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AS THE EXAMINER SEES IT
451
Richardson, Sir Harold Tempany, the Earl of Scarborough, Mr. Percy Rockliff, and Mr. Tom Williams.
HOSPITALS IN THE EIGHTEENTH CENTURY SIR,-Surely there is no difficulty in explaining what The British Rheumatic Association is not intended to you call (p. 396) " the sudden burst of philanthropic rival any existing body. It has, in fact, the approval energy... which caused the foundation of s6 many of of the Empire Rheumatism Council, and is seeking our voluntary hospitals in the first half of the eighteenth registration as a charity trust. It has been formed century." They were the outcome of the Evangelical to to rheumatic sufferers help themselves ; Revival, which primarily help stirred the public conscience in that as but its membership is open to all who are interested in in other matters of social reform. The Oxford Moverheumatism, whether sufferers or not. The subscription ment had a similar effect in the establishment of hospitals has been tixed at 10s. per annum. Donations would be in the middle of the nineteenth century., Voluntary welcomed. The headquarters are at 118-120, Wardour are the expression of the concern of the comhospitals but written communications should’ W.1, London, Street, inspired ,munity, by religious principles, for the welfare hon. Mr. C. M. to the A. be addressed Bowen, of their fellow men. secretary, B.A., at the clerical department, 111, Woodville Road, Worcester Infirmary, like several others, was in a New Barnet, Herts. F. HERNAMAN-JOHNSON cathedral city. The development of the twentieth Chairman Chairman of Council, B.R.A. century is that in one place the community may find expression in either instead of both ways. Birmingham MORE STONES FOR OUR GLASS HOUSE has a fine hospital centre but only a parish church as SIR,—In your current issue three people discuss the cathedral. Liverpool has a magnificent cathedral but in the used a of language by contributor, no hospital centre. degree precision and such criticism might well be more frequent. On the C. E. A. BEDWELL. BEDWELL., .....London, S.E.24. next page one writer tells how " a young man died following excision of the rectum " and another notes that RUBELLA AND INFANT MORTALITY " In most public lavatories there are no wash-basins." SIR,—German measles is an epidemic disease attaining Did the young man die of’ heart-failure before he of incidence in certain years and in certain seasons peaks could catch up with the excision, and are lavatories with of these years. One expects that, as the numbers of seats instead of wash-basins a result of the abolition of pregnant women affected with german measles must compulsory Latin ? vary according to the periodicity of the disease, so also AN ADMIRER OF OLD TESTAMENT LANGUAGE. must the births of children with congenital defect due London, W.I. to this cause show an epidemic trend. SIR,—If we are, as I hope, to have some interesting A child born with congenital defect, especially heart correspondence on the use and abuse of the English disease, would be more likely to succumb during early language by doctors, may I contribute a note on the word micturition ? Micturition is defined in the Pocket Oxford Dictionary " as (A morbid frequency in) passing urine." The term should, then, properly be used to refer to the symptom of increased frequency of urination. Indeed, a patient might suffer from micturition pure and simple. JAMES MARSHALL. London, S.W.I. -
AS THE EXAMINER SEES IT
SIR,—May I add one hint for use in clinical examinations —a hint
possibly no more superfluous than those regarding dirty hands and halitosis ? It is : always proffer thanks for help and a hopeful " goodbye " to the patient. When I did so, perhaps a trifle ostentatiously, at an examination not so long ago, I saw surprised glances pass between two examiners standing by, and I felt instinctively that I had successfully negotiated that hurdle.
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J. L. B.
BRAIN AND MIND SIR,—Your leading article of Sept. 6 under this heading prompts me to point to a psychosomatic phenomenon, which, although not uncommon, rarely receives the attention which it deserves. I refer to the symptom known as perseveration. By this is meant the pointless persistence or repetition of an idea or movement. Perseveration is found in association with concussion, epilepsy, encephalitis, apoplexy, barbiturate intoxication, insulin coma, and convulsion therapy; but it also occurs in certain mental disorders, notably schizophrenia, where no known organic factor is at work. What makes it of interest in connexion with mind-body relationship is that in certain cases motor and mental repetition can be demonstrated to occur together, indicating that for the time being mind and body are being governed by a single principle of operation-viz., that involving a propensity to repeat or perpetuate a previous pattern of activity. Thus, a patient when recovering from a convulsion, or entering into insulin coma, may sometirnes endlessly repeat an aimless movement or maintain a fixed attitude, but at the same time show ’in response to mental tests that his ideas are also persisting, and even imprinting their mark on succeeding ideas. Yet an idea is something mental whereas the sort of movement in question seems wholly physical. Since ideas and movements are in their essence incomparable, their subordination to similar functional laws in pathological states offers a promising field for investigation. Perseveration is not the only symptom in which such functional parallelism exists. THOMAS D. POWER. Brentwood Mental Hospital, Essex.
YEAR
life, not of necessity from the defect itself but from the equally lethal effect of intercurrent disease. One would therefore expect a year of high incidence of rubella to be ’ followed by a year of high infantile mortality. The infant death-rate in Manchester over a period of many years has shown a gradual decline, but in the course of this gradual improvement there occur bad years when the rate rises. The accompanying graph of the infant mortality and incidence of rubella in Manchester1 since 1926 shows five such " bad years," preceded by a year of high rubella incidence. It is possible that this association is merely a coincidence. The medical officer of health of Manchester has informed me that, in the same years of high infant 1. Annual
Reports of the Health of the City of Manchester, 1926-45.
Richardson, Sir Harold Tempany, the Earl of Scarborough, Mr. Percy Rockliff, and Mr. Tom Williams.
HOSPITALS IN THE EIGHTEENTH CENTURY SIR,-Surely there is no difficulty in explaining what The British Rheumatic Association is not intended to you call (p. 396) " the sudden burst of philanthropic rival any existing body. It has, in fact, the approval energy... which caused the foundation of s6 many of of the Empire Rheumatism Council, and is seeking our voluntary hospitals in the first half of the eighteenth registration as a charity trust. It has been formed century." They were the outcome of the Evangelical to to rheumatic sufferers help themselves ; Revival, which primarily help stirred the public conscience in that as but its membership is open to all who are interested in in other matters of social reform. The Oxford Moverheumatism, whether sufferers or not. The subscription ment had a similar effect in the establishment of hospitals has been tixed at 10s. per annum. Donations would be in the middle of the nineteenth century., Voluntary welcomed. The headquarters are at 118-120, Wardour are the expression of the concern of the comhospitals but written communications should’ W.1, London, Street, inspired ,munity, by religious principles, for the welfare hon. Mr. C. M. to the A. be addressed Bowen, of their fellow men. secretary, B.A., at the clerical department, 111, Woodville Road, Worcester Infirmary, like several others, was in a New Barnet, Herts. F. HERNAMAN-JOHNSON cathedral city. The development of the twentieth Chairman Chairman of Council, B.R.A. century is that in one place the community may find expression in either instead of both ways. Birmingham MORE STONES FOR OUR GLASS HOUSE has a fine hospital centre but only a parish church as SIR,—In your current issue three people discuss the cathedral. Liverpool has a magnificent cathedral but in the used a of language by contributor, no hospital centre. degree precision and such criticism might well be more frequent. On the C. E. A. BEDWELL. BEDWELL., .....London, S.E.24. next page one writer tells how " a young man died following excision of the rectum " and another notes that RUBELLA AND INFANT MORTALITY " In most public lavatories there are no wash-basins." SIR,—German measles is an epidemic disease attaining Did the young man die of’ heart-failure before he of incidence in certain years and in certain seasons peaks could catch up with the excision, and are lavatories with of these years. One expects that, as the numbers of seats instead of wash-basins a result of the abolition of pregnant women affected with german measles must compulsory Latin ? vary according to the periodicity of the disease, so also AN ADMIRER OF OLD TESTAMENT LANGUAGE. must the births of children with congenital defect due London, W.I. to this cause show an epidemic trend. SIR,—If we are, as I hope, to have some interesting A child born with congenital defect, especially heart correspondence on the use and abuse of the English disease, would be more likely to succumb during early language by doctors, may I contribute a note on the word micturition ? Micturition is defined in the Pocket Oxford Dictionary " as (A morbid frequency in) passing urine." The term should, then, properly be used to refer to the symptom of increased frequency of urination. Indeed, a patient might suffer from micturition pure and simple. JAMES MARSHALL. London, S.W.I. -
AS THE EXAMINER SEES IT
SIR,—May I add one hint for use in clinical examinations —a hint
possibly no more superfluous than those regarding dirty hands and halitosis ? It is : always proffer thanks for help and a hopeful " goodbye " to the patient. When I did so, perhaps a trifle ostentatiously, at an examination not so long ago, I saw surprised glances pass between two examiners standing by, and I felt instinctively that I had successfully negotiated that hurdle.
-
J. L. B.
BRAIN AND MIND SIR,—Your leading article of Sept. 6 under this heading prompts me to point to a psychosomatic phenomenon, which, although not uncommon, rarely receives the attention which it deserves. I refer to the symptom known as perseveration. By this is meant the pointless persistence or repetition of an idea or movement. Perseveration is found in association with concussion, epilepsy, encephalitis, apoplexy, barbiturate intoxication, insulin coma, and convulsion therapy; but it also occurs in certain mental disorders, notably schizophrenia, where no known organic factor is at work. What makes it of interest in connexion with mind-body relationship is that in certain cases motor and mental repetition can be demonstrated to occur together, indicating that for the time being mind and body are being governed by a single principle of operation-viz., that involving a propensity to repeat or perpetuate a previous pattern of activity. Thus, a patient when recovering from a convulsion, or entering into insulin coma, may sometirnes endlessly repeat an aimless movement or maintain a fixed attitude, but at the same time show ’in response to mental tests that his ideas are also persisting, and even imprinting their mark on succeeding ideas. Yet an idea is something mental whereas the sort of movement in question seems wholly physical. Since ideas and movements are in their essence incomparable, their subordination to similar functional laws in pathological states offers a promising field for investigation. Perseveration is not the only symptom in which such functional parallelism exists. THOMAS D. POWER. Brentwood Mental Hospital, Essex.
YEAR
life, not of necessity from the defect itself but from the equally lethal effect of intercurrent disease. One would therefore expect a year of high incidence of rubella to be ’ followed by a year of high infantile mortality. The infant death-rate in Manchester over a period of many years has shown a gradual decline, but in the course of this gradual improvement there occur bad years when the rate rises. The accompanying graph of the infant mortality and incidence of rubella in Manchester1 since 1926 shows five such " bad years," preceded by a year of high rubella incidence. It is possible that this association is merely a coincidence. The medical officer of health of Manchester has informed me that, in the same years of high infant 1. Annual
Reports of the Health of the City of Manchester, 1926-45.