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Paralysis.—This category includes the various cases of paralysis or paresis
of one or more limbs or certain muscles, disturbances of the nerves affecting
respiration, e.g., panting breathing, slow breathirtg, snorting, snuffles, etc., and
speech, e.g., stammering, slurred, staccato or explosive speech.
Sleep.—Cases which are manifested by an inverted sleep rhythm or by
restlessness and noisy behaviour at night. In many cases the patients tear up
the beclothes or are otherwise destructive.
Miscellaneous.—Refers to various other physical or nervous manifestations
not covered in the above categories.
Sub-Normal.—Signifies that the patients, though not suffering from any
very specific after-effects, are not as well as they were before their illness.

The experimental unit at the Metropolitan Asylums Board's Northern Hospital,
Winchmore Hill, was opened in November, 1925, for the residential treatment and
observation of children between 3 and 16 years of age suffering from the after-effects
of encephalitis lethargica. The experiment is of great importance as it is the first
attempt of the kind which has been made by a public authority to deal with these
cases. Children are admitted on the application of the Council or the various
Boards of Guardians. As soon as information of children suffering from the sequelæ
of encephalitis is received from the various sources, i.e., medical officers of health,
hospitals, school care committees, school medical service, etc., domiciliary enquiries
are made through the care committees and particulars obtained on a report form.
Arrangements are then made to examine selected cases at County Hall and the
Metropolitan Asylums Board's admission forms are completed for suitable cases and
forwarded to the Board. If the Board's neurologist approves, the children are
admitted and the parents are asked to contribute toward their maintenance according
to their means, the assessments for this purpose being made by the school care
committees. The total amount of contributions thus collected is forwarded to the
Board by the Comptroller.
The Metropolitan Asylums Board's report on the first year's working of the
unit demonstrates that the outlook in certain classes of case is hopeful, whilst in others
there has been little or no response to treatment. It further indicates that the
future purpose of the institution, apart from its usefulness in effecting definite
improvement in the milder type of case, may well be that of a clearing house where
patients suffering from the heterogeneous forms of the sequelæ of encephalitis
lethargica may be observed, classified and allocated in the various ways, according
to the nature of the defect. For example, it is suggested that the milder types of
"mental" cases should be dealt with at a hospital school and, as they become 16
years of age, drafted to a residential colony, although, as is pointed out, there is
at present no power to institute such a colony or detain the patients therein. The
patients who could be certified either as mentally defective or insane can be dealt
with under the appropriate Acts. At present a patient who exhibits mental
symptoms, following encephalitis lethargica, can only be dealt with statutorily if