with philosophic exhortation, and in his latest book (Keep Fit in War-time. Watts. Pp. 90. Is.) he has made his rather workaday subject the text for an encouraging and reassuring lecture. He has a- Cobbett-like trick of finding that apparently small issues really have a wide social and moral significance ; so that though he says all the usual and important things about keeping physically fit he also says a great many others which have more to do with mental well-being. He reminds us that the outstanding characteristic of man compared with other animals is his power of adapting himself. To illustrate this point he takes his readers on a short round tour of Sir Walter Raleigh, the Saxons and Normans, the Plantagenets and an unexpected Chinese mandarin, so giving the subject a new setting and rubbing in the fact that what begins as adaptation may end as habit. ’’ Now we have a testing time," he goes on ; and instead of experiencing the sinking feeling which remarks of that kind are apt to excite we find ourselves reading cheerfully about Defoe, who said that there were a hundred thousand stout country fellows in his time ready to fight to the death against Popery without knowing whether Popery was a man or a horse - reminding us that man is instinctively equipped to meet risk. It is a bracing book, with plenty of practical advice on hobbies, exercise, food, cooking, gardening, life in the blackout and first-aid built into the sensible confident structure. AIR-RAID FEARS SPEAKING in Edinburgh on the psychological effects of air-raids, and their treatment, Miss Mary Collins, Ph.D., said that everyone must realise that to feel afraid was a normal reaction, fear being one of the great self-preserva- tive tendencies of the human being. If fear was not felt when danger threatened the individual would not take steps to protect himself. The bodily accompaniments of fear must be known so that when they occurred they could be recognised as being normal. These were particularly acceleration of the heart, rapid breathing, dryness of the mouth, shivering, trembling of the limbs, and loss of voice. There was mental strain and tension ; the reasoning power was diminished but the imagination was increased so that rumour spread easily. Fear might only be felt momentarily, especially if adequate protec- tion was available, but if protection was inadequate, or means of escape cut.off, it might develop to any extent. To prevent initial panic when the sirens sounded some job should be allotted to each person, who alone should be responsible for its execution. Knitting and card playing were useful distractions during a raid, and deep breathing and community singing had also been found to be steady- ing. To be isolated in the presence of danger was to increase fear and hence it was best to be in the company of others and to engage in group activities whether recreational or protective. IPECACUANHA THE effect of the alteration of the B.P. monograph on ipecacuanha (see Lancet, July 6, p. 25) will be to extend official recognition to the root gathered in the eastern states of Brazil-namely, Bahia and Minas Geraes-and so to bring larger supplies to the central London drug market with a consequent fall in the cost of this drug. Hitherto the only description of ipecacuanha root answering the pharmacopeeial tests has been that obtained from the Brazilian state of Matto Grosso, and supplies have been subnormal for a long time past. The main cause of the shortage is the natives’ preference for the better paid job of collecting rubber rather than pulling up ipecacuanha root, which is a slow process, especially when the ground is hard ; another reason why the labourers are reluctant to undertake this work is that after at least a century of intensive destruction of this plant it is necessary to go far into the forest to find it. It is extremely rare for imported Matto Grosso root to fail to respond to the alkaloidal test of the B.P. 1932, but much of the root originating in Bahia and Minas Geraes is still below the standard as now amended. The records of a London drug merchant who is one of the principal importers of ipecacuanha root show that over a number of years about 50% of the specimens of Minas root and 40% of those from Bahia would not have reached the new standard, but even if only half the samples meet the new requirements the scarcity of B.P. ipecacuanha root may now be relieved. The present price of sound Matto Grosso root in London is four times that which was considered normal a few years ago, but prices have occasionally been just as high in the past. Thus in 1928, owing to labour troubles in Brazil, it was difficult to obtain supplies of the root and " famine " prices were paid in London. The prices of Bahia and Minas root are now about half those quoted for Matto Grosso root.
