THE EDUCATION OF THE DEAF.

296

KING EDWARD’S HOSPITAL FUND FOR LONDON.

Correspondence.

A SPECIAL meeting of the President and General Audi alteram partem." Council of King Edward’s Hospital Fund for London was held at St. James’s Palace on Feb. 1st. Lord THE EDUCATION OF THE DEAF. DONOUGHMORE, member of the President’s Powers To the Editor of THE LANCET. Committee, being in the chair. At the beginning of the proceedings it was resolved SIR,—The Teacher of the Deaf for February conta.ins to send a message of loyal and humble duty to the the following : " We understand that on .Tan. 27th King and Queen on the occasion of the betrothal of last the Board of Education issued a circular to local H.R.H. Princess Mary to Viscount Lascelles, and education authorities, informing them that in view heartfelt wishes were expressed for her Royal High- of the present financial position the Board thought it ness’s lifelong happiness. desirable to warn such authorities that they may have Lord SOMERLEYTON, hon. secretary. after announcing to restrict their total expenditure on blind, deaf, and the appointment of Lord Cave and Lady Mount Stephen defective children in 1922-23 to the amount incurred as members of the Council of the Fund, put from the in 1 921-22." The Board further point out that this chair a resolution expressing deep regret at the death warning " is given without prejudice and must not be of Mr. Walter Morrison,who had contributed more than taken as implying that even further reductions of 60,000 to the Fund. This was unanimously carried. expenditure may not be found necessary." The restrictions foreshadowed in this circular, the Postponement of the Contributory Scheme. of which lies in its second sentence, Reports of the Revenue Committee and the Manage- true significancemenace the future efficiency of deaf ment Committee were presented, and resolutions were very seriously and endeavour should be made to education, every passed to the effect that: 1. The King’s Fund take avert this of the suicidal particular threatening to the scheme for a combined into steps put operation which to influence tendency appears present policy in public appeal. 2. That it is not desirable to proceed to education. The great majority of people do to the institution of a contributory scheme " until regard the results which follow the " combined public appeal" not realise that the deaf child is merely an individual In the meantime, steps should be taken who has been bereft of what is, educationally speaking, are known. to obtain the considered opinion of the medical pro- his most important sense. Ile shows no more fession in London, upon whom the duty of carrying any tendency to mental defect than do hearing children. such scheme into practice would ultimately devolve. Beyond the loss of this sense he is as normal as his 3. That until the General Council shall otherwise direct, hearing fellow, and consequently possesses an equal the Management Committee shall have the powers of right to the best possible education. Hearing is the the General Council in respect to the sanctioning of most important education sense because it is the the expenditure by the Revenue Committee of the channel through which the child obtains the speech and language withoutwhich he cannot think and sums necessary for the combined public appeal. Sir ALAN ANDERSON, the chairman of the Revenue reason clearly. This physiological education comCommittee, presented a further report of the committee, mences practically in the cradle. By means of which stated that it had considered the various other hearing the child is storing up sensory impressions of every minute of his waking life, and without suggestions for increasing hospital income discussed language no motor mechanism of speech can be developed. by Lord Cave’s Committee in their report, and par- them The deaf child is thus denied the physiological educaticularly the following recommendations :tion which is his right, and unless its place is taken by That all to (a) subscriptions hospitals from employers should be allowed as a deduction from profits for the education through another sense-channel (i.e., through vision by lip-reading) his intellectual faculties remain purpose of income tax (par. 53). no (b) That when residuary estate has been bequeathed undeveloped, so that his mind at 5 has reached to a hospital the hospital should be allowed to claim further than that of a hearing child at 2. Since aim of modern teaching of the deaf is to repayment of income tax as from the expiration of a the whole the deaf child to take his place in the battle prepare death from the testator’s 54). (par. year of life as equal footing as possible with the upon That to should be all testamentary gifts (e) hospitals a special physiological education is necessary exempted from legacy and succession duties (par. 55). hearing, before the former can be subjected to the pedagogical Appeal to the Government. education which suffices for the latter. The report was seconded by Lord SOMERLEYTON These considerations may serve to expose the and carried unanimously, it being also decided to urge glaringly fatuous condition of the law which enacts the Government to take immediate steps to give effect that blind and hearing children shall commence their to the above recommendations of the Cave Com- education at the age of 5, while their deaf fellows shall mittee, while the Revenue Committee of the Fund not go to school until 7, thus denying them the was authorised to press the matter forward. highly -specialised teaching that they so urgently The following notice of motion was moved by Lord require. Teachers of the deaf have been long anxious BURNHAM, seconded by Sir JAMES KINGSTON FOWLER, to secure the alteration of this anomalous law. For and agreed to :years I have strenuously advocated the early " That it be an instruction to the Hospital Economy many of the deaf child, and the excellent results education to and Committee consider report how best to connect and which have attended the oral instruction of little ones utilise the vacant accommodation and service of Poor-law infirmaries within the area of the Fund for the general of 5 and even 3, when brain and larynx are most plastic to mould and apt to retain, have amply purposes of hospital work." A vote of thanks to the Chairman then terminated justified my opinion. By early education alone can one hope to obtain a speech which will become the proceedings. automatic. Hitherto the education authorities have THE MOUNT EVEREST EXPEDITION.-Dr. T. G. allowed grants for deaf children from the age of 5, Longstaff will accompany as its medical officer the party and have permitted parents to send their children to which sails from England at the end of February under the school at a still earlier age. It must be patent to all who have the success of leadership of Brig.-Gen. C. G. Bruce with the object of climbing Mount E verest. Dr. Longstaff, now in his forty-eighth deaf education at heart that the effect of the Board year, is an Oxford and St. Thomas’s man who, after qualifying of Education’s circular will be to restrict the numbers in 1903, held resident appointments at the Urompton, of deaf children sent to the special schools, and that West London, and Ormond-street Hospitals. He was awarded in 1908 the Gill Memorial Prize by the Royal it means in future a rigid adherence to the strict letter Geographical Society for his journeys in Tibet and the of the law in respect to the age of admission. This Himalayas, and has contributed to the study of the causation will mean throwing upon the streets many highly of mountain sickness. intelligent deaf youngsters whose parents would ..

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297 otherwise willingly send them to school. The waste of it and the pity of it sickens one. In a word, the circular menaces a serious blow at the very root of one of the most elficient departments of the education system of the country. That everyone, save those who are responsible for extravagances, is crying out, for economy is undoubted, but such foolish acts as those with which education is at present threatened are not acts of economy. They are. indeed, the reverse, since they will have for effect the ultimate throwing of more useless persons upon State aid. That the education methods of the country generally need thorough investigation and reform cannot be denied, but false economies will accentuate rather than effect it. Nor is the present education of the deaf perfect, but it is making steady progress, and any such action as that foreshadowed by the Board of Education will seriously retard its forward march. I am, Sir, yours faithfully, MACLEOD YEARSLEY, Consulting Aural Surgeon to the London County Council. Welbeck-street, W., Feb. 5th, 1922.

B-VITAMIN AND PIGEON BERI-BERI. .

To the Editor f)/ THE LANCET. a letter in your issue of Jan. 14th Dr. W. H. de Wyss, following Prof. W. R. Hess. maintains that the symptoms of B-vitamin deficiency are due to inhibition of the oxidative processes of the tissues, and suggests that the B-vitamin furnishes the structural basis of the oxidative ferments of the body. The evidence on which this theory is based is twofold-experiments in vitro with tissues of pigeons suffering from beri-beri are said to show reduction of the oxidative processes compared with the normal controls, and the symptoms of beri-beri are said to be produced on injecting potassium cyanide, which is known to inhibit oxidation in living cells. It must be pointed out, however, that even if we agree that the oxidative processes are depressed in fully developed beri-beri, we cannot at once conclude therefrom that the point of action of the vitamin is It must first be demonon the tissue cells in general. strated that the effect described immediately follows the removal of the vitamin from the diet. In the experiments I detailed in your issue of Dec. 10th, 1921, I demonstrated that within 24 hours of with-

SIR,—In

holding the vitamin, symptoms of insufficiency of the alimentary canal, such as diminished intake of food and paresis of the gut, make their appearance, and that these symptoms are immediately relieved The intestinal on re-adding the vitamin to the diet. phenomena mentioned can be noted when the animal appears to be otherwise in perfect health, and cannot therefore be regarded as part of a general depression of the tissues throughout the body. Thus the primary site of action of the vitamin is the alimentary canal, and the diminution in the oxidative powers of the tissues which Hess observed in animals suffering from an advanced stage of beri-beri, can be explained by the intoxication which is secondary to the condition of ileus produced by withholding the vitamin from the diet. The experiments of Messerli, quoted by Dr. de Wyss, are not conclusive to the contrary, as owing to the abnormal condition of the intestine it is not certain that charcoal would succeed in completely removing alimentary toxins which were being continuously elaborated. The conception underlying the theory of Hess, that the B-vitamin is a substance which is essential to the life of all cells, has already been criticised by Dr. W. Cramer in a recent issue of THE LANCET (Dec. 10th, 1921). The evidence there brought forward showed that this attitude can no longer be successfully maintained. I am, Sir, yours faithfully, SAMSON WRIGHT. Department of Physiology, Middlesex Hospital, W., Jan. 25th, 1922.

A RED CROSS CLINIC FOR CIVILIANS. 7’o the Editor of THE LANCET. SIR,—As is generally known the Kensington and other divisions of the County of London Branch of the British Red Cross Society have developed clinics for the treatment of ex-Service men with massage, electricity, radiant heat, and remedial exercises. Although, owing to the closing of the Fulham Clinic, the Kensington division finds that its work for pensioners must continue for a further indefinite period, yet the executive committee recognise that within a comparatively short time there will not be enough of this work to justify the maintenance of the clinic, and they have, after consultation with some local representative medical practitioners, including the Mayor of Kensington, decided to open a clinic for the general public, members of which, however, will only be able to avail themselves of the services of the clinic on the recommendation of a medical practitioner. A medical expert in physico-therapeutics will be in charge of the medical and surgical side of the work, while the administration will be in the hands of the Kensington division, B.R.C.S., who, in professional matters, will be assisted by an advisory committee of medical men. Fees will be charged on a graduated basis up to a maximum of 5s. per treatment, anybody able to pay more than this sum being ineligible for treatment at the clinic. The clinic was opened for civilians on Feb. 3rd, the hours of attendance being from 2.30 to 9 P.M. At a time when the development of municipal clinics has aroused much opposition in the ranks of the medical profession, it is to be hoped that credit will be given to the Kensington division of the British Red Cross Society for its endeavour to further the interests of the general public, the medical profession, and the masseurs and masseuses. Moreover, some at least of the provisional medical advisory committee hope that this attempt of the B.R.C.S. to develop, in conjunction with the medical profession, a muchneeded physical treatment centre may serve as an example of how clinics may most usefully be developed, and suggest the solution of many difficulties now confronting the medical profession. I am, Sir, yours faithfully, HAROLD H. SANGUINETTI, Hon. Sec., Provisional Medical Advisory Committee. Feb. 3rd, 1922.

THE ERECT POSTURE. To the Editor of THE LANCET. SIR,—Dr. Knox Thompson’s conclusion regarding the liability of the pulmonary apices to be compressed by the ribs can be tested by the results of postmortem examinations. Is there any post-mortem evidence of a special tendency on the part of the apices to collapse or semi-collapse ? My observations on the living subject suggest that the inspiratory muscles attached to the upper part of the chest are at great pains to keep the lungs expanded. Am I not right in saying that even in the last stages of phthisis they contract powerfully ? Respecting the influence of the upright posture on the cerebral circulation Dr. Thompson writes (Feb. 4th, p. 251): " It must be remembered, too, that the cerebral vessels are poorly supplied with vasomotor fibres, and that the onus of regulating the intracranial blood pressure rests largely with the splanchnics, the resistance of the cerebral arterioles altering very little." It has always seemed to me that Dr. Leonard Hill (whose teaching Dr. Thompson is following here) has exaggerated the part played by the splanchnics in regulating the cerebral circulation. No doubt these nerves exercise an important influence in regulating the general arterial blood pressure, but I much doubt whether they play an appreciably greater part in regulating the cerebral circulation than the circulation elsewhere. The local circulation of the brain, as of other parts, is, I believe, regulated by the