ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1984.tb00242.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SummaryPioneer researches concerning the connection between the smoking addiction and lung cancer provided the National Health Service with its first major test in the field of preventive medicine. It is instructive in examine how this problem was handled in the period 1950 to 1962. The NHS legislation of 1946 envisaged that the new service would take on an active preventive rote and that it would respond flexibly to new demands. At the heart of the new central administration was an elaborate professional advisory machinery designed precisely for the purpose of ensuring prompt response to new needs.The connection between smoking and lung cancer became a live issue in the immediate post‐war period through the researches of Kennaway sponsored by the British Empire Research Campaign. This work was carried to a striking conclusion in the epidemiological context by Doll and Hill in 1950. Subsequent investigations strongly supported their conclusions.Within the Ministry of Health smoking and lung cancer was the prerogative of the Cancer Standing Advisory Committee for which this problem was an uncongenial side issue. Positive action was precluded by strong objections within the Cancer SAC to ‘cancer education’. A vociferous minority within the advisory structure campaigned to generate a more positive attitude, but once formed there was great reluctance to modify, let alone reverse, medical policy decisions. Eventually the unresponsive Cancer SAC was by‐passed. The mart prestigious and broadly based Medical SAC and the Central Health Services Council gradually awoke to the importance of this issue. Crucial to keeping this issue alive was the increasing publicity in the press which resulted in persistent parliamentary questioning.Complete conversion was rendered more difficult by virtue of lack of sympathy of Ministers and officials within the Ministry of Health. MRC generally supported the work of Doll and Hill, but a strongly positive and independent line would have prejudiced relations with the Ministry of Health. A distinct change in the official attitude awaited the 1962 report of the Royal College of Physicians, after which further procrastination seemed inadmissible. But even then, after 12 years of inactivity, the National Health Service was not mobilized to make smoking and health a major issue on its

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1984.tb00243.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SummaryThe formation of drug control policy in Britain in the first three decades of the twentieth century is reviewed. Pharmaceutical controls over sales, based on professional self‐regulation gave way to controls on possession and use during the First World War, These war‐time restrictions were the basis of the 1920 Dangerous Drugs Act which fulfilled Britain's international treaty obligations. During the 1920s, the Home Office attempted to establish a penal policy on the American model; the Rolleston Report of 1926 established the ‘British system’ of drug control. The ‘political’ significance of British drug control in this period, in particular its polemical use in the struggles to liberalise American drug policies in the 1960s, has inhibited a more developed analysis of policy. The tensions over policy and the 1926 Report were not simply battles between rival conceptions of control or a ‘victory’ for the ‘medical model’. This approach ignores the control aspects of both penal and medical views and the complexity of the interactions between them. The 1926 Report was not a ‘medical victory’ but the result of an accommodation and collaboration between medical and bureaucratic elites with sim

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1984.tb00244.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SummaryThe drug addict or ‘problem drug taker’ is the focus of a number of overlapping systems of regulation from moral to medical and penal. It is consequently difficult to analyse the development of policy in this area without lapsing into oversimplifications which imply either a process of medicalization or the unity of a totalitarian system of social control. It is argued here that we cannot adequately understand the development of policy in the field of drug addiction by reference to the medicalization of social problems and that a more fruitful course is opened up by analyzing developments of ‘rational knowledge’ which underpin policy shifts. In the light of this argument the apparent shifts in policy in the 1960s following the Second Brain Report are re‐

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1984.tb00245.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SummaryThe relationship between the state and the use and abuse of alcohol has been a long and complicated one. Alcohol has been seen, at one and the same time, as a product to be taxed, a threat to social order, a danger to public health and an economic activity to be fostered. Differing government departments, with their differing responsibilities, have implemented contradictory policies, and this has been complicated by the interaction of parliament, pressure groups and local government.Records relating to alcohol production and consumption are widely scattered amongst the archives of parliament, local authorities, private companies and individuals. The records of the central departments of state and courts of law on this subject, however, are held together at the Public Record Office, and are an invaluable source for research.The state has taxed the importation, production and retailing of alcohol for many centuries. A record of this activity can be found in the documents produced by the accounting sections of the Exchequer and by the revenue boards. On the other hand, the threat to public order presented by drunkenness and the congregation of the lower orders in inns is amply documented in Elizabethan wine licenses and in the State Papers. This threat was met by licensing retail outlets, an activity supervised by the Home Office from the mid‐19th century, and by the suppression of disorder, as revealed in the records of the Metropolitan Police. More subtle forms of ‘control’ can be seen in the activities of the Central Control Board, established in 1915 in an attempt virtually to nationalize the alcohol industry in areas where munition workers were active. The CCB came under the authority of the Home Secretary and as such its records have been preserved with those of the Home Office. These records also contain information on the Home Secretary's responsibilities for the supervision of retreats for habitual drunkards under the various Inebriates Acts of the late 19th century. At the same time, however, the records of the Board of Trade, and of the Colonial and Dominions Offices, show the state actively fostering the export of alcohol as a valuable component of British trade. Information relating to the commercial production of alcohol can be found in the records of the Companies Registration Office and of the companies liquidation and winding up proceedings in Chancery and the Supreme Court.An overview of policy in these matters can be found in the records of the Cabinet Office and of the Treasury, the latter being responsible for the financial sanction of civil service expenditure. The Treasury appears to have been more interested in the quiet manipulation of price and alcohol content than in outright intervention.The records of many of these bodies are complex and voluminous and the PRO provides readers with explanatory guides and a

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1984.tb00246.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SummaryThis paper investigates the sources of the common Victorian belief that drunkenness was the most significant cause of insanity. While acknowledging the role of the Temperance Movement in promoting this belief, the paper argues that its development was rooted in the social conditions and prejudices of the time, as well as in the experience and reasoning of Victorian medical men. The asylums which reported the highest proportions of drink‐induced insanity generally lay in urban, industrial areas where drinking was perceived to be a serious problem and catered to a predominately working‐class clientele. The superintendents of the asylums were inclined to conclude from their experience that drink was the most common cause of insanity. Their tendency to do so was increased by medical uncertainty about the exact relationship between drunkenness and insanity, the habit of many doctors of reasoning in circular fashion, and their proneness to link theories of causation to traditional moral imperatives. These tendencies were evident in speculation about the causes of conditions such as paresis and ‘hereditary’ mental di

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1984.tb00247.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SummaryMuch medical, psychiatric and social thinking in the second half of the nineteenth century was influenced by the concept of progressive hereditary degeneration most systematically formulated by the French psychiatrist B.A. Morel (1809–1873). Alcoholism was one of the conditions postulated by Morel as leading to direct hereditary consequences for the offspring. This essay examines the pervasiveness of hereditary degenerationism in general, and alcoholic degenerationism in particular, in British and European psychiatry in the period, and then describes the work of several individuals who challenged this notio

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1984.tb00248.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SummaryIn the years 1899–1907 new critique of alcohol evolved which pointed to increasing female insobriety as factor in infant mortality. Exploiting the opportunity of governmental committee appointed to investigate physical deterioration, 14 leading medical doctors, well known for their antipathy to drink, submitted evidence which subsequently formed the basis for the Report's conclusion associating alcoholic abuse with racial deterioration. Between 1905 and 1907 six of these doctors, together with Sir Thomas Brunton and Professor Sims Woodhead, orchestrated concern over drink's deleterious impact on pregnant women and babies. By condemning alcohol as one important source of infant deaths and national inefficiency, these anti‐drink doctors, all except one members of the Society for the Study of Inebriety, encouraged the medical profession to adopt more critical public posture towards drink and compelled the Government to permit hygiene and temperance instruction in elementary schools. They further provided the rationale early in 1907 for George Sims’ newspaper articles, which emphasized the imperial consequences of Britain's high infant mortality. He alone publicized the prevalence of babies and small children taken into public houses, where they were given alcohol or contracted fatal respiratory diseases. Breast milk contaminated with alcohol also endangered their lives. Following these revelations, sympathizers formed the Tribune Committee, and, with the support of the eight anti‐drink doctors and others, helped translate Sims’ proposal to prohibit children under 14 from licensed premises into le

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1984.tb00249.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SummaryWhile international concern and cooperation about alcohol programmes date back almost a century, modem programming in international agencies has been primarily focused in the World Health Organization. Aside from a spate of work in 1950–1955, the primary effort has come since 1970. The main lines of this work are described. Assessing the record, the programme has been successful in symbolic accentuation of alcohol issues, and productive in information collation, conceptual development and collaborative research, but has failed as yet to become institutionalized as a regular‐budget activity. The difficulties for WHO and other public health institutions in facing the terrain of alcohol control are discus

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1984.tb00250.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

SummaryIn 1931 the Royal Commission an Licensing concluded that the drink problem was no longer a ‘gigantic evil’. Measured by the reduction in per capita consumption, the resolution of ‘the drink question’ took place mainly in the early years of the twentieth century. This paper contrast*the respective fortune*of the temperance movement and the drink trade*and argues that before 1900 the drink trades displayed little concern about the anti‐drink campaign. Only after 1900 when total demand fell and a wider range, of policy options were proposed, did the drink trades read. Even so, the anti‐drink campaigners greatly overestimated the economic, political and social influence of the drink interest. Business records affirms and trade associations in the Scotch whisky industry show that it was not until ‘the People’ Budbget’ of 1909 which increased excise duty on spirits that the industry began to subscribe to the Conservative party and to attempt to influence shareholders and employees. With the First World War, stringent controls on drink consumption and production were proposed but in direct negotiations with the Government whisky producers were able to modify the proposals. Patent still distillers met a national need far munitions spirit and yeast. Nationalization of the drink industry was not supported by the whisky trade, in contrast to the brewing industry. After the war, Scotch wins by producers continued to see the anti‐drink campaign, especially prohibition, as a threat and developed more effective means of defence. How relevant trade defence and legislation were to the resolution of the drink question remains doubtful as underlying cultural changes altered the use made of leisure time and the distribution of c

ISSN:0952-0481    

DOI:10.1111/j.1360-0443.1984.tb00251.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY