DOCTORS IN CONFERENCE.

Otago Daily Times, Issue 19278, 16 September 1924, Page 11

DOCTORS IN CONFERENCE.

PREVENTION OF SICKNESS

GENERAL PRACTITIONERS’ NEW ROLE.

TREATMENT OF EPILEPSY. (From Odr Own Correspondent.) LONDON, July 30. A discussion on the nature and treatment ot epilepsy took place in (he Neurology and Psychological Section of the British Medical Conference at Bradford. The discussion was opened bv Dr James Collier, who argued that in the majority of cases epilepsy was certainly not a disease of the brain, but due 1o some acute poisoning process. It was a remarkable fact that the habitual epileptic was immune from many of the common diseases which were the plague of the world, such as the specific fevers of childhood tuberculosis, pneumonia, and cancer. In this the epileptic was, comparable with the subjects of infantilism and idiocy, where it was believed that an essential cause was the perversion of the body metabolism. Epilepsy in his view was an expression of this same metabolic error, while the mental deterioration, mental aberration, and terminal dementia were the results uopn the brain of this same process, either by wav of deprivation of activators or long-con-tinued poisoning. It was a remarkable fact that only a small percentage of gross injuries to the brain were followed by epilepsy; some 5 per cent, of such cases during the war became epileptic. The speaker opposed operation unless this was indicated by physical signs oilier than those, of pure epilepsy. The value of general hygienic measures in the treatment of epilepsy admitted of no dispute, and he was convinced that the less one departed from the routine of a normal healthy life and the fewer restrictions one made the better for the patient. In conclusion. Dr Collier referred to the status cpilepticus, which was said to prove fatal in more than half the cases. Such a high mortality called for a scrutiny of the time-honoured treatment of that condition. VITAMINS AND DIET. In the section of Public Medicine and Industrial Diseases, Dr Boyd Orr contended that the results of modern work showed that a faulty diet was not only the direct cause of many diseases, but was also a potent predisposing cause of certain infectious diseases. Though much was still obscure, there was now sufficient knwoledge, and, what waa of almost equal importance, sufficient interest, to make dietetics au important factor in preventive medicine. Of the 15 chemical elements which entered into the composition of the body, and were recognised as essential ten were minerals, and each was known to perform functions which could not adequately be performed by any of the others. Children, in proportion to their weights, required more minerals than adults, owing their need for constructive material .or growth. The first line of defence against rickets, he said, must be the adjustment of the mineral contents of the diet. Fortunately, mineral deficiencies could easily be corrected by including in the diet foodstuffs the virtues of which were universally recognised. Milk, green vegetables, and certain fruits were rich in ralcium. The only certain sources of iodine were green vegetables and cod liven oil. Fruits and vegetables had an excess of alkali, and thus corrected a diet which was too acid. On account of its groat wealth of calcium and iron spinach should b© of special value for infants. These foodstuffs which were rich in inorganic constituents liable to be deficient in the modern diet were also rich in vitamins. Dr J. Anson pointed out how men had come home after the Armistice absolutely fit and healthy as a result of service diet, but that they had lost weight owing to the lack of brofbs. soups, meat, potatoes, and vegetables, substituting for this meals of preserved meats, pickles, bread and margarine, and tea. INDUSTRIAL WELFARE. The increasing interest that not only the medical profession but also manufacturers are tailing in industrial welfare was clearly shown by the large number of medical and business men who attended the meeting of the section of public medicine and industrial disease when this subject waa discussed. Dr W. P. Dearden (Medical Officer of Health, Manchester), who opened the dlamission, said that prior to the war industrial welfare had been regarded as an interesting philanthropic experiment on the part of employers, but it was now necognised as of great economic value, and could be regarded as a going concern. There were now some 700 welfare supervisors in the country as against 25 before the war. Employers were bound to realise that 3 the healthy and contented worker would stick to his situation longer, do better work, and lose less time than the sickly or discontented man. Professor Collis had shown by a careful analysis that hy the careful administration of industrial medical supervision it would be possible to effect an annual saving to industry of £140,000,000 per year. Ks thought! the co-operation of medical men should be sought by employers who desired to ensure health of their employees, and that in the case of a large works the services of a fulltime works doctor was desirable. The great value of- such a system would be to detect the early symptoms of certain occupational diseases, and in time to prevent them becoming established in the patient. Mr Mackay, a Bradford dyer, advocated vocational tests, which, he said, would prevent the tragedy of industrial misfits, and told ot a case when a man who had been trained for four years in the dyeing industry proved an absolute failure, for a simple reason, that it was not discovered until the end of that period that he was colour-blind. Dr Robb,.who was formerly medical officer at Bouxnvilie, spoke on the question from the point of view of the workman. “There is no doubt in my mind,” he said, "that if you coddle people too much they lose their spirit of independence. I think where a doctor is paid by a firm he is too much influenced by the firm. If we are going to improve the people physically and mentally we should take it out ot the hands of industrial enterprise and make it a national responsibility.’ At another session Dr H. Brackenbury expressed the opinion that the general practitioner is passing out of the class which deals only with people who are ill, and is becoming more and more their adviser when they are well. “Practitioners,” he said, “are afraid to take part in the formation of public opinion in health matters by the fear of their fellows saying they are advertising themselves.” MENTAL DEFICIENCY. A discussion on mental deficiency in children was opened by Dr A. F. Tredgold, physician to the out-patient department of Bethlem Hospital, London. Continuing the discussion, Dr Robert Hutchison, London, as the result of studying the upper classes in private practice, expressed the opinion that there was no evidence of heredity in mentally deficient children. The striking fact in his cases of congenital mental deficiency was that the child was the first born of the family. It would almost look as if Nature required some practice before she was able to produce a normal child. It was absurd to say that mentally deficient children came of neurotic stock. “We all came of neurotic stock; that was, those who were worth anything.” He believed mental deficiency arose fortuitously, and that each generation would continue to produce its crop of such children. Dr Leonard Findlay, Glasgow, agreed with Dr Hutchison that, the neurotic individual was usually at the top of the tree. He had seen more mentally defective children among the better classes in proportion than among the poorer classes. The discussion had given no real solution of the problem. lie won-, dered whether the special rate-aided institutions and schools for defectives were worth while.