MENTAL WELFARE.
About Institutions and Epilepsy. By Alan
McDougall, M.D.,
Director of the David Lewis Colony and of Colthurst House School. A quarter of a century ago Manchester gave birth to four institutions, of which three concern themselves with epilepsy and one with feeblemindedness. This activity was roused by the separate enterprise of three Manchester citizens. Miss Mary Dendy brought into existence the Lancashire and Cheshire Incorporated Society for the Permanent Care of the Feebleminded and its residential schools at Great Warford within three miles of Alderley Edge station on the Crewe Alderman John Royle was the first cause of the to Manchester railway line. David Lewis Manchester Epileptic Colony that stands for the most part in Little Warford and abuts on the land of the Incorporated Society : both Institutions having erected their first buildings on ground (given to them by the David Lewis Trust) that had been part of the Sandlebridge estate. Alderman Royle was the first cause also of the Manchester Poor Lav/ Guardians' Epileptic Colony that is situated at Langho, a few miles distant from Blackburn. Mr. C. H. Wyatt, the then Director of Education in Manchester brought about the establishment of the Manchester Education Committee's residential epileptic school at Sossmoss between Alderley Edge and the two Warfords. At the three epileptic institutions all the patients are voluntary boarders and free, if they choose, to leave at any time. This was so too, at first, at Miss Dendy's institution, but since the passing of the Mental Deficiency Bill there has are
been certification and power of detention there. In each of the four institutions all the beds were soon filled : not indeed wholly by Manchester patients, applications for admission came in from all parts of the country. We at the David Lewis Colony have admitted middle-class English patients from India, Japan, South Africa and the Falkland Islands. Premises have been extended : the Incorporated Society's institution that began as two houses and a school building is now a farspread colony, the David Lewis Colony that at the start had two hundred beds has now four hundred : the Langho Colony has been extended to accommodate five hundred colonists : and were Sossmoss to add a hundred beds to its original hundred they would probably soon be filled.
It is neither desirable nor practicable to detain people against their will on the sole grounds that they have epilepsy. Patriots exist who would make it compulsory for parents to send their epileptic children to residential schools. The long-time result of such legislation would probably be to diminish, not to increase, the number of such children in such schools. Apparently the majority of English doctors still believe that a child starting with epilepsy would if it saw others having fits have more fits itself and so lessen its chance of cure. I think their notion a mistaken one : but it is held honestly by them and on their evidence magistrates would refuse to convict: and what is more serious, doctors would be strengthened in their (I think mistaken) judgment that seeing fits increases the frequency of fits. For another reason to have power to detain.
who
charge of epileptic colonies do not desire be compelled so to manage our institutions as will cause those under our care to prefer to remain with us than to leave us while they are unable to hold their own in the world without. This compulsion we
are
We wish
in
to
*
MENTAL WELFARE.
certain degree of good management that is not inevitable, though not impossible, where people must remain whether they will or not. The degree is not necessarily very high : for those who have epilepsy have little choice of conI take fits." Answered genial abiding-places. Said a new-comer to" the colony Here that is not against the rules." him one who had been with us five weeks There are few spots in the world where having an epileptic fit is not for practical purposes against the rules. ensures a
"
no one would be found living permanently in an institution at his friends or to the State, every man from reaching manhood to reaching senility would be seen earning his living. But here in England few of the people who have epilepsy can succeed long in earning a living : one sound reason for this being that the constant expectation of their having a fit proves a great strain to those who work beside them. For this and other reasons epilepsy frequently leads to idleness. The idle?whether they be idle-rich or idle-poor? easily degenerate. From that degeneration most of those who have epilepsy can be saved by congregation in a place where they can find apparently useful occupation, and where they can live the life that is lived by those around them. It is true that the financial value of their work does not equal the cost of their maintenance, but all over the world workers feel rather than question that they have earned their pay. It is true too that the work done by colonists has no extracolony worth : but it is equally true that the work of civilised man has no extracivilisation value; there is nothing in psychology to hinder a colonist from being as well satisfied with the work of his hands Js other civilised folks are with the work of theirs. But to secure them that boon you must abstain from setting them to manufacture articles that they see you cannot use, nor get rid of but by imploring visitors to buy them for the love of God.
In
a
Utopia
financial cost
to
That work in an institution should be something more than pass-time is a point often overlooked, and it is indeed one that may not be discovered even by an investigator who is making a special study of institution life. Long years ago there came to the Colony one morning a visitor who was commissioned to collect evidence that embodied in a report might lead on to legislation. He had already visited institutions in America and in Germany. He was a man of marked intelligence, his manners were admirable (o rara avis in terris: most visitors put on their zoo manners for the occasion), he chatted pleasantly and tactfully with various colonists. Yet he said genially to one who was busy scrubbing the tiled floor of " a verandah, It helps to pass the time, doesn't it." The colonist looked up in amazement for he was under the full conviction that he was cleaning the floor because it needed cleaning. If occupation be but pastime it is better found at the billiard table than
on
the verandah floor.
It has been said that a ruler's inabilities are as necessary to success as his for to ensure zeal in his officers he must let them be able to feel that he needs the help of their gifts. If the head of an institution gets his satisfaction by being the intelligent cause of effects he must be careful to keep in mind that all the members of his staff and all the colonists under his care find satisfaction in that same way he must allow to each one of them scope for a little judgment and a little choice in the ultimate way of carrying out an allotted duty.
abilities,
Colony life tends to raise rather than lower because it tends to increase selfrespect. With so much to be done there is opportunity for every individual. The longer his stay the more likely each one is to have acquired some duty?it may be to make such a score as will bring the billiard cup to his house, or to take wickets fast enough for the Colony to win cricket matches played against visiting elevens on summer evenings and Saturday afternoons, or to keep a certain grass border
10
MENTAL WELFARE.
trim and neat, or to keep a certain brass knob bright?that will make his absence felt when he is away on holiday at his home. It is an easy matter to find for everyone some special duty that will give him the feeling that at the Colony at any rate he is a person of importance. The cultivation of pride in personal appearance and of distinction in dress helps to prevent loss of individuality. Our Saturday evening dance, that has not failed summer or winter in twenty years, gives especially to the women but also It arrives sometimes to the men scope for distinction in personal appearance. that two women are admitted to the Colony at the same time from the same union wearing dresses that look alike. So powerful is the crochet-hook, so potent a bunch of ribbon, that before the first Saturday night comes the likeness has gone. This diversification is furthered through our custom of giving to each colonist The matron somehow a present of a few shillings value on Christmas morning. knows what particular present each one of nearly four hundred colonists covets most, and thus those of them who are not well furnished with brave vesture by their families can still shine as the stars with pride on Saturday evenings. Not only can institution life allow individuality, it can also develop sociabilIt is (or ought to be) known to psychologists that in human beings the urge to be allied preponderates its colleague the urge to rival. (Co-operation is a Our colonists being more fundamental property of protoplasm than rivalry is). human are ungrudging in their applause of him who is bringing credit to the house in which they live by helping to win the inter-house billiard cup or by singing a song well on a Saturday night.
ity.
Before we invite those who have epilepsy to live in colonies we ought to have faith that they themselves will benefit by colony life. Institutions institutionise their inhabitants. Oxford oxfordises : the Church churchises. But to say that I know harm in don or dean were to say more than I know : and to say that living in an institution necessarily corrupts were to say more than I know also. I speak this not without prejudice, having undergone the institutionising process here and in hospitals for over thirty years. Surely the shape of our dwelling place matters less than its tone? If institutionising were necessarily deleterious to the institutionised we ought our colonists become from year to year more troublesome, or else more demented. But that is what we do not find. Our troublesome people are as a rule the newcomers. Many, but by no "means all, of them come to us showing some of what are disparagingly called the characteristics of the epileptic." Years, or months, or even only weeks, afterwards those characteristics have disappeared, for they were not characteristics of epilepsy but were the consequences of unsuitable environment. If you were made to live for a year or two the life that most epileptic people are made to live in the world without, you would not get epilepsy, but you would show " the characteristics of the epileptic." Why would you ? Because there is fundamental in every fragment of healthy protoplasm an urge to be of service to something that is not its individual self. Protoplasmic self-realisation is found only in self-sacrifice. Consequently if people are forced to confine their serviceableness to the serving of themselves alone, they degenerate, as judged from the points of view of nature and of nature's waste product civilisation, and acquire features that make them a nuisance to their neighbours. It is only in so far as it gives to its epileptic residents scope for service that the world without must needs deny to them that an epileptic colony is q to find that
success.
11
MENTAL WELFARE.
A success from the colonists' point of view, that is to say. It is held by some people that a colony exists primarily as a place where epilepsy may be studied and investigations made that, it is hoped, will lead ultimately (How long, O Lord, how long?) to the finding of a cure for epilepsy. That notion has never yet influenced the David Lewis Colony : there the welfare of the colonists actually in residence has always been the overwhelming consideration. Each house is supplied with newspapers daily, each of the men's houses has its billiard table, most of them full size; a dozen of the men, a few of the women, and several members of the staff have their own listening-in sets : every house has its piano. Very many colonists visit their families periodically or have relations of theirs to stay a few days in the near neighbourhood and take them out for the day. These things are necessary if dementia, the natural end of human life, is to be staved off till body and brain have become senile by reason of years. Do what one will, dementia supervenes in a few epileptic people at a very early age : but early dementia is not an essential feature of epilepsy : a lady who was said to have started with epilepsy at the age of seven and had during the half dozen years she was at the colony half a dozen major epileptic fits a month, was bright and cheerful to the last and died at the age of eighty-five showing much less dementia than the average ordinary person of her years. In writing and in talking it is convenient to use the expression "the epileptic." The mother-in-law convention of But the practice is misleading and noxious. the comic papers will seldom do harm, every reader meets numerous mothers-inlaw in actual life and forms his opinions of them from what he sees more than from what he reads. But very few people meet many folks who have epilepsy, most have to form their opinions from what they read, and are apt to arise from their " " reading with the belief that the epileptic of literary convention exists actually. That belief leads to much wrong-handling of epileptic patients. One person who
has epilepsy differs as much from another person who has epilepsy as one man charplays golf differs from another person who plays golf. Name any acteristic of the epileptic," and we of the colonies will recall to mind the names of a dozen colonists who have shown the characteristic, and of fifty who have not. One must go to literature, not to life, to find the epileptic nature." The nature of those who have epilepsy is ordinary human nature : and to believe otherwise is to run great risk of mis-handling the epileptic people confided to your care. Mis-handled they (as you would do) become troublesome : treat them decently and you will come to speak well of them. Of course, epilepsy does not associate itself with saints alone, nor is it a cure for evil-doing; we have our troublesome people as you have yours; you have your people also who are good-humoured, honest, industrious and unselfish : we have ours. Proportionately our on-thewhole-good people are I think as numerous as yours. Essentially bad people are rare in either world, but a considerable number of epileptic people who gain admission to the existing colonies prove to be, however innocently, a prevention of the welfare of their fellow colonists. The English colonies do not solve completely the problem of housing congenially all the people who have epilepsy. There are epileptic people who for one or more of a variety of reasons interfere too much with the comfort of other colonists to be allowed to remain and yet are not in need of certification and retention in a general mental hospital. Most of the epileptic children I have lived with and known with some intimacy have seemed to me to be quite ordinary in their psychology. The uncompanionable child occurs frequently enough to test the rule, but with the advent of mental puberty the peculiarity disappears and the noli-me-tangere child beChildren similar to them in this respect are comes a social man. plentifully found in the world without: epilepsy is not the explanation of the condition. "
who
"
MENTAL WELFARE.
12
Is there a parental temperament that is a fore-runner of epilepsy in the off spring? We know well that there are many parents who add greatly to the difficulty of treating their epileptic children. But is it only when treating epilepsy that practitioners find that treatment of the child involves treatment of the parents? Pastor von Bodelschwingh, whose experience was uniquely great, used to say that the biggest difficulty in epileptic work is to find the right people to look after those who have epilepsy. The explanation seems to be that they do not exist wild, but are products of special training. We must bear in mind that keeping the sick alive is congenial with civilisation but is contrary to nature. For nature scraps the sickly. The wise treatment of the sick is not a gift of nature but is an art that has to be learnt individually by everyone who undertakes the duty, whether as doctor, nurse, parent or friend. Therefore, simply from the fact that many parents treat their epileptic children unwisely, we are not justified in making the inference that there is a temperament in parents that induces but somewhat confident epilepsy in their offspring. I used to have a tentative " belief that I recognised a mother-of-the-epileptic type. But one fine specimen proved to be the child's stepmother. And even if such a mother exist she is exceptional, most of the women who have an epileptic child show no obvious defect. We have no reason to believe that by following any practical line of birth control we can stamp out epilepsy without at the same time stamping out the nation. We must recognise that there will continue to be in our midst epileptic people and that by the rules of civilisation their right to live is as good as ours. The practical problem is that of preventing their being unhappy themselves and a source of unhappiness to their neighbours. That can only be done by acting on the theory that though they have epileptic fits their nature is human nature. -
"
About Institutions and Epilepsy. By Alan
McDougall, M.D.,
Director of the David Lewis Colony and of Colthurst House School. A quarter of a century ago Manchester gave birth to four institutions, of which three concern themselves with epilepsy and one with feeblemindedness. This activity was roused by the separate enterprise of three Manchester citizens. Miss Mary Dendy brought into existence the Lancashire and Cheshire Incorporated Society for the Permanent Care of the Feebleminded and its residential schools at Great Warford within three miles of Alderley Edge station on the Crewe Alderman John Royle was the first cause of the to Manchester railway line. David Lewis Manchester Epileptic Colony that stands for the most part in Little Warford and abuts on the land of the Incorporated Society : both Institutions having erected their first buildings on ground (given to them by the David Lewis Trust) that had been part of the Sandlebridge estate. Alderman Royle was the first cause also of the Manchester Poor Lav/ Guardians' Epileptic Colony that is situated at Langho, a few miles distant from Blackburn. Mr. C. H. Wyatt, the then Director of Education in Manchester brought about the establishment of the Manchester Education Committee's residential epileptic school at Sossmoss between Alderley Edge and the two Warfords. At the three epileptic institutions all the patients are voluntary boarders and free, if they choose, to leave at any time. This was so too, at first, at Miss Dendy's institution, but since the passing of the Mental Deficiency Bill there has are
been certification and power of detention there. In each of the four institutions all the beds were soon filled : not indeed wholly by Manchester patients, applications for admission came in from all parts of the country. We at the David Lewis Colony have admitted middle-class English patients from India, Japan, South Africa and the Falkland Islands. Premises have been extended : the Incorporated Society's institution that began as two houses and a school building is now a farspread colony, the David Lewis Colony that at the start had two hundred beds has now four hundred : the Langho Colony has been extended to accommodate five hundred colonists : and were Sossmoss to add a hundred beds to its original hundred they would probably soon be filled.
It is neither desirable nor practicable to detain people against their will on the sole grounds that they have epilepsy. Patriots exist who would make it compulsory for parents to send their epileptic children to residential schools. The long-time result of such legislation would probably be to diminish, not to increase, the number of such children in such schools. Apparently the majority of English doctors still believe that a child starting with epilepsy would if it saw others having fits have more fits itself and so lessen its chance of cure. I think their notion a mistaken one : but it is held honestly by them and on their evidence magistrates would refuse to convict: and what is more serious, doctors would be strengthened in their (I think mistaken) judgment that seeing fits increases the frequency of fits. For another reason to have power to detain.
who
charge of epileptic colonies do not desire be compelled so to manage our institutions as will cause those under our care to prefer to remain with us than to leave us while they are unable to hold their own in the world without. This compulsion we
are
We wish
in
to
*
MENTAL WELFARE.
certain degree of good management that is not inevitable, though not impossible, where people must remain whether they will or not. The degree is not necessarily very high : for those who have epilepsy have little choice of conI take fits." Answered genial abiding-places. Said a new-comer to" the colony Here that is not against the rules." him one who had been with us five weeks There are few spots in the world where having an epileptic fit is not for practical purposes against the rules. ensures a
"
no one would be found living permanently in an institution at his friends or to the State, every man from reaching manhood to reaching senility would be seen earning his living. But here in England few of the people who have epilepsy can succeed long in earning a living : one sound reason for this being that the constant expectation of their having a fit proves a great strain to those who work beside them. For this and other reasons epilepsy frequently leads to idleness. The idle?whether they be idle-rich or idle-poor? easily degenerate. From that degeneration most of those who have epilepsy can be saved by congregation in a place where they can find apparently useful occupation, and where they can live the life that is lived by those around them. It is true that the financial value of their work does not equal the cost of their maintenance, but all over the world workers feel rather than question that they have earned their pay. It is true too that the work done by colonists has no extracolony worth : but it is equally true that the work of civilised man has no extracivilisation value; there is nothing in psychology to hinder a colonist from being as well satisfied with the work of his hands Js other civilised folks are with the work of theirs. But to secure them that boon you must abstain from setting them to manufacture articles that they see you cannot use, nor get rid of but by imploring visitors to buy them for the love of God.
In
a
Utopia
financial cost
to
That work in an institution should be something more than pass-time is a point often overlooked, and it is indeed one that may not be discovered even by an investigator who is making a special study of institution life. Long years ago there came to the Colony one morning a visitor who was commissioned to collect evidence that embodied in a report might lead on to legislation. He had already visited institutions in America and in Germany. He was a man of marked intelligence, his manners were admirable (o rara avis in terris: most visitors put on their zoo manners for the occasion), he chatted pleasantly and tactfully with various colonists. Yet he said genially to one who was busy scrubbing the tiled floor of " a verandah, It helps to pass the time, doesn't it." The colonist looked up in amazement for he was under the full conviction that he was cleaning the floor because it needed cleaning. If occupation be but pastime it is better found at the billiard table than
on
the verandah floor.
It has been said that a ruler's inabilities are as necessary to success as his for to ensure zeal in his officers he must let them be able to feel that he needs the help of their gifts. If the head of an institution gets his satisfaction by being the intelligent cause of effects he must be careful to keep in mind that all the members of his staff and all the colonists under his care find satisfaction in that same way he must allow to each one of them scope for a little judgment and a little choice in the ultimate way of carrying out an allotted duty.
abilities,
Colony life tends to raise rather than lower because it tends to increase selfrespect. With so much to be done there is opportunity for every individual. The longer his stay the more likely each one is to have acquired some duty?it may be to make such a score as will bring the billiard cup to his house, or to take wickets fast enough for the Colony to win cricket matches played against visiting elevens on summer evenings and Saturday afternoons, or to keep a certain grass border
10
MENTAL WELFARE.
trim and neat, or to keep a certain brass knob bright?that will make his absence felt when he is away on holiday at his home. It is an easy matter to find for everyone some special duty that will give him the feeling that at the Colony at any rate he is a person of importance. The cultivation of pride in personal appearance and of distinction in dress helps to prevent loss of individuality. Our Saturday evening dance, that has not failed summer or winter in twenty years, gives especially to the women but also It arrives sometimes to the men scope for distinction in personal appearance. that two women are admitted to the Colony at the same time from the same union wearing dresses that look alike. So powerful is the crochet-hook, so potent a bunch of ribbon, that before the first Saturday night comes the likeness has gone. This diversification is furthered through our custom of giving to each colonist The matron somehow a present of a few shillings value on Christmas morning. knows what particular present each one of nearly four hundred colonists covets most, and thus those of them who are not well furnished with brave vesture by their families can still shine as the stars with pride on Saturday evenings. Not only can institution life allow individuality, it can also develop sociabilIt is (or ought to be) known to psychologists that in human beings the urge to be allied preponderates its colleague the urge to rival. (Co-operation is a Our colonists being more fundamental property of protoplasm than rivalry is). human are ungrudging in their applause of him who is bringing credit to the house in which they live by helping to win the inter-house billiard cup or by singing a song well on a Saturday night.
ity.
Before we invite those who have epilepsy to live in colonies we ought to have faith that they themselves will benefit by colony life. Institutions institutionise their inhabitants. Oxford oxfordises : the Church churchises. But to say that I know harm in don or dean were to say more than I know : and to say that living in an institution necessarily corrupts were to say more than I know also. I speak this not without prejudice, having undergone the institutionising process here and in hospitals for over thirty years. Surely the shape of our dwelling place matters less than its tone? If institutionising were necessarily deleterious to the institutionised we ought our colonists become from year to year more troublesome, or else more demented. But that is what we do not find. Our troublesome people are as a rule the newcomers. Many, but by no "means all, of them come to us showing some of what are disparagingly called the characteristics of the epileptic." Years, or months, or even only weeks, afterwards those characteristics have disappeared, for they were not characteristics of epilepsy but were the consequences of unsuitable environment. If you were made to live for a year or two the life that most epileptic people are made to live in the world without, you would not get epilepsy, but you would show " the characteristics of the epileptic." Why would you ? Because there is fundamental in every fragment of healthy protoplasm an urge to be of service to something that is not its individual self. Protoplasmic self-realisation is found only in self-sacrifice. Consequently if people are forced to confine their serviceableness to the serving of themselves alone, they degenerate, as judged from the points of view of nature and of nature's waste product civilisation, and acquire features that make them a nuisance to their neighbours. It is only in so far as it gives to its epileptic residents scope for service that the world without must needs deny to them that an epileptic colony is q to find that
success.
11
MENTAL WELFARE.
A success from the colonists' point of view, that is to say. It is held by some people that a colony exists primarily as a place where epilepsy may be studied and investigations made that, it is hoped, will lead ultimately (How long, O Lord, how long?) to the finding of a cure for epilepsy. That notion has never yet influenced the David Lewis Colony : there the welfare of the colonists actually in residence has always been the overwhelming consideration. Each house is supplied with newspapers daily, each of the men's houses has its billiard table, most of them full size; a dozen of the men, a few of the women, and several members of the staff have their own listening-in sets : every house has its piano. Very many colonists visit their families periodically or have relations of theirs to stay a few days in the near neighbourhood and take them out for the day. These things are necessary if dementia, the natural end of human life, is to be staved off till body and brain have become senile by reason of years. Do what one will, dementia supervenes in a few epileptic people at a very early age : but early dementia is not an essential feature of epilepsy : a lady who was said to have started with epilepsy at the age of seven and had during the half dozen years she was at the colony half a dozen major epileptic fits a month, was bright and cheerful to the last and died at the age of eighty-five showing much less dementia than the average ordinary person of her years. In writing and in talking it is convenient to use the expression "the epileptic." The mother-in-law convention of But the practice is misleading and noxious. the comic papers will seldom do harm, every reader meets numerous mothers-inlaw in actual life and forms his opinions of them from what he sees more than from what he reads. But very few people meet many folks who have epilepsy, most have to form their opinions from what they read, and are apt to arise from their " " reading with the belief that the epileptic of literary convention exists actually. That belief leads to much wrong-handling of epileptic patients. One person who
has epilepsy differs as much from another person who has epilepsy as one man charplays golf differs from another person who plays golf. Name any acteristic of the epileptic," and we of the colonies will recall to mind the names of a dozen colonists who have shown the characteristic, and of fifty who have not. One must go to literature, not to life, to find the epileptic nature." The nature of those who have epilepsy is ordinary human nature : and to believe otherwise is to run great risk of mis-handling the epileptic people confided to your care. Mis-handled they (as you would do) become troublesome : treat them decently and you will come to speak well of them. Of course, epilepsy does not associate itself with saints alone, nor is it a cure for evil-doing; we have our troublesome people as you have yours; you have your people also who are good-humoured, honest, industrious and unselfish : we have ours. Proportionately our on-thewhole-good people are I think as numerous as yours. Essentially bad people are rare in either world, but a considerable number of epileptic people who gain admission to the existing colonies prove to be, however innocently, a prevention of the welfare of their fellow colonists. The English colonies do not solve completely the problem of housing congenially all the people who have epilepsy. There are epileptic people who for one or more of a variety of reasons interfere too much with the comfort of other colonists to be allowed to remain and yet are not in need of certification and retention in a general mental hospital. Most of the epileptic children I have lived with and known with some intimacy have seemed to me to be quite ordinary in their psychology. The uncompanionable child occurs frequently enough to test the rule, but with the advent of mental puberty the peculiarity disappears and the noli-me-tangere child beChildren similar to them in this respect are comes a social man. plentifully found in the world without: epilepsy is not the explanation of the condition. "
who
"
MENTAL WELFARE.
12
Is there a parental temperament that is a fore-runner of epilepsy in the off spring? We know well that there are many parents who add greatly to the difficulty of treating their epileptic children. But is it only when treating epilepsy that practitioners find that treatment of the child involves treatment of the parents? Pastor von Bodelschwingh, whose experience was uniquely great, used to say that the biggest difficulty in epileptic work is to find the right people to look after those who have epilepsy. The explanation seems to be that they do not exist wild, but are products of special training. We must bear in mind that keeping the sick alive is congenial with civilisation but is contrary to nature. For nature scraps the sickly. The wise treatment of the sick is not a gift of nature but is an art that has to be learnt individually by everyone who undertakes the duty, whether as doctor, nurse, parent or friend. Therefore, simply from the fact that many parents treat their epileptic children unwisely, we are not justified in making the inference that there is a temperament in parents that induces but somewhat confident epilepsy in their offspring. I used to have a tentative " belief that I recognised a mother-of-the-epileptic type. But one fine specimen proved to be the child's stepmother. And even if such a mother exist she is exceptional, most of the women who have an epileptic child show no obvious defect. We have no reason to believe that by following any practical line of birth control we can stamp out epilepsy without at the same time stamping out the nation. We must recognise that there will continue to be in our midst epileptic people and that by the rules of civilisation their right to live is as good as ours. The practical problem is that of preventing their being unhappy themselves and a source of unhappiness to their neighbours. That can only be done by acting on the theory that though they have epileptic fits their nature is human nature. -
"
