Document gDy5pDzK5B7JbEvwORj27Bpmq

\ mi i i ia Niwbn 1 r. A M. A* ' 'Its nn-KH.S Queries and Minor Notes AM) MIXOR XOi'liS if) treatment of the primary ailment and secondarily toward tinvertigo. Such latter efforts tend to pattern themselves after the treatment in vogue for Meniere* syndrome, although tin causation of the latter and the history and findings are thougi-j T >1 > tNoMMI' H>^ JTHIIMIM' IM\> HMN I'KHAUM' M .OMl'UlKSt i 111 (* w 11 [ v inn no soi. uoufvm. mm'IOsim th> opinions <> ObHilAI. Mllims CM!" Sl'MIMMI.n S ? A t 1 * is mi u t PI. v. A SON > MO I V | ..MM I Ml A I loss AN I. l U I s ON Pi'SMI ( AKI*S VA I l.l. NOT Noli. M >. Kom l.MIKk HIM i o N T AI Si THE VA U17 Ml S NAM* ASH aiU'HM-. Kt I I ir * p Will. PI MSN.ih" os KlV'Mi. HAZARDS OF EXPOSURE TO GLASS WOOL, GLASS to Ir- quite different from that seen in persons with bv/xrtr;j*foM I he physician may try limitation of fluids p,r a *whi|( tj,. water may Ik. restricted to alx>ut I pint a day. In this countrv' Vhowever, many favor instead a low sodium diet and the ing< timi of ammonium chloride as recommended by Furstenl - * TIk- latter is Kivi-n in capsules, six 7'A (-rain <0..s'(,m >' "L* U-niK taken three times daily with meals. This is kept m, , three days and the druK is then omitted for two day, and Lam FRIT OR FOAM GLASS To the fdifor--Can you five me any information at to the hazards to the health of workers employed in the making of gloss floss? Jean Henderson, M.D., Stamford, Coon. Ansu kk.--Tlu* term "glass floss" is a nondescript one vari ously applied to "glass wool, to 'loam glass *nd fh*-' glass Irit" H'- iisfd in porcelain enamels. Tlic manufacture of the la-t named entails the greater exposures. since common frits mav contain lead, silica, fluorspar, cryolite, nitrates, antimony and tin- like. Further, colored frits may contain selenium, cadmium, chromates, uranium or manganese, depending on the enlor desired. Some of these enamel frits long have lieen regarded as a frequent source of lead poisoning. However, it seems more likely that this inquiry refers to "glass wool" or fiber gla"." The process of manufacture differs with the ultimate usi- contemplated, such as the manufacture of glass 'ilk" for garments, diving suits, coverings for machinery or. instead, glass pads i,,r air conditioning, insulation, refrigeration # <r lahoraiorv usage. All further comment is limited to tiled /alter and coarser pn*css. Dla" to be reduced to the "wool" slate is already made, although the composition may lie dis similar to ordinary glass. The starting noint for "glass wool" is the remelting of this glass. Furnaces are so constructed that, resumed. It is best to ive the druK in divided dose, Utwcen mouthtuls of food to avoid gastric distress and vomiting 7 lie treatment is earned on for about six weeks when the ammonium Itlort.le is discontinued, but the salt poor diet is pursued further tor another six weeks. Constipation should be avoided. Kxcessive u,c of tobacco and abuse of tea and coffee should be forbidden. Small do-c ot plienobarbital as well as jiotassium bromide are occasionally tound useful The sodium salts of these should not be iveii. t c patient is an older person some thought should be given to the jHissihility of the presence and the correction of a vitamin lack. The patient should Ik* cautioned about sudden changes in jHisition of the bead, as in suddenly arising from bed and in leaning forward to wash the face and tie the shoe lace'- It F obvious that the treatment recommended is not based on an exact knowledge of the cause of the symptoms and i' but a rationalization of the incomplete knowledge of the day. References: Mc.\)|v. U, J., ?imI Stuart. K. A.: Vertigo from fh* Standpoint >( thf Oti.Ury ngxlugi't, Jr. Am Acod. Ophth & Otoiurxn; -*:** 194], ( f'isac. S J ( onirm-nts on the foregoing, Year Book of K>e. tar, Nusr. Ihr*.it. Chicago, Year Book Puhli'Hrr. 194J. when suitable temperatures are reached, the molten glass may he discharged through a sievelike structure. The strings of glass immediately are blown on with live steam or air under pressure. The result is a disintegration of the glass strings into minute fibers lying somewhat in parallel lines in the direction of the air blasts. Since the process starts with preformed glass, the Usual exposures of glass manufacture may lx eliminated. I he remaining and specific exposures may Ik- three in nunilxr and are ( 1 > the usual ill effects of high tenqxrature'. (Jj mechanical injuries from spicules of glass ,r <A> carlvon tetra chloride or ether vapors, which chemical' are sometimes used to remove a mineral oil lubricant, at times applied to the glass bbers to promote disentanglement. Any handling of fibrous glass may lead to the penetration oi the skin by numerous minute glass particles. This may lead to isolated, slow healing minor furuncles or a more dittii'e dermatitis. For the purj>osc of lubrication a light mineral oil may Ik- applied to the ma'Mof glass w h * I in connection with its "combing." Later this must Ik removed through the use oi some oil solvent, of which carfxm tetrachloride is hut one example. Although Schulz (Gasma'ke 11:57. mentions ati a'lx'to'is-hke condition of the lung oi a inan working with glass wool, it may lx- doubted that any specific pm iimom h omosis tx likely to arise A publication entitled "Sale Practice in the Manufacture ami Usage of Fibre Cilass." being Safe Practice Bulletin No. 58 of the Pennsyl vania Department of halmr and Industry. February 1V40. fur nishes extensive information alxnit the e\i*'iire' incident to this industry VERTIGO IN PATIENTS WITH HYPERTENSION To tho (ditor--Is there any ffMlatiit rfcot rditm wftigo in nut oi hypertension, especially atnowg the oped, wise* reduction in tfce blood pressure does not give relief from the vertigo? M ^ flhnaii As>whk.-- I he cause or causes oi vertigo in iktsoiis with hypertension js not accurately known. Persons with hy|K*rten* ''ion with or without cerebral arteriosclerosis may conceivably, by sudden motions oi the head, alter the blood supply to. and thereby tile hydrodynamics oi, tfie eiidolymph system of the >tatic labyrinth aiul so produce dizziness. Changes in the walls of the end arteries of the labyrinth may further lead to degenera tive alterations in the neuroepithelium of the inner ear and so cause vertigo. Blood- vessel changes of this tyf>e may also be responsible lor ixcasiona] and minute hemorrhages into the labyrinth, producing thereby abnormal sensations roughly classed as vertiginous. It is clear that treatment must in large part le empiric and symptomatic. In general, therapy should be directed toward the UNCOOPERATIVE PATIENTS WITH SYPHILIS Ta tho (ditor--In October I9B warried couple cmmo ta we wiH TD*'j*** hi Hie initial stage. They were pat oo alternating neooesphenomine v Gm. and intramuscular bismuth sabtolicylote according to tHe Public Health Service tchedul* until March 23, 1940, receiving in time eighteen dates of neoortphenomme and four dote* of bitmutb oocn. i March 1940 I become ill but orroaged for tbeir treatment with o neigh boring physician of their own choice. On returning to work in July I penuoded them >tk coMideroblc trouble to resume treatment, wnicn I completed in December 1*41. They have in that time received rnirry- towr dotci of neaortphenamine and thirty-i dotet of bumuth caa. the interval of four months during which I wot ill they did not take any treatment at I had arranged for them. Incept for thote fovr "oaths they were puite regular in coming in for their treatment. On Jan. JO, 1943 I took o Wastermoon tet, which wot positive in the wife, as wer? the Kline and Kofcn reactions. I do not believe that these people will be willing ta take entensivo treatment again. They hove o large family and I should like to give them such treatment as they are willing to take and such os will keep down tho infection until the disease gets more odvoncedThese ore the Hungs that I wish to know What would you suggest as the minimum mothsd of keeping the difast under control? How long will it probably bo until those cases can he depended on to bo noamfectiows without treatment? m.D., Iowa. \\swi.k.--There i' no minimum method of keeping syphilis under control. No guess can be expressed as to the length ot time in which tln-'e patients will remain noninfectiuus without treatment. Tile onlv thing that can be said in this respect is that 85 |K-r cent of infectious relapses occur within the first two years aiter the cessation of treatment. The first correct procedure in the management of this situa tion at the moment i' an immediate examination ot the spinal fluid in both husband ami wife. The enquirer gives no informa tion as to the recent serologic status of the husband, although it is implied, since the wife is still seropositive, that the hu'band may Ik* seronegative. If the husland shows no physical evidence of syphilis, if hi' blood test is negative now and if the spinal fluid is now normal, he does not require further treatment but should be followed with blood tests every two months lor the next year, every six months thereafter for an indefinite period of time, am) with annual physical examinations. The wife certainly requires more treatment. The nature and kind of this cannot be outlined without knowledge as to the spinal fluid findings. There is no royal road to the cure of syphilis, and it the jmtietits refuse to take adequate treatment they should do so at their own risk after the possible consequences have been iully explained. To give an occasional treatment "such as they are willing to take ami such as will keep down the infection until the disease gets more advanced" is medically indefensible. 01 022 1273