BOÏAL M LÜIGO-P8TCH Ü LOGICAL »88OOIATIOK LIBRARY THE BRITISH JOURNAL OF PSYCHIATRY (THE JOURNAL OF MENTAL SCIENCE)

[Published by Authority of the Royal Medico-Psychological Association]

SUPPLEMENT, JULY 1967

THE ROYAL MEDICO-PSYCHOLOGICAL ASSOCIATION

ADJOURNED ANNUAL MEETING Wednesday, 3 May, 1967

The Annual Meeting, which had again been ad- Privy Council. This sets out the conditions undei journed in February, reassembled in Liverpool under which our pétition may well be successful. the Presidency of Professor E. Stengel. The Pétition Committee is exploring the implica- In the absence of the General Secretary, Dr. W. tions of the requirements asked for by the Privy Warren, Treasurer, read the following statement: Council. The position may be clearer at the time of the July Meeting, and if this proves to be true, a fuller "As a result of prolonged and energetic negotiations, statement may be made then." an encouraging letter has been received from the The Annual Meeting was further adjourned.

SPRING QUARTERLY MEETING

THE SPRING QUARTERLY MEETING was held in Election of Ordinary Members Liverpool on 2 and 3 May, 1967, under the Presidency The following were unanimously elected to of Professor E. Stengel and by invitation of Professor Ordinary Membership: Frank Fish. BRITTEN CHARLES STEWART, M.B., B.S., Senior House Minutes Officer, Royal Edinburgh Hospital, Edinburgh 10. Proposed by Drs. A. D. Forrest, Sarah Gray, R. L. The Minutes of the Quarterly Meeting held in Cundall. London on 9 February, 1967, having been published CHRISTIE ALEXANDER BARLAS, M.B., Ch.B., M.R.C.P., in the Supplement to the Journal, were approved. Registrar in Psychiatry, Law Hospital, Carluke, Lanark- shire. Proposed by Professor T. Ferguson Rodger, Drs. H. I. Obituary Clapham, M. O'Gorman. The President announced with regret the death of DA VIES, ROY JAMES, M.B., B.Ch., D.P.M., Senior Specialist the following members: in Neuro-Psychiatry in the Royal Air Force; Officer in Charge, Child Guidance Clinic, Families Medical BAKER, Jack Pedley, Consultant Psychiatrist, Wolver- Centre, Limassol, Cyprus. hampton and District. An Ordinary Member since Proposed by Drs. P. O'Connor, R. A. Miller, R. 1957- Seidelin. EHRLICH, FREDERICK, M.B., B.S., F.R.C.S., Unit Director, GELLNER, LISE, I 719, East Bijou, Colorado Springs, Surgical and Rehabilitation Service, Psychiatric Centre, Colorado, U.S.A. An Ordinary Member since North Ryde, New South Wales, Australia. 1952. Proposed by Drs. J. M. Collins, R. Migodzinski, K. M. MACKIE, MURIEL JEAN, Fellow, Crichton Royal, Koller. JOHNS, NANCY ROSE, B.A., M.B., Ch.B., D.C.H., Registrar. Dumfries. An Ordinary Member since 1955. Department of Child Psychiatry, Royal Hospital for Sick MACKINLAY, WILLIAM WOODSIDE, Assistant Psy- Children, Glasgow. chiatrist, Woodilee Hospital, Glasgow. An Ordinary Proposed by Drs. F. H. Stone, Isabel Sutherland, Member since 1964. Cecilia Brebner. KAHANS, DANIEL, M.B., B.S., D.P.M., Assistant Psychia- Council received the report of the Special Com- trist, Netherne and Fairdene Hospitals, Coulsdon, mittee which it is hoped will in due course become the Surrey. Court of Electors. It noted that active steps were Proposed by Drs. H. E. S. Marshall, E. F. Carr, R. K. being taken to draft regulations for the proposed new Freudenberg. qualification and to work out details of the form of KERR, ARTHUR, M.B.,B.Ch., BA.O., M.R.C.P.I., D.P.M., examination. Council also noted that the Special Senior Registrar, Gransha Hospital, Londonderry, N. Ireland. Committee were concerned with the possibility that if Proposed by Drs. E. P. Jones, R. H. McGucken, T. R. Great Britain enters the Common Market it will be Haire. necessary to create a roll of approved specialists. MAXWELL, MORNA KATHLEEN CUMMINGS, M.B., B.Ch., Council appointed the President-Elect, Dr. H. V. Senior House Officer, Department of Mental Health, Dicks, and the General Secretary to keep this whole Queens University, Belfast. matter under review. Proposed by Drs. W. O. McCormick. M. T. Kennedy, Council received proposals for the Joint Meeting J. B. Walsh. of the American Psychiatric Association and the MENON, M. SARADA, M.D., M.B., B.S., D.P.M., Superin- R.M.P.A. in Boston in May, 1968, and details will be tendent, Government Mental Hospital, Madras, India. published as soon as possible. Proposed by Drs. O. Somasundaram, P. S. Chary, A. Walk. The Editor-in-Chief reported that the Special Publication Recent Developments in Schizophrenia was in SHANNON, VIOLET COURTNEY, M.B., Ch.B., D.Obst. R.C.O.G., Senior House Officer, Royal Dundee Liff an advanced state of preparation. It will be avail- Hospital, Dundee. able to members at a favourable rate. Proposed by Drs. J. F. McHarg, A. L. Rae, P. G. The Education Committee reported that prepara- Aungle. tions were in hand for the Conference on Postgraduate SIMPSON, GEORGE MEGAHY, B.Sc., M.B., Ch.B., Super- Psychiatric Education to be held in the autumn of vising Research Psychiatrist, Rockland State Hospital, 1968. Council approved, with alterations, the mem- Orangeburg, New York, U.S.A. orandum on the Medical Assistant grade. Proposed by Professor M. Hamilton, Drs. J. W. S. The Parliamentary Committee reported that it had Angus, J. G. Edwards. kept under review the whole situation regarding the SMITH, JEAN FENWICK, B.SC., M.B., Ch.B., Senior House Officer, Dingleton Hospital, Melrose, Roxburghshire. Medical Termination of Pregnancy Bill. At the end of Proposed by Drs. J. M. Todd, Maxwell Jones, M. S. the Committee Stage this Bill still embodied the Raschid. R.M.P.A.'s main recommendations. Representatives SORIN, MIGUEL, M.D., Professor of Medical Psychology, of the R.M.P.A. would shortly be meeting the proposer University of Havana School of Medicine, Cuba. of the Bill at the House of Commons. The Committee Proposed by Professor Max Hamilton, Dr. A. Walk, also reported that they had found a wide measure of Professor T. Ferguson Rodger. support for the Lord Chief Justice's suggestion made TRIMBLE, GEORGE X., MA., M.D., Medical Director, some time ago that increased use should be made of Catholic Hospitals Medical Education Foundation, admission to hospital on hospital orders with restric- Kansas City, U.S.A. Proposed by Drs. J. C. Barker, M.D. Enoch, A. Walk. tion, under Section 65 of the Mental Health Act. The Papers and Discussions Committee reported that a paper would be given at the Annual Meeting, Election of Associate Members on the morning before the Presidential Address, by The following candidates for Associate Membership, Professor Querido of Amsterdam. A full programme, having been approved by Council, were elected: with particular emphasis on psychotherapeutic sub-

MCKELLAR, THOMAS PETER HUNTLY, M.A., Ph.D., jects, had been arranged. F.B.Ps.S., Senior Lecturer in Psychology, University of Letters had been received from the B.M.A. con- Sheffield. cerning the possible control of LSD 25 and restrictions Proposed by Dr. F. A. Jenner, Professor E. Stengel, Dr. on prescription of amphetamines. Council agreed to W. L. Tonge. set up a Special Committee to keep these matters WRIGHT, BARRY FORSYTH, M.A, B.Sc., F.C.S., Psycho- under review and to recommend action if necessary. logist, Horton Hospital, Epsom, Surrey. Proposed by Drs. J. H. Watkin, H. R. Rollin, D. L. McNeill. Seminars The following Seminars were presented on Tues- Report of Council Proceedings day, 2 May, 1967. In the absence of the General Secretary, Dr. W. "The Measurement of Change in Neurotic Warren, Treasurer, read the following report: Patients." Dr. R. Kellner, Mr. B. Sheffield.

2 "Recent Advances in Psychological Testing for "Obsessional Disorder and Neurological Brain Damage." Dr. R. R. Hetherington. Illness" by Dr. L. Grimshaw. "Problems in Communication in the General "Under-inclusion: a Cognitive Characteristic Hospital." Mr. Phillip Ley. of Obsessional Disorder" by Dr. G. Reed. "Delusions of Infestation (Acarophobia)." Pro- "Patterns of Meaning in Obsessional Neur- fessor Frank Fish. oses" by Dr. I. M. Marks. "Perfection and Discrimination" by Dr. Papers H. B. G. Thomas. Wednesday, 3 May, 1967 Dr. P. Pinkerton read a paper on "Teaching by There was a Symposium on Postgraduate Tape: a Method of Postgraduate Instruction in Training in Psychiatry in which the following Psychiatry" at the meeting of the Child Psychiatry speakers participated : Section. At the meeting of the Psychotherapy and Social Professor Sir Denis Hill; Psychiatry Section Dr. Robert Kellner read a paper Dr. R. H. Cawley. entitled The discussions was opened by Dr. G. Hopkinson. "The Methology of Research in Psycho- Professor Malcolm Millar; therapy." Dr. C. P. B. Brook. Hospitality The Discussion was opened by Dr. C. Tetlow. Members were the guests of the University of Liverpool at a Reception on Tuesday, 2 May, and Section Meetings were received by Professor White, the Pro-Vice- At the meeting of the Research and Clinical Chancellor of the University, and Mrs. White. Section a Symposium on "Anankastic Disorders" The Chairman of the Liverpool Regional Hospital was held under the Chairmanship of Dr. D. W. K. Kay, Board, Sir Thomas Harley, received members at and the following papers were read : lunch on Wednesday, 3 May.

AUTUMN MEETING 18 November, 1966 DISCUSSION ON THERAPEUTIC ABORTION The opening paper was read by Sir Dugald in the past, the more maternai traits a patient had Baird, formerly Regius Professor of Obstetrics and in her personality the more likely was she to Gynaecology in the University of Aberdeen (see have feelings of guilt about the termination. Con- Journal, this issue, p. 701). versely, the more immature, hysterical or psycho- Dr. C. M. B. Pare read the following paper entitled : pathic, the more a termination left the patient un- "A Follow-up Study of Patients referred for affected. In fact mild guilt feelings were relatively Termination of Pregnancy on Psychiatrie common, though usually they only lasted a matter of Grounds". two to three weeks and very few lasted as long as six months. Between 1961 and 1965 I saw 118 patients for con- sidération of termination of pregnancy and was able Table I to follow up the majority of these personally. In 21 Patients Referred for Termination of Pregnancy cases (2 terminated, 19 refused) information had to be obtained from the relatives or G.P., and 4 patients Married Single Total (3 terminated) could not be followed up. Terminated • • 33 20 53 Of the 114 patients followed up, 53 were terminated Refused termination •• 39 22 61 on my recommendation. In 61 cases termination was Total .. 72 42 114 not advised. In both groups there were nearly twice as many married as single women (Table I). Patients Refused Termination Patients Terminated Of the 61 patients who constituted this group, only None of these 53 patients had any serious ill-effects 38 (62 per cent.) continued the pregnancy and had a from the opération. As other people have mentioned live baby; 23 (38 per cent.), had an abortion in one

2* way or another or, in 3 cases, had a premature icus four months after an illegal abortion and died delivery and/or stillbirth. Furthermore, of the ones before admission to hospital. In both these cases one who continued the pregnancy a further 9 (16 per must wonder what would have happened if termina- cent.) had the baby adopted or fostered. In other tion had taken place through the proper channels. words, less than half the patients of the group con- I wish to acknowledge the help of the obstetricians tinued their pregnancy and kept their baby. and gynaecologists who allowed me to follow up Looking at the possible reasons for these figures, their cases, and also the help of Miss P. Bartlett. social factors appear very relevant. Two-thirds of the women who were married and had a reasonably DR. ELIZABETH TYLDEN read a paper on "Abortion stable home took my advice, continued their preg- Law Reform". nancy, accepted the baby and were glad to have it. On the other hand, patients who were either single or There is a change in the official attitude to the estranged from their husbands only continued the operations used to terminate a pregnancy. Such oper- pregnancy and kept their baby in one-quarter of the ations have become more and more common, and cases (Table II). when carried out by doctors and nurses, with modern anaesthetics and adequate antibiotics, carry a lower TABLE II risk of death or permanent damage to the woman's Illustrating the Relationship between Outcome and Marital reproductive apparatus than ever before. The Status in Patients who were Refused a Termination of their stringency of past laws against abortion has been Pregnancy partly ethical but partly because termination of pregnancy by artificial means has always been a Kept Abortion or Baby hazardous affair. At Pompeii the guides show visitors Baby stillbirth adopted or the curettes and probes of Roman abortionists, fostered Total chattering about the sinfulness and decadence of a civilization which could sink to such practices. A few Stable Marriage 21 8 I 30 miles away, in the caves outside Naples, babies drag Single or out a miserable existence for a few hours, days or Estranged 8 15 8 31 months, partly because of the philosophy that repro- Total 29 23 9 61 duction must not be checked, however unplanned the society and however sparse the availability of food, shelter and cleanliness, commodities essential to I must stress that these were patients attending a the rearing of a normal child. Central London hospital, and are almost certainly But we live in a different part of the European not representative of the United Kingdom as a whole. family, we have tried to legislate particularly for the Whereas patients terminated on my advice had no needs of babies, and we have a large organization serious ill-effects, this was far from the case in those devoted to planned parenthood. It might seem sur- to whom termination was refused. Two of the 61 cases prising that we need any such organization as the can be said to have been disasters. These two women, Abortion Law Reform Society; that we have one, one married and one single, kept their babies on my however, reflects our own awareness of the short- advice and fully accepted them, but though they comings of our Family Planning and of our general were perfectly well and free from psychiatric symp- overall planning for the mother of today and the toms before the pregnancy, they developed quite adults of tomorrow during their vulnerable years. serious and relatively disabling neurotic symptoms as The fact of the matter is that marriage is an institu- a consequence of the stress of looking after the child, tion in our urban society which too often isolates and two and four years later still require regular young parents from a cohesive social group and lands support and, on occasions, admission to hospital. them with the sole responsibility for rearing children Three others, including one who had to be hospital- on their own. This is an inefficient way of catering for ized for the last four months of her pregnancy, babies, and throws too heavy a physical and emotion- suffered considerably from having a termination al burden upon parents. The 'Wider Family' of Africa, refused. the harem, the kibbutz, and the systems of Day Two other patients died. On patient had a history Nurseries as used during World War II, all offer the of depression; she relapsed after having an illegal child a wider physical and emotional security in abortion and within two months committed suicide. which the capacity to grow and develop normally is Another single woman, who had a history of mild epi- not threatened should parents fall ill, suffer an sodic asthma, had a sudden attack of status asthmat- accident, or have to nurse their own parents, or

4 should the mother have a difficult and complicated have had to wait five years for a baby. "The pill" is, pregnancy. of course, far more likely to be taken by women in Our society has, however, pushed inexorably to- the groups exposed to further education; such women wards the "little boxes" in which single families are articulate and able to express their rebellion in struggle independently to rear children, and a "little the press and have access to the legislature. box" is virtually the only place in which a woman can Unfortunately procuring an abortion is not a rear a baby; marriage providing the only social simple matter, so much so that there are many differ- institution which is recognized as making provision ences of opinion about methods and techniques. In for normal children. By definition in our society this it reflects a general law of medicine that the less children who are born outside marriage, or are efficient any part of this craft is, the greater the orphaned, or are cast to become a burden on their number of techniques offered and the more dogmatic family, are automatically labelled underprivileged, is each craftsman in the exposition of his own tech- and the special provisions made for them, whether nique. foster homes or children's homes, are of varying There are, however, certain principles which can degrees of difference from those available in the be generally accepted. (1) There is no drug, hormone "little boxes". Such children are in fact different pill or chemical which will procure an abortion with- from children brought up in a normal family. Adopt- out permanently damaging or even killing the mother. ed children are too often passed like a parcel from Either the mother is seriously damaged in getting hand to hand because of the machinery of adoption. rid of the pregnancy, or the method doesn't work. This happens in early infancy at a time when matura- (2) From the beginning of the pregnancy until the tion requires a consistent background if it is to pro- tenth week a pregnancy can be induced to abort by ceed uneventfully. The resulting disturbance may or perforating the growing ovum through the cervix by may not subside in the bonds of adoptive parents. the vaginal route. Illegal abortionists often hope that Similarly, society as such makes no provision which a strong douche will do this, a douche which damages is satisfactory for the woman whose pregnancy occurs the conceptus through the cervix would have to be in circumstances which bar her from her "little box" so violent however, as to perforate the tract in other or whose pregnancy is the last straw on an over- places and such a procedure is moreover so dirty as to burdened family. Both married and unmarried cause general infection. Owing to female anatomy women become relatively helpless for a period of any instrumental interference requires the full months, at the end of a pregnancy and the beginning cleanliness and ritual of an operating theatre, other- of the life of a baby. Tiny babies need incessant super- wise fatal infections and perforations ensue, leaving vision in a consistent environment; the mother aside a risk of sudden death peculiar to this operation; usually has the drive to provide this, but only a stable this is, however, diminished by expert anaesthesia. marriage offers an easy way for her to do it. True, the The termination of pregnancy by the vaginal route State is usually relatively generous to mothers of small requires from 2 to 3 days in hospital. Complications babies, but an allocation adequate for a new-born can prolong this for up to 10 days, but these are un- baby is rapidly outgrown, and anyhow the allow- uncommon. ances fall pitifully short of providing a standard of (3) After the tenth week many gynaecologists per- living as high as that to which a secretary, a student form an abdominal hysterotomy. This is convenient or a woman in a profession is accustomed. Added to when an older woman with a large family needs this, the stream of activity in a university or a pro- sterilization at the same time, though this is seldom fession is normally one which is smooth and well considered under the age of 30. In a young women, defined, it is not geared to an interruption of months however, as well as the risks of haemorrhage peculiar or years, and women who are in this stream face to the operation, one has to consider the fact that scars interruption and demotion. This is not merely in the abdomen and the uterus can be inconvenient financially punishing but extremely emotionally dis- and are better avoided. turbing: the sort of thing which society as a whole In Czechoslovakia, there is a method in use where- would regard as justifying a full-scale nervous break- by abortions are procured in the out-patients depart- down in a man. ment using a vacuum extractor. This method too has Babies are easily conceived, and the injudicious its risks, and English surgeons are reluctant to use it intermittent use of "the pill" in very young women until the results are better known. Out-patient abor- renders them particularly fertile, in a society in which tions were abandoned some years ago in the Soviet casual sexual contact is condoned. It is possibly for Union because they proved so dangerous to the this reason that there are now more than enough mother, and this may hold true when the results of babies for would-be adopters, who in the 50's might vacuum extraction can be analysed. 5 At the moment, to be safe, any woman has to be pleasantness for the patient, inevitably carries with it admitted to hospital for an abortion. The opération a load of fear, of guilt, and of ambivalance. Staff who has to be performed by a gynaecologist, and following are torn between their duty to the woman with an opération the patient needs skilled nursing. Owing to unwanted pregnancy and the more obviously easy many factors both trained people and hospital beds duty to prevent cancer and chronic disability can are so limited that every hospital has a waiting list for find these former patients difficult to handle. any gynaecological opération; this wait varies be- tween a couple of weeks to three years, depending on the urgency of the condition. Ail abortions have to be Dr. J. G. HOWELLS read a paper entitled: "The admitted as emergencies, displacing women on the Woman and Extended Birth Control". waiting list; early abortions occupy a bed for three days. late ones for ten days. Medicai and nursing staff "I will not be the earth to an unwanted seed", said tend to enter the profession to preserve life, and many the woman. of them not only regard abortions as taking away a By this the woman meant that she should decide human life but also bitterly resent the fact that what grows inside her body and she does not want it women having abortions are using a bed which could used against her wishes. Her body, she feels, is her be used to cure serious disease such as cancer. The own, and hers alone the right to put an end to the fact that a gynaecologist is prepared to do abortions growth in her utérus of a fertilized ovum; in the early does not guarantee that his staff agree with him, and months this is something which in her mind is as yet in every ward there are staff who disagree either amorphous. because of their religion or because life has denied Agreement with the woman amounts to the exten- them children. It is a great advance in nursing care sion of birth control into pregnancy freely given to her that nurses must take their own émotions into account as a legai right. Should her beliefs on the matter be when caring for their patients and not retreat into a accepted, it follows that législation will be successful cold professionalism. Emotions in this situation are, only if it meets these beliefs. The législation suggested however, particularly exaggerated. After abortion to date fails to do this and, however permissive, would many women are surprised at the depth and intensity ultimately lead to malpractice in the attempi by of their reaction, nurses who are reacting equally woman and doctor to contend with the real require- emotionally can find this extremely difficult to deal ments of the situation. with. But let us examine the woman's beliefs. The moral of ail this is that it is better to use efficient contraceptives than to acquire an unwanted The Control of Childbirth pregnancy. An unwanted pregnancy's safest outcome The woman's position must be assessed against the is a live baby; the mother who asks for an abortion is background of the control of childbirth. No sect of asking the doctor to make her temporarily ili—some- the Christian religion objects to démographie control. times dangerously so—by carrying out an abortion. They may disagree about methods, claiming that If the doctor is honest, he must weigh this against the some are more naturai than others, which creates severity of her mental illness should the pregnancy some philosophical difficulty, as it is not clear how continue, and the extremely remote possibility of man, a naturai phenomenon, can act in a way con- suicide. trary to his nature. At times procréation is haphazard, The present condonation of abortions is already with terrible conséquences. With increasing know- putting severe pressure on gynaecological consulta- ledge, man now strives to limit the population to a tion times, waiting lists for admission and theatre dimension that will offer the optimum conditions for time. There is a gross inequality between adjacent his welfare and happiness in the circumstances in hospitals, whether or not a woman can get an abor- which he fìnds himself. Thus, to control the number tion depends on where she lives and whether she can of children born, we destroy potential life. get to a doctor who considers this opération per- We may check potential life at many points. The missible. There is little point in changing the law refusai to have children in marriage, for instance, unless there is an increase in gynaecologists, the destroys potential life. Again, the use of the "safe psycho-social services, and the number of beds avail- period" destroys potential life. Indeed, contraception able for the patients needing them. It is inefficient to in any form destroys potential life. Yet again, nature carry out abortions at the expense of women rendered itself is wasteful of potential life, as one in three of chronically uncomfortable and socially impaired fertilized ova will never develop (i), and at least while waiting a gynaecological investigation and twelve per cent, of first pregnancies end in spontane- opération. Abortion, aside from its physical un- ous abortion.

6 Extended Birth Control states that after conception they must be grown irre- Should this control of potential life be extended spective of the feelings of wanting and of loving. into the pregnancy? The woman behaves as if it If she were aware of theological and legal matters, should. Between eighty and one hundred thousand she would know that before the 28Ü1 week the foetus, abortions (2) are induced annuaìly \yet the law permits except for the Roman Catholic Church, is not an less than three thousand in National Health Service entity that requires baptism by the English Church, or Hospitals (3). This gross disparity between the notification under the law. practice of the woman and a law which is apparently designed for her well-being, must provoke closer The Basis of Legislation examination of the origins of the motivation in the The woman, too, may know of the present unsatis- woman. factory state of the law. The Cambridge study (4) Allow me to presume to understand. And let me at showed that 90 per cent, of terminations are asked this point remind you that a woman, even a woman for on grounds of psychological distress. Yet we must who wants an abortion, does not bow to man in her know that only a few psychiatrie conditions are fondness for children. Many women having abortions worsened by pregnancy. Our response to her is the already have children. Perhaps in her intimate response to the appeal of a woman anguished at the involvement she feels more strongly about the circum- thought of an experience distasteful to her. And so stances of the birth of children than a man does. we find a medicai reason to bring her relief. The Pregnancy can come by chance and from unfore- amendment to the law now before Parliament and seen situations. The safety of birth control measures the formulations of the British Medicai Association (5) varies with changing circumstances and is not the and the Royal Medico-Psychological Association (6) same for all. Children, she feels, should be born of would lead to relaxation in the law. This relaxation love and joy and gaiety, and not from chance, mor- will allow us even greater opportunity to find medicai bidity or misery. A child should be born of affection, and psychiatrie rationalizations, but will still obscure it needs parents to want and love it; wanting and the fact that we are acting because of the over- loving go together. Too many children are already whelming need to relieve the woman in an intolerable unloved and we must support the aspiration to pro- situation. Thus, the law will again be unclear and duce them wanted, loved children, with a capacity dishonest. for happiness. The woman would wish that we put aside these dis- But the centrai thought of woman is that she does honest formulations, frame the law on the facts as they not want her body violated or trespassed on. She are, and give her, openly, the right to refuse what she wishes to be able to decide what should grow within does not want. her body, and under what conditions. She abhors the This general acceptance of the situation would go idea of her body being used against her wishes. To a long way towards relieving the terror and tyranny demonstrate her viewpoint let us imagine the turmoil of guilt; this relief would extend not only to the precipitated by the knowledge that within her is mother, but also to the doctor. Everyone, of course, growing the product of rape, an unwished for trespass both doctor and mother, would be free to act in by a hated being; she has been violated, used, and whichever way they thought best in the circum- made to grow what is hated and repellent. In the same stances. Those bound by religious convictions, such way, the woman can feel equally strongly about other as those belonging to the Church of Rome, could act trespasses. She does not want to be used, she wants to freely by those convictions. want a child.

The Destruction of Potential Life The Later Months One might ask, "Is the woman not aware that she If the control of childbirth should extend into destroys potential life?" The probable answer is that pregnancy, how far should it extend is the next issue she is not aware. The woman does not regard the before us. Terminations after three months should be embryo in the early months as a child. She has no few, because the issue will have already been deter- image of a child. Therefore, she cannot kill something mined in the first three months. However, due to a which has no reality for her. She regards her act as combination of circumstances, in a few instances, the an extension of birth control and often refers to it as issue may have to be decided in later months. "starting a period". She may, indeed, be aware of the But, in these later months another strong emotional illogicality of a situation, which in one voice says that feeling on the part of the mother begins to emerge. before pregnancy children are loved things to be Although the law may not accept the child as an planned for, and wanted, and that in another voice an entity until the 28th week, by this time it may well

7 have become a real entity to the mother. It would ask himself : would be he agreeable to giving the same seem. that this begins to develop when the mother feels right to his wife in the control of his body ? While the foetal movement, or "quickening", at about the i6th final right would be the wife's, the husband would week. When the infant becomes a reality, and a clearly be consulted. Should there be no consultation, psychological reality is no less a reality than a legal, it is unlikely that there would have been any profit in moral, or social one, then there may be a reluctance it. on the part of the mother to destroy what she now In the same poil a substantial number of women regards as a child. She, the mother, like us, is a however, sensibly, said that they would wish to con- représentative of public opinion. Public opinion may sult a doctor. It is desirable and necessary to be sure share her view that the psychologically real child that the woman has thought round every implication should not be destroyed without good reason. The of her situation, that her décision is realistic and mother may feel that legal adoption for an unwanted unlikely to be regretted later. In the early months child may be a more acceptable solution than ter- there would be no legal issue to be decided. The mination of her pregnancy. doctor would be a counsellor. Advice and consulta- Thus, at this moment, it may be necessary to adopt tion would necessarily have to be, of course, in con- stricter criteria, perhaps based on considérations fidence. Should the law become permissive, but in similar to those of the Royal Medico-Psychological practice create embarrassment and lack of confiden- Association (6), allowing termination when there is tiality, then rather than face this the woman will con- serious threat to the life, health and welfare of the tinue to "go around the corner". mother. It is implicit in what has been said that the psycho- The Doctor logical reality of a child develops before the legal and Another issue which remains is: what part would religious reality. Thus, it may be convenient to fix a the doctor play in this new policy ? By tradition doctors point at about four months up to which time termina- can be conservative. We take to new advice with tion should be freely possible on the request of the caution. Formai statements of our views are partic- mother, and after which time termination should be ularly cautious. It is not unlikely that many, if not legally controlied on defined criteria. It might be most, doctors find the present situation unsatisfactory argued on gynaecological grounds that three months (9), and would wish to be able to deal with the matter might be more suitable in that an abdominal opéra- of termination honestly, freely and openly. If public tion is not required normally. opinion were to support what many feel already— Modem advances are frequently merely the that this is not a matter for guilt, but a logicai and systematizing of rediscovery of an old truth. Thus, we proper way to respond to the unhappy situation of a are not surprised to find that Aristotle (7) anticipated woman—then they would be relieved of guilt. us about 320 B.C., when he said: "There must be a In these circumstances it might not be difficult to limit fixed to the procréation of offspring, and if any arrange facilities that, in the great majority of cases, people have a child as a resuit of intercourse in con- would in volve simple procédures. With the new travention of these régulations, abortion must be freedom might come expérimentation and simpler practised on it before it has developed sensation and techniques. Risks in a healthy sample of women would life;for the line between lawful and unlawful abortion will be very small. Many instances would be within the be marked by the fact of having sensation and being alive." compass of the General Practitioner who might well (My italics). So, Aristotle makes clear the distinction feel it his business to deal with this aspect of families, between permissible interference in early pregnancy whose trials and tribulations he knows so well. and abortion in later pregnancy, which he prohibits. Should special clinics be necessary in the interim, it might be considered a function of birth control The Woman Décidés clinics. If we accept the woman's view that she has a right It will be a happy day when we shall see the end to stop the growth of a fertilized ovum in her utérus of back-room abortions, and when their distressing up to the time it becomes for her a psychologically conséquences will no longer occupy hospital beds. real child, then we have to consider whether the With the new policy, terminations in late pregnancy woman alone should decide the issue. too will become fewer and fewer. Women themselves are adamant that the right is theirs. In the National Opinion Poil (8) only 31 per Conclusion cent, thought the fathers should be able to prevent a Extended birth control is only one measure amongst woman having an abortion. Can a man doubt the a number in the begetting and caring for children. good sense of this ? If he does, then perhaps he might There must be a safe and active birth control policy. 8 Sterilization of male and iemale should be more interests. The décision was largely left to the individuai freely available. In those cases where birth control doctor, and the only officiai guidance was s Statement measures have been ineffective and children are given by the Faculty of Medicine back in 1899. unwanted, careful adoption will help to give an Within this vague framework medicai practice answer; but adoption is not the whole answer to developed gradually under the influence of changing unwanted pregnancies because no one wishes to social and ethical attitudes. According to a special carry and give birth to a child for someone else's survey, there were, in 1954, 3,157 legal abortions convenience, and, furthermore, a large increase in the performed by doctors in hospitals, and to this figure number of children for adoption would make adop- should be added an undetermined number of non- tive homes difficult to find. Paradoxically, some registered but legal cases performed on an ambula- elements in society, so anxious to condemn abortion, tory basis. In the same year there were 6,460 regis- can still make it almost impossible for the single tered spontaneous abortions. The number of "criminal woman to look after her wanted child. Here again abortions" was estimated at 7,300, based upon there is room for change in public attitude. information given by the various hospitals about Most laws are made by men, but in the instance suspicious cases admitted. The number of live births before us it is necessary to enter the world of women. amounted to 62,739. We, as doctors, are particularly privileged to concern This situation was in itself hardly satisfactory. The ourselves with the areas of feelings. Here the situation number of criminal abortions was much too high, the is a complex one, and we have to meet with the legal status of the doctors was ambiguous and some- legislator, philosopher, humanitarian, sociologist and times difficult, and for the women the situation was theologian. This difficult ground has its fascination, unpredictable because it depended upon the personal but it is one which induces humility. Standpoint of the doctors available to her. From a The woman has put before us that she should have psychiatrie Standpoint it was feit that the procedure the sole right to stop the growth of a fertilized ovum, would quite often lead to pathogenic guilt feelings in before it has for her the reality of a child. Her view the woman, and for the psychiatrist the position as merits thoughtful and compassionate considération. an intermediary between the patient and the gynae- We may then come to say to the woman: "You will cologist was sometimes disturbing. not be the earth to an unwanted seed." Besides, we have in Norway relied much less than you have in this country upon the principle of com- REFERENCES mon law. Our traditions are more in the direction of 1. STEVENSON, A. C., DUDGEON, M. Y., and MCCLURE, codified législation. Nevertheless we have hesitated H. I. (1959). Arui. hum. Genet., 23, 395. before the problem of a codified abortion law, and 2. RHODES, P. (1966). "A gynaecologist's view." In several reform bills have been dropped. It has been Abortion in Britain. London: Pitman Médical felt that a law which would more or less confirm the Publishing Co. established abortion practice would be unacceptable 3. Hospital In-patients Enquiry of 1958, Part II. Ministry to fairly wide circles of the people. At the same time of Health and Registrar General's Office. 4. Therapeutic Abortion (1966). Brit. med. J., i, 1105. a more restrictive law would most likely be unen- 5. Therapeutic Abortion (1966). Report ofB.M.A. Special forcible. It was in fact not until 1959 that the gap Committee. Ibid., ii, 40. between conflicting convictions was bridged to an 6. Summary of Memorandum by R.M.P.A. (1966). Ibid., extent which made it possible for Parliament to find ii, 44. a compromise solution. 7. ARISTOTLE. Politics. VII, xiv, 10. (Translated by According to the law of 1959 (which came into Rackham, H. London: Heinemann.) effect on 1 February, 1964) an abortion can be per- 8. NATIONAL OPINION POLLS, LTD. (1966). Survey on formed on three types of indications : Abortion. For the Abortion Law Reform Associa- 1. Eugenie, when there is serious danger of the child tion. having a grave mental or bodily defect. 9. ABORTION LAW REFORM ASSOCIATION (1965). Survey of Doctors. London. 2. Ethical, when the woman is insane or a low-grade mental defective, or if the pregnancy is a result of rape or correspondingly serious offences. Dr. 0RNULV 0DEGÂRD spoke as follows: 3. Medicai, when an interruption of the pregnancy Until recenüy we had in Norway no special légis- is necessary in order to protect the woman against a lation on abortion. Practice was based upon the serious danger to her life or health. general principle that an action which is in itself A fourth group of "social indications" was unani- unlawful can be justified if it is necessary in order to mously proposed by the Royal Commission which protect human life or correspondingly important drafted the bill (and of which I was the psychiatrie

9 member), but this turned out to be politically un- Dr. W. L. NEUSTATTER, who said he had had the feasible. Instead the law includes what might be honour of speaking with Sir Dugald Baird at the called "extended médical indications" : In evaluating F.P.A. meeting in Aprii 1966, warmly endorsed Sir the danger to the woman's life or health the doctor Dugald Baird's views. Dr. Neustatter said that, like should take into considération her conditions of living many of his colleagues, he felt that the frequently and other circumstances which could lead to a lasting propounded view that psychiatrists were not fìtted to break in her somatic or psychic health. This clause is deal with social factors was nonsense. They were clearly (or perhaps unclearly) a resuit of compromise, always having to deal with them. He also disagreed and might be said to let the social indications in with the view that doctors could not judge a mother's through a back door. It has probably been one of the capacity for parenthood. main reasons why it has proved difficult to reach a For example, he had had a patient who had killed uniform practice ali over the country. her child. When she had another child, no less than But apart from such local variations, the general three différent sources wanted his opinion on the pattern has remained very much the same as before difficult question as to whether she was fit to look the law. In the year 1965, 4,715 women applied for after the child, or whether it should be taken into an abortion and 3,455 of these applications were care. This was an obvious example of having to granted (43 of them after appeal). (Ali figures can be decide on fitness for motherhood. multiplied by 10 in order to obtain data correspond- The present law makes it impossible to recommend ing to the population of the United Kingdom). As to termination, for example, in severe subnormality, the illegal abortions, we have less opportunities than psychopathy or chronic psychosis, where, especially formerly of reaching a reliable estimate, because in the former two, it could not be shown that ter- complications are so easily avoided by the use of anti- mination would alleviate the mother's condition. biotics. What information we do have seems to Yet what more unsuitable mother could there be suggest that the number has remained about the same. than an irresponsible, drug-taking psychopath having On the whole, therefore, it appears that the law has a number of illegitimate pregnancies ? It was illogica! not made much of a différence, and this is consistent when we spoke of increasing instability and delin- with experience in many countries. Düring the quency due to bad homes, that such children should preparatory work it was, as a matter of fact, stated bereared. Inaworldofrapidly expandingpopulation, repeatedly that the law should aim at nothing more a realistic view of these problems was needed. than a status quo, and that the social evil of abortion should be prevented by other methods. Dr. S. I. COHEN said that at the London Hospital It is of interest to note that the attitude towards the Psychiatric Department several years ago initi- this new law is divided according to well-known ated regulär monthly meetings with the Gynaeco- politicai and ideological lines: "conservatives" feel logical Department in which ali patients referred for that it has gone too far, whereas "radicals" regard it termination of pregnancy or sterilization during the as too restrictive. The medicai profession sees it as a preceding month were discussed. The purpose of these duty to put up a barrier of ethical, social and medicai meetings was to clarify our understanding of the considérations, which is not too dépendent upon the grounds on which they recommended or refused wording of the law—but the pressure on the part of termination or sterilization. Décisions in individuai pregnant women asking for help will always tend to cases remained the responsibility of the doctors overflow the barrier. directly in charge of the patients, and had, in fact, almost always been taken by the time the monthly PROFESSOR W. M. MILLAR, referring to practice in meetings took place. Aberdeen over many years, said that women con- These meetings had been a great help to ali of sidered for termination were referred in the normal them, and an interesting fact had emerged. The way for obstetric and psychiatrie opinion. Some cases average frequency of recommendation of termination were terminated and others were not, but in every was about 40 per cent. When these meetings began, case the best treatment plan was worked out after full one member of the staff was recommending termina- consultation with the family doctor, the obstetrician tion in over 60 per cent, and another in about 25 per and the psychiatrist. The law in Scodand had made cent, of cases. After several years, both were recom- it possible for termination to be approached as a mending termination at about the average rate of 40 medicai problem, and it was in the context of good per cent. medicai practice that ali these cases were considered. In any study of the prognosis in patients referred Ali relevant factors—medicai, psychological and for termination of pregnancy it was most important social—were taken into account. to obtain as complete a picture as possible, and in

10 order to do this the questions which were asked must throughout the country, and any variation in the be carefully chosen. This was illustrated by some frequency with which the opération was carried out remarks of a patient who was followed up by Dr. on the recommendation of psychiatrists depended on G. A. Heasman, one of their Senior Registrare, three how much local gynaecologists were prepared to co- years after termination had been refused. This patient operate. This point had been well brought out by Dr. was a single woman, and when asked how she feit Tylden. It seemed that gynaecologists did not always about having her boy of two years, she said: "He's understand the basis of psychiatrie recommendations. wonderful; I wouldn't be without him for the world." The memorandum by the Royal College of Obste- But when she was asked whether she thought the tricians and Gynaecologists showed a very lukewarm hospital had made the correct décision three years attitude to the role of the psychiatrist in this respect, earlier, she said she was sure it had been wrong and a point which was emphasized by their miscalling added: "It has ruined my whole life." them psychologists in that report. There would seem to be a need to discuss these PROFESSOR T. FERGUSON RODGER, in commenting matters with gynaecologists so that they could have on the discussion, said that what struck him most was a better understanding of our position, and perhaps the fact that on an impressionistic basis the indications we ought to follow the lead of Dr. Cohen in having which Professor Sir Dugald Baird had outlined were conférences on those cases in which the opération those which were followed by many psychiatrists has been suggested.

SOUTH-EASTERN DIVISION

THE SPRING DIVISIONAL MEETING was held at St. In accordance with the Bye-laws, the following Francis Hospital, Haywards Heath, Sussex, on nominees of the Divisional Committee of Manage- Thursday, 6 April, 1967, by kind invitation of the ment were elected for the current year : Hospital Management Committee and the medical Chairman ...... Dr. B. M. Gilsenan staff. Secretary ...... Dr. A. J. Oldham Members were conducted around the hospital and Assistant Secretary . . . . Dr. D. M. Leiberman were shown wards and centres of special interest, Junior Représentative on Council Dr. D. I. Brough including the W.R.V.S. Shop, the excellent newly Dr. A. G. Mezey was duly elected to the Divisional built swimming pool with its view of the South Downs, the occupational therapy department, industrial Committee of Management. therapy units, and the admission villa. The following were elected to ordinary membership The Chairman of the Hospital Management Com- of the Association : mittee, Mr. J. C. Donne, welcomed the División on BARNES, KENNETH HARLEY, M.B., B.Ch., D.P.M., Con- behalf of St. Francis Hospital, and Dr. B. M. Gilsenan, sultant Psychiatrist, The Priory, Priory Lane, London, Chairman of the División, replied on behalf of the S.W.15. Association, Proposed by Dr s. J. Flood, I. Black, Carice Ellison. The Secretary read the Report of the Divisional BICKNELL, DOROTHY JOAN, M.B., Ch.B., Psychiatric Committee of Management. In this report the matter Registrar, Queen Mary's Hospital, Carshalton, Surrey. of amalgamations between general and psychiatric Proposed by Drs. B. H. Kirman, Valerie Cowie, Elaine hospitals was again mentioned. Following advice Donoghue. from Sub-Committees, Council had recommended BRUDE, TERENCE JOHN ROBERT, M.A., M.B., B.Chir., that no further amalgamations should take place, M.R.G.S., L.R.C.P., Senior House Officer, Fulbourn and they had forwarded this advice to all the Hospital, Czmbridge. Proposed by Drs. O. E. F. Hodgson, H. B. G. Thomas, Authorities who might be concerned. The Autumn S. N. Wolkind. Meeting was planned to be held at St. Clement's Hos- CHAIKIN, YOALL MEIR, M.B., B.S., Assistant Psychiatrist, pital, London, while a later meeting of the División Leavesden Hospital, Abbots Langley, Watford, Herts. would be held under the aegis of Dr. Monro at Long Proposed by Drs. E. W. Shepherd, J. T. R. Bavin, C. I. Grove Hospital. The future of the Medical Assistant Finn. Grade had come under discussion but no unanimity CHAPPELL, JOAN, M.B., Ch.B., Registrar, Marlborough of views had yet been reached and the matter con- Day Hospital, London, N.W.8. tinued to be considered by Council. Proposed by Drs. J. Bierer, P. M. Turquet, R. Gosling. DICKINSON, HOWARD JAMES LLEWELLYN, B.M., B.Ch., ROONEY, JOHN FOSTER FENTON, M.B.E., B.A., M.B., M.R.C.S., L.R.C.P., Clinical Assistant, Bethlem Royal B.Chir., Clinical Research Assistant, Roche Products Hospital, Beckenham, Kent. Ltd.; The Copse, Pampisford, Cambridge. Proposed by Drs. E. H. Hare, W. Falkowski, J. L. Proposed by Drs. A. Gage, A. Walk, Professor T. McClure. Ferguson Rodger. ENFIELD, CECIL CHARLES, M.B., B.Ch., D.P.M., Regis- ROOTH, FRANCIS GRAHAM, B.A., M.B., B.S., M.R.C.S., trar, West Park Hospital, Epsom. L.R.C.P., Registrar, Bethlem Royal and Maudsley Proposed by Drs. M. C. Cocheme, Jean Laidlaw, J. Hospitals; 42 Lower Camden, Chislehurst, Kent. Merry. Proposed by Drs. E. H. Hare, J. L. McClure, W. FARNAN, NIALL DESMOND, M.B., Ch.B., B.A.O., D.P.M., Falkowski. Consultant Psychiatrist, Warley Hospital, Brentwood, Essex. SARAN, BRIY MOHAN, B.SC., M.B., B.S., M.R.C.P.E., Proposed by Drs. D. P. Cronin, G. C. Heller, J. P. D.P.M., Registrar, Maudsley Hospital, Denmark Hill, Farrell. S.E.5. GOONETILLEKE, ALAN SIRI RAJA, M.B., B.S., Senior Proposed by Drs. L. K. Hemsi, P. J. Noble, M. E. D. Medical Officer, Darenth Park Hospital, Dartford, Johns. Kent. SHAFFER, DAVID, M.B., M.R.C.P., Registrar, Maudsley Proposed by Drs. W. Wollen, P. G. Woolf, G. M. Hospital; 9 Apollo Place, London, S.W. 10. Tucker. Proposed by Drs. W. Warren, P. Flor-Henry, D. HINSHELWOOD, ROBERT DOUGLAS, B.Sc., M.B., B.S., Abrahamson. Senior House Officer, Department of Psychological Medicine, University College Hospital, W.C.i. STEINBERG, DEREK, M.B., B.S., M.R.C.S., L.R.C.P., Proposed by Drs. E. W. Dunkley, B. Garvey, J. A. Psychiatric Registrar, Brookwood Hospital, Knaphill, Kohiyar. Woking, Surrey. KEARNEY, GARRETT DONAGH ANTHONY, M.B., B.Ch., Proposed by Drs. R. Emery, N. I. Lavin, J. M. Frew. D.P.M., Assistant in Psychiatry, Oakwood Hospital, WALLACE, DAPHNE ROWENA DUCKWORTH, M.B., Ch.B., Maidstone, Kent. Senior House Officer, St. Francis Hospital, Haywards Proposed by Drs. R. G. McLaren, W. N. L. Haynes, Heath, Sussex. J. A. Kelleher. Proposed by Drs. A. Folkson, S. Jacobson, R. H. NASSER, MOHIT MAFI, M.D., Senior House Officer, Bexley Wheeler. Hospital, Dartford Heath, Bexley, Kent. Proposed by Drs. M. Radzan, D. M. Leiberman, A. Dr. J. S. Stead, Consultant Psychiatrist, read a Norton. PERINPANAYAGAM, KULENTHIRAN SAVÜNTHARARAJ, M.B., most interesting paper on "Group Reactions to the B.S., Registrar in Psychiatry, Darenth Park Hospital, Paranoid Personality". In this Dr. Stead reviewed Dartford, Kent. the history of this subject and illustrated the subject Proposed by Drs. W. Wollen, P. G. Woolf, Professor T. matter with personal cases. Ferguson Rodger. Dr. Klaus Bergmann, Consultant Psychiatrist, then PINKEY, BASIL, M.B., B.Ch., D.P.M., Registrar, Royal Free read the second paper "Problems of Psycho- Hospital, London, W.C.i. geriatric Care in the Mid-Sussex Area". Proposed by Drs. S. W. Hardwick, P. K. Bridges, N. I. Dr. Bergmann stressed the need for more psycho- Swift. geriatric beds, and discussed the relationship between PITT-AIKENS, TOM, M.B., Ch.B., Registrar in Psychiatry, St. Crispin Hospital, Duston, Northampton. this and the Community services. Proposed by Drs. T. E. Lear, A. N. Graham, P. H. Both papers were well received and a number of ROGERS. members took part in the discussion.

SOUTH-WESTERN DIVISION

THE AUTUMN MEETING of the South-Western Hospital Management Committee. The Divisional Division was held at Borocourt Hospital, near Chairman, Dr. A. J. Galbraith, gave thanks in reply. Reading, on Thursday, 20 October, 1966, by kind invitation of the Hospital Management Committee Report of the Divisional Committee of Management and Dr. G. O'Gorman, Physician Superintendent. Düring the forenoon, members were shown around It was reported that the proposed meeting of the the Hospital and were most impressed by the new Psychotherapy and Social Psychiatry Section in buildings. At lunch, members and guests were wel- Bristol had had to be cancelled owing to lack of comed by Sir Godfrey Nicholson, Chairman of the support.

12 With reference to the payment by Regional Hos- BLYTH, ROBERT IAN KENNEDY, M.R.C.S., L.R.C.P., pital Boards of Course fees, travelling and subsistence Medical Officer, H.M. Prison, Exeter. allowances to attend medical meetings, the Com- Proposed by Drs. I. G. W. Pickering, F. P. D. Easby, D. Prentice. mittee had received and accepted an explanatory letter from Professor Russell Davis regarding changes CARPENTER, WILLIAM HOWARD KENNETH, M.B., Ch.B., M.P.S., Senior Hospital Medical Officer, Stoke Park which the South-Western Regional Hospital Board Hospital. Stapleton, Bristol. had now introduced. Dr. Monro had also written Proposed by Drs. W. A. Heaton-Ward, J. Janear, L. that the Association would take the matter up in a Lynch. general way at national level. DENING-SMITHERMAN, PETER, M.B., B.S., Medical Officer, Members were asked to forward any specific com- H.M. Prison, Parkhurst. plaint to the Divisional Secretary. Proposed by Drs. R. R. Prewer, G. G. Brown, I. G. W. The following nominations were suggested for Pickering. appointments to Regional Hospital Boards: ELLIOTT, EDWARD SYDNEY, B.M., B.Ch., M.R.C.S., L.R.C.P., Medical Officer, H.M. Prisons, Parkhurst and Wessex Dr. A. J. Galbraith Camp Hill. Oxford Dr. R. G. Mclnnes, if he were available, and Proposed by Drs. R. R. Prewer, J. S. Know, I. G. W. failing him Dr. B. M. Mandelbrote. Pickering. The Committee again noted with concern that LYNCH, MARGARET THERESA, L.R.C.P., Medical Assistant, St. Lawrence's Hospital, Bodmin, Cornwall. several Regional Hospital Boards still had no psy- Proposed by Drs. D. D. Ellis, L. F. W. Rowe, D. E. chiatric member and hoped that this situation would Suleman. soon be rectified. OSTLER, EDWARD GEORGE, M.B., B.S., M.R.C.S., The Proceedings of the last two meetings of Council L.R.C.P., Registrar, Glenside Hospital, Bristol. were received and discussed. Proposed by Drs. D. F. Early, A. H. Ogden, A. Leitch. SEDGWICK, JOHN PHILIP, M.B., B.S., M.R.C.S., L.R.C.P., Medical Adviser to John Wyeth and Brother, Hunter- Medical Assistant Grade come Lane South, Taplow, nr. Maidenhead, Berks. The difficulties in filling these posts were discussed. Proposed by Drs. D. J. Richards, N. W. Imlah, J. The Committee considered that the feeling had arisen Owens. that this was an inferior position, especially on SHANKARAPPA, THIPPE S., B.Sc., M.B., B.S., D.P.M., account of the salary scale, and that it was rarely Registrar, Barrow Hospital, Barrow Gurney, nr. Bristol. Proposed by Drs. J. D. W. Fisher, P. N. Sarkar, C. E. accepted as a step in the promotion ladder to Con- Salter. sultant status. There should be more flexibility in WALLEN, GERALD DESMOND PATRICK, M.B., Ch.B., relationship to increments. It was also considered that M.R.C.S., L.R.C.P., D.(Obst.)R.C.O.G., D.P.M., the post of Registrar was often being wrongly used in Registrar, Barrow and Glenside Hospitals, Bristol. Psychiatry. Proposed by Drs. R. E. Hemphill, A. Leitch, A. Flood. The Committee decided that these views should be WILCOCK, PHILIP GEOFFREY JOSEPH, M.B., Ch.B., Generla reported to the Educational and Parliamentary Practitioner and Clinical Assistant for Psychotherapy, Committees of the R.M.P.A., who should be asked Exe Vale Hospital, Exeter. to investigate the position nationally. Proposed by Drs. G. E. Langley, W. Rodger, W. J. T. Kimber. WILLIAMS, CHRISTOPHER JOHN HAROLD, M.B., Ch.B., Date and Place of Next Meeting Registrar, St. Ann's Hospital, Canford Cliffs, Poole, It was decided to accept an invitation from the Dorset. Chairman, Dr. A. J. Galbraith, to hold the Spring Proposed by Drs. A. C. Gibson, M. Valvis, G. F. Meeting at Knowle Hospital and the Wessex Regional Andrews. School of Psychiatry on Thursday, 6 April, 1967. WRIGHT, JOHN GERALD, M.B., Ch.B., D.P.M., Lecturer in Mental Health, University of Bristol; Hon. Senior Registrar, United Bristol Hospitals. Election of Ordinary Members Proposed by Professor D. Russel Davis, Drs. F. J. Roberts, A. Flood. The following Candidates were elected to Ordinary Membership :

ANTHONY, ERIC, M.B., Ch.B., D.C.H., Medical Officer, PAPERS AND DISCUSSION Neuropsychiatrie Centre, R.A.F. Hospital, Wroughton, Day Hospital Children and their Parents Swindon. Proposed by Dr. R. H. Cawley, Professor W. H. Dr. NINA MORTON-GORE said that there was much Trethowan, Dr. D. N. Johnstone. evidence to show that children tended to develop

13 intellectually, emotionally and socially more satisfac- normal with a superimposed psychosis when the torily when living at home than they did when condition was really schizophrenia beginning at an separated from their families. She discussed the early age and it -vvas the subnormality which was benefits of the Day Hospital system, both for the secondary. This often happened with the autistic child, child and the mother. The day centre at Borocourt who excluded many external stimuli and there Hospital attempted to provide the retarded child with resulted a failure of intellectual growth. The aim was educational and social situations which would help to induce the patient to make more use of his available him to mature in a permissive setting run on psycho- intelligence. therapeutic lines. It now catered for over 40 children The development of the child's intelligence was and performed two main functions: (a) it served as a very much retarded by the psychotic process, and training school and special care unit and (6) it was what happened in later life very much depended on an observation, diagnostic and treatment centre. the age of onset of the schizophrenic illness. Referral and placement procedures were described. Emotional disturbance short of psychosis could also Dr. Morton-Gore stressed the importance of psy- result in intellectual retardation. He criticized the chiatric support and help to the parents when effects of overcrowded classes on the deprived sub- necessary, and explained her arrangements to cover normal. this, which included an active Parents' Association It was not the subnormality alone which commonly affiliated to the Hospital League of Friends. She then led to admission to hospital. The reason for admission went on to describe what happened to the child when was usually an additional physical or emotional he first came to the Day Hospital, and the gradual disability. process of complete psychological, psychiatric and The hospital had a dual role, acting as a hospital medical investigation and assessment. An integrated caring for mentally and physically sick people, and approach was made towards treatment, the aim being also as a sort of training school for people who needed to produce an individual who was emotionally well to be taught how to live in society and how to hold adjusted and functioning to the maximum of his down a job. potential. Within the day hospital setting, emphasis Dr. O'Gorman described the various departments must constandy be placed on a dynamic, stimulating of the hospital, and the treatment, care and rehabili- and loving atmosphere, which must also be receptive tation carried out. He then gave a critical appraisal to changing ideas and progressive methods of of the design and construction of the new units, which approach. were costing £ii million to provide 160 new beds. He concluded by proposing that there was a need for Design and Functions of the new Subnormality members of the profession or the R.M.P.A. to discuss Hospital and agree on a basic ward pattern, as in his view the Dr. G. O'GORMAN described the types of patients acceptance of this would reduce building costs admitted to Borocourt Hospital, stressing that not all nationally. were subnormal and that it was no longer the policy to insist on an IQ of below 100. Admission included Many members participated in the wide and varied a proportion of emotionally disturbed, psychopathic discussion which followed both papers. and psychotic children, and he considered that a Dr. A. Heaton-Ward, in proposing the vote of Subnormality Hospital was best equipped and had thanks, congratulated both speakers on their stimu- most experience to look after these patients until the lating papers and their efficient answering of the many time when special units might be instituted. He questions. He stressed the need for an integrated believed that some patients were often said to be sub- service for subnormality.

NORTHERN AND MIDLAND DIVISION

THE AUTUMN MEETING of the Northern and resolved to recommend to Council that if and when Midland Division was held at St. Nicholas Hospital, the Association becomes a College it should, in Gosforth, Newcastle-upon-Tyne, on 20 October, searching for new premises, consider moving outside 1966, by kind invitation of the Hospital Management London, bearing in mind the cost, convenience and Committee. prestige of such a move. In the morning, members made a tour of inspection It was decided that the Spring Meeting of the of the hospital. Division should be held at Winwick Hospital, The Divisional Committee reported that they had Warrington.

H The Divisional Representative on Council reported SWINSON, RICHARD PRICE, M.B., Ch.B., Registrar, Liver- on the further progress that had been made towards pool Royal Infirmary and Royal Southsea Hospital, the formation of a College. Liverpool. Proposed by Professor F. J. Fish, Drs. I. Leveson, G. The following were elected to Ordinary Member- Hopkinson. ship: TERRY, HAROLD, M.B., Ch.B., Medical Officer, H.M. Prison, Lincoln. BEAUMONT, GEORGE, M.B., Ch.B., M.R.C.S., L.R.C.P., Proposed by Drs. H. Hunter, M. S. M. Rayner, D. (Obst.)R.C.O.G., D.C.H., General Practitioner; W. A. S. Falla. Medical Adviser, Geigy (U.K.) Ltd., n Dorchester Road, Hazel Grove, nr. Stockport, Cheshire. Proposed by Drs. E. H. Kitching, W. I. N. Kessel, C. S. PAPERS MELLOR. Two papers were read at the morning session and BENSA, ROBERT GUY ROMERIL, M.B., Ch.B., Registrar, two more in the afternoon. All these papers stimulated Shelton Hospital, Shrewsbury. keen and full discussion. The following is a summary: Proposed by Drs. S. Lucas, J. C. Barker, F. Kane. "Factors associated with the Onset of Neur-

BROOKS, JOHN HAMILTON, M.B., Ch.B., Senior House osis in Old Age" by DR. D. W. KAY. Officer, Crumpsall Hospital, Manchester. This work is based on interviews with a random Proposed by Drs. N. J. de Ville Mather, G. G. Hay, sample of elderly people living in their own homes. M. J. MacCulloch. The frequency of various kinds of neuroses in old BYRON, ALAN JOHN, M.B., Ch.B., Registrar, Lancaster age are described and the results of a study of their Moor Hospital; 15 Daisy Bank, Lancaster. association with various medical and social factors Proposed by Drs. S. Smith, J. R. Theobalds, D. L. discussed. Aspinall. "Clinico-Pathological Correlations in the CHOUDHURI, AJIT KUMAR, B.Sc., M.B., B.S., Registrar, De La Pole Hospital, Willerby, Hull. Psychoses of Old Age" by DR. G. BLESSED. Proposed by Drs. H. EUett-Brown, I. C. Church, Pathological findings in 40 patients are described J. A. R. Bickford. and compared with the clinical findings during life.

DUNLEABY, DESMOND LEO FRANCIS, M.B., B.Ch., B.A.O., A comparison is made with a control group of Registrar, Walton Hospital, Liverpool, 9. similar age. The relevance of the findings in the Proposed by Drs. J. T. Rose, E. M. Bell, C. Maxwell. diagnosis of dementia in old age is discussed.

ENTWISLE, MICHAEL, M.B., B.S., D.(Obst.)R.C.O.G., "Psychometric Assessment of the Aged: Assistant in Psychiatry, Glenfrith Hospital, Leicester. Some Recent Advances in Cognitive and Proposed by Drs. A. A. Valentine, S. Reid, N. Kaye. Personality Measurement" by DR. R. D. SAVAGE.

HALLAS MARGARET, M.B., Ch.B., D.P.M., Registrar, St. This paper will discuss some recent research work James's Hospital, Leeds. on cognitive and personality assessment in the aged Proposed by Drs. S. M. Leese, J. M. Roberts, J. R. with special reference to their clinical use. It will Burgess. include advances in techniques to measure intellec- JOHNSON, DONALD ARTHUR WHEATLEY, L.R.C.P., tual deterioration, personality deviation, verbal L.R.C.S.I., L.M., D.Obst.R.C.O.G., Registrar, Spring- learning and generalized brain damage, as well as field Hospital, Manchester. cognitive state and mental health screening in the Proposed by Drs. H. L. Freeman, J. C. Devlin, M. C. community aged. Ingham. "Psychogeriatrics : A Community Problem" KEEVIL, GWENDOLINE MARY ELSIE, M.B., B.S., D.C.H., by DR. P. MORGAN. D.P.M., Registrar, Cheadle Royal Hospital, Cheadle, Methods of overcoming the problems of integrating Cheshire. Proposed by Drs. E. Howarth, W. V. Wadsworth, the hospital and local authority services are discussed. M. B. Edwards. Attention is drawn to the importance of recruiting and training social workers. The uses and limitations SPENCER, ELSPETH CATTO, M.B., B.S., D.P.M., Registrar, Newcastle General Hospital, Newcastle-upon-Tyne. of sheltered accommodation and day centres are con- Proposed by Drs. R. Orton, L. Marinovich, S. Brandon. sidered.

SCOTTISH DIVISION

THE WINTER MEETING of the Scottish Division was Membership of Regional Hospital Boards. It was held at Hartwood Hospital on 2 December, 1966. decided to put forward the names of Dr. R. A. Y. The following business was transacted: Stewart for the North-Eastern Regional Board, Dr.

15 M. M. Whittet for the Northern Régional Board and Geriatrie Patients. It was reported that the Chief Dr. A. K. M. Macrae for the South-Eastern Régional Medical Officer had indicated that he would be Board. Dr. A. P. Russell is at present a member of the interested in holding a joint meeting at St. Andrew's Western Régional Hospital Board. House between représentatives of the R.M.P.A., the Scottish Society of Geriatricians and himself. This had been discussed in the Committee of Management Report from the Committee of Management. and it was feit that the Division was probably not clear on their policy with regard to geriatrie beds and Requestfrom the Education Committee of the R.M.P.A. It that before having such a meeting with the C.M.O. was reported that the Education Committee of the they should have a discussion in the Division on the Association had been considering the use of the arrangements for treatment in the elderly. It was Médical Assistant Grade and had asked the Division agreed that this would be a suitable subject for the to supply information mainly of a factual nature con- March Meeting. cerning the employment of Médical Assistants in Scotland. The Secretary reported that he had Memorandum on the Care of Handicapped Children. This written to the S.A.M.O.s of Régional Boards in Memorandum was prepared by the Child Psychiatry Scotland asking how many Médical Assistant posts Section and was introduced by Dr. Isabel Sutherland. in Psychiatry were in the Région and whether there With minor amendments it was agreed. It was to be was any difficulty in filling the posts. The S.A.M.O.s forwarded to the Secretary of the Committee on the were also asked whether they would regard Médical Care of Handicapped Children. If the Division were Assistant posts as training posts and as a possible step asked to give oral evidence it was recommended that towards a Consultant post. When the information the Chairman and Secretary of the Child Psychiatry was available it would be forwarded to the Education Section, the Secretary of the Mental Deficiency Committee. There followed a brief discussion on the Section and the Chairman and Secretary of the Médical Assistant Grade, in which it became clear Division should form the délégation. that many members were unhappy about this grade Memorandum on Epilepsy. This Memorandum, which and particularly critical of the name itself. had been prepared by an ad hoc committee, was Mental Deficiency. It was reported that the Mental approved and it was agreed that it should be for- Deficiency Section were concerned that there was no warded to the Standing Medicai Advisory Commit- Consultant in Mental Deficiency on the National tee's Sub-Committee on Epilepsy. Panel of Specialists and that therefore the National Memorandum on the Farquharson-Lang Report. This Panel Représentatives on appointments committees Memorandum was discussed at some length and for consultant posts in Mental Deficiency were drawn various amendments were accepted. The Memoran- from the field of général Psychiatry. This matter had dum was then transmitted to the Secretary of the been raised with the Home and Health Department Scottish Home and Health Department. on a previous occasion, but it was agreed that further Memorandum on the Requirements for Residential Care of représentation should be made. Mentally Disturbed Adolescent Delinquents. This Memor- Child Psychiatry. Dr. Philip Barker had drawn andum, which was prepared by the Forensic Psy- attention to the fact that in the Home and Health chiatry Section, was introduced by Dr. K. H. R. Department's allocation of Senior Registrar posts to Wardrop. It was accepted by the Division and was to the Régions the allocation was a total one for Senior be forwarded to the Scottish Home and Health Registrar posts in Psychiatry and did not separately Department and to the Standing Medical Advisory identify how many Senior Registrar posts there Committee's Sub-Committee on Forensic Psychiatry. should be in e.g. Child Psychiatry and Mental Working Party on Suggestions andComplaints in Hospitals. Deficiency. Régional Boards had no means of knowing A Working Party on Suggestions and Complaints in how many training posts there should be in Child Hospitals had been set up by the Department under Psychiatry to fill future consultant vacancies and it the Chairman of Mr. Elliott-Binns. The Working would therefore be more appropriate for the Depart- Party had asked the Division for its views, and the ment, who presumably had this knowledge, to iden- Secretary had written to Physician Superintendents tify these posts. After discussion it was agreed to ask and Consultants in general hospital units asking for the Home and Health Department when making their comments. There had been a very good response their allocation of Senior Registrar posts in Psychiatry from members in this way and it appeared that many for each Région to identify the number of such posts hospitals had a pamphlet which was given to patients for Child Psychiatry, Mental Deficiency and Forensic and their relatives when they were admitted and Psychiatry. that these pamphlets contained information on how

16 complaints and suggestions could be channelled. In which should be submitted to the Department, but many hospitals also there were regular ward meetings that it could not be submitted to the Department which provided an excellent opportunity for patients until it had been approved by the Division at the to make suggestions and raise complaints. It was felt March Meeting. that the administration of most mental hospitals was such as to encourage a free flow of communications PAPERS and that complaints and suggestions were quite freely In the morning Dr. M. J. Harfst presented a paper made. It was also pointed out that to have too firm on a trial of 'Heminevrin'. Considerable interest was an apparatus for dealing with complaints and sugges- expressed not only in the content of the paper but in tions would be disturbing to some patients. The the methodology of the trial. Secretary was instructed to report to the Working Dr. R. N. Antebi read a paper on "Absconders" Party incorporating these views and pointing out the which was part of a study he had carried out while in statutory functions of the Mental Welfare Com- Birmingham. This paper also stimulated a very lively mission. active discussion. The Division is grateful to both Social Work and the Community. The Scottish Home speakers for presenting such interesting papers. and Health Department had invited the División to The Division would wish to thank Dr. Dymock and make comments on the White Paper on Social Work his Board of Management for the excellent arrange- and the Community. They had requested that these ments made for the meeting and for the kind hos- comments be given by 31 January, 1967. It was pitality provided. agreed that the Committee of Management should The next meeting was fixed for Friday, 10 March, meet in January in order to draw up a Memorándum 1967 in Edinburgh.

IRISH DIVISION

THE SPRING MEETING of the Irish Division was cussed cases occurring after pelvic injury and men- held on 4 March, 1967, by kind invitation of the tioned the medico legal complications. Reverend Mother and Dr. P. Pearse O'Malley, at The papers were discussed by Drs. Glass, Moore, the Mater Hospital, Belfast. McGrath, Bradley, Whiteley, D. Eustace and Members lunched at the Midland Hotel, by in- Professor Gibson. vitation of Rev. Mother Superior. At the Business Meeting which followed, it was The meeting was held in the Nurses Training reported that only four nominations had been re- School attached to the Mater Hospital. ceived for the Divisional Committee of Management, Dr. P. PEARSE O'MALLEY read a paper entitled and these members, Dr. S. D. McGrath, Dr. D. J. "Impotence: a Clinical Study". He discussed a Bradley, Dr. Hugh Gath and Dr. J. J. Meenan, were series of 25 cases referred to him from local marriage unanimously elected. guidance clinics, and gave the case history and diag- The Northern Ireland members were asked to for- nosis. Most of the cases were anxiety states and some ward two names who would be co-opted at next depressives, and a few paranoid schizophrenics. When meeting. the underlying psychiatric condition was treated the Dr. M. Heffernan gave a report on the Sub-Com- impotence usually improved. mittee meeting with the Irish Medical Association to Mr. GILLIGAN, a surgeon, gave the organic causes discuss the prescribing of drugs. which came his way for treatment, and said that in every case he took a careful history and complete The next meeting was fixed for Saturday, 10 June, blood and urine test, and did urethroscopy. He dis- 1967, at St. Davnet's Hospital, Monaghan.

17 NOTICES BY THE HONORARY LIBRARIAN

The Library is open to members between the hours Anais Portugueses de Psiquiatría. of 9 a.m. and 5 p.m. Mondays to Fridays. Books are Annales Médico-Psychologiques. issued to borrowers during these hours. Annali di Neurologia e Psichiatria. The Hon. Librarian will endeavour to obtain, as Archives of General Psychiatry. far as possible, any books on psychiatry and allied Archives of Neurology. subjects required by members. Archivio di Psicologia, Neurologia, e Psichiatria. Arquivos do Departamento de Assistência a Psicópatas Library Lending Department Regulations do Estado de Sào Paulo. Arquivos de Neuro-Psiquiatria. 1. Books shall be lent to members within the Bethlem-Maudsley Hospital Gazette. United Kingdom and Eire who are not in arrears Bibliographia Neuropsychiatrìca. with their subscriptions. Brain. 2. No member may borrow from the Library more British Hospital and Social Services Journal. than three volumes at one time. British Journal of Addiction. 3. Books and journals are sent carriage paid from British Journal of Criminology. the Library, but members are responsible for the British Journal of Medical Psychology. books from the time they leave the Library until they British Journal of Psychiatric Social Work. are received back, and for the return postage. British Journal of Psychiatry. 4. Books damaged or lost while in possession of a British Journal of Social and Clinical Psychology. member will be repaired at his expense or must be Bulletin of the Menninger Clinic. replaced by him. Canadian Psychiatric Association Journal. Central African Journal of Medicine. 5. A member shall be entitled to retain a book or Comprehensive Psychiatry. periodical borrowed from the Library for a period of Czechoslovak Journal of Psychiatry. twenty-eight days (or longer by special arrangement), Digest of Neurology and Psychiatry. unless the book is required by another member, in L'Évolution Psychiatrique. which case it can be recalled by the Librarian at the Excerpta Medica [Psychiatry]. expiration of fourteen days. Film User. 6. In the event of a member failing to return any German Medical Monthly. book or periodical within seven days after receiving Howard Journal of Penology and Crime Prevention. notice from the Librarian (on the expiration of the Indian Journal of Psychiatry. period referred to in Rule 5), the Library Committee International Journal of Neuropsychiatry. shall be at liberty to purchase another copy, the cost International Journal of Neurology. to be charged to such member, who shall not be International Journal of Psychiatry. allowed to borrow another book until the sum thus International Journal of Psychoanalysis. expended shall have been paid. International Journal of Social Psychiatry. 7. All communications should be addressed to Israel Annals of Psychiatry. "The Librarian, R.M.P.A., Chandos House, 2 Queen Jornal Brasileño de Psiquiatría. Anne Street, London, W.i". Journal of American Academy of Child Psychiatry. Journal of Analytical Psychology. Journals Journal of Child Psychology and Psychiatry. Journal of the College of General Practitioners. The following Journals are available: Journal of Comparative and Physiological Psychology. A Crianza Portuguesa. Journal of the History of Behavioral Sciences. Acta Neurologica. Journal of Individual Psychology. Acta Psychiatrica Scandinavica. Journal of Mental Deficiency Research. Acta Psiquiátrica y Psicológica de America Latina. Journal of Mental Subnormality. Acta Psychologica Sínica [Chinese]. Journal of Nervous and Mental Disease. Actas Luso-Españolas de Neurología y Psiquiatría. Journal of Neurology, Neurosurgery and Psychiatry. American Journal of Mental Deficienty. Journal of Neuropathology and Psychiatry [Korsakov, American Journal of Orthopsychiatry. Russian]. American Journal of Psychiatry. Journal of Psychology. American Journal of Psychotherapy. Journal of Psychosomatic Research. Mental Health. CONGRESS OF NEUROLOGY AND Mental Hygiene. PSYCHIATRY, 1967 Nordisk Psykiatrisk Tiddsskrift. The First Congress of the Bulgarian neurologists, Pavlov Journal of Higher Nervous Activity [/fautan]. psychiatrists and neurosurgeons will take place in Psychiatric Quarterly. Sofia, from 4 to 6 October, 1967, and guests from Psychiatiy. abroad are most cordially invited to attend it. Psycho-Analytic Quarterly. The main themes of the Congress are as follows: Psychological Abstracts. 1. Tumours of the nervous system. Psychological Monographs. 2. Schizophrenia. Psychological Record. Psychological Reports. A Symposium will also be organized, to deal with Psychosomatic Medicine. "THE SOCIAL PROBLEMS OF EPILEPSY". Psychosomatics. The official languages of the Congress will be Quarterly Journal of Studies on Alcohol. Bulgarian, Russian, English, French and German. Revista Argentina de Neurología y Psiquiatría. For any further details, please apply to Assoc. Prof. Revista del Hospital Psiquiátrica de la Habana [Cuba\. Dr. K. Zaimov, V.M.I. (Higher Medical Institute), Revista de Neuro-Psiquiatría. Psychiatric Clinic, Sofia 31, Bulgaria. Revista de Psicoanálisis, Psiquiatría y Psicología. Revista de Psicología General y Aplicada. Revista Psiquiátrica Peruana. ASLIB CRIMINOLOGY GROUP Revue de Médecine Psychosomatique. A Criminology Group has been formed by Aslib Rivista di Neurología. (Association of Specialist Libraries), to bring to- Rivista di Patología Nervosa e Mentale. gether those concerned with documentation in the Scientific Film. field of criminology, whether as librarians, research W.H.O. Chronicle. workers, administrators or practitioners. Criminology World Mental Health. is interpreted in its widest sense, to include abnormal psychology, social pathology, treatment and other related subjects. Besides holding meetings and arranging visits to libraries, the Group intends to promote easier access THE ASSOCIATION'S MEDALS AND to criminological literature by compiling lists of PRIZES libraries and their holdings of periodicals, by exam- ining abstracting and indexing services, and by Attention is specially drawn to the Medals and promoting co-operation among libraries. Prizes which are offered annually by the Association. Membership of the Group is open to all who are The conditions of award are set out fully in the members of Aslib, or work for a body, such as a Year-Book. university, which is a corporate member. Further details are available from: Aslib, 3 Bel- Gaskell Medal and Prize grave Square, London, S.W.i. 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 UNIVERSITY OF CAMBRIDGE INSTITUTE are due by 31 March. OF CRIMINOLOGY Post-Graduate Course in Criminology Bronze Medal and Prize The University of Cambridge has established an Dissertations for the Association's Bronze Medal annual Post-Graduate Course in Criminology, to be and Prize should be forwarded to reach the Registrar given by the Institute of Criminology. The seventh not later than 30 April. course will be held during the three terms of the academic year beginning October 1, 1967, ending in July 1968. A Diploma in Criminology will be award- Divisional Prizes ed by the University to those who have diligently Papers certified as eligible for this competition attended the course, and who, at its completion, pass must be forwarded to reach the Registrar not later a written examination in five papers. than 30 April. Admission to the course will be open to those who

19 already hold a university degree in any subject. The Particulars and application forms are available number of admissions in any one year will be limited from the Secretary, Institute of Criminology, 7 West in order to maintain the highest possible standard. Road, Cambridge. The completed forms, together Those admitted to the course will be made members with evidence of necessary qualifications, should of the University, and will be expected to seek reach the Secretary by 1 April, 1967, for the course admission to a college. beginning in October 1967.

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