A Retired Habitation: A History of The Retreat, York
- Typep:
Book Reviews & Abstracts
- Author:
Harold Capper Hunt.
London. H. K. Lewis & Co. Pp. XVI : 144. Price 7/6.
No account of the reforms which have taken Place in the treatment of the insane would be adequate which did not give a reasonably de- tailed account of the inception and progress of Ihe Retreat at York, and, inseparably con- nected with this, of those enlightened and humane men who were responsible for the conception of the scheme and for the pioneer ^’ork which served to bring it into being. It xvas not that the idea of reform was entirely n?vel or that no attempt had been made to im- prove the conditions in which the insane lived:
^?rgagni, Vincenzo Chiarugi, Pinel, and t^aquin of Savoy, may be mentioned as re- formers. But the movement was so limited that it hardly detracts from the merits of the uinovators at York to mention it. The names of William Tuke and of his grandson, Samuel fuke, would seem, therefore, sure of immor- ahty in this connection.
It is nearly a hundred and twenty years since aniuel Tuke’s masterly ” Description of The Retreat ” was published?a work which may tv, k-e studied with edification and profit?so here is ample room for the excellent and read- able account which Mr. Hunt has given us. (It ls interesting to note that it is also the work ? a layman?as was the ” Description “?for 1 ? Hunt is steward of the hospital). In it he as recapitulated the early history, portrayed le chief personalities among those who have rued on the good work, noted the changes k lch had inevitably to take place in order to ceeP the hospital abreast of the times, re- Unted the opinions of distinguished visitors, ^scribed war-time conditions, and brought the TiC0Untup to date with a chapter on “Modern r lles.” In addition, there are twenty-one well ?(Produced illustrations, a valuable chapter on IsTp-i 3 future of Mental Treatment,” by Dr. Pier eoc^? and a foreword by Dr Bedford Ce> to whose memory the book is dedicated, d ? Avas for thirty years Medical Superinten- laill “The Retreat,” whose death we ino-anc^ regarding whom it is not surpris- tim-, ? Jearn that ” in later years he was affec- “onately referred to as ? Father.’ ” Of the influence of the example of ” The Retreat ” in this and in other countries there can be no doubt: yet it was obviously the quality of the scheme and not its extent which was the factor at work. For, in the early days, the practical experience was limited : and we have it on the authority of Samuel Tuke that from 1796 to the end of 1811 the admissions amounted to one hundred and forty-nine. In view, also, of what is probably still a prevalent misconception it is worth noting what Mr. Hunt says in regard to the matter of restraint; ” Though the Retreat was a pioneer in the matter of relaxing control by mechanical restraint, the treatment of mental patients with- out any such restraint was not undertaken until 1838, when Dr Charlesworth and Mr. Gardiner Hill abolished all mechanical restraint in the asylum under their charge at Lincoln. Shortly after this Dr Conolly adopted the same meas- ures on a much larger scale at Hanwell.” It is as well to note that experience has justified some modification in the extreme view in this respect?for example, in surgical cases. The same may be said in regard to control by drugs of which Mr. Hunt remarks that: ” it is not difficult to see that this may be even more cruel than restraint by straps, and the use of such methods has always been disapproved by the Directors and Committee of The Retreat.” In writing of the Tukes and their work, Mr. Hunt might have mentioned the excellent account, for example, given of them by Dr. Rene Semelaigne in his large and comprehen- sive “Alienistes et Philanthropes,” which has for its sub-title ” Les Pinel et Les Tuke.” These are small criticisms of this most inter- esting and admirably produced book?and one which everyone interested in the treatment of the insane will wish, and ought, to add to his library. H.J.N. The Health of the School Child. Annual Report of the Chief Medical Officer of the Board of Education for 1931. H.M. Sta- tionery Office. Price 2/6 net. 1932.
Sir George Newman can always be relied upon to provide an attractive and interesting opening to his annual report on the Health of the School Child. This year he has given us several paragraphs on the ” ancestry ” of the School Medical Service. Although this service as a statutory institution has only existed since the Education (Administrative Pro- visions) Act of 1907, its origin can be dated back as far as the foundation of St. Paul’s School by John Colet in 1509; though medical care, in the modern sense did not begin in Eng- land until the eighteenth century with the work of Robert Owen and Lord Shaftesbury. With reference to Special Schools, Sir George Newman points out that the increase in accommodation in schools for the mentally defective, the blind and deaf has proceeded at a much slower rate than the schools for the physically defective. In 1909 there was accom- modation for 3,291 physically defective child- ren; to-day that has increased to 30,266. The total accommodation for the mentally defective in schools to-day is only 16,862. He attributes this to the fact that the open-air schools, cripple schools, etc., are far and away more promptly effective than the others and their value is quickly and rightly realised by public opinion. In fact, as a result of the benefit de- rived from open-air schools, 80% of the ordin- ary school building plans submitted to the Board for approval, contain proposals for the adaptation of some or all classrooms to make them available as open-air classrooms.
In summarising the work of the school medical service, Sir George Newman considers it under four headings:?the ascertainment, by periodical medical examination, of any disease, defect or impairment, where such ex- ists; the medical and surgical treatment carried out in School Clinics and hospitals; the reduc- tion of the incidence and mortality of disease, including a striking reduction in mortality due to tuberculosis; and finally, the emergence of a health conscience by the teaching of personal hygiene and cleanliness and by organised physical exercises and games. Writing of this development of a ” health conscience,” he states : ” Out of this public service has sprung the special school and its particular form of education (for the blind, deaf, physical or mental cripple), and above all, the responsibil- ity of the parents has been awakened and stim- ulated. There can be no question of the trans- formation which has resulted from these simple and almost domestic reforms, far more power- ful in themselves than any Act of Parliament or than any specific medical treatment of the defective child … the children are as a whole cleaner, better in physique, better fed, better clothed, better nurtured, than they have ever been since we possessed records of them, and this evidence is clinched by the simple fact that their parents have themselves been through the same hygienic discipline and know its value.”
300 Careers for Women. Compiled by Vyrnwry Biscoe. London. Lovat Dickson. 1932. Pp. 227. Price 2/6. The book has been compiled to open the eyes of ” girls, schoolgirls, students and older women,” to the immense number and variety of occupations and professions that are now open to women. The compiler speaks from a wide and varied experience as the director of a vocational bureau and an admirable preface is contributed by the Rt. Hon. Margaret Bondfield. Information concerning available training, probable cost, grants-in-aid, length of training, etc., is given in almost every case, but unfortunately, in the laudable attempt to tabulate and concentrate information, an erroneous impression of the ease with which certain professions may be entered has been given, and in some cases strict accuracy has been sacrificed. In the section on ” Mental Welfare Work,” for example, particulars have evidently been taken from the syllabuses of the various training courses for one particular year and generalisations have been made from them, with rather misleading results.
However, the book will be most useful as a signpost to direct those interested to the place where fuller information may be obtained on any particular profession, and in doing this it will have fulfilled its purpose.
M.U.W. Studies in the Psychology of Delinquency- By Grace W. Pailthorpe, M.D. Issued by the Medical Research Council (Special Report Series No. 170). Price 2/-. This is a study of the psychology of delin- quency which deals with the investigation ot the female inmates of prisons and of the lfl* mates of preventive and rescue homes for girls and young women.
The preface states that the author is person- ally responsible for the results and the opinions she rests upon them.
Dr Pailthorpe’s preamble of the history of scientific criminology is very interesting and she suggests that modern psycho-pathology takes cognizance of certain symptomatic and characterised reactions which were previously Snored as unimportant or ” natural ” habits.
The material for this report has been gath- ered over a period of five years and the ^umbers considered, 200 : of whom 100 were Prison inmates and 100 inmates of rescue homes, etc. The method of interviewing pris- oners is elaborated, and one realises the diffi- culties of getting the truth from some of these subjects, which is only gained by very tactful eatnient and the experience of years.
For those who showed defect in intelligence, he Hamblin Swinten scheme of tests was ^sed, but occasionally supplemented by the met Terman series.
Her observations and summary of results may be of use to those dealing with mental efectives, but it must be remembered that the JJereuSe of mental tests is not sufficient, but right conclusions deduced. One is glad to See that the importance of ” scattering ” is emphasised.
It was rather surprising to see that 15% of ese female prisoners were of defective intelli- gence, but of course, 100 cases do not allow of much margin.
in^?t a single case of her series was educated ^ a public or private school, and Dr Pail- jn?rPe considers that there is something lack- pJ%ln elementary school education and sug- w s. *hat it may be ” co-ordinated character trainmg ” t aS’ree with her when she remarks on the lo Parative absence of any kind of parental of 4iln ^ves ?f some of the children (34 out . this absence was almost complete) and qUe^s seen particularly amongst child delin- On t^s e cannot but be interested to learn from cjefG st_udy that ” cases diagnosed as mentally ac^; lve have as a result of psycho-analysis POtyeJ^Mconsiderable liberation of intellectual ^oubf/T^01-1 llsec^ to ^ie ru^e? ^ day j 1 ^ ^ prevails to any great extent to- ?thern-an^ uP-to-date institutions certified or all on 1Stf a ^er assertion ‘’ that in England alone/-Homes anc^ Institutions are still run ous ^nes and they are all under religi- J Trisdiction,” is too sweeping.
Appendix 6, which is a report on prisons and homes on the Continent in 1927, is very in- structive and might have been enlarged. There is a good bibliography of the works consulted.
E.J.B. The Child in Home and School. By Florence M. Surfleet. Headley Bros. Pp. 137. Price 3/6.
Of books dealing with the problems of child- hood there seems no end. Small wonder that the parent seeking guidance is often be- wildered. But here is one which will surely prove helpful to many. Young parents who are just beginning to realise what their new responsibilities involve, will find in ” The Child in Home and School,” Florence M. Sur- fleet, an excellent introduction to psychology, written in such simple language that no one could fail to grasp its plain teaching. It is quite refreshing to find so much com- mon-sense in one book; in these days of small families there seems a tendency to keep child- ren for ever in the limelight, constantly keyed up to the highest pitch, an unhealthy state for any young, growing thing; it is a relief to read in the chapter on activity and rest … “he should be left quite alone to play as he chooses for long periods at a time.” How much young children suffer from the constant attentions and interference of grown-ups we can never know, but this seems to me one of the most valuable pieces of good advice in a book full of practical suggestions.
The chapter dealing with the physical care of the child is most welcome; it cannot be said too often that ” Nail-biting does not mark a stage through which most children pass, but, like bed-wetting and thumb-sucking, is usu- ally found in the child who is too dependent on the adult in his environment … or whose life has lacked stability.” And again, how many homes would be infinitely happier if those in charge of the children could be made to act on the good advice that “it is defin- itely harmful to children to receive much com- mendation for a habit which should be taken for granted.” (The author is here speaking of constipation) and to remember that there are many children (as well as grown-ups) like Brenda who ” did not sem to mind which kind of attention she got (scolding or coaxing) so long as she got attention.”
Chapter VII on ” Fear,” contains nine ex- amples of children’s fears, all of which could have been so easily prevented with a little more forethought or knowledge on the part of the parent. How many young children suffer untold fears from ” confused ideas about everything pertaining to sex, due to the age- long sex-repression and fearfulness which makes it improper to speak of the subject.” The advice 011 page 145 to answer a child’s question’s simply and truthfully is good?but to explain to a child that in some cases it is better for him not to discuss these questions with other children, seems to me to be asking for trouble or rather paving the way for such discussions.
It is perhaps still not generally realised how remarkably susceptible children, especially in- fants, are. They ” sense fear in the grown-up even when the grown-up herself does not recog- nise its presence.” For this reason, as Miss Surfleet says, ” it is very important that the grown-up should realise the power of her un- spoken fears, her half-conscious or wholly un- conscious fears.” She should also have the compensation of realising “just how powerful a force for good her confidence in the child’s ultimate achievement may be” and what better illustration of this point could be given than that wonderful work ” Oliver Untwisted,” which is recommended to readers in the Biblio- graphy on page 147.
The form of this book, the short chapters with many illustrative stories and the ques- tions at the end of each chapter, should make it especially useful for discussion groups, for the informal discussions which should arise at parents’ meetings in connection with Nursery Schools, etc. : it is for such groups, as well as for individual young parents, that ” The Child in Home and School” can be thoroughly recommended.
Z.B. Nervous Disorder in Infancy and Child- hood. By N. Hobhouse. Lewis, London. 1932. 8/6 net.
Rather more than half this book is descrip- tive of nervous disorders of an organic type, but throughout there is shown appreciation of the psychological concomitants of even the more stereotyped physical conditions. One is disappointed, however, that the section deal- ing with conditions which would formerly have been called functional, does not go into the same detail as the previous section, and modern psychological practice would disagree with the author in certain of his statements, for in- stance, that enuresis is frequently hysterical and that masturbation in infants should be mechanically controlled.
The chapter on mental deficiency is short, and the author shows so many signs of great understanding of the difficulties faced by the defective, that it is a pity he did not deal with educational maladjustments in more detail. At a time when there is a tendency to sec only the psychological in nervous disorders of children, such a book is welcome, and, though pure pediatricians 011 the one hand and child psychologists on the other will each find much to disagree with, the author has adopted a11 attitude which is undoubtedly facing in the right direction.
The book would appeal mainly to the medico* post-graduate, who will find in its pages much that is new and stimulating. W.M. On Certain Aspects of Human Biology. By C. J. Bond. Lewis. London. 1932. Pp- Price 2/6.
In the third lecture given in the Willi?111 Withering Series of Lectures at the University of Birmingham, dealing with certain aspect-1’ of Human Biology, by Mr. C.J.Bond, C.M.G-> F.R.C.S., the lecturer dealt particularly ^vl* genetics in relation to Public Health and Pre” ventive Medicine.
The theme was that further progress in PlC ventive Medicine could only be brought abo^ by the application of biological methods. Th chief lesson which a study of the course 0 human evolution taught was the all-import?11 part played by biological factors in hum?1 history. Among these factors the mental temperamental endowment and capacity resist disease and injurious environmental 111 fluences are the most important. j Environmental influences both good and oa ^ help to promote 01* to arrest the development inherited tendencies and capacities, but th y can only do so within the limits fixed by here- ditary endowment. If Eugenics means the application of this genetic knowledge to human life, then Eu genics constitutes the greatest Problem of our time.
The only way in which we can increase the Proportion of citizens endowed with the essen- tial qualities of adaptability and educability is by the eugenic method.
In spite of the good work done by the School Medical and other social medical activities, the Writer thinks there are evident signs of racial deterioration manifest, and there is no evidence of.any growth in intelligence or innate cap- j*city. In other words, the improvement has been in Nurture and not in Nature, and we are replenishing our population from the less well endowed rather than from healthy and vigor- ous stocks.
While interfering with and preventing the operation of natural selection, civilised man las) up to the present, evolved no organised Method of control to take its place. f he practice of conception control, and the paving of child lives, he thinks, is having a ysgenic effect on the population as a whole. -lUch of our social and domestic legislation ?~day is not founded on sound biological prin- Jples. The weak are aided at the expense of e normal citizen, and much the same effect is r?nght about by some of the activities of Medical science and practice.
He pleads for a more favourable attitude on e part of the medical training schools towards r e teaching of genetics, and puts forward as nedies, (a) endeavour to encourage eugenic ^arriage, (b) the restriction of the choice of Stikr.ria8”e and the prevention of procreation in Jects of hereditary defects.
^Though some readers may think the picture mf^u1 *S ^ar ^00 ?l?omy> there is nevertheless tUr substantial food for thought in this lec- re e” The status of the lecturer commands sid an^ reasoned opinions must be con- life f an^ weighed- To revert to the social ?f the early 18th century is unthinkable, Welf en Progress has been as rapid in social half^ as has been the case during the past PausCentUry’ ^ behoves all thinking people to f?r 0 t? analyse the results achieved and to are r a*e schemes for adjustment where they ?Und to be necessary.
O.M.H.
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