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Christmas Quiz
1454
Jung’s children living in the flat upstairs. Seymour Kety says he is not a psychiatrist but has been deeply concerned in psychiatric research for thirty years. The denial comes strangely from someone who was a professor of psychiatry at Johns Hopkins. One or two of the contributions step at times rather close to the perfunctory and the pedestrian, and one or two of the contributors have used the occasion as an ego-trip. For me the outstanding essay was Dr Assen Jablensky’s. He probes more deeply than the other authors into the philosophical basis of psychiatry. Because its practitioners deal with the human mind and behaviour they cannot be entirely divorced from the values of the society they live and work in. The influence of these values, he argues, bears on all medical disciplines, but particularly on psychiatry, which by its nature cannot be "soulless" and has to try to relate the biological features of a patient to the "here and now" of his life and personality. Dr Jablensky’s essay is of special interest also because, as the Bulgarian contributor, he is the only author to have practised in eastern Europe. In the light of all the publicity given to the treatment of dissidents in Russian mental hospitals, it is surprising to be told that in eastern Europe these institutions
Round the World
play a smaller part in the care of psychiatric patients than in the west and that community psychiatry is more developed. Dr Jablensky now works for the World Health Organisation. Like his fellow contributor (Dr Lambo) from that body, he is concerned about the prospects of Third World countries obtaining the skilled workers they need for their growing populations, which are as much at risk of mental disorders as people in the west. But, unlike Dr Lambo, he does not see psychiatry as a means of promoting that vague concept "mental health", whether of individuals or of society. It should confine itself to the recognised area of mental illness, major and minor, as medically defined though incorporating a social dimension. The general impression the book conveys is fairly pessimistic, a tale of schism and too little solid science. But psychiatrists for whom successful treatment is the goal, even if the treatment is empirical, will be less dissatisfied. The prospects for their specialty may be hazy. But there can be no doubt that for most patients the outlook is far, far better than it was twenty-five years ago. 15 Dartmouth Row, Greenwich SE10
ALAN NORTON
have been set aside. Indeed the Administration’s supporters have realise that, in the public mind as a whole, these social issues take a very second place to concern over the economy and its problems. Neither the public nor the politicians in Congress liked these attempts of the radical right to subvert the constitution. In the heat of these discussions it seems that an even more serious crisis loomed. By attacking these proposals to the Government’s financing bills and by the veto of the budget proposals of Congress by the President, it might come about that money to pay the Armed Forces might be unavailable. White House aides stated that such pay might be provided, despite lack of Congressional financial provision, by Presidential decree. The possible constitutional results of that could be dreadful and surely would have shocked the Founding Fathers, who drew up our Constitution, to the marrow. But Congress overcame the Presidential veto and we were saved-till the next time. come to
From
our
Correspondents
United States THE CONSTITUTION AND SOCIAL ISSUES
DURING the pressure of international events, you may not have noted that this country has been going through a serious constitutional crisis, narrowly averted-a determined assault by conservative politicians on the basis of our Constitution. We have a written Constitution and whatever the legislature arm, Congress, or the executive, the President, and his officials may wish to do, they have to operate within the limits set by the Constitution, which guarantees individual and collective rights. The body that sees these limits are not exceeded is the Supreme Court. In its long history, the Supreme Court has sometimes interpreted Constitutional rights in rather odd decisions; and it is usually under attack from the political right or left. For years, the right, especially the Southern Democrats, opposed desegregation efforts in Congress by filibustering; and so opponents tended to get round this by appealing to the courts, and, when the court ruled in their favour, the wrath of the right mounted. Two court decisions roused especial wrath: the ruling that is was unconstitutional to have prayers in the public schools; and the judgment that women had a right to abortion. The orthodox way of reversing these decisions is by a Constitutional amendment, but this is a long, expensive, and hazardous route. So an alternative approach, with Presidential support, was attempted. The proposal of the radical right was that certain items-such as the abortion and the school prayer issues should be removed from the Supreme Court’s jurisdiction and determined solely by decision of Congress accepted by the President. The degree of support these proposals received in Congress caused no little concern, but divisions soon appeared. It occurred to religious supporters of the school-prayer proposal that a Congress which determined that prayers should be offered in public schools might go on to specify just what prayers. Similarly the anti-abortion forces were far from united. Meanwhile, the liberal opponents of these proposals were bolstered by strong support from the legal profession over the attempt to hamstring the Supreme Court and to curb its powers. In the Senate the liberals of both parties took a leaf from the conservative book and organised a filibuster, which the proponents could not break and so for the moment these issues
Christmas
Quiz
ANYONE READ THE LANCET? How well have you read The Lancet in the past
year?
1. What surgeon laboured for ’o6? 2. Why might shishai be good forfremai, nefyo, godif, and wenesh? 3. Who, with his monkey, earned a living by multiplying trillions and billions? 4. Where did the causes of death include a coconut and shark’s
liver? 5. Who was clubbed at the Brompton? 6. Who recommended dashing away with the smoothing iron, and why? 7. What competed, unsuccessfully, with ginger in the revolving chair? 8. What, by getting into a paddy, might cause an epidemic? 9. Who was remembered, perforated, in brown with blue
trimmings? 10. What fungus is silly? A copy of Pluto’s Republic, by Sir Peter Medawar, will beawardedfor the first three correct (or nearly correct) entries opened. Entries should be sent to the London office of The Lancet and will be held until opened on Monday, Feb.
21.
Jung’s children living in the flat upstairs. Seymour Kety says he is not a psychiatrist but has been deeply concerned in psychiatric research for thirty years. The denial comes strangely from someone who was a professor of psychiatry at Johns Hopkins. One or two of the contributions step at times rather close to the perfunctory and the pedestrian, and one or two of the contributors have used the occasion as an ego-trip. For me the outstanding essay was Dr Assen Jablensky’s. He probes more deeply than the other authors into the philosophical basis of psychiatry. Because its practitioners deal with the human mind and behaviour they cannot be entirely divorced from the values of the society they live and work in. The influence of these values, he argues, bears on all medical disciplines, but particularly on psychiatry, which by its nature cannot be "soulless" and has to try to relate the biological features of a patient to the "here and now" of his life and personality. Dr Jablensky’s essay is of special interest also because, as the Bulgarian contributor, he is the only author to have practised in eastern Europe. In the light of all the publicity given to the treatment of dissidents in Russian mental hospitals, it is surprising to be told that in eastern Europe these institutions
Round the World
play a smaller part in the care of psychiatric patients than in the west and that community psychiatry is more developed. Dr Jablensky now works for the World Health Organisation. Like his fellow contributor (Dr Lambo) from that body, he is concerned about the prospects of Third World countries obtaining the skilled workers they need for their growing populations, which are as much at risk of mental disorders as people in the west. But, unlike Dr Lambo, he does not see psychiatry as a means of promoting that vague concept "mental health", whether of individuals or of society. It should confine itself to the recognised area of mental illness, major and minor, as medically defined though incorporating a social dimension. The general impression the book conveys is fairly pessimistic, a tale of schism and too little solid science. But psychiatrists for whom successful treatment is the goal, even if the treatment is empirical, will be less dissatisfied. The prospects for their specialty may be hazy. But there can be no doubt that for most patients the outlook is far, far better than it was twenty-five years ago. 15 Dartmouth Row, Greenwich SE10
ALAN NORTON
have been set aside. Indeed the Administration’s supporters have realise that, in the public mind as a whole, these social issues take a very second place to concern over the economy and its problems. Neither the public nor the politicians in Congress liked these attempts of the radical right to subvert the constitution. In the heat of these discussions it seems that an even more serious crisis loomed. By attacking these proposals to the Government’s financing bills and by the veto of the budget proposals of Congress by the President, it might come about that money to pay the Armed Forces might be unavailable. White House aides stated that such pay might be provided, despite lack of Congressional financial provision, by Presidential decree. The possible constitutional results of that could be dreadful and surely would have shocked the Founding Fathers, who drew up our Constitution, to the marrow. But Congress overcame the Presidential veto and we were saved-till the next time. come to
From
our
Correspondents
United States THE CONSTITUTION AND SOCIAL ISSUES
DURING the pressure of international events, you may not have noted that this country has been going through a serious constitutional crisis, narrowly averted-a determined assault by conservative politicians on the basis of our Constitution. We have a written Constitution and whatever the legislature arm, Congress, or the executive, the President, and his officials may wish to do, they have to operate within the limits set by the Constitution, which guarantees individual and collective rights. The body that sees these limits are not exceeded is the Supreme Court. In its long history, the Supreme Court has sometimes interpreted Constitutional rights in rather odd decisions; and it is usually under attack from the political right or left. For years, the right, especially the Southern Democrats, opposed desegregation efforts in Congress by filibustering; and so opponents tended to get round this by appealing to the courts, and, when the court ruled in their favour, the wrath of the right mounted. Two court decisions roused especial wrath: the ruling that is was unconstitutional to have prayers in the public schools; and the judgment that women had a right to abortion. The orthodox way of reversing these decisions is by a Constitutional amendment, but this is a long, expensive, and hazardous route. So an alternative approach, with Presidential support, was attempted. The proposal of the radical right was that certain items-such as the abortion and the school prayer issues should be removed from the Supreme Court’s jurisdiction and determined solely by decision of Congress accepted by the President. The degree of support these proposals received in Congress caused no little concern, but divisions soon appeared. It occurred to religious supporters of the school-prayer proposal that a Congress which determined that prayers should be offered in public schools might go on to specify just what prayers. Similarly the anti-abortion forces were far from united. Meanwhile, the liberal opponents of these proposals were bolstered by strong support from the legal profession over the attempt to hamstring the Supreme Court and to curb its powers. In the Senate the liberals of both parties took a leaf from the conservative book and organised a filibuster, which the proponents could not break and so for the moment these issues
Christmas
Quiz
ANYONE READ THE LANCET? How well have you read The Lancet in the past
year?
1. What surgeon laboured for ’o6? 2. Why might shishai be good forfremai, nefyo, godif, and wenesh? 3. Who, with his monkey, earned a living by multiplying trillions and billions? 4. Where did the causes of death include a coconut and shark’s
liver? 5. Who was clubbed at the Brompton? 6. Who recommended dashing away with the smoothing iron, and why? 7. What competed, unsuccessfully, with ginger in the revolving chair? 8. What, by getting into a paddy, might cause an epidemic? 9. Who was remembered, perforated, in brown with blue
trimmings? 10. What fungus is silly? A copy of Pluto’s Republic, by Sir Peter Medawar, will beawardedfor the first three correct (or nearly correct) entries opened. Entries should be sent to the London office of The Lancet and will be held until opened on Monday, Feb.
21.