Poore disbelieves in the possibility of such a transfer, and with Gowers is of the opinion that the liability of the left hand to suffer has been overestimated.
In my experience, as regards telegraph operators, the majority who use the left arm soon notice symptoms of the disability in it. Of 43 cases of this form of copodyscinesia which have come under my observation, in 21 the left arm was implicated; in 12 there was no such implication, although the arm was used; of the remaining 10, 8 had never tried to telegraph or write with the left arm; 1 had only one arm, the left; and 1 was doubtful. Throwing out of consideration the last 10, 21 out of the 33 had this symptom, equivalent to 63.63 per cent.
PROPHYLAXIS.—The only prophylactic measures are the observance of the most easy and least fatiguing method of performing the act which it is feared will bring on the trouble, and the avoidance of overwork.
Tobacco and alcohol generally act injuriously, and therefore should be avoided as much as possible by those who are predisposed by occupation or otherwise to these disorders.
In writing it is advisable to avoid an awkward manner of holding the pen-holder, which should be of good size; large, moderately soft pens and paper of good quality should be used.
It is also important that the table or desk upon which the writing is done should be of a convenient height, with plenty of room for the arrangement of the paper; otherwise an awkward manner is inevitable.
As regards the position of the paper, R. Berlin97 (Stuttgart) states substantially as follows: In writing the head is almost invariably held so that the line passing through the two eyes, if projected upon the paper, shall cross at right angles the oblique line of the writing: when the paper is placed to the right and parallel to the edge of the table, as generally directed by teachers, the tendency is to twist the spine and incline the head to the right in order to conform to this rule, and a cramped position is the result; but by placing the paper in an oblique position directly in front of the writer—i.e. turned toward the left—this cramped position is avoided, and the least fatigue, both to the muscles of the spine and arm, produced. Tight sleeves or anything that might possibly impede the free play of the muscles or cause pressure upon the nerves should be discarded.
97 “Physiology of Handwriting,” Von Graefe's Archiv, xxviii. p. 259, review in Ophth. Review, London, vol. i. No. 14, Dec., 1882, and Jan. 1, 1883.
It is now almost universally conceded that the conjoint movement in writing—that is, the arm movement for all the small letters, and the finger movement only to assist in making the long ones—is least likely to produce fatigue.