TREATMENT OF WHOOPING-COUGH

520 siderable amount of evidence from anthropology, history, TREATMENT OF WHOOPING-COUGH and psycho-analysis which relates the desire to exercise SIR,—Whooping-cough in infancy is a serious disease power to mental abnormality, or at least to personality becomes particularly grave when bronchowhich deviation. Dr. West himself has already drawn attention pneumonia supervenes. The following case may be of to the singular convenience of political office as a platinterest. for form the " unconscious play-actor from childhood." A premature baby, born at the 7th month, had been reared While it is possible to classify primitive societies into on diluted cow’s milk since the age of 3 months ; at 2 months power-centred and life-centred types, the first aggressive she-had had bronchopneumonia. and repressive, the second largely cooperative and social, When 7 months old she contracted whooping-cough. She in larger cultures like our own it is more accurate to speak was first seen after 10 days-of severe coughing, frequently of power-centred and life-centred individuals. Centralised culminating in vomiting ; weight 5’9 kg. When seen 12 authority selects the former, and tends to exemplify the days later, the baby was gravely ill, cyanosed, dyspnoeic, syndrome of " cruelty, chastity, and coercion " which temp. 39°C ; rhonchi and crepitations (mostly crackling at the bases) all over chest. She had just had a 4-day course has been identified in aggressive primitive societies. penicillin without benefit. Many writers, from William Godwin to Riewald,5 have of sulphadimidine and Chloramphenicol was started with one capsule of 250 mg. drawn attention to the role of political office under modern 6-hourly. On the evening of the 2nd day the temperature conditions as an outlet for psychopathy, but a culture to fall by lysis ; the next day it was normal and it began which possesses the political background of Western remained so. The cough became infrequent and loose, and Europe does not take very readily to such a conception. vomiting abated. Unfortunately the mother ran short of the At a time when the crimes imposed by governments drug after 2 days’ administration (2 g. in all) ; but by the time the drug was resumed after a break of 2 days the baby and those committed individuals, manifestly eclipse by the orthodox notions of the function of coercion in main- was making steady progress. Chloramphenicol in the same dosage was continued for 3 further days ; and 12 days later taining sociality have been seriously undermined by the chest was clear and the weight was once more 5’9 kg. innumerable studies of the non-coercive management of In an investigation now in progress two further cases delinquents, it is distressing to find Dr. West still ready to accept the traditional concepts of the function of (one in a 9-month-old baby, the other in a rachitic baby of 2 years and 9 months) of bronchopneumonia complipower at their face value. This whole argument throws a very different light on cating whooping-cough and developing 17 and 19 days, the issue of world government. The idea of such a governrespectively, after the onset of cough have been treated withAureomycin’ with equally good results ; in neither ment is part of the tradition of the State as guarantor of the exercise of coercion-a construct case were penicillin, sulphonamides, or sedatives used. which, rights by in the light of recent work, it seems very difficult to mainIn view of the difficulty experienced by Dr. Gray tain. In any politically likely form, such a world authority (Lancet, Jan. 28, p. 150) in administering the drug to would be recruited, as is UNO, from members of existing young babies, I might add that the following method of ruling groups-in other words, from a panel where the preparation has been found satisfactory : aureomycin selection of deviants and power-centred individuals had ’4 g., liquid extract of liquorice 5 ml., gum acacia 10 ml., already once taken place. Office in such a body’would syrup q.s., and water 160 ml. Pædiatric Section, offer little incentive beyond that of still wider and still M. A. ABBOUD King Fuad the 1st University, less responsible authority, and there seems no reason Physician. Cairo. for the view that those who already show themselves dangerously delinquent in their present limited scope Public Health would become less so if it were to be made universal. The conception of power as the force which renders us social is defunct upon every evidential consideration, Influenza and there is nothing to be gained by propping it into IN the 126 great towns of England and Wales the a sitting posture. While sociological action against false following pneumonia cases and deaths and influenza deaths have been recorded : ways of group thought, on the lines of the Tensions Proj ect, is an urgent need, there comes a point at which the duty of psychiatry lies in a direct appeal to the sociality of the individual. What we need today is not more government but more responsible and rational disobedience. The individual in his capacity of citizen is the tool whereby the psychopath in office realises his psychopathy. The redirection of aggression from the external, stereotype enemy against this process itself (not against the ruler as another stereotype, as in many of the actionist ideologies of revolution) is a rational therapeutic measure. If it is true that wars originate in the minds of men, it is equally true that they will cease when individuals decline to follow their leaders into war. Fromm has already pointed to the incentive mechanism upon which this may take place, in the growth of spontaneity and security in family life. The activities of power-groups present the main barrier today to any such realisation, and a show-down between authority and psychiatry, at least as violent as that which is taking shape in penology, seems inevitable. In the course of it, we may find it necessary to question the political assumptions of our civilisation, and of the whole conception of It is learned from the Public Health Laboratory power, far more radically than Dr. West has so far been reports that virus B has been isolated from a few odd ready to urge. cases in widely scattered areas-e.g., Doncaster, London, ALEX COMFORT. London, S.E.23. Exeter, Inverness, and Ipswich. The following cities had the largest numbers of noti5. Riewald, P. Society and its Criminals. 1949. fications of pneumonia for the week ended Feb. 25: 6. Fromm, E. The Fear of Freedom. 1948.