The Effects of Radium Treatment on War Injuries in the Neighbourhood of Nerves
Authors: W. C. Stevenson
Journal: BMJ (1920)

r 1.B -rr-T It would seem, tllerefore, that althouglh definite failure in one or more of these tests is not enough, per se, on whichl to reject a candidate, still a combination of tlhree or four failures is often acconmpanied by evidence of actual or recent impairment of one or other of tlle various systems of the body.It is noteworthy also tlhat, in practically every case that could not be said to satisfv rigid standards, failure was due to inability to reach the minimum rather than to exceed the maximum limit, there evidently being a decided tendency towards diminished rather than in- creased labyrinthine reaction sensibility.4. Relationship) betiveen these Tests and others Used by the Aviationt Candidates Medical Board, Hamizpstead.In order to see if there is any relationship between the results of tllese tests and those employed routinely by the Aviation Candidates Medical Board a series of 100 cases was taken and a comparison made.The tests selected for comparison were tlhree in number-namely, tremor of eye- lids or hands, self-balancing, and the rod and board test.It was found, however, that a pilot miglht have what are accepted as normal labyrinthine reactions and yet at the same time perform only moderately or badly one, two, or all three of the above-mentioned tests.Of the pilots dis- cussed under (3), only one of the three with all four laby- rintlhine reactions unsatisfactory was poor in two tests- namely, self-balancing and the rod and board test; the otlher two performed all the tests satisfactorily.In addi- tion, in the case of the other pilots discussed under (3), abnormal labyuinthine reactions seemed to bear no rela- tionship at all to the successful execution or otherwise of these three tests.This is perhaps not surprising, as the turning reactions only test the integrity and tone of the cerebro-cerebellar-vestibular tracts, whereas it is well known that many factors may enter into the successful execution of the other tests cited.5. Value of these Tests from the Point of View of the Medical Selection of Pilots.At present, and until other and perlhaps surer standards are laid down, one is inclined to view tlle utility of these rotation tests, at all 'events from the point of view of routine examination, as being problematical.It is true that tlley may draw attention in certain instances to par- ticular defects whicll might or might not have been other- wise nioted, but, on the other hand, their rigid observance nmighit easily exclude men whose past histories and recent performances are those of perfectly successful pilots.Thleir value, however, and tlle data they give to anyone capable of interpreting such information is undoubtedlv great in certain instances, as the following two cases recently seen by myself will show: CASE I.Lieutenanit L. complained of deafness in the left ear inicurred in May, 1918.The history was that whilst descenldinig, and about 700 feet from the ground, he felt a tightness in the head and a miist before his eyes.He made a bad landintg-" pancakes" -was so dizzy on a;Uempting to alight that he could not keep