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52
Ideas on aristocracy, hereditary rights and good breeding have
not found favour in the modern world but, nevertheless, it remains
true that the difference between one person and another is due as
much, if not more, to breeding as to environment. Today, it can
be said that we are able, or have the knowledge to control the
environmental factors. For instance, advanced surgical techniques
have brought considerable reductions in infant deaths from spina
bifida, hydrocephalus and cardiac abnormalities and amelioration
in disabilities such as cleft lip or palate and talipes. Moreover,
better antenatal and obstetric care, coupled with improved management
of the premature infant, have likewise produced more
favourable prognoses for cerebral palsy, subdural haematoma, neonatal
jaundice, infantile convulsions and meningitis. However, it
is generally conceded that, apart from the teratogenic effect in early
pregnancy of certain modern drugs, infectious diseases and radiation,
congenital malformations have a relationship with chromosomal
abnormality and that our future success in reducing infant
mortality is likely to depend upon the use made of the recent
advances in human cytogenetics.
Notwithstanding the fact that the subject of human heredity
is extremely complex, it has already been established that disabilities
such as achondroplasia, familial polyposis and Huntington's
chorea are due to dominant mutant genes and that recessive mutant
genes are responsible for fibrocystic disease of the pancreas, phenylketonuria
and galactosaemia. Moreover, it has been shown that
haemophilia, diabetes insipidus and a type of muscular dystrophy
arise from sex-linked recessive genes. Since 1956, cytologists have
been able to identify the syndromes of Klinefelter and Turner as
resulting from an extra chromosome (trisomy) and a deficiency of
one chromosome (monosomy) respectively. Extensions of these
investigations have indicated that there is a connection between
mongolism, another example of trisomy, and a form of leukaemia.
Clarification of intra-embryonic mortality and congenital deformity
may well be the outcome of further chromosomal studies.
It follows that, from knowledge already gained and as a result
of the newer treatments evolved to save children from the full effects
of genetically determined disabilities, there will be an increase in
the frequency of these disorders and, in such circumstances, some
method of artificial selection seems inevitable.
The present infant mortality rate for the Borough, viz., 21.5,
is an increase of 3.6 over that estimated for the previous year with
rates of 19.0 and 18.4 being returned for England and Wales and
Greater London respectively.
Actual infant deaths recorded during the year were 80 (10
more than last year) comprising 52 males and 28 females of which