The safety of electro-convulsive therapy (E.C.T.) has been greatly increased since muscle relaxants were first introduced for this purpose. Short-acting relaxants such as suxamethonium and suxethonium reduce the usual strong tonic and clonic contractions to faint muscle twitchings, and fractures do not occur. Respiration can be maintained throughout by positive pressure inflation so that cyanosis and stertorous breathing are avoided. This may ensure that material from small pulmonary lesions is not disseminated to other areas. It is disappointing that the cardiovascular commotion is only slightly reduced, and deaths still occur, albeit rarely.
Haloperidol is a drug that fulfils Delay's criteria of a neuroleptic in that:1.It inhibits psychomotor agitation without producing sleep.2.Alleviates psychomotor manifestations.3.Produces with increasing dosage characteristic extrapyramidal signs.
A geriatric unit containing 200 female and 110 male beds was fully opened at this hospital in March, 1953. There were then resident in hospital 226 females over 70, and 165 males over 65. The aim of this paper is to discuss the mental and physical health of the inmates and assess their medical and nursing requirements. It is hoped that this information will be of value to those intending to open similar units.This hospital is unique in having a catchment area of over 1,000,000 and only 2,000 mental beds. Three hundred of these are taken by mental defectives, and 500 are over 65 years of age. There is a severe bed shortage with resulting delay in admission of elderly patients from the observation wards. The large initial death rate in the month following notification occurs mainly outside this hospital, and many patients are discharged from the observation wards without reaching the hospital. Admissions are restricted to those with severe conduct disorder. Thus the death rate and discharge rate will be lower than hospitals with a more fortunate bed-population ratio.
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