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200
Report of the County Medical Officer—Education.
So far as home conditions are concerned it appeared that the special schools are in the main
recruited from the poorer areas of London, and that in these schools there is a larger proportion with
defective or unclean clothing. The maximum proportion of mentally defective to normal children was
found in the poorer districts occupied by the older English population displaced by the clearance of a
large area in Bethnal Green, into Ilaggerslon, Hoxton, and East Finsbury, which have for long been
noted as very poor. South of the river there is much less defect. The upper map in diagram K,
facing page 116, shows the distribution of mentally defective children calculated as a percentage of the
children scheduled as mentally defective to the total number of children scheduled on 31st March,
1913. according to educational administrative areas.
Home
condition*
of mentally
defectives..
In the annual report for 1912 details were given of the distribution of mental defects among
the children in 700 families, on an average 1*43 children being defective in a family of average size
of 6 05 children. Further inquiries into 1,000 families have shown that in 48*6 per cent, some other
member of the family was known to be mentally defective or unstable, and in 26*5 per cent, more
than one other member was afflicted. The annexed diagram (I.) traces the origin of some mentally
defective children. It will be seen that both families show a history of mental defect, phthisis and
alcoholism.
Family
history of
mentally
defectives.
Epilepsy, Sfc.—In 16*5 per cent, there was a family history of epilepsy, the parents being
stated as the subjects in 5 per cent., and brothers and sisters in 8 per cent.
Alcohol.—The history of alleged alcoholism is probably somewhat untrustworthy owing to
local and personal variations of opinion as to what constitutes a noteworthy degree of this condition.
It was alluded to in greater or less measure in 26 per cent, of the cases.
Insanity.—In 12 per cent, of the cases a grand-parent, parent, uncle or aunt, brother or sister
had been in an asylum, and there is reason to think that this record erred on the side of underestimating
the prevalence of mental instability.
The Asylums Committee desired that an arrangement might be made with the Education
Committee whereby information concerning heredity in relation to feeble-mindedness might be
correlated. The Asylums Committee considered that under such an arrangement it might be possible
to ascertain how far insanity in the parents was responsible for the mental deficiency of the children
in the schools, and enable a judgment to be formed regarding the tendency of insane parents to beget
congenital imbeciles. Prior to the request of the Asylums Committee it had been the practice for
them to report to the School Medical Officer the admission to the asylums of children who ha'd been
.in attendance at special schools, and the School Medical Officer thereupon forwarded to that Committee
particulars of the children concerned taken from the school medical record cards. This method was
not, however, altogether satisfactory, and for a period of three months, afterwards extended to a
further period of six months, arrangements were made whereby the Asylums Committee notified the
names and addresses of all persons admitted to Asylums who had children of school age. Steps
were then taken to ascertain which of such children were in attendance at schools for the mentally
defective, and the School Medical Officer thereupon supplied the Asylums Committee with any
information regarding such children, many of whom were re-examined specially. The experimental
period has not yet terminated, but, up to the present, information has been furnished to the Asylums
Committee in regard to 51 children, and where necessary, the teachers have been given instructions
to avoid mental stress being placed upon such children.
Tuberculosis.—A history of one or more of the family suffering from consumption was given
in 39 per cent, of the cases under review.
Constitutional Defects.—The following percentages were recorded:—
Marked rickets 13.5 Nystagmus 1.5
Congenital heart disease 1.8 Squint 9.0
Hutchinson's teeth, scars round 2.0 Subnormal vision 22.0
lips, &c. History of prenatal trouble and of 12.0
Cataract 0.8 difficult labour.
Diseases of Childhood.—
Infantile convulsions 23.0 Infantile paralysis 1.5
Fits? epilepsy 7.5 Paraplegia 2.0
Personal
history of
in« ntally
defectives.
Teething.—In 9 per cent, of cases the appearance of the teeth of the 1st dentition is recorded as
being late, but in many instances the mothers state frankly that they cannot remember when the
child cut its teeth. There is usually a better history to be obtained in this respect in the case of 1st
or of onlv children.

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