The Commonwealth of Massachusetts.

REPORT OF THE TRUSTEES OF THE MASSACHUSETTS HOSPITAL SCHOOL.

To His Excellency the Governor and the Honorable Council.

In presenting this annual report, the trustees desire to call attention to the successful operation of the institution during its first working year, as shown by the marked improvement in condition, health and strength of the children admitted, and also the increasing number of applicants for admission.

The need of some form of special industrial education for cripples is evident as soon as the attention of the community is called to the subject; and it would at first seem strange that no provision has hitherto been made for the care of this class of children, while institutions for the care and training of idiots, epileptics, the blind and the dumb have for many years been conducted by the Commonwealth.

This is probably due to the urgent demand for care of the feeble-minded or epileptics, owing to the difficulty met in home care, and the evident need of special expert training for the blind and dumb. The nurture of crippled children, however, has not only been regarded in most communities as a family duty, but even in many families as a source of parental satisfaction; special training has not been thought necessary.

A few facts and actual experience here and elsewhere show that in a community where education is considered a part of the function of the Commonwealth, the special industrial training of cripples should be one of the first duties of State government. Especially is it clear that children with unimpaired intellects, but disabled only in the activity of their limbs, may be capable of the best development, providing a fitting opportunity is offered them. There is justice in the demand for

help for those who with aid may become independent, and without assistance are doomed to become a burden.

It may be well to call attention here to some of the problems which present themselves to the management of an institution providing for the nurture, care and training of cripples.

Crippled children can be divided into two classes: those who are permanently, and those who are temporarily, crippled. The temporarily crippled are chiefly those who are suffering from diseases of the joints and the spine, for whom special care, preventing ordinary school life, is needed for a number of years. When such care is provided for a sufficiently long period, it can be expected that a substantial recovery will take place, with a disability varying according to the extent and seat of the original disease and the amount of care given to the condition. With proper treatment, a child with tuberculosis of the spine may recover in time so completely as to gain the use of all his faculties. He will, however, if deformed, be handicapped by his deformity in the competition incidental to bread-winning. With proper education and training suited to his condition, he may be fitted for an occupation fitted to his disability, which would be beyond his reach unless education were furnished him during the invalid years of his childhood. The happiness and success of the lives of these children are largely dependent upon their nurture and training during their disabled years.

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The permanently crippled children are those with normal intelligence, suffering from forms of incurable paralysis of the limbs, from which little improvement can be expected. The children will always be disabled, and, unless specially trained, become a burden upon the community. If, however, special opportunities of education are furnished them suited to their condition, they may become either self-supporting or able to obtain some occupation which will diminish the burden of their support.

That this can be accomplished has been shown by several European institutions. The Royal Bavarian School for Cripples has educated and specially trained crippled children for more than half a century. The admirable day school in Boston, "The School for Crippled and Deformed Children," has