incurable; for proper treatment often ameliorates or removes these complications, and thus benefits the disease.

THIRD PART. THE EDUCATION OF IDIOTS.

In the education of the blind, and of the deaf and dumb, one sense is substituted for another: the touch instead of the sight in the blind, and the sight instead of the ear in the deaf and dumb; but idiots have senses although dormant. They hear, and do not understand; see, and do not perceive. They are thus disconnected from the outer world, and the principle involved in their education is to awaken their attention. Their senses must be roused so as to convey impressions to their brain by a system of sensorial gymnastics, and their brain must be stimulated so as to receive and to react on these impressions by intellectual gymnastics, both being combined with hygienic regimen. The result is that an idiot inferior in capacity and intelligence to domestic animals, becomes if not restored to society, at least restored to his family, his bad habits are corrected, he is more obedient, more active, in better health, and affectionate to those who have given him their affection and support. whilst others have been enabled to read, write, speak, and occupy themselves readily in many manual occupations. If rude is the result (asks M. Séguin) of a system followed up for ten years only and by one man, with limited means, may not much be hoped for when it is perfected by the experience of many?

Education consists not in improving the memory alone, but in developing all the functions of the body and the faculties of the mind. The education of the idiot should comprehend,-1. The active powers. 2. The intellect. 3. The will, that is the voluntary principle under the guidance of the enlightened conscience. (La spontanéité moralisée.) This is in order of their development. The infant moves and feels before he knows, and he knows before he has the consciousness of the morality of his acts and thoughts. The education of the active powers comprehends the training of the organs of motion and of sensation.

Education of the muscular system. The simplest apparatus is alone necessary. A table, a balance, a ladder, and dumb-bells, (or more simply, the two latter,) are alone required. Exercises demanding sudden and strong exertion are not required, but rather the constant exertion of force during a fixed time. There are no idiots who are well balanced,—all have either a preponderance of nervous excitability, or of muscular force, or are in complete atony. The education of the nervous system must therefore go hand in hand with that of the muscular, and be regulated according to the idiosyncrasy of the patient. Idiots are deficient in muscular sense. Prehension precedes standing in all children. When the idiot cannot use his hands he should be put on and in front of the ladder, held by his belt, and his hands and feet directed to mount and descend. If his hands refuse to hold the rounds, let him fall into the attendant's arms, and be again replaced. If this is not sufficient, M. Séguin makes the child mount the ladder behind, whilst he mounts in front holding its hands; every step being made slowly and surely. In descending he disengages one foot which clasps the step, with his own foot with which he guides the child's foot to the next step. He disengages one hand which by an instinct of

preservation, rapidly clasps the step below; by these means the inert muscles contract energetically, and support a weight and shocks which no voluntary exercise can accomplish. The same exercise may be repeated on the reversed ladder. As soon as the muscles of the hands have been taught by this instinct of preservation to contract, they must be applied to taking food, to useful purposes, such as handling stones, bricks, spades, wheelbarrows. Dumb-bells can then be used, and the balance (which is a bar of wood with wooden knobs at each end) in order to make the child stand still, and walk steadily. When the abdominal muscles are so weak as to prevent standing, the child may sit with his feet on a spring board, to be moved up and down. Some cannot even sit, and must be taught at first to sit still without any support. Before any regular action of the limbs can be obtained, the child must learn to stand still. To do this he may at first amuse his hands with dumb-bells, and fix his feet either in boxes, or (which he often prefers) in a round or square space drawn with chalk on the floor. By whatever means necessary, this power of standing still must be obtained, as it is an essential step in rendering the motions obedient to the mind. When the powers of motion are much impaired neither the capability of standing, or of ascending or descending can be acquired without great practice, varied according to the individual. All should be habituated to those uses of the fingers necessary to daily life, to dress, to button their clothes, to tie, to fold, to carry, to arrange, to wash, and comb, &c., and subsequently to be able to cut, to saw, to plane, to draw, to sow, plant, water, &c. The aim is not to make muscular prodigies, but to employ the muscles usefully, and for this purpose a modest system of gymnastics, and a master patient in little things, are wanted. It must be remembered that there are three kinds of defects of motion which may be met with,— one in which the muscular power is deficient; the second in which the power of the will is wanting; the third, defects of structure, as contraction or retraction. For the first, purely muscular exertions with or without the will; for the second, voluntary efforts duly regulated; and for the third, an orthopedic treatment adapted to the maimed limb.

Imitation is a powerful means of instruction. It is personal when its object is to modify the individual's own acts and habits, impersonal when it relates to his action on outward things.

Personal imitation. Those who have the faculty and in whom it is not directed contract grimaces, and tricks of expression. Such must be got rid of. The first step being to enforce muscular repose. This is done by the double operation of imitation and authority.

"A. H. was (says M. Séguin) indomitably petulant; clambering like a cat, escaping like a monkey; he could not be kept standing still for three seconds. I put him in a chair sitting opposite him, holding his feet and knees between mine; fixing his hands on his knees with one of my hands and with the other bringing incessantly before me his moveable face. We remained thus for five weeks, meal and bed-times excepted, after which he began to stand, and almost immoveably."

When immobility is obtained the exercises of imitation may be begun. The first lessons are to teach the idiot by gestures and word the parts of his own body, and their common uses. Then the difference between right and left. The next exercises are to make him move his limbs at the will

of the teacher and by simple imitation, singly and then together; to close his fists, to open his fingers; to bend the index finger whilst the others are stretched out, &c. This personal imitation is more quickly taught in classes.

Impersonal imitation. There are three kinds of exercises.

1. The idiot is to repeat exactly the movements he sees his teacher execute who places objects in use in very different positions. The teacher takes a plate and places it on the table, indicating to, or telling the child to do the same with another. He then returns the plate, and the child imitates this next places it vertically, &c., and puts it in numerous positions; and the same with a glass, a brush, a hat, and other objects

in common use.

2. Place objects of no use in certain forms, such as wooden bricks as squares, triangles, &c., to be imitated by the child.

3. Make a vertical line on a board with chalk, which the child must imitate first by moving his arm in the direction and then marking. Next, a similar line from below upwards: then from right to left and from left to right. All idiots prefer their left hand.

EDUCATION OF THE NERVOUS SYSTEM AND OF THE SENSES.

The senses are to be educated in the following order. Touch, sight, hearing, taste and smell, that is in the order in which they are awakened in the healthy child.

Education of the touch. The most injurious effects of the disordered direction of this sense is in that bad habit to which idiots are much exposed, often by discovering themselves the gratification derived from it, and not by imitating others. Some idiots have no consciousness of the sensation produced by touch, whilst others have neither the consciousness nor the sensation. In the former it is only necessary to awake the consciousness, whilst in the latter the sensation itself must be provoked before attention of the mind can be given. In the first case it is important to associate hearing and sight with touch; in the last this is useless, but the touch must be roused by energetic and varied shocks, by agents whose actions are opposite, such as heat and cold.

To educate the touch of idiots, it is often sufficient to give him things to handle and to distinguish without using his other senses. The exercises are 1, With hot and iced liquids; 2, astringent, emollient, oily fluids; 3, resisting or elastic bodies; 4, bodies which are rough, smooth, woolly, cottony, or silky; 5, heavy and light bodies; 6, bodies of the same form but of different size; 7, of varied form. They should be taught to distinguish slight differences in heat.

The education of the taste and smell. The children often abandon their senses to all the vagaries of their curiosity: nothing is too strong, or acrid, or fetid, or astringent, for their uncultivated tastes and smells. Although these senses have no direct connexion with the intellect, there can be no doubt that the harmony and due development of all functions is important. As a rule, stimulants should be avoided; but if necessary cayenne pepper, mint lozenges, or very small doses of colocynth may be used to stimulate the languid sense, and when it has produced its effect

it may be withdrawn. From these strong tastes the scale may be gradually descended to delicate ones. It is sometimes necessary to rouse the smell by long and frequent applications of ammonia or otto of roses, but in general the stronger smells are perceived.

The education of the ear. Very few are deaf, many however never listen, but in general the idiot loves and readily seizes rhythms, for the musical faculty is one of the gifts of idiots. M. Séguin has never seen idiots (except those absolutely paralysed) that did not express the liveliest pleasure at music, and he has known a great number who sang correctly though they spoke badly and with difficulty. One chanted all the vespers though he could not pronounce two words in succession. Another came out of a deep torpor during music. Another, generally torpid, experienced great pleasure in a concert; he smiled, his face became animated, his hair stood up, his fingers contracted themselves and were agitated, and his forehead and hands covered with sweat; after the last note he sank into his usual inanity. Another repeated difficult tunes after once hearing them, whose only articulate sound was papa, which he said with difficulty, imperfectly, and inappropriately.

Idiots are more alive to energetic, rapid and gay tunes, than to slow and grave ones; also to instrumental music than to vocal. The remedial influence of music has not yet been sufficiently studied by M. Séguin, to enable him to lay down rules for its application.

There are three kinds of exercises for the ear:

1. On sounds in general. The child must be taught to hear the sound of bodies falling, or of the contact of one sonorous body with another. 2. The gamut. He must be taught the differences in musical notes. 3. The voice as indicating the feelings. He should be made familiar with the expressions of joy, fear, and pain; in these exercises it may be necessary that the ear alone should be addressed, the action of the other senses being for the time suspended.

Education of speech. Some idiots are dumb from paralysis, perforated palate and deafness; but in general their muteness does not depend on want of voice, for the voice is strong; nor on the inability to articulate, as they can pronounce distinctly some words; but it consists in the few syllables or words they can pronounce not being spoken apropos, nor voluntarily, nor intentionally, and these accidental sounds having no sense. The idiot is said to be unable to speak, because he is unable to express his wants or sensations in words. This inability depends principally on two causes,-an incapacity to move at will and with ease his organs of speech, and that want of will, that repugnance to perform any spontaneous act which is the characteristic of idiotcy. The organs of voice should be carefully examined, as their structure is often anomalous,—such as defect of action of the muscles of the cheeks and lips, contraction or great width of jaws, atrophy, hypertrophy, or immobility of the tongue; great elevation or depression of the arch of the palate.

First exercise. When the child has been taught to imitate, his attention should be directed to his mouth. The index finger should be put across his lips, then horizontally, then between them, and then two or three fingers introduced into his mouth. Let him hold a ruler between his lips, if they do not contract increase its weight; if they are too far apart gradually diminish its size. Make him masticate hard food, next make him

simply imitate the motions of the lips in speaking. If there is a want of proportion between the tongue and the palate, as the latter cannot be improved, the tongue must be rendered more agile by a system of tongue gymnastics. He should be taught to move his tongue out of his mouth, up and down and sideways, keeping it some time in each position. If this cannot be done by imitation or direction, the tongue should be directed with a wooden knife or ivory spoon.

Second exercise. The next step is the development of the voice. The principle M. Séguin follows, is to observe the natural course of this development and to pursue the same. Thus children begin with sounds like pa, ma, dada, bo-bo-mi-mi; not with a vowel but with a labial consonant followed by a vowel; and they love to repeat the syllable. Such sounds, (as they are much easier, than vowels alone, or than consonants preceded by a vowel,) should form the first lessons. Even this plan must be modified according to circumstances. Some cannot make a long and pure vocal sound, and must be taught by imitation to do this before they can articulate; and in some whose lips do not contract it may be necessary to begin with linguals before labials, as the difficulty of the latter will discourage them. Two cases are given which show the method more clearly than mere rules.

A. T. a hydrocephalic child, with a high, deeply-grooved palate, talked constantly, but could not articulate. The letters he could pronounce were N, as non, which he repeated many thousand times a day, M, as ma, and P simply. He could remember and sing tunes. As he could pronounce labials, he was first made to practise them, to distinguish PA from PO, and MA from MU. From P and M he was led to B, through BO and BU. V and F were next attained by placing his under lip beneath his upper incisor, teeth, and this led to the sibilants S, CH, Z. J. By elevating the tongue anteriorly LA was pronounced, and next the labials T and D, and thence to the gutturals. He completely acquired speech.

The second instance is of a child of 13, with a small circular head, whose faculties were seriously impaired but whose voice was good. He could imitate any syllable of two letters only, but could not unite two unless they were the same repeated. Thus he could say mama, but not maman. M. Séguin first made him repeat A, following it with a syllable of two letters, as A-TA; next, A, O, which after some time he accomplished, and seizing a moment of excitement his teacher added T, so as to make it A, TO, a double articulation previously impossible, then A-DO, A-LO, &c., then the labials; next two syllables, keeping the first syllable and second vowel constant, and only changing the second vowel, as TALA, TA-BA, TA-RA. Next changing the second syllable wholly, as TABO, TA-VO; then changing the first only-then changing the vowels only. For syllables of three letters, which were next attempted, the two first were kept as constants, the last changed. The task was long and painful, but the child spoke distinctly at last.

As this part of education is the slowest and most difficult, it should not be begun until some power of imitation has been attained; and all the exercises must be practised a long time; analogous syllables must be first united, then different ones, then whole words, until those of the most difficult pronunciation are articulated. Stammering often hinders

progress. Its remedy must depend on the circumstances of the case, and