London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1920
Annual report of the Council, 1920. Vol. III. Public Health
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39
By arrangement with the Invalid Children's Aid Association,158 children attending the Open Air
Schools for tuberculous children, whose parents were unable to take them away for a holiday, were each
sent for a fortnight's holiday, the Council making a grant amounting to £316 for their maintenance. The
Council also paid the railway fares amounting to £28 18s. Id.
The children were distributed as follows:—
88 boys were sent to a private house belonging to Miss Sanderson, who generously lent the
house for the occasion.
47 girls were sent to St. Mary's Home, Broadstairs.
23 girls were sent to St. John's Home, Kemp Town.
Mental Deficiency Act, 1913.
On the 31st December, 1920, of the 2,051 cases being dealt with at the expense of the Council
there were—In institutions, 900; under guardianship, 14; under supervision, 1,079; in places of safety
waiting other action, 58. There remained 1,936 out of the total number 3,987 of cases of alleged mental
defect, of which notice has been received since the Act came into operation. These cases include 248
in which no action could be taken; 621 ascertained not defective, or not to be London cases; 373 dealt
with through the Poor Law; 354 removed from the register (died, discharged, or removed, to lunatic
asylums), and 340 still under consideration.
During the year 698 cases were examined with the following results:—
| Type. | Male. | Female. | Total. | Type- | Male. | Female. | Total. |
|---|---|---|---|---|---|---|---|
| Idiot | 15 | 15 | 30 | Not defective | 22 | 18 | 40 |
| Imbecile | 121 | 71 | 192 | Insufficient evidence | 4 | 13 | 21 |
| Feeble-minded | 198 | 220 | 418 | ||||
| Moral imbecile | — | 1 | 1 | Total | 360 | 338 | 698 |
In continuation of the analysis of the records made last year, the aetiological factors in a random sample of cases under the Mental Deficiency Act have been extracted.
| Percentage of frequency. | Percentage of frequency. | ||
|---|---|---|---|
| 1.8 | |||
| Family history of— | |||
| Acquired insanity | 21.6 | ||
| Feeblemindedness (all grades) | 16.0 | Premature birth | 9.8 |
| Moral imbecility | — | Prolonged parturition— | |
| Epilepsy | 14.4 | Protracted pressure | 9.0 |
| Hysteria, neurasthenia, spasmodic asthma, chorea | 17.0 | Instrumental delivery | 5.8 |
| Asphyxia | 2.8 | ||
| Deaf mutism | — | Accident at birth | 1.0 |
| Habitual criminality | 2 | Twin birth | 2.8 |
| Intemperance | 30.6 | ||
| Drug habit | 14 | ||
| Syphilis | 20 | ||
| Tuberculosis | 48.6 | Infantile convulsions | 12.4 |
| Epilepsy | 18.4 | ||
| Infantile paralysis | 5.4 | ||
| Meningitis | 4.2 | ||
| Mental stress arising from tidings of failure, | 30.8 | Chorea | 2.8 |
| trouble or death | Injury to head from fall, blow, etc. | 12.0 | |
| Physical disturbances—general bad health | 7.4 | Febrile illness, e.g. | |
| from any cause, privation, etc. | Scarlet fever | 1.6 | |
| Falls or injuries | 9.2 | Diphtheria | |
| Influence of deleterious occupation—exhausted vitality from extreme mental or physical exertion | 1.8 | Whooping cough | |
| Measles | |||
| Enteric fever | |||
| Specific fevers or other general infections | — | Small pox, etc. | |
| Syphilis | 4 | Malnutrition in early life (signs of rickets, etc.) | 100 |
| Manifestation of syphilis | 6 |
The family history is of importance as indicating a predisposition to mental defect, or instability
which may be of great weight in a doubtful case, but it is important not to overweight this factor should
it conflict with actual observation.
Dr. Shrubsall has analysed the returns with a view to ascertaining the extent to which the mental
status of defectives is affected by the physical characters of their defects. For the purpose of making this
comparison he has used as an index, the quotient obtained by dividing the assessed mental age as ascertained
by mental tests, by the chronological age, or by 16, whichever be the lesser number. It has been
suggested by American observers that those with a quotient below .25 should be regarded as idiot, those
with a quotient between 25 and 5 as imbecile, and those with a quotient between 5 and .75 as feebleminded,
while a subject with a quotient between .75 and .9 might be regarded as dull, and this, coupled
with evidence of vicious, or criminal tendencies undeterred by punishment would be sufficient to bring
him within the definition of moral imbecile. The quotients shown in the following tables have been
calculated since action was taken, and show the degree of correspondence between the older and newer
methods.