525

the specialist services that would meet the needs of allthe armies in the field. United by their desire toserve, these experts were divided by their belief, inthe importance of their own specialties, and they weremostly unaccustomed to the ways and aims of theircolleagues in the regular service. It says much forHOOD that he was able to build so much diversematerial into an efficient and smoothly runningmachine. As its governor, he had to listen to the

proposals of each and all of his directorates, branches,and consultants, and from these select and supportthose that were practicable and compatible andwould in the end give most benefit to the soldier.His genial, even jovial, control of his group wassure and firm : he attracted to the service the

complete loyalty of his associates, and by loadingthem with responsibility he extracted the greatestcontribution each could make. Judged by results,the medical service thu5, directed and conducted wasas good as any army has known.HOOD did more, however, than perfect a mechanism

inherited from his predecessor : he enlarged its scope.His innovating quality is revealed most clearly,perhaps, in the support he gave, often against advice,to the development of psychiatry at a time whenthis had to contend with opposition not only frompowerful military authorities but also from powerfulmembers of our profession. Another thorny questionwas that of investigation into matters of health andmilitary efficiency, requiring a modus vivendi withthe Medical Research Council. From the beginningof the war the council had placed its facilities at thedisposal of the Forces, and when HOOD took officeit was engaged in numerous inquiries for the Army.Believing, however, that research must not be divorcedfrom active service and become the monopoly of anoutside body, he felt that the best results would beobtained by establishing, within his staff, a directorateof medical research, which should collaborate withthe M.R.C. and facilitate the work of its operationalresearch units. Serving officers were encouraged topropose and undertake investigations, and in orderto help them, and. to supply a factual basis foradministrative policy, a statistical section was

developed in the research directorate. Meanwhile, asthe war entered its later phase, the conservation ofman-power became the major preoccupation of theArmy Council, and the preventive and health-pro-moting activities of the Army Medical Departmentincreasingly outweighed the purely curative. Ceaseless

changes in the categorisation of personnel, more

systematic efforts at -reablement, and medical con-tributions to the maintenance and improvement ofmorale were the order of the day ; and the changeof emphasis was illustrated by HooD’s, inclination tochange the name " medical services " to " healthservices " and his desire for the replacement of sick-parades by a " doctor’s hour " comparable to the" padre’s hour." At the same time, the applicationof scientific methods to the military art faced themedical director-general with a difficult and almostnew problem. Medicine was now asked to concernitself not only with the health of the individual asa human being but also with his efficiency as a fightinganimal;’ and in pursuit of relevant informationofficers of the Royal Army Medical Corps were ledinto activities which must deprive them of the pro-

tection of the Geneva Convention. After long andcareful thought HOOD decided that, if the Army wasto have the best medical attention, its medicalservices must dissociate themselves from everythingnot related to the preservation and promotion of thehealth of the soldier as a human being ; and allinquiries into military efficiency were accordinglypassed over to the Scientific Adviser to the ArmyCouncil, under whose control medically qualifiedofficers could engage in

"

aggressive medicine " with-out making any claim on the protection of the redcross. Medical scientists applying their science to

purely military matters were rightly distinguishedfrom doctors bound by the Hippocratic oath and

solely concerned with promoting health and preventingand curing disease.

It can fairly be said that under General HOOD’Sdirection the Army Medical Services disregarded noadvance in medicine, and reduced almost to a mini-mum the time-lag between discovery and applicationin the field. The effect of his work was a reductionin pain, suffering, and mutilation, and he has theprivilege of knowing in his own time that what hedid was good. In doing it he attracted the affectionateloyalty of those who served with him, and now that--too soon, it seems-he has stepped off the top of theinexorable Service escalator they will wonder how hishigh talents can be further employed. It has been saidthat, even now, his capacity has never been fullytested ; and certainly the best reward for a man who

has succeeded in one task is to give him another andharder. If we had to choose, we should suggest thegovernorship of some part of the Empire wheremedico-sociological problems are paramount. Mean-while we can only wish the new director-general,Major-General CANTLIE, equal success-without theopportunities of war.

Disabilities: and How to Live withThem

THE effect of a chronic disability depends onits nature and extent, on the disabled person’sage, financial standing, intelligence, occupation, andeducation, and on whether his family are a liabilityor a help-for the burden will be immeasurablylightened if someone is able and willing to share it.Besides these there are many less tangible reasonswhy the same lesion will make one man a querulousinvalid while to another it acts as a stimulus to better

things. The series of fortnightly articles which beginsin this issue will, we hope, reveal some of the factorsconcerned ; but our primary aim in getting patientsto discuss their disabilities is to turn their experienceto the advantage of others who face similar difficulties.The person whose happiness and efficiency depends ondetails of management must always make demands onthe imaginative insight of his doctor ; but there is,we believe, a great store of private knowledge on whichthey should both be able to draw in order to make thebest of a bad job. The first article, by a woman whowas 23 when her spinal cord was damaged at thelevel of Tll-12, illustrates how much can be doneby a patient to minimise discomforts and dangersand to enlarge the remaining openings for an activelife.

,