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One of the latest developments of public education closely related to the treatment of the feeble-minded is the special classes for backward children in the public schools. Such children are characterized by moral and mental weaknesses verging on defect such as faulty expression and lack of normal growth, nervous disorders from lack of tone to muscular tremors, and digestive disorders resulting from malnutrition. Many of them have misshapen heads, highly arched palates, faulty chests, and defects of the special senses. An examination of 100,000 children out of 600,000 registered in the New York City schools in 1906 showed 66 per cent needing medical or surgical attention or better nourishment, 40 per cent in need of dental care, 38 per cent having enlarged cervical glands, 31 per cent defective vision, 18 per cent enlarged tonsils, and 10 per cent post-nasal growths. (164) Dr. M. P. E. Groszmann says that these atypical children are the product of unfavorable hereditary and environmental influences, but differ from the really abnormal children in that special training and normal life conditions will allow them to reestablish within themselves a fair normality. (165)

(165) See Dr. Groszmann's classification and discussion of atypical children, Charities, vol. xii., 1904, p. 897.

Three kinds of classes are proposed for abnormal children: training classes for the mentally deficient, coaching classes for the slightly backward, delicate, or exceptional, and disciplinary classes for the truant and disorderly. In many cities a few such classes now exist, but in general the teachers in charge of them have had no special training in the recognition of mental deficiencies and are not adequately equipped for their peculiar task. In Boston, selected teachers are given an opportunity at city expense to observe the methods in the best schools for the feeble-minded, and a teachers' course is now offered at the New Jersey Training School for Feeble-minded Boys and Girls. The movement is recognized as highly important not merely for the relief of the teachers of normal children in the public schools, but as a preventive measure. Such children become in many cases semi-criminal, or at least incapable of self-support. Among the group of backward children will be found those who with this special training and medical care may become normal, and among them also some who will prove to be really feeble-minded and in need of institutional care. In either case the work of prevention is economical as well as humane. (166)

A further and quite recent differentiation in the classes mentally and nervously diseased is the provision of colony care for epileptics. It has long been recognized that their presence in institutions for the feeble-minded and the insane is unfortunate from the standpoint of the other patients, while at the same time the special attention they need cannot be given them. At most of the large institutions for other classes, special wards or buildings are provided where those subject to epileptic seizures may be cared for. But even this arrangement is inadequate, since the epileptic, in the earlier stages of the disease at least, is a sane person, and conscious of his surroundings in the intervals between attacks. By far the larger part of them are without institutional care, and the unhappy condition of the epileptic in the world is thus described by Dr. Barr: --

"Cut off more or less from school companionship and association. . .however well prepared he may become, his infirmity must always prove an impediment to securing positions of trust or responsibility. An object thus of terror or of pity. . .he gravitates toward a life of self-indulgence or of monotony and loneliness, tending greatly to produce mental deterioration. . . . Various phases of the disease are characterized by wanderings, delusions, or even by the perpetration of violent acts of which the patient may be oblivious. . .. This leads to the crowding of these unfortunates into insane asylums or into institutions for the feeble-minded. This is a double wrong. . .because he is more lonely than at home with no motive for active pursuits." (167)

There were enumerated in 1904 in insane asylums 11,652 epileptics, in institutions for the feeble-minded 3015, and in almshouses 2106. Mr. Letchworth estimated in 1900 that there were 113,000 epileptics in the United States; other authorities think that 160,000 is nearer the truth. Epilepsy, like feeble-mindedness, is preeminently a disease of neurotic heredity. In a study of 1200 cases in the Massachusetts Hospital for Epileptics, Dr. A. V. Cooper found that 15.4 per cent presented a well-marked history of hereditary transmission; Spratling and Barr give much higher percentages, while none of the foreign observers give any less. (168) Dr. Peterson emphasizes its interrelations with other neuroses; he says: --