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AIR-RAID PRECAUTIONS
344
AIR-RAID PRECAUTIONS.-GRAINS AND SCRUPLES
Dr. Saunders considers that the ill-health and the consequent mortality of many young children are due to the- physical inability of their mothers to rear them. The young girls go largely to industrial work and at the moment female labour is in demand. "To enter a factory would seem to be the general ambition, and the years which should have been spent in acquiring knowledge of what is, after all, perhaps, the most specialised job in the world are
occupied in attending possible atmosphere
machines in, perhaps, the worst for subsequent family life."
No doubt this problem is not peculiar to Cork or to Ireland, but there are concomitant conditions which render the position more serious there than elsewhere. The average marriage rate is exceptionally low and the average marriage age late. Moreover this is not essentially a question of poverty for there are many countries in which the standard of living is lower but the marriage rate higher. It is well that medical officers of health should be alert to note and draw attention to the effect on health of such social conditions.
CORRESPONDENCE AIR-RAID PRECAUTIONS
To the Editor
of
THE LANCET
I be allowed to make the following the official statement from the air-raid precautions department of the Home Office published on p. 296 of your issue of August 1st ? 1. " The scheme that has been devised " by the air-raid precautions department of the Home Office for the protection of the civil population of this country in case of hostile air attack should not, I consider, receive the support of the medical profession as a body because gas-defence is no more a function of the medical profession than it is of any other class of the community ; and we must be careful not to allow ourselves to be led into the false position of assuming a responsibility that is not ours. 2. The only part of the subject that is special to our profession is the treatment of trauma to certain tissues by a group of special persons. The inclusion of instruction in this in undergraduate education should be opposed: (a) because the five years of the curriculum are so overcrowded that there is literally no room for the addition of a single class of one hour even of an optional nature ; (b) because the inclusion of a minute specialism is contrary to all that is good in medical education. 3. As medical men each individual must be left to follow his own inclination, experience, and conscience, whether to take " the instruction of post-graduates that is offered or to refrain from doing so. 4. As a matter of psychology it may be doubted whether the " measures " devised will " maintain the morale of the population." They may be as likely to I am, Sir, yours faithfully, diminish it. T. B. LAYTON.
SIR,-May
comments
on
GRAINS AND
SCRUPLES
of THE LANCET Surgeon’s polished and philo-
To the Editor
SIR,-A London sophical contribution to this column last week is a sheer delight to read; but like other polished grains it seems to lack something vital, and this is not surprising. With one or two distinguished and most happy exceptions, alliances between surgery and philosophy have not been satisfactory, and the reason why is not far to seek. By the time the surgeon feels the urge to talk of many things life’s handicap has usually proved too much for him, for the atmosphere of pomp and circumstance in which a surgeon spends the greater part of his working day is a dangerous one. It is a moot point who suffers more from idolatry, the idol or the idolater, but one thing is fairly certain : a man must be of finer fibre than that of the normal, healthy, combatant, and humanitarian male to be the idol of his generation and to remain unspoiled. These reflections are the natural reaction to the
easy complacency with which A London Surgeon dismisses the medical contemporaries of his youth as failures, and relegates to an altogether inferior grade of mankind the despised research man. Are these facile judgments decorous in one who aspires to muse at large on men and matters ? Are they even true ?’? Can it be that A London Surgeon lacks something which should go to the make-up of a philosopher’? What does life actually mean to him?‘l His conception of the perfect life is a simple one, but how revealing ! " Steady employment... reasonable remuneration, a succession of tasks sufficiently varied to demand constant care and provide constant interest ... ," but why continue, for indeed the heart of the matter is here. One appreciates that essentially the surgeon’s mind is a reflex one ; he is trained to respond briskly to life’s demands, to do lovely things, not dream them, all day long. For him the fight against disease is finished when something has been cut out or sewn in. His not to reason In fact, give him a succession why, his but to do of congenial stimuli and he is completely satisfied. Now the despised research man is also responsive to external stimuli, but in addition he has developed the power of independent thought, and his conception of the battle of life and what is worth fighting for naturally differs from that of the surgeon ; he sees, in fact, just tinsel where the other sees pure gold. The two points of view are, of course, incompatible, but while the medical researcher may dimly comprehend the activities of the surgeon, for, after all, his time is largely occupied with the study of the lower forms of life, it is doubtful if a surgeon, any more than any other highly motile organism, can appreciate the mind of the seer at the other end of the microscope. To the latter surgery is a " sad mechanic exercise " about which Hood might well have written a song had not a shirt provided him with an even more pathetic theme....
Stitch ! Stitch! Stitch1 Gut and fascia and skin
....
As things are he realises that somebody must do the job, and it is only fair that the poor fellow should be richly remunerated as a compensation for the loss of those more intellectual pursuits which he altruistically renounces. I enclose my card, Sir, and beg to remain, as your contributor does, ANONYMOUS. August 3rd. To the Editor
of
THE LANCET
SIR,-I believe that the great majority of your readers have much appreciated the various points of view set forth by your contributors to the articles under the above caption. I wonder how many of them will feel as I did when I read this week the contribution under this heading " From a London Surgeon." I cannot help thinking how much better
AIR-RAID PRECAUTIONS.-GRAINS AND SCRUPLES
Dr. Saunders considers that the ill-health and the consequent mortality of many young children are due to the- physical inability of their mothers to rear them. The young girls go largely to industrial work and at the moment female labour is in demand. "To enter a factory would seem to be the general ambition, and the years which should have been spent in acquiring knowledge of what is, after all, perhaps, the most specialised job in the world are
occupied in attending possible atmosphere
machines in, perhaps, the worst for subsequent family life."
No doubt this problem is not peculiar to Cork or to Ireland, but there are concomitant conditions which render the position more serious there than elsewhere. The average marriage rate is exceptionally low and the average marriage age late. Moreover this is not essentially a question of poverty for there are many countries in which the standard of living is lower but the marriage rate higher. It is well that medical officers of health should be alert to note and draw attention to the effect on health of such social conditions.
CORRESPONDENCE AIR-RAID PRECAUTIONS
To the Editor
of
THE LANCET
I be allowed to make the following the official statement from the air-raid precautions department of the Home Office published on p. 296 of your issue of August 1st ? 1. " The scheme that has been devised " by the air-raid precautions department of the Home Office for the protection of the civil population of this country in case of hostile air attack should not, I consider, receive the support of the medical profession as a body because gas-defence is no more a function of the medical profession than it is of any other class of the community ; and we must be careful not to allow ourselves to be led into the false position of assuming a responsibility that is not ours. 2. The only part of the subject that is special to our profession is the treatment of trauma to certain tissues by a group of special persons. The inclusion of instruction in this in undergraduate education should be opposed: (a) because the five years of the curriculum are so overcrowded that there is literally no room for the addition of a single class of one hour even of an optional nature ; (b) because the inclusion of a minute specialism is contrary to all that is good in medical education. 3. As medical men each individual must be left to follow his own inclination, experience, and conscience, whether to take " the instruction of post-graduates that is offered or to refrain from doing so. 4. As a matter of psychology it may be doubted whether the " measures " devised will " maintain the morale of the population." They may be as likely to I am, Sir, yours faithfully, diminish it. T. B. LAYTON.
SIR,-May
comments
on
GRAINS AND
SCRUPLES
of THE LANCET Surgeon’s polished and philo-
To the Editor
SIR,-A London sophical contribution to this column last week is a sheer delight to read; but like other polished grains it seems to lack something vital, and this is not surprising. With one or two distinguished and most happy exceptions, alliances between surgery and philosophy have not been satisfactory, and the reason why is not far to seek. By the time the surgeon feels the urge to talk of many things life’s handicap has usually proved too much for him, for the atmosphere of pomp and circumstance in which a surgeon spends the greater part of his working day is a dangerous one. It is a moot point who suffers more from idolatry, the idol or the idolater, but one thing is fairly certain : a man must be of finer fibre than that of the normal, healthy, combatant, and humanitarian male to be the idol of his generation and to remain unspoiled. These reflections are the natural reaction to the
easy complacency with which A London Surgeon dismisses the medical contemporaries of his youth as failures, and relegates to an altogether inferior grade of mankind the despised research man. Are these facile judgments decorous in one who aspires to muse at large on men and matters ? Are they even true ?’? Can it be that A London Surgeon lacks something which should go to the make-up of a philosopher’? What does life actually mean to him?‘l His conception of the perfect life is a simple one, but how revealing ! " Steady employment... reasonable remuneration, a succession of tasks sufficiently varied to demand constant care and provide constant interest ... ," but why continue, for indeed the heart of the matter is here. One appreciates that essentially the surgeon’s mind is a reflex one ; he is trained to respond briskly to life’s demands, to do lovely things, not dream them, all day long. For him the fight against disease is finished when something has been cut out or sewn in. His not to reason In fact, give him a succession why, his but to do of congenial stimuli and he is completely satisfied. Now the despised research man is also responsive to external stimuli, but in addition he has developed the power of independent thought, and his conception of the battle of life and what is worth fighting for naturally differs from that of the surgeon ; he sees, in fact, just tinsel where the other sees pure gold. The two points of view are, of course, incompatible, but while the medical researcher may dimly comprehend the activities of the surgeon, for, after all, his time is largely occupied with the study of the lower forms of life, it is doubtful if a surgeon, any more than any other highly motile organism, can appreciate the mind of the seer at the other end of the microscope. To the latter surgery is a " sad mechanic exercise " about which Hood might well have written a song had not a shirt provided him with an even more pathetic theme....
Stitch ! Stitch! Stitch1 Gut and fascia and skin
....
As things are he realises that somebody must do the job, and it is only fair that the poor fellow should be richly remunerated as a compensation for the loss of those more intellectual pursuits which he altruistically renounces. I enclose my card, Sir, and beg to remain, as your contributor does, ANONYMOUS. August 3rd. To the Editor
of
THE LANCET
SIR,-I believe that the great majority of your readers have much appreciated the various points of view set forth by your contributors to the articles under the above caption. I wonder how many of them will feel as I did when I read this week the contribution under this heading " From a London Surgeon." I cannot help thinking how much better