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Subscriptions may be sent to Messrs. Holt and Co., 3, Whitehall-place, and marked" R.A.M.C. War Memorial Correspondence. Fund." I am, Sir, yours faithfully, T. H. J. C. GOODWIN, " Audi alteram partem." April, 1919. Lieutenant-General, D G. A.M.S.

A WAR MEMORIAL TO THE OFFICERS AND WAR NEUROSES: MEN OF THE R.A.M.C. THE DISCUSSION AT THE SPECIAL CLINICAL MEETING To the Editor of THE LANCET. OF THE BRITISH MEDICAL ASSOCIATION. Si R, -Very many officers and men, past and present, of all To the Editor of THE LANCET. branches of the have recently SIR,-I have read in your issue of to-day the report of expressed the view that a memorial should be erected to the British Medical Association discussion on war neuroses. those officers and men of all branches of the Corps who have I was present at the meeting, and regret that so brief an fallen in this war. These number 560 officers, 4091 other account of Dr. Gordon Holmes’s contribution is given. He ranks. A committee composed as follows was formed for the not only stated that he had been impressed by the purpose of considering the matter :- failures of the psycho-analysts and hypnotists," but also a Chairman.-Lieutenant-General Sir Alfred Keogh, G.C.B., good deal more. Dr. Holmes is, of course, entitled to his G.C.V.O., C.H., M.D., F.R.C.P. opinion that the disappointing results of treatment in this Vice-chairman.-Lieutenant-General Sir John Goodwin, department were due to " medical officers who were not K.C.B., C.M.G., D.S.O., K.H.S. nerve he mean and A. R. D.S.O. specialists [did organic neurologists ?], Secretary.-Captain Wright, who were with the measures so Regular Army.-Lieutenant-General Sir Arthur Sloggett, unacquainted successfully K.C.B., K.C.M.G., K.C.V.O., K.H.S., Lieutenant-General employed before the war." Presumably he is not alone in Sir Launcelotte Gubbins, K.C.B., M.V.O., -General this belief. But when Dr. Holmes refers to commercialism, S. Macdonald, C.B., C.IM.G., K.H.P., Major-General Sir and in the terms that he actually used, he carries the H. R. Whitehead, K.C.B., Major-General Sir W. G. discussion beyond the limits of scientific debate. Macpherson, K.C.M.G., C.B., C. R. Tyrrell, C.B., It is now conceded that the treatment of the 0. L. generally Colonel Robinson, C.M.G., K.H.P., Brevet Colonel Sir neuroses demands an outlook. The E. St. J. A. open psychological Worthington, Knt., K.C.V.O., C.M.G., Major who would cure the number must be Maughan, D.S.O., R. E. a a physician greatest Captain Todd, sergeant-major, to deal with the emotional element in the staff-sergeant, and a private. prepared case, Territorial Force.-Major-General Sir Berkeley Moynihan, and if need be to investigate the patient’s mental life. K.C.M.G., C.B., F.R.C.S., Colonel A. D. Sharp, C.B., The discussion on war neuroses left a very different C.M.G., F.R.C.S., Lieutenant-Colonel A. M. Macmtosh, impression on the mind. One speaker described with M.B., F.R.C.S., Major E. B. Waggett, D.S.O., aud Captain modest pride the methods by which he had saved his G. T. Willan, D.S.O. from and worse." In the last A. A. patients hypnotism quarter Special Reserve.-Lieutenant-Colonel Watson, D.S.O., a Major S. G. McAllum, M.D., and Captain J. G. McCutcheon, of an hour speaker was called on who described up-to- M.B. date methods of dealing with war neuroses, but with this Temporary Commissioned Officers. -Colonel Sir T. Crisp single exception the impression left on the mind was that English, K.C.M.G., M.B., F.R.C.S., Major P. Turner, M.B., Britain has no use for psychological medicine unless it be F.R.C.S., and Captain A. R. Owst, F.R.C.S. of a very elementary type, as described by two of the Consultants.-Major-General Sir George Makins, G.C.M.G., Sir Bertrand speakers. C.B., F.R.C.S., Major-General Dawson, It seems unfortunate that our American G.C.V.O., C.B., M.D., Major-General Sir Anthony Bowlby, peculiarly K.C.M.G., K.C.V.O., C.B., F.R.C.S., Brevet-Colonel Sir friends, who are certainly ahead of us in this matter, W. Hale White, K.B.E., M.D., and Sir Norman Moore, should take away an impression that we are more back- M.D., F.R.C.P., President Royal College of Physicians. ward than is the case. Does the British Mrdical Associa- Ireland.-Colonel W. Taylor, M.B., F.R.C.S. tion include none of the staff of Maghull, which has been Scotland.-Colonel H. M. W. Gray, C.B., C.M.G., F.R.C.S., used as a training school for many months, and where and Colonel Sir H. Stiles. Rows, Hart, not to mention others, have been at work It will be seen that the committee contains representatives for ° Are William of the and years? McDougall, Rivers, Myers, Nicoll, Regular, Territorial, Special Reserve, Temporary the British Commissioned officers. Brown, T. A. Ross all outside the pale of Medical Association ?’? Or was it that no effort was made This committee has recommended :— to secure their cooperation ? Judging from the fact that 1. That a memorial or monument be erected in permanent Dr. Holmes was one of the secretaries of the meeting one if in Dublin and , with, possible, replicas Edinburgh. is inclined to surmise that a balanced and representative 2. That a fund be formed from which in aid be grants discussion was not aimed at. It was not achieved. to the families of non-commissioned certainly given officers, officers, I am, Sir, yours faithfully, and men of aU branches of the Medical Royal Army Corps London, W., April 26th, 1919. H. CRICHTON MILLER, M.D. who have fallen or been disabled in this war, or who may be in necessitous circumstances owing to the exigencies of military service. DISEASE AND CHYME INFECTION. 3. That or memorial for officers and scholarships prizes To tlte Editor of THE LANCET. men of the Royal Army Medical Corps be founded for research work. SIR,-The bulk of disease, apart from acute infections, is . Field-Marshal H.R.H. the Duke of Connaught, K G., has the consequence of the contamination by organisms of the consented to be graciously honorary chairman of the Com- food-supply of the body as represented by the contents of mittee. the stomach and small intestines. In a paper in THE LANCET, There is reason to believe that others outside the Royal Sept. 28th, 1918, I pointed out that :--- Medical are desirous of to Army Corps being permitted Just as which the skeleton of the labourer subscribe to this memorial. It is not to II every change, therefore proposed undergoes in order to accommodate itself to its surroundings, limit subscribers to officers and men who have served with tends to shorten the life of the individual, so do all the the Corps, but to accept subscriptions from individuals who changes, which the organs undergo to meet their altered may be sympathetic with the object and wish for various surroundings in association with and dependent upon reasons to take part in the project. those in the gastro-intestinal tract, tend to shorten life. Such in the are as In order to attain the objects aimed at in an adequate changes organs classified diseases. manner a considerable sum of money will be necessary. In the normal subject digestion in the stomach and small During the course of the war 17,338 officers and 179,711 intestine is effected by chemical processes, and the contents other ranks have served in or with the Corps. There is there- of these organs are sterile. The texture of every tissue in fore confidence that an amount commensurate with the needs the-. body varies according to the nature of the materials will be obtained if the project can be brought to the notice which are absorbed from the chyme, just as the skeleton, of all now serving and of those who have returned to their muscles, and ligaments alter with variations in the mechanical civil occupations, as well as to the notice of members of the relationship of the whole body to its surroundings. If the general public who may be desirous of subscribing. chyme is infected by organisms the function and structure