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CYCLIC VOMITING.
1292
Correspondence. "Audi alteram partem."
SOCIAL CAPACITY IN DELINQUENCY. To the Edditor of THE LANCET.
SIR,—I have read with great interest the article by Dr. R. P. Jarrett in THE LANCET of Nov. 20th, but there are 01 e or two points in the paper which In the first place, the seem to call for discussion. Porteus " maze " tests would hardly seem the best choice for determining the individual’s apperceptive abilities. Their value lies in estimating powers of mental representation and planfulness in dealing with geometrical figures rather than with a concrete situation such as the individual is likely to meet with in ordinary daily life. To be sure, Porteus1 himself claims considerably more than this for the test, but his statements havenot been verified by other investigators. In my opinion, by far the most valuable test of this nature, and one which has a fairly high correlation with social apperceptions, is Healy’s " Pictorial Completion II."2 In this test, which is, I believe, too little known in England, the examinee is faced in
whether in. the form of punishment, detention, fosterhome placing, or other mode of attack would be of any avail. In this connexion I should like to mention the recent and remarkable work of Ifealy and Bronner,6in which, in a thorough investigation and follow-up of the careers of 4000 delinquents, extending over a period of 1 1 years, the causes of delinquency and results of various methods of prevention and treatment have been assessed in an unusually scientific On the basis of these investigations, they manner. conclude that hereditary factors and so-called innate mental characteristics are of little value in prognosis and show but a very low correlation with the ultimate success or failure of their cases. I agree with Dr. Jarrett that there is at present much loose and unscientific talk concerning the causation of delinquency, but is this an adequate reason for falling back upon the gloomy and fatalistic conception of innate and incurable defect ? Recent researches have done much to disprove this doctrine and to show the very great value of constructive treatment suited to the requirements of the individual offender. What is urgently needed to-day is a scientific evaluation of all the factors concerned in making the delinquent what he is. This must be the first step in the development of a rational therapy which is already long overdue.-I am, Sir, yours faithfully. R. EVELYN LUCAS,
pictorial form with ten concrete situations such as he is likely to meet with in everyday life, these situations Rockefeller Medical Fellow. varying from picture to picture instead of being, as maze " tests, all the same type. in the Porteus Even in this test (P.C. II.), though considerable work CYCLIC VOMITING. has been done in correlating the test results with the social efficiency of the individual, the best authorities To the Editor of THE LANCET. make decidedly guarded statements. Bronner,3 in SIR,—My experience of cyclic vomiting in childhood a very thorough investigation of 1043 mentally normal with that of Dr. Cameron, corresponds individuals, of whom 729 were repeated offenders, but I would essentially also direct attention again to the remarkstates that " case studies show that in some instances able cases I in THE LANCET (1924, i., 1045) -defective apperceptions are directly related to delin- of volvulus ofpublished the small intestine in which the diagnosis quency, indeed, are, perhaps, the main cause," and of cyclic vomiting had been made. I am inclined to that " it is worth while to study the apperceptive think that there is something more to be learnt about abilities - of individuals because they represent a the influence of abnormal of the intestines particularised ability that has prognostic value and as a factor in some of thesemobility cases of cyclic vomiting She adds, however, than is commonly supposed. Although the bearing important social implications." that " delinquents as a group, even repeated offenders, of such curious and exceptional cases on the subject have apperceptive ability not differing from non- is the American observations commented obscure, 4 delinquents sufficiently to be significant." Perry, upon in your annotation interested me as an indepenin the study of 340 feebleminded individuals, condent contribution to the problem. One other point cludes that " analvsis of test results and social of interest is that I havehad under my care several behavior in some of the irregular cases suggests that cases of who in earlier life had suffered cyclic vomiting in the Healy’pictorial completion II.’ we may from coeliac disease. have a valuable tool for aid in discovering those of I am, Sir. vours faithfully. "
the feebleminded who havethe mental traits most necessary for social adjustment." In view of these distinctly moderate statements, it seems that one should be very wary of accepting any test, or even a social reactions group of tests, as indicating the of the individual. It would be interesting to check Dr. Jarrett’s results by an investigation of the aftercareer of the tested individuals and also to compare his findings with the results obtained from testing a group of non-delinquent individuals of similar age, educational opportunity, and social status. So far as I understand from the paper, neither of these investigations has been carried out. Again, Dr. Jarrett quotes Burt as stating that "conduct and misconduct are always, in the last -analysis, the outcome of mental life," and deduces from this that Burt considers the delinquent to be a " innate mental constitution." person of peculiar Surely no one who has read -Burb’s5 careful and thorough work can fail to appreciate the very great stress which he lays on environmental conditions of every type. Were delinquency due to innate, and, no treatment, therefore, causes,
possible
irremediable
1 S. D. Porteus : Guide to Porteus Maze Test, 1921. 2 W. Healy: Pictorial Completion Test II., Journal of Applied Psychology, September, 1921. 3 A. F. Bronner: Apperceptive Abilities of Delinquents, Journal of Delinquency, vol. vii., No. 1, January, 1922. 4 D. E. Perry : Interpretation of the Reactions of the Feebleminded on the Healy Pictorial Completion Test II.—Social Implications, Journal of Delinquency, vol. vii., No. 2, March, 1922. 5 C. Burt: The Young Delinquent, 1925.
F. JOHN POYNTON.
THE DISSOLUTION OF INSULIN. To the Editor ofTHE LANCFT. SIR,—Dr. Funk’s reputation as a biochemist renders a careful consideration of any statements he may make necessary, but I agree with Dr. Lawrence that the letter published in your issue of Nov. 27th is not as clear as could be wished. Dr. Funk’s second letter states his position more definitely, but does not furnish sufficient detail for a critical examination of his claims, and until this is available useful criticism is not possible. The hyperglycEemic effect of ordinary insulin in rabbits, referred to by Dr. Lawrence, appears to have been first described by Zondek and Ucko in 1925.1 Early this year a similar effect in several cases of diabetes was reported by H. J. John.2 I have met with a few diabetics in whom the first effect of injected insulin has been to cause a rise in the blood-sugar, and experiments Mr. Howard and I have carried out with rabbits and guinea-pigs have shown that in certain animals an initial hyperglycsemia can be regularly induced under suitable conditions. The 6
Healy and Bronner:
Delinquents and Criminals, their Company, N.Y., 1926. 1 Klin. Wchschr., 1925, iv., 6. Jour. Lab. and Clin. Med., 1926, xi., 6.
Making and Unmaking, 2
The Macmillan
Correspondence. "Audi alteram partem."
SOCIAL CAPACITY IN DELINQUENCY. To the Edditor of THE LANCET.
SIR,—I have read with great interest the article by Dr. R. P. Jarrett in THE LANCET of Nov. 20th, but there are 01 e or two points in the paper which In the first place, the seem to call for discussion. Porteus " maze " tests would hardly seem the best choice for determining the individual’s apperceptive abilities. Their value lies in estimating powers of mental representation and planfulness in dealing with geometrical figures rather than with a concrete situation such as the individual is likely to meet with in ordinary daily life. To be sure, Porteus1 himself claims considerably more than this for the test, but his statements havenot been verified by other investigators. In my opinion, by far the most valuable test of this nature, and one which has a fairly high correlation with social apperceptions, is Healy’s " Pictorial Completion II."2 In this test, which is, I believe, too little known in England, the examinee is faced in
whether in. the form of punishment, detention, fosterhome placing, or other mode of attack would be of any avail. In this connexion I should like to mention the recent and remarkable work of Ifealy and Bronner,6in which, in a thorough investigation and follow-up of the careers of 4000 delinquents, extending over a period of 1 1 years, the causes of delinquency and results of various methods of prevention and treatment have been assessed in an unusually scientific On the basis of these investigations, they manner. conclude that hereditary factors and so-called innate mental characteristics are of little value in prognosis and show but a very low correlation with the ultimate success or failure of their cases. I agree with Dr. Jarrett that there is at present much loose and unscientific talk concerning the causation of delinquency, but is this an adequate reason for falling back upon the gloomy and fatalistic conception of innate and incurable defect ? Recent researches have done much to disprove this doctrine and to show the very great value of constructive treatment suited to the requirements of the individual offender. What is urgently needed to-day is a scientific evaluation of all the factors concerned in making the delinquent what he is. This must be the first step in the development of a rational therapy which is already long overdue.-I am, Sir, yours faithfully. R. EVELYN LUCAS,
pictorial form with ten concrete situations such as he is likely to meet with in everyday life, these situations Rockefeller Medical Fellow. varying from picture to picture instead of being, as maze " tests, all the same type. in the Porteus Even in this test (P.C. II.), though considerable work CYCLIC VOMITING. has been done in correlating the test results with the social efficiency of the individual, the best authorities To the Editor of THE LANCET. make decidedly guarded statements. Bronner,3 in SIR,—My experience of cyclic vomiting in childhood a very thorough investigation of 1043 mentally normal with that of Dr. Cameron, corresponds individuals, of whom 729 were repeated offenders, but I would essentially also direct attention again to the remarkstates that " case studies show that in some instances able cases I in THE LANCET (1924, i., 1045) -defective apperceptions are directly related to delin- of volvulus ofpublished the small intestine in which the diagnosis quency, indeed, are, perhaps, the main cause," and of cyclic vomiting had been made. I am inclined to that " it is worth while to study the apperceptive think that there is something more to be learnt about abilities - of individuals because they represent a the influence of abnormal of the intestines particularised ability that has prognostic value and as a factor in some of thesemobility cases of cyclic vomiting She adds, however, than is commonly supposed. Although the bearing important social implications." that " delinquents as a group, even repeated offenders, of such curious and exceptional cases on the subject have apperceptive ability not differing from non- is the American observations commented obscure, 4 delinquents sufficiently to be significant." Perry, upon in your annotation interested me as an indepenin the study of 340 feebleminded individuals, condent contribution to the problem. One other point cludes that " analvsis of test results and social of interest is that I havehad under my care several behavior in some of the irregular cases suggests that cases of who in earlier life had suffered cyclic vomiting in the Healy’pictorial completion II.’ we may from coeliac disease. have a valuable tool for aid in discovering those of I am, Sir. vours faithfully. "
the feebleminded who havethe mental traits most necessary for social adjustment." In view of these distinctly moderate statements, it seems that one should be very wary of accepting any test, or even a social reactions group of tests, as indicating the of the individual. It would be interesting to check Dr. Jarrett’s results by an investigation of the aftercareer of the tested individuals and also to compare his findings with the results obtained from testing a group of non-delinquent individuals of similar age, educational opportunity, and social status. So far as I understand from the paper, neither of these investigations has been carried out. Again, Dr. Jarrett quotes Burt as stating that "conduct and misconduct are always, in the last -analysis, the outcome of mental life," and deduces from this that Burt considers the delinquent to be a " innate mental constitution." person of peculiar Surely no one who has read -Burb’s5 careful and thorough work can fail to appreciate the very great stress which he lays on environmental conditions of every type. Were delinquency due to innate, and, no treatment, therefore, causes,
possible
irremediable
1 S. D. Porteus : Guide to Porteus Maze Test, 1921. 2 W. Healy: Pictorial Completion Test II., Journal of Applied Psychology, September, 1921. 3 A. F. Bronner: Apperceptive Abilities of Delinquents, Journal of Delinquency, vol. vii., No. 1, January, 1922. 4 D. E. Perry : Interpretation of the Reactions of the Feebleminded on the Healy Pictorial Completion Test II.—Social Implications, Journal of Delinquency, vol. vii., No. 2, March, 1922. 5 C. Burt: The Young Delinquent, 1925.
F. JOHN POYNTON.
THE DISSOLUTION OF INSULIN. To the Editor ofTHE LANCFT. SIR,—Dr. Funk’s reputation as a biochemist renders a careful consideration of any statements he may make necessary, but I agree with Dr. Lawrence that the letter published in your issue of Nov. 27th is not as clear as could be wished. Dr. Funk’s second letter states his position more definitely, but does not furnish sufficient detail for a critical examination of his claims, and until this is available useful criticism is not possible. The hyperglycEemic effect of ordinary insulin in rabbits, referred to by Dr. Lawrence, appears to have been first described by Zondek and Ucko in 1925.1 Early this year a similar effect in several cases of diabetes was reported by H. J. John.2 I have met with a few diabetics in whom the first effect of injected insulin has been to cause a rise in the blood-sugar, and experiments Mr. Howard and I have carried out with rabbits and guinea-pigs have shown that in certain animals an initial hyperglycsemia can be regularly induced under suitable conditions. The 6
Healy and Bronner:
Delinquents and Criminals, their Company, N.Y., 1926. 1 Klin. Wchschr., 1925, iv., 6. Jour. Lab. and Clin. Med., 1926, xi., 6.
Making and Unmaking, 2
The Macmillan