Lactancia materna y estado nutricional de niños entre 1 y 3 años de edad / Breastfeeding and nutritional status of children between 1 and 3 years of age

Se estudia la relación entre la lactancia materna y el estado nutricional de 127 niñas y 143 niños (n =270) de 1 a 3 años de edad, mediante un estudio de campo descriptivo y transversal, en ambulatorios de Caracas. Las variables estudiadas fueron: edad, sexo, estrato socioeconómico, tiempo y duración de la lactancia materna, peso, talla y las circunferencias del brazo y cabeza, para obtener la combinación de indicadores peso para la edad, peso para la talla y talla para la edad, y con ambas circunferencias el Índice de Kanawati-McLaren (K-McL= Circunferencia de brazo/Circunferencia de cabeza). Se aplicaron cuestionarios semiestructurados, al binomio madre-niño Predominaron los estratos sociales IV y V (Pobreza relativa y Crítica, respectivamente) según Graffar modificado, solamente el 17 % de la muestra pertenecía al estrato III (condiciones económicas medias). Al establecer la relación entre la lactancia y el estado nutricional según los indicadores hubo un comportamiento sin diferencias estadísticamente significativas. En cuanto a la combinación de indicadores y el tiempo y tipo de lactancia practicada en los niños ubicados entre percentiles 10 y 90 y con seis meses de lactancia exclusiva fue realizada sólo por el 8,33% de ellos. En los desnutridos con talla normal, la cifra fue igualmente cercana: 10,81% para esa práctica. Los varones estaban desnutridos en un 21% y las niñas en un 13%. Al aplicar K-McL: 75,63% de los niños amamantados hasta el día de la entrevista resultaron normales (percentil 50 o mediana) y los no amamantados hasta ese momento sumaron un 70,83%(AU)

This study examines the relationship between breastfeeding and nutritional status of 127 girls and 143 boys (n =270) 1 to 3 years of age. It was carried out a field descriptive and cross-sectional study in clinics of Caracas. The anthropometric variables were: age, sex, socioeconomic strata, time and duration of the maternal breastfeeding, weight, height, and cephalic and arm circumferences, for the combination of indicators: weight for age, weight for height and height for age, and with both the index Kanawati-McLaren (K-McL) circles and semi structure questionnaires have been implemented. The social stratum IV and V predominated (relative poverty and criticism, respectively) according to modified Graffar, only 17% of the sample belongs to the stratum III (average economic conditions). To establish the relationship between breastfeeding and nutritional status according to the indicators, there was a behavior without statistically significant differences. The combination of indicators and the time and breastfeeding practiced in located children (between 10 and 90 percentile) and six months of exclusive breastfeeding was performed only by 8.33 % of them. In the malnourished with normal stature, the figure was also close: 10,81% for this practice. The boys were undernourished by 21% and the girls by 13%. Applying K-McL: 75, 63% of the children breastfed until the day of the interview were normal (percentile 50 or median), and not breastfed until that time amounted to 70, 83 %(AU)

Professor McLaren (2). His Theories of Psychiatry / 신경정신의학

Professor Dr. Charles I. McLaren (1882-1957) of the Department of Psychiatry, Severance Union School of Medicine in Seoul, Korea had introduced not only Christianity but medicine and psychiatry of his time with his own theories to Korea while he had served as a Christian missionary from Australia to Korea from 1911 to 1941. Based on his view of Christianity and knowledge of modern science and medicine, he tried to explore the etiology, symptoms, treatment and spiritual meaning of mental disorders including general paresis, dementia praecox, mania, melancholia, paranoia, neurasthnenia, hysteria, hypochondriasis, and even psychophysiological disorder. Though he accepted that mental disorders are related to disrupted functions of brain or neurons, he believed that fundamental causes of insanity is spiritual. Regarding etiology, he suggested that people's choice not to follow God's logos by their free-will and consequent disharmony with nature or human society or failure of self to adapt to reality causes mental disorders. And he explained psychotic phenomena in view of Christian spirituality. In addition, he argued "psychic" (psychological or spiritual) conflict, sensitivity and guilt feeling as a possible etiology of psycho-neurosis including neurasthenia, hysteria and hypochondria. Conflict includes not only sexual conflicts but social conflicts related to family, job, money, or guilt feeling. He also emphasized the meaning and purpose of life in relation to development of mental illness. Remarkably, he introduced idea of "spill-over" to explain how emotional problems influence autonomic dysfunction resulting in psycho- physiological symptoms. He can be recognized as a psychiatrist who integrated bio-medical descriptive psychiatry with psycho-social approach, dynamic psychotherapy and even spiritual approach as a fundamental one. Though many scientific criticism can be given to his theories of psychaitry, he is deserved to be rediscovered and recognized as a pioneer who had shown another apprach to mental disorders to present psychiatrists who are lost in confusion with so many uncertainties in regard to understanding and treating mental disorders.

Professor Charles I. McLaren, MD (1) : His Life and Medical Philosophy / 신경정신의학

Professor Charles I. McLaren (1882-1957) was an Australian Christian missionary and a professor of psychiatry in Korea. As the first psychiatrist from a Western country, he accomplished tremendous achievements in clinical, teaching and writing activities as well as in his missionary work. He graduated from the University of Melbourne in 1906 and, after residency training under Professor Dr. Sir Richard Stawell at the Royal Melbourne Hospital, he and his wife came to Korea in 1911. He practised medicine at Margaret Whitecross Paton Memorial Hospital in Chinju, Korea and later was appointed as a professor of psychiatry at the Severance Union Medical School in Seoul, Korea. He left Korea for a while to participate in WWII as a military doctor and he also once traveled to Vienna to learn new skills, including fever therapy and psychoanalysis. Because of his love for the Korean people, Dr. McLaren not only introduced into Korean society modern Western psychiatry and a humanitarian approach to patients with mental disorders, but he also practised medicine according to his own unique medical philosophy drawn from Christian spirituality and he educated Korean native students in psychiatry and Christianity. He and his wife also made efforts to improve old customs in Korean society. Because he argued against Japan's enforcement of emperor-worship, he had to resign from the Severance Medical College in 1939, and he returned to Chinju. Immediately after the bombing of Pearl Harbour, he was arrested, imprisoned, interned, and subequently expelled to Australia in 1942. In Melbourne, received wide press coverage and great controversy. He lectured widely and contributed to various professional and other publications, covering not only subjects in Christianity and medicine/psychiatry, but also his opinions about the war and Japan, communism and the White Australia policy. As a Christian me-dical doctor and scientist, he was interested in the "nature of man", the relationship or interaction between body (brain and/or material) and mind/spirituality, the origin of human consciousness in relation to time-space energy, the healing of disease, and the etiology of mental illness and spiritual treatment. He was passionate in his stated belief that God's Word applied to the whole spec-trum of human relationships, from personal to international, as well as to the natural world. Dr. McLaren kept his conservative Christian beliefs, but he respected traditional Asian philosophies. His thoughts and experiences were publically expressed through lectures, journals and books, not only in Korea but also in China and Australia. He was a man of compassion, courage and ceaseless intellectual activity, a pioneer of psychiatry and a lifelong explorer of the Bible. Korean psych-iatrists, who may feel confused by the many complicated new medical theories and advanced technologies, still find Dr. McLaren's simple and clear teachings on science, medicine, and human nature and his practice of caring for mental patients with a compassionate, humanitarian and Christian attitude a challenging example to emulate.

The Establishment of SUMC(Severance Union Medical College) Psychiatry Department and the Formation of Humanistic Tradition / 의사학

Psychiatry is a branch of medicine which deals with the problem of mental health. Although psychiatric concept and treatment is not absent in traditional medicine in Korea, it was not regarded as an independent discipline of medicine. Modern psychiatry was introduced into Korea as modern Western medicine was introduced in 19th century. The American medical missionary Dr. Allen and Dr. Heron gave the first classification of mental diseases of Korean patients in their first year report of Jejoongwon hospital. The statistics are characterized by relatively high rate of hysteria patients among the patients with mental disorders. It was Dr. Mclaren who took the charge of the Psychiatric Department of Severance hospital, the successor of Jejoongwon hospital. As a psychiatrist, Dr. Mclaren had a deep interest in human nature and mind. His thinking on the subjects was based on his Christian faith and philosophy. He claimed that Christian faith plays an important role in curing mental diseases. And several medical students decided to become a psychiatrist under his influence. Among them is Dr. Lee Chung Chul who took the charge of the Department of Psychiatry after Mclaren. After graduation in 1927, Dr. Lee studied in Peking Union Medical College, Australia, and Japan. His main research interests were focused on the biological aspects of mental disorders, and he published several important papers on the subject. But his unexpected early resignation and subsequent expulsion of Dr. Mclaren from Korea by Japanese colonial government hindered further development of psychiatry in Severance Union Medical College until the Liberation from Japanese occupation in 1945. But some of their students specialized in psychiatry during the hard period of early 1940s and they played an important role in the development of modern psychiatry in Korea after the Liberation.