The National Association for the Feeble- Minded

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and infant welfare, and it would tend to bridgeover the gap, already lessened by the war, betweenthe masses and the classes. Moreover, it has strongeducative possibilities, for it would bring home toevery subscriber one aspect of that grim strugglewhich the State and sanitary authorities are cease-lessly waging-the fight against death from pre-ventable disease. Further, the interest aroused bysuch a scheme would probably lead to a greatincrease in the number of local voluntary workers.

The National Association for theFeeble- Minded.

THE annual report of the National Association forthe Feeble-Minded has reached us accompanied bya reprint of the proceedings at the Conferenceheld in June, 1915, at the Guildhall, London,to determine the best methods of ascertainingthe presence of mental defect. The two docu.ments furnish much valuable matter for theconsideration of medical men and other socialworkers who are interested in the care and trainingproper to mental defectives, and in the due controlof such persons for the benefit of the communityat large. The National Association for the Feeble- ’,Minded, an active body, was founded in 1901 for "

promoting the welfare of the feeble-minded," butit has extended its efforts beyond the object specifiedin its title, and aims at the prevention of many mani-fest evils that result from the uncontrolled liberty ofmany persons who are not liable to restraint underthe lunacy law. Shortly after its foundation theassociation, among other public bodies, impressedupon the Government the gravity of the existingposition, and contributed to the combined effortswhich led in 1904 to the appointment of a RoyalCommission to inquire into the whole subject, aninquiry which led to the passing of the Mental

Deficiency Act in 1913. Two prominent membersof the association, Mrs. HUME PINSENT, and

Mr. W. H. DICKINSON, M.P., were on the RoyalCommission, and are now on the Board of Controlwith which the Lunacy Commission has been

associated. To found and maintain homes and colonies for the feeble-minded is one of the most important objects of the association, and wewould call attention to the statement of the

secretary, Miss KIRBY, that at this time especially,when both public interests and public funds areso largely absorbed in the European war, it is stillleft to the voluntary homes to bear the greaterpart of the burden of’the care of the feeble-minded.The last report of the work of the associationshows clearly how much more could be achievedby adequate support.The valuable Conference at the Guildhall, which

had for its object "to determine the methodsof examination best adapted to ascertain the

presence or otherwise of mental defect," was con-cerned with the due recognition of the mental defectwhich indicates the need of care or control, but whichoccurs in subjects who are not amenable to the

operation of the Lunacy Acts. Such persons are nowliable to be dealt with under the Mental DeficiencyAct, and, indeed, form by far the most importantgroup with which that Act was intended todeal. This is the group of defectives known

generally as feeble-minded, as distinguished fromthe lower grades of idiots and imbeciles who,in many instances, were cared for and con.

trolled to some extent under pre-existinglaws. Seeing that the Mental Deficiency Act hasnow created a statutory class of "mentallydeficient" persons quite outside that which is

conventionally and legally known as" lunacy" or" unsoundness " of mind, it is a matter of practicalimportance for all administrators and local autho-rities under the new Act to endeavour to come tosome general agreement on the due diagnosis ofmental deficiency. It may be well to rememberthat the Royal Commission which was instructed toreport on this subject generally, and also on theworking of the lunacy laws and on any amendmentsof these laws that might seem desirable, recom.mended that the persons now described as mentallydeficient should be brought within the scope of anamended lunacy law, and that the Act as amendedshould include, under the comprehensive title of" mental defect," all cases of such defect from what.ever cause arising, including, of course,

"

insanity,"or lunacy, or unsoundness of mind. The Mental

Deficiency Bill, as introduced into Parliamentfinally in 1913, and much altered in many respects,seemed to many observers to raise more difficultyin the matter of the due recognition of cases ofmental deficiency usually known as "congenital"than of those usually spoken of as " acquiredinsanity."

Sir BRYAN DONKIN, who presided over the Con-ference, pointed out that in cases of " insanity,"as well as in all other cases of mental defect,the diagnosis and consequently the necessity ofcare and control depends in practice mainlyon the careful observation, often over a longperiod of time, of the conduct of the person in

question. He further mentioned the difficulty feltby some in the apparent requirement by the termsof the Act of a strict demonstration of the origin" at birth or an early age " of " mental deficiency."

This difficulty is occasioned by the promineut placeaccorded at the head of the Act to the so-called" definitions of mental deficiency and may be

more apparent than real. A well-reasoned opinionon the nature of any case of this kindshould be as valid in evidence as it is nowin other cases of mental or physical disease.It is certainly clear, however, that some adminis-trators do find this difficulty a considerable one,especially in cases where the early history of amental defective cannot be arrived at by observa-tion or inquiry; but it may at least be hopedthat it will prove as surmountable in practice asSir BRYAN DONKIN seems to anticipate. There is nodoubt that at the present moment the diagnosis andcare of our mental deficients is a pressing matter,