141THE NATIONAL INSTITUTE FOR THE DEAF.

Army authorities started a mass experiment in 1921,the men of five Army Corps being provided withprophylactic packets, while the men of five otherArmy Corps were not thus equipped, the conditionsbeing, otherwise, approximately similar. In the ArmyCorps provided with packets, the incidence of gonor-2hcea was reduced from 10’92 per thousand to 7’51-areduction of 3’41. But, in the case of the Army Corpsnot thus equipped, the incidence of gonorrhoea perthousand was reduced from 18’70 to 10’30-a reduc-tion of 8’40. A similar difference in favour of the mennot provided. with packets was observed in the caseof syphilis. _

Venereal Disease in British Guiana.During the afternoon Session, Mr. L. S. AMERY,

M.P. in the Chair, a paper was read by Dr. B. N. V.BAILEY on venereal disease in British Guiana. As aresult of his experience in this country, he was aversefrom compulsory measures. Of the 13,000 in-patientstreated in the Georgetown Hospital during 1927, 915were reported as suffering from one or other of thevenereal diseases, while, of 27,000 out-patients, over2,600 were so diagnosed, or approximately 8 per cent.of the total number of cases treated. Of the in-patients at the Georgetown Hospital in 1927, as manyas 769 suffered from syphilis and only 42 from gonor-rhoea. He commented on the remarkable infrequencyof organic nervous disease due to syphilis, and hesuggested that, in a country where malaria is so pro-foundly endemic, this disease might have some

influence on the development of syphilis of the centralnervous system.

Dr. R. E. HOPTON gave an account of the organisa-tion of the anti-venereal disease campaign in Cyprus.He was sent there in 1927 as a venereal diseasespecialist, and now has the assistance of a fullyqualified English bacteriologist.

False Names and Addresses.

During the morning session on July 10th, Mr.SOMERVILLE HASTINGS, M.P., in the Chair, Col. L. W.HARRISON produced some statistics dealing with thefrequency with which the patients attending the malesection of his department at St. Thomas’s Hospitalgave false names and addresses. Of 4950 follow-upletters sent to patients on first default in the five-yearperiod, 1924-28, 1280, or between 25 per cent. and 26per cent. were returned through the Dead Letter Office.Except for 1924, when the percentage was 21, theproportions were very constant, varying only between26 per cent. and 28 per cent. The percentage of thepatients who resumed attendance as a result of thisfirst letter was between 23 per cent. and 24 per cent.and just under 9 per cent. wrote and explained theirabsence. Of the large remainder of between 42 peroent. and 43 per cent. who did not reply or resumeattendance at once, many eventually resumed attend-ance. In the female section of his department falsenames and addresses were given very rarely. Dis-cussing the comparative merits of a venereal diseasecentre, inside or outside of a general hospital, he wasinclined to think that this question was subordinateto that of the personality of the staff of such a centreand he remarked on the devastating efficiency withwhich an unsympathetic member of the staff couldempty such a centre. He described in some detail theattractions which he had encouraged in order to makepatients less clinic-shy. In the discussion whichfollowed this paper, a speaker from Scotland tem-pered his praise of Col. Harrison’s paper with thesuggestion that the compulsory measures which manyof the authorities in Scotland would like to see intro-duced, were, in the long run, likely to prove moreeffective than the blandishments with which venerealdisease workers in England were trying to keep theirpatients under continuous medical supervision.Answering these and other criticisms, Col. Harrisonapologised for having introduced the subject of com-pulsory versus free treatment, but he confessed tobeing still an unrepentant advocate of gentle moralsuasion, without draconic measures.

Some Figures from India.In a paper on the venereal diseases in the United

Provinces (India), Dr. A. B. SousA said that Col. H.Stott had, for one year, carried out the Wassermanntest on all the patients coming to the Kasauli Institutefor treatment for dog-bite, and had found it positivein about 22 per cent. The incidence of syphilis andgonorrhoea in the adult population of Lucknow wasapproximately 20 per cent., whereas it was uncommonin the rural areas. While the incidence perthousand of all forms of venereal disease in the Indiantroops in Lucknow had fallen from 99 in 1926 to 85 in1928, the corresponding figures for the British troopsin the same area were 160 and 66 respectively-a verymuch greater decline.

Conclusion.This Congress has served many useful purposes. It

has brought together many of the men who, during thelast few years have taken out post-graduate courses,formal or informal, and have carried out and sometimesmodified, according to circumstances, in differentparts of the world, the system which has been organ-ised at home under Col. Harrison. Many tributeswere paid to the British system by those who haveattempted to follow its main principles in other lands.The question of the comparative merits of compulsionand freedom was in the air most of the time, and it isprobable that many of the delegates have left theCongress with the impression that the choice betweenthe two systems must largely depend on geographicaland ethnical factors. In defining the policy of theBritish Social Hygiene Council, Mrs. NEVILLE ROLFEpointed out that it tries to give expression to thewishes of its constituents, without imposing anyarbitrary or oligarchical policy.

THE NATIONAL INSTITUTE FOR THEDEAF.

THE fifth annual meeting of the National Institutefor the Deaf was held at the Caxton Hall, West-minster, on July llth, when Lord Charnwood, thePresident, occupied the chair. He was supportedby Mr. Somerville Hastings, M.P., and Sir FrankBenson. There was a large attendance.

Before the report of the Committee and the accountsfor the year were submitted to the meeting forapproval, Mr. A. J. Story, the secretary, summarisedthe history of the National Institute for the Deaf. Itcommenced its activities, he said, four years ago,before which time, although there were a number oflocal organisations for promoting the welfare of thedeaf, there was no central body whose concern it wasto watch over the interests of the deaf and thedeafened. The Committee felt that the time had nowarrived in the social history of the country to placethe case of the deaf persons before the public, takingnote of the intellectual, social, industrial, and religiousquestions which constituted a great problem. Therewere many indications, he said, that the nationalconscience was awakening to the gravity of deafness,both as it affected those who suffered from it andthe economic interests of the country. The estimatehad been made that the annual loss caused by deaf-ness in this country amounted to 7,000,000. Animportant feature of the report was a reference to thework of the Committee in devising methods for safe-guarding the deafened against the disappointmentand loss involved in dealing with firms whose onlyapparent concern for deafness was the extent of theirsales. It had been decided to maintain a register offirms and dealers who had agreed to the conditions :-

(1) That each client will be advised on the meritsof his case as to whether an electrical or mechanical orno instrument at all is likely to help ;

(2) That, in the event of a client being dissatisfiedwith the performance of the instrument supplied, thefirm or dealer will refund the purchase money, less

142 STERILISATION OF MENTAL DEFECTIVES.

10s. 6d. to cover expenses, if the instrument isreturned in good order and condition within fourweeks and;

(3) That no call will be made at the home of aninquirer unless at his request;A number of reliable firms and dealers who con-

duct their business on these fair conditions hadcooperated with the Committee, and no doubt otherswould be willing to add their names to the register.Deafened persons were strongly advised in their owninterests to treat only with those firms and dealerswho had agreed to the conditions, and lists would besent to any inquirer on receipt of postage.Mr. W. G. Yates the hon. treasurer, submitted the

report and accounts for the year 1928-29, statingthat although the Committee were able to meet theirexpenditure during the year, there was only a smallbalance of .8221, so that anxiety was felt regardingcurrent income, which was entirely inadequate to theneeds. [The document, which was in circulation inthe room, dealt in detail with the work of the Instituteand the national organisation of welfare work,reviewed the social and industrial position of the deafand deafened, and emphasised the imperative needfor Government inquiry. A large portion of the reportwas devoted to the serious matter of the commencingas well as of the higher education of the deaf and thetraining of teachers of lip-reading. It can beobtained from the Office of the National Institute forthe Deaf, 2, Bloomsbury-street, London, W.C.]Lord Charnwood then moved the adoption of the

report and accounts, and referred to the effortswhich he had made in the House of Lords, supportedby the Duke of Montrose and others, to induce theGovernment to set up a body for inquiry into theposition of the deaf. Although the attitude of theGovernment at that time was unsympathetic, hehoped that the future would be more promising.

Mr. M. Birley, chairman of the Executive Com-mittee, seconded the adoption of the motion, whichwas unanimously carried.

Mr. Somerville Hastings, M.P., aural surgeon tothe Middlesex Hospital, moved :-

" That having regard to the grave social and industrialhardships caused by deafness in the lives of large numbersof adolescent and adult persons who were born deaf or havebecome so, and to the fact that no official inquiry into theresults (in the terms of improved social and industrial well-being) of large public expenditures in their education hasever been held, this meeting is strongly of opinion that thetime has arrived when a complete investigation into theconditions and needs of these deaf and dumb and deafenedpersons should be made ; and, further, that this meetingurgently calls upon the Government to make such aninvestigation by means of a Departmental Committee, orotherwise, at an early date."

He said that the inquiry into the condition of thedeaf was urgently needed and that the right andproper body to make that inquiry was the Governmentof the country. The question was sometimes askedas to which was the most unfortunate individual, thewholly blind or wholly deaf. He would not attemptto make a decision, but he was quite sure that theperson who was almost blind was mtlch less to bepitied than the person who was almost deaf. Theperson who was almost blind could see just enoughlight to get about without assistance, but the personwho was almost deaf was shut off from his friends.There was a peculiar psychology associated with deaf-ness which, apart from the deficiency of hearing, wasprovocative of much sympathy. The sensation ofhearing was, perhaps, evolved by the necessity of theanimal to protect itself against its enemies, and theperson who lacked that sense lacked a primitive func-tion. There was therefore little surprise, grantingthe truth of that theory, that the deaf person was veryliable to be introspective, to shun his fellows, to beshy and to be morose. Knowing this, a good manyof those who, like himself, had to deal with the deafprofessionally, advised them to cultivate more thananything else " cheek "-to be pushful. The deaf,particularly the industrial deaf, were handicapped

by lack of the qualities of self-assertion throughouttheir industrial lives. The employer was afraid thatthe deaf would be more liable to accidents, and heinstanced a case which had recently come before hisnotice in which a skilled engineer had been compelledto take a job as a labourer by reason of becomingdeaf, and not only was his work affected, but his con-sequent moroseness had blighted the amenities of anotherwise happy home. It should be remembered,.too, that no one was free from the possibility ofbecoming deaf. Therefore the condition of the deafman or woman was one that needed special care, andit was time that the State took notice of the matter.A large proportion of deafness among children wasdue to middle-ear disease, and, while a good deal ofthat could be prevented, the State was not doing allthat it might do for those below school age. Althoughthe State did do something for the congenitally deafchild, care started too late, as the early years of edu-cation were all important-this criticism, he said,did not apply to Scotland. He would like to seecomplete deafness in children made a notifiabledisease, so that the State could know exactly whowere the deaf and would be able to deal with themsensibly. As for the adult deaf, the State did nothingfor them, and those who had the matter at heartshould demand the Government to make an

investigation into the condition of the deaf generally,by means of a Departmental Committee or otherwise.

Sir Frank Benson, who seconded, made an earnestplea for sympathy and help for the deaf, a wordwhich he said implied a tragedy. Everything thatdelayed action and communication of thought delayedthe progress of the people and the welfare of theState, and it was up to everybody to see that no effortssuffered from slackness.The resolution was supported by Mr. Hugh

Morrison and carried unanimously.On the motion of Lady Charnwood, seconded by

a member of the audience, the thanks of the meetingwere given to those who had served during the pastyear on the Executive Committee, and the followingwere elected for the ensuing year: Rev. F. W. G.Gilby and Rev. A. Smith ; Sir Harry Stephen; Col.H. S. Ravenhill, C.M.G. ; Major F. J. Wegg Prosser ;

, Dr. Chas. Heath and Dr. D. A. H. Moses ; Misses H.I Davids ; M. Hare, B. Nevile, and F. M. Townsend ;: The Hon. Mrs. John Tennant; Messrs. E. Ayliffe,: H. J. Gibbons, W. McDougall, C. F. Mott, S. A. N.I Oxley, L. B. Phillips, C. Shaw, and A. W. Taylor.i A vote of thanks to the Chairman terminated the; proceedings.

MENTALLY DEFECTIVE ADULTS.THE QUESTION OF STERILISATION.

IN the first instalmentl of their report the Joint Com-mittee of the Board of Education and the Board ofControl discussed briefly the extent to which sterilisa-tion of mentally defective adults in the present genera-tion would reduce the volume of mental deficiency inthe next, and came to the conclusion that, even ifthis measure were rigidly applied to all the mentallydefective, the reduction would not be great. The lastinstalment2 considers a more cogent ground for advo-cating sterilisation, namely, that its application wouldease the economic burden by enabling defectives whowould otherwise have to be permanently segregatedin institutions to return to the community with norisk of their becoming parents, and that a number ofthem could live happily and harmoniously outsideinstitutions. If it could be proved, say the Committee,that sterilisation could safely and profitably be appliedeven to certain groups or categories of defectives,the question of its adoption would no doubt deservecareful attention.

1 Report of the Mental Deficiency Committee. Parts I. and II.H.M. Stationery Office. 2s.

2 Same Report. Part III. 1s. 6d.