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210 13, it was found that 37 per cent. were mentally defective, 12 per cent. were retarded, 51 per cent. normal, and none superior. The striking difference in the comparison of those over 13 with the 7 to 13 class lies in the number of those previously reckoned as retarded who are later classified as mentally defective. The latter group has risen from 14 per cent. to 37 per cent. In an appendix Prof. R. A. Fisher says : "It would seem that a number of children who are later to be regarded as mentally defective or retarded are considered to be normal in the first seven years of their lives, and that many who are later to be classified as mentally defective are, until their fourteenth year, still placed in the retarded group." The investigation further yielded the inter- esting fact that of 3247 mentally defective women known to the local authorities to have had children 66 per cent. were unmarried. This finding illustrates that the legal prohibition of marriage for defectives would constitute but an incomplete solution of the problem of limiting their fertility. Causation of Mental Defect and Disorder The report contains chapters on our present know- ledge of the causation of mental defect and disorder. In regard to mental defect, the chief conclusions are that : (1) in many cases there exists in the family some form of mental abnormality such as insanity, psychoneurosis, epilepsy, defect, or dullness. In the majority of such cases there is evidence of heredity, but the mode of transition is at present unknown ; (2) low-grade mental defect is more frequently asso- ciated than is high-grade with environmental factors and it appears to be fairly equally distributed among all classes of society; (3) high-grade mental defect occurs proportionately more frequently in the lowest social stratum than in the rest of this population. (It is regarded as possible that the bad environment prevalent in the social problem group and the assortive mating which there takes place may contribute to this result.) In regard to mental disorders, it is stated that, apart from Huntington’s chorea and myoclonus- epilepsy, there is no conclusive evidence that inheri- tance follows mendelian ratios ; whereas in general psychopathic parents tend to have psychopathic children, the view that familial mental instability is usually progressive and tends to become more severe in each succeeding generation, thus conforming to the so-called " law of anticipation," is not confirmed ; and manic-depressive insanity and schizophrenia appear to show markedly higher familial incidence than other types of mental disorder which are of frequent occurrence. Other findings of importance are that the fertility of mental defectives is, on the whole, probably below that of the average of the population. At the same time, the committee found evidence from Nottingham, Liverpool, and London that the families from which defectives come are larger than average families in the same locality. IRELAND (FROM OUR OWN CORRESPONDENT) ANOTHER " CUTS " BILL THE text of the Local Services (Temporary Eco- nomies) (No. 2) Bill, 1933, was circulated a few days ago. It gives powers to the several local authorities to make deductions during the year 1934 from salaries paid to their officers and from certain scales of expenses. The deduction shall be such as the local authority shall in each case think proper, but shall not be less than the minimum deduction laid down in the schedule to the Bill for such a salary nor more than shall be sanctioned by the Minister. The mini- mum deductions stated in the schedule are similar to those laid down in the Act passed last year dealing with the salaries of civil servants. No deduction is to be made from a salary which does not exceed 300 a year. The minimum deduction on a salary which does not exceed S400 is to be 2 per cent., and a rapidly increasing scale will apply to the higher salaries. Medical officials as well as their colleagues will suffer under the Act, but a special concession is to be made in the case of dispensary medical officers- the salary shall be taken to be E50 per annum less than the actual amount thereof. The remuneration of comparatively few dispensary medical officers exceeds £ 350 a year, and therefore most of them will escape the operation of the cut. It will not be so with the whole-time medical officers, such as medical officers of health and the medical officers in mental hospitals. A salary of E800 a year, for example, will suffer a minimum deduction of E24. Although the Bill was introduced to the Dail in November there were rumours that it would not go any further. It is generally admitted that the " Cuts " Act of last year, dealing with the salaries of civil servants, has not brought about any real economy. In fact the deductions have been more than counterbalanced by the pensions that have had to be granted to a large number of civil servants who had statutory rights under the treaty. The Government has announced that there is no intention to continue the Act this year, and it is surprising to find them proposing to apply to local officials a policy which has failed to produce any useful result when applied to the civil service. The net result in each case is much unrest and disquietude in the services, the members of which see that their security of contract no longer holds. In one particular the present Bill is more harsh than its predecessor. It states a minimum deduction, the maximum being at the will of the local authority subject to the discretion of the Minister. In the previous case there was a fixed scale. THE CHIEF MEDICAL OFFICER It is just over a year since Mr. Edward Stephenson relinquished the office of chief medical officer to the Department of Local Government and Public Health, and a certain amount of speculatiori had taken place over the delay in appointing a successor. The Minister took the unusual course of referring the appointment to the Civil Service Commission, which advertised the vacancy and called in the assistance of a selection board. The appointment of Mr. Robert Percy McDonnell, F.R.C.S. Irel., is now announced. Mr. McDonnell had been acting as chief adviser during the interval since Mr. Stephenson retired. Mr. McDonnell was qualified in 1901, and at once went on active service to the South African War. On his return he engaged in private practice and was for a time assistant surgeon to St. Vincent’s Hospital, Dublin. In the late war he served in Gallipoli, Serbia, and France as a captain in the Royal Army Medical Corps. In 1922 he held the rank of colonel in the Medical Service of the Irish Free State Army. For several years he has been an inspector in the Department of Local Govern- ment and Public Health. His appointment will give pleasure to the medical profession in Ireland, parti- cularly to those in the public services. His experience in practice and in administrative work has given him a wide knowledge of medical affairs, while medical officers have always found him a capable and sympa- thetic official.

IRELAND

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210

13, it was found that 37 per cent. were mentallydefective, 12 per cent. were retarded, 51 per cent.normal, and none superior. The striking differencein the comparison of those over 13 with the 7 to 13class lies in the number of those previously reckonedas retarded who are later classified as mentallydefective. The latter group has risen from 14 percent. to 37 per cent. In an appendix Prof. R. A.Fisher says : "It would seem that a number ofchildren who are later to be regarded as mentallydefective or retarded are considered to be normal inthe first seven years of their lives, and that many whoare later to be classified as mentally defective are,until their fourteenth year, still placed in the retardedgroup." The investigation further yielded the inter-esting fact that of 3247 mentally defective womenknown to the local authorities to have had children66 per cent. were unmarried. This finding illustratesthat the legal prohibition of marriage for defectiveswould constitute but an incomplete solution of theproblem of limiting their fertility.

Causation of Mental Defect and DisorderThe report contains chapters on our present know-

ledge of the causation of mental defect and disorder.In regard to mental defect, the chief conclusions arethat : (1) in many cases there exists in the familysome form of mental abnormality such as insanity,psychoneurosis, epilepsy, defect, or dullness. In the

majority of such cases there is evidence of heredity,but the mode of transition is at present unknown ;(2) low-grade mental defect is more frequently asso-ciated than is high-grade with environmental factorsand it appears to be fairly equally distributed amongall classes of society; (3) high-grade mental defectoccurs proportionately more frequently in the lowestsocial stratum than in the rest of this population.(It is regarded as possible that the bad environmentprevalent in the social problem group and the assortivemating which there takes place may contribute tothis result.)

In regard to mental disorders, it is stated that,apart from Huntington’s chorea and myoclonus-epilepsy, there is no conclusive evidence that inheri-tance follows mendelian ratios ; whereas in generalpsychopathic parents tend to have psychopathicchildren, the view that familial mental instability isusually progressive and tends to become more severein each succeeding generation, thus conforming to theso-called " law of anticipation," is not confirmed ;and manic-depressive insanity and schizophreniaappear to show markedly higher familial incidencethan other types of mental disorder which are of

frequent occurrence.Other findings of importance are that the fertility

of mental defectives is, on the whole, probably belowthat of the average of the population. At the sametime, the committee found evidence from Nottingham,Liverpool, and London that the families from whichdefectives come are larger than average families in thesame locality.

IRELAND

(FROM OUR OWN CORRESPONDENT)

ANOTHER " CUTS " BILLTHE text of the Local Services (Temporary Eco-

nomies) (No. 2) Bill, 1933, was circulated a few daysago. It gives powers to the several local authoritiesto make deductions during the year 1934 from salariespaid to their officers and from certain scales of

expenses. The deduction shall be such as the local

authority shall in each case think proper, but shall

not be less than the minimum deduction laid down inthe schedule to the Bill for such a salary nor morethan shall be sanctioned by the Minister. The mini-mum deductions stated in the schedule are similar tothose laid down in the Act passed last year dealingwith the salaries of civil servants. No deduction isto be made from a salary which does not exceed 300a year. The minimum deduction on a salary whichdoes not exceed S400 is to be 2 per cent., and arapidly increasing scale will apply to the highersalaries. Medical officials as well as their colleagueswill suffer under the Act, but a special concession is tobe made in the case of dispensary medical officers-the salary shall be taken to be E50 per annum lessthan the actual amount thereof. The remunerationof comparatively few dispensary medical officersexceeds £ 350 a year, and therefore most of them willescape the operation of the cut. It will not be sowith the whole-time medical officers, such as medicalofficers of health and the medical officers in mentalhospitals. A salary of E800 a year, for example, willsuffer a minimum deduction of E24.

Although the Bill was introduced to the Dail inNovember there were rumours that it would not goany further. It is generally admitted that the" Cuts " Act of last year, dealing with the salaries ofcivil servants, has not brought about any realeconomy. In fact the deductions have been morethan counterbalanced by the pensions that have hadto be granted to a large number of civil servantswho had statutory rights under the treaty. TheGovernment has announced that there is no intentionto continue the Act this year, and it is surprising tofind them proposing to apply to local officials a policywhich has failed to produce any useful result whenapplied to the civil service. The net result in eachcase is much unrest and disquietude in the services,the members of which see that their security ofcontract no longer holds. In one particular the

present Bill is more harsh than its predecessor. Itstates a minimum deduction, the maximum being atthe will of the local authority subject to the discretionof the Minister. In the previous case there was afixed scale.

THE CHIEF MEDICAL OFFICER

It is just over a year since Mr. Edward Stephensonrelinquished the office of chief medical officer to theDepartment of Local Government and Public Health,and a certain amount of speculatiori had taken placeover the delay in appointing a successor. The Ministertook the unusual course of referring the appointmentto the Civil Service Commission, which advertisedthe vacancy and called in the assistance of a selectionboard. The appointment of Mr. Robert PercyMcDonnell, F.R.C.S. Irel., is now announced. Mr.McDonnell had been acting as chief adviser during theinterval since Mr. Stephenson retired. Mr. McDonnellwas qualified in 1901, and at once went on activeservice to the South African War. On his return he

engaged in private practice and was for a time assistantsurgeon to St. Vincent’s Hospital, Dublin. In thelate war he served in Gallipoli, Serbia, and France asa captain in the Royal Army Medical Corps. In 1922he held the rank of colonel in the Medical Service ofthe Irish Free State Army. For several years he hasbeen an inspector in the Department of Local Govern-ment and Public Health. His appointment will givepleasure to the medical profession in Ireland, parti-cularly to those in the public services. His experiencein practice and in administrative work has givenhim a wide knowledge of medical affairs, while medicalofficers have always found him a capable and sympa-thetic official.