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MEASLES AND THE POST-OFFICE AUTHORITIES.
1784 would probably be delicate while they lived and a burden on the community. Why should freedom of action be allowed to these women, many of them evidently feeble-minded, and all of them practically too feeble-minded to appreciate what every sensible woman can appreciate and endeavour to avoid-i.e., anything that would endanger the life or welfare of their unborn children ? It seems as if the State were encouraging these poor short-sighted women in theirI evil courses and were extraordinarily unwilling to curtail their liberty to do evil. An artisan takes scarlet fever or some other of the eruptive or continued fevers in a mild ambulatory form and is detected. The health of his neighbours demands his immediate removal to a hospital, where, in spite of the curtailment of his usefnlly employed liberty, he is detained until he is well and innocuous to his fellow This is acquiesced in by all as necessary to the health men. of the community. Why are the lowest and most degraded of the female sex, whose liberty is licence of the most abominable kind, allowed to go about diseased and capable of spreading amongst their neighbours or of transmitting to their offspring a disease that is far more insidious and persistent than any of the eruptive fevers and probably far more disabling and deadly, if we include among the results of syphilis the cases of ataxy, of general paralysis of the insane, and the other miserable beings that die from its effects after many many years of suffering ? The
voluntary system
with
,
regard
...
to
eruptive
when the real work of life begins that the child of the alcoholic parent first shows visible signs of early nervous exhaustion, morbid fears, or more serious mental disorder. I am quite prepared to be told that examination proves that in early life these children develop more rapidly and are more brilliant, but experience teaches that this rapid development and brilliancy is often the result of a hypersensitive nervous system which begins to show abnormal symptoms when it is exposed to the stresses of adult life. The earliest symptoms of nervous exhaustion are often purely subjective, and at first no importance is attached to them, or maybe they are misinterpreted, and even when the person himself begins to notice them he seldom speaks to another individual about them. This alone shows how difficult it is to make an accurate investigation as to the real comparison of the minds of the two classes of children. All that can be said at the moment is that there are no changes which are so gross as to be discoverable by the ordinary methods of
investigation. As
one
who
appreciates
the extreme difficulties of investi-
gating early nervous changes owing to their subjective or purely personal nature, I may be pardoned for doubting the value of drawing any deductions from these observations as to the true effect of parental alcoholism on the mental life of the offspring.-I am, Sir, yours faithfully, MAURICE CRAIG. London, W., June 18th,I910.
,
and
con-
MEASLES AND THE POST-OFFICE AUTHORITIES.
tinued fevers did not succeed, hence any people suffering from these diseases are, as soon as possible, compulsorily isolated and treated. The voluntary system has less chance of success amongst the victims of syphilis, and the compulsory detention of such cases would prove as effectual and would not prevent their applying for relief. In the old days when we had the power of detention we had as many admissions as we have now, and had also the great satisfaction of sending them out cured. There were many valid objections to the C.D. Acts as they were administered, both here and abroad, but the abolition of the power of detention in the cases I have above described was a great mistake. To allow low, degraded, syphilitic women such licence in the spread of disease amongst people poor and ignorant as themselves, to allow them to disregard the welfare of their unborn children, is a blot on the civilisation and humanity of the twentieth century that I hope will soon be erased. It is only those nurses and doctors who have experienced the stupidity, the heartlessness, the selfishness, and the dangerous character of these women who fully realise the hopelessness and the fatuity of their efforts to cure the patients under present conditions. The public, who do not look below the surface, believe that these women are being treated in the hospitals they have provided for them, and many of them would be shocked to know how futile is the provision so made. Many of the poor sufferers would be glad to be saved from themselves, as they have not the strength of mind to resist temptation. The maternal instinct itself is in abeyance, and the welfare of their progeny is not a factor of any moment in their lives, except as it may be an obstacle to their licentiousness.-I am, Sir, yours faithfully, WILLIAM ALEXANDER, M.D. R.U.I., F.R.C.S.Eng.,
To the Editor of THE LANCET.
SIR,-Medical officers of health of large
towns and school medical officers of large public elementary schools have definitely come to the conclusion after abundant and repeated experience that uninfected contacts do not carry measles infection, and it is quite a common practice nowadays to permit all children over7 years of age who have previously had measles to attend school, even if living in an infected house. The problem to be met in the case of measles is the great infectivity of the individual case, which for about three days before the characteristic rash appears is in a more infectious state than at any subsequent period when precautions usually begin to be taken. When " measlesis about every young child who has not previously had measles and who develops signs of a feverish cold should be forthwith isolated in bed for three or four days in any case, and, of course, longer if the measles rash develops ; and in this way alone will it be practicable to bring this disease under absolute control. I am, Sir, yours faithfully, J. T. C. NASH. The Shirehouse, Norwich, June 17th, 1910.
THE REPRESENTATION OF MIDWIVES ON THE CENTRAL MIDWIVES BOARD.
To the Editor of THE LANCET. of the Midwives Institute which appears in THE LANCET of June 18th merits some attention. There will be agreement generally upon the principle of representation which is advocated. The quesVisiting Surgeon to the Liverpool Workhouse Hospital. tion, however, arises whether any reason exists which June l8th 1910. compels the medical profession to become the catspaw of the Midwives Institute. It is quite true that certain members of the profession were ALCOHOLISM AND OFFSPRING. its catspaws when the Midwives Act was passed, but a very To the -Editor of THE LANCET. large majority refused to be. The majority were, however, SiR,-There seems to be a tendency for some persons to defeated and have accepted their defeat with philosophy, and believe that the recent investigations of Miss Elderton and have been much comforted by the sight of those wallowing Professor Karl Pearson prove that alcoholism in the parent in the Slough of Despond and in vain efforts to secure the does not lead to degeneracy in the offspring, whereas all success of a piece of badly considered legislation. that can be claimed is that except for a higher death-iate in I venture to suggest that the delegation of the subject of the children of alcoholic parents there is no marked mental midwifery into the hands of the Midwives Institute and the or physical degeneracy as compared with the children of withdrawal of the subject from the compulsory subjects of sober ancestry. medical examination are matters for serious consideration. Now this investigation, interestinç- as it may be, does not The student is already overburdened with subjects, examinatake us far, as it must be borne in ]111 ’Id that it is confined tions, and fees to examining authorities. A very large number within the limits indicated by tlin’ords childhoodand of practitioners do not practise midwifery ; many are com "children," and does not extend even into early adult pelled to do so for various reasons, but would gladly relife. The experience of men working amongst nervous linquish the subject. Very few can now derive profit from diseases, I venture to think, i that it is during the next paying much attention to the subject, owing to female comtwo decades that symptoms of degeneracy usually appear. petition. Time therefore appears to be ripe for the removal It is either towards the end of a long educational training or of a compulsory subject for which the profession has annually
SIR,-The letter of the Secretary
.
-
I
I
voluntary system
with
,
regard
...
to
eruptive
when the real work of life begins that the child of the alcoholic parent first shows visible signs of early nervous exhaustion, morbid fears, or more serious mental disorder. I am quite prepared to be told that examination proves that in early life these children develop more rapidly and are more brilliant, but experience teaches that this rapid development and brilliancy is often the result of a hypersensitive nervous system which begins to show abnormal symptoms when it is exposed to the stresses of adult life. The earliest symptoms of nervous exhaustion are often purely subjective, and at first no importance is attached to them, or maybe they are misinterpreted, and even when the person himself begins to notice them he seldom speaks to another individual about them. This alone shows how difficult it is to make an accurate investigation as to the real comparison of the minds of the two classes of children. All that can be said at the moment is that there are no changes which are so gross as to be discoverable by the ordinary methods of
investigation. As
one
who
appreciates
the extreme difficulties of investi-
gating early nervous changes owing to their subjective or purely personal nature, I may be pardoned for doubting the value of drawing any deductions from these observations as to the true effect of parental alcoholism on the mental life of the offspring.-I am, Sir, yours faithfully, MAURICE CRAIG. London, W., June 18th,I910.
,
and
con-
MEASLES AND THE POST-OFFICE AUTHORITIES.
tinued fevers did not succeed, hence any people suffering from these diseases are, as soon as possible, compulsorily isolated and treated. The voluntary system has less chance of success amongst the victims of syphilis, and the compulsory detention of such cases would prove as effectual and would not prevent their applying for relief. In the old days when we had the power of detention we had as many admissions as we have now, and had also the great satisfaction of sending them out cured. There were many valid objections to the C.D. Acts as they were administered, both here and abroad, but the abolition of the power of detention in the cases I have above described was a great mistake. To allow low, degraded, syphilitic women such licence in the spread of disease amongst people poor and ignorant as themselves, to allow them to disregard the welfare of their unborn children, is a blot on the civilisation and humanity of the twentieth century that I hope will soon be erased. It is only those nurses and doctors who have experienced the stupidity, the heartlessness, the selfishness, and the dangerous character of these women who fully realise the hopelessness and the fatuity of their efforts to cure the patients under present conditions. The public, who do not look below the surface, believe that these women are being treated in the hospitals they have provided for them, and many of them would be shocked to know how futile is the provision so made. Many of the poor sufferers would be glad to be saved from themselves, as they have not the strength of mind to resist temptation. The maternal instinct itself is in abeyance, and the welfare of their progeny is not a factor of any moment in their lives, except as it may be an obstacle to their licentiousness.-I am, Sir, yours faithfully, WILLIAM ALEXANDER, M.D. R.U.I., F.R.C.S.Eng.,
To the Editor of THE LANCET.
SIR,-Medical officers of health of large
towns and school medical officers of large public elementary schools have definitely come to the conclusion after abundant and repeated experience that uninfected contacts do not carry measles infection, and it is quite a common practice nowadays to permit all children over7 years of age who have previously had measles to attend school, even if living in an infected house. The problem to be met in the case of measles is the great infectivity of the individual case, which for about three days before the characteristic rash appears is in a more infectious state than at any subsequent period when precautions usually begin to be taken. When " measlesis about every young child who has not previously had measles and who develops signs of a feverish cold should be forthwith isolated in bed for three or four days in any case, and, of course, longer if the measles rash develops ; and in this way alone will it be practicable to bring this disease under absolute control. I am, Sir, yours faithfully, J. T. C. NASH. The Shirehouse, Norwich, June 17th, 1910.
THE REPRESENTATION OF MIDWIVES ON THE CENTRAL MIDWIVES BOARD.
To the Editor of THE LANCET. of the Midwives Institute which appears in THE LANCET of June 18th merits some attention. There will be agreement generally upon the principle of representation which is advocated. The quesVisiting Surgeon to the Liverpool Workhouse Hospital. tion, however, arises whether any reason exists which June l8th 1910. compels the medical profession to become the catspaw of the Midwives Institute. It is quite true that certain members of the profession were ALCOHOLISM AND OFFSPRING. its catspaws when the Midwives Act was passed, but a very To the -Editor of THE LANCET. large majority refused to be. The majority were, however, SiR,-There seems to be a tendency for some persons to defeated and have accepted their defeat with philosophy, and believe that the recent investigations of Miss Elderton and have been much comforted by the sight of those wallowing Professor Karl Pearson prove that alcoholism in the parent in the Slough of Despond and in vain efforts to secure the does not lead to degeneracy in the offspring, whereas all success of a piece of badly considered legislation. that can be claimed is that except for a higher death-iate in I venture to suggest that the delegation of the subject of the children of alcoholic parents there is no marked mental midwifery into the hands of the Midwives Institute and the or physical degeneracy as compared with the children of withdrawal of the subject from the compulsory subjects of sober ancestry. medical examination are matters for serious consideration. Now this investigation, interestinç- as it may be, does not The student is already overburdened with subjects, examinatake us far, as it must be borne in ]111 ’Id that it is confined tions, and fees to examining authorities. A very large number within the limits indicated by tlin’ords childhoodand of practitioners do not practise midwifery ; many are com "children," and does not extend even into early adult pelled to do so for various reasons, but would gladly relife. The experience of men working amongst nervous linquish the subject. Very few can now derive profit from diseases, I venture to think, i that it is during the next paying much attention to the subject, owing to female comtwo decades that symptoms of degeneracy usually appear. petition. Time therefore appears to be ripe for the removal It is either towards the end of a long educational training or of a compulsory subject for which the profession has annually
SIR,-The letter of the Secretary
.
-
I
I