My apology for bringing forward this subject at the present time is that considerable interest with regard to it has recently been evidenced by correspondence and comments in the medical journals, as well as by inquiries set on foot by the Lunacy Commissioners and the Local Government Board. The former have published in their 49th Annual Report, just issued, a “Return showing the Number of Pauper Idiot, Imbecile, and Epileptic Children in the Asylums, etc., on 1st September, 1894,”† and a return of similar character as to such children in workhouses has been issued by the latter. The upshot of the whole matter is that, according to these returns, there are in lunatic asylums 525 children of this class (335 males, 190 females), and in workhouses 485 (281 males, 204 females). The latter number includes, however, 93 children returned as “epileptic only,” so that of idiots and imbeciles in workhouses under 16 years of age there are but 392. Adding together those in lunatic asylums and in workhouses we find that a total of 917 youthful idiots and imbeciles are provided for by the Poor Law in these institutions. The Local Government Board return, however, gives us no information as to the large number of such children living with poor parents who receive on their behalf some parochial relief. In the Commissioners' return the children are classified as idiots and imbeciles respectively, 399 in the former, 126 in the latter class; and 154 are said to be in the opinion of the medical officers likely to be improved by special training. In the Local Government Board return the children are classified as “imbecile only,” “epileptic only,” and “both imbecile and epileptic;” and the number of children who, in the opinion of their medical officers, would be likely to be improved by special training is set down as 178. Consequently if we are guided solely by these returns we should be led to the conclusion that in England and Wales—excluding the Metropolitan district, for which separate arrangements exist—there are no more than 332 improvable pauper idiots and imbeciles under 16 years of age remaining to be provided for in addition to the 225 paupers already accommodated in voluntary institutions for the training of imbecile children. Indeed, deducting 52 now resident in the special idiot block of the Northampton County Asylum, there remain but 280, a number insufficient to fill a decent-sized special institution!
The Relation of Mental Symptoms to Bodily Disease, with special reference to their Treatment outside Lunatic Asylums
