The Education of Crippled Children.

454 with many friends in many parts of the country. Each one biological teachers, one of the most original of British he employed to find, so far as time and opportunity would surgeons, and the first real exponent of the value of the permit, specimens for his museum and to collect facts for his experimental methods in medicine. general work. When any point seemed doubtful and he was unable to fill up for himself the lacuna in his arguments he would write to one or other of his correspondents The Education of and entreat them to observe the facts or to ascertain Children. But he spared the truth of some previous report. THE national importance of the medical profession is. himself. not Working early and late, rising at perhaps in nothing more evidenced than in the fact that itsdaybreak and going late to rest, he devoted every outlook and scope have long ceased to be limited to the moment not absorbed by his professional work to the peralleviation of individual suffering, or even to the preventionfecting of his museum. Successful as he was in practice, he thereof by the inculcation of personal hygiene ; that they valued that practice mainly for the power which it gave him have over-passed even the field of disease-prevention in the to enlarge his museum and thus to gain more systematic to effective action the public perknowledge ; and the spirit with which he himself worked he present by stimulating that as man’s each well-being depends not only on inculcated in others. He asked no one else to do what he ception ; his own obedience to the laws of health but on that of others was not able and willing to do himself to aid in the discovery each has an interest in the healthy living of all, from of the truth and the augmentation of human knowledge. also, which perception has arisen scientific sanitation ; and that HUNTER died poor. Apart from his museum and his notes now these energies are directed to the guidance of the he left almost nothing ; and by his will we know that he awakened public foresight in securing the utmost looked to the purchase of his collection by the Government recently and moral efficiency for the coming race. to provide for the family which he left behind him. And physical, mental, In warfare every disabled soldier not only robs the fighting though it was a time of war, of storm and stress, and of line of an effective unit, but if he remains in it he hampers enormous calls upon the public funds, the Government even and impedes the efficiency of the remainder. A wise general, of that day, with claims upon it whose urgency we in these softer times can hardly guess, was able to spare the small therefore, looks for the prompt removal of such to the rear outside the sphere of action, where he may, if possible, be sum required to buy HUNTER’S museum. And so it came to pass that the Hunterian Museum, great promptly restored to the effective strength in the field or, beyond all comparison in HUNTER’S day, was a few years failing that, be caredfor at the least possible tax on the after his death entrusted to the keeping of the Royal effectiveness of the fighting force. Life, not only the life College of Surgeons of England, a State trust as the of the individual, but still more the life of a nation, is a President of the College has pointed out. On the warfare, and those who are born physically below the basis of JOHN HUNTER’S museum the authorities of the average, or who become so in their earliest years through the

Crippled

by such conservators as WILLIAM CLIFT, ignorance or indifference of those on whom they are entirely RICHARD OWEN, JOHN QUEKETT, WILLIAM FLOWER, dependent for care and support, are the nation’s future CHARLES STEWART, and ARTHUR KEITH, have formed a non-effectives. For this reason the adjustment of their collection of human anatomy, both normal and pathological, relation to the education system, whereby each individual of comparative anatomy, both of plants and animals, far is trained ultimately to play his part in the nation’s surpassing any similar collection in the whole world. JOHN warfare, is highly important. In a recently issued pamphlet, The Care of Invalid and HUNTER’S museum was large-enormous for his time and for the work of one man-but the museum of the Royal College Crippled Children in School,"Mr. R. C. ELMSLIE has of Surgeons of England is the greatest collection of its kind republished a series of five lectures, the nrst of which in the world ; its completeness and its value can only be was delivered in the course of advanced school hygiene at appreciated by a careful and prolonged inspection. At a University College, London, the other four having been large total cost of money, during the many years which delivered to the school nurses attached to the London County have elapsed since the museum was first entrusted to its care, Council invalid schools. They are now modified in detail the College has nourished the collection as it deserved to be and somewhat added to to suit a wider public than that for nourished ; it has been liberally supplied with funds, and which they were originally written. While all the lectures above all things it has been wisely and jealously supervised. are of public utility, the first especially is of far-reaching For all who are capable of knowing good work when it is significance and deserves to be widely read. The writer done, of appreciating the value to science of such a collec- aims to define the term "physical defect" as applied to tion as the museum, must acknowledge that the College school children and as used in the Elementary Education could not have done more than it has done : it could (Defective and Epileptic) Act of 1899. In this term he not have more worthily carried out the work it has under- would include, not only all deformities and diseases of the taken. What would have been the surprise, the pleasure, bones, joints, and spine, which obviously cripple the child, and the pride of JOHN HUNTER if he could but see the but also all general defects of physique and chronic illMr. nesses, anything which continuously interferes either with museum into which his own collection has grown. on last Tuesday (see p. 417) was EDMUND OwEN’S oration 1 The Care of Invalid and Crippled Children in School. By R. C. what those who know him might have expected ; it was a Elmslie, M.S. Lond., F.R.C.S. Eng., Medical Officer (Invalid Schools). London County Council Education Committee. London: The School clear, forcible, and eloquent picture of the greatest of Hygiene Publishing Co., Limited. Price 1s.

College,

assisted

455 attendance at school or with the ability of the scholar Rev. HENRY HAWKINS, at that time the learned chaplain of to follow in full the ordinary school routine. The duties 1the Colney Hatch Asylum, put into active motion an idea of the school medical officer he divides into sepa- Jae had formed of the advantage, even the necessity, of rating such children, supervising them, whether in ordi-Following up some of the persons discharged as cured with nary or special schools, both at work and at play, advising the view of aiding them during the period between the their natural guardians when treatment is necessary, andreturn to home and the capacity for resuming occupathe instruction that may properly be given to has already been done to provide education Much them. under suitable conditions for certain classes of such subjects, but the great need is for the provision of resident hospital

supervising

and sanatorium schools, where children who require prolonged hospital care (as, for instance, in the case of ortho-

tion.

Mr. HAWKINS’S idea

through

dint

efforts of the

of his

taken up, but the persistent Lord MEATH, a few

only slowly advocacy, aided by was

great Lord SHAFTESBURY, medical men, and an energetic band of ladies, the movement attained considerable vis viva, and it now is generally

recognised as a charity with great scope of usefulness. Owing to the pressure on accommodation in the county paedic patients asylums it is necessary to discharge " recovered " patients as during prolonged can have their education carried on children, simultaneously soon as possible, but there is no doubt that in many with proper physical care. Mr. ELMSLIE very cogently points instances the "recovery"" is not firmly established ; it out’, in answer to an objection which is sometimes urged, may be technically true, but it does not satisfy the especially in regard to the education of permanently crippled ideas of those who know all about the case and are children-viz., that they are of no value to the community, familiar with the relapses that so frequently occur in and that by helping and educating them we are enabling those whose convalescence is prematurely interfered with them to survive and perpetuate their defects in their through having to return to work at once without having children-that they do survive whether we help them or not, gone through an annealing process, so as to become tempered and that by training them to make the most of themselves to the arduous surroundings of their avocations after leaving in spite of their limitations we lessen the burden on the the fostering care of the institution. There are many other community through workhouses and infirmaries; and, reasons why " recovery" in these discharged cases is only a secondly, that in most cases such defects are acquired, comparative term. Patients, with the concurrence of their and in the present state of our knowledge the inherit- friends, are anxious to get free from the appanages of reance of acquired defects is to be regarded as not proved I straint, however graciously they may be exercised; they and improbable. The early admittance of children to schools think that the shorter the time they are away from and the careful medical inspection of infant schools would home the less serious will their illness be thought to lead to prompt discovery during the remediable stage of have been ; they know that in their absence the rest many cases of tuberculous bone disease, for these frequently of the family is reduced to strains which make it imoriginate before ordinary school life starts, when the vague- perative that they should resume at the earliest date the care of those from whom they have been sequestrated. ness of the accompanying phenomena (which by no means as is commonly supposed, easily recog- And then again, there is a legal difficulty in detaining in an generally include, nisable characters, such as pain and deformity) makes the asylum persons who have technically become well mentally, conditions appear trivial to the parents. Finally, crippled even though it may be well known that the repair to and defective children, more than others, especially need the breach of continuity is of a very fragile nature and may be easily disrupted unless time is given for its an efficient technical training to minimise their disabilities and enable them to compete with the healthy and well- consolidation. The outside public views with distrust the employinformed ; and the earlier manual instruction is given the ment of persons who havejust been discharged from more easily is dexterity attained, so that the loss of many initial years in elementary education is an even greater asylums; if they knew that a period of probation had drawback to the defective than to the normal child. elapsed between the time of leaving the institution and that all had gone well in the meantime they would have more confidence in resuming relationships. So cognisant of the The After-Care Association. advantages of a probationary interval are the authorities of THE annual meeting of this society was held on many asylums that they actually do discharge tor varying Feb. 8th, under the presidency of Mr. H. D. GREENE, lengths of time, granting money allowances in the meanls.C., one of the honorary Commissioners in Lunacy-a while, many patients who are really free from the symptoms notable incident, because persons of such delicately and for which they were originally detained, but who are not importantly responsible positions do not often preside over thought sufficiently recovered to resume work at once ; but esoteric functions. The presence in the chair of a Lunacy it must be remembered that during the period of ’’ absence Commissioner on this occasion gave the cachet of on trial" these people are still considered to be patients recognition and authority to an institution founded and and remain under the force of their certificates, whereas maintained in a true philanthropic spirit, and affords us under the auspices of the After-Care Association they a reason for bringing before our readers in a prominent As an are unfettered and have full sense of responsibility. manner its very valuable design. The association had a very economic factor this association has been of much use in small beginning in the year 1869-though it was not preventing early convalescents from relapsing, thus becoming until 1897 that it assumed a corporate form-when the again chargeable to the rates and going through the misery of or

subjects of bone tuberculosis), children convalescent treatment, or phthisical

"

"

’