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INFANT MORTALITY AND THE WELFARE OF INFANCY.
906
INFANT MORTALITY AND
THE WELFARE OF INFANCY.
Votes given in response to knowledge of the good instruction is given to graduates." tin the remaining work done by a candidate are also rightly given, medical schools returning replies, instruction is but such good work should be susceptible of public considered to be given in the general curriculum of the hospital, sometimes by the physicians, test and not merely vouched for by the candidate’s sometimes by the surgeons, sometimes by the friends. Lastly, votes given " to oblige " are vicious obstetricians and gynaecologists, and sometimes by in elections to such bodies as the Council of the lecturers on general hygiene. It is this assumption that instruction in infant hygiene is already being Royal College of Surgeons of England. given that makes us feel particularly sympathetic towards a movement the wisdom of which must otherwise have been challenged on the simple ground that to ask a student, already overburdened, to carry another weight was injudicious. But it is a " Ne quid nimis." question whether the student is being asked so much to carry another weight as to have those which he is now carrying arranged in a manner INFANT MORTALITY AND THE WELFARE OF The recommendamore convenient to the porter. INFANCY. tions of the executive committee are as follows:THE National Association for the Prevention of That degree and licence-conferring bodies should require Infant Mortality and for the Welfare of Infancy is from each candidate for the final examination in medicine memorialising the General Medical Council with a certificate of having attended a course of clinical instructhe hope that the authorities of medical education tion on infant hygiene, to include lectures or demonstrations may raise the standard of their requirements as toi on the management of infants, and the prophylaxis and the knowledge shown by students in the subject treatment of infantile diseases. Such a course should include instruction in the part played of infant hygiene. We view with considerable to the increase apprehension any suggestion scope by the State in infant hygiene, with special reference to the of the examinations which the medical student is duties and functions of the medical practitioner, the midwife, hospital and local sanitary authorities, and the health required to pass, inasmuch as it is allowed on all the visitors. hands that the present curriculum is either overThe certificate required from candidates in midwifery for loaded or ill-arranged, as the time taken by the the final examination should include evidence that they average candidate to obtain a degree or diploma is have received instruction in antenatal pathology and hygiene, already over six years; but infant hygiene is a and in the management of infants during labour, the subject of the first importance to all practitioners, puerperium, and the period of lactation. as well as one of overwhelming practical interest Weagree with the executive committee in thinking to the State, and from this point of view Sir Thomas that the machinery for such a course of instruction Barlow, the chairman of the executive committee already exists in most of the leading centres of of the association, and his enthusiastic colleagues medical education, and that - the rearrangements are justified in the action which they are taking. which could be effected by a little organisation Moreover, it is demanded by the following resolution would lead to most medical students receiving the which was adopted at the English-speaking Con- instruction outlined in the recommendations. ference on Infant Mortality held in London on August 5th, 1913 :TONE IN RELATION TO SHOCK. That this conference requests the executive committee of the National Association for the Prevention of Infant THE lecture delivered by Mr. Rendle Shorty in Mortality and for the Welfare of Infancy to communicate which he directs attention to the possibility of loss with the General Medical Council and the degree and the causation licence-conferring bodies, with a view to infant hygiene of muscular tone being concernedofin the increasing being given a more important place in the medical of shock, offers another instance attention which is being directed to this matter curriculum. of tonicity. There is little doubt that it constitutes The executive committee of the association, in a function of elemental and fundamental importcarrying out the above instruction, prepared a ance. Though the slight degree of resistance to report upon the whole subject which shows that full relaxation of muscular elements looks to be of the various teaching centres are not unwilling trivial significance, the fact that prominent cerebral to provide the requisite instruction. They have centres concern tonic activities, as represented made inquiries of all the medical schools and for skeletal tissues by the cerebellum, and for children’s hospitals where teaching is given the corpus striatum, indicates visceral structures throughout the United Kingdom, 51 in number, that wider functionsby are to be expected than this relaas to present or proposed facilities for the teaching mechanical action. Developmentally, of infant hygiene, and have received replies from tively simple tonus had a dominant representation in contractile 27 of these institutions. " In four cases," says the " elements. Before an integrating nervous mechanism report, viz., Manchester, Glasgow, Dublin, and enforced the value of concerted and graded moveBelfast-a course and certificate of special attendthis power of automatic contraction was the ments, In six casesance and instruction are required. simplest defensive mechanism possessed by the viz., Guy’s, Middlesex, St. Bartholomew’s, West- lowest organisms. Though this simple response has minster, King’s, and University Hospitals, Londonsince been superseded by skeletal organisation, long there is a special department or course of instrucits impress upon such organisation is increasingly tion in this subject. At the Royal Free Hospital as Sherrington’s work shows. It is a for Women, London, a weekly infant clinic is to bE recognised, for is which of reinforcexample, capable opened this year. At two special hospitals—Evelins quality, skeletal activity to a remarkable degree, and and Great Ormond-street, London-as at the Wesi ing this it does at no sacrifice to the delicacy of such London Hospital and other hospitals withoul And just those influences, included by medical schools, and in the comprehensive course activity. the psychologist under the term affective statesheld annually in London under the National Associa 1 THE tion for the Prevention of Infant Mortality, specia LANCET, March 14th, 1914, p. 731.
Annotations.
I
-
INFANT MORTALITY AND
THE WELFARE OF INFANCY.
Votes given in response to knowledge of the good instruction is given to graduates." tin the remaining work done by a candidate are also rightly given, medical schools returning replies, instruction is but such good work should be susceptible of public considered to be given in the general curriculum of the hospital, sometimes by the physicians, test and not merely vouched for by the candidate’s sometimes by the surgeons, sometimes by the friends. Lastly, votes given " to oblige " are vicious obstetricians and gynaecologists, and sometimes by in elections to such bodies as the Council of the lecturers on general hygiene. It is this assumption that instruction in infant hygiene is already being Royal College of Surgeons of England. given that makes us feel particularly sympathetic towards a movement the wisdom of which must otherwise have been challenged on the simple ground that to ask a student, already overburdened, to carry another weight was injudicious. But it is a " Ne quid nimis." question whether the student is being asked so much to carry another weight as to have those which he is now carrying arranged in a manner INFANT MORTALITY AND THE WELFARE OF The recommendamore convenient to the porter. INFANCY. tions of the executive committee are as follows:THE National Association for the Prevention of That degree and licence-conferring bodies should require Infant Mortality and for the Welfare of Infancy is from each candidate for the final examination in medicine memorialising the General Medical Council with a certificate of having attended a course of clinical instructhe hope that the authorities of medical education tion on infant hygiene, to include lectures or demonstrations may raise the standard of their requirements as toi on the management of infants, and the prophylaxis and the knowledge shown by students in the subject treatment of infantile diseases. Such a course should include instruction in the part played of infant hygiene. We view with considerable to the increase apprehension any suggestion scope by the State in infant hygiene, with special reference to the of the examinations which the medical student is duties and functions of the medical practitioner, the midwife, hospital and local sanitary authorities, and the health required to pass, inasmuch as it is allowed on all the visitors. hands that the present curriculum is either overThe certificate required from candidates in midwifery for loaded or ill-arranged, as the time taken by the the final examination should include evidence that they average candidate to obtain a degree or diploma is have received instruction in antenatal pathology and hygiene, already over six years; but infant hygiene is a and in the management of infants during labour, the subject of the first importance to all practitioners, puerperium, and the period of lactation. as well as one of overwhelming practical interest Weagree with the executive committee in thinking to the State, and from this point of view Sir Thomas that the machinery for such a course of instruction Barlow, the chairman of the executive committee already exists in most of the leading centres of of the association, and his enthusiastic colleagues medical education, and that - the rearrangements are justified in the action which they are taking. which could be effected by a little organisation Moreover, it is demanded by the following resolution would lead to most medical students receiving the which was adopted at the English-speaking Con- instruction outlined in the recommendations. ference on Infant Mortality held in London on August 5th, 1913 :TONE IN RELATION TO SHOCK. That this conference requests the executive committee of the National Association for the Prevention of Infant THE lecture delivered by Mr. Rendle Shorty in Mortality and for the Welfare of Infancy to communicate which he directs attention to the possibility of loss with the General Medical Council and the degree and the causation licence-conferring bodies, with a view to infant hygiene of muscular tone being concernedofin the increasing being given a more important place in the medical of shock, offers another instance attention which is being directed to this matter curriculum. of tonicity. There is little doubt that it constitutes The executive committee of the association, in a function of elemental and fundamental importcarrying out the above instruction, prepared a ance. Though the slight degree of resistance to report upon the whole subject which shows that full relaxation of muscular elements looks to be of the various teaching centres are not unwilling trivial significance, the fact that prominent cerebral to provide the requisite instruction. They have centres concern tonic activities, as represented made inquiries of all the medical schools and for skeletal tissues by the cerebellum, and for children’s hospitals where teaching is given the corpus striatum, indicates visceral structures throughout the United Kingdom, 51 in number, that wider functionsby are to be expected than this relaas to present or proposed facilities for the teaching mechanical action. Developmentally, of infant hygiene, and have received replies from tively simple tonus had a dominant representation in contractile 27 of these institutions. " In four cases," says the " elements. Before an integrating nervous mechanism report, viz., Manchester, Glasgow, Dublin, and enforced the value of concerted and graded moveBelfast-a course and certificate of special attendthis power of automatic contraction was the ments, In six casesance and instruction are required. simplest defensive mechanism possessed by the viz., Guy’s, Middlesex, St. Bartholomew’s, West- lowest organisms. Though this simple response has minster, King’s, and University Hospitals, Londonsince been superseded by skeletal organisation, long there is a special department or course of instrucits impress upon such organisation is increasingly tion in this subject. At the Royal Free Hospital as Sherrington’s work shows. It is a for Women, London, a weekly infant clinic is to bE recognised, for is which of reinforcexample, capable opened this year. At two special hospitals—Evelins quality, skeletal activity to a remarkable degree, and and Great Ormond-street, London-as at the Wesi ing this it does at no sacrifice to the delicacy of such London Hospital and other hospitals withoul And just those influences, included by medical schools, and in the comprehensive course activity. the psychologist under the term affective statesheld annually in London under the National Associa 1 THE tion for the Prevention of Infant Mortality, specia LANCET, March 14th, 1914, p. 731.
Annotations.
I
-