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This miscellaneous group were mostly inevitable deformities, but many might have been alleviated
had good treatment been carried out earlier. The cases of rickets are not very numerous, only children
in whom a severe deformity had arisen, or in whom the process had remained active later than usual
being admitted to special schools. If these children were detected on admission to the Infants' departments
at 3 or 4 years of age, and proper treatment enforced, they would be mostly cured by the age of 5.
(6) Infantile Paralysis.—In 68 per cent, of these cases the paralysis had its onset
in the first two years of life, and practically all the recovery that will take place has done so by the
age of admission to school, so that examination of infants at entrance would at once weed out those
requiring treatment in special schools. A large proportion of children shew neglect in treatment either
as regards correction of deformity or provision of instruments.
Of the last class 38 have abandoned treatment. These numbers refer to the lower limbs ;
of the four other cases, three had had amputation, and in one the arm only was affected. Many slighter
cases of infantile paralysis and of paralysis of the upper limbs remain in the ordinary schools, and the
above numbers therefore give no indication of the relative proportion between slight and severe cases.
These cases are particularly the victims of bone-setters, and cases were often seen in which treatment
had been stopped, or instruments removed by those appearing at music halls or elsewhere.
(7) Cases of Spastic Paralysis.
Hemiplegia 22
Paraplegia 25
Diplegia 17
Most cases of paraplegia and diplegia (22 of 48) dated from birth, the hemiplegias (18 of 22)
generally arose during childhood. There are other such cases in the ordinary schools or amongst the
mentally defective children. From the damage to the brain the general intelligence is apt to be low,
and 19 cases (3 hemiplegic, 9 paraplegic, and 7 diplegic) were judged to be mentally defective as well.
(8) Cases of Progressive Paralysis.
Pseudohypertrophic palsy 8
Friedreich's ataxia 1
(9) Heart Disease.
Congenital heart malformations17
Acquired heart disease 107
Of the congenital heart cases 16 were " blue children " with pulmonary stenosis, and 1 had aortic
stenosis—12 were boys, and only 5 girls. The acquired heart diseases were chronic valvular lesions
as results of rheumatism or chorea (St. Vitus' dance), except 1 case of dilated heart, 1 of rapid heart
and 7 in whom no valvular lesion could now be detected. Prognosis was attempted from the evidence
in each case, and could only be said to be good in 33 out of 124 ; the congenital being all regarded as
bad. The histories were insufficient to estimate age incidence.

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