THE DEVELOPMENT AND ORGANIZATION OF A CHILDREN'S PSYCHIATRIC HOSPITAL

Thistletown Hospital is a children's psychiatric hospital which was established by the Department of Health of the Province of Ontario. Special legislation permitting control of the admissions procedures was enacted. The administrative organization consists of a series of committees made up of the heads of hospital departments. An advisory board of distinguished psychiatrists and psychologists advises the Minister of Health directly on major policy changes or innovations envisaged for the hospital. Clinical organization is related to four functions: (1) service (treatment and assessment), (2) research, (3) training of staff, and (4) community education.The basic units of the hospital are related to the treatment or research design necessary in special diagnostic categories. A children's psychiatric hospital should not be restricted to in-patient facilities but should consist of a totally community-oriented service.

PAROXYSMAL SNEEZING

Although sneezing is a particularly common symptom, there are surprisingly few references to this subject in the medical literature. Many of these references are shrouded in superstition and unscientific theory. Preparation of this report was stimulated by an interesting example of severe uncontrollable non-allergic paroxysmal sneezing which was carefully investigated with regard to both physical and psychological factors. A further example of paroxysms of sneezing occurring in a patient with temporal lobe seizures is also discussed with particular reference to the control of the sneezing episodes in association with anticonvulsant medication and control of the epileptic attacks. In addition, the neurophysiological mechanisms of sneezing are reviewed and the specific neurological references to the subject are discussed in relation to physiological and clinical data. At times the symptom of sneezing would appear to reflect some unknown disorder which may have central and possibly cortical affiliations.