care of the aged

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Page 1: CARE OF THE AGED

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and Einthoven’s string galvanometer led to the Cambridgeelectrocardiograph which Sir Thomas Lewis helped todesign. From a massive piece of apparatus occupyinga whole laboratory there has now been developed thecardiograph which can be carried to the bedside in asmall suitcase. Other types of apparatus producedin the workshops include Keith Lucas’s apparatus fortiming minute intervals in the study of nervous impulsesand his slow-motion device for microscope tubes, elec-trodes for measuring hydrogen-ion concentrations, andan instrument invented by C. T. R. Wilson for renderingvisible the paths of the alpha-particles from radium.Science has advanced from the treadle lathe to the

calculating machine which can solve ten simultaneouslinear equations with ten unknowns; but there is stillneed for the faultless skill of the workman.

CARE OF THE AGED

THE Act which in 1940 set up the supplementarypensions scheme was intended to do more than providefor a weekly distribution of cash. It required thePublic Assistance Board to administer the scheme " insuch a manner as may best promote the welfare of

pensioners." The latest report of the Board, under itschairman Lord Soulsbury, describes the work done tomeet this obligation. The result is a sympathetic andunderstanding survey of the problems of the aged.The welfare work of the Board’s officers has been, for

the most part, to advise those pensioners who are unableproperly to manage their own affairs, and to help inbringing their problems to the appropriate authorityor organisation. Many of the difficulties found amongthe aged arise from a solitary existence, and much canbe done to relieve loneliness by visitors and old peoples’clubs; but the greatest need, in the Board’s opinion, hasbeen for a home-help service to assist pensioners whocannot do necessary domestic work for themselves.The pensioner needs a small house that is easy to run,and these should have a place in any long-term housingscheme. Those old people who, though not sick, requiresome care and attention can best be accommodated, itis thought, in hostels ; but provision for the chronicsick and bedridden is a matter which will need specialattention in planning the new health services. The

report emphasises the need for continued investigationof both the social and medical aspects of age. TheNuffield Foundation has undertaken an inquiry into thissubject ; but the Board believes that there should besome permanent body charged with making continualresearch into the requirements of age. In the Govern-ment’s white-paper on Social Insurance it is estimatedthat, whereas- in 1945 there are 16 pensioners for every100 contributors, there will be in 1975 about 31 for every100. As the Board says, " it is only by acting in thelight of the latest and most up-to-date knowledge thatthe legitimate interests of the old can be properly servedwithout increasing the burden on the younger membersof the community beyond all reasonable bounds."

THE FALLING SICKNESS

OLIVER WENDELL HOLMES once wrote : " If I wishedto show a student the difficulties of getting at truthfrom medical experience, I would give him the historyof epilepsy to read." In the history of epilepsy, indeed,one can read in bright epitome much of the history ofmedicine. It starts off well with the sound clinicalobservation, and the challenge to current supernaturalbeliefs, of the Hippocratic writings ; and thenceforwardwe can clearly see the grounds of battle between supersti-tion, religion, empiricism, scholasticism, and science.

In an able and scholarly book 1 Dr. Temkin tells thestory with a remarkable degree of completeness-withinthe limits he has set himself. Unfortunately, after he1. Temkin, O., The Falling Sickness. Johns Hopkins Press.

Pp. 380. $4.

has led us, with increasing interest, through the earlypart of last century up to the historic contributions ofHughlings Jackson, who gets the credit to which he isentitled, the narrative stops, and we are without manyof the links that connect present outlook and presentproblems with the past. Is this not a mistake Shouldnot historians strive to carry through to the present ’?General history must be the study of every educatedman, for thereby he has much to learn about manythings of today. Medical history is sometimes said toappeal only to the medical historian and to the specialistin folk-lore, anthropology, or ancient religions : exceptin so far as it deals with the last half-century it has littleattraction and less value for the ordinary medical man.A historical survey ending, like this one, about 1880tends to encourage this pessimistic view. We wish, too,that Dr. Temkin had written rather more for the ordinarydoctor and a little less for the medical historian. Hewould then have allowed some references to contem-porary events in the world to creep in ; would haveprovided a chronological table giving the name, nationali.ties, and dates of the principal writers ; and, mostimportant, would have gone a little out of his way toselect and stress ancient observations or theories thatwould be of particular interest to us, as clinicians orscientists, today. This would have enhanced the

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importance of a work which in any case will have anhonoured and permanent place among the histories ofdisease.

THOMAS HUNT MORGAN

By -the death of T. H. Morgan the biological worldloses an outstanding figure. He was born in 1866 in

Lexington, Kentucky, and joined Columbia Universityas professor of experimental biology in 1904. From1890 onwards he made many outstanding contributionsto experimental embryology until 1910, when, largely’through his association with E. B. Wilson, he becamedeeply interested in the mechanism of chromosomebehaviour. With the help of his associates, Bridges andStortevant, Morgan astonished the world by the discoveryof linkage after linkage among the genes of drosophila.The publication of The Physical Basis of Heredity in 1919made his views available to students everywhere; hebecame well known as the man who had put the genes ofthe fruit-fly on a map, and for this work he was awardedthe Nobel prize in medicine or physiology in 1933. Theprecision and intricacy of the measurements obtained offunctional distances on the chromosomes were new andstartling and there arose inevitably a tendency in somequarters to minimise the significance of the results. Theobservations were said to represent merely statisticalfacts about flies and could not be expected to apply toman. Subsequent work, however, amply confirmedMorgan’s conclusions with respect to drosophila, and helived long enough to see at least one linkage, that betweenhaemophilia and colour-blindness, measured in man.The value to medicine of Morgan’s genetical work,

however, like that of his embryological work, is mainlyindirect. It established the necessary basis for futureresearches. Fundamentally, he may be said to haveforged the link between the sciences of genetics andcytology. It was characteristic of his vigorous personal-ity that, when he had accomplished this, he returned,during the last fifteen years of his life, to his originalinterest, experimental zoology.

AN exhibition is to be held at Brighton next June, whenthe Chief Constables’ (Cities and Boroughs of England andWales) Association will hold its jubilee conference. Itsobjects will be to create a wider public interest in the problemsof the police and to draw attention to advances in forensicscience. Invitations will be extended to members of thelegal and medical professions, to see certain scientific andcriminal exhibits which will be shown privately in the King’sapartments of the Royal Pavilion.