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

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London County Council 1934

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

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examined between the years 1926 and 1933, inclusive, and the proportion of the
sexes nominated, those found suitable for a special school and those for the time
being unsuited for school attendance are shown in the following table :—

Table 42.

Type of defect.Percentage of sexes in those
Nominated for examination.Passed for a special school.Invalided.Deemed ineducable.
Physically defective50.249.850.249.850.149.9--
Mentally defective58.341.756.743.354.445.6

These figures seemed to indicate an excess of boys over girls in the epileptic
and mentally defective classes. The proportion of the sexes attending the ordinary
elementary schools at the beginning of 1933 was male, 50.6; female, 49.4. As
the figures for the physically defective are very similar it is evident that there is no
clear sex selection in this field where also the proportions of the sexes among those
found defective and those nominated are reasonably constant. A little over 69 per
cent, of those put forward as physically defective are found suited for special school
education, and just over 8 per cent, of either sex found temporarily unfit for school
attendance. That about 78 per cent, of the nominees are found unfit for the ordinary
school shows that the nominations are soundly based.
In the case of the epileptics the distribution is more irregular; more boys than
girls are nominated and more boys are accepted for special school education, but
more girls are invalided for a period. If the two groups are added it is found
that there is no material sex difference in suitability of selection, 65.1 per cent, in
the case of boys and 65.8 per cent, in the case of girls, of those nominated being
found to evince such manifestation of epilepsy as to render them unfit for education
in ordinary schools, though the proportions among those accepted show a slight
preponderance of males. This question of sex distribution in epilepsy is one on
which there is some difference of opinion, most English text books stating that there
is a slight preponderance of females and most American text books that there is a
preponderance of males.
This is a question on which the accommodation available, and even the number
of persons actually admitted to schools, throws little light. Special school accommodation
for epileptics is entirely of a residential character, and children are only
sent subject to the consent of their parents. This is an important feature, for the
dissatisfied parent of a child placed therein against his will could upset the equanimity
of other parents on visiting days, and this in turn would react adversely on the
children, for placid and equable conditions play an important part in the treatment
of epilepsy. It is true that attendance could be enforced by law if it could be shown
that the refusal of the parental consent was unreasonable, but, as this refusal is not
to be held unreasonable if withheld in a bona fide belief that it is for the child's
benefit, and as it is not difficult for any parent to get a medical certificate that a
child would be better at home lest he should fret if removed, it is in effect useless,
save in most exceptional cases, to attempt such action. The preceding tables indicate
clearly that while there is little difference in the sex incidence of epilepsy of such a
degree as to interfere with ordinary schooling there is a much greater willingness
on the part of parents to allow boys to be sent to boarding schools. This may be
partly due to special affection for the girls, but is more probably connected with the
greater difficulties in early life which arise from the unstable behaviour of epileptic
In the case of the mentally defective the proportion of boys is greater in all the
categories but is greatest in the numbers nominated and smallest in those deemed