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Acidosis and alkalosis in infancy, including treatment, embraces another article.
Treatment of cancer and other subacute and chronic infections by radioionic medication of uranium is the next article.
The management and treatment of bronchial asthma is recorded.
A comprehensive section is donated to nervous, delicate and backward children.
Under the subdivision of neurology, psychiatry and psychology are studies, with plates, on brain anatomy at the University of Zurich. Remarks cover secondary degenerations, experimental athétosis, as well as the question of aphasia and diseases of the extrapyramidal system are discussed, particularly in the light of new data following epidemics of encephalitis. Photographs are given of various facial involvments, postural defects and types of tremors.
Professor Hess of the University at Zurich sets forth comprehensive data regarding the unconscious and the instincts.
Professor Bümke of Munich has a short article regarding psychoanalysis. This is a criticism of certain sweeping conclusions which he considers unwarranted, and he suggests psychoanalysis has a limited use in the management of nervous diseases.
Under surgery the treatment of empyema and stab wounds of the chest are considered.
An unusual case of dermoid cyst is set forth in case record style. Under the subject of travel are notes regarding European medicine and medical education particularly pertaining to Italy. The present renaissance of Italian medicine is written by Professor Cattell.
A biography of the late Sir Clifford Allbutt is the closing article of this volume.
(1) The Fundamentals of Statistics. By L. L. THURSTONE, M. E., Ph. D., Associate Professor of Psychology, University of Chicago. (2) Principles and Methods of Statistics. By ROBERT EMMETT CHADDOCK, Professor of Statistics, Columbia University.
Statistical analysis has been so generally accepted as a necessary instrument in social, psychological and psychiatric investigations, that no special plea need be made for the recognition of additional text-books. No one book can satisfy the needs of all types of students, and it is therefore an advantage to have available different approaches to the same subject.
There was a time when the psychiatrist and the social worker were interested only in the use of the "case method" as a means of research. To them statistical analysis meant a more or less rough survey which was to serve
as an introduction to an intensive study of selected cases. Fortunately this attitude is disappearing. The logical foundation of statistical method is more clearly understood, and is becoming part of the case worker's stock in trade. The social worker may find it necessary, for example, to identify an individual mentally or physically. Must he not be compared with certain norms or standards? Everyone now knows that these are nothing more nor less than statistical generalizations of our experience with mental and physical growth. On the other hand there will normally be found varying degrees of deviation from these standards or types; how is one to test their significance? These examples of the practical applications of statistical methods may be multiplied indefinitely, and illustrate the necessity of at least a passing accquaintance with the science of statistics.
Both books furnishing the subject matter of this review may be recommended to the beginner. When thoroughly understood they should prove an adequate stepping-stone to the study of still more fundamental problems in the rapidly growing field of mathematical statistics. The non-mathematically minded need not fear these books, however. Both are clearly intended for students who have long since forgotten their high school or college mathematics; and the development is so clear, especially in Professor Chaddock's book, that it is difficult to believe a mature person will be unable to follow the texts.
Dr. Thurstone's book is directed primarily to the needs of the psychologist, and draws most of the illustrative material from the fields of mental and educational tests. It begins with a brief description of the frequency table, the column diagram, known more familiarly as a histogram, and the frequency polygon. After some chapters on the straight line and its graphic representation, the text takes up the various averages, and measures of dispersion. There then follows a discussion of the binomial expansion as applied to the laws of chance, the normal curve, and the probable error. The volume closes with chapters on the measurement of correlation by the product-moment, and rank methods.
The arrangement of the chapters merits criticism. It appears desirable to follow the discussion of the frequency table, with that on averages and measures of dispersion. These so-called statistical constants besides serving as summary descriptions of the frequency table, may be tied up with the problem of curve-fitting. This text provides only an empirical method of fitting a straight line to experimental and observational data, but the exact methods of least squares and moments are both capable of simple presentation. Furthermore the discussion of the straight line ought to be preceded by one on the scientific concept of law for the obvious purpose of fitting a mathematical curve is to aid in forecasting changes. As arranged at present the chapters on linear and non-linear curves show little relation to ordinary statistical reasoning.
The following criticisms may be made of minor points. In speaking of graphical tabulation, the author says that a frequency table is ordinarily a step in the preparation of the graph. It seems to the reviewer on the other hand, that the graph is simply a visual aid to the interpretation of the frequency table. The discussion of the straight line is made unnecessarily complicated by the failure to generalize the equation at once as an expression of the first degree. In describing the mean, the author shows, among others, what are said to be two distinct methods of deriving this constant. In reality they are one and the same, the difference being that in one case the arbitrary origin is placed at the beginning of the scale, and in the other, towards the center. There is available a very simple generalization of this method which should be introduced in the chapter on the mean. In discussing the mode the author fails to define it fundamentally as the value obtained from the generalized frequency curve by finding the position corresponding to the maximum ordinate; i. e., equating the first derivative to zero. Coming to the normal curve, the author defines it as the binominal frequency. What is clearly meant, however, is that the normal curve is the limit of the point binominal, as the value of "n" in the expression (2+2)" increases without limit.
Most of these minor difficulties are avoided in Professor Chaddock's book. In common with Professor Thurstone, however, he fails to emphasize the following two points: In the first place, though both show the error in the frequency table, resulting from grouping in intervals, they do not describe the correction supplied by Sheppard. Again though both speak of the fact that the normal curve does not fit all types of frequency distributions, they nevertheless omit to describe the simple tests of "goodness of fit."
Professor Chaddock's work differs from Professor Thurstone's in several particulars. In the first place there is a very useful introduction dealing with some of the sources of error in statistical reasoning and with the logical basis of the scientific method. Secondly, the chapters follow the more logical order suggested above. In the third place, the illustrative material which was drawn for the most part from economic sources, necessitated the introduction of chapters dealing with index figures and the treatment of time series. At present these chapters will interest the economist primarily, but as social and psychological data increase in comprehensiveness, the social worker will undoubtedly desire to make comparisons over a series of years. In that event, he will have to learn how to eliminate differences that may be due to secular trends or cyclical fluctuations. Already the importance of such analysis is seen in the field of mortality and morbidity statistics. The wealth of illustration and explanatory details make this book particularly valuable to the student.
ABSTRACTS OF GOVERNOR SMITH'S MESSAGES RELATING
TO THE DEPARTMENT OF MENTAL HYGIENE
The deep interest of Governor Smith in the development of the State institutions for the care and treatment of the mentally afflicted is clearly manifest in his message to the State Legislature at the opening of the session of 1927. The following are abstracts from the message:
On the whole question of the care of the mentally afflicted I propose to communicate with you much more fully at a later date and at that time I will set forth the exact condition at all of the State hospitals, showing in detail improvements made as a result of the expenditure of the money received from the sale of bonds. For the purpose of this message, I will deal only with the progress made in care and prevention.
The establishment of a unified department of mental hygiene to exercise the functions of the present State Hospital Commission and State Commission for Mental Defectives and to supervise the care of epileptics is a great forward step. The State thus recognizes the fact that the institutional care of the mentally afflicted is a single problem and that progress will be facilitated by union of effort. A high standard of care of patients has already been reached by the institutions brought together in the new depart. ment, but it is believed that through free interchange of ideas the various institutions will be mutually helpful in the solution of their many problems. The establishment of a division of prevention in the new Department of Mental Hygiene commits the State to a new policy with respect to mental defectives. Heretofore the State has provided generously for the care and treatment of the mental patients sent to institutions, but has done comparatively little to prevent the development of mental disease in the community. No one can predict the possibilities of preventive work in this field; but from the marvelous results that have been accomplished in the prevention of physical disease, we may confidently hope that the influx of patients in the State hospitals may be checked and that the heavy burden thereby imposed on the people of the State may be lessened.
Judging from the experience gained in the prevention of physical diseases, three major lines of activity are indicated in the field of mental hygiene. Research work should be conducted on a more comprehensive scale. Preparations to do this are being made by the erection of a large Psychiatric Institute and Hospital to form a part of the new Medical Center in New York City. Now that this main institution of the State Hospital system in New York City is about to take form, I would recommend the development of one or more similar institutions of smaller size in strategic centers up-State, particularly in cities where medical schools are located. Last winter I approved a bill which authorized the construction of a State
Psychiatric Hospital in Syracuse in connection with the University Medical Center there, as soon as funds are available for construction. I urge that an appropriation for the construction of this institution be made available this winter in order that an up-State center for early treatment and teaching purposes may shortly follow that in New York City. The studies carried on in these centers should be supplemented by field work and by researches in the State hospitals and other institutions. The field is broad and research work therein difficult; but every means must be taken to discover more effectual methods of relieving the mentally afflicted and of preventing the development of mental disorders.
The clinics conducted by the State hospitals for the early treatment of persons suffering from mild nervous and mental disorders, and to aid in the adjustment to community life of paroled and discharged patients, have proved of great value, and should be extended so as to become more effective preventive agencies. Thus far, the clinics have dealt principally with adults. Children manifesting marked behavior disorders should also be reached. This could best be done by the establishment of permanent child guidance clinics in the principal cities of the State.
Marked progress has been made in the development of occupational treatment of patients in the State hospitals. At the close of the fiscal year the number of patients receiving occupational therapy in special classes was 11,379, as compared with 9,848 at the end of the previous year. This treatment which is conducted by trained occupational therapists and physical instructors under the supervision of the medical staff, is proving of inestimable benefit to the patients.
Through the joint efforts of the State hospitals and the Medical Examiner's Office, 458 alien and 758 non-resident insane patients were removed from the State during the past fiscal year. This was the largest number removed in any one year since 1914. In view of the crowded condition of our State hospitals and the high cost of new buildings and of maintenance the removal of these patients, who have no claim on the bounty of the State, helps to alleviate these conditions.
One matter which does not come under the bond issue is the annual appropriation for improved fire protection for these institutions which has been made for the past three years. I recommend that it be continued. Through the construction of fire walls, fire exits, fire escapes and sprinkler systems and the installation of new fire alarm systems, much has been accomplished to safeguard patients necessarily cared for in non-fireproof buildings. Although conditions with respect to the protection of patients from fire hazards are now better than ever before, much still remains to be done, and it is believed that the policy of doing a reasonable amount of this work each year until it is completed should be continued.