MTE Journal, Vol 1 No 4, September 1941 - Medical Training Establishment

6 involving risk of damage to the eye-ball e.g. racing drivers footballers skiers pilots and those who hunt or shoot as strange though it may seem, a direct blow upon the eye in the case of an indi­vidual wearing a contact lens is most unlikely to cause breakage of the -lens. 2. Those suffering from chronic disease of the cornea e.g. Corneal ulcers and relapsing Kera­ titis especially of the neuroparalytic type. This includes cases of Trigeminal Neuralgia in which an alcohol injection or removal of the GasSerian Ganglion has produced loss of corneal sensitivity. Contact Glasses have also been used in individuals suffering from Albinism or those with partial or total aniridia where photophobia is a constant worry. A tinted Contact Glass is used in such cases. Although Contact Lenses have many advantages in special circumstances it is most unlikely that they will ever displace ordinary spectacles because not only are they expensive and at first difficult to wear, but they take some little time to insert even by those who are skilled in their use and for the individual who requires merely to pop on a pair of glasses for reading or at the cinema Contact Lenses are obviously not any advantage. I am indebted to Messrs. Keeler of 47 Wigmore Street, London for the loan of the illustrations. References :—1 .Bristol Medico-Chirurgical Journal :Vol. LVI No. 212 March 81939 :"Some Advances ”in Ophthalmology by A.G. P a lin M.A. B.M. B.Ch.(Oxon.) F.R.C.S.(Ed.). 2. Esquire :Nov ember 1939 :The o d ore E . O brig .Food and Health in Wartime Squadron Leaders F.T. MACRAE Ph.D. D.Sc., W.and P. STAMM M.B. B.S. M.R.C.S. L.R.C.P. In the last 20 years great advances have been made in the science of nutrition but considering the importance of the subject the medical profession has been lamentably slow in taking much interest. It is unfortunate that doctors have paid little attention to the question of correct feeding either of the general population or of their patients or ever think of diet as the possible etiological factor of their patients’ illness. It is common to hear them say that there cannot be any widespread malnutrition as they never see cases of scurvy, beri-beri or pellagra this complacent attitude is wrong since malnutrition has to be gross before any such frank mani­festations develop. The earliest signs of malnutrition consist of increased liability to infections and such vague symptoms of disturbance of function as lassitude depression inability to concentrate, loss of appetite loss of morale and insomnia. Later objective signs begin to appear such as loss of weight anaemia various skin and mouth lesions and certain eye conditions. A great deal of evidence is accumulating in support of the view that the speed of recovery from many different diseases is largely governed by the patients state of nutrition. In order to maintain any community in the best state of health and to ensure that any member falling ill shall have the best chance of a speedy recovery it is therefore extremely important to ensure that the diet is inadequate all respects. It is not enough M .T.E. JOURNAL SEPTEMBER 1941 for the diet to be such as to prevent the appearance of even the earliest signs of deficiency the diet must be adequate to maintain efficiency. With a good mixed diet there is little chance of widespread malnutrition but as many articles are already rationed or difficult to get certain factors are already nearing the borderline of adequacy. As foods become more limited in amount and variety the difficulty of obtaining an adequate supply of these factors will increase. Many of the essential factors are easily destroyed in the preparation of food for the table cooking on a large scale is particularly liable to be destructive since it necessarily involves certain methods which are conducive to destruction. Work is therefore being carried out in the R.A.F. to ensure that the maximum use is made of the available food by intro­ducing methods of cooking which will preserve the essential food factors as far as possible subject to the limitations imposed by the conditions of large scale feeding. It is cheering to know that these cooking methods which preserve the essential food factors also preserve flavour and make the food more palatable. The practice of these recommended methods of cooking is of immediate importance and in the future is likely to become imperative. At the same time careful watch is being kept for any signs of malnutrition and analyses are being made to make sure that the diets are both theoretically and actually Inadequate. order to offset some of the losses caused by food rationing, certain new types of food are being investigated with a view to their general introduction. There is one “new ”food which has already been introduced the general use of which is undoubtedly of paramount importance—National Wheatmeal Flour. There is no other single measure which will do as much to dispel the possibilities of malnutrition as the general use of National Wheatmeal Bread and National Wheatmeal Flour. When wheat is milled four main fractions are roughly speaking obtained :bran which for the most part consists of pericarp middlings or wheatings which include amongst other parts of the grain the aleurone layer the germ and the white flour which consists mainly of endosperm. The white flour whilst containing the greater part of the energy- producing elements of the wheat grain is lacking in the valuable vitamins high quality proteins and mineral salts particularly available iron. These important factors are however con­tained in large amounts in the germ and middlings or wheatings, and to a less extent in the bran. Although comparatively rich invaluable food elements the bran contains much fibre, and it is the bran which imparts the flavour to ordinary brown bread which about 95 percent of the population of this country do not like. Many ordinary brown flours consist mainly of white flour and bran and contain little germ and middlings. On the other hand National Wheatmeal Flour consists of the endosperm the middlings and most of the germ and contains therefore most of the nutritious part of the grain but little of the rather unpleasant bran. In contrast to brown bread, National Wheatmeal Bread is extremely pleasant to eat and practically everybody who tries it prefers it to white bread. Quite apart from the advantages of the National Wheatmeal Bread from the nutritional standpoint there is another very good reason why National Wheatmeal Bread should be eaten. To make 100 lbs. of National Wheatmeal Flour 118 lbs. of grain are required to make 100 lbs. of White Flour 137 lbs. of grain are required therefore for every 100 lbs. of National Wheatmeal Flour used 19 lbs. of grain are saved. This means that if the whole population of this country were to consume National Wheatmeal Flour instead of White Flour about three-quarters of a million tons of shipping space would be saved annually. At present in the Service National Wheatmeal Bread is being issued to the extent of 25 percent of the total bread issue. A greater issue has not been made as some people fear it will not be popular and will be wasted. Should it prove to be popular the issue will be increased. It is therefore up to you to play your part by asking for more and by enlightening your less well-informed friends on the advantages of National Wheatmeal Bread both to yourselves and to the country.
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