the alps for children

1
538 wish to buy quinine, whether they are governments or individuals, cannot afford to buy it in adequate amount at its present cost. It follows that even if a satisfactory synthetic substitute is ever found, it cannot benefit mankind to the full unless it can be sold far more cheaply that are the cinchona alkaloids at the present time. A FUND FOR RESEARCH WORKERS INFECTIVE endocarditis is one of the most hopeless diseases with which the physician can be confronted. No means at his disposal have any effect on the essential lesion in the heart, and even if the local disease is limited in its extent the patient suffers from chronic septicaemia to which eventually he succumbs. Our actual knowledge of the pathogenesis of the disease is limited, and although its manifesta- tions are well recognised they illustrate fundamental pathological processes with which at present we are quite unable to cope. No other disease calls more urgently for organised investigation, and to this end Sir Lester Harmsworth and Mr. H. C. A. Harms- worth founded in 1924 a Research Fund in memory of Robert Lovell St. John Harmsworth, who died of infective endocarditis. The fund is administered by a board of trustees advised by a small scientific committee, consisting of Lord Horder, Dr. M. H. Gordon, and Prof. E. H. Kettle, and grants in aid of research work are made from time to time to duly accredited persons. The attention of clinical and scientific workers who are particularly interested in the problem of malignant endocarditis is drawn to the existence of this fund of which Dr. P. Seymour Price, 33, Sloane-gardens, S.W.I, is the secretary. Applications for grants should be made to Dr. Price who will give information about the conditions governing such grants, and the lines along which it is suggested that investigations might proceed. THE ALPS FOR CHILDREN NEARLY a year ago we announced 1 that the ancestral Buol chateau overlooking Davos-Dorf had been placed at the disposal of the Birmingham Children’s Hospital for use as a place for convalescent treatment. The report of the hospital for the year 1932, which was presented on Monday last, contains an account of how this offer has been utilised, although the first twelve months’ working is not yet complete. Groups were sent out in May, August, and December, amounting in all to 53 children, of whom 38 were still in Davos at the end of the year. Of the 15 who returned after a stay of 3 or 6 months all except one were regarded as fit for returning ; the exception was a boy who was sent home for further operative treatment. Sixteen of the 53 lucky children were selected because they had not fully recovered from an attack of pneumonia, chronic bronchitis, or other chest condition; 14 were asthmatic; 5 had failed to become robust after prolonged illness ; 18 were suffering from actual tuberculosis of bones, joints, glands, or skin. The children are under the care of the very competent head of the Pro-juventute Sanatorium at Davos- Platz, and Prof. L. G. Parsons or some other member of the honorary medical staff of the parent hospital visits the chateau at least once a quarter to discuss progress, and to determine which child should come home and which should stay longer. A staff of five nurses and a certified teacher are supplied from home. It is of course too soon to speak of anything but immediate results ; the report states that the 1 THE LANCET, 1932, i., 632. medical staff have been immensely impressed with the results and possibilities of this new department. The impression was formed by observation on the spot, in free consultation with other children’s specialists for whom the chateau has become some- thing of a meeting-place. The report also states that the condition of the children who have returned proves that the same benefits would not have been possible in the same period of time in England, and that in many of the cases now at Davos it is recognised that their only chance of a permanent cure will be in a prolonged stay at a high altitude. These are brave words, for which it might not be possible . at the moment to give chapter and verse. But confirmatory evidence is available in the valley from the observation of children sent from Vienna for periods of a few months at a time to the rather less favourably situated hamlet of Wiesen-Filisur. Davos has a well-equipped institute for physiological research, making it specially suitable for an experi- ment which is being watched with sympathetic interest by all those interested in the prophylaxis of tuberculosis by the timely care of the susceptible and recently infected. While the time may be gone by when a short sojourn in the Alps was considered specific for recognised disease of the lungs, there may well be an opportunity for trying out to its logical conclusion some such scheme as the enter- prise of Birmingham and the generosity of Mr. Christian Kunzle are making possible in the Davos valley. THE LAW AND THE OFFENDER THE vigorous movement for the scientific study of crime, though very necessary, has tended to disparage somewhat unfairly the present arrange- ments for dealing with offenders. This excess of zeal received a salutary correction from Mr. Claud Mullins in a lecture he gave on March 2nd to the Friends of ’the Institute of Medical Psychology. He admitted that the system contained several anomalies. For instance, if a man keeps a brothel or exposes his person indecently he has no right of trial by jury and cannot receive more than three months’ imprisonment, but if he steals 6d., sells an indecent book, or lends his motor licence to a friend, he has a right to trial by jury and is liable to a more severe sentence. If a woman who has been deserted by her husband for six years marries again, her crime must be dealt with in the same way as murder- namely, by judge and jury at assizes-but if she encourages the prostitution of her child under 16 she is dealt with at quarter sessions. On the other hand, the legal system of this country, he said, possesses two features which render it much more humane than that of most others; an offender is deemed innocent until he is proved guilty, and his past record is not admissible until he is proved guilty. It is frequently alleged that magistrates, in common with the criminal law, lay too much stress on a man’s offence and too little on the man ; that they make little attempt to probe into the offender’s mind. Mr. Mullins would have an expert available in every prison and for special cases in the police-court, but his conviction of the paramount importance of presuming the innocence of the accused person compels him to object strongly to any kind of examination before the verdict in most cases. As he pointed out, modern psychology is better at diagnosis that at cure, and the treatment it offers is still in the experimental stage. Many people talk as if a psycho-therapeutic treatment could be poured into the patient like a dose of medicine ;

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Page 1: THE ALPS FOR CHILDREN

538

wish to buy quinine, whether they are governmentsor individuals, cannot afford to buy it in adequateamount at its present cost. It follows that even if a

satisfactory synthetic substitute is ever found, itcannot benefit mankind to the full unless it can besold far more cheaply that are the cinchona alkaloidsat the present time.

A FUND FOR RESEARCH WORKERS

INFECTIVE endocarditis is one of the most hopelessdiseases with which the physician can be confronted.No means at his disposal have any effect on theessential lesion in the heart, and even if the localdisease is limited in its extent the patient suffersfrom chronic septicaemia to which eventually hesuccumbs. Our actual knowledge of the pathogenesisof the disease is limited, and although its manifesta-tions are well recognised they illustrate fundamentalpathological processes with which at present we arequite unable to cope. No other disease calls moreurgently for organised investigation, and to this endSir Lester Harmsworth and Mr. H. C. A. Harms-worth founded in 1924 a Research Fund in memoryof Robert Lovell St. John Harmsworth, who died ofinfective endocarditis. The fund is administered bya board of trustees advised by a small scientificcommittee, consisting of Lord Horder, Dr. M. H.Gordon, and Prof. E. H. Kettle, and grants in aidof research work are made from time to time to

duly accredited persons. The attention of clinicaland scientific workers who are particularly interestedin the problem of malignant endocarditis is drawnto the existence of this fund of which Dr. P. SeymourPrice, 33, Sloane-gardens, S.W.I, is the secretary.Applications for grants should be made to Dr. Pricewho will give information about the conditions

governing such grants, and the lines along which itis suggested that investigations might proceed.

THE ALPS FOR CHILDREN

NEARLY a year ago we announced 1 that theancestral Buol chateau overlooking Davos-Dorf hadbeen placed at the disposal of the BirminghamChildren’s Hospital for use as a place for convalescenttreatment. The report of the hospital for the year1932, which was presented on Monday last, containsan account of how this offer has been utilised,although the first twelve months’ working is not yetcomplete. Groups were sent out in May, August,and December, amounting in all to 53 children, ofwhom 38 were still in Davos at the end of the year.Of the 15 who returned after a stay of 3 or 6 monthsall except one were regarded as fit for returning ;the exception was a boy who was sent home forfurther operative treatment. Sixteen of the 53

lucky children were selected because they had notfully recovered from an attack of pneumonia, chronicbronchitis, or other chest condition; 14 were

asthmatic; 5 had failed to become robust after

prolonged illness ; 18 were suffering from actualtuberculosis of bones, joints, glands, or skin. Thechildren are under the care of the very competenthead of the Pro-juventute Sanatorium at Davos-Platz, and Prof. L. G. Parsons or some other memberof the honorary medical staff of the parent hospitalvisits the chateau at least once a quarter to discussprogress, and to determine which child should comehome and which should stay longer. A staff of fivenurses and a certified teacher are supplied fromhome. It is of course too soon to speak of anythingbut immediate results ; the report states that the

1 THE LANCET, 1932, i., 632.

medical staff have been immensely impressed withthe results and possibilities of this new department.The impression was formed by observation on thespot, in free consultation with other children’sspecialists for whom the chateau has become some-thing of a meeting-place. The report also statesthat the condition of the children who have returned

proves that the same benefits would not have been

possible in the same period of time in England, andthat in many of the cases now at Davos it is recognisedthat their only chance of a permanent cure will bein a prolonged stay at a high altitude. These arebrave words, for which it might not be possible .

at the moment to give chapter and verse. Butconfirmatory evidence is available in the valley fromthe observation of children sent from Vienna forperiods of a few months at a time to the rather lessfavourably situated hamlet of Wiesen-Filisur. Davoshas a well-equipped institute for physiologicalresearch, making it specially suitable for an experi-ment which is being watched with sympatheticinterest by all those interested in the prophylaxisof tuberculosis by the timely care of the susceptibleand recently infected. While the time may be goneby when a short sojourn in the Alps was consideredspecific for recognised disease of the lungs, there

may well be an opportunity for trying out to itslogical conclusion some such scheme as the enter-prise of Birmingham and the generosity of Mr.Christian Kunzle are making possible in the Davosvalley.

THE LAW AND THE OFFENDER

THE vigorous movement for the scientific studyof crime, though very necessary, has tended to

disparage somewhat unfairly the present arrange-ments for dealing with offenders. This excess ofzeal received a salutary correction from Mr. ClaudMullins in a lecture he gave on March 2nd to theFriends of ’the Institute of Medical Psychology.He admitted that the system contained severalanomalies. For instance, if a man keeps a brothelor exposes his person indecently he has no right oftrial by jury and cannot receive more than threemonths’ imprisonment, but if he steals 6d., sells anindecent book, or lends his motor licence to a friend,he has a right to trial by jury and is liable to a moresevere sentence. If a woman who has been desertedby her husband for six years marries again, hercrime must be dealt with in the same way as murder-namely, by judge and jury at assizes-but if she

encourages the prostitution of her child under 16she is dealt with at quarter sessions. On the otherhand, the legal system of this country, he said,possesses two features which render it much morehumane than that of most others; an offender isdeemed innocent until he is proved guilty, and hispast record is not admissible until he is provedguilty. It is frequently alleged that magistrates, incommon with the criminal law, lay too much stresson a man’s offence and too little on the man ; that

they make little attempt to probe into the offender’smind. Mr. Mullins would have an expert available inevery prison and for special cases in the police-court,but his conviction of the paramount importance ofpresuming the innocence of the accused personcompels him to object strongly to any kind ofexamination before the verdict in most cases. Ashe pointed out, modern psychology is better at

diagnosis that at cure, and the treatment it offersis still in the experimental stage. Many peopletalk as if a psycho-therapeutic treatment could bepoured into the patient like a dose of medicine ;