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RHEUMATISM VACCINE
391 because German measles is on the official list a demand for hospitalisation is made on the grounds that the patient cannot be isolated elsewhere. Why isolate at all anywhere, seeing that possible transmission of the infection to others has occurred before the disease is recognisable in the patient, and that the disease itself is a comparatively minor disability? The root of the trouble is that the Board of Education lumps this disease with all the other notifiable or non-notifiable infectious diseases and expects school medical officers to try and prevent its spreading among children. Several years ago I stopped excluding from school contacts of cases of German measles and chickenpox because (a) it was a waste of time and a loss of education, and (b) in my opinion it is better to have these diseases, if one can, in childhood rather than in adult lifewhen both may be more uncomfortable or career-disturbing. How many parents whose children at preparatory schools are quarantined as contacts because of one of the minor infectious illnesses would not be grateful if an altered lead were given as a result of official pronouncement. I am, Sir, yours faithfully, A. D. SYMONS, Medical Officer of Health, Shrewsbury.
free of
charge on application by letter to the secreWhen writing it would be of assistance if medical officers were to mention their previous experi-ence, if any, with our methods. I am, Sir, yours faithfully, ELLERT FORBES, Charterhouse Rheumatism Clinic, tary.
56-60, Weymouth Street, W.1.
Secretary.
TESTS FOR DRUNKENNESS
SiR,—The determination of the percentage of alcohol in the blood seems to lead nowhere if different percentages are accompanied by different effects on the central nervous system (see Lancet, Feb. 17, p. 322). It is not the state of the blood but the state of the brain that is important. Electro-encephalography here steps into the breach. According to Baudouin and Fischgold (Biol. méd. 29, 639), alcohol at first increases the amplitude of the &bgr; waves and decreases that of the a waves; as unconsciousness supervenes, waves of high frequency and large amplitude disappear, giving place to a slow rhythm (about 5 a second). Their article is illustrated with tracings for three successivestages: (1) drunk and unresponsive ; (2) sober but silent and (3) apparently normal. I am, Sir, yours faithfully,
VISITING IN CHILDREN’S WARDS
SILENUS.
SIR,—As practising child psychiatrist I feel I must add my voice to Dr. Bowlby’s protest in your issue of Feb. 10. I, too, cannot agree with leading article of Jan. 27 wherein you imply the absence of any but the most trivial and of emotional disturbances in hospitalised children. My experience in child guidance clinics has led me also to take notice of the deleterious effects of hospitalisation on character development, especially in very young children. I have collected quite a number of cases (their publication has unfortunately been postponed owing to the outbreak of the war) which show in no uncertain manner the emotional upheaval consequent on the removal to, and more or less prolonged stay in hospital; with the production in some of the children at any rate of symptoms as varied as night terrors, ties, stammering and all kinds of behaviour disorders. In one case I investigated a stay of six months in hospital; with the production in some of the children a
your temporary
anxiety state. Quite contrary
to the opinion expressed in your editorial I have evidence to show that children feel the absence of visitors far more than do adults. True, the child is not always able or willing to express his distress openly, as can the more articulate adult, but it is often in the absence of overt and easily recognised emotional disturbances that the danger lies. Repression is a very common defence in children against unpalatable feelings, and that this happens more often than has up to now been recognised is shown by the appearance after the return home of ’’ symptomswhich so clearly turn out to be substitute formations for the repressed feelings. I would urge with Dr. Bowlby a more careful ascertainment of the facts before embarking on the suppression of visiting in children’s wards, so lightly assumed by your editorial to be devoid of danger. I am, Sir, yours faithfully, H. EDELSTON. Leeds.
Appointments BANNERMAN, R. G., M.D. Edin., temporary assistant pathologist at the Central Middlesex County Hospital. BOLT, EVELYN H., M.B. Durh., assistant medical officer in the school medical services, South Shields. CANE, L. H., M.B. Camb., medical officer, Tanganyika Territory. COATES, J. C., M.B. Leeds, F.R.C.S., resident surgical officer, Royal Infirmary, Bradford. DAVIDSON, WINIFRED M., M.B. Edin., resident medical officer at the Canwell HaL] Babies Hospital, Birmingham. DICKSON, A. M., M.B. Mane., resident surgical officer at the Royal Manchester Children’s Hospital. ELLIOTT, R. W., M.B. ShelfD.P.H., assistant medical officer for Surrey. GEORGE, T. C. R., M.R.C.S., D.P.H., district medical officer of health for Breconshire.
LEGGETT, H. A., M.D. Lond., D.P.H., assistant medical officer for Surrey. MAIR, JAMES, M.B. Glasg., D.P.H., temporary assistant school medical officer and assistant medical officer of health for
Coventry. PARKIN, THOMAS, M.B. Edin., clinical assistant in the dermatology department, Royal Infirmary, Sheffield. ROBERTSOK, ANNE C., M.B. Belf., D.P.H., D.R.C.O.G., assistant medical officer in the maternity and child-welfare services, Ealing. ROBERTSON, FRANK, M.B. Durh., medical registrar at the Royal Victoria Infirmary, Newcastle-on-Tyne. SHAW, G. H., M.R.C.S., D.P.H., assistant medical officer for Berkshire.
SLEGGS, GORDON, M.Ch. Orth. Lpool. resident surgical officer at the Accident and Surgical Hospital, Barry. SMITHSON, W. E., M.R.C.S., assistant resident medical officer at Holgate Municipal Hospital, Middlesbrough. STRATTON, FRED, M.B. Mane., D.P.H., blood-transfusion officer at the Royal Infirmary, Manchester. THOMPSON, A. R. F., L.R.C.P., B.D.S., radiologist in the dental department of Guy’s Hospital, London. WooLF, ERNEST, M.R.C.S., resident assistant medical officer in the tuberculosis section of the public health department, Birmingham. WYSE, R. W., M.B. Glasg., F.R.C.S.E., resident surgical officer at the Salford Royal Hospital. Medical referee under the Workmen’s Compensation Act, 1925: Mr. PETER MCEWAN for the county-court districts of Bradford, Keighley. Otley and Skipton. Examining surgeons under the Factories Act, 1937 : Dr. W. W. STOTHERS (Shettleston and Tollcross district, Lanarkshire)-, Dr. T. R. MURRAY (Balfron district, Stirlingshire) ; Dr. P. C. MCKINLAY (Beverley district, Yorkshire) ; and Dr. A. S. DRUMMOND (Yarmouth, Isle of Wight district).
,
MALE NURSES
RHEUMATISM VACCINE
SIR,—Medical officers in the three Services who desire to treat rheumatic personnel by the standard method of the Charterhouse Rheumatism Clinic can obtain supplies of the vaccine used at that institution
AND ARMTT EXEMPTION.—At a meeting Royal College of Nursing on Feb. 15, matrons were advised to apply for exemption on behalf of male nurses who were called up during their training on the groundu that they were only partly trained and in the middle of their course of st udies, and that nursing was
of the
"
a
reserved
occupation.
-
free of
charge on application by letter to the secreWhen writing it would be of assistance if medical officers were to mention their previous experi-ence, if any, with our methods. I am, Sir, yours faithfully, ELLERT FORBES, Charterhouse Rheumatism Clinic, tary.
56-60, Weymouth Street, W.1.
Secretary.
TESTS FOR DRUNKENNESS
SiR,—The determination of the percentage of alcohol in the blood seems to lead nowhere if different percentages are accompanied by different effects on the central nervous system (see Lancet, Feb. 17, p. 322). It is not the state of the blood but the state of the brain that is important. Electro-encephalography here steps into the breach. According to Baudouin and Fischgold (Biol. méd. 29, 639), alcohol at first increases the amplitude of the &bgr; waves and decreases that of the a waves; as unconsciousness supervenes, waves of high frequency and large amplitude disappear, giving place to a slow rhythm (about 5 a second). Their article is illustrated with tracings for three successivestages: (1) drunk and unresponsive ; (2) sober but silent and (3) apparently normal. I am, Sir, yours faithfully,
VISITING IN CHILDREN’S WARDS
SILENUS.
SIR,—As practising child psychiatrist I feel I must add my voice to Dr. Bowlby’s protest in your issue of Feb. 10. I, too, cannot agree with leading article of Jan. 27 wherein you imply the absence of any but the most trivial and of emotional disturbances in hospitalised children. My experience in child guidance clinics has led me also to take notice of the deleterious effects of hospitalisation on character development, especially in very young children. I have collected quite a number of cases (their publication has unfortunately been postponed owing to the outbreak of the war) which show in no uncertain manner the emotional upheaval consequent on the removal to, and more or less prolonged stay in hospital; with the production in some of the children at any rate of symptoms as varied as night terrors, ties, stammering and all kinds of behaviour disorders. In one case I investigated a stay of six months in hospital; with the production in some of the children a
your temporary
anxiety state. Quite contrary
to the opinion expressed in your editorial I have evidence to show that children feel the absence of visitors far more than do adults. True, the child is not always able or willing to express his distress openly, as can the more articulate adult, but it is often in the absence of overt and easily recognised emotional disturbances that the danger lies. Repression is a very common defence in children against unpalatable feelings, and that this happens more often than has up to now been recognised is shown by the appearance after the return home of ’’ symptomswhich so clearly turn out to be substitute formations for the repressed feelings. I would urge with Dr. Bowlby a more careful ascertainment of the facts before embarking on the suppression of visiting in children’s wards, so lightly assumed by your editorial to be devoid of danger. I am, Sir, yours faithfully, H. EDELSTON. Leeds.
Appointments BANNERMAN, R. G., M.D. Edin., temporary assistant pathologist at the Central Middlesex County Hospital. BOLT, EVELYN H., M.B. Durh., assistant medical officer in the school medical services, South Shields. CANE, L. H., M.B. Camb., medical officer, Tanganyika Territory. COATES, J. C., M.B. Leeds, F.R.C.S., resident surgical officer, Royal Infirmary, Bradford. DAVIDSON, WINIFRED M., M.B. Edin., resident medical officer at the Canwell HaL] Babies Hospital, Birmingham. DICKSON, A. M., M.B. Mane., resident surgical officer at the Royal Manchester Children’s Hospital. ELLIOTT, R. W., M.B. ShelfD.P.H., assistant medical officer for Surrey. GEORGE, T. C. R., M.R.C.S., D.P.H., district medical officer of health for Breconshire.
LEGGETT, H. A., M.D. Lond., D.P.H., assistant medical officer for Surrey. MAIR, JAMES, M.B. Glasg., D.P.H., temporary assistant school medical officer and assistant medical officer of health for
Coventry. PARKIN, THOMAS, M.B. Edin., clinical assistant in the dermatology department, Royal Infirmary, Sheffield. ROBERTSOK, ANNE C., M.B. Belf., D.P.H., D.R.C.O.G., assistant medical officer in the maternity and child-welfare services, Ealing. ROBERTSON, FRANK, M.B. Durh., medical registrar at the Royal Victoria Infirmary, Newcastle-on-Tyne. SHAW, G. H., M.R.C.S., D.P.H., assistant medical officer for Berkshire.
SLEGGS, GORDON, M.Ch. Orth. Lpool. resident surgical officer at the Accident and Surgical Hospital, Barry. SMITHSON, W. E., M.R.C.S., assistant resident medical officer at Holgate Municipal Hospital, Middlesbrough. STRATTON, FRED, M.B. Mane., D.P.H., blood-transfusion officer at the Royal Infirmary, Manchester. THOMPSON, A. R. F., L.R.C.P., B.D.S., radiologist in the dental department of Guy’s Hospital, London. WooLF, ERNEST, M.R.C.S., resident assistant medical officer in the tuberculosis section of the public health department, Birmingham. WYSE, R. W., M.B. Glasg., F.R.C.S.E., resident surgical officer at the Salford Royal Hospital. Medical referee under the Workmen’s Compensation Act, 1925: Mr. PETER MCEWAN for the county-court districts of Bradford, Keighley. Otley and Skipton. Examining surgeons under the Factories Act, 1937 : Dr. W. W. STOTHERS (Shettleston and Tollcross district, Lanarkshire)-, Dr. T. R. MURRAY (Balfron district, Stirlingshire) ; Dr. P. C. MCKINLAY (Beverley district, Yorkshire) ; and Dr. A. S. DRUMMOND (Yarmouth, Isle of Wight district).
,
MALE NURSES
RHEUMATISM VACCINE
SIR,—Medical officers in the three Services who desire to treat rheumatic personnel by the standard method of the Charterhouse Rheumatism Clinic can obtain supplies of the vaccine used at that institution
AND ARMTT EXEMPTION.—At a meeting Royal College of Nursing on Feb. 15, matrons were advised to apply for exemption on behalf of male nurses who were called up during their training on the groundu that they were only partly trained and in the middle of their course of st udies, and that nursing was
of the
"
a
reserved
occupation.
-