892 SHOULD THE ART OF WRITING BE ALLOWED TO DECAY?

of nearly 40 years there have been many changes in methodsof building and in conditions, of life so that the regulationsappropriate for the guidance of a past generation may betmduly restrictive to-day. When new methods of construc-tion and design constantly come into being, revision of by-laws must inevitably be required. By-laws with respectto walls which were framed with particular referenceto brick construction and imposed restrictive conditionsas to thickness and the use of materials, are inappro-priate to types of construction now in use, such as build-ing with hollow blocks or slabs of terra-cotta, .concrete,and the like material, reinforced brickwork, or reinforcedconcrete. Again, as the circular reminds us, many of theolder by-laws do not provide for hollow and half-timberedwalls and steel or other framed walls hung with tiles or

slates, and filled in where necessary with incombustible

materials, yet these are ordinary methods of modern building.With regard to such matters as th.ese.and to the system to beadopted in supervising the safety of recent modes of build-ing, the Board expresses its willingness to assist authoritiesin the framing of fresh clauses. It then addresses itself toa matter of considerable and growing importance -namely,the need for better cottage accommodation in rural areas,

gauging the connexion between this need and the restrie-tion imposed by needlessly inflexible and, unsuitable buildingregulations. It might strike some as extraordinary thata,great Government Department should advise rural districtcouncils to see that their building regulations prescribeconditions essential to health without offering impedimentsto the erection of suitable dwellings. It might be’thoughtthat the rural district council would pride itself upon

understanding the needs and .limitations of its own

countryside. The Board,. however, goes on to state,and many from their experience will be able to corroborateit, that there are some rural districts in which a codeof by-laws based on the Board’s original model series,which was drawn np with special reference to urban

areas, is still in force. These rules, being not onlymore stringent than is now considered necessary for rural

areas, but less subject to relaxation and modification thanthose now deemed to be sufficient for urban localities, havenaturally a tendency to diminish building operations whichit is the desire of all to encourage. To foster the small

holding, or rather to bring it into being, to bring back to theland the peasant who once tilled it and to give him

a personal interest in its cultivation, to retain inrural areas the remnant of the population still left

there, including the more vigorous portion of that

remnant which is always the readiest to move else-

where, is, let us hope, becoming to an increasing extent arecognised feature in the future policy of the nation, a

policy that might well be cooperated in by all independentlyof party. The model series of by-laws dealing with buildingin ;r.ij.ral districts was framed in 1901, and the Board hasmore recently produced a series with a view to meeting the , .,requixeknents of rural areas which are beginning to assumeurban characteristics. In these, for example, a modifica- ’,tion exists affecting small dwellings sufficiently isolated byexempting them from structural requirements relating to their walls. Undoubtedly in the present day the principalobstacle to the building of better small houses and cottagesin rural districts is the cost viewed in relation to the

pecuniary return which tbose paying it, may reasonably ’expect to obtain. Looked at apart from the question ofcost, buildings erected for the use of the working classes in ithe country during recent years need only be compared with some of those now happily disused and.: falling. into decay,which still survive as monuments of the past,.in order that,the advance made may be realised. That advance has been

due, not only to legislation, but to that growing appreciationof hygienic requirements Which has prompted legislation,and the medical profession may take credit to itself for

having done,its full share in stimulating public and privateopinion to that end.

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SHOULD THE ART OF WRITING BE ALLOWEDTO DECAY P

THOSE engaged in the conduct of journals have, perhapseven more than a " former examiner in several universities,"first-hand knowledge of bad handwriting, and the letter of’’ M. D., LL. D. " in the Tirrzes of Sept. 20th strikes in our breasta responsive chord. In a later issue of the same paper,the headmaster of Sherborne, Mr. Nowell Smith, contests

the charge of "M.D., LL.D." that our great secondaryschools are chiefly, if not entirely, to blame, and pointsout that handwriting can be taught satisfactorily onlyin childhood-i.e., in ,the home and in the preparatoryschool. Intelligent reading, clear writing, and the correctspelling of common words lie describes as the tools

without which a child cannot properly attack the literaryside of his education, and these tools he should beginto handle properly at home, and should have them

,completely at command by the time he leaves the

; preparatory school. Both "M.D., LL. D. " and Mr.;Nowell Smith regard the typewriter as being a seriousobstacle in the way of good handwriting; but the lattercorrespondent points to the fact that there are plenty of menand women "whose handwriting was formed in all itswickedness long before the introduction of the type-writer. On the other hand, a business man, discussing thissubject in another paper, writes in effect that the advantagesof the typewriter are so obvious that writing at all is rapidlybecoming no longer necessary, and suggests that nowadays allthat is really necessary for anyone is that he should be ableto sign his own name. There is, however, a physio-logical aspect of this question. The educational value

of neuromuscular coordinations is well argued by Dr. LutherH. Gulick, director of physical training in the New Yorkpublic schools (Nem York Medical Journal, Oct. 17th, 1908),who points to the existence of the complex neuromuscularmechanism of breathing as ready to use on the birth of thechild, and contrasts it with the coordinations which are notperfect at birth but have to be perfected later, such as theuse of the eyes, the erect posture, walking, and so forth. It

is now admitted that it is action which determines structurerather than the reverse, so that not merely neuromuscularcoordinations should be taught to children, but specific,highly complicated, and racial ones. To follow the oppositecourse wo.uld.tend towards the breaking down of the struc-ture that has been built up through all the ages. Sir T. CliffordAllbutt laid stress on the same idea when, in his address atthe World’s Fair in St. Louis in 1904, he deplored theseparation of the handicraft of surgery from medicine.Dr. Gulick says that even though it may be true that thetime will come when man may no longer need to run or evento walk, we cannot conceive of a time coming when theadult man will not need to have learned to walk at the

proper age, because of the bearings of this upon his neuro-muscular system. It is hard to imagine the mere tapping ofthe keys of a typewriter having the same educational valuefor the neuromuscular mechanism as the more delicate, variedand complex movements of writing. If writing must continueto be taught, it is in the plastic stage of early childhood thatit should most efficiently be done. Care and accuracy inthis stage will ensure at least legible writing, and that oncehaving been thoroughly acquired the writing will alwaysremain, even when hurried, more legible than that of othersb-idly trained. Moreover, there is an intimate personal

893SLEEPING SICKNESS IN NORTHERN RHODESIA.

relation in handwriting which, however superfluous it maybe in business, is indispensable in personal correspondence.We feel, as a consequence of its power of expressingindividuality, a sense of present companionship in the well-known handwriting of our intimates that must of necessity be

lacking in a typewritten letter. We could never reoognisethe personal authorship in the typewritten screed.

THE BENEFIT OF COLD AIR IN THE TREATMENTOF PULMONARY TUBERCULOSIS.

IT is not so long ago that sufferers from pulmonary tuber-culosis were kept by medical direction in carefully warmedrooms from which all draughts were strictly excluded ; andwhen Bodington had the hardihood to propose treatingcases of pulmonary consumption out of doors he was muchabused. The open-air treatment of phthisis is happilynow firmly established, though all authorities are not agreedupon its preeise modus operandi. An interesting contribu-tion on the subject has been lately published in the Julynumber of American Medicine by Dr. Charles E. Woodruff, ofSan Francisco, who insists upon the damage done to con-sumptives by moderate amounts of heat and light. He holds

that there is no evidence whatever that sunlight, which inthe view of some is a valuable therapeutic agent, is

of any benefit in tuberculosis cases, and he also holds

that there is no proof that an ideal climate should have

a maximum of sunshine. In his opinion, the benefit of

cold air and the damage done by moderate heat are thetwo great modern ideas now being substantiated byexperiments all over the world. After dwelling upon theviews of Leonard Hill and others as to heat and moisture

being the harmful conditions produced in crowded and

unventilated rooms, he goes on to attribute much of the

improvement which phthisical patients derive from the

open-air treatment to the relief from the damage doneby small degrees of heat in confined rooms." In proofthat sunlight is not concerned with this improvement, heinstances a series of experiments recently undertaken in

France by Lannelongue and Achard, who took several

groups of guinea-pigs of the same size and weight, andinoculated them on the same day in the peritoneal cavitywith the same amount of the same culture of tuberclebacilli. The different groups were placed under different

hygienic and climatic conditions-some in the country,others on the seashore, some at high and others at lowaltitudes, some in the North and others in the

South of France. The last group was kept in the laboratoryin a dark room, but with a window constantly openall of these animals received the same amount and kind ojfood. Whenever one of them died the body was sent to Pari!for examination in Lannelongue’s laboratory. It is note.

worthy that the group of guinea-pigs which resisted thtuberculous process longest was that kept in the dark roonwith the window constantly open. The ideal climate for

consumptives described by some authors is one having ’’ the greatest possible amount of sunshine, light winds, dratmosphere, and a porous soil, with elevation sufficient t<

increase the respiratory act in depth and vigour." Reference iithis connexion is made by Dr. Woodruff to cases treated wit]success by Sir William Bennett in London, where climati,conditions during the treatment were the exact opposite othose described above, since there was little sunshine, hig]winds, wet atmosphere, non-porous soil, and low elevationAs regards the benefits obtained by consumptives treated in the Swiss Alps, some practitioners attribute the improvement to the effects of sunlight; but in Dr. Woodruff’

opinion the cold air is chiefly responsible for the amelioration. There is, he says, little or no improvement in sue]

cases until the skin gets heavily tanned and keeps out th

light " (the light rays are largely stopped at the surface and in proportion to the density of the pigment in the skin)." Blondes who won’t tanj won’t improve." The best resultsare obtained in winter when the light is least intense.

Attention is drawn to the danger of " light baths " fortuberculous patients owing to the tendency to pulmonaryh&aelig;morrhage during sun exposure, and on what he terms;

’’ misplaced consumptives the author makes some inter-esting remarks. He considers that they are best treatedin the localities in which they were brought up, and thatphthisical negroes, for example, should not be sent to anyregion where the temperature ever falls below 750 F. or

rises above 80&deg;.. In conclusion, the author asks that hisarticle be not regarded as a plea for treating consumptivesin darkness, but rather for keeping them from the damageinflicted by minor grades of both light and heat. It is

strange, he says, that men in cold countries will spendimmense sums to secure a, harmful heat in dwellings andplaces of assembly, but in hot countries they will not expenda cent. to cool these places, though everyone knows the

harm done by the heat, and knows also the ease with whichthe air may be cooled by modern machinery at little cost.

SLEEPING SICKNESS IN NORTHERN RHODESIA.

A REPORT by Dr. A. May, the principal medical officer ofNorthern Rhodesia, has been recently issued, containing anaccount of work done in regard to sleeping sickness preventionup to last February. A commission, under Dr. Allan Kinghorn,of the Liverpool School of Tropical Medicine, investigatedthe disease prevalence in the Luangwa Valley, and con-firmed the fact that glossina morsitans transmits the trypano-some, about 5 per cent. of the flies becoming permanentlyinfected and capable of transmitting the virus. Further

experiments are now being carried out under different

climatic conditions on the Muchinga plateau area. As to the

exact identity of the trypanosome found there seems to besome doubt. Stephens and Fantham consider it to be a newspecies, trypanosoma rhodesiense. The disease appears tohave existed in the Luangwa Valley for a considerabletime under the native name of chilotera. In the examination

of the native population the signs found to be of most

value in making a. diagnosis have been pyrexia, puffiness .ofthe face and eyelids, tremor of tongue and general shakiness,a vacant expression, and slowness of movement and speech.Glands are palpated and punctured, and microscopicexaminations of the blood and gland juice carried out,Dr. May considers blood examination to be of little value

compared with gland puncture, trypanosomes being rarelyfound in the peripheral circulation (except during pyrexialattacks) by the methods of microscopic examination

practicable under the circumstances. There is, un-

fortunately, little doubt that the extent of country infestedby glossina morsitans is much greater than was the case afew years ago. Dr. May does not altogether agree with theopinion, extensively held in Rhodesia, that the largerantelopes are responsible for the presence of tsetse Ry,and that their destruction would be quickly followed

by its disappearance. There are also many practicaldifficulties in the way. An experiment, however, is

being now carried out in a definitely restricted fly beltwhich will furnish grounds for deciding whether the com-plete destruction of all game in a limited area is the best

procedure to adopt. The three possible methods of prophy-laxis are considered : 1. Destruction of the fly cannot beattempted with any hope of success by any means known atpresent. 2. Removal of all sources of infection implies not.only removal of infected human beings---i. e. , segregation&mdash;but also removal of infected animals. Segregation of theinhabitants is regarded with extreme distrust and fear-not