SEPT. 27, 1947
crying, Sister said and repeated, " It is the baby crying "-and hostels run on the freer lines of voluntary ones. All authorities
encouraged to follow the lead of those progresit was. The mother also heard it. I got a foetal stethoscope and should, however, becounty
boroughs which have already provided
counties and
went round to the front of the mother to listen to the foetal sive
cases for several years. Their experience
heart and heard the crying again, louder than before. The baby proves what great satisfaction is given to those old people capable
cried a third time, but I had left the room hoping to find another of enj6ying a fairly active and normal way of life in the backdoctor near, and only Sister and the patient heard it. No further ground of an ordinary large house.
intrauterine crying was heard.
Part II consists mainly of advice on how to build new institutions
More liquor drained during the afternoon. Contractions for the old. It is to be hoped that this will be relevant some day,
of our oldbegan about 6 p.m., and the baby was born at 12.10 a.m.-i.e., as most people would like to see scrapped the worst
public assistance buildings. In view of the present buildover 12 hours after the intrauterine crying. It cried at onre fashioned
ing crisis, however, authorities are unlikely to be able to build
and is quite well.
afresh for some years. If, therefore, I were to republish my booklet
(It would have been possible for the Drew-Smythe to haye to-day
I should stress the advisability of buying up or taking over
been passed into the child's mouth.)-I am, etc.,
ordinary fairly large houses, which do not require very much
adaptation. In some ways they may even be preferable to new
Examining Overseas
SIR,-The recent tragic death of one of the most able members
of our profession shortly after a long round of examinations
,overseas calls attention to an.important aspect of these tours.
I can speak with personal experience'of several such trips and
considerable experience of long-distance flights. In thisparticular case 1 met two of the examiners in Cairo on their
way home. Both were tired men, and one was completely
Those invited to undertake this work are of necessity busy
men with heavy commitments at home. It is sometimes held
out as an inducement that no time will be wasted and that the
tour will only occupy some surprisingly short period of weeks.
The tour in such circumstances is extremely trying. Oral
examinations and marking of papers are crowded into a
minimum of time before the examiners fly-often at awkward
hours-to their next appointment, and finally start on their
homeward journey tired out, usually to pass through rapid
changes of climate with only a few hours' rest at night. Return
home involves instant immersion in a welter of arrears and
urgent engagements, and a holiday is an impossibility.
If further tragedies are to be avoided these tours should be
planned to allow reasonable leisure, and a rest in some pleasant
surroundings should be arranged to take place before the trip
home. Electing bodies should not only pravide for such rest
but insist that it should be followed in spite of possible protests
by examiners.-I am, etc.,
London, W.1.
Housing the Infirm
SIR,-The recent B.M.A. booklet- on The Care and Treatment of the Elderly and Infirm is so excellent that all who are
interested in the welfare of old people hope that it will reach
a wide public. This subject, once scarcely developed, is now
being given more prominence, and it is to be desired that
many more doctors should realize the interest of tackling this
difficult problem, of exploring new methods and seeking for
fresh solutions. There is plenty of room for creative work.
Among the list of publications consulted by the B.M.A.
special committee which drew up this work my booklets are
mentioned. As they are now out of print, I have given one
of the few remaining copies of Housing the Infirm to the
B.M.A. Library. I wish to point out, however, that it was
written in 1937, and that if I were going to republish it to-day
it would have to be amended in several important respects.
There is little that I should wish to omit, but much that I
might add.
Part I consists of suggestions for brightening up existing public
assistance institutions, both how to improve the appearance of the
rooms and how to provide a more interesting life for the inmates.
Points like permission for daily visiting, the wearing of private
clothing, and the provision of more occupations have now been
officially recommended in the Ministry of Health Circular 49/47.
The chapter on pocket money is now out of date, since Miss Irene
Ward's Poor Law (Amendment) Act, 1938, allowed the authorities
to give it to inmates aged 65 or more; and, after a long campaign,
all of them, including the Scots, agreed to do so. Further sections
could weli be added in order to mention the more difficult types of
patient-senile, bedridden, incontinent, and so on-as I am afraid
that to readers unfamiliar with institutions the impression might be
given that the author believes that the majority of inmates would
be suitable for' transfer to small hostels. This is not the case.
Probably no more than a fifth, or at most a quarter, of the present
elderly inmates in institutions could be suitably provided for in
erections, since they were built originaily as private homes and
therefore do not smack of institutions.
The last chapter in the book I would now put first, since I regard
it as the most important. It stresses the fact that it is the staff,
far more than the building, which makes or mars the happiness of
those who "go in."-I am, etc.,
London, S.W.7.
British Rheumatic Association
SIR,-An association to forward the interests of sufferers from
rheumatism has been formed on the lines of the well-known
Diabetic Association. Mr. H. G. Wells, who was largely responsible for the founding of the Diabetic Association in 1933,
prophesied that it would be followed by other associations of
people with a common disability.
A. letter dated House of Commons, May 19, 1947, was signed
by five M.P.s representing all parties: Lady Megan Lloyd
George; Col. Stoddart-Scott, and Major C. York; Dr. S. W.
Jeger and'Mr. Stephen Taylor. This was published in the Press.
The key paragraph read as follows:
"A Rheumatic Association is visualized to organize the general
welfare of sufferers on'-a--national scale both by direct action and
advice and by assisting existing institutions. There would be an
executive and an advisory staff, and a monthly journal to keep
sufferers. and the public generally, informed of developments in the
treatment of rheumatism, of research into the disease, and of matters
of public health bearing on rheumatism."
The response to this letter justified the founding of the Association. It has been constituted essentially as a lay body with
lay activities; its Council must always have a non-medical,
majority. Apart from xnyself, the medical men at present
serving on the Council are: Dr. Francis Bach, Dr. S. W. Jeger,
M.P., Dr. C. E. Lakin, Col. Stoddart-Scott, M.P., and Dr. H. D.
Wyatt. The following are among those who have consented
to be titular vice-presidents: the Marchioness of Reading, Lady
Megan Lloyd George, the Dean of Westminster, Sir Ian Fraser,
Sir Alan Herbert, Sir Ralph Richardson, Sir Harold Tempany,
the Earl of Scarborough, Mr. Percy Rockliff, and the Rt. Hon.
Tom Williams.
The British Rheumatic Association is not intended to rival
any existing body. It has, in fact, the approval of the Empire
Rheumatism Council, and is seeking registration as a charity
trust. It has been formed primarily to help rheumatic sufferers
to help themselves; but its membership is' open to all who are
interested in rheumatism, whether sufferers or not. The subscription has been fixed at lOs. per annum. Donations would be
welcomed. The headquarters of the Association is at 118-120,
Wardour Street, but written communications should be addressed
to the Hon. Secretary, Mr. A. C. M. Bowen,- B.A., at the clerical
department, 11l, Woodville Rcad, New Barnet, Herts.I am, etc.,
New Barnet. Herts.
Chairman of Council, B.R.A.
The Report of the London Council of Social Services for the
Year 1946-7 has recently been published. Of particular interest is
the expansion of the Old People's Welfare Department that it'
reveals. An experimental London Federation of Homes for the
Aged has been set up with the obiect of raising the standard of
homes for the aged and for providing a consultation service. The
Federation is planning a conference for matrons of old people's
homes. The London Council has surveyed the home he:p. available
for old people in various boroughs., Ten local committees are now
providing mobile meals services and canteens.