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NURSING EXPERIENCE FOR MEDICAL STUDENTS
83 often followed up-scores of cases which have been quickly and permanently relieved by a few treatments
I have, of course, seen failures too. I personally an more interested in getting my patients well than in a-priori theorising. Hence, if I am satisfied that certain treatment is good, I will use it first and enter into discussion as to how it works only as a secondary consideration. I suggest that if more surgeons were to study the thing at first hand, this would be the most effective way of doing, away with both " unqualified " practice of osteopathy (the American graduate has a four-year training !) and with the accusation so often brought-and not altogether without justification: hidesee Mr. Charnley’s letter-that the profession is
by osteopaths.
bulletins to the
public a strong protest against the extending compulsion on doctors to place their medical records of State patients at the disposal of various lay bodies, thus necessitating breaking the Hippocratic oath, which has governed the conduct of the medical profession in’ all civilised countries from immemorial ages. It is adding to this protest the demand that the
Amending
Act shall
assure
the withdrawal of these
regulations. House of Commons.
E. GRAHAM-LITTLE.
ILLUSIONS WHILE FALLING ASLEEP
SIR,—The phenomenon described by Dr. Nettell (Dec. 18) is not uncommon. both in psychuneurotics L. J. BENDIT. London, S.W.3. and in people not labelled explicitly as such. Like other unpleasant dreams occurring repeatedly in the same form, POSTOPERATIVE PERIOD it is at times a rather troublesome experience. We may assume that Dr. Nettell’s patients have also had other SIR,—Your leading article last week is fairly and disorders, very likely of the psychosomatic type in the but if I doubt the of doctors lucidly written, majority In such instances the sense of the word. narrower will agree with your conclusions. My experience as a disturbance of self-perception--even though only during general practitioner and part-time specialist is that most superficial sleep-must be considered as part of the doctors are disgruntled and most patients under the syndrome from which the patient happens to suffer. N.H.S. are no better off but rather worse off. The condition of superficial sleep conduces to the L. S. WOOLF. London, N.W.11. experience of disintegrated perception of the somatic self; the dominant content of hypnagogic hallucinations is frequently the position of one limb or the irritation of NURSING EXPERIENCE FOR MEDICAL an organ-function, pictorially expressed. STUDENTS May I advise that no practitioner attempts to interpret SIR,—In our hospital a scheme will shortly be intro- analytically the phenomena of enlarged head or limb, &c., duced whereby students will give up three weeks of to his patient ?P The risks are the stimulation of further their course to do general nursing tasks under the unpleasant sensations and hypochondriac obsessions. He supervision of ward sisters. Whilst it cannot be denied should, however, explain that the phenomena in question that some knowledge of ward routine would be gleaned are insignificant and only part of people’s occasional we feel strongly that such expenditure of time is general " nervousness." If it is decided to discuss the ridiculous in an already overcrowded curriculum. In life situation and stresses, this should be done patient’s two vears as a clinical clerk and dresser the student manifestly with a view to improving the other, psychocannot help becoming sufficiently acquainted with this somatic, complaints ; and the hope should be expressed routine. that the hypnagogic phenomenon may also cease with Lest it should appear that we are embittered by time. To hasten the transition between half sleep and such domestic duties, we wish to point out that we deep sleep, sedatives with cortical and subcortical actions are now in our final year and are unaffected by the (e.g., bromide gr. 15 with sod. barbitone gr. 71/2) may be change. useful in cases of recent origin ; though patients of the Would it not be better if we had the opportunity of introspective and obsessional type may not react well to performing but one forceps delivery ?P We write in the this therapy. hope that such a scheme may not spread to other Patients who complain of these symptoms while being hospitals. treated for psychoneurosis are almost always personalities R. H. CARRUTHERS of the autistic make-up and are suffering from rather London Hospital Medical College, R. E. RICHARDSON. London, E.!. deep-seated deficiencies and severe symptoms. In a number of such cases I could not avoid the impression that the experience of inflated head or limb was indeed PROFESSIONAL SECRECY a distorted hallucinatory picture of genital erection; SIR,—You have taken an interest in sustaining the this may be true, of course, in females as well as males. profession in its struggle against Ministerial compulsion to This is one of the reasons for my warning against any disclose professional secrets. It is encouraging to find that symbolic interpretation of it outside a carefully handled the Minister of Health has been constrained to annul by situation. psycho-analytical regulation (no. 2517, 1948) the repeal of the Act of 1916 SAMUEL LOWY of Psychological Medicine, Department which made it a statutory obligation to ensure to patients Clinical Assistant. St. Bartholomew’s Hospital, London. of of from V.D. records suffering complete confidentiality their disease. STAPHYLOCOCCAL COAGULASE I have a special interest in this matter. In April, 1928, the Edinburgh Corporation was promoting a Bill in articles in the Lancet- and other SIR,-In Parliament, imposing notification of venereal disease in journals andmany in textbooks one often finds statements their area. Mr. Pethick Lawrence (as he then was) about the staphylococcal coagulase (e.g., Moss et al. moved, and I seconded, a motion for rejecting the Bill, Lancet, 1948, i, 320). In English and American literature which was strenuously supported by the Scottish Departthe circumstances of the discovery of this enzyme are, ment and Scottish members. The motion was approved however, nearly always omitted or wrongly given. by a large majority, and patients suffering from v.D. Though Much 1 was the first to observe the coagulating enjoyed statutory protection against the disclosure of activity of staphylococci on fibrinogen, he did not their condition, until the N.H.S. Act, 1946, automatically the importance -of this property in relation to recognise removed that protection. virulence. This is why in the two decades after his finding Mr. Bevan’s retreat has been occasioned, not by no further work had been done on this subject. medical, but by lay, pressure, the spearhead of which In 1926 I found 2-without knowing about Much’s has been the Association for Moral and Social Hygiene. previous experiments-that the fibrinogen-coagulating It is encouraging to learn that the bodies which have property was confined to virulent staphylococci. My won this victory are becoming interested in the opposition work established this as a valuable method of differento Statutory Instruments 506 and 507, which must tiating pathogenic from non-pathogenic staphylococci. widen the area in which disclosure must be made of the The finding of this differentiation was more important medical records of patients treated under the N.H.S. than the observation that some cocci possessed a coagubound.
’
’
’
Act, 1946.
It is still more encouraging that the Fellowship for Freedom in Medicine is issuing as one of its earliest
1. Much, H. 2. Zbl. Bakt.
Biochcm. Ztschr. 1908, 14, 143. 1926, 99, 74. Wien. med. Wschr. 1927, 77, 149.
I have, of course, seen failures too. I personally an more interested in getting my patients well than in a-priori theorising. Hence, if I am satisfied that certain treatment is good, I will use it first and enter into discussion as to how it works only as a secondary consideration. I suggest that if more surgeons were to study the thing at first hand, this would be the most effective way of doing, away with both " unqualified " practice of osteopathy (the American graduate has a four-year training !) and with the accusation so often brought-and not altogether without justification: hidesee Mr. Charnley’s letter-that the profession is
by osteopaths.
bulletins to the
public a strong protest against the extending compulsion on doctors to place their medical records of State patients at the disposal of various lay bodies, thus necessitating breaking the Hippocratic oath, which has governed the conduct of the medical profession in’ all civilised countries from immemorial ages. It is adding to this protest the demand that the
Amending
Act shall
assure
the withdrawal of these
regulations. House of Commons.
E. GRAHAM-LITTLE.
ILLUSIONS WHILE FALLING ASLEEP
SIR,—The phenomenon described by Dr. Nettell (Dec. 18) is not uncommon. both in psychuneurotics L. J. BENDIT. London, S.W.3. and in people not labelled explicitly as such. Like other unpleasant dreams occurring repeatedly in the same form, POSTOPERATIVE PERIOD it is at times a rather troublesome experience. We may assume that Dr. Nettell’s patients have also had other SIR,—Your leading article last week is fairly and disorders, very likely of the psychosomatic type in the but if I doubt the of doctors lucidly written, majority In such instances the sense of the word. narrower will agree with your conclusions. My experience as a disturbance of self-perception--even though only during general practitioner and part-time specialist is that most superficial sleep-must be considered as part of the doctors are disgruntled and most patients under the syndrome from which the patient happens to suffer. N.H.S. are no better off but rather worse off. The condition of superficial sleep conduces to the L. S. WOOLF. London, N.W.11. experience of disintegrated perception of the somatic self; the dominant content of hypnagogic hallucinations is frequently the position of one limb or the irritation of NURSING EXPERIENCE FOR MEDICAL an organ-function, pictorially expressed. STUDENTS May I advise that no practitioner attempts to interpret SIR,—In our hospital a scheme will shortly be intro- analytically the phenomena of enlarged head or limb, &c., duced whereby students will give up three weeks of to his patient ?P The risks are the stimulation of further their course to do general nursing tasks under the unpleasant sensations and hypochondriac obsessions. He supervision of ward sisters. Whilst it cannot be denied should, however, explain that the phenomena in question that some knowledge of ward routine would be gleaned are insignificant and only part of people’s occasional we feel strongly that such expenditure of time is general " nervousness." If it is decided to discuss the ridiculous in an already overcrowded curriculum. In life situation and stresses, this should be done patient’s two vears as a clinical clerk and dresser the student manifestly with a view to improving the other, psychocannot help becoming sufficiently acquainted with this somatic, complaints ; and the hope should be expressed routine. that the hypnagogic phenomenon may also cease with Lest it should appear that we are embittered by time. To hasten the transition between half sleep and such domestic duties, we wish to point out that we deep sleep, sedatives with cortical and subcortical actions are now in our final year and are unaffected by the (e.g., bromide gr. 15 with sod. barbitone gr. 71/2) may be change. useful in cases of recent origin ; though patients of the Would it not be better if we had the opportunity of introspective and obsessional type may not react well to performing but one forceps delivery ?P We write in the this therapy. hope that such a scheme may not spread to other Patients who complain of these symptoms while being hospitals. treated for psychoneurosis are almost always personalities R. H. CARRUTHERS of the autistic make-up and are suffering from rather London Hospital Medical College, R. E. RICHARDSON. London, E.!. deep-seated deficiencies and severe symptoms. In a number of such cases I could not avoid the impression that the experience of inflated head or limb was indeed PROFESSIONAL SECRECY a distorted hallucinatory picture of genital erection; SIR,—You have taken an interest in sustaining the this may be true, of course, in females as well as males. profession in its struggle against Ministerial compulsion to This is one of the reasons for my warning against any disclose professional secrets. It is encouraging to find that symbolic interpretation of it outside a carefully handled the Minister of Health has been constrained to annul by situation. psycho-analytical regulation (no. 2517, 1948) the repeal of the Act of 1916 SAMUEL LOWY of Psychological Medicine, Department which made it a statutory obligation to ensure to patients Clinical Assistant. St. Bartholomew’s Hospital, London. of of from V.D. records suffering complete confidentiality their disease. STAPHYLOCOCCAL COAGULASE I have a special interest in this matter. In April, 1928, the Edinburgh Corporation was promoting a Bill in articles in the Lancet- and other SIR,-In Parliament, imposing notification of venereal disease in journals andmany in textbooks one often finds statements their area. Mr. Pethick Lawrence (as he then was) about the staphylococcal coagulase (e.g., Moss et al. moved, and I seconded, a motion for rejecting the Bill, Lancet, 1948, i, 320). In English and American literature which was strenuously supported by the Scottish Departthe circumstances of the discovery of this enzyme are, ment and Scottish members. The motion was approved however, nearly always omitted or wrongly given. by a large majority, and patients suffering from v.D. Though Much 1 was the first to observe the coagulating enjoyed statutory protection against the disclosure of activity of staphylococci on fibrinogen, he did not their condition, until the N.H.S. Act, 1946, automatically the importance -of this property in relation to recognise removed that protection. virulence. This is why in the two decades after his finding Mr. Bevan’s retreat has been occasioned, not by no further work had been done on this subject. medical, but by lay, pressure, the spearhead of which In 1926 I found 2-without knowing about Much’s has been the Association for Moral and Social Hygiene. previous experiments-that the fibrinogen-coagulating It is encouraging to learn that the bodies which have property was confined to virulent staphylococci. My won this victory are becoming interested in the opposition work established this as a valuable method of differento Statutory Instruments 506 and 507, which must tiating pathogenic from non-pathogenic staphylococci. widen the area in which disclosure must be made of the The finding of this differentiation was more important medical records of patients treated under the N.H.S. than the observation that some cocci possessed a coagubound.
’
’
’
Act, 1946.
It is still more encouraging that the Fellowship for Freedom in Medicine is issuing as one of its earliest
1. Much, H. 2. Zbl. Bakt.
Biochcm. Ztschr. 1908, 14, 143. 1926, 99, 74. Wien. med. Wschr. 1927, 77, 149.