THE JOURNAL OF SCHOOL HEALTH 137

FOR THE MEDICAL DIRECTOR JOHN LAMPE, M.D.

Suicides in Adolescence It has been stated that there are 100 attempts a t suicide for every

death from this cause among adolescents. By conservative estimate there are some 20 to 25 thousand deaths annually from suicide. In a recent study in New York City, suicide was the fourth leading cause of death among individuals aged 15 to 24 years. Suicide and threat of suicide is thus a significant problem for those concerned with the health and welfare of young people. Some facts based upon the New York study may be of help in dealing with this problem:

0 Suicide is on the increase 0 Suicide exceeds tuberculosis, poliomyelitis, appendicitis, rheumatic

fever, measles, scarlet fever, pertussis, and diabetes as a cause of death among teenagers

0 Suicide is more common among males than females by a ratio of 3:l 0 Attempted suicide is more frequent among female than male teen-

agers, 75% of the attempts were made by girls 0 Spring (April to June) is the worst season for attempted suicide 0 Suicide attempt is not limited to any social, economic, or racial group 0 In over 50% of the attempted suicides, one or both parents were in

0 School problems were blamed for less than 10% of the attempts 0 Three-fourths of the individuals who commit suicide have previously

It should be emphasized that a n y threat or preoccupation with suicide among young people must be considered seriously. Dismissing or ignor- ing such situations is asking for trouble. Immediate and open discussion is indicated. Schools share this responsibility with the community as a whole and must be aware of the problem both on an individual basis and on a group basis.

Attempted Suicides in Adolescence, H. Jacobziner, M.D., J A M A 101 : l:lOl, January 4, 1965.

t,he immediate vicinity

threatened or attempted to do so

P a i n Attributed to Eyestrain Teachers, nurses, and physicians are all concerned with pain attributed

to eystrain. J. M. Heaton of the Institute of Ophthalmology in London has investigated such pain. He concludes that the pain does not stem from fatigue of ciliary or extraocular muscles. It does not correlate with duration or intensity of work of these muscles. He has been unable to demonstrate correlation between degree of refractive error and degree of eyestrain. Further, experimentally induced contraction of ciliary and iris muscles usually produces a type of pain clearly different from that of eyestrain. Conversely, experimental paresis of the ciliary muscles in patients with eyestrain failed to prevent or alleviate the pain.

There seems little doubt in light of Heaton’s work that eyestrain is not the result of ciliary or extraocular muscle activity. The implications

138 THE JOURNAL OF SCHOOL HEALTH

for those associated with students are apparent. None the less the reality of pain from eystrain cannot be denied. What then is its origin? The answer is not clearcut from Heaton’s work, but some interesting observations were made. Heaton feels that eyestrain is more likely to occur in individuals who are “field dependent.” That is, those whose orientation is primarily through vision rather than by other bodily experi- ence, and thus are more sensitive to changes in their visual world.

In essence then the etiology is more likely cortical than peripheral in location. Eyestrain is common after head injury, as well as in con- valescence, anxiety states, and depression. These observations as well as some experimental evidence suggest a central basis for the pain of eyestrain. This interesting work may explain some of the situations en- countered in the daily routine of those concerned with the visual health problems of students, but it also leads to equally perplexing quest ions. It clearly emphasizes the complexity of the nature of visual function.

Source of Pain in Eyestrain, J. M. Heaton, M.D., American J o n m a l o j Ophthalmology 61: 104-112, 1966.

Use of Water During Practice It has long been a common practice to limit the consumption of water

by athletes immediately before and during both practice and actual par- ticipation in strenuous athletics. Players are seen rinsing their mouths or taking but a very small amount of water a t all seasons of the year, and in all climates. There is little doubt that the practice is a common one and widely accepted by those engaged in sports. Players, their fathers, and coaches all are aware of the dictum prohibiting free use of fluids.

It is certainly well established that the fluid needs of the body increase with activity. Also well established is the shift of fluid from intra to extra cellular com- partments as the need arises, and the concomitant shift in ions that takes place. From a physiologic point of view, withholding fluids during vigorous exercise seems unwise. Despite this, the time honored restric- tion continues. Recently some coaches have indicated that they 110 longer limit fluids for their athletes.

W. W. Gray, M.D., writing in the Journal of the Xational Athletic Trainers Association (Autumn 1966 issue, page 13), states that he has permitted free use of fluids for many years. His experience, as well as that of others, has been favorable. Perhaps one more practice which has been followed on an empiric basis will disappear. Certainly it will not be to the regret of thirsty players.

One wonders about the physiology of this practice.

* * * * *

Safety for School Music Trips is the title of a new 10 page leaflet published by the joint Committee of the Music Educators National Conference of the N.E.A. and the Elementary School Section of the National Safety Council. The document is organized as a helpful check- list, which developed from submission of an experimental form to more than 4,000 members of the MENC. Single copies are available from the National Education Association for 25#, with a reduction on quantity orders. * * * * *