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847 BRITISH EMPIRE CANCER CAMPAIGN AT the annual meeting held in London on Nov. 26 H.R.H. the Duke of GLOUCESTER, president, said that in celebration of the campaign’s 25th anniversary next year a special appeal for funds will be launched. In the past financial year the public subscribed S135,000, not including sums raised in the autonomous areas. This is the highest figure yet reached, but does not permit the necessary extension and intensification of the work. Lord HoRDER, reporting as chairman of the Scientific Advisory Committee, said he felt more hopeful than ever before about the results of cancer research and treatment, and more certain of the service rendered by the campaign. The problem is still the causation of cancer-not the cause, " for of causes of cancer we have already an abundance." Any one of the many somewhat isolated facts may prove a pointer. Planning is essential -first the strategy and then the tactics. The 25th anniversary appeal will give the public an opportunity of making the programme which the campaign has in view a real and not a visionary one. It is an ambitious programme, and very expensive, but vital in the public interest : . 1. A special committee has been set up to develop research into the whole virus position in relation to cancer. This involves the activation of several ad-hoc teams up and down the country. A grant of 5.:25,000 has already been set aside for this research. 2. Travelling fellowships are imperative, with long-term agreements of from five to ten years’ duration, if the acute shortage of workers is to be provided against. 3. The campaign requires another special committee set up to organise research on chemotherapy. 4. The new tools of atomic-energy physics must be made available to B.E.C.C. workers. 5. Lastly there is great need of education with regard to cancer, both of the doctor and of the public. Thousands of lives are lost every year through want of diagnosis during the curable stage of the disease. Not only so, there is also the question of prevention ; here there is more need for education. THE MENTAL HOSPITALS THE annual report of the Board of Control tells of continued overcrowding in our mental hospitals. At the end of 1946 there were 146,444 people under care under the Lunacy and Mental Treatment Acts, 128,579 of these being in public mental hospitals. The total beds in these hospitals fall short of this number by some , 1500, and their numbers are further reduced-from such causes as staff-shortage, need for restoration and re-equip- ment, and diversion of beds to war-time casualties- by over 15,000. Thus overcrowding amounts to 13’1 % on the basis of recognised bed-space. More than half the admissions in 1946 were of voluntary patient.-!. Total admissions showed an increase of 6009 over those of 1945-an increase due, the board feel sure, not to a rise in the incidence of mental illness but to a growing awareness of the need for early treatment. They esti- mate that during the next ten years an additional 1500 beds a year may be needed ; and presumably they assume that these will be in addition to existing idle and diverted beds when these have been reclaimed for the mental hospital service. The " most serious single handicap " under which the service has laboured has been, and is, shortage of nursing staff. By the turn of the year, it seems, some hospitals found the situation easing slightly, and many made use of auxiliary staff-orderlies and the like-and of part- time voluntary workers from the British Red Cross Society and the Order of St. John, and from the Woxnen’s Voluntary Services. The practice of requiring nurses to sleep on the wards seems to be dying out. The board note that the possibilities of occupational therapy for patients with long-standing mental disorder are not yet fully understood by many who work in hospitals. 1. Part I. H.M. Stationery Office. 1947. Pp. 40. 9d. In England Now A Running Commentary by Peripatetic Correspondents THIS is no time for lightly proposing new textbooks and manuals, but I am worried about recently qualified men who don’t understand what the patient says. Oughtn’t there to be a glossary of lay terms for medical people; for remember the man who, when a patient told him she " hadn’t seen anything for three months," sent her to the Eye Department ? P Does every new doctor realise that " tummy trouble," spoken of in an open and cheerful manner, means upper abdominal pain, whereas if there is a dropping of the voice and eyes it means diarrhoea ? " Inside trouble," is always gynaecological, and to " have all one’s inside out " is to have a total hysterectomy not a pan-evisceration. " Something coming down " is again usually gynaecological, but may occasionally be a thrombosed pile. Another point to remember is that the urinary bladder is rude and will be referred to in a shamefaced way as the waterworks. while the gall-bladder is a polite and interesting organ and ’can be discussed freely at tea-parties ; and if a woman ruefully confesses that she has " fallen again," the doctor should not ask if any skin was knocked off. " Dizzy turns" and " blackouts," of course, may be anything, but usually after exhaustive investigations prove not to be epileptic attacks. In fact, anyone who has had to deal with soldiers will recognise blackouts as simple blackouts, and leave it at that. The glossary should also deal with terms in use in various parts of the country. At my first outpatients in a Nottingham children’s hospital the first mother complained that her child was " tissucky " and the second that hers was " mardy." The first child had a mild bronchitis ; the second was fractious, bad-tempered, and generally difficult. Both lovely words but very confusing at first acquaintance. * * * Invited by the ever-attractive possibility of getting something for nothing, we found ourselves a week or so ago wandering through the doors of the London Medical Exhibition. As we stepped into the Odeon-like foyer we were eyed narrowly by a gentleman suspiciously demanding if we were " of the Profession." We reassured him with some disdain, adding in explanation of our immaturity and general untidiness that we were residents of St. Ethelred’s. ’’ Ah yes," he beamed at us, " most welcome, I’m sure. You will find the bar on the lower floor." I am an experienced exhibition-goer, being educated all the way from the original Wembley extravaganza by way of the Ideal Homes, Radiolympia, the Motor Show, and the 1937 Exposition de Paris, to last year’s Chelsea Flower Show. At all of these gatherings, with the understandable exception of the Flower Show, an exuberance of free samples was available to be carried away by the delighted visitors. I have left such affairs .to find my pockets bulging with all sorts of junk from model rubber tyres and improved lavatory brushes to a free annual subscription to a society journal. The subse- quent problem of finding what the hell to do with the collection appears negligible against the thrill of their costless acquirement. The Paris exhibition was highly satisfying from the sampler’s point of view, for the champagne and cognac stands cascaded their wares, and free.bottles of Grand Marnier went along with buckshee crepes suzettes. At the Horticultural Hall we had to content ourselves with jostling towards a salver of diabetic chocolate, a couple of diabetic rolls (no butter), a cup of baby food, some, strained carrots, and what later turned out to be a handful of raspberry-flavoured laxative. In addition, we are now confidently expecting the daily arrival of small though gratuitous packages of malt drinks, pheno- barbitone, nose-drops, hair-oil, and contraceptives. As we wandered through this hippocratic bazaar we greatly enjoyed listening to an all-electric stethoscope and diathermying large slices from an appetising hunk of raw horse-meat. We were enchanted with an illumi- nated tableau of the internal workings of the halibut, and with a sort of radar screen ultimately attached to a frog’s gastrocnemius. The corset-stand attracted our

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847

BRITISH EMPIRE CANCER CAMPAIGN

AT the annual meeting held in London on Nov. 26H.R.H. the Duke of GLOUCESTER, president, said thatin celebration of the campaign’s 25th anniversary nextyear a special appeal for funds will be launched. In thepast financial year the public subscribed S135,000, notincluding sums raised in the autonomous areas. This isthe highest figure yet reached, but does not permit thenecessary extension and intensification of the work.

Lord HoRDER, reporting as chairman of the ScientificAdvisory Committee, said he felt more hopeful thanever before about the results of cancer research andtreatment, and more certain of the service rendered bythe campaign. The problem is still the causation ofcancer-not the cause,

" for of causes of cancer we havealready an abundance." Any one of the many somewhatisolated facts may prove a pointer. Planning is essential-first the strategy and then the tactics. The 25thanniversary appeal will give the public an opportunityof making the programme which the campaign has inview a real and not a visionary one. It is an ambitiousprogramme, and very expensive, but vital in the publicinterest : .

1. A special committee has been set up to develop researchinto the whole virus position in relation to cancer. Thisinvolves the activation of several ad-hoc teams up and downthe country. A grant of 5.:25,000 has already been set asidefor this research.

2. Travelling fellowships are imperative, with long-termagreements of from five to ten years’ duration, if the acuteshortage of workers is to be provided against.

3. The campaign requires another special committee set upto organise research on chemotherapy.

4. The new tools of atomic-energy physics must be madeavailable to B.E.C.C. workers.

5. Lastly there is great need of education with regard tocancer, both of the doctor and of the public. Thousands oflives are lost every year through want of diagnosis during thecurable stage of the disease. Not only so, there is also thequestion of prevention ; here there is more need for education.

THE MENTAL HOSPITALS

THE annual report of the Board of Control tells ofcontinued overcrowding in our mental hospitals. Atthe end of 1946 there were 146,444 people under careunder the Lunacy and Mental Treatment Acts, 128,579of these being in public mental hospitals. The total bedsin these hospitals fall short of this number by some

, 1500, and their numbers are further reduced-from suchcauses as staff-shortage, need for restoration and re-equip-ment, and diversion of beds to war-time casualties-by over 15,000. Thus overcrowding amounts to 13’1 %on the basis of recognised bed-space. More than halfthe admissions in 1946 were of voluntary patient.-!.Total admissions showed an increase of 6009 over thoseof 1945-an increase due, the board feel sure, not toa rise in the incidence of mental illness but to a growingawareness of the need for early treatment. They esti-mate that during the next ten years an additional 1500beds a year may be needed ; and presumably theyassume that these will be in addition to existing idleand diverted beds when these have been reclaimed for themental hospital service.The " most serious single handicap " under which the

service has laboured has been, and is, shortage of nursingstaff. By the turn of the year, it seems, some hospitalsfound the situation easing slightly, and many made useof auxiliary staff-orderlies and the like-and of part-time voluntary workers from the British Red CrossSociety and the Order of St. John, and from the Woxnen’sVoluntary Services. The practice of requiring nursesto sleep on the wards seems to be dying out.The board note that the possibilities of occupational

therapy for patients with long-standing mental disorderare not yet fully understood by many who work in

hospitals.

1. Part I. H.M. Stationery Office. 1947. Pp. 40. 9d.

In England NowA Running Commentary by Peripatetic CorrespondentsTHIS is no time for lightly proposing new textbooks

and manuals, but I am worried about recently qualifiedmen who don’t understand what the patient says.Oughtn’t there to be a glossary of lay terms for medicalpeople; for remember the man who, when a patient toldhim she " hadn’t seen anything for three months,"sent her to the Eye Department ? P Does every new doctorrealise that " tummy trouble," spoken of in an open andcheerful manner, means upper abdominal pain, whereasif there is a dropping of the voice and eyes it meansdiarrhoea ? " Inside trouble," is always gynaecological,and to " have all one’s inside out " is to have a totalhysterectomy not a pan-evisceration. " Somethingcoming down " is again usually gynaecological, butmay occasionally be a thrombosed pile. Another pointto remember is that the urinary bladder is rude and willbe referred to in a shamefaced way as the waterworks.while the gall-bladder is a polite and interesting organand ’can be discussed freely at tea-parties ; and if awoman ruefully confesses that she has " fallen again," thedoctor should not ask if any skin was knocked off." Dizzy turns" and " blackouts," of course, may beanything, but usually after exhaustive investigationsprove not to be epileptic attacks. In fact, anyone whohas had to deal with soldiers will recognise blackoutsas simple blackouts, and leave it at that.The glossary should also deal with terms in use in

various parts of the country. At my first outpatientsin a Nottingham children’s hospital the first mothercomplained that her child was " tissucky " and the secondthat hers was "

mardy." The first child had a mildbronchitis ; the second was fractious, bad-tempered, andgenerally difficult. Both lovely words but very confusingat first acquaintance.

* * *

Invited by the ever-attractive possibility of gettingsomething for nothing, we found ourselves a week or soago wandering through the doors of the London MedicalExhibition. As we stepped into the Odeon-like foyerwe were eyed narrowly by a gentleman suspiciouslydemanding if we were " of the Profession." We reassuredhim with some disdain, adding in explanation of ourimmaturity and general untidiness that we were residentsof St. Ethelred’s. ’’ Ah yes," he beamed at us, " mostwelcome, I’m sure. You will find the bar on the lowerfloor." ’

I am an experienced exhibition-goer, being educatedall the way from the original Wembley extravaganzaby way of the Ideal Homes, Radiolympia, the MotorShow, and the 1937 Exposition de Paris, to last year’sChelsea Flower Show. At all of these gatherings, withthe understandable exception of the Flower Show, anexuberance of free samples was available to be carriedaway by the delighted visitors. I have left such affairs.to find my pockets bulging with all sorts of junk frommodel rubber tyres and improved lavatory brushes to afree annual subscription to a society journal. The subse-quent problem of finding what the hell to do with thecollection appears negligible against the thrill of theircostless acquirement.The Paris exhibition was highly satisfying from the

sampler’s point of view, for the champagne and cognacstands cascaded their wares, and free.bottles of GrandMarnier went along with buckshee crepes suzettes. Atthe Horticultural Hall we had to content ourselves withjostling towards a salver of diabetic chocolate, a coupleof diabetic rolls (no butter), a cup of baby food, some,strained carrots, and what later turned out to be ahandful of raspberry-flavoured laxative. In addition,we are now confidently expecting the daily arrival ofsmall though gratuitous packages of malt drinks, pheno-barbitone, nose-drops, hair-oil, and contraceptives.As we wandered through this hippocratic bazaar we

greatly enjoyed listening to an all-electric stethoscopeand diathermying large slices from an appetising hunkof raw horse-meat. We were enchanted with an illumi-nated tableau of the internal workings of the halibut,and with a sort of radar screen ultimately attached toa frog’s gastrocnemius. The corset-stand attracted our