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Industrial Hygiene Digest
October. 196:
as caretakers and made himself available for personal consultation. Third, the psychiatrist
offered continuing formal education in the form of seminars for medical officers but later rel
on informal individual contacts with referring medical officers as the best means of increasir
the medical officers' involvement in human problems. Of the three, the first seemed to be th
most important but would have been ineffective without the other two methods. As a result of
this increased communication, preventive measures were given added emphasis and, in genei
human problems were better handled, as evidenced by the reduction in the incidence and dura-
of psychiatric illness. There are six references.
-- Author's summary
938 Electrocardiogram in Alcoholism and Accompanying Physical Disease. R.G. Priest, J. K. B and A.H. Kitchin. Brit. Med. J. 1, 1453-1454 (June 11, 1966).
The extent of electrocardiographic changes and concomitant physical disease in alcoholics pre
senting as psychiatric problems were studied. In a series of 37 psychiatric inpatients with
alcoholism, 20 had abnormal ECGs. The usual changes found were those specific for alcoholi
cardiomyopathy (dimple and cloven T-waves); many reverted to normal during the hospital ad
mission. An abnormal ECG was the most frequent physical abnormality found in these patient
The abnormal electrocardiograms were significantly associated with body weight occurring se
in underweight patients (tau= -0.44, P= 0.02), and never in the authors' obese patients (tau =
P= 0.02). They showed a tendency to occur in the presence of abnormal cardiovascular signs
The liver was enlarged or tender in 1 5 of the 37 patients (but only in one were the flocculation
tests unequivocally abnormal). An evaluation of the physical health of the patients in this seri
showed relevant symptoms, physical signs, or abnormalities of special investigations in 32 of
the 37 patients.
.. J. Am. Med. Assn. References Review!
939 ''Skid Row" Syndrome: A Medical Profile of the Chronic Drunkenness Offender. Can. Med. Assn. J. 95, 205-214 (July 30, 1966).
J.S. Olin.
From skid row, 227 chronic "drunks, " inmates of the Toronto Jail, were studied to determine
the physical features and illnesses of this group. Complete physical examinations, liver funct
tests, routine hematology, urinalysis, chest radiographs were carried out and previous hosplt
records were obtained for each man. The data were analyzed by IBM computer and reported i
terms of body systems. Items that occurred in sufficient frequency were separated out and lis
to compile a "skid row" syndrome. The men averaged 45 years of age, had been drinking heai
for 20 years and had four drunken convictions a year. Tuberculosis was found in 8.8%. Epile;
was confirmed in 8%. Cirrhosis of the liver was definite in 3% of the group; 75% were under tl
Canadian average weight, and 25% had significant body deformities. It was estimated that, if
necessary therapy was carried out, 90% of the men would be able to perform useful labor. Thi
are 36 references.
-- Author's abst.
940 The Accident Process. III. Disability: Acceptable and Unacceptable. A.H. Hirschfeld and R.C. Behan. J. Am. Med. Assn. 197, 85-89 (July 11, 1966).
Peptic ulcers and other suggestions of depression appear in histories of accident victims, Indi
cating that disability exists before the mishap. After the accident has occurred, this disability
is linked with an apparent physical defect, and it becomes acceptable to both patient and society
Breaking this linkage is an important factor in successful therapy. Of equal interest is the fac-
that prior depression has measurable physical components. Increases occur in adrenal and
gastric secretions. Ketosteroid, metadrenalin, normetadrenal, thyroid, and estrogen titers
change, some in blood, others in urine. Such physical variables of preaccident depression cou
be measured for prediction and possibly for preventive therapy.
-- Authors' abst.
941 Surfer's Knots. Associated Bone Changes and Medical Problems. D.W. Gelfand. J. Am. Med. Assn. 19", 149-150 (July 1 1, 1966).
Surf riding is largely confined to the beaches of California and Hawaii, but is now gaining in
popularity on the east coast as well. The physical hazards of this very exhilarating sport are
those expected from the use of a heavy fiber glass surfboard in a pounding surf. These hazard:
include a large assortment of cuts and bruises, and an occasional fatality produced by a rapidly
moving board striking the head. In addition, regular devotees of the sport acquire surfers' kne
soft-tissue swellings on the dorsum of the foot and just below the knee. Changes tn the small
bones of the feet are frequently found in association with surfers' knots. These bone changes
consist of chipping and spurring of the dorsal surfaces of the tarsals and metatarsals. It was
found that the surfers' knots are frequently symptomatic and occasionally require treatment.
The problems encountered included pain and deformity of the foot, and erosion, hemorrhage,
and infection of the surfers' knots.
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