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inertia which condition is usually a progressive one in cases in which the seizures are frequent, severe or prolonged. Experience has shown that in connection with proper physical treatment, a mental therapeusis is also possible and beneficial.
Epilepsy thus develops in the individual that mental status which is manifest in a lack of initiative for mental or physical effort, as well as of continuity of such effort, when once set in motion. It is a noticeable feature of these cases that the manual dexterity, previously referred to as exhibited by many characteristic epileptics, is not associated with a corresponding mental condition, but that some cases which manifest much manual deftness and activity are very dull and slow in perception and other mental qualities. It has been the effort of the medical officers of the Colony, accordingly, to develop a system of school education, with a view to improving the arrested or impaired mental development of such residents as are capable of receiving benefit therefrom. For this work teachers specially qualified are required, since individualization of the several cases, is all important, and extension of this department will necessitate provision for additional skilled teachers.
The ever present and foremost need of the Colony is for added dormitory accommodation. Nearly every resource of importance to the general establishment in administration otherwise, is now provided. The sewer and water system, the electric plant and agricultural departments are all in such condition that extension from time to time, to meet the needs of increasing numbers of colonists, are mainly what will be required in the future. The provision for housing resources for all the dependent epileptics now under care in various counties of the State, are, however, far short of actual requirements and a further extension must, accordingly, be provided for in the coming year and by the necessary legislative appropriation, in order that these cases may be received into the Colony.
It is to be remembered in the construction of cottage dormitories for these cases, that their external form and internal arrangement are modified to a greater or less extent by the necessities of the class of patients for which such provision is to be made. A proper classification of the epileptics requiring care, involves the gathering into separate groups of those presenting similar bodily and mental conditions. These vary in many grades from the quiet and comparatively simple case to the bed-ridden and disturbed or semi-voilent class.
It is apparent, therefore, that separate and adequate dormitory provisions must be established for each such group. It is also to be borne in mind that the members of these general groups are by no means stationary, in their conditions, but that many of them change, from day to day, and, consequently require a transfer from one group to another. The quiet case of to-day may, in a few days, become irritable or even violent. These facts cannot be ignored, in arranging the cottages for the reception of such cases, but demand consideration as to the extent and character of such accommodations. Uniformity of construction and arrangement cannot be rigidly followed in the buildings for the several classes.
It is evident, therefore, that some of the cottage dormitories can be arranged in a simple form with a very moderate per capita cost for housing quiet inmates, while for bed-ridden or disturbed cases ampler provisions, at an increased per capita cost, will be required. It is estimated that for the class requiring the smallest provision, $275 per capita for housing can be secured, while for the more complicated cases a per capita cost of as high as $450 is necessary. For other classes of cases a per capita cost, varying between these extremes, will be necessary.
One more point in this connection should be referred to, and that is that it is not the lowest possible per capita cost which is to be adopted, but such a per capita cost as shall secure the facilities for custody and care, which are required by the statutes regulating the administration of the Colony, in the care of its wards. That economy in construction is the wisest which fully meets the needs of the inmate and the requirements of a successful administration. This can be secured by such care in the perfection of plans as experience demands, and in this way only can those mistakes be avoided which are otherwise inevitable in so extended a provision for care as the Craig Colony presents.
In closing this report, your committee desire to express their conviction that the responsibility of the State Board of Charities in the development of the Craig Colony demands a continuous and scrupulous supervision of all efforts for development of these departments.
ENOCH V. STODDARD, M. D.,