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Congenital Syphilis.—In 50 of the 615 cases submitted for my examination, there was
strongly-marked evidence of inherited specific disease (congenital syphilis). These 50 are only the
children whose lives have been so ruined that they were deemed unfit for school, but there remain
hundreds who are still able to attend school or are invalided for a time, but for whom special
education does not need to come in question.
It was very difficult to assign places to some of the 27 girls and 23 boys thus noted ; for instance,
15 of them had degrees of blindness and deafness combined. Three 13-year-old children, previously
intelligent, were undergoing mental degeneration of the most marked kind, unfitting them for any
education.

Epileptics.—It is scarcely realised how urgently definite provision for all classes of epileptics
is wanted in London. In 100 cases examined during the year, epilepsy was scheduled as the chief trouble.
Here, as is so frequently the case, multiplicity of authorities results in an impasse. Were all
public authorities for special purposes under the ultimate direction of the County Council, this great
and crying evil of no accommodation existing, except for wealthy or pauper epileptics, would soon be
removed.
An epileptic is always a source of trouble and distress, not only to himself but to others. The
attacks are often exceedingly alarming, and when, as is frequently the case, a whole household, perhaps
of tired workers, is roused night after night by shrieks of a relative; or when they are subject to
recurrent though transient attacks of aberration, violence, or even more persistent unreasonableness
and wilfulness by epileptic children, life becomes a burden. Its weight is no less heavy because the
complaints are not organised by associations or published to the world.
The great unseen burden exists, and the ever present fear of accident, or possibly of the criminal
or even murderous outbreaks we hear of, presses hourly on thousands in London, who are too poor
to pay the charges required for relief, or not poor enough, or the sufferer not bad enough to compel the
guardians to do their duty.
The appeals and complaints of harassed or worn-out relatives which come almost daily make
it necessary to urge on every one the necessity of this question being dealt with, and at once.
So far as school children are concerned, the duty of providing the special education lies with
the Council, as education authority. Education for epileptics, in most cases, can only be properly
managed in residential institutions. The ordinary schools are thereby freed from interruption, the
patients safeguarded from accident, and the lives of their immediate relatives freed from an intolerable
strain and anxiety.
Considering that heredity is a more marked feature in epilepsy than perhaps in any other disease,
the question of custodial or other preventive treatment must come up in future, but at present does
not in any way complicate the educational question. Whatever ultimate methods may be adopted
children will always have to be separately cared for, housed, and educated, apart from older patients.
Epileptic children will be best treated in a school colony, which should be large enough to admit
of classification, and to which every case, however complicated, may be sent.
The late authority in 1903, entered into some negotiations with the National Society for the
Employment of Epileptics. It was proposed that the Society and School Board should co-operate
in establishing an epileptic school in connection with the Chalfont Colony. There was no particular
advantage in such a school being established there, and serious disadvantages in want of control, and
the scheme was not carried through.
During last year, the chairman of the special schools sub-committee and some of the members
had a conference with various Council officials in regard to special school accommodation, and it was
then suggested that the Christian Social Union, which maintains homes for epileptics at Lingfield,
would make arrangements for boarding and educating the children sent by the County Council. There
has been some negotiations with representatives of the Lingfield Homes and a suggestion has been
put forward as to an arrangement for increasing the accommodation by at least 200 places to provide
for these children. Meanwhile, as a temporary arrangement, a few places are being paid for, but they
are quite inadequate in number, and at present, practically every case which cannot be kept at a day
school, has to be scheduled as epileptic and 85 per cent. written off as unfit for school, losing education
and often running the streets.
No arrangements will be satisfactory unless all epileptic cases can be taken, however degraded,
troublesome or afflicted they may be. Probably the very cases which are most urgent will remain
on our hands, unless the Council itself makes provision and manages the whole care and education of
London epileptic children. It is a permanent problem, which will remain with us, and one not suitable
for temporary treatment.
Epileptics scheduled during 1905-6.
12006 F