![JOURNAL of MENTM=^Fence [Published by Authority of the Royal Medico-Psychological Association] SUPPLEMENT](http://data.docslib.org/img/997ee653ea20f09d3cf34f445a617a48-1.webp)
THJ JOURNAL OF MENTM=^fENCE [Published by Authority of the Royal Medico-Psychological Association] SUPPLEMENT
JANUARY, 1957
THE ROYAL MEDICO-PSYCHOLOGICAL ASSOCIATION AUTUMN QUARTERLY MEETING THE AUTOMN QUARTERLY MEETING of the Association was held on 16 November, 1956, at 11 Chandos Street, Cavendish Square, London, W.l, under the Presidency of Dr. T. Percy Rees.
MINUTES The Minutes of the Spring Quarterly Meeting, held on 17 May, 1956, to be published in a forthcoming Supplement to the Journal of Mental Science, were taken as read, and confirmed and signed by the President.
OBITO ARY The President announced with regret the death of: DR. EFFIE L. HUTTON, Clinical Director, Bürden Neurological Institute, Bristol; an Ordinary Member since 1938. DR. RUBEN LIPMAN, Visiting Psychiatrist, Liverpool Psychiatric Clinic; an Ordinary Member since 1952. DR. C. D. BRUCE, O.B.E., Medicai Superintendent, State Institution, Carstairs, Lanarkshire; an Ordinary Member since 1932. DR. RUTH MEIER-BLAAUW, Psychiatrist, St. Andrew's Hospital, Norwich; an Ordinary Member since 1945. DR. A. F. MARY CHRISTIE, formerly Medicai Director, Larches Child Guidance Clinic, Preston; an Ordinary Member since 1946. PROFESSOR G.- KRAUS,-Professor of Psychiatry, University of Groningen, Holland; a Corresponding Member since 1934. - "J
ELECTION OF ORDINARY MEMBERS The following were unanimously elected to Ordinary Membership:" AARONRICKS, PAUL JAMES FREDERIC, M.B., Ch.B., Registrar, The Warneford Hospital, Oxford. Proposed by Drs. I. Skottowe, R. G. Mclnnes, R. W. Armstrong. ALLCHIN, WILLIAM HENRY, M.A., B.M., B.Ch., Registrar, The Bethlem Royal and Maudsley Hospitals. Proposed by Drs. D. L. Davies, C. P. Blacker, Prof. A. Lewis. DAVIES, HYWEL WILLIAM DYFODWG, M.B., B.S., D.P.M., Senior Medicai Officer, St. Luke's-Woodside Hospital, Muswell Hill, N.10. Proposed by Drs. N. Harris, J. A. Hobson, A. Duddington. 2
FREEMAN, HUGH LIONEL, M.A., B.M., B.Ch., Lieutenant, R.A.M.C., Royal Victoria Hospital, Netley, Hants. Proposed by Drs. J. McQuillan, G. P. Walsh, J. McGhie. HADFIELD, IAN, B.M., B.Ch., Senior House Officer, St. Luke's-Woodside Hospital, Muswell Hill, N.10. Proposed by Drs. N. Harris, J. A. Hobson, A. Duddington. IRWIN, JOSEPH ALAN, M.R.C.P., D.C.H., D.P.M., Consultant Psychiatrist, Holloway Sanatorium. Proposed by Drs. R. Macdonald, Harriette Bogie, C. R. Harris. KAPLAN, THEODORE HARRY, M.B., B.Ch., D.P.M., Senior Registrar, Middlesex Hospital; St. Luke's-Woodside Hospital, N.10. Proposed by Drs. N. Harris, J. A. Hobson, A. Duddington. LEGGAT, WILLIAM, L.R.C.P.&S.E., L.R.F.P.S.G., J.P. (Queensland, Australia), Junior Medicai Officer (locum tenens), Darenth Park Hospital, Dartford, Kent. Proposed by Drs. G. J. Bell, M. E. Grant, H. N. Hefferman. MCBRYDE, HUGH MCGILLIVRAY, M.B., Junior Medicai Officer (locum tenens), Warlingham Park Hospital, Warlingham, Surrey. Proposed by Drs. T. P. Rees, W. H. Shepley, E. H. Hare. MILLAR, JOHN, M.B., Ch.B., D.P.M., Senior Medicai Officer, North Wales Hospital, Denbigh. Proposed by Drs. J. H. O. Roberts, D. O. Lloyd, G. Williamson. MULES, ROGER JOHN, M.B., B.S., Junior Medicai Officer, Digby Hospital, Exeter. Proposed by Drs. J. Russell, J. Scott, Bertha Mules. OUNSTED, CHRISTOPHER, M.A., D.M., D.P.M., D.C.H., Senior Registrar, The Warneford Hospital, Oxford. Proposed by Drs. I. Skottowe, R. G. Mclnnes, R. W. Armstrong.
PARGITER, RUSSELL ASHBY, M.B., B.S., D.P.M., Senior Registrar, St. Clement's Hospital, Ipswich. Proposed by Drs. I. J. Davies, P. McCauley, J. K. Marshall.
ROBERTS. GEOFFREY CYRIL STUART, M.B., Ch.B., Junior Medicai Officer, The Lawn, Lincoln. Proposed by Drs. J. F. R. Goodlad, W. Sargant, R. W. Armstrong.
ROSE, HARRY KAYE, L.R.C.P.&S.E., L.R.F.P.S.G., D.P.H., D.P.M., Registrar, Warlingham Park Hospital, Warlingham, Surrey. Proposed by Drs. T. P. Rees, W. H. Shepley, E. H. Hare. SHERRY, COLIN CAMPBELL, L.M.S.S.A., Junior Medicai Officer, Hellingly Hospital, Hailsham, Sussex. Proposed by Drs. R. M. Ellison, D. Rice, R. Maggs. SMITH, DAVID WALTER, Ph.D., B.Sc., M.B., B.S., Medicai Research Assistant, St. Ebba's Hospital, Epsom, Surrey. Proposed by Drs. J. C. Batt, M. Reiss, J. J. Bradley.
THORPE, FREDERICK GRAHAM, M.B., Ch.B., Registrar in Psychiatry, Mapperly Hospital, Nottingham. Proposed by Drs. D. Macmillan, C. Rose, W. L. Jones. Re-Election (Resigned 1951): BROWN, ISABELLA PATRICIA, M.B., Ch.B., 1 Logan Road, Newcastle-upon- Tyns 6. Proposed by Drs. J. Milne, L. N. Cook, A. MacNiven.
ELECTION OF ASSOCIATE MEMBER The following was unanimously elected an Associate Member, his candidature having received the approvai of Council on 17 July, 1956: INGLIS, JAMES, M.A., Dip. Psych., Staff Psychologist, Institute of Psychiatry, Maudsley Hospital, London, S.E.5. Proposed by Drs. J. G. Hamilton, J. P. Dewsbery, W. Warren.
REPORT OF THE COUNCIL The Report of the Council, as follows, was read by the General Secretary and approved: At their meeting yesterday the Council learned with pleasure that the Treasurer had succeeded in obtaining relief from the proposed increase in rates, which means in effect that we shall continue to pay the same rate as previously, at least for the next few years. The Editor-in-Chief reported that he regretted that there would be some delay in bringing out Volume III of Recent Progress in Psychiatry, as there had been some hold-ups in its préparation. The Registrar reported that there had been a very good attendance at the three- day Refresher Course held at the beginning of this week. This was a unique occasion in that every Professor of Psychiatry in the United Kingdom and Eire gave a paper. The Council congratulated Dr. Sargant on this outstandingly successful course, and expressed their appréciation of his administrative work in putting on such a valuable and interesting programme. It was pointed out that there was no obstacle in the way of holding Maudsley Bequest Lectures elsewhere than in London, but it is for members in the provinces to take the initiative in offering suggestions to the Registrar. The Council noted that the Films Sub-Committee had put on its first Film Evening at the beginning of the week, and congratulated the Committee on the success of this occasion. It is hoped that another film showing can be arranged during the February Quarterly Meeting. The Council has set up a Committee to discuss means by which the Association can contribute to the general éducation of the public and the press in matters of mental health, and to report back to the Council. In the meantime, authority has been delegated to the General Secretary, in consultation with the President, to take action, where necessary, in correcting mis-statements appearing in the national press. The Council discussed the question of savings accounts operated by patients in mental hospitals, and decided that this was one among many of the détails of patients' privilèges which should be taken up after the Royal Commission has published its report. The Papers at the February Quarterly Meeting will be on "The Practical Applications of Psychotherapy in Mental Hospitals and Out-Patient Units". The opening speakers at the morning session, which will be on "Psycho-dynamics", will be Dr. J. D. Sutherland and Dr. F. K. Taylor. Dr. Denis Leigh and one other speaker will give the opening papers in the afternoon, which will be devoted to the practical aspects of the question. 4
The May Meeting will be arranged in collaboration with Dr. Hemphill, who will be the Association's host in Bristol. The proposed Study Tour of England by Swiss Psychiatrists is likely to take place during the last three weeks of May 1957, and a Study Tour in Scotland is being arranged for 1958. The Council approved a Memorandum on Social Workers in the Mental Health Field to be forwarded to the Younghusband Working Party on Social Workers, and authorized the Committee who prepared the Memorandum to appoint représentatives to give orai evidence if requested to do so.
The Council considered the establishment of a College of Psychiatry, and feeling that the time was not yet ripe to proceed with this approach, adopted a resolution to the effect that there should be established within the Association a Fellowship in Psychiatry, and referred this matter back to the Education Committee to make recommenda tions.
The Council considered a report from the Sub-Committee studying training in eclectic psychotherapy and were of the unanimous opinion that there is a real need for training in this technique. It was decided to recommend to Regional Boards, university departments and teaching hospitals that facilities should be made available for training in Psychotherapy, and the Sub-Committee was asked to draft an additional list of suitable persons to give this training.
The Council made the usuai annual recommendations for filling vacancies on Regional Hospital Boards, the Central Health Services Council, the Standing Mental Health Advisory Committee and the Boards of Governors of the Bethlem and Maudsley Hospitals.
The Home Secretary has consulted the Association about a clause in the new Bill dealing with Capital Punishment which relates to the doctrine of Diminished Responsibility, and recommendations have been made which have been noted by those responsible for framing this clause. It may be necessary to make further recommendations during the passage of the Bill, and'is being carefully watched.
The Council gave permission for the Child Psychiatry Section's Memorandum on the Report of the Committee on Maladjusted Children to go forward to the interested bodies, if approved by the Section at their meeting held last night. It is understood, however, that considération of the Memorandum has been postponed by the Section.
Members may wish to be reminded of the dates of next year's Meetings, which are as follows: Wednesday and Thursday, 13 and 14 February, in London. Wednesday and Thursday, 1 and 2 May, at Barrow Hospital, Bristol. Tuesday, Wednesday, Thursday and Friday, 2, 3, 4 and 5 July, Annual Meeting at Oxford. The Tenth Annual Meeting of the World Fédération for Mental Health will be tield in Copenhagen from 11-17 August, 1957, and the subject will be, "Growing up in a Changing World". If Members who have spare copies of the Journal of Mental Science which :hey do not require would let us know, we should be grateful, as we have had -equests for help in obtaining sets from newly-established Universities and individual ioctors in isolated places in Africa, and would like to be able to help them if possible. 5
DISCUSSION "The Place of Medical Administration in Mental Hospitals." Opening Papers: Dr. J. A. Carse. Dr. C. Tetlow.
Before the discussion Dr. I. Frost asked for permission to move two motions, but it was agreed that in order to conform with Bye-Laws 120 and 122 these must be submitted in writing to the General Secretary before the February Quarterly Meeting.
MAUDSLEY LECTURE The Thirty-first Maudsley Lecture was given in the Barnes Hall, The Royal Society of Medicine, 1 Wimpole Street, London, W.l, by John R. Rees, C.B.E., M.A., M.D., F.R.C.P., D.P.H. (Director, World Fédération for Mental Health) on "Psychiatry and Public Health". Dr. H. B. Craigie proposed the vote of thanks to Dr. Rees, and this was carried by acclamation.
SOUTH-WESTERN DIVISION The AUTUMN MEETING of the South-Western Division was held at the Royal Victoria Hospital, Netley, Hampshire, on Thursday, 27 October, 1955, by kind invitation of the Director of Army Psychiatry, Brigadier J. T. Robinson, and the Officer Commanding, Royal Victoria Hospital, Colonel R. Phillipson. 35 members were present. The Honorary Divisional Secretary reported that the Divisional Committee of Management had agreed on nominations for the offices of Chairman, Junior Représentative on Council and Honorary Divisional Secretary, which would be circulated to members in due time for the Spring Meeting in 1956.
They also agreed to suggest to the Meeting that Drs. S. M. Allan and K. C. Bailey be re-elected to the Committee of Management, and that Colonel R. Phillipson, Dr. E. O. Hagedorn and Dr. A. J. Galbraith should be elected as new members to that Committee. It was also intimated that the Divisional Committee of Management had received a kind invitation from Dr. G. W. T. H. Fleming to hold the Spring Meeting, 1956, at Hume Towers, Bournemouth, and they recommended the acceptance of this invitation. The report was adopted, and as no nominations had been received from members for election to the Divisional Committee of Management, the ñames suggested in the above paragraph were unanimously agreed to by the Meeting for election to the Committee.
The following candidate was elected unanimously to Ordinary Membership: RUSHTON, HELEN SHACKFIELD, M.D., B.S., Senior House Officer, Bristol Mental Hospital, Fishponds, Bristol. Proposed by Drs. D. Early, E. G. Grant and E. C. Turton. 6
By kind permission of the Chairman, the subject of the possible re-introduction of the R.M.P.A. examinations for nurses was discussed and a good deal of divergence of opinion was revealed which did not, however, resuit in a motion being put to the Meeting.
PAPERS Colonel Philipson read a paper on "Psychological Medicine in the Army Today". He gave a concise and lucid description of the organization of Army Psychiatry and the functions of the Command Psychiatrist. He said that the task of Army Psychiatry was the maintenance of health, the prévention of disease and the care and treatment of the sick. Of the 2,400 young men called up every fortnight, 150 (or 7 per cent) were referred for psychiatrie report, and of these, 60 per cent were found fit to serve in full, 20 per cent to serve in a reduced category, 18 per cent were dull and backward but could be usefully employed in a special unit, and 2 per cent were recommended for invaliding from the Service.
Colonel Phillipson gave a detailed list of the duties of a Command Psychiatrist, from which it was clear that these are very comprehensive and cover ail aspects of the mental health and the treatment of mental sickness in the Army.
He said that at the Royal Victoria Hospital in the past four years, there had been an annual turnover of 1,200 patients through the 300 beds, 100 of which were used for psychotic patients and 200 for the treatment of neuroses. It was of interest to note that, of a large group of severe neurotics, 50 per cent had been returned to duty in the Army. The commonest neurosis was the anxiety state in over- dependent personalities who could not adjust. Colonel Phillipson pointed out that 999 of every 1,000 called up were fine young men in every way, but that even the loss of one in a thousand was considérable.
Colonel Phillipson was warmly complimented on his paper, which had given members a very clear picture of the comprehensive psychiatrie service with which he was associated.
Brigadier J. T. Robinson, O.B.E., M.A., M.D., D.P.M., D.T.M. & H., then read a paper on "Psychoendocrine Investigations at the Royal Victoria Hospital". He said that there was some evidence that those with endocrine disturbances are more vulnérable to stress. After quoting some recent researches, he said that these seemed to indicate that further endocrine investigation might yield informa- tion as to the cause of vulnerability, and consequently influence the Army situation. He said that, from the point of view from which he was speaking, patients could be divided into three catégories: (1) Those showing a psychiatrie syndrome, but with no endocrine disturbance; (2) those showing a psychiatrie syndrome with concomitant endocrine disturbance, but in whose case a return to normal under care and environmental protection took place; and (3) those showing similar syn- dromes with endocrine disturbance, who failed to respond to general care. He thought that only in the third group would endocrine treatment seem to be indicated, and further, that where endocrine disturbance was correlated with the severity of the syndrome, endocrine treatment appeared to improve the condition.
He then described the investigations at the Royal Victoria Hospital, which had been concerned with the assessment of thyroid and adrenal cortical function. After describing in some détail the techniques and the programme of the investiga- tions, which were mainly concerned with the measurement of thyroid function by the use of radio-active iodine, and the measurement of adrenal cortical function by the estimation of 17-ketosteroids, Brigadier Robinson went on to compare groups of cases and to quote individuai cases, showing the return of endocrine 7 status to normal coincidentally with the clearing of the clinical syndrome. He said that there was much need for further study of endocrine changes taking place during spontaneous recovery, and that reliable data from the investigation of endocrine function would help greatly in disposai after treatment. He concluded by saying that although the series was comparatively small, he thought that it showed, even with existing methods of investigation, some cases could be usefully treated by endocrine means. In the discussion which followed, Dr. D. E. Sands emphasized the potential interest of endocrine investigation of the spontaneously remitting patient and said that in some cases the biochemical state might be a more important indication than a constellation of symptoms. Dr. Myre Sim doubted whether we really knew what an endocrine disturbance was, and was sceptical of the value of endocrine therapy in such varied syndromes. Dr. Hemphill advocated a physiological approach to Psychiatry, but agreed that clinical findings must be given great importance in évaluation. Dr. Stevenson thought that médication which appeared to lead to clinical improvement was surely relevant to the problem. Several other members took part in the discussion, which reflected the great interest which had been taken in Brigadier Robinson's paper. The Chairman, on behalf of the Meeting, expressed his thanks to Brigadier Robinson and Colonel Phillipson for the time and thought they had devoted to the préparation of these valuable contributions to the Meeting. Prior to the opening of the afternoon meeting, and in the course of the luncheon, the Division had been welcomed to Netley by the Director-General Army Medicai Services, Lt.-Gen. Sir Frederick Harris, K.B.E., C.B., U.C., M.B., Q.H.S. At the close of the meeting, the Chairman, Dr. Shepherd, on behalf of the Division, expressed the warm thanks of the members to those who had acted as hosts, and complimented them on the excellence of the arrangements and the success with which Brigadier Robinson and Colonel Phillipson had given members an insight into both the Service and the research aspects of Army Psychiatry at the Royal Victoria Hospital.
THE SPRING MEETING of the South-Western Division was held at Hume Towers, 27 Branksome Wood Road, Bournemouth West, on Thursday, 5 April, 1956, by kind invitation of the Chairman and Committee of Barnwood House, Gloucester, and Dr. G. W. T. H. Fleming, Physician Superintendent. At the luncheon to which the Division was entertained prior to the Meeting, members were welcomed by the Chairman of the Committee of Barnwood House, W. I. Croome, M.A.(Oxon), F.S.A., who gave a brief account of the acquisition of Hume Towers by Barnwood House, and alluded to the value of research in Psychiatry and to the changes which had taken place since he became interested in it. The Chairman, in reply, thanked Mr. Croome and his Committee for their kindness in inviting the Division to Hume Towers and for the generous hospitality which was displayed. In the afternoon, and prior to the opening of the formai meeting, Dr. Shepherd (Chairman) referred to the untimely death of Dr. Dalton E. Sands, Physician Superintendent of St. Ebba's Hospital, Epsom, who had been a member of the Association for many years and was well known to the South-Western Division, Members stood in respectful silence, 8
1. MINUTES The Minutes of the last Meeting were read and signed.
2. PRESENT 23 members were present at the meeting and a number of apologies for absenc were received.
3. REPORT OF THE DIVISIONAL COMMITTEE OF MANAGEMENT
4. ELECTION OF CHAIRMAN, HONORARY SECRETARY AND JUNIOR REPRESENTATIVE A COUNCIL Dr. I. Atkin and Dr. R. G. Mclnnes were elected to the offices of Chairmai and Honorary Divisional Secretary, respectively, for the ensuing year. Dr. Atkin thereupon took the Chair, and, investing him with the badge o office, the retiring Chairman, Dr. Andrew Shepherd, congratulated him and extendei his good wishes for his chairmanship. In reply, Dr. Atkin called upon the Meetin¡ to join him in thanking Dr. Shepherd for his very valuable services as Chairman which had been greatly appreciated by all members.
Dr. C. P. SEAGER was elected Junior Representative on the Council.
5. ELECTION OF CANDIDATES TO ORDINARY MEMBERSHIP The following candidates were unanimously elected to Ordinary Membership GOUGH, DONALD, M.A., M.B., B.Ch., Junior Hospital Medical Officer, Ton Vale Hospital, near Taunton, Somerset. Proposed by Drs. K. C. Bailey, F. Bodman and R. W. Armstrong.
MAINE, JOHN LEIF FRANCIS, M.R.C.S., L.R.C.P., Assistant Medical Officei Broadmoor Institution. Proposed by Drs. J Gould, S. G. James and R. Payne.
MANDELBROTE, BERTRAM, D.SC., M.B., Ch.B., M.R.C.P., D.P.M., Medica Superintendent, Horton Road and Coney Hill Hospitals, Gloucester. Proposed by Drs. K. Cameron, D. L. Davies and D. Leigh.
NEALE, DEREK HARVEY, M.A., B.M., B.Ch., General Duty Medical Officei R.A.M.C., Royal Victoria Hospital, Netley, Hants. Proposed by Drs. R. Phillipson, T. B. Stephens and D. C. V. Stewart.
SIMPSON, ROBERT WALLACE, M.D., D.P.M., Senior Medical Officer, Know! Hospital, Fareham, Hants. Proposed by Drs. A. J. Galbraith, L. C. Cook and F. H. Taylor. Dr. I. Atkin was unanimously elected to serve on the Executive Committe of the Psychotherapy and Social Psychiatry Section, as representative of the South Western Division, for one year from November, 1956. Dr. G. W. T. H. Fleming read a paper on "Experimental Psychoses". He sail that this had been mainly concerned with three aspects of mental functioning— ;i) The effects of the interference with oxygen supply; (2) the effects of medianica ind electrical stimulation; and (3) the effects of chemical substances. Dr. Flemini »ave a review of experimental work which had been done from 1919 onwards. Referring first to experiments in anoxia which had produced severe menta symptoms, including incoherence and distortion of judgment, the similarity o: ;hese to some fatigue states had been noted. 9
He devoted most of his paper to biochemical investigations and experiments, including those which had been concerned with the effects of toxic amines and the so-called hallucinogenic drugs. He gave a detailed account of some of the work which had been done in this field and drew attention to the findings with mescaline, L.S.D. and other chemically-related substances. It had been suggested that schizophrenia might be due to a specific disorder of the adrenals and that certain deteriorative products of adrenalin could produce effects similar to those produced by the hallucinogens. It was noteworthy that nearly all the known hallucinogens are indoles. It appeared from some of the work that had been done that cycles of activity involving the pituitary, the adrenals and the cerebral cortex, were probably all involved in the production of deteriorative metabolic substances which might interfere with normal brain function. In the discussion which followed, the Chairman, Dr. Atkin, complimented Dr. Fleming on his interesting paper and expressed the view that further research of this kind was much needed, especially in the schizophrenic group of disorders. Dr. Kelsey thought that the subject under discussion had a direct bearing on the question of body-mind relations, and referred to the tendency in some such conditions to regress back to a pre-natal status. Dr. Hemphill emphasized the dissimilarity between the effects of hallucinogens and schizophrenia. Dr. Parfitt quoted cases of excitement, like catatonia, which were discovered to be due to atropine, and drew a distinction between chemically-produced psychoses and schizophrenia. Dr. Bailey wondered whether the blood chemistry was substantially altered by the presence of unusual substances circulating in the blood stream, and thought that the mental disturbances seen probably represented something more fundamental than the direct effect of the drug itself. Dr. Shepherd and others also contributed to the discussion. Dr. Atkin added that he felt the effects of hallucinogenic drugs must depend to some extent on the personality of the individual and asked whether the effects of mescaline, for example, were specific or differed from one person to another. Replying to the discussion, Dr. Fleming said he thought that there would be differences of this kind and, in more general terms, he advocated a much more intense team study of brain and blood chemistry. Dr. Atkin repeated his appreciation of Dr. Fleming's paper, and the meeting endorsed his remarks by acclamation.
SCOTTISH DIVISION
THE AUTUMN MEETING of the Scottish Division was held on 5 October, 1956, at the Royal Mental Hospital, Montrose. Thirty Members were present.
ELECTION OF ORDINARY MEMBERS The following were unanimously elected to Ordinary Membership:
BEATTIE, DONALD ELLIOTT HAMILTON, M.B.E., M.B., Ch.B., Senior Registrar, Bangour Village Hospital, Broxburn. Proposed by Drs. A. K. Macrae, B. E. A. Magill, F. G. Lasselle. HEWETT, JOHN RICHARD, M.B., Ch.B., Registrar, Bellsdyke Hospital, Larbert. Proposed by Drs. A. P. Russell, M. Devlin, M. R. Inglis. Ross, HAROLD STORMONT, M.B., Ch.B., Registrar, Perthshire Mental Hospital, Murthly, Perth. Proposed by Drs. J. McDougall, H. Stalker, T. A. Wylie. 10
REPORT FROM COMMITTEE OF MANAGEMENT, AND MATTERS ARISING THEREFROM The Secretary said that the Sub-Committee appointed had not yet met the Psychiatric Social Workers and it was suggested that 8 November in Edinburgh would be a suitable date and place, and that arrangements would be made for this Meeting. The postponed Meeting of the Committee of Management to consider further the White Paper, "The Law Relating to Mental Illness and Mental Deficiency in Scotland", was arranged for Friday, 9 November, in Glasgow. Dr. Stalker's reply from the Registrar of the General Nursing Council was read to the Meeting and it was decided that meanwhile no further action be taken. A letter from Professor Kennedy about a Post-Graduate Course in Edinburgh was read. The Secretary was requested to transmit to the other Professors a copy of the proposais contained in this letter. A letter from Dr. Devlin, the Secretary of the West of Scotland Association of Psychiatrists, had been considered by the Committee of Management and further considération was given to it at the Divisional Meeting. Gratitude was expressed to Dr. Devlin for bringing up the question of an Institution for Psychopathie patients. The Division as a whole decided to ask Dr. Inch (Department of Health) to present, as soon as convenient, a paper on the present position in relation to the treatment of psychopaths in Scotland. The second question raised by the Association of Psychiatrists in the Western Region was the matter of the structure of Hospital Medical Establishments, and the Secretary was instrueted to ask Dr. Angus MacNiven, the Division's représenta- tive on the Central Consultants' and Specialists' Committee, to keep this matter in mind when it arises for discussion by that body. The Committee of Management reported that they were satisfied with the present représentation of the Division on the Central Health Services Council— Professor W. M. Miliar and Dr. P. K. McCowan. It was agreed to put forward no further nominations meanwhile, but that an opportunity would be welcomed to do this in the future. This was unanimously agreed. Dr. John MacDougall raised the question of a Scottish D.P.M. and asked that this matter be reconsidered by the Division. He was strongly supported by several Members, and the Division agreed to consider this question in more detail before the next Meeting. The next meeting of the Scottish Division was fixed for Friday, 14 December, 1956, to be held at Bangour Village Hospital, by kind invitation of Dr. A. K. M. Macrae, the Physician Superintendent and his Board of Management.
SUB-COMMITTEES The Forensic Psychiatry, on this occasion, was the only Sub-section that met. An interesting Paper was read by Dr. Allan A. Bell. It was illustrated by lantern slictes. Early documents used in the legal certification of patients were shown. Dr. R. M. Stewart was in the Chair and moved the voté of thanks.
IRISH DIVISION
THE SUMMER QUARTERLY AND CLINICAL MEETING of the Irish Division was held on Wednesday, 4 July, 1956, at St. John of God Hospital, Stillorgan, by kind invitation of the Prior and Community, and Dr. D. McGrath. 11
The Members were entertained most hospitably to lunch. A vote of thanks was passed by Dr. Fitzgerald. The November Meeting was fixed for Wednesday, 7 November, 1956, at the Royal College of Physicians, Kildare Street, Dublin. DR. K. MCDAID, St. Patrick's Hospital, Castlerea, was unanimously elected an ordinary member. It was proposed by Professor Dunne and seconded by Dr. Glass that a Papers Committee be formed to arrange for communications at future meetings. This motion was passed unanimously, and Drs. V. Glass, Monaghan; D. McGrath, St. John of God Hospital; P. Meehan, Clonmel; Eithne O'Sullivan, Grangegorman and J. Shea, Ballinasloe, were elected. The Secretary was also asked to send officiai recommendation to the Depart- ment of Health and R.M.S. that facilities be afforded to members of this Committee to attend meetings of their Committee in Dublin when necessary. Dr. John Ryan then read his communication on the Open Door system in Mental Hospitals, referring particularly to Warlingham Park Hospital, where in 1942 ali but four wards were opened, and there were now no locked doors at ali. A group system of administration became necessary owing to the relatively small staff (150 nurses and 12 doctors to 1,100 patients). In two occupational therapy units it was found that mixing male and iemale patients contributed greatly to contentment and easy management of patients. Groups were organized for deteriorated patients, for the insulin units, alcoholics, neurotics and psychopaths. The Physician-Superintendent accompanied by some of the staff presided over a new patient conférence every week and the patients' suggestions were as far as possible acted on. There was a very advanced system practised with neurotics of the younger age group. A unit consisting of 10 men and 10 women was housed in a corner of the grounds. Treatment consisted of a series of discussion groups with a planned background of work and récréation. The patients themselves did ali the work, domestic duties, etc. They were encouraged to speak of their personal difficulties and problems. He concluded that the open door system was a major step in the humane treatment of the mentally ili. The combination of freedom and occupation could cause a change for the better in the chronic patient which bordered on the miraculous. The open door was but a prelude to stili greater advances in the welfare and eventual cure of their patients. The Paper was discussed by: Doctors J. Fitzgerald, J. Shea, V. Glass, B. Ramsay, D. McGrath, J. Dunne, B. Honan. Dr. Ryan then replied.
THE AUTUMN QUARTERLY AND CLINICAL MEETING of the Irish Division of the Royal Medico-Psychological Association was held at the Royal College of Physicians, Kildare Street, Dublin, by kind permission of the President and Fellows, on Wednesday, 7 November, 1956. Twenty-nine Members were present. The Minutes of the previous meeting were read and signed. The Spring Meeting was fixed for Wednesday, 1 May, 1957 at Mullingar Mental Hospital, by kind invitation of Dr. Fitzgerald. 12 Dr. W. A. Gordon MacCallum, Senior Registrar, St. Luke's Hospital, Armagh, was unanimously elected an Ordinary Member. Dr. C. B. Robinson, Purdysburn Hospital, Saintfield Road, Belfast, was nomi- nated as représentative of the Psychotherapy Section. Dr. M. E. O'Sullivan raised the question of permission being refused by the Department of Health for Assistant Medicai Officers to attend Maudsley Bequest lectures in London. Dr. Dolphin, in reply, stated it was part of the economy drive. Dr. Moran proposed that it be recorded in the minutes that the Division noted with regret that, owing to the fìnancial position, assistant medicai officers cannot be sanctioned to attend the Maudsley bequest lectures in London. This was seconded by Dr. Honan. Dr. Eamon O'Sullivan then read his paper on "Impressions of some Psychiatric Hospitals in U.S.A." His trip to U.S.A. was confined to Minnesota and its surrounding States. He described St. Paul, the capital city on the Mississippi river, where the population is mostly of Swedish, German and Irish descent. He visited the Mayo Clinic, Rochester, where the psychological and neurologica! unit is on the tenth floor. It is a diagnostic centre and patients are referred to suitable surroundings and hospitals for treatment. He described a quiet "run around" of the Rochester State Hospital, having 1,000 acres of ground. He was impressed by their up-to-date kitchen, deep freeze unit, etc. Moose Lake Hospital, built 20 years ago, has accommodation for 1,000 patients. It is comprised of detached buildings with central kitchen and tiled subways. Dr. O'Sullivan was struck by the fanatical use of drugs, mostly the tranquillizers, valuable as palliatives. In pushing Serpasil and Largactil the depression was countered by Ritalin. Drs. Shea, D. McGrath, Moran, N. Moore, E. O'Brien, T. Foley, F. Barnes, Dolphin, J. P. Hill, C. B. Robinson and C. Kidd spoke in the discussion and Dr. Eamon O'Sullivan replied.
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