London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1904

[Report of the Medical Officer of Health for London County Council]

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43
Imbeciles.—Imbeciles and those of worse degree, idiots, are expressly excluded from the
operation of the Elementary Education (D and E) Act of 1899. Any child decided to be imbecile
is thereby excluded from school. But the definition of what is an imbecile is very difficult. An
individual whose mental powers are, in great measure always have been, and permanently remain
beyond the reach of reason may be taken to be an imbecile.
At present there is no statutory duty laid on any authority for the care of imbeciles who are
not paupers, but the whole matter is now being investigated by a Royal Commission, before whom
various representatives of the Council have given evidence.
The necessity for such an inquiry was fully shown in my First Report (page 22).
There are children referred to occasionally as "morally defective," or in some cases as "moral
imbeciles." This class is an exceedingly small one. The children who are word deaf or word blind
are such in virtue of defects in the small areas of brain which should store the memories of word
sounds or word images. The body of memories stored up, comprising the conventions which
regulate our conduct in relation to society, comprise morality, a body of memories probably not more
complex than written or spoken speech. These memories are a very late evolution, but earlier
than speech. We cannot locate them, but if this idea of morality is correct one should expect
localisation, which may, however, be in the silent area of the brain, and is screened from
observation by the action of the lower centres. Want of development of these regions will give
rise to exactly the type of individual that is found with word blindness or word deafness.
Incapable of appreciating one class of memory, incapable of education or improvement in that
respect and normal in all other ways, and a normal individual who is wanting in all moral
behaviour except such as his lower emotions or appetites suggest, will appear in some ways
exceedingly clever. Such are the children who occasionally come to notice as moral imbeciles or
moral defectives.
Most of these have hitherto passed through the schools unnoticed. They really are not
provided for by the Education Acts, as they are quite capable of learning moat things in school.
Many in later life undoubtedly will become a danger to the community, and where this is associated
with other defects which bring them into notice should not be permitted to be in ordinary schools.
Residential institutions or a colony or ship where they can be under constant observation will be
the best treatment during school life. They should be registered by the finger-print method, so that
in later life on once coming into the hands of the police their dangerous qualities will be known.
Epileptics.—A scheme is under consideration for dealing with epileptics. As yet epileptics
are considered first with respect to their mental qualities. Are they fit for the ordinary school, or
feeble-minded? Then they are considered with regard to the epilepsy. Can this child attend
school, or are the epileptic attacks too frequent for it to be advisable to attend? If so, the child is
excluded as invalid. The absence of provision for this class is the greatest gap in our Educational
System.
INTERMEDIATE SCHOOLS.
Considerable numbers of old children are still recorded in Standards I. and II.
In the second Report to the late School Board (p. 33), the special treatment of backward
children in intermediate schools was advocated. It was there estimated that 10 per cent. of the
school population were in such a condition, from reasons either of a permanent or of a chronic
but temporary nature, attending school under such conditions that the work of the ordinary school
is almost wasted on them, if not in many cases actually harmful.
This is the more required in that large numbers of children who make little progress in school,
and who would greatly benefit by manual work, under the present conditions never reach the
standards in which manual work becomes part of the ordinary school course. They may pass their
whole school life and for want of scholastic attainments never see the inside of a manual
training room.
The cases of children already referred to not blind but yet unfit for the continuous ocular strain
of school work, the children with aural defects, the simply debilitated children, children backward