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The work of the mental nurse is exacting, physicallyand mentally. It is fitting that her salary should bemaintained at a higher rate than that of the general-trained nurse. The 96-hour fortnight, which is regardedby the subcommittee as essential, might, we suggest,even be reduced in this branch of nursing. Otherrecommendations are what might be expected : recruitsshould be medically examined and radiographed beforestarting work, and examined again at yearly intervals ;they should have at least a month’s preliminary trainingbefore being admitted to the wards ; the higher postsshould be held only by nurses with double qualificationsin general and mental nursing ; superannuation schemesshould be interchangeable, and nurses working in institu-tions for the mentally defective should have the samepension rates as nurses in mental hospitals ; the ratio ofnurses on day duty to patients-1 nurse to 11 patients-should be substantially reduced ; and ward-maids shouldbe employed. The subcommittee hold that all trainedmental nurses should be entitled to live out if they wish,but the amount of living-out allowances is not discussed.Student nurses, it is agreed, should normally live in thenurses’ home, or in quarters provided in the hospital;but they should be able to gain permission to live out ifthey can satisfy the hospital authorities that this is intheir best interest. The old practice, still unfortunatelycurrent in some hospitals, of allowing the nurse to sleep" on the ward," so that she can be on call in case ofemergency, is to be discontinued. Off duty, the nurseshould have as far as possible the liberty of the privateperson, and the formation of nurses’ councils is advised.Opportunities for recreation, and for the entertainmentof friends, and better catering, should be arranged.The great changes in mental treatment since the

beginning of the century have brought the hope of

recovery to many more patients, and a new interest tomental nursing. Our growing knowledge of the properpsychological management of the mentally disorderedhas made it essential that the women and men whoundertake mental nursing should be intelligent, trust-

worthy, self-controlled, and instructed in their task.Recruits are scarce and drawn in many cases from thesimpler rather than the more intelligent groups. Theircourses of lectures, usually given by junior doctorswhose interests lie elsewhere, are often sketchy and ill-suited to their purpose. The training of the mentalnurse needs revising thoroughly, by those whose experi-ence and knowledge qualifies them to advise. A new

spirit in the nursing staff will come most quickly from anew spirit among the doctors teaching them.

SPECIAL DIETS IN CANTEENSTHE conference on special diets in canteens, arranged

by the Industrial Welfare Society and held at the CentralMiddlesex Hospital on Oct. 18, may well be a sign of thetimes. It is usually social necessity that compels us tostudy the dietetic needs of any definable group of thepopulation. Here it was the worker in industry sufferingfrom an incipient ulcer, or a recovered patient, who wasbeing considered. But how much attention did we payto the feeding of schoolchildren until the inquest on theSouth African War drew attention to the poor physicalcondition of many of the recruits ? ‘ And little interestwas taken in the right feeding of the aged before thepopulation curve made us realise that in twenty years’time the productive capacity of the old might be a matterof supreme importance. How far, then, was this confer-ence prompted by the vague awareness that a policy ofhigh employment makes it necessary to reduce the figuresof absenteeism ? Miss F. Garratt, in her paper onSome Existing Schemes and Plans, mentioned thisaspect of the problem in her reference to Soviet experi-ence. In 1935, according to the report of Burnet andAykroyd to the League of Nations, 600,000 workers inthe u.s.s.R. were receiving special diets in their canteens.

Most of the early Russian researches were undertaken byProfessor Pevsner and his colleagues, whose workhas not been fully appreciated in Britain. Pevsner was

studying the subject in 1922, but it was not until 1925that he obtained permission to open an experimentaldepartment associated with a factory ; and only in 1931was the Moscow clinic established for the study of theinfluence of diet on incipient tuberculosis, rheumaticconditions, gastric ulcer, and other ailments. The pro-cess of industrial reconstruction doubtless delayed theapplication of Pevsner’s findings ; but the evidence

suggests that even in a country with a high level ofemployment there were health authorities who neededto be convinced that the scheme was practicable.

Dr. F. Avery Jones, who spoke on The Patient Returnsto Industry, was mainly concerned with the recoveredulcer patient. For such a man regular meals, a lightdiet, and the avoidance of undue fatigue are indispens-able, if his ulcer is not to recur. Such foods as frieddishes, twice-cooked meat, new bread, pastries, meatsoups, curries, stews, coarse-fibred vegetables, and fruitwith pips or seeds should be avoided ; and this demandsspecially prepared dishes served at correct intervals." The man," said Avery Jones, " is not an invalid, andwill be capable of a very good day’s work, provided thehours are regular and there is no constant bending and hehas the right diet." In their brief review of existing

- facilities. Miss Garratt and Miss J. Bond said thata great number of firms who have not yet initiatedschemes for special diets are anxious to do so and areseeking guidance. The number of workers benefitingfrom the present canteen services rose steadily in 1944-45,as employees gained confidence in a diet that would helpthem to keep fit. The " Invalid Kitchens " organisationin London now operates eight centres with a deliveryservice capable of providing diet meals to small factorieswhere no canteen exists. These modest experimentsmay well be the seeds of an inclusive scheme that will intime help to save the country several hundred thousandhours of absenteeism in an average working week. Butit is not, it seems, until a country is compelled to weighthe cash value of output per man by the shrinkage of itslabour reserve that it begins to set a value on preventiveservices of this nature. The benefit to the sufferersthemselves could scarcely be reckoned in money alone.

RELEASE OF DOCTORS FROM SERVICES

GENERAL-DUTY medical officers in the Army are to bereleased as follows : groups 25-30 during January,groups 31-38 during February. Specialists in groups 25and 26 will be released during January and those ingroup 27 during February. Because of their greater ageon entry, the majority of specialists are in the first 30groups, and proportionately the release of general-dutymedical officers in groups 1-38 is equivalent to release ofspecialists in groups 1-27. The Central Medical WarCommittee is still recruiting specialists for the Armyso as to facilitate release of specialists in later groups.The Royal Air Force is stated to be releasing doctors

in groups 27 and 28 in February and March.

Dr. H. E. MAGEE is to deliver the Milroy lectures at theRoyal College of Physicians of London on Tuesday andThursday, Feb. 12 and 14, at 5 P.M. He is to speak on theApplication of Nutrition to Public Health--Some Lessonsof the War.

’

Air Vice-Marshal T. J. KELLY, c.B.E., M.c., has been

appointed an honorary surgeon to the King in succession toAir Vice-Marshal F. C. Cowtan, who vacates the appointmenton his retirement from the Royal Air Force.The Middlesex County Council have appointed Dr. J. B.

COOK honorary consulting physician’to the West MiddlesexCounty Hospital. Dr. Cook retired last month after 32 yearsas medical director (formerly medical superintendent) and atotal of 38 years’ service to the hospital.