THE JOURNAL OF MENTAL^STTENC®' [Published by Authority of the Royal Medico-Psychological Association] SUPPLEMENT

SEPTEMBER, 1961

THE ROYAL MEDICO-PSYCHOLOGICAL ASSOCIATION

SPRING QUARTERLY MEETING

THE SPRING QUARTERLY MEETING of the Association was held on Wednesday, 3 May, 1961, at Horton Road and Coney Hill Hospitals, Gloucester, under the Presidency of Dr. Alexander Walk.

Morning Session at Coney Hill Hospital

MINUTES The President stated that there had been some delay in the printing of the Minutes in the Supplement to the Journal of Mental Science, and as they had not been circulated confirmation of the Minutes was held over until the next meeting.

OBITUARY The President announced with regret the death of the following members: GJESSING, R., Lorn, Norway; a Corresponding Member since 1938. GLAISTER, JOHN NORMAN, late Physician to the British Hospital for Nervous and Mental Disorders; an Ordinary Member since 1939. MAYER-GROSS, WILLIAM, Department of Experimental Psychiatry, University of Birmingham and formerly Professor of Psychiatry in the University of Heidelberg; an Ordinary Member since 1939, an Honorary Member since 1960. HARRISON, GEOFFREY J., Physician-Superintendent, Winwick Hospital, Warrington, Lancashire; an Ordinary Member since 1930. LADY JEFFERSON, High Bank, Didsbury, Manchester; an Ordinary Member since 1938. SMITH, GEORGE WILLIAM, Wyke House, Isleworth; Treasurer, 1931-46; an Ordinary Member since 1905; an Honorary Member since 1944.

ELECTION OF ORDINARY MEMBERS The following were unanimously elected to Ordinary Membership: ASUNI, TOLANI, M.A., M.D., D.P.M., Medical Officer, Government of Western Nigeria, Neuropsychiatric Centre, Aro Hospital, Abeokuta. Proposed by Drs. T. A. Lambo, P. D. Scott, J. P. Dewsbery. ÎLIOPOULOS, CONSTANTINT, M.D.(Athens), Psychiatrist, Saskatchewan Hospital, Wey burn, Saskatchewan, Canada. Proposed by Drs. H. Osmond, A. B. Monro, G. A. Ives.

IRWIN, EDNA MARGARET, M.D., M.R.C.P.E., Tutor/Registrar, Queen's University, Department of Mental Health, Belfast City Hospital. Proposed by Drs. J. G. Gibson, W. F. McAuley, R. J. Mcllwaine.

KERNOHAN, GEORGE ANDREW, M.B., B.Ch., B.A.O., M.R.C.P.I., D.P.H., D.P.M., Senior Registrar, Londonderry and Gransha Hospital, Northern Ireland. Proposed by Drs. A. S. Clenaghan, D. J. C. Dawson, T. R. Haire.

MCCLURE, DAVID JOSEPH, M.B., B.Ch., B.A.O., D.P.M., Senior House Officer, Purdysburn Hospital, Belfast. Proposed by Drs. C. B. Robinson, W. A. Norris, E. S. Lamont.

MOFFATT, WILLIAM RAYMOND, M.B., B.Ch., B.A.O., D.P.M., Senior Medical Officer, Eastern Special Care, Muckamore Abbey, Antrim, Northern Ireland. Proposed by Drs. W. A. Norris, B. G. Scally, T. W. H. Weir.

PROCTOR, OSWALD H., M.B., B.Ch., B.A.O., D.R.C.O.G., D.P.M., Medical Officer in Psychiatry, Purdysburn Hospital, Belfast. Proposed by Drs. W. A. Norris, E. S. Lamont, C. B. Robinson.

ROBERTS, ALBERT GEORGE, B.Sc., M.D., Chief of Male Admission Service, Connecticut State Hospital, Middletown; Associate Psychiatrist, Elmcrest Manor, Portland, Connecticut, U.S.A. Proposed by Drs. F. E. Pilkington, A. B. Monro, A. Walk.

SHAMSIE, SYED JALAL, B.Sc., M.B., B.S., Resident in Psychiatry, Verdun Protestant Hospital, Montreal, Canada. Proposed by Drs. C. P. McAree, J. S. Werry, K. A. Handcock.

ELECTION OF ASSOCIATE MEMBER The following was unanimously elected to Associate Membership. Candidature approved by Council 15 February, 1961. HETHERINGTON, RALPH RAILTON, B.Sc., Ph.D., F.B.Ps.S., Principal Clinical Psychologist, United Liverpool Hospitals; Lecturer in Clinical Psychology, University of Liverpool.

REPORT OF COUNCIL PROCEEDINGS The General Secretary reported that Council had met at 2.15 p.m. on the previous day at Horton Road Hospital. Arising from the Minutes the question of the International Conference for Psychotherapy in 1964 was discussed. The Psychotherapy and Social Psychiatry Section indicated that they supported the idea of the R.M.P.A., giving support to the holding of this Congress to be held in London in 1964. Council felt that further enquiries were necessary regarding finance and details of organization before a definite decision could be reached. The Editor-in-Chief reported that it was proposed to issue the papers read at the Conference on Hallucinogenic Drugs as a monograph. The Education Committee reported that a small editorial Sub-Committee had been set up to proceed with all possible speed in the preparation of a new edition of the Red Handbook. The question of providing refresher courses for G.P.s on 3 psychiatric topics was discussed, and it was decided that this matter should only be pursued after obtaining the views of the College of General Practitioners. The Papers and Discussions Committee reported that the programme of speakers for the July meeting was arranged and that the morning session of the November meeting would include a discussion of the Ministry of Health's recent report on the results of leucotomy. There was a discussion on the advisability of inviting members of the press to attend meetings of the Association. It was decided that this practice should start at the July meeting in Belfast, unless there were any objections from speakers or from organizations acting as hosts to the Association. The Special Committee considering the future of organized psychiatry sub- mitted a Report consisting of two memoranda, relating to the possibility of either forming a College of Psychiatry, or a Faculty of the Royal College of Physicians, or of the R.M.P.A., taking on some of the functions of a College. After discussion Council decided to circulate these memoranda to all members of the R.M.P.A. as soon as possible, emphasizing that it was most important to know the views of all members, and asking members to use any influence they might have to prevent hasty action by any organized body. Council also decided that the Ministry should be written to about the staffing position in Hospitals for the Subnormal, with a strong recommendation that the number of Consultants should be increased.

PAPERS The following Papers were read: "Gloucester and the Beginnings of the R.M.P.A." By Dr. Alexander Walk (in collaboration with Dr. D. Lindsay Walker) (See Journal, July, 1961, p. 603.)

"Psychogenic Psychosis" By Dr. Paul Faergemann, Psychiatric Department, Aarhus University, Risskov, Denmark.

Afternoon Session at Coney Hill Hospital

Papers on "Problems of Isolation and Sensory Deprivation" were read by Drs. J. P. Dewsbery and R. Beech.

SEMINARS The Seminars held on Tuesday, 2 May, dealt with the relationship between Psychiatry, the Law, and the Public, under the Mental Health Act. The speakers included Dr. Patrick G. McGrath, Physician Superintendent, Broadmoor Hospital; Dr. M. A. B. Fenton, Senior Medical Officer, Prison Medical Service; Dr. K. M. Tomlinson, J.P., General Practitioner; a representative of the legal profession; Dr. G. F. Bramley, Medical Officer of Health, Gloucestershire; Dr. George B. Matthews, General Practitioner; Mr. Kenneth Robinson, M.P., and Baroness Wootton of Abinger.

HOSPITALITY Before the Meeting commenced, on Monday evening, Messrs. Harvey's of Bristol invited members to a tasting of German wines. On Wednesday, members and their wives were the guests of the Hospital Management Committee at a most enjoyable luncheon. In the evening the Mayor and Corporation of the City of Gloucester invited members and their wives to a Ball at the Guildhall. 4 During the evening the Mayor welcomed the Association in a short speech. The President in his reply referred to the importance of Gloucester and Gloucestershire in the history of British psychiatry; the work of Sir George Paul in the early 19th century; the foundation of the R.M.P.A.; the prominent part taken in its affairs by Gloucester members, such as Drs. Needham, Greig Soutar and Fleming; and the progress made in recent years at Horton Road and Coney Hill Hospitals and in the organization of psychiatric services in Gloucestershire. A proof of Gloucester's enlightened attitude was that it was the only city that proudly included an account of its mental hospitals in its official guide-book. On Tuesday, at the invitation of the Committee of Doctors' Wives, the ladies went on a very enjoyable coach tour of the Cotswolds, being entertained to lunch and tea en route. On Wednesday morning, after coffee, there was a most interesting conducted tour of Gloucester Cathedral.

SOUTH-EASTERN DIVISION THE AUTUMN DIVISIONAL MEETING was held at Shenley Hospital, near St. Albans, Herts, on Wednesday, 5 October, 1960. by kind invitation of the Hospital Management Committee and Dr. O. W. S. Fitzgerald, Physician Superintendent. Members of the Association were received by Dr. Fitzgerald and his medical colleagues, and parties shown round the Hospital. Visits were made to the wards and the various departments of the hospital. Of particular interest were the work- shops which had been largely built with the aid of patient labour. The large gathering at lunch included over 60 members of the Association and nursing and auxiliary members of the staff of the hospital. The Chairman of the Hospital Management Committee, Mr. Charles Knifton, J.P., extended a cordial welcome to the visitors. The Divisional Chairman, Dr. Fitzgerald, responded on behalf of the Division. The Secretary gave the report on the Meeting of the Divisional Committee of Management held that morning, and the resolutions respecting nomination to the Regional Boards were confirmed by the meeting. The following were elected to Ordinary Membership: BERGIN, JOHN THOMAS, M.B., B.Ch., D.P.M., Senior Registrar, Broadmoor Hospital, Crowthorne, Berkshire. Proposed by Drs. B. A. O'Conngll, P. G. McGrath, J. L. F. Maine. BOURNE, STANFORD, M.B., M.R.C.P., D.P.M., Senior Registrar, Shenley Hospital, nr. St. Albans, Hertfordshire. Proposed by Drs. S. T. Hayward, O. W. S. Fitzgerald, D. Bardon. GRAZ, HERTA, M.D.(Prague), D.P.M., Consultant Psychiatrist, Portman Clinic; Medical Director, Battersea Child Guidance Clinic. Proposed by Drs. Susannah Davidson, D. Rumney, L. H. Rubenstein. LIMENTANI, AMEDIO, M.D.(Rome), D.P.M., D.T.M.&H., Consultant Psychiatrist, Italian Hospital: Psychotherapist, St. Bartholomew's Hospital. Proposed by Drs. A. Shapiro, Louis Rose, S. H. Lucas. LOMAS, PETER ERIC SAMUEL, M.B., Ch.B., Flat A, 89 Redington Road, Hampstead, N.W.3. Proposed by Drs. T. F. Main, A. Brook, M. Rosenthall. MAJOLIER, CHLOE. M.B., B.S., Senior House Officer, Shenley Hospital nr. St. Albans, Hertfordshire. Proposed by Drs. P. D. W. Shepherd, L. Hurst, Yolande I. M. Glaser. NUGENT, STEPHEN MICHAEL, M.B., B.Ch., D.P.M., Psychiatric Registrar, Holloway Sanatorium, Virginia Water, Surrey. Proposed by Drs. R. Macdonald, C. R. Harris, M. R. Medhurst.

OKASHA, AHMED MAHMOND FAHMY, M.B., B.Ch.(Cairo), Clinical Assistant, Bethlem Hospital, Beckenham, Kent. Proposed by Drs. R. F. Hobson, W. Dorreil, B. Davies.

RICH, ELIZABETH MARGARET, M.B., Ch.B.(N.Z.), Senior House Officer, Shen- iey Hospital, nr. St. Albans, Hertfordshire. Proposed by Drs. B. M. C. Gilsenan, David Duncan, L. Hurst.

SHAW, JEREMY FRANCIS, M.B., Ch.B., Senior House Officer, Shenley Hospi- tal, nr. St. Albans, Hertfordshire. Proposed by Drs. S. T. Hayward, B. M. C. Gilsenan, David Duncan.

SWIFT, NANCY IRIS, B.A., B.Sc., M.B., B.S., D.P.M., First Assistant, Depart- ment of Psychological Medicine, Royal Free Hospital Group. Proposed by Drs. Portia Holman, A. Elithorn, Felix Brown.

WHATMORE, PETER BANKS, LL.B., M.B., B.S., M.R.C.S., L.R.C.P., Registrar, Maudsley Hospital, Denmark Hill, S.E.5. Proposed by Drs. S. I. Cohen, A. A. Black, W. P. K. Calwell.

WINN, PAULINE IMOGEN MARGARET M.B., Ch.B., D.P.M., Junior Medical Officer, Brookwood Hospital, Knaphill, Woking, Surréy. Proposed by Drs. Leonard Barber, John Garai, D. C. Dewar. The following Papers were read by members of the staff of Shenley Hospital; "Problems of Passivity in Hospital" By Dr. D. Duncan. "Observations on a Unit for Mothers and Babies in Shenley Hospital'4 By Dr. Yolande Glaser,

The papers were received with considerable interest and the following took part in the discussion: Drs. Fitzgerald, Baker, Barton, Bierer, Beccle, Taylor, Crowcroft and Moylett. Dr. Beccle proposed a vote of thanks to the Physician Superintendent öf Shenley Hospital and his Management Committee for their hospitality.

THE SPRING DIVISIONAL MEETING was held at South Ockendon Hospital, Essex, on Wednesday, 26 April, 1961, by kind permission of the Hospital Management Committee and Dr. B. Matheson, Physician Superintendent. Members of the Association were received by Dr. Matheson and his medical colleagues, and parties were shown round the Hospital. Visits were made to the wards and various departments of the Hospital. Excellent guides and plans were provided for the visitors. The Hospital, opened in 1932 to serve West Ham and East Ham, had at that time only three villas. Six further villas, a Recreation Hall, Administrative Block, Nurses' Home, O.T. Departments, central Kitchen, Laundry, Artisan Work- shops and Staff Houses were completed by 1939. Further extensions since then have been the Gloucester Clinic (38 beds) with departments for Pathology, Physiotherapy, Dentistry and Minor Surgery; staff houses, and a new "School" for severely sub- normal children. Visitors were particularly invited to visit the Gloucester Clinic, the School, the modern type wards—Cedars Villa and Briars or Redmays Villa. A Club 6 Premises for Staff (funds generously provided by the King Edward Hospital Fund) is nearing completion and further developments are contemplated in extensions to the School, a unit for disturbed, psychotic adolescents, facilities for spastic patients, an indoor playground and a church. In the Annexe of the Gloucester Clinic a small number of interesting cases were presented, including gargoylism, naevoid amentia, phenylpyruvic amentia, hyper- telorism and arachnodactyly. The Chairman of the South Ockendon Group Hospital Management Committee, Mr. A. L. A. Seaman, in welcoming the visitors at lunch, said that Dr. Matheson and he were very proud of their Hospital, and he hoped that they would see something to stimulate their interest and perhaps add to their knowledge. Dr. O. W. S. Fitzgerald in reply said that he was impressed with the spirit of the hospital staff and their high standard of skill. He agreed that there was much for the visitor to learn from a visit to South Ockendon Hospital and he was sure this meeting would prove one of the most successful ones we had had. MEETING The Minutes of the last Divisional Meeting held at Shenley Hospital on 5 October, 1960, were accepted and confirmed. Apologies for absence were received from Drs. A. A. Baker, D. H. Clarke, J. Gould, W. A. H. Stevenson and J. Ainslie. The Secretary gave the report on the Meeting of the Divisional Committee of Management held that morning. In accordance with the By-laws the Division elected the following officers: Chairman: Dr. O. W. S. Fitzgerald. Secretary: Dr. S. W. Hardwick. Assistant Secretary: Dr. A. J. Oldham. Junior Representative in Council: Dr. Rosalind Bearcroft. In accordance with the By-laws the following were elected to the Divisional Committee of Management in replacement of retiring members: Dr. G. Somerville. Dr. E. W. Shepherd. Dr. T. P. Rees. Dr. B. Cates. Dr. D. V. Martin. Dr. A. W. Watt. The following were elected to Ordinary Membership of the Association: BAVIN, JACK THOMAS RAINSFORD, B.Sc., M.B., B.S., Senior Registrar in Psychiatry, Leavesden and Cell Barnes Hospitals. Proposed by Drs. A. Shapiro, D. H. H. Thomas, J. N. Badham.

BIER, WALTER JULIUS, M.D., Psychiatrist, Child Guidance Clinic, 37 Heath Hurst Road, N.W.3. Proposed by Drs. J. Bierer, E. K. Ledermann, L. M. Henry.

BERSTOCK, REVA LEAH, B.A., M.B., B.Ch. B.A.O., Psychiatric Registrar, West London and Fulham Hospitals. Proposed by Drs. G. A. Dransfield, J. L. Swift, A. Walk.

CARLISH, SIDNEY, M.B., Ch.B., Registrar, Maudsley Hospital. Proposed by Drs. M. J. Raymond, P. L. G. Gallwey, J. A. Gumbfell.

CHAZAN, LISBETH SUSANNE, M.B., B.S., Registrar, St. Francis and Lady Chichester Group of Hospitals. Proposed by Drs. J. S. Stead, Isabel M. Crotty, R. H. Wheeler.

COLLINS, DAPHNE CLAIRE, M.B., B.S., D.P.M., Senior Psychiatric Registrar, The London Hospital. Proposed by Drs. M. Whalen, H. R. Rollin, J. H. Watkin. 7

CRAGGS, DAVID FREDERICK, M.B., B.S., D.P.M., Senior Psychiatric Registrar, St. Clement's Hospital, Bow. Proposed by Drs. A. B. Monro, R. A. Parry, J. S. Harris.

DOBBIE, JOHN ALASTAIR, M.B., B.S., D.P.M., Junior Medical Officer, Tooting Bee Hospital. Proposed by Drs. G. B. Barker, T. H. Bewley, R. D. Watson.

FIDLER, RACHEL DOMONEY, M.R.C.S., L.R.C.P., D.P.H., Senior Medical Officer, Mental Health Department, Middlesex County Council. Proposed by Drs. A. Shapiro, D. H. H. Thomas, J. N. Badham.

FIELD, LEOPOLD HENRY, M.B., B.S., M.R.C.P.E., D.P.M., Consultant Psychiatrist, Metropolitan Hospital, S.E. Essex Group of Hospitals, and H.M. Prisons. Proposed by Drs. F. Brown, R. W. Crocket, A. B. Monro.

FRANCIS, ANNIE, M.B., Ch.B., Part-time Psychotherapist, 10 Makepeace Avenue, Highgate, N.6. Proposed by Drs. R. F. Barbour, P. L. Backus, A. Walk.

GLANCY, LUKE J., M.B., B.Ch., B.A.O., D.P.M., Senior Registrar, St. John's Hospital, Stone, near Aylesbury, Bucks. Proposed by Drs. R. Emery, I. Shribman, M. L. Honigsberger.

GREENBERG, ROBERT CECIL, M.B., B.S., D.P.H., Senior Medical Officer, Mental Health Service, Middlesex County Council. Proposed by Drs. A. Shapiro, D. H. H. Thomas, J. N. Badham.

LIANANTONAKIS, EMANUEL, B.M.(Athens>, Clinical Assistant, Maudsley Hospital. Proposed by Drs. K. Cameron, W. H. Gillespie, W. Warren.

LIGHTBODY, MARY, M.B., B.Ch., B.A.O., D.P.H., Registrar, St. Francis Hospital, Haywards Heath. Proposed by Drs. D. W. Liddell, A. Folkson, R. H. Wheeler.

LINKEN, ARNOLD, M.B., B.Ch., Physician, Student Health Association, University College, W.C.I. Proposed by C. J. Lucas, A. B. Monro, A. Walk.

MAI, FRANÇOIS MARIE MARTIN, M.B., Ch.B., Registrar, Belmont Hospital. Proposed by Drs. W. Sargant, A. S. Thorley, C. M. Stewart.

PANDAY, DAMODAR, M.B., B.S., Medical Officer, St. Lawrence's Hospital, Caterham. Proposed by Drs. J. Gibson, B. W. Richards, A. Walk.

PARKES, COLIN MURRAY, M.B., B.S., D.P.M., Member of Scientific Staff, Medical Research Council Social Psychiatry Unit, Maudsley Hospital. Proposed by Drs. J. K. Wing, A. A. Black, W. O. McCormick.

SOMASUNDARAM, OTTILINGAM, M.B., B.S., D.P.M., Psychiatrist, Government Mental Hospital, Madras, India (at present on a Colombo Plan Fellowship in United Kingdom), 9 Canadian Avenue, S.E.6. Proposed by Drs. W. T. Wales, J. Lister, P. H. Griffiths. 8 TARSH, MICHAEL JUSTIN, M.A., B.M., B.Ch., Registrar, Long Grove Hospital, Epsom. Proposed by Drs. A. B. Monro, J. Denham, L. J. Clein. WEIR, JOHN GORDON, M.A., M.B., Ch.B., D.P.M., Senior Registrar, St. Mary's Hospital, Paddington, W.2. Proposed by Drs. J. D. W. Pearce, D. Blair, R. F. Hobson. WESTON, JOSEPH WHITTINGTON, M.R.C.S., L.R.C.P., L.M.S.S.A., D.T.M., Junior Medical Officer, Severalls Hospital, Colchester. Proposed by Drs. Russell Barton, A. Walk, J. Llewellyn Jones. The Secretary referred to future meetings of the Division, stating that the Autumn meeting would be with the Darenth and Stone Group. The Secretary referred to a letter he had received from Dr. G. C. Heller, in which he wished included in the agenda the following: "That the R.M.P.A., recommend to the Regional Boards to grant expenses for those members who participate actively at Psychiatric Congresses; this to include a Congress for Psychotherapy." In the discussion which followed, Dr. Heller explained that he had been asked to read a paper at the International Congress of Psychotherapy to be held in Vienna. Dr. Gibson pointed out that the attitude of the Regional Boards seemed to vary. So far as he could ascertain there were two classes concerned—those who sat on a committee or were reading a paper, and those who did not. The former were likely to receive financial support, and the latter not. Dr. Shapiro, who also spoke, raised the question as to the entitlement of Registrars. No formal resolution was passed, but it was agreed that the Secretary write to Dr. Monro, so that the matter could be raised at the next Quarterly Meeting. The following papers were then read: 1.- "The Incidence of Temporal Lobe Epilepsy among a Hospital Population of Subnormal and Severely Subnormal Patients and Preliminary Findings from Autopsy Evidence" By Dr. J. H. Margerison and Dr. J. A. N. Corsellis. 2. "The Growth and Development of the Mongol" By Dr. G. Dutton. A short discussion followed in which several members took part,

NORTHERN AND MIDLAND DIVISION THE AUTUMN DIVISIONAL MEETING was held at Queen's Park Hospital, Black- burn, on Tuesday 18 October, 1960, by kind invitation of the Hospital Management Committee and of Dr. M. Silverman, Consultant in Psychological Medicine. After touring the Unit, which consists of 99 beds, the members sat down to an excellent luncheon to which they were welcomed by the Chairman of the Hospital Management Committee, Mr. Woolley. The Divisional Chairman, Dr. Cuthbert, thanked the hosts for their hospitality. Thirty-six members were present and apologies were received from eight members. The Divisional Committee of Management reported that they had met on the previous evening. Dr. Barton Hall had offered hospitality at his Department at the University of Liverpool on Saturday 15 April, for the Spring Meeting, 1961. ^

9 The Secretary gave details of what had transpired since the motion of the Spring Divisional Meeting of the División held at Shelton on 7 April, 1960, namely: — (i) that it should be formally put before Council that the size of all Divisions be re-considered with a view to splitting them into smaller groups, thus giving readier access, particularly of júnior hospital staff, to Association Meetings, and (íí) that an endeavour should be made to make the meetings more attractive scientitically, and (/ií) that the future policy should be to contact all members of the División, professorial Departments and medical staff committees of mental hospi- tals and psychiatric units, inviting them to submit to the Divisional Committee of Management suggestions for suitable papers or suitable clinical material for discussion. The Secretary had placed the above proposals before Council and as a result Council had set up a special Committee consisting of the Sénior officers together with the Divisional Chairman and Secretarles. The Committee had put the follow- ing proposals before Council: (i) to divide the Northern and Midland División using the Pennines as a rough dividing line. 07) to keep the two sub-divisions informed of each other's meetings (it was felt that this could best be done by circular letter enclosed with informa- tion already circulated about the Quarterly Meetings). (Í'I'I) these suggestions should be taken to the next Divisional Meeting of the Northern and Midland División for further discussion. If acceptable, detailed consideration should be given to the exact boundaries of the two Divisions. It was further pointed out that several centres had rtow formed their own local Psychiatric Associations and therefore rather than increase the number of Divisional Meetings of the R.M.P.A., it would be preferable to arrange such meetings to give the máximum time possible to the presentation of papers of high standard. These recommendations received Council approval, but Council pointed out that in view of the discussions which were at present taking place regarding the possibility of the creation of a College of Psychiatry and the revisión of the by- laws, the whole question of Divisional boundaries and activities might have to be re-examined. Council asked that the Divisional Secretary should report the present situation back to his Committee of Management. The meeting accepted the Committee of Management's recommendation to leave matters in abeyance for the time being.

REPORT OF DIVISIONAL REPRESENTATIVE ON COUNCIL The Secretary read extracts from the minutes of the meeting of Council held at Chandos Street on 10 February, 1960. and from the Annual Report of Council, June, 1959 to May, 1960.

ELECTION OF MEMBERS The following candidates were elected to Ordinary Membership of the Association: OAKLEY, DAVID VINCENT. M.B.. Ch.B., Registrar. Rainhill Hospital, Rain- hill, nr. Liverpool. Proposed by Drs. G. P. Walsh, I. R Nussbaum, G. Elizabeth McNair. 10 DILLON, JOHN BLAKE. M.B., B.Ch., Clinical Assistant, Mapperley Hospital, Nottingham. Proposed by Drs. Duncan Macmillan, H. Fisher, W. Fabisch. KERRY, RAPHAEL JAMES, M.R.C.S., L.R.C.P., D.P.M., Senior Registrar, United Sheffield Hospitals. Proposed by Prof. E. Stengel, Drs. W. Tonge, F. A. Jenner. LEVENE, LESLIE JOSEPH, M.B., B.S., Registrar in Child Psychiatry, Booth Hall Children's Hospital, Manchester. Proposed by Drs. T. R. Malloy, J. H. Kahn, A. Walk. MATTHEWS, VALERIE, B.Sc., M.B., B.Ch., D.P.M., Senior Registrar, St. Luke's Hospital, Middlesbrough. Proposed by Drs. T. M. Cuthbert, J. Russell, Eileen Atkinson. ROSE, JOHN THOMAS, M.B., Ch.B., D.P.M., Senior Registrar in Psychiatry, St. James's Hospital, Leeds. Proposed by Drs. M. R. Leahy, D. G. Brown, J. C. Little. Dr. Pentreath, speaking as a member of the Films Sub-Committee, reported that he had contacted all the Medical Superintendents in the Sheffield region and they were all interested in the idea of Package Programmes, and asked which of those members present at the Divisional Meeting were in favour of such pro- grammes. A show of hands proved that 90 per cent, favoured this suggestion. Considerable discussion took place with reference to the Journal of Mental Science, and certain criticisms were expressed as to the general policy, but the feeling was also expressed that any change might lower the standard of the Journal; it was finally agreed to place an item on the agenda of a future Quarterly Meeting. PAPERS "A Comprehensive Department of Psychological Medicine" was described by Dr. M. Silverman. This was an interesting account of the well-planned Queen's Park Hospital unit of 99 beds, which in its first three months of full operation was already coping with 89 per cent, of the total of psychiatric illness in its catch- ment area of 254,000 population. Dr. Silverman stressed the absence of patient selection and examined staffing and organizational problems. "Brain Tumours Masquerading as Psychiatric Problems", by Mr. G. K. Tutton, F.R.S.C., Consultant Neurosurgeon at Preston and Chorley, Blackburn, Burnley. Blackpool and Fylde, Lancaster and Kendal Hospitals Groups, was a thought- provoking paper in which Mr. Tutton grouped the presentation of these patients under five main heads: (1) Terms of reference at fault. (2) Epilepsy with behaviour disorder. (3) Memory loss and dementia due to arterio venous malformation. (4) Dysphasia. (5) Tumour involving directly or by pressure the hypothalamus or midbrain. Instructive case-records illustrated by slides were presentated and there was a brief but stimulating discussion.

SCOTTISH DIVISION THE SPRING MEETING of the Scottish Division was held on Friday, 24 March. 1961. at Bangour Village Hospital, near Edinburgh. 11 Sixty-four members were present,, including the President of the Association, Dr. Alexander Walk. Professor Millar, Divisional Chairman, welcomed Dr. Walk to the Division, and to mark the occasion presented him with a book which had been donated by Dr. Angus MacNiven. He invited Dr. Walk to take the Chair, in accordance with the By-Laws. Dr. Walk thanked Professor Millar for his kind words. He recalled past meetings of the Association in Scotland, particularly the first of these visits, which took place in 1858 under the Presidency of the illustrious John Conolly. He then handed the Chair over to Professor Millar. The Chairman referred to the passing of their late Honorary Member, Dr. W. Mayer-Gross, and the Division expressed its sympathy in the usual manner. The Chairman welcomed Professor G. M. Carstairs to his first Divisional Meeting since taking up his appointment in Edinburgh, The minutes of the last Meeting were confirmed. The following were elected to Ordinary Membership: COWAN, LAURENCE HIERSCHEL, M.B., Ch.B., Clinical Assistant, Lansdowne Clinic, Glasgow. Proposed by Drs. T. Freeman, J. M. Davie, D. Gilmour. FRAME, ARCHIBALD HAMILTON, M.B., Ch.B., D.Obst.R.C.O.G., Senior House Officer, Department of Psychological Medicine, Southern General Hospital, Glasgow. Proposed by Drs. G. C. Timbury, W. B. Spry, A. McQuaid. HENDERSON, ALEXANDER SCOTT, M.B., Ch.B., Senior House Officer, Rös$ Clinic, Cornhill Road, Aberdeen. Proposed by Professor W. M. Millar, Drs. J. G. Henderson, A* K. C. Sinclair-Gieben. MACKAY, KENNETH JAMES, M.B., Ch.B., D.R.C.O.G., Registrar, Royal Edin- burgh Hospital for Mental and Nervous Disorders. Proposed by Drs. J. W. Affleck, J. K. Binns, A. Stevenson. MACLEOD, ERIC CAMPBELL, M.B., Ch.B., D.P.M., Registrar, Glasgow Royal Mental Hospital. Proposed by Drs. Angus MacNiven, W. L. Flanagan, M. Vallance. MAXWELL, KATHERINE NEIL, M.B., Ch.B., Registrar in Psychiatry, Glasgow Royal Mental Hospital. Proposed by Drs. Angus MacNiven, J. F. Rober'tsoii, W. L. Flanagan. MOFFAT, JOHN, M.B., Ch.B., Registrar in Psychiatry, Southern General Hospital, Glasgow. Proposed by Drs. H. I. Chapham, I. M. Ingram, G. C. Timbury.

ELECTION OF OFFICE BEARERS The following were elected for the ensuing year : CHAIRMAN : Professor T. Ferguson Rodger. HON. DIVISIONAL SECRETARY: Dr. M. M. Whittet. ASSISTANT HON. DIVISIONAL SECRETARIES : Dr. A. C. Tait. Dr. A. K. M. Macrae. JUNIOR REPRESENTATIVE ON COUNCIL : Dr. J. Harper. 12 COMMITTEE OF MANAGEMENT : Professor W. M. Millar, Dr. T. A. Munro, Dr. A. P. Russell, Dr. K. R. H. Wardrop, Dr. Angus MacNiven, Dr. E. J. C. Hewitt, Dr. J. Owens. ELECTION OF OFFICE BEARERS FOR SECTIONS The following were elected for the ensuing year: Chairman, Forensic Psychiatry Section: Dr. P. K. McCowan. Secretary, Forensic Psychiatry Section: Dr. H. Stalker. Chairman, Papers and Discussions Section: Professor T. Ferguson Rodger. Secretary, Papers and Discussions Section: Dr. I. R. C. Batchelor. Chairman, Research and Clinical Section: X. Secretary, Research and Clinical Section: Dr. J. F. McHarg. Chairman, Child Psychiatry Section: Dr. F. H. Stone. Secretary, Child Psychiatry Section: Dr. J. D. Haldane. Chairman, Mental Deficiency Section: Dr. J. R. Bailey. Secretary, Mental Deficiency Section: Dr. H. S. Ross. Report from Committee of Management. It was reported that in the fore- noon the Sections had met. Dr. A. L. Goodall read a Paper on the "Health and Personality of King James VI" to the History Sub-Section, and Dr. G. C. Timbury read a Paper on "The Psychiatric Aspects of Thyroid Disease" to the Research and Clinical Sub-Section. These Papers were stimulating and enjoyable. It was mentioned that a possible Training Scheme for nurses in Mental Defi- ciency would be the subject of a Memorandum for the Mental Deficiency Section. The Chairman, Professor Millar, referred to the proceedings of the Associa- tion's Committee on the possible formation of a College of Psychiatry and mentioned the various tentative proposals. The Division felt, however, that they should not express a definite opinion at this stage until the advantages and disad- vantages were presented to them in a more detailed way and a longer time was given for consideration. The next Meeting was fixed for June at a place and date to be arranged later. Dr. Angus MacNiven raised the point that the Committee of Management Meeting might be held earlier in the day and it was agreed to consider this matter further, as also his further suggestion that there should be a levy from Members of the Scottish Division to facilitate travelling to Meetings in London for representatives of the Division. Dr. Betty E. A. Magill read an interesting Paper on "The Work of the Adolescent Unit in Bangour Hospital" which was very well received. All the Members who were present will wish to record their appreciation to Dr. Macrae and his staff, as well as his Board of Management for the excellent arrangements and the generous hospitality the Division received on the occasion of this meeting.

IRISH DIVISION THE AUTUMN QUARTERLY MEETING of the Irish Division was held on Wed- nesday, 16 November, 1960, at the I.M.A. House, 10 Fitzwilliam Place, Dublin. Twenty-three members and five visitors were present. Dr. O'Higgins took the Chair. The Minutes of the previous Meeting were read and signed. Dr. Bowers, who is training in Psychiatry in Canada, read a paper on "The Psychiatric Approach to Criminology" which was discussed by Drs. O'Higgins and McLoughlin. 13 The Criminal Justice Bill was discusseci by Dr. Glass and Dr. O'Connor, and Professor Dunne's written comments were read to the Meeting. The following candidate was elected : WHITELEY, ROGER WILLIAM, M.D., D.P.M., Consultant Psychiatrist, St. Luke's Hospital, Armagh, N. Ireland. Proposed by Drs. J. A. S. Mulligan, A. S. Clenaghan, Mary Sullivan. Lt was decided to put the new Syllabus for Nurses on the Agenda for the next Meeting.

THE SPRING MEETING of the Irish Division was held on 8 May, 1961, at Verville Retreat, Clontarf, Dublin, on the kind invitation of Dr. Mary Sullivan. Forty-one members were present, including the President of the Association, Dr. Alexander Walk, and there were also five guests. In the morning a Golf Compétition for the Boileau and Boyd Cup was held at the Sutton Golf Club, and this was won by Dr. J. D. Sullivan. Members were most hospitably entertained to lunch by Dr. Mary Sullivan. TheChairman of the Division, Dr. O'Higgins, proposed a vote of thanks, which was seconded by Dr. A. Walk. In accordance with the By-Laws, Dr. Walk was invited to take the Chair at the meeting. Dr. Walk conveyed tò the meeting the fraterna! gfeetings of thè Divisions in Great Britain, and his interest in the subject to be discussed that afternoon. He then handed over the Chaii to Dr. O'Higgins. Dr. S. D. McGrath read an interesting paper on "The Ganser Syndrome". Ganser's original description in 1897 had not been bettered since. The incidence of the syndrome was not easy to ascertain. Ganser himself reportêd òn twenty cases between 1897 and 1902. Few cases were noted until 1941, when several weré described in men trying to escape military service. Dr. McGrath discussed the relationship of the syndrome to simulation and to psychosis. He described a case he had himself investigated—the Symptoms followed head injury in a labourér aged 28. He gave détails of his investigation and findings, particularly of the results of psychological testing at difficult stages of the illness. The paper was discussed by Professor Dunne and Drs. Robinson, McEvoy; Crotty, Eustace, McKenna and McCollum. A discussion on the new Mental Nursing syllabus of the Irish Nursing Council was opened by Dr. B. M. Ramsay, who explained how the syllabus was based on the recommendations published by W.H.O. in 1956 The syllabus was criticized by Dr. O'Higgins and Dr. O'Brien, and was supported by Professor Dunne. Dr. Walk described the circumstances which had led to the introduction of the 1957 "experimental" syllabus of the English General Nursing Council, with the full support of the R.M.P.A. The syllabus had been devised. as one specially adapted to the needs of the mental nurse and not tied to the syllabus in general nursing. The first year course had deliberately been kept on an elementary level. The syllabus had been well received and the first results were encouraging. Drs. Shea, Moran and Hegarty also spoke. Further considération was given to the Minister of Health's withdrawal of members' privilèges. It was agreed, on the motion of Professor Dunne, seconded by Dr. Hegarty, that the Minister should be asked to receive a Deputation from the Division. After the meeting, members were further entertained to tea at Verville Retreat, and in the evening dined together at the Gresham Hotel.- 14 THE FUNCTIONS OF THE MEDICAL DIRECTOR OF A CHILD PSYCHIATRY (CHILD GUIDANCE) CLINIC Circulars on Child Guidance were issued by the Ministries of Health and Education (Circulars H.M. (59) 23, 3/59 and 347) in March, 1959 (1). Observations on these circulars while still in draft form had been invited from the Royal Medico- Psychological Association (2) and were submitted to the appropriate authorities. The R.M.PA. does not wish to comment again in detail on these circulars, but it is noted that Circular 347 states as its object the laying of a sound basis for the present organization of the Child Psychiatry (Guidance) Service and for the planning of future developments as and when this becomes possible. This being so, it is noted that it is now laid down that the clinic "will be under the medical direction of the psychiatrist". In order to be of help in the re-organization of present child psychiatric (guidance) clinics and in the planning of future clinics, it is considered that it would be helpful to define the functions of the medical director of a clinic. This memorandum therefore, sets out to examine these functions and to make suggestions that will enable them to be put into practice. It is in no way intended to be fully comprehensive but merely to indicate in a structured way, the general and particular responsibilities of the Medical Director. It is appreciated that where a clinic is linked with a School Psychological Service, the Educational Psychologist, even if attached to the Clinic for some duties, will have separate responsibilities in connection with activities outside the clinical field. The duties of the Medical Director of a Child Psychiatry (Guidance) Clinic may be considered under five main headings: 1. Clinical; 2. Administrative; 3. Liaison; 4. Teaching; 5. Regional. 1. Clinical Duties These include clinical responsibility for every patient referred to the clinic in the same way that a patient referred to a medical clinic or out-patient department of a hospital in any other branch of medicine is the responsibility of the doctor in charge; the primary duty of any clinician being his responsibility for his patient, both for diagnostic assessment and for treatment. Thus the child psychiatrist, who is Medical Director of the clinic, bears ultimate clinical responsibility in the fields of assessment, diagnosis and treatment of the patient in his family setting. This applies although he is working with his professional colleagues (psychologist, psychiatric social worker, play therapist, etc.). It is essential therefore, for all referrals to the clinic to be made to the Medical Director, who also bears the responsibility for assessing the urgency of referrals and arranging priorities on the waiting list. The Medical Director, although bearing the ultimate responsibility, will need to confer closely with his professional colleagues in the clinic, to discuss and collate relevant data from them in order to make his diagnosis, and so that treatment under his general direction can be carried out. It will be his particular task to arrange, either directly or through the appropriate channels, for special investigations where indicated (pathological, X-rays, EEGs, audiometry, psychological tests, etc.) the results of which need interpretation in the context of the physical, emotional and psycho- logical state of the patient and his family. It will also be his responsibility to write a report to the referring agent under his own name, as is done by all other medical specialists. He will be responsible for the nature and duration of treatment of the child and of the family as a whole, whether this is undertaken personally or delegated to colleagues in the clinic. He remains responsible for prescription of drugs or other special medical treatment, where indicated, either personally or through other medical channels. The Medical Director, at the same time, needs to maintain good staff relationships with other professional colleagues and other personnel working in the clinic. The efficiency of treatment will depend largely upon harmonious work between all con- cerned, whatever their special duties. Thus it is important that he shall have the 15 opportunity to advise the appropriate committee which appoint personnel of all grades to the clinic, by invitation to sit on the appointment committee. 2. Administrative Duties The administrative duties of the Medicai Director will include overall responsibility for : 1. The Organization of the work of the clinic so that each worker is utilized effectively. 2. Ensuring the provision of adequate diagnostic and therapeutic equipment and facilities. 3. General supervision of the clérical and secretarial staff and of office procédures; the Organization and design of records; general allocation of work; and for the main- tenance of the secrecy of clinic records. 3. Liaison It is the responsibility of the Medicai Director to ensure that liaison is maintained with the wide range of officiai bodies and their officers, who have contact with the clinic, since effective solution of the Problems presented by a particular child will so often depend upon their co-operation or that of others in the field of child health and éducation. It is necessary for the clinic to have good relationships with them so that there is mutuai understanding of their respective functions and of the work being done at the clinic. These relationships are a function of the whole clinic team and, for example, the Psychologist has particular professional links with the Educational field and the Psychiatric Social Worker with other organizations in the field of social work. In more detail the organizations and individuals concerned include Hospitals and their Officers and Committees; the staff of Local Authority Departments, such as the Health, Education and Children's Departments. Medicai Staff in other specialties and, in particular, Paediatric and Adult Psychiatric Departments; General Practitioners individually and through représentative committees and societies; Juvenile Courts and Probation Officers; Schools—ordinary and special—Teachers and Teacher Organizations. Contacts will also need to be fostered with those who look after children in Nurseries, Children's Homes, Hostels, Clubs, etc. It is especially important that there should be continuous psychiatrie contact with residential schools where children are placed on psychiatrie recommendations. In addition, there are a large number of voluntary organizations working independently or together with officiai bodies in this field of child and family care. These include, amongst others, the National Society for the Prévention of Cruelty ta Children, Physically Handicapped Children's Association, Marriage Guidance Councils, National Council for Social Service. It is also considered important that opportunities should be given for the Medicai Director to attend clinical sessions in association with colleagues in Paediatrics and in Adult Psychiatric Units. Finally, it is important to maintain liaison with other Child Psychiatry (Guidance) Clinics in the adjacent areas. 4. Teaching and Prévention The study and teaching of general principles of normal and abnormal develop- ment of the child is an important function of the clinic. The Medicai Director and his colleagues, apart from taking part in teaching and research programmes and clinical instruction of medicai and other professional staff in the clinic, may be required to assist in training programmes for nurses, teachers, probation officers, child care officers, health visitors, etc. The teaching of mental health principles to the public can be covered by addresses to parent-teacher associations or other voluntary bodies concerned with child and family health. When the clinic is a University Teaching Unit, undergraduate and post-graduate students may attend for their training. 16 5. Regional Duties In the case of clinics directly under the Regional Hospital Board, there is usually access to the Board through appropriate committees, such as the Hospital Manage- ment Committee or Psychiatric Advisory Committee or Medical Staff Committee. It is recommended that in the case of Joint or Local Authority Clinics comparable arrangements should be made by representation on appropriate planning, advisory or administrative committees. In clinics where there is more than one consultant psychiatrist the role of Medical Director will be modified in that each consultant will carry his own clinical responsibilities for his patients.

The above analysis of the duties of the Medical Director is founded upon the knowledge gained during the past twenty-five years and which has led to the full realization that genetic, physical, family and school factors require full investigation if a worthwhile diagnostic assessment of the child is to be secured and suitable treatment is to be planned and implemented. For this reason, also, it is important that a child psychiatrist has, not only a sound training in internal medicine, but also in adult psychiatry, in addition to the special problems of the psychiatrically disturbed child and adolescent, as has been stressed in the R.M.P.A. Memoranda on the Training and Recruitment of the Child Psychiatrist (3), (4).'

BIBLIOGRAPHY 1. Circulars H.M. (59) 23, 3/59 and 347. 2. Memorandum on "Observations on the Draft Circulars of the Ministry of Health and the Ministry of Education on Child Guidance". 3. Memorandum on the "Recruitment and Training of the Child Psychiatrist", Royal Medico-Psychological Association. 4. Memorandum on the "Training Facilities for Consultant Status in Child Psychiatry", Royal Medico-Psychological Association. May, 1961

THE WORLD PSYCHIATRIC ASSOCIATION An international society for the Organization of World Congresses of Psychiatry has been in existence since the First World Congress was held in PARIS in 1950. Now at the Third World Psychiatric Congress held in MONTREAL in June, 1961, it was decided to change this Organization into a WORLD PSYCHIATRIC ASSOCIATION. This was a unanimous décision of the 40 delegates of the various countries attending. The newly formed WORLD PSYCHIATRIC ASSOCIATION is to have wider scoped functions than the Society it replaces. The first special General Assembly will be held in GENEVA in 1962 and its headquarters are to be centred there. The following were elected the first officers of the Association: President D. E. CAMERON (Canada) Vice-President F. G. BRACELAND (U.S.A.) General Secretary H. EY (France) Assistant Secretarles W. SARGANT (Great Britain) J. J. LOPEZ IBOR (Spain) Treasurer P. SIVADON (France) There was also an international Committee formed of 25 Members from the participating countries. Signed: H. EY, General Secretai 17 NOTICES BY THE HONORARY LIBRARIAN The Library is open to members between the hours of 9 a.m. and 5 p.m., Saturdays, 9 a.m. and 12 noon. Books are issued to borrowers during these hours. The Hon. Librarian will endeavour to obtain, as far as possible, any books on psychiatry and allied subjects required by members.

Library Lending Department Regulations 1. Books shall be lent to members within the United Kingdom and Eire who are not in arrears with their subscriptions. 2. No member may borrow from the Library more than three volumes at one time. 3. Books and journals are sent carriage paid from the Library, but members are responsible for the books from the time they leave the Library until they are received back, and for the return postage. 4. Books damaged or lost while in possession of a member will be repaired at his expense or must be replaced by him. 5. A member shall be entitled to retain a book or periodical borrowed from the Library for a period of twenty-eight days (or longer by special arrangement), unless the book is required by another member, in which case it can be recalled by the Librarian at the expiration of fourteen days. 6. In the event of a member failing to return any book or periodical within seven days after receiving notice from the Librarian (on the expiration of thé period referred to in Rule 5), the Library Committee shall be at liberty to purchase another copy, the cost to be charged to such member, who shall not be allowed to borrow another book until the sum thus expended shall have been paid. 7. All communications should be addressed to "The Librarian, Royal Medico- Psychological Association, 11 Chandos Street, Cavendish Square, W.l." Circulation of Journals The following Journals are available at the Library: American Journal of Mental Deficiency. American Journal of Orthopsychiatry. American Journal of Psychiatry. Annales Medico-Psychologiques. Archives of Neurology and Psychiatry. Brain. British Journal of Addiction. British Journal of Delinquency. British Journal of Medical Psychology. British Journal of Psychiatric Social Work. Bulletin of the Menninger Clinic. Digest of Neurology and Psychiatry. L'Evolution Psychiatrique. Excerpta Medica, Neurology and Psychiatry. Hospital and Social Services Journal. Howard Journal. International Journal on Alcohol and Alcoholism. International Journal of Psycho-Analysis. International Journal of Social Psychiatry: journal of Analytical Psychology, 18 Journal of Child Psychology and Psychiatry. Journal of Mental Deficiency Research. Journal of Mental Subnormality. Journal of Mental Science. Journal of Neurology, Neurosurgery and Psychiatry. Journal of Nervous and Mental Disease. Journal of Psychology. Journal of Psychosomatic Research. Mental Health. Mental Hygiene. Psychiatric Quarterly. Psychological Abstracts. Scientific Film Review. World Mental Health.

THE ASSOCIATION'S MEDALS AND PRIZES, 1961-62 Attention is specially drawn to the Medals and Prizes which are offered annually by the Association: The conditions of award are set out fully in the Year-Book. Bronze Medal and Prize Dissertations for the Association's Bronze Medal and Prize should be for-; warded to reach the Registrar not later than 30 April. Divisional Prizes Papers certified as eligible for this competition must be forwarded to reaçh the Registrar not later than 30 April. Gaskell Medal and Prize The examination for the Gaskell Medal and Prize is held in May. An entrance fee of £3 3s. is charged, returnable to bona-fide candidates. Entrance fees are due by 31 March.

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