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school; but there is undoubtedly need for special schools being established under the Blind and
Deaf Act not only for those who will go through life with some vision, but for those who suffer
from chronic eye conditions which extend over a large part of school life, and who at the same
time should be educated under conditions which eliminate writing with pens or pencils, drawing
maps, sewing, or doing any kind of fine work with the head bent much forward. This has already
been referred to on p 16.
It would be advisable, too, that in the Blind schools some attention should be paid to the
appearance of the eyes and to the habits of the children. All attending these schools should wear
dark blue glasses (dark smoked domes). This would prevent many bad habits—picking the eyes
and so on. In the case of dirty sockets, it would also protect from irritation. Children who have
partial vision and wear glasses should either always wear their spectacles or these dark protective
domes. I have seen a girl in a residential school sent there out of the ordinary school to relieve her
of eye work owing to progressive high myopia, but employed at the Blind school in sewing without
glasses and with the work held close up to the eyes.
Children who have had an eye removed grow up to have an unpleasant appearance, and when
the lids turn inwards sometimes suffer a good deal from want of support to the tissues and lids
during growth. To prevent the contraction which will otherwise occur, they should be encouraged
to wear some artificial support in the orbit.
Deaf.—There are ten Day schools and three Besidential schools for the deaf. The Residential
schools are Anerley for elder boys, Oak Lodge for elder girls, and the school at Homerton is chiefly
for children, boys and girls, who present other defects combined with deafness. Training is carried
on in the last named both orally and by signs.
The careful examination of the vision of the deaf in residential schools is also undertaken by
Mr. Harman, as the fullest possible acuity is necessary for these children, particularly if they depend
on lip reading.
Deafness is not absolute in all cases. Many present various degrees of acquired deafness, and
some are capable of improvement by operative treatment, particularly in those cases where chronic
otitis has followed one of the exanthemata, and the ears present granulations and constant discharge.
The seriousness of this being allowed to continue year after year cannot be too strongly insisted on.
Cases are seen occasionally where apparently meningitic symptoms have recurred from time to time
without effective treatment being followed out. The majority of these cases of chronic suppurative
otitis may be regarded as neglected by the hospitals, no thorough or determined efforts being made
to effect a cure; and, indeed, they cannot be properly treated except by continuous dressings
several times daily, and if this is not effective in a few weeks, then by radical operation. Like the
determination of refraction in the eye, the routine treatment of numerous cases of chronic otitis is
most uninteresting, and it can scarcely be expected that any man will voluntarily give up hours
daily to such work. This is one of the flaws of the voluntary hospital system that a great amount
of work not only in this but in ruany other respects which is requisite and necessary in the interests
of the public health, is, except here and there in special hospitals, practically neglected. The want
of hearing, totally or in part, produces very considerable mental retardation, and the educational
capacity of deaf cases varies very greatly. It would be an interesting study to follow up the work,
expensive and tedious as it is, of the teachers in the deaf schools, and inquire how many children,
trained in the purely oral system, attain such perfection that it is of practical use in after life.
Great harm is undoubtedly done by voluntary institutions for the care and help of the deaf,
collecting them together, and separating them from their fellows by encouraging the use of sign
language, and, what is worse, in many cases leading to the marriage of congenital deaf mutes.
A considerable proportion of the deaf do not make progress with oral teaching, most have
defects of obscure nature, some of articulation, some of intellect. Most of these are at present
classified as "also mentally defective," but they require much closer study than we are able to give
them, and to be classified and worked according to their abilities. Some at Homerton are slowly
progressing with oral speech. Some are being educated by the use of speaking tubes, and others
are using signs.
Undoubtedly some of these cases would repay very careful study in the hands of a highly trained
teacher or of a medical examiner used to this class of work.