- Email: [email protected]
MENTAL DISEASE EXPLAINED
188
tion, suitable fellowship lectures, meetings, and
.
recreative gatherings. Treatment should not be such that a man was never subjected to temptation. A test of the work done in six years at the Salvation Army’s island settlement in Sweden, which had accommodation for 56 male patients, showed that 60 per cent. definitely benefited and 39 per cent. were cured. Diet everywhere was mainly fruitarian and vegetarian. Drink was stopped at once ; there was no weaning. Women inebriates and drug-addicts had to have a milk diet, and those bordering on delirium tremens were generally kept on lemon juice and soda. They were given a blanket-bath and sponged with hot water in which a little vinegar was placed; they had small mustard packs applied to the base of the spine and the back of the neck, and their feet were placed in hot mustard-and-water, with a cool bandage on the head. In conclusion Commissioner Lamb said that the cause of temperance and total abstinence was undoubtedly making progress, and in the poorer areas gambling and betting were now probably greater curses than drink. In the discussion which followed Mr. W. McAdam Eccles urged the importance of preventive measures by teaching children in their homes and at their schools. A vast amount of harm was done by what was called " moderate drinking." Road accidents, injuries, and fatalities would be halved if moderate drinking was stopped by drivers and pedestrians. Sir Robert Armstrong-Jones spoke of the difficulty of reconstructing, remaking, and reconditioning the drunkard, and mentioned that for some years he had as patient a woman who had more convictions for drunkenness (265) than any other woman in the Victorian era. He did not think that poverty was the cause of drunkenness or drinking. If religion could be taught more in the schools and homes there would be far less drinking. THE GRADING OF NURSES THE first report of the Interdepartmental Committee on Nursing is expected this month and the various interests concerned are alert to receive and examine new proposals. The issue of a short book1 by " the mouthpiece of a group of nurses," setting out ideas for a radical reorganisation of professional training and conditions of employment, is therefore well timed. A crisp title and a meaty extract from the preface quoted on the dust-cover stimulate an appetite which is not fully satisfied by the text. Too much space is given to a recapitulation of familiar facts in the history of nursing, at the expense of argument on ways of grafting the suggested reforms For example, the classification on existing practice. of patients in hospitals according to their needs of nursing services would be no easy task, since these needs must fluctuate with progress towards or away from good health. The services required are differentiated into sets of duties which, according to Miss Carter, could be spread among four different types of workers, only two of which need be nurses : (1) highly skilled nursing of patients acutely ill; (2) simple nursing procedures for chronic or convalescent patients ; (3) duties such as those performed by orderlies in military and naval hospitals ; (4) purely domestic work. The " new deal " is essentially the replacement of the existing general and subsidiary state registers by two only, for the enrolment of grade A and grade B nurses who would respectively undertake duties (1) and (2) in this classification. Some other proposals are that unregistered persons should be prohibited from the practice of nursing " habitually and for gain." Nurses’ cooperations, which should be licensed, should be bound to inform each employer of the status (A or B) of the nurses sent out, and a salaried domiciliary service of nurses 1 A New Deal for Nurses. By G. B. Carter, B.Sc., S.R.N., S.C.M., formerly supervising sister, outpatient midwifery, University College Hospital; lately organising secretary to
the Midwives Institute. Pp. 319. 5s.
London:
Victor Gollancz.
1939.
should be set up on terms that do not undercut private work. Nursing schools should be graded and (rather surprisingly) some hospitals recognised for the training of both A and B nurses, being staffed also by members of both grades. After a rather superficial exposition of these and other ideas Miss Carter comments again on the traditional methods of training, and the psychological She criticises and financial obstacles to reform. present conditions and the disunity in the profession which prevents common action to amend them. She urges the need for the establishment of at least one subsidised experimental training school, associated with a group of hospitals not dependent on student labour and with the local public health department. She pleads for self-government of the profession, but visualises the ultimate replacement of the General Nursing Council by a Whitley council, representative of all kinds of nurses and of the employers and consumers of nursing services. There is no lack of constructive suggestions in this book, though some of them may be unacceptable to the parties concerned and not easily workable in
practice. THE DRUG CALL meeting of the council of the Institute of Applied Pharmaceutics on Jan. 13 Dr. F. W. CrossleyHolland, junior counsel to the institute, spoke of the increasing unwillingness of medical practitioners to grant interviews to pharmaceutical representatives. This was, he suggested, due to the greater number and the inferior types of visitor; and so effective has been the refusal that the mounting cost of successful interviews has dissuaded several firms from using the personal call as a method of propaganda. Yet, in Dr. Crossley-Holland’s view, personal contact forms the ideal means of propaganda where the appeal of ethical products is concerned, granted ability on the part of the representative to discuss things in an intelligent and knowledgeable manner. There should be some easy and certain means of enabling the doctor to differentiate between caller and caller, and this, he said, was exactly what the machinery of the institute might ensure. Its membership would be a passport to the presence of medical men. Later, he hoped, holders of the institute’s qualification would gain admission to the Register of Medical Auxiliaries. AT
a
MENTAL DISEASE EXPLAINED To
persuade people
out of the old
prejudices
about
mental disorder and its treatment is one of the most important functions of mental hygiene propaganda. These prejudices centre in the " stigma " of being certified as insane, and the supposed incurability of mental illness. Straightforward explanation of the real state of affairs can do much to kill these chimeras. It is true that they may be irrational beliefs which cannot be wholly corrected by evidence, however forcible : but even though this may sometimes be the case, there can be no doubt as to the efficacy of honest statements about the similarity of mental to other forms of illness, the need for early treatment, and the advantages of skilled care in a mental hospital, whether public or private. Such matters are simply and clearly expounded in a brochure by Dr. Horace Hill (The Public Attitude towards Mental Disease, and Urgent Reasons for Early Treatment. Salisbury. 1938. Pp. 36. Is. 6d.). In appropriately simple form he restates for the public those general and practical issues which are concerned in ensuring adequate treatment for any relative who may become mentally ill. _____
VITAMIN-B
COMPLEX
report last week of
CORRIGENDUM.-In
our
meeting of the Royal Society of Medicine’s section of pharmacology and therapeutics the remarks made by Dr. C. C. Ungley were wrongly attributed to his brother, Mr. H. G. Ungley. We also regret that, by an inadvertence for which our reporter was in no way responsible, a number of copies of THE LANCET gave the name of the last speaker incorrectly. a
tion, suitable fellowship lectures, meetings, and
.
recreative gatherings. Treatment should not be such that a man was never subjected to temptation. A test of the work done in six years at the Salvation Army’s island settlement in Sweden, which had accommodation for 56 male patients, showed that 60 per cent. definitely benefited and 39 per cent. were cured. Diet everywhere was mainly fruitarian and vegetarian. Drink was stopped at once ; there was no weaning. Women inebriates and drug-addicts had to have a milk diet, and those bordering on delirium tremens were generally kept on lemon juice and soda. They were given a blanket-bath and sponged with hot water in which a little vinegar was placed; they had small mustard packs applied to the base of the spine and the back of the neck, and their feet were placed in hot mustard-and-water, with a cool bandage on the head. In conclusion Commissioner Lamb said that the cause of temperance and total abstinence was undoubtedly making progress, and in the poorer areas gambling and betting were now probably greater curses than drink. In the discussion which followed Mr. W. McAdam Eccles urged the importance of preventive measures by teaching children in their homes and at their schools. A vast amount of harm was done by what was called " moderate drinking." Road accidents, injuries, and fatalities would be halved if moderate drinking was stopped by drivers and pedestrians. Sir Robert Armstrong-Jones spoke of the difficulty of reconstructing, remaking, and reconditioning the drunkard, and mentioned that for some years he had as patient a woman who had more convictions for drunkenness (265) than any other woman in the Victorian era. He did not think that poverty was the cause of drunkenness or drinking. If religion could be taught more in the schools and homes there would be far less drinking. THE GRADING OF NURSES THE first report of the Interdepartmental Committee on Nursing is expected this month and the various interests concerned are alert to receive and examine new proposals. The issue of a short book1 by " the mouthpiece of a group of nurses," setting out ideas for a radical reorganisation of professional training and conditions of employment, is therefore well timed. A crisp title and a meaty extract from the preface quoted on the dust-cover stimulate an appetite which is not fully satisfied by the text. Too much space is given to a recapitulation of familiar facts in the history of nursing, at the expense of argument on ways of grafting the suggested reforms For example, the classification on existing practice. of patients in hospitals according to their needs of nursing services would be no easy task, since these needs must fluctuate with progress towards or away from good health. The services required are differentiated into sets of duties which, according to Miss Carter, could be spread among four different types of workers, only two of which need be nurses : (1) highly skilled nursing of patients acutely ill; (2) simple nursing procedures for chronic or convalescent patients ; (3) duties such as those performed by orderlies in military and naval hospitals ; (4) purely domestic work. The " new deal " is essentially the replacement of the existing general and subsidiary state registers by two only, for the enrolment of grade A and grade B nurses who would respectively undertake duties (1) and (2) in this classification. Some other proposals are that unregistered persons should be prohibited from the practice of nursing " habitually and for gain." Nurses’ cooperations, which should be licensed, should be bound to inform each employer of the status (A or B) of the nurses sent out, and a salaried domiciliary service of nurses 1 A New Deal for Nurses. By G. B. Carter, B.Sc., S.R.N., S.C.M., formerly supervising sister, outpatient midwifery, University College Hospital; lately organising secretary to
the Midwives Institute. Pp. 319. 5s.
London:
Victor Gollancz.
1939.
should be set up on terms that do not undercut private work. Nursing schools should be graded and (rather surprisingly) some hospitals recognised for the training of both A and B nurses, being staffed also by members of both grades. After a rather superficial exposition of these and other ideas Miss Carter comments again on the traditional methods of training, and the psychological She criticises and financial obstacles to reform. present conditions and the disunity in the profession which prevents common action to amend them. She urges the need for the establishment of at least one subsidised experimental training school, associated with a group of hospitals not dependent on student labour and with the local public health department. She pleads for self-government of the profession, but visualises the ultimate replacement of the General Nursing Council by a Whitley council, representative of all kinds of nurses and of the employers and consumers of nursing services. There is no lack of constructive suggestions in this book, though some of them may be unacceptable to the parties concerned and not easily workable in
practice. THE DRUG CALL meeting of the council of the Institute of Applied Pharmaceutics on Jan. 13 Dr. F. W. CrossleyHolland, junior counsel to the institute, spoke of the increasing unwillingness of medical practitioners to grant interviews to pharmaceutical representatives. This was, he suggested, due to the greater number and the inferior types of visitor; and so effective has been the refusal that the mounting cost of successful interviews has dissuaded several firms from using the personal call as a method of propaganda. Yet, in Dr. Crossley-Holland’s view, personal contact forms the ideal means of propaganda where the appeal of ethical products is concerned, granted ability on the part of the representative to discuss things in an intelligent and knowledgeable manner. There should be some easy and certain means of enabling the doctor to differentiate between caller and caller, and this, he said, was exactly what the machinery of the institute might ensure. Its membership would be a passport to the presence of medical men. Later, he hoped, holders of the institute’s qualification would gain admission to the Register of Medical Auxiliaries. AT
a
MENTAL DISEASE EXPLAINED To
persuade people
out of the old
prejudices
about
mental disorder and its treatment is one of the most important functions of mental hygiene propaganda. These prejudices centre in the " stigma " of being certified as insane, and the supposed incurability of mental illness. Straightforward explanation of the real state of affairs can do much to kill these chimeras. It is true that they may be irrational beliefs which cannot be wholly corrected by evidence, however forcible : but even though this may sometimes be the case, there can be no doubt as to the efficacy of honest statements about the similarity of mental to other forms of illness, the need for early treatment, and the advantages of skilled care in a mental hospital, whether public or private. Such matters are simply and clearly expounded in a brochure by Dr. Horace Hill (The Public Attitude towards Mental Disease, and Urgent Reasons for Early Treatment. Salisbury. 1938. Pp. 36. Is. 6d.). In appropriately simple form he restates for the public those general and practical issues which are concerned in ensuring adequate treatment for any relative who may become mentally ill. _____
VITAMIN-B
COMPLEX
report last week of
CORRIGENDUM.-In
our
meeting of the Royal Society of Medicine’s section of pharmacology and therapeutics the remarks made by Dr. C. C. Ungley were wrongly attributed to his brother, Mr. H. G. Ungley. We also regret that, by an inadvertence for which our reporter was in no way responsible, a number of copies of THE LANCET gave the name of the last speaker incorrectly. a