759

DOCTOR AND CLERGY

FIFTY years ago medicine rested confidently and

comfortably on a bed of material science. Bacteriologyand cellular pathology were in their prime, modernpsychology in its infancy; physics had not invadedchemistry, atoms being solid particles of known weight;neurology divided " diseases of the nervous system "sharply into organic and functional, and had small concernfor the second category; the word psychosomatic was notcoined or the underlying conception recognised; sugges-tion, whether pathogenic or therapeutic, was almost out-side the pale of orthodox medicine, by which indeed themind (save as the seat of mental disease) was recognisedrather grudgingly. The medical superintendent of a

large asylum-not then a " mental hospital "-could tell

an inquiring student that he believed the brain to secretethought, as the liver bile.Every kind of doctor spoke of " cases " without feeling

either shallow or inhumane: " the ruptured kidney innumber ten " did not seem either a comic or an offensiveway of describing the patient in that bed. Doctors, as aclass, were unquestionably more materialist than patients,as a class; and the doctor with a religious creed found it aseasy as the agnostic to confine himself to the care of thebody. A convenient fence divided this from the field of thepriest, and the two did not overlap.

Since then we have found that nothing is what itseemed. The well at whose bottom lies truth turns out tohave no bottom; the simple, confident, science-basedmaterialism of the early 1900s is " out ", and most doctorsare now, pretty certainly, less materialist than most

patients. A doctor may find himself in the curious positionof trying to persuade his patient to believe in the realityof his mind and in its power to produce symptoms andinfluence his body. We have, perhaps, an almost excessiveregard for the machinations of " psyche " (continuallysearching for her under the bed), and psychology mani-festly postulates the existence of mind, if not of spirit.In so far as the minister of religion may be held to ministerto the spirit and attempt the healing of its wounds anddiseases, it is clear that our fields do indeed overlap. Butthe fence, though scientifically and rationally unjustified,is still up in practice-partly perhaps because " goodfences make good neighbours ". Parson and doctor nodto each other in the street or on the hospital staircase butnever meet at the bedside and very rarely consult togetherfor the patient’s good. Patients in their houses, and sistersin hospital wards, take great care that medical and clericalvisits shall not coincide, and there is general embarrass-ment when they do.A booklet published by the Australian Council of

Churches contains five thoughtful and instructive papersread at a Clergy-Doctor Group Consultation held nearSydney last summer. The three clerical contributors area former vice-principal of a theological college, a formersenior chaplain for general hospitals in Victoria, and thechaplain of a mental hospital; the editor of the MedicalJournal of Australia and a practising hospital physician ofSydney speak for medicine. Views apart, they describewhat is being done in clerical colleges and medical schoolsto educate clergymen in their role in the care of thesick " and doctors " in their role in relation to the spiritualneeds of patients "; and what is being done, though per-haps less than is reported from the U.S.A., is considerableand increasing. Also described is the gradual acceptance1. The Doctor and the Minister. Sydney: Ambassador Press. Pp. 40

of the chaplain to a mental hospital as a working member ofthe therapeutic team. Restraint, good sense, clear thinkingand good will are as much in evidence as idealism, and thebooklet is worth reading for its analysis of the problemsas well as for its positive suggestions.

In this country, though hospital chaplains are moregenerally recognised as part of the hospital establishment,we seem more ready to be content with things as they are.But Dr. Hugh Jolly’s address to chaplains which wepublish this week shows that here, too, some attempt isbeing made to bring about a clearer recognition of thefunctions of doctor and minister in the service of the sickand to bring them nearer together.

1. Ministry of Health: Final Report of the Committee on Cost of Prescrib-ing. 1959. See also Lancet, Feb. 18, 1961, p. 379.

2. Supplies permitting, copies will also be obtainable on application to theEditor, Prescribers’ Journal, Chesham House, 136, Regent Street,London, W.1, at 6d. a copy, post free.

"PRESCRIBERS’ JOURNAL"

To meet the need for " impartial information on newdrugs and preparations in convenient and readily acces-sible form ", the Hinchliffe Committee thought that thePrescribers’ Notes issued by the Ministry of Health shouldbe replaced by an independent journal " run by the medicalprofession for the profession ".1 The arrangements for thenew Prescribers’ Journal do not follow quite all thecommittee’s recommendations, but we trust that theresult may justify all their hopes. It is to be compiled bya professional committee of management supported by anadvisory board of experts, and it will be issued six times ayear to all general practitioners in the National HealthService, to the medical staff and chief pharmacists ofhospitals, to clinical teachers in medical schools, and tostudents in their three final years.2 The managementcommittee has Prof. M. L. Rosenheim as its chairman,with two professors of pharmacology as his deputies; andits other members are four general practitioners, a pharma-cist, and professional advisers from the Health Depart-ments. The editor is Dr. J. L. Hunt.The first issue contains much useful information

presented clearly and in an independent way. Dr. C. D.Calnan writes on the value of griseofulvin; the topicalapplication of corticosteroid preparations for skin disordersis discussed editorially; and in the first of a series of paperson antibacterial drugs Prof. L. P. Garrod discusses the useof the various penicillins now available. Besides publish-ing signed review articles on trends in treatment, the com-mittee intends to provide expert advice on new drugs, tocomment on the possible toxic effects of drugs both newand well established, and " to run certain regular features,such as summaries of clinical trials which are in progressor which have recently been completed, information aboutdrugs dealt with by the Standing Joint Committee on theClassification of Proprietary Preparations (the CohenCommittee); and abstracts from topical articles about

drugs which have been published in the medical press ".While there is great need for constant economy in pre-scribing, the journal, Professor Rosenheim says, willconcentrate on good prescribing; for the committee thinksthat " good prescribing must prove both effective andeconomic ".

Sir ROBERT PLATT has been re-elected president of the RoyalCollege of Physicians of London.

Dr. R. A. LENNIE, a former regius professor of midwiferyin the University of Glasgow, died on March 26 at the age of 71.