of 1 /1
1267 are given by mouth to dogs, only insignificant changes in the amounts of aluminium in different tissues are found, and it follows that aluminium salts are not absorbed from the alimentary tract, except in traces. As a result of a scare in the United States, that the use of aluminium baking-powders was dangerous to health, the Department of Agriculture instituted an inquiry. The report, published in 1914, describes experiments on 26 university students carried out in three different universities, who were given amounts of alum varying from 0-2 to 10-0 g. daily for about six months. It was unanimously reported from the results of these experiments that the amounts of alum likely to be consumed as a result of the presence of alum in baking-powder-estimated as a little over gr. 1 of aluminium per person per day-are much too small to have any ill-effect. The amounts of aluminium to be found in food cooked in aluminium vessels are estimated from analyses carried out by Massatch to be about gr. 1/10 per person daily. It is seen that the dangers arising from aluminium utensils have been thoroughly investigated by many workers, on many species of animals ; they have also been investigated with equal thoroughness on man. These dangers, said Dr. Burn, are non-existent; and clinical reports that symptoms of abdominal pain are relieved by discontinuing the use of aluminium must be ascribed to psychological effects, which are very common in medical practice. OCULAR MOVEMENTS 1 his Bowman lecture, delivered at the recent annual congress of the Ophthalmological Society of the United Kingdom, held at Edinburgh, Prof. J. van der Hoeve began by touching on Bowman’s friendship with the leading Dutch ophthalmologists of his time. The close association of the two countries at that time in ophthalmological matters had, he said, happily persisted until now. He then gave a masterly description of the extrinsic musculature of the eye- ball, of the movements executed by it and of the mechanism of these movements. He compared the movements of the human eyes with those of the rabbit, in which animal the absence of a macula and the slightness of the overlap of the visual fields I causes considerable modification of the ocular move- i ments. He showed how the action of each ocular muscle alters according to the primary position of the globe ; in fact, the more the mechanism of ocular movements is studied the more complex the question is found to be, for even the simplest movement is executed by the agency of a perfectly balanced synkinesis of all 12 muscles. By means of explana- tory diagrams, sketches, and -photographs, Prof. van der Hoeve reviewed the experiments which had been carried out in the past on animals and men in the investigation of ocular movements. The simpler animal experiments consisted of photographing the I eyes of an animal which was subjected to various movements in space on a board capable of rotation I in any plane ; compensatory movements of the eyes during these passive movements were elicited. Similar experiments were performed on the human subject, bound to a revolving stretcher capable of similar complex movement; the same apparatus was used in the investigation of nystagmus. More complex, though more portable, apparatus was used by the investigators, mainly Dutch and German, of the existence and position of the centre of rotation of the eveball. As a result of his own studies, and from a consideration of the work of others, Prof. van der Hoeve has been forced to the conclusion that there is no such thing as a fixed centre of rotation for the eye. but that rotation occurs around a point most suitable and most economical for the particular movement which is being carried out. The formula which has hitherto been accepted-that rotation of the globe occurs around a fixed point, with the ocular muscles acting in a line from the centre of their origin to the centre of their insertion-must be abandoned, and the alternative accepted, that the eye goes about any particular movement in the easiest, simplest, and quickest way, irrespective of the movements which preceded it or are to follow it. The lecturer hinted at the likelihood even of separate fibres of the same ocular muscle having different actions under different conditions. At the conclusion of his lecture Prof. van der Hoeve referred to the question of periscopic spectacle lenses designed and fitted with respect to a fixed centre of rotation of the globe. The idea underlying their prescription and use was, he said, a mistaken one. So far from their being peculiarly adapted to the globe in its movements, it was likely that the globe adapted itself to the glass. Hence the desired optical result was achieved in the end. OUR HOSPITALS THE second issue of the Hospitals Year Book1 is far more convenient to handle than its predecessor, since the directory, which occupied more than half its pages, has been omitted. This omission allows the insertion of interesting surveys of various aspects of hospital work. The volume. which measures roughly 11 by 9 inches, is divided into two parts. Part I., which takes up 169 pages, contains a brief financial review by Sir Charles Harris, honorary financial consultant to the Central Bureau of Hospital Information ; a general survey of the work and finance of voluntary hospitals in Great Britain and Ireland for the year 1930; and notes on the Road Traffic Act, 1930, on new hospital buildings, and on the relationship between the voluntary hospitals and the local authorities under the Local Government Act, 1929. The report by the Joint Committee of the Association and the British Medical Association on the payment of visiting medical staffs of voluntary hospitals is set out in full, and the rest of this part of the book is taken up with tables. These provide information on the volume of work done in voluntary hospitals,. and on the income and expenditure on maintenance account, with an analysis of the sources of income and the principal items of expenditure. The average cost of in-patients and out-patients in general and special hospitals is also tabulated. Less detailed accounts are supplied of the work and staffing of municipal and public assistance hospitals, mental hospitals, and sanatoriums. Part II. of the Year Book contains, among other material, an article on road accidents by Sir Alexander Butterworth, an appreciative note on THE LANCET Commission on Nursing, of which the recommendations are set out in full, an account of the work and conditions of training of a hospital almoner, a tabulated list of new buildings or extensions completed by voluntary hospitals during the last two years, and a list of memoranda on matters of administrative interest to hospitals, prepared by the Central Bureau of Hospital Information. Most of those have already been published, but Nos. 38 to 50 are here set 1 An Annual Record of the Hospitals of Great Britain and Ireland, issued under the auspices of the British Hospitals Association and the Joint Council of the Order of St. John and the British Red Cross Society. London: Central Bureau of Hospital Information. 1932. Pp. 268. 7s. 6d.

OCULAR MOVEMENTS

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1267

are given by mouth to dogs, only insignificant changesin the amounts of aluminium in different tissues arefound, and it follows that aluminium salts are notabsorbed from the alimentary tract, except in traces.As a result of a scare in the United States, that theuse of aluminium baking-powders was dangerous tohealth, the Department of Agriculture instituted aninquiry. The report, published in 1914, describesexperiments on 26 university students carried out inthree different universities, who were given amountsof alum varying from 0-2 to 10-0 g. daily for aboutsix months. It was unanimously reported from theresults of these experiments that the amounts ofalum likely to be consumed as a result of the presenceof alum in baking-powder-estimated as a littleover gr. 1 of aluminium per person per day-aremuch too small to have any ill-effect. The amountsof aluminium to be found in food cooked in aluminiumvessels are estimated from analyses carried out byMassatch to be about gr. 1/10 per person daily. It isseen that the dangers arising from aluminium utensilshave been thoroughly investigated by many workers,on many species of animals ; they have also beeninvestigated with equal thoroughness on man.

These dangers, said Dr. Burn, are non-existent; andclinical reports that symptoms of abdominal pain arerelieved by discontinuing the use of aluminium mustbe ascribed to psychological effects, which are verycommon in medical practice.

OCULAR MOVEMENTS

1 his Bowman lecture, delivered at the recentannual congress of the Ophthalmological Society ofthe United Kingdom, held at Edinburgh, Prof.J. van der Hoeve began by touching on Bowman’sfriendship with the leading Dutch ophthalmologistsof his time. The close association of the two countriesat that time in ophthalmological matters had, he said,happily persisted until now. He then gave a masterlydescription of the extrinsic musculature of the eye-ball, of the movements executed by it and of themechanism of these movements. He comparedthe movements of the human eyes with those of therabbit, in which animal the absence of a maculaand the slightness of the overlap of the visual fields Icauses considerable modification of the ocular move- i

ments. He showed how the action of each ocularmuscle alters according to the primary position ofthe globe ; in fact, the more the mechanism of ocularmovements is studied the more complex the questionis found to be, for even the simplest movement isexecuted by the agency of a perfectly balancedsynkinesis of all 12 muscles. By means of explana-tory diagrams, sketches, and -photographs, Prof. van derHoeve reviewed the experiments which had beencarried out in the past on animals and men in theinvestigation of ocular movements. The simpleranimal experiments consisted of photographing the Ieyes of an animal which was subjected to variousmovements in space on a board capable of rotation Iin any plane ; compensatory movements of the eyesduring these passive movements were elicited. Similarexperiments were performed on the human subject,bound to a revolving stretcher capable of similarcomplex movement; the same apparatus was usedin the investigation of nystagmus. More complex,though more portable, apparatus was used by theinvestigators, mainly Dutch and German, of theexistence and position of the centre of rotation of theeveball. As a result of his own studies, and froma consideration of the work of others, Prof. van derHoeve has been forced to the conclusion that there is

no such thing as a fixed centre of rotation for the eye.but that rotation occurs around a point most suitableand most economical for the particular movementwhich is being carried out. The formula which hashitherto been accepted-that rotation of the globeoccurs around a fixed point, with the ocular musclesacting in a line from the centre of their origin to thecentre of their insertion-must be abandoned, and thealternative accepted, that the eye goes about anyparticular movement in the easiest, simplest, andquickest way, irrespective of the movements whichpreceded it or are to follow it. The lecturer hintedat the likelihood even of separate fibres of the sameocular muscle having different actions under differentconditions. At the conclusion of his lecture Prof.van der Hoeve referred to the question of periscopicspectacle lenses designed and fitted with respectto a fixed centre of rotation of the globe. The ideaunderlying their prescription and use was, he said,a mistaken one. So far from their being peculiarlyadapted to the globe in its movements, it was likelythat the globe adapted itself to the glass. Hence thedesired optical result was achieved in the end.

OUR HOSPITALS

THE second issue of the Hospitals Year Book1 is farmore convenient to handle than its predecessor,since the directory, which occupied more thanhalf its pages, has been omitted. This omissionallows the insertion of interesting surveys ofvarious aspects of hospital work. The volume.which measures roughly 11 by 9 inches, is dividedinto two parts. Part I., which takes up 169 pages,contains a brief financial review by Sir Charles Harris,honorary financial consultant to the Central Bureauof Hospital Information ; a general survey of thework and finance of voluntary hospitals in Great

Britain and Ireland for the year 1930; and noteson the Road Traffic Act, 1930, on new hospitalbuildings, and on the relationship between the

voluntary hospitals and the local authorities underthe Local Government Act, 1929. The report bythe Joint Committee of the Association and theBritish Medical Association on the payment of

visiting medical staffs of voluntary hospitals is setout in full, and the rest of this part of the book istaken up with tables. These provide informationon the volume of work done in voluntary hospitals,.and on the income and expenditure on maintenanceaccount, with an analysis of the sources of incomeand the principal items of expenditure. The averagecost of in-patients and out-patients in general andspecial hospitals is also tabulated. Less detailedaccounts are supplied of the work and staffing of

municipal and public assistance hospitals, mental

hospitals, and sanatoriums. Part II. of the YearBook contains, among other material, an article onroad accidents by Sir Alexander Butterworth, anappreciative note on THE LANCET Commission onNursing, of which the recommendations are set outin full, an account of the work and conditions of

training of a hospital almoner, a tabulated list ofnew buildings or extensions completed by voluntaryhospitals during the last two years, and a listof memoranda on matters of administrativeinterest to hospitals, prepared by the Central Bureauof Hospital Information. Most of those have alreadybeen published, but Nos. 38 to 50 are here set

1 An Annual Record of the Hospitals of Great Britain andIreland, issued under the auspices of the British HospitalsAssociation and the Joint Council of the Order of St. John andthe British Red Cross Society. London: Central Bureau ofHospital Information. 1932. Pp. 268. 7s. 6d.