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Midland Branch
PUBLIC IIEALTH, July, 1952
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SOCIETY OF MEDICAL OFFICERS OF HEALTH Notice of Provincial Ordinary Meeting Notice is hereby given that an Ordinary Meeting of the Society will be held in the City Chambers, Edinburgh, on Saturday, July 19th, 1952, at 10 a.m., preceding a joint meeting with the Scottish Branch, when Prof. Sir James Learmonth, g.c.v.o., O.B.E., F.R.S. En., CII.M., F.R.C.S.ED., will give an address. AGENDA
1. Minutes. 2. Correspondence. 3. Election of the following as fully-paid Life Members, on the nomination of the Council and of their Branches : Home Counties' Branch.--Dr. Rutherford Cramb, formerly M.O H., Brighton C.B., joined the Society 1922. North-Western Branclt ~ D r . James Walker, formerly Deputy M.O.H., Preston C.B., joined the Society 1920. Scottish Branch.--Dr. G. V. T. McMichael, formerly M.O.H., Paisley Burgh, joined the Society 1913. 4. Election of Fellows and Associates (list of candidates below). 5. Nominations. 6. Any other business. By Order, G. L. C. EI,LISTON,
Executive Secretary.
Tavistock House South, London, W.C.1. June 17th, 1952.
Candidates for Election, July x9th, x95z FELLOWS
ASTON, Elizabeth Oliver, L.M.S.S.A. (LOND.), 65, High Street, Netherton, Dud!ey, Worcs. Asst. C.M.O. Staffs C.C. (T. O. P. D. Lawson, G. Ramage.) (Mid.) BRAID, Grace Fides Matilda, M.B., craB. (CLAS.), n.om, D.OBST. R.C.O.O., Health Department, 6, Grange Street, Kilmarnock. Asst. M.O.H., Kilmarnock. (B. R. Nisbet, R. L. Leask.) (Sc.) COULTER, Elizabeth Johnstone, M.B., CH.B. (OLAS.), 1, Norreys Avenue, Abingdon Road, Oxford. Asst. M.O.H. and Asst. S.M.O., Oxford C.B. (J. F. Warin, M. Fisher.) (H.C.) FAY, Leo, M.D., M.B., CH.B., D.P.H. frOND.), High Bank, Trail, Taunton, Somerset. Dep. C.M.O., Somerset and MO.H., Taunton M.B. (T. Pierson, R. H. G. H. Denham.) (W.E.) GAYE, Wilhelmine Norah, M.R.C.S. (ENG.), L.R.C.P., I).P.H. (LIV.), Mardon, Pen-y-Garth, Caernarvon N. Wales. Asst. C. and S.M.O., Caernarvonshire C.C. (M. Slater, G. W. Roberts.)
(N.W.) HIc~soN, Violet L. deA., M.mC.S. (ENO.), L.R.C.P., D.P.H. (WALES), 35, Bridge Street, Hereford. Asst. M.O., Hereford C.C. (H. Sainsbury, J. S. Cookson.) (Mid.) LINNELL, Phyllis Mary, Mm., CH.B. (BIRM.), M.R.C.S, L.R.C.p., D.P.H., 19, Tower Road, Twickenham, Middlesex. Asst. M.O., Middlesex C.C. (J. Maddison, W. Cormack.) (H.C.) LOWE, Greta, M.m, CH.B. (MANCH.), D.T M. ~ H., Resthaven, Marine Drive, Barton-on-Sea, Hants. Asst. C.M.O.H., Hampshire (Part-time). (D. J. N. McNab, E. J. Gordon Wallace.) (S) McELRoY, Robert Samt~el, M.B., B.CH.,, B.A.O. (DUBLIN), D.P.I/., n.T.M, 17, Bath Road, Swindon, Wilts. M.O.H., Highworth and Cricklade and Wootton Bassett R.D.C.s and Asst. C.M.O., Wi:ts C.C. (R. MacKay, I. Urquhart.) (W.E.). MATHESON, Kenneth William, M.B., ClI.B. (EDIN.), 70, Corstorphine Road, Murrayfie'd, Edinburgh, 12. Asst. M.O. ( M & C.W.), City of Edinburgh. (H. P. Tait, M. E. Sturrock.) (Sc.) O'FLyNN, Patricia Mary, M.B., BS (SVnNEV), 106, Ryde Road. Pymble, Sydney, N.S.W., Australia. M.O., Department of Health, N S.W. (S. Repin, E. Meyers.) (N.S.W.) PATERSON, John Thomson, M.B., CH.B. (EDIN.), 7, Oaklands Avenue, Rumford, Essex. Constdtant, Diseases of the Chest, Barking and DagenIaam Chest Clinic. (C. Herington, F. G. Brown.) (H.C.) PYZIK, Michalina Bronislawa, B.D.S. (BRISTOL), Woolwich Health Centre, Market Street, London, S.E.18. D.O., L.C.C. (J. F. A. Smyth, J. V. Bingay.) (Met.) RICnABDS, Hilda M.. M.R.C.S. (ENG.). L.n.c.P., 59, Benhurst Court, Leigham Court Road, London, S.W.16. Asst. MD., LC.C.; Lecturer (Pub!ic Health). Battersea Polytechnic, S.W.II.) (D. A. Craigmile, G. E. Wilkinson.) (Met.) ROBERTS, Constance Evelyn, MB., l~S. (LOND*), M.R.C.S., L.R.C.P., Upfield, Winscombe, Somerset. Part-time Asst. M.O.H., Bristol. (R. C. Wofinden, R. H. Parry.) (W.E.)
STEVENSON, Margaret Scott, M.B., cn.B. (EDIN.), D.P.H., 45, Dcvoushire Street, London, W.I. Dep. M.O.H. and Asst. M.O., L.C.C., Div. 3. (C. O. S. Blyth Brooke, J. E Marshall.) (Met.) WALES, Elizabeth, M.a., B.S. (LONO.), 14, Essex Gardens, Gateshead 9, Co. Durham. Asst. Welfare M.O., Durham C.C. (W. S. Walton E. S. Williamson.) (N.) WALSH, Nannie Christina, M.E., B.CH., B.A.O., D.C.H., 38, West Cromwell Road, S.W.5. Asst. M.O., L.C.C. (D. Egan, M. T. Paterson.) (Met.) WmTFIVLD, Audrey P., M.B., E.S. (LOND.), " Cornerways," 1, Barlow Road, HaInpton-on-Thames, Middlesex. Asst. M.O., Middlesex C.C. (J. Maddison, W. Cormack.) (H.C.) WILSON-MURPHY, Hannah, M.B., B.CH., B.A.O., D.P.H. (CORK), 207a, Sutherland Avenue, London, W.9. Asst. M.O., L.C.C. (A. Mower White, M. S. Gillatt.) (Met.) WOODS, Grace E., M.B., B.S. (LOND.), D.P.H., D.C.H., 21, Downs Cote View, Westbury-on-Trym, Bristol. Part-time M.O., Bristol P.H.S., Clinical Assistant (Research), Department of Child Health, Bristol. (R. C. Woflnden, R. H. Parry.) (W.E.) ASSOCIATES
BI.UMENAU, Ernest, M.D.U. (FRANKFURT),The Rectory, Woughtonon-tbe-Green, Bletchley, Bucks. School D.O., Bucks C.C. (E. Kew, K. C. B. Webster.). (H.C.) EVANS, William David Percival, i~ o.s., R.C.S. (ENG.),~ T~n-y-Lon, Rhydyfelin, Aberyswyth, Cards. Senior D.O., Cardiganshire C.C. (I. M. Watkin, E. Jones.) (Wa.) SCHROTTER, Theresa, M.D. (VIENNA), 388, Upper Richmond Road, London, S.W.15. D.O., Middlesex C.C. (M. Cohn, I. F. A Smyth.) (H.C.) SQmRES, Dorothy Winifred, L.D.S., R.F.P.S. (GLAS.), Fairacre, Harcombe Hill, Winterbourne, Bristol. D.O. Glos. C.C. (J. F. A. Smyth, J. v . Bingay.) (W.E.) REPORTS
MIDLAND BRANCH President: Dr. C. Starkie (M.O.H., Kidderminster; Din. MO., Worcs.).
Hon. Secretary: Dr. W. Alcock (M.O.H., Burton-on-Trent C.B.). The fifth meeting of the session was held at Lancaster Street Welfare Centre, Birmingham, on Thursday, March 6th, 1952, at 3 p.m. The President was in the chair and 31 members attended.
Preventive Aspects of Mental Health An address was given by Prof. J. M. Mackintosh on the above subject. In a brief historical survey Prof. Mackintosh referred to the early methods of ascertainment of mental disorder, when the chief criterion was apparently whether the patient was a nuisance to his family or to the community, and to the methods of treatment, the armamentarium of which consisted of irons, stocks and manacles. In the 18th century the Bethlem Hospital used to make a charge of 2d. to see the lunatics and raised the considerable income of £400 a year from this source. Treatment consisted in the main of bleeding, vomiting and purging, but gradually a more humanitarian approach to the problem of mental illness developed. Later developments were the separation of mental defectives from persons of unsound mind, and, in more recent years, the voluntary admission of patients to mental hospitals. Turning to the preventive side of mental health, Dr. Mackintosh stressed the necessity of first acquiring a knowledge of the root causes of mental illness and, since the child is the father of the man, of commencing with infants, if we are to develop a truly preventive Mental Health Service. At the present time there are no reliable indices for the assessment of mental illness comparable with those of physical illhealth, and there is a large field for research. The extent of psychoneurotic illness is enormous and is said to account for one-third o~ all long-term illness. What are urgently required are planned surveys of psychoneurosis, with special reference to such matters as studies of suicide rates, differentials in sex, religion, social circumstances and age, and the impact of such aspects of fear of unemployment, threat of war, or threat of national instability. Progress is hampered at the present time, however, by the lack of trained personnel and the shortage of well-equipped clinics. An interesting discussion followed, in which Drs. Jean Mackintosh, Owen, Galloway and Savage took part.
PUBLIC HEALTH,
J u l y , I952
T h e r e was general a g r e e m e n t t h a t a b e g i n n i n g should be m a d e with the m o t h e r a n d child, a n d t h a t H e a l t h Visitors, b y n a t u r e of their experience a n d training, could do a great deal on the preventive side. A h e a r t y vote of t h a n k s was accorded to Prof. M a c k i n t o s h b y Dr. P i c k u p for his most interesting a n d s t i m u l a t i n g address. T h i s was seconded b y Dr. M a r k h a m a n d approved u n a n i m o u s l y .
N o m i n a t i o n for Presidency Consideration of this m a t t e r h a v i n g heen deferred f r o m the last meeting, it was proposed by Dr. Galloway, seconded by Dr. Griffin, a n d agreed, t h a t this B r a n c h support the n o m i n a t i o n of Prof. A. T o p p i n g for the office of President for t h e session 1952-53. It was, however, proposed t h a t a representation be m a d e to t h e Executive Secretary, t h a t t h e practice of circulating n o m i n a t i o n s for Presidency from other B r a n c h e s be discontinued a n d t h a t at an appropriate t i m e a complete list of n o m i n e e s be s u b m i t t e d b y the Executive Secretary to all Branches.
NORTH-WESTERN BRANCH President: Dr. A. M. Grierson (Dep. M.O.H., M a n c h e s t e r C.B). Hon. Secretary: Dr. J. S. G. B u r n e t t (M.O.H., Preston C.B.). A n ordinary m e e t i n g of t h e B r a n c h was held in M a n c h e s t e r on Friday, M a r c h 14th, w h e n 29 m e m b e r s were present. It was d u l y moved a n d seconded t h a t Dr. J a m e s Walker, sometime D e p u t y Medical Officer of H e a l t h of the C o u n t y B o r o u g h of Preston, h a v i n g been a m e m b e r of t h e Society of Medical Officers of H e a l t h since 1920, be r e c o m m e n d e d to the Council for n o m i n a t i o n for fully-paid life m e m b e r s h i p . A letter from t h e H o n o r a r y Secretary of t h e Metropolitun Branch, dated F e b r u a r y 21st, i n t i m a t i n g t h a t t h e B r a n c h h a d u n a n i m o u s l y decided to n o m i n a t e Dr. A n d r e w T o p p i n g for t h e Presidency of t h e Society for t h e year 1952-53, was read, a n d it was agreed to support Dr. T o p p i n g ' s n o m i n a t i o n to t h e Presidency. Prof. C. Fraser Brockington t h e n delivered an address on " Some Observations on A m e r i c a n Medicine from the Point of View of a Medical Officer of H e a l t h . " A n ordinary m e e t i n g was held at the Municipal Building, Preston, on Friday, April 4th, w h e n 17 m e m b e r s a n d gnests attended. In the absence of the President the chair was occupied b y Dr. J. E. Spence, the senior Past-President in attendance.
Accidents in the H o m e T h e C h a i r m a n t h e n i n t r o d u c e d Dr. C. A. Boucher, Medical Officer at t h e M i n i s t r y of H e a l t h , who gave a talk on t h e above subject. H e gave a n outline of t h e size of the p r o b l e m and its gravity in comparison with road accidents a n d referred to t h e h e a v y incidence a m o n g s t those u n d e r five a n d over 60 years of age. Reference was m a d e to the occurrence of b u r n s a n d scalds a n d accidents f r o m domestic m a c h i n e r y in children, from b u r n s a n d falls in old people, a n d to the rise in accide~lts in t h e t h i r d q u a r t e r of t h e year. H e spoke of t h e influence of ignorance of the proper use of a p p a r a t u s a n d carelessness in its use was referred to as a c o m m o n cause of trouble. Dr. B o u c h e r t h o u g h t t h a t the figures from o t h e r countries suggested t h a t t h e type of accident was very m u c h ~n t h e same proportion elsewhere as here. A m o n g preventive m e a s u r e s discussed with a view to r e d u c i n g t h e n u m b e r of accidents was t h e compulsory fitting of g u a r d s to h o u s e h o l d fire appliances, the flash point of materials u s e d in m a k i n g ~ a r m e n t s a n d the education of t h e public in such factors as t h e f r e q u e n c y of scalding of i n f a n t s from a cup of tea. It was felt t h a t considerable p r o p a g a n d a was necessary a n d t h a t lectures to m o t h e r s in welfare centres a n d to older schoolchildren wou~-d be valuable c o n t r i b u t i o n s to t h e solution of t h e problem. Dr. W a d e s u g g e s t e d shock tactics in propaganda, b u t Dr. Robertson was pessimistic a b o u t t h e value of education on this subject. Dr. W o o d was optimistic a b o u t the effect of education of the y o u n g ( b u t was less so in respect of elderly persons. Dr. Crawford t h o u g h t t h a t local h e a l t h authorities s h o u l d be pressed to take more active steps to a c q u a i n t the public with t h e true position. H e referred also to t h e frequency of falls in elderly w o m e n who were s u b s e q u e n t l y f o u n d to be w e a r i n g ill-fitting badly-worn shoes. D r H i l d i t c h h a p p i l y expressed t h e t h a n k s of the m e e t i n g to Dr. B o u c h e r for an instructive address, w h i c h h a d b r o u g h t to o u r notice a subject t h a t was well within the field of public h e a l t h a n d a b o u t w h i c h a good deal more could be done.
I73 A n ordinary m e e t i n g of the B r a n c h was held at t h e Castle, Chester, on Friday, M a y 9th, 1952, when 39 m e m b e r s attended. T h e H o n o r a r y Secretary advised the proposed e s t a b l i s h m e n t of a n area c o m m i t t e e to deal with medical m a n p o w e r in time of war a n d the following n o m i n a t i o n s were agreed t o : - Drs. R. B. Berry, A. Brown, F. W. C. Brown, J. S. G. Burnett, R. W. Eldridge, S. C. Gawne, A. M. M. Grierson, J. Innes, E. M. Jenkins, G. H. Potter, A. S. Simpson, V. T. Thierens, K. K. Wood, J. Yule.
The School Leaver and His Entry into Industry T h e President then introduced Dr. J. N. M a c d o n a l d , Senior Medical Otficer, Lever Brothers, Port Sunlight, who spoke on the above. H a v i n g reviewed t h e history of t h e school h e a l t h service h e drew an analogy between it a n d the present developm e n t of t h e industrial h e a l t h service a n d a r g u e d t h e need for t h e successful interlocking of t h e two services. T h e r e was a p r o f o u n d need for the s t u d y of leavers from school a n d y o u n g e n t r a n t s into industry. Proper reception into i n d u s t r y was of p a r a m o u n t i m p o r t a n c e and t h e m e n t a l a p p r o a c h was valuable i n a s m u c h as t h e i m p o r t a n t senior school in a m a t t e r of 24 hours b e c a m e an u n i m p o r t a n t s m a l l boy in a new environment. It was essential, therefore, t h a t t h e new e n t r a n t s h o u l d i m m e diately be given contacts in t h e shape of his f u t u r e supervisor a n d fellow-workers a n d that he s h o u l d be t a k e n to see the j o b t h a t was to be done. H a v i n g been given i n f o r m a t i o n a b o u t his f u t u r e job it was essential t h a t h e s h o u l d t h e n go on a course in the t r a i n i n g d e p a r t m e n t of t h e i n d u s t r y where he could learn t h e history of the firm, its policy a n d t h e a m e n i t i e s available to h i m a n d what was expected of h i m in return. T h e blind-alley jobs h a d to be w a t c h e d a n d facilities t h r o u g h t h e m e d i u m of e v e n i n g classes provided to enable t h e more a m b i t i o u s to g r a d u a t e to more responsible posts. T h e medical e x a m i n a t i o n s h o u l d not exist solely for t h e purpose of rejecting unfit persons. W h e r e persons were g o i n g to be employed t h e e x a m i n a t i o n should determine the s u i t a b i l i t y . of the c a n d i d a t e for particular types of e m p l o y m e n t so t h a t he was not placed where he would be h a r m f u l to h i m s e l f or others, b u t a m a i n purpose was to establish a relation between employer a n d employee. In his own factory Dr. M a c d o n a l d indicated t h a t whilst t h e initial medical e x a m i n a t i o n was compulsory, f r o m t h e n on attendance at t h e medical d e p a r t m e n t was entirely voluntary. H e t h e n proceeded to discuss certain observed factors such as the e x t r e m e l y h i g h incidence of infested h e a d s a m o n g s t entrants, the h i g h e r absentee rate a m o n g s t those u n d e r 18 years a n d the h i g h e r accident rate d u e to susceptibility to intercurrent f a m i l y infections, to ignorance of t h e job bein K done a n d to y o u t h f u l irresponsibility. He spoke of t h e individual problems arising f r o m t h e material p h y s i c a l defect a n d discussed t h e a s s e s s m e n t of ability a n d t h e m e a n s provided w h e r e b y an a m b i tious, h a r d - w o r k i n g girl could progress to h i g h e r levels of activity. A lively discussion ensued on t h e question of infested heads, in w h i c h Dr. M a c d o n a l d e m p h a s i s e d t h e need for adequate inspection a n d for a recognition of the fact t h a t the presence of ova was proof of infestation. Dr. A r n o l d Brown c o n g r a t u l a t e d Dr. M a c d o n a l d on t h e excellence of his paper a n d t h o u g h t t h a t in view of t h e t r e m e n d o u s disability to-day from psychological causes this a p p r o a c h to t h e problem was excellent prophylaxis. H e wondered w h e t h e r Dr. M a c d o n a l d h a d a n y c o m m e n t s to m a k e on t h e effect of school dentistry as seen in later adolescence a n d asked for his views on t h e e m p l o y m e n t of persons with open tuberculosis. Dr. Macdonald, in reply, said he could not speak on specific standards, b u t h i s impression was t h a t y o u n g s t e r s c o m i n g into i n d u s t r y d u r i n g t h e war were dentally fitter t h a n those c o m i n g in to-day. As to t h e question of open tubercle, h e t h o u g h t t h a t risk was great a n d whilst h e h a d his own views as a medical m a n it was clear t h a t the m a n a g e m e n t h a d to bear very m u c h in m i n d t h e possible rather t h a n t h e probable risk a n d the issues involved. F u r t h e r discussion took place on group intelligence testing a n d Dr. M a c d o n a l d indicated t h a t both group t e s t i n g and group discussions were used fairly extensively. Dr. Yule queried their value, i n a s m u c h as t h e interpretation of t h e test was even more i m p o r t a n t t h a n its setting u p a n d he wondered w h e t h e r the e x a m i n e r s were fully c o m p e t e n t to interpret t h e results of the test, b u t Dr. M a c d o n a l d indicated t h a t t h e tests were used only as a general guide a n d other factors were given infinitely greater weight. Dr. lenkins, in m o v i n g a vote of t h a n k s to Dr. Macdonald. said t h a t we h a d been shown a picture of t r e m e n d o u s advance in industrial h e a l t h work and h e c o m p l i m e n t e d Dr. M a c d o n a l d on t h e splendid work that was bein~ done b y h i m a n d his staff for a firm t h a t h a d always been well in advance of the time.
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SOCIETY OF MEDICAL OFFICERS OF HEALTH Notice of Provincial Ordinary Meeting Notice is hereby given that an Ordinary Meeting of the Society will be held in the City Chambers, Edinburgh, on Saturday, July 19th, 1952, at 10 a.m., preceding a joint meeting with the Scottish Branch, when Prof. Sir James Learmonth, g.c.v.o., O.B.E., F.R.S. En., CII.M., F.R.C.S.ED., will give an address. AGENDA
1. Minutes. 2. Correspondence. 3. Election of the following as fully-paid Life Members, on the nomination of the Council and of their Branches : Home Counties' Branch.--Dr. Rutherford Cramb, formerly M.O H., Brighton C.B., joined the Society 1922. North-Western Branclt ~ D r . James Walker, formerly Deputy M.O.H., Preston C.B., joined the Society 1920. Scottish Branch.--Dr. G. V. T. McMichael, formerly M.O.H., Paisley Burgh, joined the Society 1913. 4. Election of Fellows and Associates (list of candidates below). 5. Nominations. 6. Any other business. By Order, G. L. C. EI,LISTON,
Executive Secretary.
Tavistock House South, London, W.C.1. June 17th, 1952.
Candidates for Election, July x9th, x95z FELLOWS
ASTON, Elizabeth Oliver, L.M.S.S.A. (LOND.), 65, High Street, Netherton, Dud!ey, Worcs. Asst. C.M.O. Staffs C.C. (T. O. P. D. Lawson, G. Ramage.) (Mid.) BRAID, Grace Fides Matilda, M.B., craB. (CLAS.), n.om, D.OBST. R.C.O.O., Health Department, 6, Grange Street, Kilmarnock. Asst. M.O.H., Kilmarnock. (B. R. Nisbet, R. L. Leask.) (Sc.) COULTER, Elizabeth Johnstone, M.B., CH.B. (OLAS.), 1, Norreys Avenue, Abingdon Road, Oxford. Asst. M.O.H. and Asst. S.M.O., Oxford C.B. (J. F. Warin, M. Fisher.) (H.C.) FAY, Leo, M.D., M.B., CH.B., D.P.H. frOND.), High Bank, Trail, Taunton, Somerset. Dep. C.M.O., Somerset and MO.H., Taunton M.B. (T. Pierson, R. H. G. H. Denham.) (W.E.) GAYE, Wilhelmine Norah, M.R.C.S. (ENG.), L.R.C.P., I).P.H. (LIV.), Mardon, Pen-y-Garth, Caernarvon N. Wales. Asst. C. and S.M.O., Caernarvonshire C.C. (M. Slater, G. W. Roberts.)
(N.W.) HIc~soN, Violet L. deA., M.mC.S. (ENO.), L.R.C.P., D.P.H. (WALES), 35, Bridge Street, Hereford. Asst. M.O., Hereford C.C. (H. Sainsbury, J. S. Cookson.) (Mid.) LINNELL, Phyllis Mary, Mm., CH.B. (BIRM.), M.R.C.S, L.R.C.p., D.P.H., 19, Tower Road, Twickenham, Middlesex. Asst. M.O., Middlesex C.C. (J. Maddison, W. Cormack.) (H.C.) LOWE, Greta, M.m, CH.B. (MANCH.), D.T M. ~ H., Resthaven, Marine Drive, Barton-on-Sea, Hants. Asst. C.M.O.H., Hampshire (Part-time). (D. J. N. McNab, E. J. Gordon Wallace.) (S) McELRoY, Robert Samt~el, M.B., B.CH.,, B.A.O. (DUBLIN), D.P.I/., n.T.M, 17, Bath Road, Swindon, Wilts. M.O.H., Highworth and Cricklade and Wootton Bassett R.D.C.s and Asst. C.M.O., Wi:ts C.C. (R. MacKay, I. Urquhart.) (W.E.). MATHESON, Kenneth William, M.B., ClI.B. (EDIN.), 70, Corstorphine Road, Murrayfie'd, Edinburgh, 12. Asst. M.O. ( M & C.W.), City of Edinburgh. (H. P. Tait, M. E. Sturrock.) (Sc.) O'FLyNN, Patricia Mary, M.B., BS (SVnNEV), 106, Ryde Road. Pymble, Sydney, N.S.W., Australia. M.O., Department of Health, N S.W. (S. Repin, E. Meyers.) (N.S.W.) PATERSON, John Thomson, M.B., CH.B. (EDIN.), 7, Oaklands Avenue, Rumford, Essex. Constdtant, Diseases of the Chest, Barking and DagenIaam Chest Clinic. (C. Herington, F. G. Brown.) (H.C.) PYZIK, Michalina Bronislawa, B.D.S. (BRISTOL), Woolwich Health Centre, Market Street, London, S.E.18. D.O., L.C.C. (J. F. A. Smyth, J. V. Bingay.) (Met.) RICnABDS, Hilda M.. M.R.C.S. (ENG.). L.n.c.P., 59, Benhurst Court, Leigham Court Road, London, S.W.16. Asst. MD., LC.C.; Lecturer (Pub!ic Health). Battersea Polytechnic, S.W.II.) (D. A. Craigmile, G. E. Wilkinson.) (Met.) ROBERTS, Constance Evelyn, MB., l~S. (LOND*), M.R.C.S., L.R.C.P., Upfield, Winscombe, Somerset. Part-time Asst. M.O.H., Bristol. (R. C. Wofinden, R. H. Parry.) (W.E.)
STEVENSON, Margaret Scott, M.B., cn.B. (EDIN.), D.P.H., 45, Dcvoushire Street, London, W.I. Dep. M.O.H. and Asst. M.O., L.C.C., Div. 3. (C. O. S. Blyth Brooke, J. E Marshall.) (Met.) WALES, Elizabeth, M.a., B.S. (LONO.), 14, Essex Gardens, Gateshead 9, Co. Durham. Asst. Welfare M.O., Durham C.C. (W. S. Walton E. S. Williamson.) (N.) WALSH, Nannie Christina, M.E., B.CH., B.A.O., D.C.H., 38, West Cromwell Road, S.W.5. Asst. M.O., L.C.C. (D. Egan, M. T. Paterson.) (Met.) WmTFIVLD, Audrey P., M.B., E.S. (LOND.), " Cornerways," 1, Barlow Road, HaInpton-on-Thames, Middlesex. Asst. M.O., Middlesex C.C. (J. Maddison, W. Cormack.) (H.C.) WILSON-MURPHY, Hannah, M.B., B.CH., B.A.O., D.P.H. (CORK), 207a, Sutherland Avenue, London, W.9. Asst. M.O., L.C.C. (A. Mower White, M. S. Gillatt.) (Met.) WOODS, Grace E., M.B., B.S. (LOND.), D.P.H., D.C.H., 21, Downs Cote View, Westbury-on-Trym, Bristol. Part-time M.O., Bristol P.H.S., Clinical Assistant (Research), Department of Child Health, Bristol. (R. C. Woflnden, R. H. Parry.) (W.E.) ASSOCIATES
BI.UMENAU, Ernest, M.D.U. (FRANKFURT),The Rectory, Woughtonon-tbe-Green, Bletchley, Bucks. School D.O., Bucks C.C. (E. Kew, K. C. B. Webster.). (H.C.) EVANS, William David Percival, i~ o.s., R.C.S. (ENG.),~ T~n-y-Lon, Rhydyfelin, Aberyswyth, Cards. Senior D.O., Cardiganshire C.C. (I. M. Watkin, E. Jones.) (Wa.) SCHROTTER, Theresa, M.D. (VIENNA), 388, Upper Richmond Road, London, S.W.15. D.O., Middlesex C.C. (M. Cohn, I. F. A Smyth.) (H.C.) SQmRES, Dorothy Winifred, L.D.S., R.F.P.S. (GLAS.), Fairacre, Harcombe Hill, Winterbourne, Bristol. D.O. Glos. C.C. (J. F. A. Smyth, J. v . Bingay.) (W.E.) REPORTS
MIDLAND BRANCH President: Dr. C. Starkie (M.O.H., Kidderminster; Din. MO., Worcs.).
Hon. Secretary: Dr. W. Alcock (M.O.H., Burton-on-Trent C.B.). The fifth meeting of the session was held at Lancaster Street Welfare Centre, Birmingham, on Thursday, March 6th, 1952, at 3 p.m. The President was in the chair and 31 members attended.
Preventive Aspects of Mental Health An address was given by Prof. J. M. Mackintosh on the above subject. In a brief historical survey Prof. Mackintosh referred to the early methods of ascertainment of mental disorder, when the chief criterion was apparently whether the patient was a nuisance to his family or to the community, and to the methods of treatment, the armamentarium of which consisted of irons, stocks and manacles. In the 18th century the Bethlem Hospital used to make a charge of 2d. to see the lunatics and raised the considerable income of £400 a year from this source. Treatment consisted in the main of bleeding, vomiting and purging, but gradually a more humanitarian approach to the problem of mental illness developed. Later developments were the separation of mental defectives from persons of unsound mind, and, in more recent years, the voluntary admission of patients to mental hospitals. Turning to the preventive side of mental health, Dr. Mackintosh stressed the necessity of first acquiring a knowledge of the root causes of mental illness and, since the child is the father of the man, of commencing with infants, if we are to develop a truly preventive Mental Health Service. At the present time there are no reliable indices for the assessment of mental illness comparable with those of physical illhealth, and there is a large field for research. The extent of psychoneurotic illness is enormous and is said to account for one-third o~ all long-term illness. What are urgently required are planned surveys of psychoneurosis, with special reference to such matters as studies of suicide rates, differentials in sex, religion, social circumstances and age, and the impact of such aspects of fear of unemployment, threat of war, or threat of national instability. Progress is hampered at the present time, however, by the lack of trained personnel and the shortage of well-equipped clinics. An interesting discussion followed, in which Drs. Jean Mackintosh, Owen, Galloway and Savage took part.
PUBLIC HEALTH,
J u l y , I952
T h e r e was general a g r e e m e n t t h a t a b e g i n n i n g should be m a d e with the m o t h e r a n d child, a n d t h a t H e a l t h Visitors, b y n a t u r e of their experience a n d training, could do a great deal on the preventive side. A h e a r t y vote of t h a n k s was accorded to Prof. M a c k i n t o s h b y Dr. P i c k u p for his most interesting a n d s t i m u l a t i n g address. T h i s was seconded b y Dr. M a r k h a m a n d approved u n a n i m o u s l y .
N o m i n a t i o n for Presidency Consideration of this m a t t e r h a v i n g heen deferred f r o m the last meeting, it was proposed by Dr. Galloway, seconded by Dr. Griffin, a n d agreed, t h a t this B r a n c h support the n o m i n a t i o n of Prof. A. T o p p i n g for the office of President for t h e session 1952-53. It was, however, proposed t h a t a representation be m a d e to t h e Executive Secretary, t h a t t h e practice of circulating n o m i n a t i o n s for Presidency from other B r a n c h e s be discontinued a n d t h a t at an appropriate t i m e a complete list of n o m i n e e s be s u b m i t t e d b y the Executive Secretary to all Branches.
NORTH-WESTERN BRANCH President: Dr. A. M. Grierson (Dep. M.O.H., M a n c h e s t e r C.B). Hon. Secretary: Dr. J. S. G. B u r n e t t (M.O.H., Preston C.B.). A n ordinary m e e t i n g of t h e B r a n c h was held in M a n c h e s t e r on Friday, M a r c h 14th, w h e n 29 m e m b e r s were present. It was d u l y moved a n d seconded t h a t Dr. J a m e s Walker, sometime D e p u t y Medical Officer of H e a l t h of the C o u n t y B o r o u g h of Preston, h a v i n g been a m e m b e r of t h e Society of Medical Officers of H e a l t h since 1920, be r e c o m m e n d e d to the Council for n o m i n a t i o n for fully-paid life m e m b e r s h i p . A letter from t h e H o n o r a r y Secretary of t h e Metropolitun Branch, dated F e b r u a r y 21st, i n t i m a t i n g t h a t t h e B r a n c h h a d u n a n i m o u s l y decided to n o m i n a t e Dr. A n d r e w T o p p i n g for t h e Presidency of t h e Society for t h e year 1952-53, was read, a n d it was agreed to support Dr. T o p p i n g ' s n o m i n a t i o n to t h e Presidency. Prof. C. Fraser Brockington t h e n delivered an address on " Some Observations on A m e r i c a n Medicine from the Point of View of a Medical Officer of H e a l t h . " A n ordinary m e e t i n g was held at the Municipal Building, Preston, on Friday, April 4th, w h e n 17 m e m b e r s a n d gnests attended. In the absence of the President the chair was occupied b y Dr. J. E. Spence, the senior Past-President in attendance.
Accidents in the H o m e T h e C h a i r m a n t h e n i n t r o d u c e d Dr. C. A. Boucher, Medical Officer at t h e M i n i s t r y of H e a l t h , who gave a talk on t h e above subject. H e gave a n outline of t h e size of the p r o b l e m and its gravity in comparison with road accidents a n d referred to t h e h e a v y incidence a m o n g s t those u n d e r five a n d over 60 years of age. Reference was m a d e to the occurrence of b u r n s a n d scalds a n d accidents f r o m domestic m a c h i n e r y in children, from b u r n s a n d falls in old people, a n d to the rise in accide~lts in t h e t h i r d q u a r t e r of t h e year. H e spoke of t h e influence of ignorance of the proper use of a p p a r a t u s a n d carelessness in its use was referred to as a c o m m o n cause of trouble. Dr. B o u c h e r t h o u g h t t h a t the figures from o t h e r countries suggested t h a t t h e type of accident was very m u c h ~n t h e same proportion elsewhere as here. A m o n g preventive m e a s u r e s discussed with a view to r e d u c i n g t h e n u m b e r of accidents was t h e compulsory fitting of g u a r d s to h o u s e h o l d fire appliances, the flash point of materials u s e d in m a k i n g ~ a r m e n t s a n d the education of t h e public in such factors as t h e f r e q u e n c y of scalding of i n f a n t s from a cup of tea. It was felt t h a t considerable p r o p a g a n d a was necessary a n d t h a t lectures to m o t h e r s in welfare centres a n d to older schoolchildren wou~-d be valuable c o n t r i b u t i o n s to t h e solution of t h e problem. Dr. W a d e s u g g e s t e d shock tactics in propaganda, b u t Dr. Robertson was pessimistic a b o u t t h e value of education on this subject. Dr. W o o d was optimistic a b o u t the effect of education of the y o u n g ( b u t was less so in respect of elderly persons. Dr. Crawford t h o u g h t t h a t local h e a l t h authorities s h o u l d be pressed to take more active steps to a c q u a i n t the public with t h e true position. H e referred also to t h e frequency of falls in elderly w o m e n who were s u b s e q u e n t l y f o u n d to be w e a r i n g ill-fitting badly-worn shoes. D r H i l d i t c h h a p p i l y expressed t h e t h a n k s of the m e e t i n g to Dr. B o u c h e r for an instructive address, w h i c h h a d b r o u g h t to o u r notice a subject t h a t was well within the field of public h e a l t h a n d a b o u t w h i c h a good deal more could be done.
I73 A n ordinary m e e t i n g of the B r a n c h was held at t h e Castle, Chester, on Friday, M a y 9th, 1952, when 39 m e m b e r s attended. T h e H o n o r a r y Secretary advised the proposed e s t a b l i s h m e n t of a n area c o m m i t t e e to deal with medical m a n p o w e r in time of war a n d the following n o m i n a t i o n s were agreed t o : - Drs. R. B. Berry, A. Brown, F. W. C. Brown, J. S. G. Burnett, R. W. Eldridge, S. C. Gawne, A. M. M. Grierson, J. Innes, E. M. Jenkins, G. H. Potter, A. S. Simpson, V. T. Thierens, K. K. Wood, J. Yule.
The School Leaver and His Entry into Industry T h e President then introduced Dr. J. N. M a c d o n a l d , Senior Medical Otficer, Lever Brothers, Port Sunlight, who spoke on the above. H a v i n g reviewed t h e history of t h e school h e a l t h service h e drew an analogy between it a n d the present developm e n t of t h e industrial h e a l t h service a n d a r g u e d t h e need for t h e successful interlocking of t h e two services. T h e r e was a p r o f o u n d need for the s t u d y of leavers from school a n d y o u n g e n t r a n t s into industry. Proper reception into i n d u s t r y was of p a r a m o u n t i m p o r t a n c e and t h e m e n t a l a p p r o a c h was valuable i n a s m u c h as t h e i m p o r t a n t senior school in a m a t t e r of 24 hours b e c a m e an u n i m p o r t a n t s m a l l boy in a new environment. It was essential, therefore, t h a t t h e new e n t r a n t s h o u l d i m m e diately be given contacts in t h e shape of his f u t u r e supervisor a n d fellow-workers a n d that he s h o u l d be t a k e n to see the j o b t h a t was to be done. H a v i n g been given i n f o r m a t i o n a b o u t his f u t u r e job it was essential t h a t h e s h o u l d t h e n go on a course in the t r a i n i n g d e p a r t m e n t of t h e i n d u s t r y where he could learn t h e history of the firm, its policy a n d t h e a m e n i t i e s available to h i m a n d what was expected of h i m in return. T h e blind-alley jobs h a d to be w a t c h e d a n d facilities t h r o u g h t h e m e d i u m of e v e n i n g classes provided to enable t h e more a m b i t i o u s to g r a d u a t e to more responsible posts. T h e medical e x a m i n a t i o n s h o u l d not exist solely for t h e purpose of rejecting unfit persons. W h e r e persons were g o i n g to be employed t h e e x a m i n a t i o n should determine the s u i t a b i l i t y . of the c a n d i d a t e for particular types of e m p l o y m e n t so t h a t he was not placed where he would be h a r m f u l to h i m s e l f or others, b u t a m a i n purpose was to establish a relation between employer a n d employee. In his own factory Dr. M a c d o n a l d indicated t h a t whilst t h e initial medical e x a m i n a t i o n was compulsory, f r o m t h e n on attendance at t h e medical d e p a r t m e n t was entirely voluntary. H e t h e n proceeded to discuss certain observed factors such as the e x t r e m e l y h i g h incidence of infested h e a d s a m o n g s t entrants, the h i g h e r absentee rate a m o n g s t those u n d e r 18 years a n d the h i g h e r accident rate d u e to susceptibility to intercurrent f a m i l y infections, to ignorance of t h e job bein K done a n d to y o u t h f u l irresponsibility. He spoke of t h e individual problems arising f r o m t h e material p h y s i c a l defect a n d discussed t h e a s s e s s m e n t of ability a n d t h e m e a n s provided w h e r e b y an a m b i tious, h a r d - w o r k i n g girl could progress to h i g h e r levels of activity. A lively discussion ensued on t h e question of infested heads, in w h i c h Dr. M a c d o n a l d e m p h a s i s e d t h e need for adequate inspection a n d for a recognition of the fact t h a t the presence of ova was proof of infestation. Dr. A r n o l d Brown c o n g r a t u l a t e d Dr. M a c d o n a l d on t h e excellence of his paper a n d t h o u g h t t h a t in view of t h e t r e m e n d o u s disability to-day from psychological causes this a p p r o a c h to t h e problem was excellent prophylaxis. H e wondered w h e t h e r Dr. M a c d o n a l d h a d a n y c o m m e n t s to m a k e on t h e effect of school dentistry as seen in later adolescence a n d asked for his views on t h e e m p l o y m e n t of persons with open tuberculosis. Dr. Macdonald, in reply, said he could not speak on specific standards, b u t h i s impression was t h a t y o u n g s t e r s c o m i n g into i n d u s t r y d u r i n g t h e war were dentally fitter t h a n those c o m i n g in to-day. As to t h e question of open tubercle, h e t h o u g h t t h a t risk was great a n d whilst h e h a d his own views as a medical m a n it was clear t h a t the m a n a g e m e n t h a d to bear very m u c h in m i n d t h e possible rather t h a n t h e probable risk a n d the issues involved. F u r t h e r discussion took place on group intelligence testing a n d Dr. M a c d o n a l d indicated t h a t both group t e s t i n g and group discussions were used fairly extensively. Dr. Yule queried their value, i n a s m u c h as t h e interpretation of t h e test was even more i m p o r t a n t t h a n its setting u p a n d he wondered w h e t h e r the e x a m i n e r s were fully c o m p e t e n t to interpret t h e results of the test, b u t Dr. M a c d o n a l d indicated t h a t t h e tests were used only as a general guide a n d other factors were given infinitely greater weight. Dr. lenkins, in m o v i n g a vote of t h a n k s to Dr. Macdonald. said t h a t we h a d been shown a picture of t r e m e n d o u s advance in industrial h e a l t h work and h e c o m p l i m e n t e d Dr. M a c d o n a l d on t h e splendid work that was bein~ done b y h i m a n d his staff for a firm t h a t h a d always been well in advance of the time.