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QUININE AND THE PREVENTION OF MALARIA.
1156 "
menisci " and " hederiform bodies " each
examiner must always retain an open mind. The medical record card system of the Ministry of Pensions is an attempt to safeguard the interests of the pensioner,and to economise the time of medical officers, and in so far as it does this it merits the active interest and participation of the consultant staffs.of hospitals.
but collected into groups in certain
EXTRA-RETINAL VISION. THERE is nothing inherently impossible in the conception of a race of human pigmies 5 or 6 inches high such as Swift imagined when he wrote the story of Gulliver’s journey to Lilliput, or of a race of giants such as the inhabitants of Brobdingnag. Neither is there anything inherently absurd in the conception of a human being in possession of other organs of vision besides his two eyes, or indeed of having these extra-visual organs scattered over the entire surface of his body. When, however, we read a book1 which purports to prove that such is the fact we naturally regard it as a jeu d’ esprit conceived in the same spirit as that which inspired the author of "Gulliver’s Travels " 200 years ago. Mons. Louis Farigoule, a supernumerary professor of the University of Paris, complains that modern physiology lags far behind the discoveries of minute anatomy. Microscopical structures are known, he says, but their functions are only guessed at, and, so far, the assistance which modern psychology might bring to their interpretation has been ignored. Starting from phenomena observed in subjects in a state of somnambulism, he observes that certain of these subjects, when blindfolded, behave as if they ’, perceived objects, persons,-even written characters. if Psychologically, the somnambulist is in a condition of consciousness different from that associated with ordinary life, but analogous to that with which the modern scientific world is more or less familiar as the result of hypnotic suggestion. Mons. Farigoule therefore hypnotised a subject and, having blindfolded him, ’, suggested that he could still see the title of a news- ’, paper. The result was successful, but the subject ’, became so fatigued that he refused to have any more experiments made on him. Nevertheless, five other I subjects were obtained-the first-comers, and in no way selected as being easily suggestible, and as the result of five series of experiments conducted on them the results obtained in the first case were confirmed and amplified. The next step was for Mons. Farigoule to experiment on himself. By dint of great efforts and at the cost of considerable exercise of patience he at length succeeded in eliciting the same phenomena subjectively that he had previously found objectively in his hypnotised subjects. Having elicited them he was able to analyse and describe them in a far more exact manner than had been possible in the case of experiments in other people. The obvious criticism on all this is that either the whole thing is a romance, or else the author is the subject of self-suggestion and is unconsciously deceiving not only his readers but himself. The book is addressed not to the public but to the scientific world, and its plausibility is greatly increased by the explanations of the phenomena
I
’I
suggested. There
are,
as
is
well
known, many different
varieties Pacinian
of
of vision.
The author goes further and
nerve-endings in the skin such as corpuscles, end-bulbs, &c., all of which have been minutely described by anatomists. In recent times modern methods of histology have disclosed yet others-namely, a certain form of nerve-endingin the superficial layer of the dermis between the papillae, which Ranvier compared to the branching of ivy and called " hederiform " bodies, and another form which has been described as occurring in the epidermis of the pig’s snout-microscopic expansions interposed between the cells and termed " menisci." The argument is that it is an unwarrantable assumption that all these various forms of nerve-ending have to do with the sense of touch, and that it is just as likely that some of them are connected with the sense 1 La
pictures these
Vision Extra-rétinienne et le Sens Paroptique. By Louis Farigoule. Paris : Office of the Nouvelle Revue Française.
as a micro-
scopic " ocellus," and each complete in itself with E6 refracting body, an ocellary retina, and a nerve fibre, parts
of the
body,
each group constituting something very much like A compound eye. The visual impulses so originated are conveyed to the central nervous system in a way similar to visual impulses from the eye, but whether they reach the occipital lobe or are arrested on some lower level of the central nervous system,,is apparently as yet not determined. Why, then, does not the ordinary person see when he is blindfolded, and why do we not all of us have a faculty not only of diplopia but of multiple vision? The suggested answer to these questions ia on psychological grounds, and an analogy is made with the well-known phenomenon of the suppression of the image in a squinting eye. The whole thesis is worked out with considerable skill, and we can commend the book to our readers, if on no other grounds, as an If taken interesting psvcho-physiological puzzle. seriously it would open a way for the blind to see, by the education of what the author professes to believe is a latent faculty, and he tells us that he has already had some success in this connexion and means to, accomplish more. It is in the interests of the blind that we would point out that to raise hopes in them which are doomed to disappointment is anything but a. kindness. ___
TANK EXHAUSTION. ACCORDING to Dr. L. R. Broster,formerly D.A.D.M.S. Tank Corps, tank exhaustion is a familiar syndrome. After running for from three to six hours in a closed tank, the crews apparently suffer from the want of ventilation, combined with excessive heat, dryness, and the presence of CO; they develop headache,. giddiness, dyspnoea, palpitation and vomiting, mental confusion, and sometimes unconsciousness. The atmosphere within the tank becomes very hot and dry; readings of 120° dry, and 860 wet bulb are quoted. Naturally the men’s temperature also rises; observations of A little carbon 100’4° and 100-5° F. are recorded. monoxide is found in the air of tanks, also petrol fumes. Fans are supplied and used, but openings are necessarily small to keep out bullets and splinters. Unless the tank be directly hit by shell, the wounds of crews are usually slight, but in action, with all openings closed, exhaustion comes on early, and after Dr. a day’s fighting the men require two days’ rest. Broster suggests that a tank might act as a protected advanced dressing station; one was used at Cambrai to bring back 16 wounded, and a tank ambulance to carry six stretchers was under construction when the armistice was signed. -
QUININE AND THE PREVENTION OF MALARIA. THE value of quinine as a prophylactic against malaria is a subject on which there has always been considerable divergence of opinion among experts, nor have the experiences of the late war led to any definite conclusions, since the difficulties and inconveniences of the systematic routine administration of quinine to every healthy member of a large body of troops were found to be such that the method, of uncertain benefit, was largely abandoned in favour of other more feasible measures of protection. Much confusion has arisen from the failure to distinguish between the essentially different problems of the protection of the healthy individual from malaria, and the control of relapses in those who have become infected with the disease. Quinine is of established value in diminishing the number and severity of relapses, if taken in adequate quantity and over a long period, although, unfortunately, it seldom leads to complete cure in the sense that no further relapses occur on discontinuance of the treatment. On the other hand. the belief is widespread among those who reside in districts where malaria is rife that quinine C1.n be relied on as affording adequate protection against the ill-effects of bites by 1
Journal of the Royal Army Medical Corps, October, 1920.
1157 with malaria parasites. These available should be welcome, nevertheless the onus of in most vulnerable to their the final opinion should rest with the medical officer, quinine parasites youngest forms, and it is probable that a dose of quinine who should have had a proper training in psychological taken every evening shortly before the period of medicine. Several speakers regarded the most suitable mosquito activity may, for a time, be effective in role for the psychologist to be the devising and destroying recently introduced sporozoites. The drug standardising of tests and of methods of investigation or is, however, rapidly excreted, and, in the absence of a education. Teachers’ representatives seemed to desire mosquito net, a second dose will be required in the course a statutory right to sign certificates of defect conjointly of the night if protection is to be maintained throughout with the medical officer, apparently overlooking their the danger period. During the later phases of their growth existing powers, under the Education Act of 1914, of within the red corpuscles, the parasites are both more reporting at the request of parent or of the local resistant and better protected from the effects of authority. In some cases teachers omit details from quinine. If taken in less frequent doses or at irregular the forms at present in use, and do not take advantage intervals, quinine is ineffective for prophylactic of opportunities of being present when children from purposes and is, moreover, harmful, in that it may their schools are examined ; if they did so they might induce a sense of security which, in fact, is non- find little cause for complaint. existent. It is evident that such a routine, difficult and Reviewing the advantages of institutions of different irksome to the individual, is well-nigh impossible in sizes, Dr. A. Rotherham, medical commissioner to the dealing with a large community, whether of troops or Board of Control, showed the great, possibilities of civilians, and more particularly so under conditions of classified recreation and variety of occupation secured, active service, and it was a wise judgment that led the while Miss Pierce pleaded for the individual care, more authorities in the latter stages of the war to give up homely life and closer personal interest in the small the futile attempt to prevent malaria by 10 gr. doses of home. Miss Dendy showed that if the institution quinine once or twice a week, and to concentrate on consisted of blocks of separate houses or villas the useful features of either type could be conserved and more effective measures, such as the details of the proper protection of individuals by means of nets, combined without limits in size. One speaker thought combined with an energetic campaign against mosquitoes that with the restriction of hours of work now in and their breeding-places in the neighbourhood of force a staff of 17 would be required for a home for 12-25 inmates, but that the proportion became camps. ’l’l1B;Jre are two aspects of malaria prevention the im- more reasonable with larger numbers. Emphasis portance of which is often overlooked: (1) The part was laid on the necessity for varied occupation played in prevention by the efficient treatment of and opportunities for real moral education and moral malaria patients, whereby the supply of parasites is choice in institutions of all types, whether State controlled at its source; this is probably the role in institutions, certified institutions, certified houses, which quinine, viewed as a Drotective agent, attains or approved homes. The final meeting on the its highest value. (2) The adequate isolation of malaria future of education for physically defective children patients by the use of nets, thereby protecting showed a unanimous desire for early ascertainment mosquitoes from infection. If it were possible in any and treatment, and a hope that in such an event community, by means of nets and screened buildings, the numbers of schools for older children might be to keep mosquitoes from access to all malaria patients materially reduced. So long as the present conditions and carriers for a season or two, there is, according to remain the teachers must urge the provision of more our present knowledge, good reason for supposing that ambulances, more school meals, and a freer general fresh infections would cease to occur in that locality, education, for the cripple child can rarely attain to and that the mosquito, in the absence of fresh importa- equality with his normal fellow at the central or trade tions of parasite carriers, though still a nuisance, would schools, and vocational education may be overdcne wit hout an adequate basis behind it. Some of the speakers become no more dangerous than the common midge.
mosquitoes infected are
.
held that,
DEFINITION AND CARE OF MENTAL DEFECT.
as scholarships and maintenance grants largely given in ordinary schools, maintenance grants should be given in the P.D. schools to cover the were
SEVERAL topics of general interest came under con- period of full-time instruction from 14-16, when the sideration at the joint conference of the Central normal child might be earning while in attendance at Association for the Care of the Mentally Defective a continuation school. The feelings, first, of dependon the part of the child, and, secondly, of irritaand the National Union of Special Schools Teachers held at the Church House, Westminster, on Nov. 25th- tion on that of the parent at having to support a child 27th. A discussion on the relation of special schools he feels should be adding to the family exchequer, are both to health and education. to certified institutions for defectives showed the difficulties in the path of adequate collaboration between the education and the control committees of THE WOMEN’S SERVICE BUREAU. local authorities. Some of these difficulties lie in the WE are not infrequently asked at this office to recomdefinitions and drafting of the Acts. The Education Acts provide for the education of children who, while mend literary assistants of various scope and for differing mentally defective, are neither dull and backward on duties, though knowledge of medical phraseology is We recommend to those in need of the one hand, nor imbecile on the other, making no always needed. attempt to define these terms. The Mental Deficiency this kind of help application to the Women’s Service Act, on the other hand, defines an imbecile as one who Bureau. The bureau, it may be remembered, was is incapable of managing himself or his affairs, or, in opened in the first week of the war, and has been the the case of a child, cannot be taught so to do. It was means of training, advising, and placing some thousands pointed out that there are many who can be taught and of women in suitable work. The war has passed, but can make definite progress in school subjects who never the need for such an agency remains, and experience acquire this amount of wisdom, so that on the com- since the armistice shows that both employers and pletion of their school career they might rightfully be applicants appreciate the value of the bureau no less in called imbeciles; but if so were they, although capable of times of peace than in times of war. From the records deriving benefit in a special school, rightfully or legally of work done it can be gathered that 10,000 employers admitted thereto? On this some coordination between have been approached since the bureau was started in the Board of Control and the Board of Education is 1914, and many administrative and other positions, such essential, although, as all children are educable within as correspondence and confidential clerks and secrelimits, it might be still easier to let the whole care of taries, receptionists, laboratory assistants, foreign correchildren under 16 rest with education authorities alone. spondents, stenographers, telephone operators, draughtsIn a discussion on the place of the medical officer, the women, fitters, welders, examiners and setters up, psychologist,, and the teacher, it was generally agreed charge hands, bench and machine workers, have been that while the teacher’s opinion should have great filled to the mutual satisfaction of both employer and weight, and the observations of a lay psychologist when applicant. The applicants have numbered some 60,000.
ence
prejudical
menisci " and " hederiform bodies " each
examiner must always retain an open mind. The medical record card system of the Ministry of Pensions is an attempt to safeguard the interests of the pensioner,and to economise the time of medical officers, and in so far as it does this it merits the active interest and participation of the consultant staffs.of hospitals.
but collected into groups in certain
EXTRA-RETINAL VISION. THERE is nothing inherently impossible in the conception of a race of human pigmies 5 or 6 inches high such as Swift imagined when he wrote the story of Gulliver’s journey to Lilliput, or of a race of giants such as the inhabitants of Brobdingnag. Neither is there anything inherently absurd in the conception of a human being in possession of other organs of vision besides his two eyes, or indeed of having these extra-visual organs scattered over the entire surface of his body. When, however, we read a book1 which purports to prove that such is the fact we naturally regard it as a jeu d’ esprit conceived in the same spirit as that which inspired the author of "Gulliver’s Travels " 200 years ago. Mons. Louis Farigoule, a supernumerary professor of the University of Paris, complains that modern physiology lags far behind the discoveries of minute anatomy. Microscopical structures are known, he says, but their functions are only guessed at, and, so far, the assistance which modern psychology might bring to their interpretation has been ignored. Starting from phenomena observed in subjects in a state of somnambulism, he observes that certain of these subjects, when blindfolded, behave as if they ’, perceived objects, persons,-even written characters. if Psychologically, the somnambulist is in a condition of consciousness different from that associated with ordinary life, but analogous to that with which the modern scientific world is more or less familiar as the result of hypnotic suggestion. Mons. Farigoule therefore hypnotised a subject and, having blindfolded him, ’, suggested that he could still see the title of a news- ’, paper. The result was successful, but the subject ’, became so fatigued that he refused to have any more experiments made on him. Nevertheless, five other I subjects were obtained-the first-comers, and in no way selected as being easily suggestible, and as the result of five series of experiments conducted on them the results obtained in the first case were confirmed and amplified. The next step was for Mons. Farigoule to experiment on himself. By dint of great efforts and at the cost of considerable exercise of patience he at length succeeded in eliciting the same phenomena subjectively that he had previously found objectively in his hypnotised subjects. Having elicited them he was able to analyse and describe them in a far more exact manner than had been possible in the case of experiments in other people. The obvious criticism on all this is that either the whole thing is a romance, or else the author is the subject of self-suggestion and is unconsciously deceiving not only his readers but himself. The book is addressed not to the public but to the scientific world, and its plausibility is greatly increased by the explanations of the phenomena
I
’I
suggested. There
are,
as
is
well
known, many different
varieties Pacinian
of
of vision.
The author goes further and
nerve-endings in the skin such as corpuscles, end-bulbs, &c., all of which have been minutely described by anatomists. In recent times modern methods of histology have disclosed yet others-namely, a certain form of nerve-endingin the superficial layer of the dermis between the papillae, which Ranvier compared to the branching of ivy and called " hederiform " bodies, and another form which has been described as occurring in the epidermis of the pig’s snout-microscopic expansions interposed between the cells and termed " menisci." The argument is that it is an unwarrantable assumption that all these various forms of nerve-ending have to do with the sense of touch, and that it is just as likely that some of them are connected with the sense 1 La
pictures these
Vision Extra-rétinienne et le Sens Paroptique. By Louis Farigoule. Paris : Office of the Nouvelle Revue Française.
as a micro-
scopic " ocellus," and each complete in itself with E6 refracting body, an ocellary retina, and a nerve fibre, parts
of the
body,
each group constituting something very much like A compound eye. The visual impulses so originated are conveyed to the central nervous system in a way similar to visual impulses from the eye, but whether they reach the occipital lobe or are arrested on some lower level of the central nervous system,,is apparently as yet not determined. Why, then, does not the ordinary person see when he is blindfolded, and why do we not all of us have a faculty not only of diplopia but of multiple vision? The suggested answer to these questions ia on psychological grounds, and an analogy is made with the well-known phenomenon of the suppression of the image in a squinting eye. The whole thesis is worked out with considerable skill, and we can commend the book to our readers, if on no other grounds, as an If taken interesting psvcho-physiological puzzle. seriously it would open a way for the blind to see, by the education of what the author professes to believe is a latent faculty, and he tells us that he has already had some success in this connexion and means to, accomplish more. It is in the interests of the blind that we would point out that to raise hopes in them which are doomed to disappointment is anything but a. kindness. ___
TANK EXHAUSTION. ACCORDING to Dr. L. R. Broster,formerly D.A.D.M.S. Tank Corps, tank exhaustion is a familiar syndrome. After running for from three to six hours in a closed tank, the crews apparently suffer from the want of ventilation, combined with excessive heat, dryness, and the presence of CO; they develop headache,. giddiness, dyspnoea, palpitation and vomiting, mental confusion, and sometimes unconsciousness. The atmosphere within the tank becomes very hot and dry; readings of 120° dry, and 860 wet bulb are quoted. Naturally the men’s temperature also rises; observations of A little carbon 100’4° and 100-5° F. are recorded. monoxide is found in the air of tanks, also petrol fumes. Fans are supplied and used, but openings are necessarily small to keep out bullets and splinters. Unless the tank be directly hit by shell, the wounds of crews are usually slight, but in action, with all openings closed, exhaustion comes on early, and after Dr. a day’s fighting the men require two days’ rest. Broster suggests that a tank might act as a protected advanced dressing station; one was used at Cambrai to bring back 16 wounded, and a tank ambulance to carry six stretchers was under construction when the armistice was signed. -
QUININE AND THE PREVENTION OF MALARIA. THE value of quinine as a prophylactic against malaria is a subject on which there has always been considerable divergence of opinion among experts, nor have the experiences of the late war led to any definite conclusions, since the difficulties and inconveniences of the systematic routine administration of quinine to every healthy member of a large body of troops were found to be such that the method, of uncertain benefit, was largely abandoned in favour of other more feasible measures of protection. Much confusion has arisen from the failure to distinguish between the essentially different problems of the protection of the healthy individual from malaria, and the control of relapses in those who have become infected with the disease. Quinine is of established value in diminishing the number and severity of relapses, if taken in adequate quantity and over a long period, although, unfortunately, it seldom leads to complete cure in the sense that no further relapses occur on discontinuance of the treatment. On the other hand. the belief is widespread among those who reside in districts where malaria is rife that quinine C1.n be relied on as affording adequate protection against the ill-effects of bites by 1
Journal of the Royal Army Medical Corps, October, 1920.
1157 with malaria parasites. These available should be welcome, nevertheless the onus of in most vulnerable to their the final opinion should rest with the medical officer, quinine parasites youngest forms, and it is probable that a dose of quinine who should have had a proper training in psychological taken every evening shortly before the period of medicine. Several speakers regarded the most suitable mosquito activity may, for a time, be effective in role for the psychologist to be the devising and destroying recently introduced sporozoites. The drug standardising of tests and of methods of investigation or is, however, rapidly excreted, and, in the absence of a education. Teachers’ representatives seemed to desire mosquito net, a second dose will be required in the course a statutory right to sign certificates of defect conjointly of the night if protection is to be maintained throughout with the medical officer, apparently overlooking their the danger period. During the later phases of their growth existing powers, under the Education Act of 1914, of within the red corpuscles, the parasites are both more reporting at the request of parent or of the local resistant and better protected from the effects of authority. In some cases teachers omit details from quinine. If taken in less frequent doses or at irregular the forms at present in use, and do not take advantage intervals, quinine is ineffective for prophylactic of opportunities of being present when children from purposes and is, moreover, harmful, in that it may their schools are examined ; if they did so they might induce a sense of security which, in fact, is non- find little cause for complaint. existent. It is evident that such a routine, difficult and Reviewing the advantages of institutions of different irksome to the individual, is well-nigh impossible in sizes, Dr. A. Rotherham, medical commissioner to the dealing with a large community, whether of troops or Board of Control, showed the great, possibilities of civilians, and more particularly so under conditions of classified recreation and variety of occupation secured, active service, and it was a wise judgment that led the while Miss Pierce pleaded for the individual care, more authorities in the latter stages of the war to give up homely life and closer personal interest in the small the futile attempt to prevent malaria by 10 gr. doses of home. Miss Dendy showed that if the institution quinine once or twice a week, and to concentrate on consisted of blocks of separate houses or villas the useful features of either type could be conserved and more effective measures, such as the details of the proper protection of individuals by means of nets, combined without limits in size. One speaker thought combined with an energetic campaign against mosquitoes that with the restriction of hours of work now in and their breeding-places in the neighbourhood of force a staff of 17 would be required for a home for 12-25 inmates, but that the proportion became camps. ’l’l1B;Jre are two aspects of malaria prevention the im- more reasonable with larger numbers. Emphasis portance of which is often overlooked: (1) The part was laid on the necessity for varied occupation played in prevention by the efficient treatment of and opportunities for real moral education and moral malaria patients, whereby the supply of parasites is choice in institutions of all types, whether State controlled at its source; this is probably the role in institutions, certified institutions, certified houses, which quinine, viewed as a Drotective agent, attains or approved homes. The final meeting on the its highest value. (2) The adequate isolation of malaria future of education for physically defective children patients by the use of nets, thereby protecting showed a unanimous desire for early ascertainment mosquitoes from infection. If it were possible in any and treatment, and a hope that in such an event community, by means of nets and screened buildings, the numbers of schools for older children might be to keep mosquitoes from access to all malaria patients materially reduced. So long as the present conditions and carriers for a season or two, there is, according to remain the teachers must urge the provision of more our present knowledge, good reason for supposing that ambulances, more school meals, and a freer general fresh infections would cease to occur in that locality, education, for the cripple child can rarely attain to and that the mosquito, in the absence of fresh importa- equality with his normal fellow at the central or trade tions of parasite carriers, though still a nuisance, would schools, and vocational education may be overdcne wit hout an adequate basis behind it. Some of the speakers become no more dangerous than the common midge.
mosquitoes infected are
.
held that,
DEFINITION AND CARE OF MENTAL DEFECT.
as scholarships and maintenance grants largely given in ordinary schools, maintenance grants should be given in the P.D. schools to cover the were
SEVERAL topics of general interest came under con- period of full-time instruction from 14-16, when the sideration at the joint conference of the Central normal child might be earning while in attendance at Association for the Care of the Mentally Defective a continuation school. The feelings, first, of dependon the part of the child, and, secondly, of irritaand the National Union of Special Schools Teachers held at the Church House, Westminster, on Nov. 25th- tion on that of the parent at having to support a child 27th. A discussion on the relation of special schools he feels should be adding to the family exchequer, are both to health and education. to certified institutions for defectives showed the difficulties in the path of adequate collaboration between the education and the control committees of THE WOMEN’S SERVICE BUREAU. local authorities. Some of these difficulties lie in the WE are not infrequently asked at this office to recomdefinitions and drafting of the Acts. The Education Acts provide for the education of children who, while mend literary assistants of various scope and for differing mentally defective, are neither dull and backward on duties, though knowledge of medical phraseology is We recommend to those in need of the one hand, nor imbecile on the other, making no always needed. attempt to define these terms. The Mental Deficiency this kind of help application to the Women’s Service Act, on the other hand, defines an imbecile as one who Bureau. The bureau, it may be remembered, was is incapable of managing himself or his affairs, or, in opened in the first week of the war, and has been the the case of a child, cannot be taught so to do. It was means of training, advising, and placing some thousands pointed out that there are many who can be taught and of women in suitable work. The war has passed, but can make definite progress in school subjects who never the need for such an agency remains, and experience acquire this amount of wisdom, so that on the com- since the armistice shows that both employers and pletion of their school career they might rightfully be applicants appreciate the value of the bureau no less in called imbeciles; but if so were they, although capable of times of peace than in times of war. From the records deriving benefit in a special school, rightfully or legally of work done it can be gathered that 10,000 employers admitted thereto? On this some coordination between have been approached since the bureau was started in the Board of Control and the Board of Education is 1914, and many administrative and other positions, such essential, although, as all children are educable within as correspondence and confidential clerks and secrelimits, it might be still easier to let the whole care of taries, receptionists, laboratory assistants, foreign correchildren under 16 rest with education authorities alone. spondents, stenographers, telephone operators, draughtsIn a discussion on the place of the medical officer, the women, fitters, welders, examiners and setters up, psychologist,, and the teacher, it was generally agreed charge hands, bench and machine workers, have been that while the teacher’s opinion should have great filled to the mutual satisfaction of both employer and weight, and the observations of a lay psychologist when applicant. The applicants have numbered some 60,000.
ence
prejudical