by commanding the idiot to do a thing which he has done well, by an imperative order in a less imperative tone; diminishing little by little the rigour of the voice, the precision and decision of articulation, gesture and expression, until it is relaxed to the ordinary usages of society; but still the pupil must always feel that the old master can reappear―he must fear the claws beneath the velvet paw.

Stimulants of the tastes and desires are numerous. The idiot loves his parents and desires to see them; he likes the country and desires to walk; he likes flowers, cakes, pictures: all these may be promised as rewards. His antipathies may be used also as preventives of disobedience and idleness; but to be efficacious these promises must be facts-something positive and actual. He should see, or touch the object desired or feared; gradually the conditions should be adjourned, and thus his desires spiritualized by putting their satisfaction at a distance.

Games hold a high place in this education. M. Séguin mixes with his pupils as their playfellow, though he imperceptibly directs their games. A game is the most spontaneous act of infancy: it is more, it is the free and voluntary accomplishment of a bodily and mental function; an idiot who can play almost deserves another name. The choice of games lies with children, their variation and graduation with the master, who should take care that the game does not become a mere routine, but that there should be always something to learn; at first the games which please his tastes, afterwards those most useful. Thus when there is inability to direct the eye, the bow and arrow; for difficulty in motions of the hand or involuntary contractions, the battledore; for unsteady gait, the wheelbarrow, &c.

Negative command, or that which is not expressed in words but depends on such arrangements as shall lead the idiot to think and act for himself; the master has only to watch quietly and patiently after making his plans; the master has at first forced him to act, next has assisted him, now he places him in such circumstances as to force him to exercise his attention, comparison, judgment, reflection and moral will. He has arrived at that point in his education when he can execute all voluntary movements; he can read and write, whatever his master wills energetically he can do; but still he is an idiot, dios, 'solitarius,' alone! He cannot act on persons or things by his own free will; he cannot spontaneously will; before acting on persons he must begin on things, and as the prehension of food is one of the first voluntary acts, the master may begin to exercise the will with this. The cloth is laid; you sit down, so does he, but the dish is wanting; you take no notice; he calls the servant, "Where are the chops?" You wait, he goes to find the dish. At first it is placed on the sideboard, where he can also smell it; another day in the passage which he has passed through; finally, in the kitchen; the same with the bread, wine, &c. Next, the dish is there, but no plate, no fork, no spoon, and he is compelled in the same quiet way to exert his own thought and seek them. Thus (if his health permits) a meal may last for hours, but the time is not mis-spent if he learns to think. At a later period he must have nothing for dinner which he has not ordered in the morning, or purchased himself beforehand. Dress is another stimulus to thought,

especially as regards cleanliness; he must not walk unless he has ordered the washerwoman to send home his clean linen.

To establish his relations with persons he must have some want or wish that they can satisfy. When therefore he goes to find an object, a third person must detain it and exchange it for some other object which the child can comprehend, and which is not injurious. The simplest relations with others depend on the sentiments of property and of resistance; the inert, inoffensive idiot, incapable of defending himself, should be encouraged by innocent struggles which develop his strength and excite his confidence and courage. With regard to property, they should be taught that some things are common to all, as their water; some personal, as their clothes; some are both, as playthings; but as all have their equivalent in money they should be taught its use, among themselves; this will reveal indifference, prodigality, theft, and avarice, which should be corrected in time. The essential point is, that the idiot should cease to be isolated, that by his wants, tastes, habits, attractions, repulsions, he should establish voluntarily the most numerous relations possible with others.

The pupil has acted, perceived, and thought for some time, but he willed nothing spontaneously: he was motionless from a languor of the soul. Now his spontaneous will has been restored to him, and he has gained the energy that distinguishes man.

In conclusion, M. Séguin says that he does not regard his book as complete, but only as a commencement: two things are wanting to make the moral treatment not of idiots only, but of the insane as scientific and humane as it should be. The first is, the concurrence of men of heart; the second is, the solution of the great problem of education: this he thinks is at hand; for that society will no longer be content with mere education of the memory, or of the intellect, but will demand an education of the whole being, of all the functions of his body and the faculties of his mind, of his aptitudes, and of his artistical and moral sense; for an education of the functions such as Rabelais, Montaigne, and Rousseau indicated, does not yet exist.

On making the preliminary survey of the volume which we now close (consisting of 730 pages), there was no doubt as to the method of treating it. To be of any service to our readers it must be analysed. We have not criticised, from feeling that to criticise a plan of education which has produced such results, would be impertinence. We have therefore preferred the humbler task of clearly making out the author's meaning and giving it an English dress, and on this we have bestowed no little pains, and no little compression. Our analysis is the spirit of the book and not a literal translation.

The principle which guided M. Séguin, appears to us most sound and philosophical. His master was the celebrated Itard, by whom the idea of educating an idiot methodically was first put in practice, and to whom M. Séguin gives the credit for the first germ of his discovery. The well-known savage of Aveyron was the man whom Itard endeavoured to educate. will be remembered that this was he whom the "philosophers" of Paris, during the revolution, regarded as a true type of an unsophisticated natural man. Disbelieving the Mosaic account they imagined man was

It

created a savage, and rose by civilization to such a philosophical height as Paris then furnished. This savage from the woods was just what they wanted to prove their theory. But Itard failed in educating him. He was an idiot. And why did he fail? From the influence (says M. Séguin) of the false metaphysical system then in vogue. He and the then fashionable school imagined that the mind consisted alone of impressions on the senses. They did not recognize the existence of the mind itself. Itard therefore thought that education consisted only in the education of the senses, and he failed in making the savage a man. Séguin is a disciple of a higher school of thought. He has lived in a better period, when French materialism has been modified by German and British spiritualism. The former school asserted that there was nothing in the intellect which was not previously in the senses; the deeper thinker admits this as a halftruth only, but adds, that besides this, there is the intellect itself. The difference between the two principles is practically immense. Educate the senses and you educate the mind, say the one. M. Séguin and his school say, you do no such thing; you must, it is true, educate the senses, but if you stop there you have done nothing, you must rouse the mind itself to act; as long as it is the mere passive organ for the reception and remembrance of impressions, its human power has not been called out : the individual is not educated. But how does it act? By means of the will under the influence of the reason and moral sense. This moral will is the distinctive attribute of man: it is this which the idiot has not the power of exerting, and this deficiency makes him an idiot. To educate not merely his senses, but to rouse his free will to activity is the end of all education. Guided by this principle, M. Séguin has framed a system of education, and has successfully put it into practice. He is modest in stating the results of his plans, but we quote the following from Dr. Conolly's admirable letters on the Lunatic Asylums of Paris, published two years since in this Journal, describing his visit to the Bicêtre.

"No fewer than forty of these patients were assembled in a moderate sized schoolroom, receiving various lessons, and performing various evolutions under the direction of a very able schoolmaster, M. Séguin endowed with that enthusiasm respecting his occupation before which difficulties vanish. In all these cases the crowning glory of the attempt is, that whilst the senses, the muscular powers, and the intellect have received some cultivation, the habits have been improved, the propensities regulated, and some play has been given to his affections; so that a wild, ungovernable animal, calculated to excite fear, aversion, or disgust, has been transformed into the likeness and manners of a man. It is difficult to avoid falling into the language of enthusiasm on beholding such an apparent miracle." (British and Foreign Medical Review. Vol. xix, p. 295.)

We take leave of M. Séguin with respect and admiration. His book increases in real interest as it proceeds, and he gets into that part of his subject where he is indeed the master, and he transfers to the reader some of that warmth which he himself feels. We have a great respect for enthusiasm and enthusiasts. Nothing great, nothing heroic, nothing largely unselfish, nothing which proves that man is indeed of a divine nature, has ever been done without it. Our own Harvey and Jenner were, equally with Howard and Clarkson, driven by that inward impulse towards their mighty objects, which their duller contemporaries regarded as akin

to madness. Many enthusiasts have, it is too true, been led away by a false and delusive light, but where, as in this instance, the path is one requiring unwearied, laborious, and self-sacrificing exertion, and the result not brilliant but silently humane, there can be no doubt that the guiding beacon is not the phosphorescent exhalation of a swamp, but a light from Heaven. We have aided in handing on the torch, and may it be the means of kindling a similar flame in the heart of even one earnest man, and of leading him to the amelioration of the sad condition of the numerous idiots in this country?

ART. II.

Beiträge zur Ohrenheilkunde von Dr. WILHELM KRAMER, Sanitäts-Rath. Nebst 19 statistischen Tabellen.-Berlin, 1845.

Contributions to Ear-Medicine. By Dr. WILLIAM KRAMER, &c. 19 Statistic Tables.-Berlin, 1845. 8vo, pp. 314.

With

THE principal of these contributions, viz., the statistics of the diseases of the ear, the author tells us, are the result of fifteen years' careful observation, and are entirely practical; the utmost possible accuracy of diagnosis and simplification of treatment, the only true aims of the practitioner, having been alone kept in view. In these respects, indeed, the author wishes the present contributions to be considered as a necessary complement to his work on the Nature and Treatment of the Diseases of the Ear, published in 1836, and noticed in the number of this Review for Jan. 1837.

The materials for the statistics are 2000 cases of diseases of the ear, all of which Dr. Kramer tells us he explored, by means of the speculum auris, the Eustachian tube catheter, the air-douche, &c., and carefully registered in his journal the results thus obtained as well as all that relates to age, sex, and residence of the patient; the date of origin and causes of the disease; the existence or absence of tinnitus and other symptoms; the hearing distance for each ear; the treatment, if any, adopted before the patient's application to the author; the author's own treatment; duration, and event.

In a system of the diseases of the ear, it is, says Dr. Kramer, “my opinion that those diseases only should be admitted which, in consequence of the peculiar structure of the organ affected, and the peculiarity of its function as an organ of sense, are accompanied by such peculiar symptoms, that they are thereby distinguishable from all other diseases of the body.'

In the classification of the diseases of the ear, Dr. Kramer says he has followed that laid down in his treatise above referred to, the more decidedly, as it is founded on the very simple and natural principle of anatomical difference of the structures composing the organ of hearing; the morbid states of which, moreover, present such definite characters, that in the course of fifteen years not a single case has occurred to him which does not find its place in his system, in a natural and unforced manner.

In the present work, for the sake of more fully carrying out his principle of classification, he goes on to say, he has changed the nomenclature

of the diseases of the auricle as follows. Instead of the names erysipelatous inflammation, scirrhous degeneration and boils, he employs respectively inflammation-of the epidermis, of the dermis, and of the cellular tissue of the auricle. For the same reason, erysipelatous inflammation of the auditory passage he now calls inflammation of the epidermis of the auditory passage.

It is, doubtless, a good principle in defining and classifying diseases to make particular reference to the structure affected, but it ought not to be pushed too far. Diseases are seldom entirely confined to a single structure, and a secondary disease is often very different in its nature and even seat from the primary which gave rise to it, and cannot, therefore, well be described under the head of the latter. Dr. Kramer, we must confess, in pushing the simplicity of his system so far as he does, loses sight of these considerations, and is thus often betrayed into the very hypothetical and speculative admissions which he takes so much pains to protest against.

In substituting the name of "inflammation of the epidermis" for "erysipelatous inflammation," Dr. Kramer certainly not only pushes his principle too far, but also makes hypothetical and speculative admissions not only uncalled for by, but positively opposed to, practical utility. Everybody knows what is meant by erysipelatous inflammation; but the name inflammation of the epidermis, even if we were for a moment disposed to admit it as correct, could be admitted only as a generic not as a specific name. The name "scirrhous degeneration" Dr. Kramer was right to drop, but we reject the name he would substitute for it, inflammation of the dermis of the auricle. There are various inflammations of the dermis. The disease Dr. Kramer refers to appears to be crustaceous herpes, or an affection resembling elephantiasis. Again, the substitution of the name of "inflammation of the cellular tissue" for boils, thus doing away with the distinction between boils and abscesses, is by no means warranted. What has just been said of the substitution of the name of inflammation of the epidermis for erysipelatous inflammation in the case of the auricle, is, of course, applicable to the erythema of the skin of the auditory passage, in which accumulation of wax has its origin.

The way in which Dr. Kramer describes and arranges this same accumulation in the auditory passage, under the head of "inflammation of the epidermis of the auditory passage," illustrates the absurdity to which principles carried out to an extreme will lead.

In articles on the ear in the Numbers of this Review for Jan. 1837, and July 1839, we took occasion to refer to an opinion of Mr. Swan's, that in a great proportion of the cases commonly put down as nervous deafness, the auditory nerves are not affected; but that the deafness is owing to a thickened state of the lining membrane of the cavity of the tympanum, involving the tympanic nerves, and that the effect of Dr. Kramer's treatment of nervous deafness by means of vapours of acetic ether was more explicable according to this view of the pathology, than according to that generally received and adopted by Dr. Kramer.

We, however, remarked that perhaps the thickened state of the lining membrane of the tympanum, which Mr. Swan had observed in his dissections of the ears of habitually deaf persons, and which has also been observed