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INTERNATIONAL FEDERATION OF SURGICAL COLLEGES
204 were elected vice-presidents. The other members of the accepts responsibility for solving its own problems. This attitude, if helped and directed into psychothera- executive committee in the first instance will be representapeutic channels, can be a powerful rehabilitating factor. tives from Holland, France, Sweden, Norway, Belgium, We should treat the family as the unit-not the patient in and Australasia. The member-institutions are: isolation. Academy of Surgery of Paris, American College of Surgeons, treatment Belgian Surgical Society, College of Physicians, Surgeons, averts the development of Community and of South Africa, Danish College of Uni. Gynaecologists antisocial attitudes and the overlay of aggression which Dutch Association of Surgeons, Italian versity Surgeons, are produced by compulsion and restrictions, and thus Royal leaves the patients free to deal with their problems of Surgical Society, Norwegian Surgical Association, Australasian College of Surgeons, Royal College of Physicians social adjustment. Their psychotic symntoms, if fully and Surgeons of Canada, Royal College of Surgeons of Edinestablished, are not eradicated, but they cease to be the burgh, Royal College of Surgeons of England, Royal College major and dominating factor in the patient’s existence. of Surgeons in Ireland, Royal Faculty of Physicians and Compulsory long-term hospital care tends to perpetuate Surgeons of Glasgow, Swedish Surgical Society. the dominance of the psychosis, whereas the more flexible The secretary of the Federation is Mr. Kennedy Cassels, regime of community treatment encourages the patient’s Royal College of Surgeons of England, Lincoln’s Inn Fields, natural tendency to social readjustment and helps him to London, W.C.2. remain in the community despite the handicap of chronic
psychosis. One definite advantage of community treatment is that by means of domiciliary visits psychiatric illness is treated at an even earlier stage than is possible with the outpatient clinic. In an integrated mental health service the home and health visitors recognise psychiatric situations before serious symptoms have developed. Potential stages of a serious breakdown can be treated, and prophylactic measures started in a way which is impossible without a community service. In taking these early steps it is essential to inform the patient’s general practitioner, so that he remains a member of the team. In Nottingham the system has tightened the links between the mental health service and the general practitioners, who often now refer patients for attendance at the day centre, and for other prophylactic measures, instead of merely referring them for admission. To sum up, community treatment not only makes possible continuity of care for all forms of psychiatric illness but by its beneficial influence on public opinion persuades patients and their relatives to come spontaneously to the mental health department for help and advice, and to accept the mental hospital, like the general hospital, as a place where the patient goes to speed his rehabilitation. Evaluation of the benefit offered to the psychiatric patient by community treatment must await scientific appraisal, but its advantages are already sufficiently clear to justify a critical attitude towards rigid measures of long-term hospital treatment. The possible methods of providing this treatment should be given a practical trial and the results of these experimental schemes studied carefully, so that we may, in due course, judge which is best for the patient.
INTERNATIONAL FEDERATION OF SURGICAL COLLEGES THIS Federation was formally inaugurated in Stockholm on July 4. Its aims are: The establishment and maintenance of close relations among and kindred institutions.
approved surgical colleges
The encouragement of the maintenance of high standards of surgery and its allied sciences.
education, training, and research in
At the meeting in Stockholm Sir Harry Platt was elected president for the next three years, and Dr. 1. S. Ravdin (U.S.A.) and Dr. E. Dahl-Iversen (Denmark)
Public Health No More Fluoride at Andover IN 1955 Andover Borough Council unanimously accepted their public-health committee’s recommendation that the town should be one of the four areas to take part in the Ministry of Health’s scheme to study the effect of adding sodium fluoride to water-supplies as a means of preventing dental decay among children. Fluoridation of the town’s water accordingly began on July 17, 1956. The proposal aroused local opposition, and an anti-fluoride association was formed which collected funds from ratepayers and ultimately brought an action against the council on the ground that they had acted beyond their powers in introducing fluoridation. ’ In the meantime, at the recent borough election, most of the councillors who were in favour of fluoridation lost their seats, and the newly elected council on July 1 adopted their public-health committee’s recommendation to stop the fluoridation of the town’s water-supply without delay. This decision was put into effect on July 2. The legal action has been adjourned sine die.
The First
Quarter
the first quarter of this year in England and Reports Wales,! Scotland,2and Eireinclude the following figures (the figures for the corresponding quarter in 1957 are included for comparison): on
In England and Wales in 1957, according to provisional figures, 6715 deaths from influenza were registered, compared with 2626 in 1956 and 2983 in 1955. Deaths from acute poliomyelitis numbered 225 in 1957-111 more than in 1956, but 16 less than in 1955. There were 2 deaths from smallpox last year-the first in this country since 1953. The infantmortality in England and Wales as a whole was 23-1 per 1000 live births in 1957, compared with 24-9 in 1955; the corresponding rates for Wales alone were 28-4 and 31-4. 1. 2. 3.
Registrar-General’s quarterly return for England and Wales, no. 437. H.M. Stationery Office. Pp. 30. 2s. Quarterly return of the Registrar-General, Scotland, no. 413. H.M. Stationery Office. Pp. 32. 2s. 6d. ObtainQuarterly report on Births, Deaths, and Marriages, no. 377. Dublin able from Government Publications Sale Office, G.P.O. Arcade, Pp.16. 6d.
psychosis. One definite advantage of community treatment is that by means of domiciliary visits psychiatric illness is treated at an even earlier stage than is possible with the outpatient clinic. In an integrated mental health service the home and health visitors recognise psychiatric situations before serious symptoms have developed. Potential stages of a serious breakdown can be treated, and prophylactic measures started in a way which is impossible without a community service. In taking these early steps it is essential to inform the patient’s general practitioner, so that he remains a member of the team. In Nottingham the system has tightened the links between the mental health service and the general practitioners, who often now refer patients for attendance at the day centre, and for other prophylactic measures, instead of merely referring them for admission. To sum up, community treatment not only makes possible continuity of care for all forms of psychiatric illness but by its beneficial influence on public opinion persuades patients and their relatives to come spontaneously to the mental health department for help and advice, and to accept the mental hospital, like the general hospital, as a place where the patient goes to speed his rehabilitation. Evaluation of the benefit offered to the psychiatric patient by community treatment must await scientific appraisal, but its advantages are already sufficiently clear to justify a critical attitude towards rigid measures of long-term hospital treatment. The possible methods of providing this treatment should be given a practical trial and the results of these experimental schemes studied carefully, so that we may, in due course, judge which is best for the patient.
INTERNATIONAL FEDERATION OF SURGICAL COLLEGES THIS Federation was formally inaugurated in Stockholm on July 4. Its aims are: The establishment and maintenance of close relations among and kindred institutions.
approved surgical colleges
The encouragement of the maintenance of high standards of surgery and its allied sciences.
education, training, and research in
At the meeting in Stockholm Sir Harry Platt was elected president for the next three years, and Dr. 1. S. Ravdin (U.S.A.) and Dr. E. Dahl-Iversen (Denmark)
Public Health No More Fluoride at Andover IN 1955 Andover Borough Council unanimously accepted their public-health committee’s recommendation that the town should be one of the four areas to take part in the Ministry of Health’s scheme to study the effect of adding sodium fluoride to water-supplies as a means of preventing dental decay among children. Fluoridation of the town’s water accordingly began on July 17, 1956. The proposal aroused local opposition, and an anti-fluoride association was formed which collected funds from ratepayers and ultimately brought an action against the council on the ground that they had acted beyond their powers in introducing fluoridation. ’ In the meantime, at the recent borough election, most of the councillors who were in favour of fluoridation lost their seats, and the newly elected council on July 1 adopted their public-health committee’s recommendation to stop the fluoridation of the town’s water-supply without delay. This decision was put into effect on July 2. The legal action has been adjourned sine die.
The First
Quarter
the first quarter of this year in England and Reports Wales,! Scotland,2and Eireinclude the following figures (the figures for the corresponding quarter in 1957 are included for comparison): on
In England and Wales in 1957, according to provisional figures, 6715 deaths from influenza were registered, compared with 2626 in 1956 and 2983 in 1955. Deaths from acute poliomyelitis numbered 225 in 1957-111 more than in 1956, but 16 less than in 1955. There were 2 deaths from smallpox last year-the first in this country since 1953. The infantmortality in England and Wales as a whole was 23-1 per 1000 live births in 1957, compared with 24-9 in 1955; the corresponding rates for Wales alone were 28-4 and 31-4. 1. 2. 3.
Registrar-General’s quarterly return for England and Wales, no. 437. H.M. Stationery Office. Pp. 30. 2s. Quarterly return of the Registrar-General, Scotland, no. 413. H.M. Stationery Office. Pp. 32. 2s. 6d. ObtainQuarterly report on Births, Deaths, and Marriages, no. 377. Dublin able from Government Publications Sale Office, G.P.O. Arcade, Pp.16. 6d.