Empowering Scotland: The Government's Programme for Scotland ...
SCOTLAND.
1
1146 Bed-wetting, for example, should never occur after 2 years of age. Of the cases that persisted beyond this age 2 per cent. were pathological, but 98 per cent. were amenable to habit training and could be cured in six months. It was impossible to exaggerate the effects on a child of this condition. He was exposed either to punishment or ridicule, and his sense of inferiority made it impossible for him to adjust himself to his surroundings. Sleep was the response which the child acquired as a satisfaction of the appetite of rest. A child should be taught when and how to sleep. The text-books said that during the first month of life a child slept 22 hours out of the 24 ; by actual obser- I vation he had never found the hours of sleep to exceed 18. No one knew how long we ought to sleep, and it was entirely a matter of habit and convenience. The emotions. Watson had made the first really valuable experi- ments on emotions in children. He found that infants were potentially emotional, but showed only two types of emotional response; the first was fear, which was produced by a sudden change in environ- ment, such as the occurrence of a loud noise, and it was expressed by a movement of flexion and a sudden inspiration. Anger, the second emotion, was produced by preventing the child from fulfilling some some desire. If the wrist were taken between the observer’s finger and thumb so that the child could not withdraw the hand, it would first make vigorous attempts to free itself ; when it failed it would express its resentment by a movement of extension and an expiratory cry. The infant had no other emotions, and adult emotions were complexities of these. It was impossible to stamp out fear or anger, but we should train the child to fear those things which it was socially acceptable - that he should fear, and be angry when it was socially accepted that anger was desirable. A child should never be given what it wanted when it showed anger as otherwise it would count on gaining its ends in this way. But it must not be concluded that every child who showed anger was spoiled. Anger was a normal quality at 2 years of age ; it increased up to 3, and then gradually diminished up to 5. The psychiatrists talked of psychotic children, but Prof. Blatz did not recognise such cases. In all the examples he had observed the fault had lain in the training. He had seen a 6-year-old boy, described as psychotic, in a children’s court, who had refused to answer the questions of a Binet test. At last his mother had been sent out of the room and he had been told she would not return until he consented to do the test. For 18 minutes he had given an exhibition of mania, flinging objects on the floor, and shouting and screaming. No one had touched or interfered with him. At the end of that time he had stopped and seated himself, the mother had come in, and he had performed the tests. The mother; however, had been less educable. She had seized him, exclaiming: " Wait till I get you home!" But when that boy was placed in a proper environment, as he would be, he would find this behaviour would not get him what he wanted, and would become normal. His intelligence quotient was high. Self-assertion reached fruition at the age of 2, and remained one of the most potent motives throughout life. Prof. Blatz referred to the curious anomaly whereby nursery schools in England and Canada tended to be the monopoly of the children of the under-privileged classes. In Canada children were expected to attend school from 8 to 16 years, so that all their important years of early childhood were unsupervised. He hoped to see a revision of the law, requiring children to begin school at 2 years and to leave when they had completed the curriculum adapted to their intellectual level. SCOTLAND. (FRO]}I OLTR OWN CORRESPONDENT). Insumnce Data for Medical Research.. I AM glad to see, from the First Annual Report, that the Department of Health for Scotland are " considering a method whereby the particulars recorded on medical certificates may be made available to them shortly after issue. This would give complete and trustworthy data from which may be compiled statistical records showing, inter alia, the illnesses to which incapacity is ascribed and the loss of working time in each area arising therefrom. It is hoped, ! incidentally, to adapt this procedure to supply information on certification which is necessary for administrative purposes." The Department are to be congratulated on this effort to make some use of the hundreds of thousands of medical cards now in their possession. Some years ago the Ministry of Health Medical Department issued an admirable study on rheumatism and the data were taken from the records of the insurance practitioners. Why these data have not been studied on a much larger scale is difficult to explain either for England or for Scotland. The insurance practitioners are required to make returns and fined if they do not. It is regrettable that this gold mine of medical facts has received so little attention during these 18 years. Insurance Domiciliary Service and the New Local Government Act. The Department are also giving careful considera- tion to the problem of securing to the insured person the institutional advantages of the new Act. " With the passing of the Local Government (Scotland) Act, it is to be expected that local authorities in Scotland, in cooperation with the great voluntary institutions which have served the insured and non-insured population in the past, will develop a service which will be of great value to all. The Department realise that to secure the fullest value from the organised medical services of the country a definite relationship must be established between the insurance prac- titioner and these institutions, and consideration is being given to the best method of securing full consultation and cooperation between all the parties concerned." This great flaw in the insurance system will now be rectified. It is gratifying to find that this immense clinical problem is brought by the Depart- ment into the front place. This new departure in " treatment " policy, as well as in the handling of -the medical returns, will be welcomed by all interested in developing the efficiency of the national insurance system. - :’dinburgh Boyallnjírmary Appeal. The appeal for z500,000 for Edinburgh Royal Infimary is now being launched, and at a meeting, convened by Lord Provost Whitson, officers were appointed to take charge of the procedure. Colonel J. M. B. Scott was appointed Appeal Director, and Mr. J. D. Imrie, City Chamberlain, will act as honorary secretary and treasurer.. The case for extension of the infirmary is overwhelming. From time to time facts about the waiting-lists have been published, and however they may be interpreted. they are always disturbing. But there is now a general consensus of lay and official opinion that the time has come for a large expansion. The Town Council, under the new Local Government Act, is proceeding with the correlation of all its medical institutions ; but this will not in any way interfere with the great appeal of the Royal Infirmary. To judge by the other Scottish hospital appeals, Edinburgh is likely to have a handsome response. It is not without significance that the 250th anniversary of the Royal College of Physicians comes next year, and, as the College was really the originator of the infirmary, the interest created by the anniversary will help the principal medical institution of the East of Scotland.
Transcript of SCOTLAND.
1146
Bed-wetting, for example, should never occur after2 years of age. Of the cases that persisted beyondthis age 2 per cent. were pathological, but 98 percent. were amenable to habit training and couldbe cured in six months. It was impossible toexaggerate the effects on a child of this condition.He was exposed either to punishment or ridicule, andhis sense of inferiority made it impossible for himto adjust himself to his surroundings.
Sleep was the response which the child acquiredas a satisfaction of the appetite of rest. A childshould be taught when and how to sleep. Thetext-books said that during the first month of lifea child slept 22 hours out of the 24 ; by actual obser- Ivation he had never found the hours of sleep to exceed18. No one knew how long we ought to sleep, andit was entirely a matter of habit and convenience.
The emotions.
Watson had made the first really valuable experi-ments on emotions in children. He found thatinfants were potentially emotional, but showedonly two types of emotional response; the first wasfear, which was produced by a sudden change in environ-ment, such as the occurrence of a loud noise, and it wasexpressed by a movement of flexion and a suddeninspiration. Anger, the second emotion, was producedby preventing the child from fulfilling some somedesire. If the wrist were taken between the observer’sfinger and thumb so that the child could not withdrawthe hand, it would first make vigorous attempts to freeitself ; when it failed it would express its resentmentby a movement of extension and an expiratory cry.The infant had no other emotions, and adult emotionswere complexities of these. It was impossible tostamp out fear or anger, but we shouldtrain the child to fear those things which it wassocially acceptable - that he should fear, and beangry when it was socially accepted that angerwas desirable.A child should never be given what it wanted when
it showed anger as otherwise it would count on gainingits ends in this way. But it must not be concludedthat every child who showed anger was spoiled.Anger was a normal quality at 2 years of age ; itincreased up to 3, and then gradually diminishedup to 5.The psychiatrists talked of psychotic children, but
Prof. Blatz did not recognise such cases. In all theexamples he had observed the fault had lain in thetraining. He had seen a 6-year-old boy, describedas psychotic, in a children’s court, who had refusedto answer the questions of a Binet test. At last hismother had been sent out of the room and he had beentold she would not return until he consented todo the test. For 18 minutes he had given an
exhibition of mania, flinging objects on the floor, andshouting and screaming. No one had touched orinterfered with him. At the end of that time he hadstopped and seated himself, the mother had comein, and he had performed the tests. The mother;however, had been less educable. She had seizedhim, exclaiming: " Wait till I get you home!"But when that boy was placed in a properenvironment, as he would be, he would findthis behaviour would not get him what he wanted,and would become normal. His intelligence quotientwas high.
Self-assertion reached fruition at the age of 2, andremained one of the most potent motives throughoutlife.
Prof. Blatz referred to the curious anomaly wherebynursery schools in England and Canada tended tobe the monopoly of the children of the under-privilegedclasses. In Canada children were expected to attendschool from 8 to 16 years, so that all their importantyears of early childhood were unsupervised. Hehoped to see a revision of the law, requiring childrento begin school at 2 years and to leave when they hadcompleted the curriculum adapted to their intellectuallevel.
SCOTLAND.
(FRO]}I OLTR OWN CORRESPONDENT).
Insumnce Data for Medical Research..I AM glad to see, from the First Annual Report,
that the Department of Health for Scotland are
" considering a method whereby the particularsrecorded on medical certificates may be made availableto them shortly after issue. This would give completeand trustworthy data from which may be compiledstatistical records showing, inter alia, the illnessesto which incapacity is ascribed and the loss of workingtime in each area arising therefrom. It is hoped,
! incidentally, to adapt this procedure to supplyinformation on certification which is necessary foradministrative purposes." The Department are to becongratulated on this effort to make some use of thehundreds of thousands of medical cards now in theirpossession. Some years ago the Ministry of HealthMedical Department issued an admirable study onrheumatism and the data were taken from therecords of the insurance practitioners. Why thesedata have not been studied on a much larger scaleis difficult to explain either for England or forScotland. The insurance practitioners are requiredto make returns and fined if they do not. It isregrettable that this gold mine of medical factshas received so little attention during these 18 years.
Insurance Domiciliary Service and the New LocalGovernment Act.
The Department are also giving careful considera-tion to the problem of securing to the insured personthe institutional advantages of the new Act. " Withthe passing of the Local Government (Scotland) Act,it is to be expected that local authorities in Scotland,in cooperation with the great voluntary institutionswhich have served the insured and non-insuredpopulation in the past, will develop a service whichwill be of great value to all. The Department realisethat to secure the fullest value from the organisedmedical services of the country a definite relationshipmust be established between the insurance prac-titioner and these institutions, and consideration isbeing given to the best method of securing fullconsultation and cooperation between all the partiesconcerned." This great flaw in the insurance systemwill now be rectified. It is gratifying to find that thisimmense clinical problem is brought by the Depart-ment into the front place. This new departure in" treatment " policy, as well as in the handling of-the medical returns, will be welcomed by all interestedin developing the efficiency of the national insurancesystem.
- :’dinburgh Boyallnjírmary Appeal.The appeal for z500,000 for Edinburgh Royal
Infimary is now being launched, and at a meeting,convened by Lord Provost Whitson, officers wereappointed to take charge of the procedure. ColonelJ. M. B. Scott was appointed Appeal Director,and Mr. J. D. Imrie, City Chamberlain, will act ashonorary secretary and treasurer.. The case forextension of the infirmary is overwhelming. Fromtime to time facts about the waiting-lists have beenpublished, and however they may be interpreted.they are always disturbing. But there is now a generalconsensus of lay and official opinion that the timehas come for a large expansion. The Town Council,under the new Local Government Act, is proceedingwith the correlation of all its medical institutions ;but this will not in any way interfere with the greatappeal of the Royal Infirmary. To judge by theother Scottish hospital appeals, Edinburgh is likelyto have a handsome response. It is not withoutsignificance that the 250th anniversary of the RoyalCollege of Physicians comes next year, and, as theCollege was really the originator of the infirmary, theinterest created by the anniversary will help the
principal medical institution of the East of Scotland.
