Kennedy-Galton Centre, Harperbury Hospital

The Kennedy-Galton Centre for Mental Deficiency Research and Diagnosis was officially opened at Harperbury Hospital in April 1965, though researches had been carried out there, less intensively, during the previous 20 years. The hospital, to which patients were first admitted in 1928, is the main mental deficiency residential unit for the County of Middlesex. It has about 1,500 patients on the books and is visited by many other patients for physical therapy, psychological assessment, clinical diagnosis, and genetical investigations. The name of the Centre indicates that much of the fund, which enabled work to start in an enlarged laboratory, came from an award from the J. P. Kennedy, Jr., Foundation. It also implies that the scientific researches on the causes of mental deficiency, to which it is dedicated, should be of a high objective standard and imaginative in conception as would be demanded by the association of the name of Francis Galton. While the laboratory was still in an embryonic condition, work had been done on the peculiarities of leucocytes in Down's syndrome, and a survey of Barr bodies in the buccal smears of all patients, carried out by M. A. C. Ridler with persistence, enabled the Down-Klinefelter syndrome to be discovered. This patient had lived in the hospital happily for some 20 years before he became famous as the owner of the first set of abnormal chromosomes to be described in the Lancet, in April 1959. After this, the setting up of a technical group, highly skilled in chromosomal analysis, was a natural development and, subsequently, numerous examples of karyotype peculiarity have been disclosed among patients and outpatients. Clinical investigation is not specifically paediatric. The mean age of the resident patients is about 40 years and it was a surprise to find among them two cases of the 'cat-cry' syndrome —a disease usually supposed to be found only in infants. One of the early projects was a survey of cases of two rare conditions. One was the Rubinstein-Taybi syndrome and the other the syndrome of Cornelia de Lange, which is probably the only example of an eponym perpetuating the observations of a lady physician. We are still in the dark as to whether to attribute these rare diseases to fresh gene mutation or to something else. To make these surveys, the boundaries of Harperbury Hospital were overstepped and, in this work as in many other matters, we were dependent upon the cooperation of physicians in many other mental deficiency hospitals—neighbours like Cell Barnes and Leavesden as well as those at a distance like St. Lawrence's at Caterham. With respect to cases which require specific biochemical and haematological investigation for research or clinical purposes, we have worked in cooperation with physicians at Northwick Park, where all kinds of sophisticated mechanical devices are available to make tests which cannot be done in a small laboratory. Nevertheless, screening of all patients for aminoaciduria, presence of other abnormal urinary metabolites, and standard pathological conditions is carried out here. The application of ultramicroscopic techniques is a new departure in mental deficiency investigation which has proved, remarkably successful. One of the first projects was examination of the tumours in epiloia, which did not lead to any striking results. Next, we turned to leucocytes and, to the surprise of everyone, strange paracrystalline bodies were discovered in the lymphocytes of all patients with Down's syndrome who were examined. Even more remarkable was an observation, made recently, on the brains of these patients. Neural synapses were seen to enclose abnormally large numbers of complex vesicles, 32-sided containers of acetycholine. Further, the Alzheimer type of degeneration, known to be of common occurrence in brains of these patients, was confirmed ultramicroscopically. Other, independent, investigations concerned the development of skin ridges in the normal foetus and the ultrastructure