To explore the hypothesis that mental retardations are in part genetotrophic diseases (diseases in which the genetic pattern of the afflicted individual requires an augmented supply ofone or more nutrients such that when these nutrients are adequately supplied the disease is ameliorated), we carried out a partially double-blind experiment with 16 retarded children (initial IQs, -17-70) of school age who were given nutritional supplements or placebos during a period of 8 months. The supplement contained 8 minerals in moderate amounts and 11 vitamins, mostly in relatively large amounts. During the first 4-month period (double-blind) the 5 children who received supplements increased their average IQ by 5.0-9.6, depending on the investigator, whereas the 11 subjects given placebos showed negligible change. The difference between these two groups is statistically significant (P < 0.05). Durin the second period, the subjects who had been given placebos in the first study received supplements; they showed an average IQ increase of at least 10.2, a highly significant gain (P < 0.001). Three of the five subjects who were given supplements for both periods showed additional IQ gains during the second 4 months. Three of four children with Down syndrome gained between 10 and 25 units in IQ and also showed physical changes toward normal. Other evidence suggests that the supplement improved visual acuity in two children and increased growth rates. These results support the hypothesis that mental retardations are in part genetotrophic in origin.About 30 years ago Williams and coworkers (1, 2) formulated the concept ofgenetotrophic disease. A genetotrophic disease is one in which, because of his genetic nature, the afflicted person requires an augmented supply of one or more specific nutrients and in which fulfilling these needs prevents or at least ameliorates the disease.The genetotrophic hypothesis was in mind when G. S., a severely retarded child, was treated by the senior author. When first seen, the patient was 7 years old and in diapers, could not speak, and had an estimated IQ of25-30. At her instigation, his blood and tissues were analyzed in the laboratories of Mary B.Allen, a biochemist in Richmond, VA. With the cooperation of a physician, Allen devised a nutritional supplement and G. S. 's parents agreed to administer it. There were no noticeable results for several weeks, but after some constituents of the supplement were increased G. S. suddenly began to improve. In a few days he was talking a little; in a few weeks he was learning to read and write, and he began to act like a normal child. When G. S. was 9 years old he read and wrote on the elementary school level, was moderately advanced in arithmetic, and, according to his teacher, was mischievous and active. He rode a bicycle and a skate board, played ball, played a flute, and had an IQ ofabout 90.

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After a year of conferring and note gathering in various matetnity clinics and centers, a two part program was devised. Briefly, it consisted of supplementing the diet of maternity patients as the initial phase, followed by the testing of their children at 3 years of age and again at 4 years of age with standardized intelligence tests. The plan was to be tried simultaneously in two very different and widely separated, well-established maternity clinics. It would require that no participant knew nor could learn which of the subjects were serving as controls and which as experimentals. The plan called fot randomly selected subjects, that is, the odd-numbered maternity clinic registrants would receive no thiamine in their supplementary tablets while the even-nimibered registrants would. The odd-numbered, nothiamine group was to be further divided into two parts. Group A whose tablets would contain only ascorbic acid, and Group C whose tablets would contain only inert material. Likewise, the even-numbered, thiamine group was also to be subdivided into two parts, Group D which would receive thiamine alone, and Gtoup B which would receive thiamine plus othet vitamins of the B-complex.* The term nurse-midwife is used to identify a registered nurse (R.N.), who has passed successfully, as graduate work, courses in midwifery taken in English or Scotch or, in later years, American schools, and who has in consequence been granted the title of State Certified Midwife (S.C.M.), by the Central Midwives Board of England or Scotland, or that of Certified Midwife (CM.), by the State of Kentucky, or Certified Nurse-Midwife (C.N.M.), by the City of New York.^ Lelia E. Robertson, administrative associate, rendered tireless service here as in many other procedures during the experimental period.