Andrew B. Semple

a) Container Traffic in Relation To Imported Food

IN recent times there has been what can only be t described as a revolution in the transport and handling of cargoes by all forms of transport; but probably the change has had greatest impact on sea transport. Formerly, though certain cargoes were crated, vast quantities of goods, especially foodstuffs, were transported stowed in ships’ holds. The modern tendency is to transport cargoes in some form of container which makes for ease of handling, speed in loading and unloading, and the possibility of the goods remaining intact from the place of manufacture to their ultimate destination. This usually means some form of ’containerization’, and for simplicity in what follows this term will be used generically to include various forms of bulk transportation of cargoes. Although many ports have been handling containers and unit loads for many years, the quantity has been limited, but now the worldwide use of containerization is upon us and all the port services must be adjusted to cope with this rapidly developing method of transport. Along with other changes, new legislation has been enacted to deal with imported foodstuffs.

Integration of the Medical Services of Britain

requirement of a comprehensive health service for the prevention of illness, the cure of illness, and for rehabilitation. This concept, however, although generally agreed, has proved difficult to achieve because of the tripartite division of the medical services in Britain. Although the underlying causes militating against integration have been many and varied, there has been no lack of goodwill and much has been done to strengthen the links between the three branches of the National Health

The health and care of immigrants.

HE COMMONWEALTH immigrant problems ~ which have achieved such prominence in Britain in recent years have not been the result of a national crisis, or a need for large numbers of people to leave their native country at short notice as has occurred elsewhere. Commonwealth immigration has not to any significant extent been due to external political forces, but mainly to our internal rising standard of life, the maintenance of full employment and the creation of our welfare society with freedom from want, social security and medical care for all.

Book Reviews : Family Failure: a study of 129 families with multiple problems, by A. F. Philp, based on research undertaken for Family Service Units by Douglas Woodhouse. 311 pp. FABER AND FABER LTD. London, 1963. £1 12s. 6d. [HJ/174]

Since the phrase &dquo;problem families&dquo; came into general use, it has been bedevilled by efforts to define it in precise terms. The Family Service Units, which have specialized in this field of social work, have now produced an excellent book which covers every aspect of the subject. The subtitle &dquo;a study of 129 families with multiple problems&dquo;, is too modest for, although this provides the basic theme for the book, much of the wisdom gained from experience by F.S.U. is contained in the text. It should be appreciated that the F.S.U. approach of intensive case work together with close identification of the caseworker with his clients, is a highly specialized one. It is not possible or desirable within the structure of the statutory social services. Nevertheless the pioneer work of F.S.U. has led to the adaptation of the health and welfare services of local authorities to make special provision for problem families. Throughout the book, which is easy to read, the author has kept rigidly to what he knows. The descriptions of applied psychology and sociology are lucid and not exaggerated. In dealing with the medical and health aspects of the research the chapters

Book Reviews : Emotional Forces in the Family, edited by Professor Samuel Liebman, M.D. 157 pp. J. B. LIPPINCOTT COMPANY. Philadelphia and Montreal (PITMAN MEDICAL PUBLISHING CO. LTD. London), 1960. £2. [H/143]

on diagnostic criteria for mental disorder. Some believe, as in this American symposium, that all mental illnesses are simply variations in severity of a few basic disturbances ; they can, therefore, all be studied in the same way. On the other hand, others insist on a fundamental distinction between the minor personality disorders, the neuroses, and the major disorders, the psychoses. According to this view, the former are essentially variations of normal psychic life; the latter are disease-processes of, as yet, unknown somatic origin. Furthermore, there is little agreement on the diagnostic criteria of schizophrenia, an illness commonly studied in epidemiological investigations. One can reflect on the difficulties of epidemiological studies, of say, smallpox, plague or malaria if investigators were unsure of their clinical diagnoses. In fact, any-

Pulmonary tuberculosis--the last stages? (b) The role of the local health authority.

HAS been frequently demonstrated that infection can be brought under control if the biological balance can be weighted against the infecting agent. This can be achieved in two ways, by preventing the spread of the infecting agent or by reducing the number of susceptible hosts by some form of immunization. In this country typhus fever disappeared when lousiness in the population diminished to such an extent that the disease-carrying body louse became a rarity. Typhoid fever became a sporadic disease and appeared only as an occasional outbreak when water supplies, the favourite vehicle of spread of the S. typhi, were rendered safe by water purification measures. Diphtheria, on the other hand, was brought under control by immunization on a national scale. With respiratory tuberculosis the problem was complicated by a number of difficulties which, until recently, seemed insurmountable. These were: (i) lack of a satisfactory specific treatment; (ii) known reservoir of tuberculous infection in the community; (iii) unknown reservoir of tuberculous infection in the community; (iv) doubts about the effectiveness of B.C.G. vaccination. I should now like to consider these factors in the light of the progress made in the last 20 years, which has so altered the whole pattern of the control of respiratory tuberculosis.