BLIND MASSEURS.
1
455 containing collections of apparatus, tubes, and prints, demonstrating the early work and subsequent advances, and the contents of the museum should be constantly kept up to date. Such an institute would become a centre for the coordination of the developments in all branches of radiography- medical, industrial, and scientific. BLOOD-PRESSURE OBSERVATIONS IN SURGICAL OPERATIONS. THE first Bulletin of a National Anaesthesia Research Society in U.S.A. deals with the import- ance of blood pressure observations before and during surgical operation. The systolic and diastolic pressures are taken by the auditory method, using the armlet and snugly binding the stethoscope below it with elastic webbing. Ptead- ings can then be taken without disturbing sterile sheets or the continuity of anaesthesia. If the diastolic pressure is between 25 and 75 per cent. of the systolic a case is probably operable, if outside these limits probably inoperable. During operation a 10 to 15 per cent. increase in pulse-rate without change of pressure, or 10 to 15 per cent. decrease in blood pressure without change in pulse-rate, is safe. A 15 to 25 per cent. increase in pulse-rate, with 15 to 25 per cent. decrease in blood pressure, is dangerous. A progressively increasing pulse-rate above 100, with systolic pressure falling to 80 or less, and a pulse pressure (difference between systolic and diastolic pres- sures) of 20 or less, lasting more than 20 minutes will be fatal. The condition of shock so denoted results in a vicious circle, the low blood pressure and stagnation of blood now occasioning increasing failure of heart and brain. The anesthetist must avoid over-dosing the patient in an effort to please the surgeon, who may be demanding a flabby musculature. Relaxation extends to the non-striated muscle, and shock results from hypostatic congestion of blood in the generally relaxed capillaries and veins of the body. citrous oxide and oxygen anaesthesia is the best preservative against shock ; it does not relax ’, muscle. -- I BLIND MASSEURS. THE Association of Certificated Blind Masseurs, registered last July, is now licensed under the Board of Trade. The objects of the Association, over which Sir Arthur Pearson presides, are :- To promote the welfare and protect and advance the interests of all certificated and qualified masseurs and masseuses who are too blind to perform work for which eyesight is essential. To assist and secure the recognition and status of such blind masseurs as aforesaid in and for the purposes of their work. To provide for such blind masseurs any assistance or advantage calculated to help them to work on terms of equality with sighted masseurs. To promote cooperation in all matters relating to massage and physical culture between the blind and sighted persons. To advocate and extend the general use or employ- ment of massage and other physical methods or exercises. Membership of the Association is conditional on the holding of the certificate of the Incorporated Society of Trained Masseuses-the limitation of title is now too familiar to need comment-or that of the late Dr. Fletcher Little, or such other cer- tificate as may be prescribed by the executive council. The registered office of the Association is at 224-6-8, Great Portland-street, London, W.l. With the objects of the Association we have the deepest sympathy ; and it is eminently satisfactory that care has been taken to provide adequate training for all its members. Far the best way to assist the blind is to render them capable of performing useful and remunerative work, and Sir Arthur Pearson’s efforts in this direction have been most successful. There is much to be said for choosing massage as a profession for the blind, though, alas, even here, the blind cannot enjoy all advantages possessed by their unafflicted fellow- workers. Many patients require remedial exercises and re-education as well as massage, and then the blind administrator is handicapped. Unless the limitation is recognised, the blind administrator will be tempted to mete out to patients inferior treatment. Teachers of massage will do well to make this clear to their blind pupils. SEX DISPROPORTION. Ix one of a series of lectures on Social Unrest, delivered at the Royal Sanitary Institute on’ Feb. 4th, Dr. R. Murray Leslie marshalled in an arresting manner the facts in regard to sex dispro- portion and its consequences. He started by suggest- ing that the numerical preponderance of females over males in England and Wales, amounting to a million and a quarter in 1911, had probably exceeded two millions by the end of the war. The figure is a likely one. Male births, it is true, exceed female births by about 4 per cent., but the mortality among infant boys is so much higher than that among infant girls that even in 1911 the excess of females per 1000 males at all ages was represented by a figure of 68 for England and Wales, while it was 62 for Scotland and only 3 for Ireland. Austria, France, and Germany then occupied an intermediate position with 36, 35, and 26 respectively. From these well- established facts Dr. Leslie went on to deduce social, economic, and national consequences of a momentous nature, associating with the disproportion of the sexes some, at least, of the assumed increase in sexual immorality, the falling off of religious observ- ance, and the decline of the birth-rate in certain elements of the population. He concluded with a classification of women into types, and a suggestion that in racial questions women may become the dominant sex. We agree with Dr. Leslie that his classification may be held by women themselves to be presumptuous, and we distrust the value of the attempts, now so often made, to place men or women into categories in accordance with what are called " types." ____ COCCIDIOIDAL GRANULOMA. Coccidioidal granuloma, of which Dr. William B. Bowman,l of Los Angeles, recently reported five cases with the X ray findings to the American Roentgen Ray Society, is an acute, subacute, or chronic disease due to infection by a parasitic organism known as the Oidium cocciclioides. It is sometimes called the Californian disease, as with but three exceptions all the reported cases have lived in or visited that State before contracting the disease, a large percentage of them coming from one district-namely, the San Joaquin Valley. The Oidium coccidioides, which is a spherical body 1 The American Journal of Roentgenology, November, 1919.
Transcript of BLIND MASSEURS.
455
containing collections of apparatus, tubes, and prints,demonstrating the early work and subsequentadvances, and the contents of the museum shouldbe constantly kept up to date. Such an institutewould become a centre for the coordination ofthe developments in all branches of radiography-medical, industrial, and scientific.
BLOOD-PRESSURE OBSERVATIONS IN SURGICALOPERATIONS.
THE first Bulletin of a National AnaesthesiaResearch Society in U.S.A. deals with the import-ance of blood pressure observations before andduring surgical operation. The systolic anddiastolic pressures are taken by the auditorymethod, using the armlet and snugly binding thestethoscope below it with elastic webbing. Ptead-
ings can then be taken without disturbing sterilesheets or the continuity of anaesthesia. If thediastolic pressure is between 25 and 75 per cent. ofthe systolic a case is probably operable, if outsidethese limits probably inoperable. During operationa 10 to 15 per cent. increase in pulse-rate withoutchange of pressure, or 10 to 15 per cent. decrease inblood pressure without change in pulse-rate, issafe. A 15 to 25 per cent. increase in pulse-rate,with 15 to 25 per cent. decrease in bloodpressure, is dangerous. A progressively increasingpulse-rate above 100, with systolic pressurefalling to 80 or less, and a pulse pressure(difference between systolic and diastolic pres-sures) of 20 or less, lasting more than 20 minuteswill be fatal. The condition of shock so
denoted results in a vicious circle, the lowblood pressure and stagnation of blood now
occasioning increasing failure of heart and brain.The anesthetist must avoid over-dosing the patientin an effort to please the surgeon, who may bedemanding a flabby musculature. Relaxationextends to the non-striated muscle, and shockresults from hypostatic congestion of blood in thegenerally relaxed capillaries and veins of the body.citrous oxide and oxygen anaesthesia is the best
preservative against shock ; it does not relax ’,muscle.
-- IBLIND MASSEURS.
THE Association of Certificated Blind Masseurs,registered last July, is now licensed under theBoard of Trade. The objects of the Association,over which Sir Arthur Pearson presides, are :-To promote the welfare and protect and advance the
interests of all certificated and qualified masseurs andmasseuses who are too blind to perform work for whicheyesight is essential.To assist and secure the recognition and status of
such blind masseurs as aforesaid in and for the purposesof their work.To provide for such blind masseurs any assistance or
advantage calculated to help them to work on terms ofequality with sighted masseurs.To promote cooperation in all matters relating to
massage and physical culture between the blind andsighted persons.To advocate and extend the general use or employ-
ment of massage and other physical methods or
exercises.
Membership of the Association is conditional on theholding of the certificate of the IncorporatedSociety of Trained Masseuses-the limitation oftitle is now too familiar to need comment-or thatof the late Dr. Fletcher Little, or such other cer-tificate as may be prescribed by the executive
council. The registered office of the Associationis at 224-6-8, Great Portland-street, London, W.l.With the objects of the Association we have the
deepest sympathy ; and it is eminently satisfactorythat care has been taken to provide adequatetraining for all its members. Far the best way toassist the blind is to render them capable ofperforming useful and remunerative work, andSir Arthur Pearson’s efforts in this direction havebeen most successful. There is much to be saidfor choosing massage as a profession for the blind,though, alas, even here, the blind cannot enjoy alladvantages possessed by their unafflicted fellow-workers. Many patients require remedial exercisesand re-education as well as massage, and then theblind administrator is handicapped. Unless thelimitation is recognised, the blind administratorwill be tempted to mete out to patients inferiortreatment. Teachers of massage will do well tomake this clear to their blind pupils.
SEX DISPROPORTION.
Ix one of a series of lectures on Social Unrest,delivered at the Royal Sanitary Institute on’Feb. 4th, Dr. R. Murray Leslie marshalled in anarresting manner the facts in regard to sex dispro-portion and its consequences. He started by suggest-ing that the numerical preponderance of femalesover males in England and Wales, amounting toa million and a quarter in 1911, had probablyexceeded two millions by the end of the war.The figure is a likely one. Male births, itis true, exceed female births by about 4 percent., but the mortality among infant boys is so
much higher than that among infant girls thateven in 1911 the excess of females per 1000 malesat all ages was represented by a figure of 68 forEngland and Wales, while it was 62 for Scotlandand only 3 for Ireland. Austria, France, and
Germany then occupied an intermediate positionwith 36, 35, and 26 respectively. From these well-established facts Dr. Leslie went on to deduce social,economic, and national consequences of a momentousnature, associating with the disproportion of thesexes some, at least, of the assumed increase insexual immorality, the falling off of religious observ-ance, and the decline of the birth-rate in certainelements of the population. He concluded with aclassification of women into types, and a suggestionthat in racial questions women may become thedominant sex. We agree with Dr. Leslie that hisclassification may be held by women themselves tobe presumptuous, and we distrust the value of theattempts, now so often made, to place men or
women into categories in accordance with whatare called " types." ____
COCCIDIOIDAL GRANULOMA.
Coccidioidal granuloma, of which Dr. WilliamB. Bowman,l of Los Angeles, recently reportedfive cases with the X ray findings to the AmericanRoentgen Ray Society, is an acute, subacute, orchronic disease due to infection by a parasiticorganism known as the Oidium cocciclioides. It issometimes called the Californian disease, as with butthree exceptions all the reported cases have lived inor visited that State before contracting the disease,a large percentage of them coming from one
district-namely, the San Joaquin Valley. TheOidium coccidioides, which is a spherical body
1 The American Journal of Roentgenology, November, 1919.
