Mental Deficiency Practice
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Book Reviews *82 Abstracts
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Shrubsall and A. C. Williams. University of London Press, Ltd. Pp. 352. 12/6 net.
This manual, which deals with the clinical and administrative aspects of the subject, is a valuable addition to the growing literature on mental deficiency. It will be especially welcomed by those medical officers of local authorities who are concerned with the certi- fication of defectives under the Education and Mental Deficiency Acts. An excellent sum- mary is given of the various clinical types en- countered and advice is given as to the best method of approach to defectives of different ages and varying types. Many workers in the field will approve of the London modification of the Binet tests (which is set out in full) and the newly-fledged certifying officer more par- ticularly will find the advice given concerning the mode of application of the tests very help- ful. The advantage of a serial scale which can be readily adapted for use with blind defec- tives, and also for the repeated examinations of sighted defectives, will be apparent to all engaged in this work. A timely warning is given as to the limitation of mental tests in the diagnosis of mental deficiency, and the danger of assessing scholastic attainments without reference to the physical, pedagogic and en- vironmental handicaps, with which the child may have had to contend, is wisely stressed. Administrative procedure in relation to the disposal of defectives is succinctly but ade- quately outlined. The merits of co-operation between the Local Education Authority and the statutory Mental Deficiency Committee are mentioned, but, while no doubt co-opera- tion is the best that can be hoped for in many areas, itis nevertheless true that the completely co-ordinated Public Health Units which now exist in many provincial areas provide for a much more efficient measure of continuous care than any system based on co-operation. Under co-ordinated conditions the complete dossier of information about an individual case is passed from one section of a department to another as circumstances warrant, and medical examinations and social investigations are cut down to a minimum. It should be remembered that Health Visitors in the course of their routine visits to homes for various purposes possess unrivalled opportunities for ascertain* ing defectives under the age of seven years, and in many areas such sources of information are being utilised to the full.
A series of completed specimen forms for use in connection with mental deficiency is given at the end of the book, and these should prove of considerable value for reference purposes- Every local authority dealing with mental defectives should have at least one copy ?* Shrubsall and Williams’ ” Mental Deficiency Practice ” for the guidance of its officers.
The Maniac : A Realistic Study of Madness from the Maniac’s Point of View. Watts & Co., London. 1932. Price 7/6.
This account of an attack of insanity that lasted five weeks was written in 1909 in the months immediately after the attack. It haS been republished with a few additional notes in the hope that with the greater interest m insanity that now prevails, better use may be made of the material presented by the author* who was an unmarried woman of 35 and a journalist when her attack began.
The author is convinced that from first to last every word spoken by the ” voices ” t0 her and by her in reply, is reproduced ^ accurately as if taken down by a shorthan reporter and that every emotion and though of which she was conscious during the attac remained fixed on her memory as if brande thereon. .
The result is a coherent and vivid acco>nn of ecstatic conversations with “Ray Hall,’ f artist whom she admired in her normal I1 but was not acquainted with, of her seducti0 by fiends and of her almost constant torture J them, and of innumerable painful deaths ea one more horrible than the last. As she beg to improve, the first to go were her delusi0 that she had been seduced by a fiend and ^ about to have a fiend child. The ” voices sisted but later they began to sound as bel inside her head rather than as proceeding j* - without and they said what she had be thinking whereas before they had said which were often contrary to her own thong and opinions. The ” voices ” decreased ^ volume of sound and in rapidity. Instea . being faster than thought they were^ as ^ as thought. Then they lagged behind a ultimately disappeared.
The author contends that insanity is the result of a severance of the Ego from the Physical body and from the brain which con- tinues to function automatically and aimlessly While the real Ego is far away. The lunatic is actually out of his mind. She is convinced that delusions and activities observed in her by nurses and doctor were at no time in her consciousness and although her doctor con- versed with her during every day of her illness for at least one hour and generally two, in only three or four occasions did his conversation reach her consciousness.
The psychosis seems to have been a benign stupor ” or possibly a katatonic episode. It was certainly not Mania and the Word ” maniac ” is here used merely as a synonym for ” lunatic.” It is a pity that we a_re told so little of the context of the psycho- sis, the situation that provoked it; and of the Patient’s pre-morbid personality. She has been reticent about so many things that mattered a^d notably about sexual matters which ob- Vlously played an important part in her dis- order; but we must remember that the book Was written before psycho-analysis had reached the British public. The value of the book would have been enhanced by the collab- 0l’ation of the doctor who observed the case.
Harris.
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