_Institutions._--Institutions are of great importance. A larger
proportion of the children of the poor than of the children of the
well-to-do are dealt with in institutions, for well-to-do parents
live in commodious houses, in which their children can be properly
cared for, they are able to summon the doctor whenever necessary,
and so on. The most important institutions in this connection are
hospitals for infants and young children. Children’s hospitals are
not as yet very numerous; hospitals for infants are still fewer. The
majority of these institutions are maintained, not by the State or by
the local authority, but by the community at large. It is owing to
the fact that children’s and infants’ hospitals are so few in number
that medical practitioners are so inadequately trained in respect
of the hygiene of childhood and pediatrics, and in especial in the
hygiene and therapy of infant life. The need for such hospitals is
not satisfied by the foundation of children’s clinics. A combination
of hospitals for infants with lying-in hospitals or foundling
hospitals is unquestionably along the proper course of development.
If we wish to ascertain the value of institutions for children
who are blind, deaf-mute, crippled, or feeble-minded--if we wish
to learn whether it is socially worth while to take special pains
for the care of such children, or whether they can be adequately
cared for in general institutions, and what would be the cost of
these respective methods--we must study statistics bearing on these
questions. But, unfortunately, these statistics are defective and
extremely untrustworthy. They are defective, because they fail to
give us precise information concerning personal data and concerning
the percentage of such children who are or may become fit to earn
their own living. They do not classify properly according to age, and
they do not state accurately how many of the children have inherited
and how many have acquired the defect from which they suffer. (The
youngest children will usually be found to suffer from an inherited
defect, since they will hardly have had time to acquire it. Among
those suffering from such defects, the young present a larger
proportion of sufferers than we find among the general population,
because the mortality of the children thus affected is higher than
the mortality of healthy children.) The statistics are untrustworthy,
because the existence of deaf-mutism is often overlooked until
childhood is comparatively advanced, and feeble-mindedness may not
be recognised at all. In the twentieth century, in the civilised
countries of Europe, we find, per 100,000 of the population, from
50 to 130 blind persons, from 60 to 250 deaf persons, 70 to 450
feeble-minded and insane (minimal and maximal figures), and about 120
cripples. According to certain statistical data, one-fourth of the
blind and two-thirds of the deaf-mutes are competent to earn their
living, and 90 per cent.
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