THE exposition at San Diego, Cal., was a swell fair. I appear to be a simple-minded person and like fairs. The ingenuity which can get up attractive exhibits in a world where the theater, movie, radio and museums, to say nothing of life itself, are in competition, commands my admiration. That they do so means that the exhibits must be right up to date, and show the latest developments of modern activitiestoo recent to get in a museum. A number of the exhibits are naturally of medical interest. The demonstration of devices to reduce different kinds of noises is one of the most important of these.
Our modern industrial civilization is accompanied by all sorts of raucous noises, and we have the most carefully controlled experiments to show that these noises are destructive to efficiency. They tend to defeat the very civilization they create, being so antagonistic to the smooth working of the civilized person’s nervous system.
This is not guesswork, but a conclusion from scientific studies. Dr. Donald A. Laird of the psychological laboratory of Colgate university, has put workers to the test, measuring their efficiency at given tasks in the presence of different kinds of noises. Whenever the noise was loud, the efficiency of the work went down, and whenever the noise stopped, there was a further increase in output. Not only that, but a partial reduction of noise will increase efficiency. For instance, a drop in loudness of 5 per cent from the loudness level of 70 reduces missed production by 3 per cent.
“This is the answer to the belief that some work places are too noisy to benefit appreciably by reducing their noise, since they cannot be made acoustically quiet.”
In my travels for the last few years I have been interested and have reported for my readers the result of the anti-noise campaigns in various cities. Probably the most astonishing result was in the once hideously noisy city of London.
The English minister of transport, the Hon. Leslie Hore-Belisha, has enforced a ruling against motor horns between 11:30 at night and 7 in the morning, and a fine of $10 for anybody using his motor horn in the streets during these hours is rigidly imposed and collected. The substitute for the horn is to flash the headlights once or twice on approaching a street intersection. The same thing has been adopted in most cities in Italy.
The headlight signal at the corner is very effective, even more so than a horn, because the approaching driver may be deaf, but certainly if he is driving a motor car, he is not blind.
WHAT’S WRONG WITH TIRED, WEAK AND Toxic PATIENT?
“What is wrong with the patient who feels tired, weak and toxic?” This is the question which one of the most eminent American physicians asked a medical society the other day.
It is an extremely important problem. Every doctor sees many of these people every day. They go from doctor to doctor. So it is the doctor’s problem.
But it is also the problem of many families who have one of these complainers in it.
Everybody agrees, in general, that there is no single organic disease at the base of the trouble. The trouble is “functional,” as the saying is. They are sometimes called “neurotics.” The eminent physician who asked the question prefers to call them “constitutional inadequates,” because they are not mentally or emotionally adequately equipped to stand the stresses of life.
One of the most important things for such a person is to understand himself. All the more important because so few doctors understand them. There is one group that have gone through extensive diagnostic studies and have had many operations without cure, even though a non-important organic defect has been diagnosed and corrected.
PAIN CHIEF COMPLAINT
Perhaps the chief complaint of these patients is pain, but careful questioning elicits that there is only soreness or a sense of intoxication or self-poisoning, miserable feeling.
The condition tends to run in families, as most borderline nervous troubles do.
They may be quite capable of mental effort and accomplishment in special lines. Charles Darwin is an example of constitutional inadequacy. He vomited for a week after each scientific address he delivered. He often went to pieces and had to retire to his bed for a week or more. Several of his children inherited these tendencies.
Physicians are often shy about making a diagnosis right away of neurosis or functional disease. The physician from whom I am quoting warns that while one is searching for some organic disease, an impending nervous breakdown may be overlooked.
NERVOUS SYSTEM TO BLAME
We have been led to the idea nowadays that everything that happens to the body can be explained on a chemical or mechanical basis. Doctors can make so many chemical examinations of the poor human body that we are bound to find something a little irregular if we look long enough. And so these patients go through life with the diagnosis of endocrine disturbance, or intestinal intoxication, or colitis, or retroverted uterus, or low blood pressure, when what is really wrong with them is their inadequate nervous system.
Can they be cured? No; that is one of the things these patients should face. They are subject to repeated breakdowns.
Can they be helped? Yes, and one of the most important things a doctor can do for them is to save them from unnecessary operations and the repeated expense of laboratory examinations. They should stick to one doctor, and not get sore at him if he doesn’t have the blood examined every whipstitch the way that new flashy doctor is examining Mrs. Jones’ blood.
How TO TREAT THAT SLUMP IN LAST HOUR OF WORK DAY
You feel it, and the industrial engineer can record it statistically. I mean that last hour slump in the afternoon work. You may not be conscious of it, but usually you are. You look at the clock a little oftener. You think of a few things that you can do tomorrow morning instead of this afternoona perfectly natural and sensible thing, be-cause probably you will be better able to do them in the morning than during the last hour.
The industrial engineer has recognized, over and over again, that in the last hour or two of the working day there is a marked falling off of the worker output. It varies a little with the type of work, but is practically a universal occurrence.
Dr. Donald A. Laird, director of the psychological laboratory at Colgate university, who has contributed so many things to our knowledge of ordinary, everyday living, suggests a way to prevent it. He does not believe that of the many explanations which have been advanced to account for the last hour slump any one will explain all cases. But he regards it of significance that the accumulation of sodium lactates in the blood as by-products of the utilization of blood sugar, or glycogen, due to muscular action, might be a cause, as also might be depletion of the available glycogen for use by the muscles.
The primary fuel used by the muscles is carbohydrates. These carbohydrates are converted into glycogen.
What more natural, then, that ingestion of something which can be quickly converted into glycogen and will restore the balance, would prevent the last hour slump?
A warm milk drink fulfills all these requirements. Milk sugar is rapidly converted into glycogen, and when the milk drink is re-enforced with some maltose, which is one of the quickest sugars to leave the stomach and also quickly becomes glycogen, it is even better.
The value of this was tested out in a group of girls working in the laboratory. One type of work was hand-addressing envelopes with a fountain pen from a printed list, and the other was inserting in these envelopes two standard letter sheets and a return envelope.
In addressing the envelopes there was 2.4 per cent more output the last half of the afternoon, when a 5-minute rest separated the halves, but when a warm milk drink was also taken, the last half output was 5.3 per cent greater. In the work of inserting sheets into the envelopes an even greater gain was obtained by the same means.
As I have intimated before, I believe the rest period is a very important part of the treatment. The use of a warm milk drink with malt in it is somewhat like a treatment used by a prominent California physician for what he calls “shopper’s headache” or “golfer’s head-ache,” which he believes to be due to the accumulation of acid in the body, for the prevention of which he recommends the use of a glass of orange juice before going shopping or before playing a round of golf.