1284

- determining criminal conduct. He also commented- on the futility of the present punitive system.

EFFECTS OF REHOUSING SCHEMES

Dr. A. K. Chalmers, formerly medical officer ofhealth for Glasgow, recently read an important paperbefore the Glasgow Royal Philosophical Society, inwhich he said that public opinion seemed to be

.completely formed on the need for slum clearance andrehousing schemes. Experience was teaching, hesaid, that a very large proportion of the inhabitantsof slum areas willingly and cheerfully react to the- improved conditions provided by rehousing schemes ;that some more respond to methods of re-educationin orderly domestic ways; while only a fractionremain for whose particular disabilities a solvent is.still needed. The continued existence of the slumhad hitherto shielded this refractory or " elusive "

group from every form of stimulus to social better-ment, and extinction of that shelter would open upnew avenues of approach, and suggest different andspecialised forms of treatment.

PUBLIC HEALTH AND FOOD PREPARATION

Prof. P. S. Lelean, of the public health department- of Edinburgh University, this year presented thediplomas and certificates to the students at the

Edinburgh College of Domestic Science (Atholl-.crescent). In considering the question of race better-ment, he said, despite temporary modern trends,there was no doubt that the big work of the futuredepended on the motherhood of all countries. Pro-

gress was apparent, and that progress would becomemore definite when we reached the point at which nogirl left school without a certificate of efficiency indomestic science. Atholl-crescent was not onlytraining those who were prepared to accept this trust- of maternity, but was also educating those who wouldso train the coming generation that the nation wouldno longer face the disgrace of a state of affairs whereby97 per 1000 children born in Scottish towns were deadbefore the year was out. Miss Wingfield, the principal,said they had enrolled this term 248 new students,just as many as they could accommodate. There were498 students now taking full courses ; 150 takingshorter courses, and a few hundred more coming infor odd lessons and lectures. A feature of the prize-giving was the absence of a large number of thestudents who had already taken up posts such asthose of warden, teacher, matron, canteen super-intendent, or cook.

IRELAND

(FROM OUR OWN CORRESPONDENT)

LUNACY CONDITIONS IN IRELAND

Mr. S. T. O’Kelly, Minister for Local Governmentand Public Health, in a speech made on opening anew mental hospital in County Louth, referred to thepossibility of reforms in the law and administrationof lunacy. He pointed out that the number of personsdetained in mental hospitals, not only in Irelandbut in other countries, was steadily increasing. Hedid not, however, regard this as altogether due toan increase in insanity. There was good reason tothink that the boundary lines of what constitutedmental disorders had changed from decade to decade,and that to-day many were cared for at the publicexpense who formerly would have been left to shiftfor themselves. The mental hospital must become

what its name implied-a real hospital-and it muststand more and more in the public estimation as ahospital and not as a place of detention. The presentprocedure for admission must be altered. At presentmost patients were admitted as if they were criminals.He would like to see established a system of voluntaryadmission which would dispense with certification,and he would like to see considerable simplificationof procedure in the cases in which the patients hadceased to be capable of expressing a wish. He thoughtpolicy ought to move on such lines, and if they foundgeneral approval, he had no doubt time would befound for the necessary legislation. He added thatthe mental hospitals were the only institutions formental defectives, and many who were defective frombirth or from an early age could be managed at homeand ’taught some handicraft. But some wouldrequire to be sent to institutions, and they did notimprove by being mixed with the ordinary patientsof a mental hospital. What was needed was a farm

colony on which they could be taught to be practicallyself-supporting.

MEDICINE AND THE LAW

Nursing-home’s Reputation VindicatedTHE result of the appeal in Powell v. Streatham

Manor Nursing Home is to reverse the substantialaward of damages against the defendants for theiralleged negligence in looking after one of their patients.The judgment is legally important, as will readilybe seen, inasmuch as it shows the Court of Appealtaking the unusual step of over-ruling the trial judgeon issues of fact. It is naturally of extreme valueto the nursing-home and its staff ; the originalverdict of negligence, had it stood, was most damagingto their good name. The brief story of the case isthat Mrs. Powell entered the home in January, 1930,to undergo hysterectomy. She (and her husbandwith her) claimed damages for two acts of allegedcarelessness in that (1) Nurse A so negligentlyattempted to pass a catheter into her as to perforateher bladder, and (2) Nurse B negligently droppedher when attempting to lift her single-handed onto the bed-pan, thereby causing an umbilical herniaand bursting the stitches of her operation wound.Mr. Justice Horridge tried the case (without a jury)for several days. He found for the plaintiffs on thefirst, but not on the second, allegation of negligence,and he awarded the husband :f:977 for his specialdamage and expense, and the wife E2500 for herpain and suffering. It was obviously an award whichthe defendants must challenge at all costs ; it istherefore satisfactory that Lord Justice Slesser shouldhave been able to say, when reviewing the case, thaton a proper examination of the evidence they stoodacquitted of all negligence or impropriety.The patient, it seems, was taken into the home on

favourable terms ; the genesis of her complaint ofnegligence synchronised, the Court of Appeal wasinclined to think, with the delivery of a demand forpayment of a small sum for fees ; the allegation aboutthe misuse of the catheter was certainly not promptand clear. The nursing-home witnesses said at thetrial that they had none but rubber catheters in thehome. There was substantial medical evidence that,if a rubber catheter were used, the bladder could nothave been perforated. Mr. Comyns Berkeley, con-sulting obstetric surgeon at the Middlesex Hospital,said he had never heard of any sort of catheter

perforating the bladder. He offered another possible