Title: The Idiot - His Place in Creation, and His Claims on Society
Author: Bateman, Frederick
Language: English
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    THE IDIOT;

    _HIS PLACE IN CREATION_,
      AND
    _HIS CLAIMS ON SOCIETY_.



    [Illustration: THE EASTERN COUNTIES' ASYLUM FOR IDIOTS AND
    IMBECILES.]



    THE IDIOT;

    _HIS PLACE IN CREATION_,
      AND
    _HIS CLAIMS ON SOCIETY_.

    BY

    SIR FREDERIC BATEMAN, M.D., LL.D.,

    _Fellow of the Royal College of Physicians_;
    _Consulting Physician to the Norfolk and Norwich Hospital, and to
      the Eastern Counties' Asylum for Idiots_;
    _Associé et Lauréat de l'Académie de Médecine de Paris_;
    _Citation de l'Institut de France_;
    _Corresponding Member of the Psychiatrical Society of St. Petersburg_;
    _Hon. Member of the New York Neurological Society_;
    _Foreign Associate of the Medico-Psychological Society of Paris_.

    _Author of "Aphasia, or Loss of Speech";
    "Darwinism tested by Language," &c._

    SECOND EDITION.

    LONDON:
    JARROLD & SONS, 10 & 11, WARWICK LANE.
    1897.



PREFACE

TO

THE SECOND EDITION.


As stated in the preface to the first edition, the arguments contained
in this essay formed the nucleus of an address advocating the claims
of the Idiot upon the philanthropists of East Anglia, at a public
meeting held in Norwich, in support of the Eastern Counties' Asylum
for Idiots, under the presidency of His Grace the Duke of Norfolk,
K.G., Earl Marshal of England.

In acceding to the request of the Board of Directors to publish a
second edition, I have thought it right to retain the form of a public
oration, as requiring less modification in the phraseology of the
appeal for help, than would otherwise have been necessary.

Much additional matter has been added, especially in reference to
Consanguine Marriages, Parental Intemperance, Overpressure in
Education, and other factors in the causation of Idiocy.

I have tried to show how the study of the Idiot is calculated to throw
light upon the abstruse question of the connection between Matter and
Mind, and that it is a subject fraught with interest not only to the
Philanthropist, but to the Theologian, and to the Political Economist.

Although I have endeavoured to explain my views in popular language, I
trust it has not been at the sacrifice of strict scientific accuracy.

                                                   FREDERIC BATEMAN.

    _Norwich,
    January, 1897._



THE IDIOT;

HIS PLACE IN CREATION,

AND

HIS CLAIMS ON SOCIETY.


As Consulting Physician to the Eastern Counties' Asylum for Idiots, it
is my privilege to advocate the claims of one of the most important
charities connected with the Eastern District of England, and which,
as such, is calculated to excite an especial interest amongst the
philanthropists of East Anglia.

The Eastern Counties' Asylum for Idiots is an institution founded
specially for the reception of patients from Norfolk and the three
other Eastern Counties, just in the same way as the Royal Albert
Asylum, at Lancaster, is intended for patients from the seven northern
counties. It is, therefore, essentially an East Anglian Charity, and I
dwell especially on this point, because, being situated at Colchester,
I think there is an impression in certain quarters, that this
institution is less intimately connected with this locality than some
other charities, the claims of which are periodically brought under
our notice. I feel that the managing body themselves have been to
blame for this impression, from having in the first instance adopted
the ill-advised name of Essex Hall--a name, however, now abandoned, as
tending to convey the impression that it was an Essex charity,
whereas, as I have before said, it is an institution intended for the
care and treatment of Idiots from the four Eastern Counties of
Norfolk, Suffolk, Cambridge, and Essex.

I have so often been called upon to plead the cause of this charity
before a Norfolk audience, that I should have preferred that some
other person had been selected to represent the Asylum at this
meeting; for when the subject of the appeal is always the same, it is
difficult to prevent one's thoughts from occasionally running in a
similar channel as on former occasions; the Board of Directors having,
however, invited me to act as one of their deputation, I acceded to
their request with the greater readiness, as it affords me the
opportunity, on the part of the authorities of the Asylum, of
expressing our grateful thanks to his Grace the Duke of Norfolk for
the honour he has done us by his presence here to-day, thus evincing
the interest he takes in the charitable institutions of the county, by
consenting to preside over a public meeting in the historical city of
Norwich.

In the few words that I shall address to you, I wish particularly to
avoid falling into the error common to many speakers--that of
exaggerating the importance of the subject they are treating. Many a
good cause has been damaged by the indiscretion of its own advocates,
who, in their undue zeal, endeavour to impress their audiences with
the notion that the particular charity for which they plead is the one
above all others that has a paramount claim on the support of a
philanthropic public. Now, I have no desire to produce a sensational
effect, or to create an artificial interest in my subject by indulging
in the language of hyperbole. I have a plain unvarnished tale to tell,
that requires no meretricious adornment to arrest your attention, for
I am here to plead the cause of an unfortunate branch of the human
family, who, by the very nature of their infirmity, are unable to say
a single word for themselves, and whose mute appeal must excite
universal sympathy.

Happily, we live in an age when the spirit of philanthropy is abroad,
and all that Christian sympathy can suggest is being done to relieve
the sick and suffering poor. Amidst all the boasted culture of
antiquity there existed no hospital; go to Athens and to Rome, those
seats of early civilization, and you will find at the former the ruins
of the Acropolis, and those of the Coliseum at the latter, but no
trace of the remains of a hospital or asylum; whereas in the present
day, hospitals and asylums are springing up in every locality, and
East Anglia is certainly no exception to the rule, abounding, as it
does, in charitable institutions of every description, the object of
which is to improve the condition of the labouring class, and to
lessen the ills that flesh is heir to; and it may truly be said, as
far as this country is concerned, that--

    "The quality of mercy is not strain'd;
    It droppeth, as the gentle rain from heaven
    Upon the place beneath; it is twice bless'd:
    It blesseth him that gives, and him that takes."

Whilst admitting all this, I maintain that there is an unfortunate
class--that of idiots--which has not hitherto received that share of
attention to which it is entitled. Why is this? Is it due to a
pampered selfishness which has chosen to draw a curtain of
indifference around this unfortunate branch of the human race? Is the
fountain of charity frozen up in East Anglia? Nothing of the kind,
and I think this apparent neglect is mainly due to a misconception as
to the nature of idiocy, and as to the amount of amelioration of which
the subjects of this unfortunate infirmity are susceptible. It is with
the view of removing this erroneous impression, that I have been
requested to say a few words to you about idiocy, from a scientific
point of view, my desire being to instruct the mind of the public as
to the nature and character of the evil to be contended with, as to
the probability of alleviating it, and as to the means best adapted to
the attainment of this object.

In the few remarks that I shall make, I hope to show you that the
study of idiocy is fraught with interest, not only to the man of
science and the philanthropist, but to the political economist, the
statesman, and the theologian. If it be asked what possible connection
there can be between theology and idiocy, I would say, that if time
permitted, I could show that the study of the nature and attributes of
the idiot has a striking bearing on the much-disputed question of the
connection between matter and mind, and also that it points to a
conclusion directly opposed to the materialistic tendencies of the
day.



DEFINITION OF IDIOCY.


Great confusion exists in the public mind as to the nature of idiocy.
What is an idiot? Dr. Séguin, a celebrated writer on this subject, has
described idiocy as a "specific infirmity of the cerebro-spinal
centre," a definition which I need not say applies to a variety of
infirmities to which flesh is heir, and such a definition only serves
as a cloak for ignorance. Shakespeare, that wonderfully accurate
observer of human nature, in several of his dramas has given a very
good description of the acts of the idiot, who, he says, is "one who
holds his bauble for his God;" and again, as "one who tells a tale
full of sound and fury, signifying nothing." But neither he nor the
psychologists of his day knew enough of the natural history of the
idiot to attempt a logical definition.

As I have spent a great deal of time in the investigation of obscure
points of cerebral pathology, of course the question of the idiot has
not escaped my attention, and I submit the following definition:--

An idiot is a human being who possesses the tripartite nature of
man--body, soul, and spirit, σωμα, ψυχη, πνευμα, but who is the
subject of an infirmity consisting, anatomically, of a defective
organisation and want of development of the brain, resulting in an
inability, more or less complete, for the exercise of the
intellectual, moral, and sensitive faculties. There are various shades
and degrees of this want of development, from those whose mental and
bodily deficiencies differ but slightly from the lowest of the
so-called sound-minded, to those individuals who simply vegetate, and
whose deficiencies are so decided as to isolate them, as it were, from
the rest of nature.

Dr. Langdon Down[1] divides Idiocy into three primary groups:
Congenital, Developmental, and Accidental. The Congenital includes all
cases which at the period of birth manifest signs of the defective
mental power. The Developmental group includes cases where the child
manifests an average intelligence through infancy, but he is born with
a proclivity to a mental break-down during one of the developmental
crises, such as the first dentition, the second dentition, and
puberty; the brain and nervous power are sufficient for their early
years, but are insufficient to carry them through evolutional stages.
The Accidental group includes cases where the child has been born with
a normal nervous system, when unfortunately a fall, a fright,
epilepsy, or some other cause may lead to a mental break-down, not of
a genetic, but of a purely accidental origin. The various forms of
idiocy are described in minute detail by Dr. Ireland,[2] to whose
classical work I would refer those who may desire further information
on this subject.

The first idiot that attracted the attention of scientific men was
looked upon as a savage man, and every treatise on the subject
contains some allusion to the so-called savage of the Aveyron, who
excited so much curiosity, speculation, and interest among the
psychologists of Paris in the early part of the present century.

In old books on medical nomenclature idiocy was classed amongst the
varieties of insanity, and the visitor to a lunatic asylum half a
century ago, would find the idiot skulking in the corner of a
courtyard chained to a staple, and lying on a litter of straw; in
fact, he was considered and treated more like a wild beast than a
human being. He had but little talent given, and by neglect or abuse
that little was lost; until, growing more and more brutal, he sank
unregetting and unregretted into an early grave, without ever being
counted as a man. Now, idiocy is not a form of insanity, and it is
most important that no confusion should exist in the public mind upon
this point, as the association of idiots and insane patients in the
same asylum is a positive disadvantage to both classes. It is always a
painful thing to see idiot children, whose mental faculties and
physical powers, as I shall presently show, are capable of much
development and improvement, wandering, without object or special
care, about the wards of a Lunatic Asylum. They cannot receive there
the training and supervision they specially require, and they often
seriously interfere with the comfort of the other inmates, and meet in
return, with ridicule and unkindness; moreover, their presence is a
serious obstacle to the complete recovery of convalescent lunatics. I
desire especially to press this point upon the legislators of the
country, and, as in this county, our union houses are far too large
for the requirements of the age, I would suggest that one or more of
them might, with advantage, be devoted to the care and treatment of
pauper idiots.[3]

Insanity is a loss more or less complete of faculties formerly
possessed, it consists of a perturbation of the mental faculties after
their complete development, it begins with average intelligence which
gradually diminishes; whereas idiocy begins with a low amount of
intelligence, which, in many instances, gradually increases; the
difference has been thus beautifully described by a French
psychologist, "_L'homme en démence est privé des biens dont il
jouissait autrefois, c'est un riche devenu pauvre. L'idiot a toujours
été dans l'infortune et la misère._" (The man that is mad is deprived
of possessions which he formerly enjoyed, it is a rich man become
poor; whereas the idiot has always been in misfortune and misery.) The
distinction between the idiot and the insane is clear and marked. The
madman suffers from abnormal development of brain, the idiot from an
ill-developed brain--the mind of the madman is not in proper balance,
in the idiot it is not in proper power.

The poor idiot (the word being derived from the Greek ιδιοτης[4]) is
alone in the world; isolated as it were from the rest of nature, he
sees but does not perceive, he hears but does not understand or
appreciate; the organs of sight and hearing may be perfect and yet
useless; the impressions formed upon the optic and auditory nerves are
duly transmitted to the sensorium, but no idea is there excited; he
cares for nothing, and is alike indifferent to the grandeur as to the
beauties of Nature; he stands unmoved at the thunder clap, the foam of
the rushing cataract, or the roar of the mighty ocean; he heeds not
the hum of the insect world or the song of the early lark, that winged
chorister of the air; the star-bejewelled canopy of heaven, the
mountain landscape lighted up with all the purple splendour of the
setting sun, all these are nothing to him--he is a soul shut up in
imperfect organs.

FOOTNOTES:

[1] See an interesting article on Idiocy, by Dr. Langdon Down,
"Quain's Dictionary of Medicine." Vol. I., p. 926.

[2] "Idiocy and Imbecility," by W.W. Ireland, M.D. P. 36.

[3] I am glad to find that this question of the depletion of our
workhouses is engaging the attention of Boards of Guardians, as shown
by a meeting lately held in Norwich, to consider the propriety of
reducing the number of workhouses in the district. At this conference,
which was attended by delegates from various unions, Mr. Bartle H.T.
Frere stated that the Aylsham workhouse, originally built for 619
persons, had never had more than 117 inmates during the past eleven
years; and that in other unions, not more than a quarter of the actual
workhouse accommodation was utilized, although a complete staff of
officials was kept in each union. Mr. Frere pointed out the folly of
keeping up such elaborate machinery, for such totally inadequate
results, and that an enormous saving would be effected by the
amalgamation of two or more unions for the purpose of housing their
pauper population.

[4] This term is applied by the Greek writers to a person unpractised
or unskilled in anything--one who has no professional knowledge,
whether of politics or any other subject, and it seems to have
corresponded with our word layman; thus, Thucydides, in describing the
plague that broke out at Athens during the Peloponnesian War, in
speaking of a physician and a layman, uses the phrase ιατρος καἱ
ἱσιωτης; Plato also uses the word in the same sense (Legg. 933 D), and
the same author, in contrasting a poet with a prose-writer, uses the
phrase, "εν μéτρω ὡς ποιητης, ἡ ἁνευ μéτρου ὡς ιδιωτης" (Phaedr. 258
D). I doubt very much the appropriateness of the word idiot as applied
to these unfortunate creatures, and I think the American term of
Feeble-minded more correctly represents their condition.



CAUSES OF IDIOCY.


It will be utterly impossible in the short time allotted to me, to
enter at any length upon the various causes of idiocy, a study of
which is, however, fraught with many a useful lesson. Suffice it to
say that as the cause is always antecedent to any personal history of
the child, idiocy is never dependent on the idiot himself, who has
never become so through any vices of his own; he being in many
instances the feeble expression of parental defects, and sometimes of
parental vices, and is therefore more an object for commiseration than
certain lunatics, who, in many instances, have become so through
faults of their own. As to the social aspect of idiocy, it recognises
no distinction of rank; it may occur in the homes of the affluent, or
in the hovels of the most indigent. It is found in all civilised
countries, but it is not an evil necessarily inherent in society, and
is the result of the violation of natural laws, in some way or other,
and at some time or other, and the effect may not show itself for two
or three generations. A very large class of persons ignore the
conditions upon which health and reason can co-exist; they pervert the
natural appetites of the body, and the natural emotions of the mind,
and thus bring down the awful consequences of their own ignorance upon
the heads of their unoffending children.

Idiocy may be a congenital infirmity, or may be developed in early
infancy. In the first category, the cause must necessarily be traced
to intra-uterine life, and must be sought for in the history of the
parents; in the second class, the cause may sometimes depend upon
parental defects, and sometimes is due to a cerebral affection
occurring soon after birth, but even in this class of cases,
hereditary predisposition must be considered as a powerful factor in
the genesis of the disease. In fact, the development of idiocy,
whether congenital or otherwise, is in most instances to be attributed
to an hereditary morbid vice, and it is one of the most common and
striking forms of the degeneration of the human species.

Hereditary tendencies have much to do with the development of physical
defects and bodily ailments, and this result is especially apparent
in diseases of the nervous system; and there can be no doubt that
heredity is a potent factor in the production of idiocy. Dr. Ireland
says, "idiocy is, of all mental derangements, the most frequently
propagated by descent;" and the statistics of Ludwig Dahl, of
Christiana, showed that fifty per cent. of idiots had insane
relations, those of Dr. Fletcher Beach showed a history of hereditary
predisposition in 76 per cent., whilst those of Moreau, of Tours, give
a proportion as high as 90 per cent.

In thus expressing myself, I should be sorry that my remarks should be
construed as intended to cast any imputation upon those who have
unfortunately an idiot in their family; the cause of the evil may be
in some remote progenitor, for the transmission of the infirmity is
not always direct, and the neurotic tendency may skip a generation, or
be traced even further back.


_Intemperance._ One of the most fruitful causes of idiocy is the
_abuse_--mark, I do not say the _proper use_--of alcoholic stimulants,
which tends to bring families into a low and feeble condition, which
thus becomes a prolific cause of idiocy in their children. From a
report on idiocy, by Dr. Howe and other Commissioners appointed by the
Governor of Massachusetts to ascertain the causes of this calamity in
that State, it is stated that "out of 359 idiots, the condition of
whose progenitors was ascertained, 99 were the children of inveterate
drunkards;" and the report goes on to say further, "that when the
parents were not actually habitual drunkards, yet amongst the idiots
of the lower class, not one quarter of the parents could be considered
as temperate persons. From a table drawn up by the late Dr. Kerlin, an
American physician, in which the causes of the infirmity are given in
100 cases of idiotic children, I observe that in 38 of the number,
intemperance on the part of the parents is traced as an accessory,
main, direct, or indirect cause.

At the annual meeting of the British Medical Association, held at
Cambridge, Dr. Fletcher Beach read a paper on the Intemperance of
Parents as a predisposing cause of idiocy in children. In 430
patients, he was enabled to trace a history of parental intemperance
in 138 cases, or 31·6 per cent.; of this number, 72 were males and 66
females."[5]

Other observers lay less stress upon parental intemperance as a cause
of idiocy. Dr. Wilbur found that out of 365 cases in the State of
Illinois, only eight cases were assigned to the abuse of drink in the
parents; and Dr. Shuttleworth could trace this cause in only 16·38 per
cent. of the cases observed by himself and by Dr. Fletcher Beach;[6]
the same writer, under the head of toxic idiocy, mentions the case of
an idiot boy, who was said to have been brought up on porter instead
of milk. It will therefore be seen that there exists a great
difference of opinion about the influence of intemperance of the
parent in the causation of idiocy; but although statistics may vary
upon this point, there cannot be a doubt that the children of drunken
parents inherit an unhealthy nervous system, which in many cases
culminates in idiocy.

Idiocy is especially prevalent in Norway, and Ludwig Dahl, a Norwegian
writer, says that to the abuse of brandy, especially in the fathers,
but also in the mothers during pregnancy, may be assigned an
important, perhaps the most important, influence in the production of
the large number of idiots in that country.

In considering this question, we must bear in mind that intemperance
is only a relative term; for in the early part of the century we read
of our ancestors indulging in a bottle of port wine to each
individual, without, it seems, incurring the charge of drunkenness.
There cannot be a doubt, however, that the habitual use of alcohol,
without being carried to the extent of actual intoxication, is
calculated to cause a low and feeble condition of the body, and thus
conduce to the production of idiocy in the offspring; for we may
fairly assume that what too severely tries the nervous system in one
generation will appear in their descendants.[7] Without, therefore,
exaggerating the influence of alcohol on the genesis of idiocy, I
think I shall not be deviating from the path of strict scientific
accuracy, if I say that over indulgence in alcoholic beverages is
calculated to produce a low state of vitality, and a degeneration of
nerve tissue which may culminate in the development of idiocy in
subsequent generations.[8]

Just now that the attention of the Legislature is being prominently
called to the treatment of habitual drunkards, it cannot be too widely
known that their innocent offspring are but too frequently the victims
of the brutish excesses of their parents, who, a few years ago, were
well described by the then Secretary of State for the Home Department,
when receiving a deputation on the subject, as not quite criminals nor
quite lunatics, although nearly approaching both classes in many
cases. The above statistics fully corroborate the pertinency of Lord
Cross's remarks.

I do not allude to these facts with the view of casting any reflection
upon the poor, honest, and temperate East Anglian labourer, who may be
afflicted with the calamity of having an idiot child; but I merely
mention them in order that they may serve as an additional caution
against habits of intemperance, and may strengthen the hands of that
noble band of philanthropists who are endeavouring to check the
torrent of this hideous vice so prevalent in the present day.

_Consanguine Marriages._ There is no point connected with the
causation of idiocy that has given rise to so much controversy as the
marriage of near relations; formerly one of the most popular notions
was that consanguineous marriages were among the most common causes of
idiocy, whereas the researches of later observers have tended to
modify, to a considerable extent, this sweeping assertion.

Different observers have furnished different results, as to the
proportion of idiots found to be the offspring of consanguine
marriages; thus Dr. Grabham's statistics give the proportion as about
2 per cent., Dr. Langdon Down's rather more than 5 per cent., and Dr.
Shuttleworth's less than 5 per cent. The statistics of the Eastern
Counties' Asylum, kindly supplied to me by Mr. Turner, the Resident
Superintendent, show that about 6·5 per cent. were the offspring of
cousins.

Of 359 cases observed by Dr. Howe, 17 were known to be the children of
parents nearly related in blood. The history of these 17 families, the
heads of which being blood relatives intermarried, showed that there
were other causes to increase the chances of an infirm offspring,
besides that of intermarriages, as most of the parents were
intemperate or scrofulous; some were both the one and the other. There
were born unto them 95 children, of whom 44 were idiotic, 12 others
were scrofulous and puny, one was deaf, and one was a dwarf! In one
family of 8 children, 5 were idiotic.[9]

Dr. Ireland, who has investigated this point with great minuteness,
pertinently remarks that it has been the custom to collect instances
of cousins who have married, and have had unhealthy children, as if
this never happened to anyone else; and he adds that "the proper way
to examine the question clearly, is to find what is the proportion of
marriages of blood relations in a given population, and then to
inquire if there be in the issue of such marriages a larger percentage
of insane, idiotic, or otherwise unhealthy children."[10]

There cannot be a doubt that consanguinity has hitherto been
considered too great a factor in the production of idiocy, and that in
weighing the evidence, we must not lose sight of the fact that in many
cases recorded, other factors beside intermarriage of relatives have
contributed concurrently to the development of the mental defect.[11]


_Educational Overpressure._ There is one cause of idiocy which has
been pointed out by Dr. Séguin, and which he says is due to the
unsatisfactory social conditions under which women of the present day
exist. "As soon," he says, "as women assumed the anxieties pertaining
to both sexes, they gave birth to children whose like had hardly been
met with thirty years ago."[12]

Great prominence has lately been given to this subject by an oration
on "Sex in Education," by Sir James Crichton Browne, at the Medical
Society of London, in which he called attention to the "growing
tendency to ignore intellectual distinctions between the sexes, to
assimilate the education of girls to that of boys, and to throw men
and women into industrial competition in every walk of life."
Elsewhere, he adds, that "to throw women into competition with men is
to insure to them a largely increased liability to organic nervous
disease.... Woe betide the generation that springs from mothers
amongst whom gross nervous degenerations abound." Sir J.C. Browne
supports his views by showing that there are organic cerebral
differences between men and women, and that therefore they must be
educated in different ways, being destined to play different parts on
the stage of human life.[13]

The above views of Sir J.C. Browne have not remained unchallenged, and
the eminent psychologist has found uncompromising opponents in Mrs.
Garrett Anderson and others, who stoutly refuse to recognise the
position of the "_Tacens et placens uxor_" of old-time dreams. Mrs.
Anderson, who, I need scarcely add, writes most temperately upon this
matter, in alluding to Sir J.C. Browne's assumption of the
intellectual difference between men and women, remarks, "All I would
venture to say is that, if it could be proved that an average man
differs from an average woman as much as Newton differed from a
cretin, it would still be well to give the cretin all the training
which he was capable of receiving.... When we hear it said that women
will cease to be womanly if they enter professions or occasionally
vote in parliamentary elections, we think that those who conjure up
these terrors should try to understand women better, and should rid
themselves of the habit of being frightened about nothing."[14]

The limits of this essay will not permit me to dwell at any great
length on the important question under consideration. There cannot be
a doubt that the tendency of the present age is to encourage women to
choose careers and to accept burdens unfitted for them. In thus
expressing myself, I distinctly deprecate any hostility to the woman's
movement of the present day, which rests on the claim for women for an
open career; and I should be glad to see our universities ignore the
ancient and exploded prejudices, which led to the long subjection of
women to hardship and inequality. They ask for the same facilities as
are enjoyed by men, and they have amply shown that they can compete
with men in intellectual pursuits, and all they ask is to be allowed
to compete on equal terms. I therefore cordially welcome the gradual
emancipation of women from comparative subjection to comparative
freedom; but the multifarious fields of energy and usefulness open to
modern women, have brought with them disadvantages as well as gains.

Whilst, therefore, unreservedly admitting the claims of the _fin de
siècle_ woman to freedom of action and to intellectual equality, I
must think there are certain branches of study, described by a modern
writer as belonging to the "gynagogue" class, which are less suited to
women than some others; and amongst these, I would name the abstruse
study of mathematics, for although success in this branch of knowledge
may lead to a brilliant career as a high wrangler, I think that a
female mathematical athlete is not suited for the duties and
responsibilities of maternity, and that the mental endowments of her
children are likely to be below the average.

I am quite aware that I am treading on dangerous and delicate ground,
but although I would not discourage the highest aspirations of women,
whether of an intellectual, social, or æsthetic character, I must
think that a word of caution is necessary against the overpressure of
the present day in the direction above indicated.[15] With every
desire to treat this question from a liberal point of view, I desire
to emphasise the fact that men and women have different parts to play
on the stage of life, and should be trained differently; but provided
mental overpressure is guarded against, I have no fear of women
engaging in certain occupations which custom has not hitherto
recognised as feminine, and experience has shown us that they may be
safely left to follow the promptings of their own powers and
instincts.

       *       *       *       *       *

Amongst the various other predispositions to idiocy, I would mention
scrofula, which, according to Dr. Ireland, is the remote cause of
two-thirds of all cases; phthisis and epilepsy in the parents are also
potent factors in the development of idiocy in their offspring.

       *       *       *       *       *

Before quitting the question of the cause of idiocy, I should like to
say a word or two about what is technically called its histology and
its pathological anatomy. What is there in the brain that makes one
man a senior wrangler and another an idiot? What is it that unfits one
person for the discharge of the ordinary duties of domestic and social
life, and endows another with capacities adapted for a statesman, a
mathematician, or a philosopher? Is it a defect in the quantity or in
the quality of the nervous matter of the brain? Does it depend on a
malformation of the cranium, on the size or shape of the head? does
the form of a cranium illustrate the quality of the mind whose
cerebral substratum it encloses, or can genius of a high order
enshrine itself in a comparatively narrow and malconstructed
tenement?[16] Does mental capacity depend on the size or weight of the
brain, or on the degree of complexity of the cerebral convolutions, or
on their symmetry in each hemisphere?[17] Upon this point, I am bound
to tell you that science speaks with a somewhat uncertain sound,
volumes having been written upon it without any definite solution or
tangible result.

An eminent Italian psychologist, Dr. Mingazzini, in a recent work on
the study of the cerebral convolutions, shows that in men of genius,
the brain offers no certain indications of intellectual eminence,
either by the greater richness of the frontal or the parietal lobes;
and in support of this opinion he cites the researches of Wagner,
which showed that, in the development and richness of the
convolutions, the brains of many celebrated Gottingen professors were
inferior to those belonging to individuals of low intellectual
capacity.[18]

The average brain weight in man may be said to range from 40 to 52-1/2
ounces, and in women from 35 to 37-1/2 ounces; the question of the
increase in size and weight of the brain, in proportion to
intellectual power, is by no means determined; statistics exist of the
weight of 23 eminent men, the list being headed by Cuvier, the
naturalist, whose brain weighed 64-1/2 ounces, whilst that of the
orator, Gambetta, weighed only 39 ounces, being much below the average
weight in the adult male; an imbecile died at the Montrose Asylum,
whose brain weighed 63 ounces, and the heaviest brain on record, which
weighed 67 ounces, was that of a bricklayer, who could neither read
nor write; it must therefore be conceded that no definite statement
can be made as to the relation that brain weight has to
intelligence.[19]

It was formerly supposed that idiots always presented some obvious
malformation of the cranium or skull. This is by no means necessarily
the case; one of the most remarkable cases of idiocy that has come
under my notice was that of a child with a well-formed head,
remarkably handsome face, and a well-proportioned body.

Dr. Ireland says, "the principal anomalies met with in the skull of
genetic idiots are flatness of the head behind, a rapid
slope of the clivus, an osseous rim round the foramen magnum,
unsymmetrical size of the cavities on each side, irregularities in the
wings of the sphenoid, and differences in the size and shape of the
jugular and other foramina; but these appearances are not constant,
and often the skull is quite regular, both in structure and
capacity."[20]

One of the most noted writers on the subject, after stating that a
number of scientific men had spent thirty years in measuring and
weighing the heads of idiots, sums up their conclusions as follows:--

1st. There is no constant relation between the development of the
cranium and the degree of intelligence.

2nd. The dimensions of the anterior part of the cranium, and
especially of the forehead, are, at least, as great among idiots as
others.[21]

3rd. Three-fifths of idiots have larger heads than men of ordinary
intelligence.

4th. There is no constant relation between the degree of intelligence
and the weight of the brain.[22]

5th. Sometimes the brain of idiots presents no deviation in form,
colour, and density from the normal standard; it is, in fact,
perfectly normal.

After such a statement as this, I can readily imagine that some of you
may say, it seems to us that you doctors really know but little about
the genesis of idiocy. I am afraid this is, to some extent, true. We
are only on the threshold of inquiry, and science of to-day is unable
to bridge over the gulf that separates matter from mind.

Modern investigation, however, does not quite bear out the above
sweeping statements in their integrity, although the most conflicting
theories have been enunciated. Doubtless, attention has been too much
concentrated on the gross morphology of the brain, without taking into
account microscopical appearances. Dr. Shuttleworth, in giving the
result of his long experience at the Royal Albert Asylum says, "We
have occasionally found, when least expected, extraordinary defects in
brain conformation;... microscopic examination will discover in many
instances some abnormality of structure, such as the preponderance of
simply formed braincells devoid of processes, denoting persistence of
fœtal structures; or, on the other hand, degenerative changes
resulting from inflammatory atrophy."[23]

Professor Luys, of Paris,[24] gives the result of the examination of
the brain of 14 idiots, the anomalies observed being want of symmetry
in the frontal lobes, and partial atrophy of the cortical folds
especially of the frontal convolutions.[25]

Quite recently, Dr. Andriessen, at a meeting of the Leeds and West
Riding Medico-Chirurgical Society, exhibited specimens of the brains
of epileptic idiots, which showed conditions of microgyria with
atrophy and sclerosis of the convolutions.

In considering the pathology of idiocy, I think sufficient attention
has not been given to the chemical constitution of the cerebral
substance. The most extravagant notions were at one time prevalent as
to the rôle played by phosphorus in the animal economy; the Dutch
naturalist, Moleschott, maintaining that "without phosphorus there was
no thought." A celebrated chemist, Couerbe, also considered
phosphorus to be the exciting principle of the brain, and according to
him, the brain of ordinary men contained 2-1/2 per cent. of
phosphorus, that of the idiot 1-1/2, and that of the madman 4 to
4-1/2; from these data he concluded, "that the absence of phosphorus
in the brain reduced man to the condition of the brute; that a great
excess of this element irritated the nervous system and plunged the
individual into the frightful delirium which we call madness; and that
a medium proportion re-established the equilibrium and produced the
admirable harmony which is none else than the soul of the
spiritualists."[26] Professor Janet, in criticising the above theory,
remarks that the brain of fishes, who do not pass for great thinkers,
contains a large amount of phosphorus, also that the statistics of M.
Lassaigne have shown that the brain of madmen does not contain more
phosphorus than that of sane individuals.[27]

The late Bishop of Carlisle, in rebutting this phosphorus theory,
remarks, "Why should we not go further and assert that there could be
no thought without carbon or without any other element of which the
human body is composed; for you can have no actual thought without a
living creature, and no living creature without a body, and no body
without carbon."[28]

I have treated the subject of the Chemistry of the Brain at
considerable length in my treatise on "Aphasia and the Localisation of
Articulate Language," to which book I would refer those who desire
further information in reference to the connection between the amount
of phosphorus and intellectual vigour.

FOOTNOTES:

[5] The question of the influence of alcoholic stimulants on the
development of mental disease formed a prominent feature in the
proceedings of this congress, and it is also a subject which is just
now engaging the attention of pathologists in all parts of the world.

[6] "Mentally-deficient Children, their treatment and training." By
G.E. Shuttleworth, M.D. Page 36.

[7] Toussenel, a French writer, says "La plupart des idiots sont des
enfants procréés dans l'ivresse bacchique. On sait que les enfants se
ressentent généralement de l'influence passionelle qui a présidé à
leur conception." At a discussion at the Obstetrical Society, Dr.
Langdon Down is reported to have entertained similar views.

[8] I would refer those who may wish to pursue the inquiry as to the
baneful influence of alcohol on the human frame, to the celebrated
Cantor Lectures on Alcohol, by my friend Sir B.W. Richardson, in which
he introduces the physiological argument into the temperance cause,
asserting that alcohol cannot be classified as a food; that
degeneration of tissues is produced, that it neither supplies matter
for construction nor production of heat, but, on the contrary,
militates against both. Sir B.W. Richardson's latest views upon this
subject are developed in the pages of the "Hospital" for February 1st
and March 14th, of this present year.

In France, M. Lunier, Inspector of Asylums, has shown that the
departments in which the consumption of alcohol had increased most,
were those in which there had been a corresponding increase of
insanity, and this was shown most strikingly in regard to women, at
the period when the natural wines of the country gave way to the
consumption of spirits.

In Sweden, Dr. Westfelt has lately made a communication to the
Stockholm Medical Society, containing the statistics of alcoholic
abuse and its results in Sweden. He calculates that at least from 7 to
12 or 13 per cent. among males, and from 1 to 2 per cent. among
females, of all cases of acquired insanity, are due to the abuse of
alcohol; and in reference to its influence on progeny and race, he
shows that a steady diminution of the population was coincident with a
period when drunkenness was at its greatest height.

[9] "On the Causes of Idiocy." By S.G. Howe, M.D. Page 35.

[10] "Op cit," page 19.

[11] That eminent clinical observer, the late Professor Trousseau, in
treating of the influence of consanguine marriages, gives the history
of a Neapolitan family, in which an uncle married his niece. There had
previously been no hereditary disease in the family; of the four
children, the issue of this marriage, the eldest daughter was very
eccentric; the second child, a boy, was epileptic; the third child
very intelligent; and the fourth was an idiot and epileptic. "Clinique
Médicale de l'Hôtel-Dieu de Paris." Tome ii., page 87.

[12] "New Facts and Remarks concerning Idiocy," by E. Séguin, M.D., p.
28. Dr. Séguin has been a voluminous contributor to the literature of
Idiocy, and for many years his writings were the only available source
of information on the management and education of idiots.

[13] Sir J.C. Browne, in speaking of the brain of men and women, says
there can be no question of inferiority or superiority between them
any more than there can be between a telescope and a microscope; but
they are differentiated from each other in structure and function, and
fitted to do different kinds of work in the world. He maintains that
the weight of the brain is less in women than in men, that the
specific gravity of the grey matter is less, that the distribution of
the blood varies in the two sexes to a considerable extent, and that
the blood going to the female brain is somewhat poorer in quality than
that going to the male brain, and contains four millions and a half
corpuscles to the cubic millimetre, instead of five millions in the
case of the male.

[14] It seems that one of their own sex is of a different opinion, as
in a series of articles in the "Nineteenth Century" for 1891 and 1892,
Mrs. Lynn Linton strongly deprecates any departure from the
comparatively restricted area of usefulness hitherto open to women,
and she even baldly states that it is for maternity that women
primarily exist! She also adds, "be it pleasant or unpleasant, it is
none the less an absolute truth--the _raison d'être_ of a woman is
maternity ... the cradle lies across the door of the polling booth and
bars the way to the senate."

In a powerful article in the same serial, entitled "Defence of the
so-called Wild Women," Mrs. Mona Caird severely criticises Mrs. Lynn
Linton's views as to the restrictions she would impose upon the
freedom of women to choose their own career.

[15] Although the injurious effects of overpressure in education have
been principally referred to in the education of girls, the same
pernicious results may accrue in the case of boys. Dr. Wynn Westcott,
in his work on "Suicide," states that during the last few years there
have been several English cases of children killing themselves because
unable to perform school tasks. He also says that child-suicide is
increasing in England and in almost all Continental states, and that
the cause in many cases is due to overpressure in education. Dr.
Strahan, writing upon the same subject, in his treatise on "Suicide
and Insanity," corroborates Dr. Westcott's views, and remarks that
fifty years ago, child-suicide was comparatively rare; but that during
the last quarter of a century it has steadily increased in all
European states, and that the high-pressure system of education is
generally considered as the cause of it.

If any apology be needed for dwelling at such length on the evils of
the educational overpressure so prevalent in our days, I would observe
that it has an indirect bearing upon the causation of idiocy; for
although the sinister results recorded by Drs. Westcott and Strahan
may be comparatively rare, still, consequences of a more remote
character may ensue, for the injury done to the nervous system is
cumulative and transmissible from generation to generation, and a
neurotic tendency may be engendered in the offspring of those who have
been exposed to this evil, which may manifest itself in the appearance
of idiocy or some lesser form of mental defect.

[16] One of the most distinguished French psychologists, has thus
expressed himself on this point--"Dans des réunions ou l'idiotisme
étendait son triste niveau, il m'est arrivé plusieurs fois de
rencontrer des crânes, qui dans leur partie frontale eussent fait
honneur aux hommes les plus justement célèbres, et où l'on eût pu
trouver avec avantage les organes de toutes les sortes d'esprit, de
celui même qui apprend à rire des mystifications et des sots."--_Rejet
de l'Organologie Phrénologique_, par F. Lelut, p. 196.

[17] Dr. Wilmath, of the Pennsylvania Institution for Feeble-minded,
reports that in six brains the island of Reil was exposed through
defective development of the 3rd frontal convolution; in four cases,
on both sides; in two cases, on one side only.--_Notes on the
Pathology of Idiocy._

[18] Il Cervello in Relazione con i Fenomeni Psichici. Studio sulla
morfologia degli emisferi cerebrali dell'uomo, Torino, 1895. P. 89.

This is a work of great merit, in which the author compares the
structure of the brain of man with that of other primates; he then
treats of the morphology of the brain in different races, in
criminals, in the insane, in deaf mutes, and in microcephales. An
extremely interesting chapter is that devoted to the assumed
difference of the cerebral hemispheres in the two sexes, containing
statistical tables constructed by Dr. Mingazzini himself and others.
Although he mentions certain minor differences that have been noticed
by different observers, he summarises his own opinion by the statement
that, "from the numerous but incomplete observations upon this
subject, it may be concluded with certainty that essential differences
do not exist" (si può inferire quasi con certezza che differenze
essenziali non esistono).

[19] Further information as to brain weight and cranial capacity, will
be found in the author's treatise on "Aphasia and the Localisation of
Articulate Language," chapter xii. (_Prize Essay of the Academy of
Medicine of France._)

[20] Op. cit., page 64.

[21] The attention of the medical profession has lately been called to
the obstetric aspect of idiocy, and I would refer those who take an
interest in this subject to the valuable statistics of Dr. Langdon
Down, which contain the result of his inquiries into the history of
2,000 cases of idiocy that have come under his observation; from which
it would seem that primogeniture plays an important part, as no less
than 24 per cent. of all the idiot children observed were primiparous.
The increased difficulty of parturition seemed to be an important
factor. In reference to the use of the forceps in delivery as an
assigned cause of idiocy, Dr. Down says, "there is no evidence that
instrumental interference has any injurious influence on the mental
condition of the children, but he thinks that those who delay the use
of the forceps incur a much greater risk from the prolongation of
pressure, resulting in suspended animation, which condition should be
especially avoided. Of Dr. Down's 2,000 cases, the ratio of males to
females was 2·1 to 0·9. This was probably due to the larger size of
the head giving rise to the prolonged and difficult parturition,
continued pressure, and suspended animation."--_Obstetrical Journal_,
vol. iv., p. 681.

[22] Dr. Hammond, Professor of Diseases of the Nervous System at
Bellevue College, New York, has published some interesting statistics
in reference to the relative weight of the brain, as compared with
that of the body, in various classes of vertebrate animals, by which
he shows that there is no definite relation between the intelligence
of animals and the absolute or relative size of the brain. Thus, he
says, "the canary bird and the Arctic sparrow have brains
proportionately larger than those of any other known animals,
including man, and yet no one will contend that these animals stand at
the top of the scale of mental development. Man, who certainly stands
at the head of the class of mammals, and of all other animals, so far
as mind is concerned, rarely has a brain more than one-fiftieth the
weight of the body, a proportion which is much greater in several
other mammals, and is, as we have seen, exceeded by many of the
smaller birds."

[23] Clinical Lecture on Idiocy, p. 14.

[24] L'Encéphale, March 1881, p. 82.

[25] At a meeting of the Medico-Psychological Society of Paris, my
friend M. Auguste Voisin exhibited plates of the brains of idiots who
had only begun to speak at the age of from three to five years, in
which the frontal and first parietal convolutions were rectilinear
without secondary folds, resembling the fœtal condition of the
convolutions at the sixth month of intra-uterine life.

[26] The imagination of certain psychologists seems to have gone
rampant upon this subject; one writer, M. Moreau, of Tours, maintained
that genius was a nervous disease--"le génie est une névrose"; and in
order that there may be no mistake about his meaning, he adds that
"the constitution of many men of genius is in reality the same as that
of idiots!" M. Moreau's doctrine may thus be summarised in his own
words--"Les dispositions d'esprit qui font qu'un homme se distingue
des autres hommes par l'originalité de ses pensées et de ses
conceptions, par son excentricité on l'énergie de ses facultés
affectives, par la transcendance de ses facultés intellectuelles,
prennent leur source dans les mêmes conditions organiques que les
divers troubles moraux, dont _la folie et l'idiotie_ sont l'expression
la plus complète."

[27] Le Cerveau et la Pensée, par Paul Janet Membre de l'Institut.
Paris, 1867, p. 58. This learned treatise contains an immense deal of
information in reference to the mysterious connection between matter
and mind, and I have found it of great service to me in my
psychological researches.

[28] "Nineteenth Century," March, 1880, p. 509.



MATTER AND MIND.

  "Quare frustra sudaverit, qui cœlestia religionis arcana nostræ
  rationi adaptare conabitur." _Bacon, "De Augmentis Scientiarum."_


I have already stated that the study of idiocy was of great interest
to the theologian, for I can imagine no more powerful weapon for
combating the materialistic tendencies of the day than is furnished by
a consideration of the natural history of the idiot. This is neither
the time nor the place for me to enter into the question of the
mysterious connection between matter and mind, a subject which I have
developed at some length in my published works.[29] In my various
public appeals on behalf of the Asylum for Idiots, I have also usually
taken the opportunity of pointing out how the experience afforded by
the study of idiocy is utterly opposed to the extravagant dogmas of
the materialistic school, and to the crude notions which
pseudo-science has engendered; and I have also shown how the results
of idiot training furnish a forcible demonstration of the dualistic
theory of mind and matter, upon which science reposed till the times
of Spinosa, Laplace, Haeckel, Huxley, and others.

The pseudo-philosophers of our time have bewildered the public mind by
the wild flights of their imagination; thought, the so-called
spiritual attributes of man, are merely a function of brain
protoplasm; the brain, say they, secretes thought, just as the liver
secretes bile, or as oxygen and sulphur produce sulphuric acid, and
all the varied phenomena of nature are nothing more than the molecular
changes of matter; the operations of the mind are but the products of
the caudate cells of the brain, and volition and consciousness are
mere physical manifestations. They see only the physio-chemical side
of nature, they utterly ignore any spiritual attribute in man, they
regard metaphysics as a relic of mediæval superstition, and they
assert that all mental operations are bodily functions, and simply the
result of some molecular or atomic change in the brain; indeed, the
German philosophers go so far as to say that life itself is only a
"special and most complicated act of mechanics;"[30] that there is no
real distinction between living and dead matter, and that vitality is
a metaphysical ghost (_ein metaphysisches Gespenst_).[31]

At the International Psychological Congress held in Paris, in 1878, at
which it was my privilege to be present, Professor Mierzejewski, of
St. Petersburg, laid before the congress the result of his elaborate
experiments on the brains of idiots, his communication being
illustrated by casts of the brains of idiots, and also of certain
animals, and the learned Russian professor's conclusions strongly
militated against the theories of the philosophers of whom I have been
speaking.

In order to understand the great value and import of Dr.
Mierzejewski's investigations, I must remind you that the human brain
is composed of two kinds of nerve structure, of an essentially
different nature, grey matter and white matter. Examined
microscopically, the grey matter is found to be composed of cells,
while the white matter consists of fibres; their function also is
different, the former being regarded as the generator of nerve force,
while the latter simply serves as the medium by which this force is
transmitted. As the manifestation of the intellectual powers is
supposed to be in some way connected with the development of the grey
matter of the cerebral convolutions, one would expect to find in
idiots a deficiency of this element of brain tissue.[32] Dr.
Mierzejewski maintained that this is by no means the case, and he
mentioned an instance of an idiot in whose brain the surface of grey
matter was enormous. So it would seem that there is no fixed relation
between the amount of grey matter of the brain and intellectual power,
for richness of grey substance and abundance of nerve cells may be
accompanied by idiocy.

Now, as these startling statements of the Russian professor were not
made in a hole and corner, but were enunciated in the presence of
leading psychologists from all parts of the world, I felt myself
justified in telling the materialists that they must be faced, and
either answered or admitted as correct; and as my comments upon these
experiments were subsequently published in a leading London periodical
and widely circulated, I am now justified in assuming that the
inferences I then drew from these remarkable experiments cannot be
controverted, and that the time has not yet arrived when the broad
distinctions between mind and matter are to be obliterated, and man
reduced to a mere automaton, a creature of a blind necessity.

Without unduly exaggerating the importance of Dr. Mierzejewski's
experiments, it must be admitted that very great interest attaches to
them at this juncture, when attention is so widely directed to the
mysterious connection between matter and mind. Unhappily, instead of
solving the question, the Russian professor's researches tend to
shroud it in a still deeper mystery, and show that what has been
termed the "slippery force of thought--the _vis vivida animæ_"--cannot
be weighed in the balance; and they fully justify the eloquent
language of a recent writer when he says, "Far more transcendent than
all the glories of the universe is the mind of man. Mind is indeed an
enigma, the solution of which is apparently beyond the reach of this
very mind, itself the problem, the demonstrator, the demonstration,
and the demonstrants."

Those who maintain that the brain is the organ of the mind, do not
tell us what we are to understand by organ, brain, or mind; they seem
to me to confound two things, the one with the other. In fact, they
make no distinction between thought, mind, consciousness, and the
_instrument_ by which these attributes become externally manifested.
It is true, we have no evidence to show that the mind can operate
independently of the nervous system; on the contrary, all
physiological data bearing upon the question of this mutual relation,
go to prove that where there is no nervous system there are no mental
manifestations. Moreover, as G.H. Lewes says, "It is the man, and not
the brain, that thinks: it is the organism as a whole, and not one
organ, that feels and acts."[33]

Every faculty manifests itself by means of matter, but it is important
not to confound the faculty with the corporeal organ upon which the
external manifestation of such faculty depends. The word organ is the
name given to a part of the human frame by which we have sensation,
and by means of which we do a certain act or work; such are the organs
of sight, sound, smell, taste, and touch. All these organs are
passive, and require to be operated on _ab extra_, precisely in the
same way as the musical organ, which is an instrument constructed by
man, requires man's interference for the production of musical sounds.

When a musician sits down to a piano, the music cannot be said to be
in the instrument, but in the soul of the performer. If the instrument
be in good order, the inspiration of a Thalberg or of a Liszt will
become apparent; break the cords or otherwise damage the instrument,
and nothing but discordant strains are produced, the musical faculty
of the performer, however, remaining unaffected. We are all familiar
with Plato's celebrated dialogue on the Immortality of the Soul, where
a disputant with Socrates inquires if the soul is not like the
harmony of a lyre, more beautiful, more divine than the lyre itself,
but yet is nothing without the lyre, vanishing when this instrument is
broken.

Let me further illustrate this point by an allusion to the electric
telegraph, by means of which ideas and words are transmitted from mind
to mind with a rapidity to which ordinary language cannot attain. Now,
the electrical battery may be not inaptly compared to the brain, and
the telegraph wires to the nerves which emanate from it. If the
battery be out of order, or the telegraph wires be broken, this
lightning language, by which mind speaks to mind, becomes impossible.
In the same way, idiocy may be considered as a disease of the
instrument rather than of the performer; the idiot's brain is damaged
and has become an unfit instrument for the outward manifestation of
the powers of the mind, but the lowest idiot possesses the germs of
intellectual activity and moral responsibility; and within his
malconstructed organism, there lies concealed in its fragile, fleshly
casket, a precious jewel of immortality--an imperishable essence that
is destined to live on for ever and for aye, through countless æons of
time, when the dicta of these dreamers of whom I have been speaking,
to use the language of one of them, "shall have melted away like
streaks of morning cloud into the infinite azure of the past."

I repeat it, we must take care not to confound the organ with the
person who possesses this organ: the eye is not that which sees, it is
only the organ by which we see; the ear is not that which hears, it is
only the organ by which we hear. Precisely in the same way and in the
same sense, the brain is the organ of mind, the organ by which our
mental faculties become _externally_ manifested. That it cannot be
otherwise is shewn by the results of memory. The brain is of a
perishable nature, its atoms are constantly changing; the body is
continually throwing off old particles and appropriating new ones,
every breath that is drawn, and every exertion that is made, cause
some minute change in the bodily frame-work, so that it is never
entirely the same;[34] there is no person, therefore, who has the same
brain that he had 20 years ago; and the vivid impressions of the past
are utterly inexplicable on the supposition that mental activity is a
mere function of any perishable organ like the brain, but they
necessitate the conclusion that mind and body, spirit and matter, are
two entirely heterogeneous substances, and that mind--the concrete
_Ego_--is independent of the material organ by which its external
manifestation is alone possible.[35]

However tempting it might be, I feel I must not trespass any further
by dwelling on the mysterious connection between matter and mind, a
subject the complete comprehension of which is beyond the limits of
our finite capacities. As Goethe philosophically remarks, "We are
eternally in contact with problems. Man is an obscure being, he knows
little of the world, and of himself least of all."

It would seem that the great Roman orator, nearly 2,000 years ago,
with prescient eye, foresaw the attempts that would hereafter be made
to pry into the hidden mysteries of Nature, when he said:--

"Latent ista omnia, Luculle, crassis occultata et circumfusa tenebris,
ut nulla acies humani ingenii tanta sit, quæ penetrare in cœlum,
terra intrare possit."

These lines of Cicero would seem to be peculiarly applicable to
certain modern philosophers, who, in their attempts to bridge over the
gulf--the impassable gulf--which separates matter from mind,
persistently ignore the fact that there are certain things which, from
their very nature, are beyond the pale of precise knowledge, and which
cannot be determined by physical investigation--which, in fact, lie
outside the sphere of man's intellect. I believe the question I am
discussing is one of these, and that, although we may grope with the
taper of science into the dark caverns whence seem to issue the
springs of humanity, we shall probably fail to understand the
mysterious connection between matter and mind, a theme essentially
beyond the grasp of human intelligence, and which cannot be fathomed
by the puny plummet of human thought or touch.

The study of the idiot is calculated to elucidate this overwhelmingly
important subject, and I believe the Idiot Asylum is destined to
become the arena and battlefield on which this great question will
have to be fought out.

FOOTNOTES:

[29] "Darwinism Tested by Language," Rivington, 1877; "Aphasia or Loss
of Speech, and the Localisation of the Faculty of Language," 2nd
edition, Churchills, 1890. The reader is referred to these treatises,
and especially to his work on Darwinism, for a fuller exposition of
the author's views, here only incidentally sketched; and also for a
more complete knowledge of the scientific facts and different
authorities quoted in support of the position here taken in reference
to the connection between Matter and Mind.

[30] "Das Leben ist nur ein besonderer, und zwar der complicirteste
Act der Mechanik; ein Theil der Gesammtmaterie tritt von Zeit zu Zeit
aus dem gewöhnlichen Gange ihrer Bewegungen heraus in besondre
organisch-chemische Verbindungen, und nachdem er eine Zeit
lang darin verharrt hat, kehrt er weider zu den allgemeinen
Bewegungsverhältnissen zurück."--

_Gesammte Abhandlungen zu wissenschaftlicher Medicin_ s. 25.

[31] One of the leaders of scientific thought in this country tells us
that "Life is composed of ordinary matter, differing from it only in
the manner in which its atoms are aggregated," and it has been gravely
stated that the production of man in the chemist's retort may be
recorded as one of the future discoveries of the age!

A clever French writer, commenting on these purely hypothetical
statements of the "mechanistic school," makes the following
appropriate remarks--

_"Quand on nous dit que l'organisme des êtres vivants n'est qu'un
laboratoire où tout se passe en combinaisons et en compositions des
éléments matériels primitifs, on oublie que ce laboratoire est habité
par un hôte intime, le principe vital qui ne fait qu'un avec les
éléments en fusion. Ici la combinaison chimique ne se fait pas toute
seule; elle s'opère sous l'action d'une cause qui en transforme les
éléments de façon à en faire un produit d ordre nouveau qui s'appelle
la vie."--"La Vie et la Matière," par E. Vacherot, Revue des Deux
Mondes,"_ 1878.

[32] In an original and very remarkable essay, entitled "The Brain not
the Sole Organ of the Mind," Dr. Hammond, of New York, says, "There is
no exception to the law that mental development is in direct
proportion to the amount of grey matter entering into the composition
of the nervous system of any animal of any kind whatever; and that in
estimating mental power, we should be influenced by the absolute and
relative quantity of _grey nerve tissue_, in which respect we shall
find man stands pre-eminent, although, as we have already seen, his
brain, _as a whole_, is relatively much smaller than that of many
other animals; and it is to this preponderance of grey matter that Man
owes the great mental development which places him so far above all
other living beings. As this grey tissue is not confined to the brain,
but a large proportion of it is found in the ganglia of the
sympathetic and some other nerves, and as an amount second only to
that of the brain in quantity--and, indeed, in some animals larger--is
present as an integral constituent of the spinal cord, Dr. Hammond
infers, and he cites numerous experiments in support of this
inference, that mental power must be conceded to the spinal cord, and
that the brain can no longer be considered as the sole organ of the
mind."

[33] "The Physical Basis of Mind." Page 441.

[34] The late Bishop of Carlisle illustrates the independence of the
Ego, by an allusion to moral feelings. "A murderer," he says, "is
convicted twenty years after the offence had been committed, or he
gives himself up after so many years, because his memory and his
conscience make his life miserable. He has no doubt as to the fact
that the person who did the deed of darkness years ago, is the same
person as he who feels the pangs of remorse to-day. Every material
particle in his body may have changed since then, but there is a
continuity in his spiritual being out of which he cannot be argued,
even if any ingenious sophist should attempt the task."--_Nineteenth
Century_, March, 1880, p. 510.

[35] To those who may wish to pursue this subject further, I recommend
a perusal of an essay on "Materialistic Physiology," in the _Journal
of Psychological Medicine_ for April, 1877. In this article, the
writer, Dr. Winn, seems to share my views as to the paramount
importance of boldly facing this matter, when he says--

"The unphilosophical and extravagant dogma, that matter can think, is
now so loudly and confidently asserted, and so widely spread by a
numerous class of medical men and physiologists, both in this country
and abroad, that the time has arrived when a doctrine so fallacious,
and so fraught with danger to the best interests of society, should be
fairly and carefully scrutinised. It is not by mere assertion, or the
use of obscure and pedantic language, that such a theory can be
established; and if it can be shown that the arguments on which it is
based are shallow and speculative, words can scarcely be found too
strong to censure the recklessness and folly of those who promulgate
views so subversive of all morality and religion.

"The physicists have utterly failed to establish their position. They
were asked to prove by inductive reasoning the truth of their theory,
that the universe is the mere outcome of molecular force, and their
defence has been clearly proved to be of the most evasive and
inconclusive character.

"The doctrines of the modern school of materialistic physiology are
permeating all classes of society, and it is these doctrines, based on
the assumption that mind is a mere function of the brain--an
assumption that, if true, would reduce man to the level of the beasts
that perish--that we are offered as a substitute for the belief in the
immateriality of the mind."

The essay from which the above quotations are taken is full of sound
and logical reasoning, and the writer's position is not supported by
mere _theoretical statements_, but by arguments drawn from
_well-accredited facts_ in anatomy and physiology.



THE PNEUMA, OR SPIRITUAL ATTRIBUTE OF THE IDIOT.

    Ὁ δε νους εοικεν εγγινεσθαι ουσια
    τις ουσα, και ου φθειρεσθαι.

                                Aristot. _De Anima_, I. 4.


Inasmuch as the instrument by which the manifestation of mind is alone
possible is undoubtedly damaged in idiots, they were formerly supposed
not to belong to the human family, and their place in the order of
creation was disputed. All admitted that they had the σωμα, or
material part of our nature; they also conceded to them the ψυχη, or
principle of animal life, but they considered that the πνευμα, or
spirit of immortal life--that which essentially differentiates man
from the brute--was absent in the idiot. This idea seemed to have been
entertained by a great theologian of the 16th century, who, on being
asked by a father what he was to do with his idiot boy, replied that
the child might be drowned as he possessed no soul! Times are happily
changed. We don't admit the lawfulness of drowning idiots in these
days, but we teach them to swim against the adverse currents to which
they are exposed; we buoy them up on the tempestuous waves of life; we
pilot them through the rocks and shoals of their ill-starred career
till their chequered race is run, and they are safely landed in the
haven of everlasting rest.

Not only in the 16th century, but certain philosophers of a later date
have questioned the idiot's place in creation, and have disputed
his right to be classed among the human family; and some
scientists--believers in the so-called doctrine of Evolution, as
applied to the Descent of Man--have gone so far as to pretend that the
brain of the microcephalic idiot is so far removed from the human
type, as to constitute him a connecting link between man and the
anthropoid apes! Now, the interesting results of our training
institutions, showing _the capacity for progressive improvement_ which
exists in the idiot, gives the lie to this absurd and purely
sensational hypothesis.

Here let me add that I strongly deprecate introducing the _odium
theologicum_ into the discussion of this subject, being fully
conscious of the futility of attempting to check an unwelcome or
distasteful theory by means of ecclesiastical censures; and I further
admit that in anything like a scientific demonstration of truth, an
appeal to the affections would be absurdly out of place.[36] Moreover,
I should not reject the Darwinian theory from any sensational notion
that its adoption was derogatory to Man's dignity, and I fully echo
the sentiment of the naturalist who said that he would prefer being
descended from a good honest monkey, than to be obliged to avow
himself the offspring of certain fanatical enemies of scientific
knowledge and progress; but I do complain of the tendency of the
present day to accept new ideas without knowing or caring how to sift
them. Everything is hypothetical, and allowed to enter the mind
through the ivory gate of fancy; and on purely hypothetical premises,
an attempt is made to found conclusive arguments. Strip the assertions
of all their vagueness and superficial varnish, and reduce them to a
skeleton of logical statement, and we shall see how much is assumed
and how little is proved; and we shall find that we are asked to
accept a chain of hypotheses, as if it were an induction founded on
ascertained and indisputable facts. In thus expressing myself, I wish
to add that the ultimate goal of the scientist is the establishment of
truth, and I should as soon attempt to stop the progress of the
avalanche that has become dislodged from the mountain top, as to try
to bar the path of scientific progress, or to extinguish the torch of
discovery. The tide of scientific truth will continue to flow on in
spite of the modern Canutes, who may utter from time to time their
imperial commands to stay its course. _Magna est veritas et
prevalebit._

The supporters of evolution base their arguments upon the remarkable
resemblance between the brain of man and that of certain other
animals. Now, I admit this striking analogy; I admit that every chief
fissure and fold in the brain of man has its counterpart in that of
the gorilla and the ourang-outang; and I am not prepared to deny the
statement, that as far as the organ of intelligence is concerned,
there is no very striking physical difference between him who weighs
the stars and makes the light tell its secrets as to the constitution
of distant worlds, and the howling senseless brute, who lives merely
to satisfy his animal appetites. All animals of the vertebrate type
are constructed on a plan which is essentially similar, not only as
regards their skeleton, but as regards their brain. I don't deny that
man is an animal, and that he has the essential properties of a
highly organised one; but what I do maintain is, that the brain, after
all, is merely an _instrument_ by which the high psychological
attributes peculiar to man become _externally_ manifested.[37] Thought
is not phosphorus, as some would have us believe; the human mind is
not the result of a mere molecular arrangement of cerebral matter.
There is something over and above all this, and the very resemblance
of man's physical nature to that of some members of the brute
creation, proves beyond all doubt that his superiority to them is
hyperphysical, and I fully endorse Mr. Froude's philosophical remarks,
when he says, "It is nothing to me how the Maker of me has been
pleased to construct the organised substance which I call my body. It
is mine, but it is not I. The νους, the intellectual spirit, being an
ουσια--an essence--I believe to be an imperishable something which has
been engendered in me from another source." The unhappy idiot, that
stricken member of our race, possesses the tripartite nature of
man--for he has not only the σωμα or material part, and the ψυχη or
principle of animal life, but he also undoubtedly possesses the πνευμα
or principle of immortal life.

The above statement could be amply borne out by a reference to cases
which have been observed in idiot asylums. I will, however, mention
but three:--An idiot boy has been known to retire alone, when there
was a thunderstorm, to ask God to take care of his father, who was a
sailor. A former superintendent of our Asylum, the late Mr. Millard,
noticed one of the inmates praying in private, and on saying to the
boy, "God hears prayer," he quietly observed, "Yes, and answers it,
too." A little boy in the Massachussetts Asylum for Idiots was in
declining health, and became, during his dying illness, an object of
great interest to the matron and attendants. Unbidden, he said his
prayers frequently, and putting up his little hand, he muttered, "Me
want to go up! me want to go up!" Surely he was thinking of some sort
of hereafter, because he added distinctly, "They'll say, here comes
one of the boys from the Boston School for Idiots." The approach of
death seemed to awaken his spiritual life; out of the decaying body
appeared to rise the growing soul, for, after repeating the verse of
a hymn, the spirit of this simple child became liberated from its
earthly tenement--its material habitat--the connection between matter
and mind was severed, and, to use the touching language of his
biographer, "this poor little idiot boy bade a long adieu to his
sorrowing friends, and doubtless there was then joy in heaven, as the
recording angel wrote in the Book of Life the name of George
Tobey."[38]

In an interesting essay published many years ago, entitled, "A Morning
at Essex Hall, Colchester," its author, the Rev. Edwin Sidney, in
describing his visit to the Asylum, remarked that, "The conduct of
those who go to Church on Sunday is very decorous. One of the most
cheering things in connection with these objects of benevolent
solicitude, is the capability some of them manifest in receiving and
being comforted by religion. There are amongst them instances of high
conscientiousness and piety, which might be examples to such as are
gifted with unimpaired faculties."

If any apology be due for pointing out how the mysterious connection
between mind and matter may be illustrated by a study of idiocy, I
will observe that the subject is of such absorbing interest that it is
well that it should occasionally be removed from the heated arena of
biological bias, into the calmer and more judicial atmosphere of the
class of readers who may be interested in the important subject I am
endeavouring to elucidate.

FOOTNOTES:

[36] I strongly deprecate, as lamentably wrong and needless, the
violent language sometimes used by writers on both sides of this great
controversy of the origin of man. If the _odium theologicum_ may have
inspired some of the opponents of evolution, it is undeniable that
there is strong evidence of an _odium antitheologicum_ amongst not a
few of the supporters of this doctrine, who indulge in abusive
epithets, launching into personalities of a most objectionable kind;
for instance, we are informed that "orthodoxy is the Bourbon of the
world of thought; it learns not, neither can it forget." Now I protest
against the attempt to obscure argument by appeals to the passions and
to prejudice. Science and Theology should not be regarded as two
opposing citadels, frowning defiance upon each other, but their
votaries should look upon each other as co-labourers in the cause of
truth, and they should welcome light and knowledge from whatever
quarter it may come, being fully convinced that all systems and
theories irreconcilable with truth, are built upon the sand, and must
ultimately be swept away.

[37] One of our popular novelists, Sir Walter Besant, has
philosophically said, "there is between the condition of Man and the
Brute an interdependence which cannot but be recognised by every
physician. So greatly has this connection affected some of the modern
physicians, as to cause doubt in their minds whether there be any life
at all hereafter; or if when the pulse ceases to beat, the whole man
should become a dead and senseless lump of clay. In this they confuse
the immortal soul with the perishable instruments of brain and body,
through which in life it manifests its being and betrays its true
nature, whether of good or evil."--_Faith and Freedom._

[38] Cases like this would seem to illustrate the truth of the
statement of that great philosopher, Sir Thomas Browne, when he says,
"Thus it is observed that men sometimes, upon the hour of their
departure, do speak and reason about themselves. For then the soul,
being more freed from the ligaments of the body, begins to reason like
herself, and to discourse in a strain above mortality."--_Religio
Medici_, p. 208.



TREATMENT AND RESULTS.

    "Distinguish'd link in being's endless chain,
    Midway from nothing to the Deity.
    Though sully'd and dishonour'd, still divine,
    An heir of glory, a frail child of dust.
    Helpless immortal!"--_Young._


According to the census of 1881, there were about 32,717 idiots and
imbeciles in England and Wales; the Census Commissioners, however,
ascertained that owing to the reticence of parents, the returns were
far from trustworthy, and, after careful inquiry, they estimated the
total number of idiots and imbeciles at 41,940; of these, it is
calculated that about 3,000 cases belong to the four Eastern Counties.
Of this number, it is estimated that, after deducting pauper and other
cases not considered suitable for this charity, there remain at least
1,000 idiots who need the benefits of the Eastern Counties' Asylum,
whereas, our present accommodation is limited to 250 cases.[39]

The Board of Directors being forcibly impressed with their inability
adequately to supply the wants of the district, have recently
instituted a Permanent Endowment Fund. As the institution is mainly
supported by voluntary contributions, the fluctuating nature of which
has often caused considerable anxiety, the Board has felt the
desirability of placing a considerable portion of their resources on a
more solid basis; and it is with the view of giving stability and
permanence to the work of the Asylum, that the Endowment Fund has been
started, which it is proposed shall be inalienable, the interest only
being used for the purposes of the Institution. In the year 1891,
H.R.H. the Prince of Wales, with the view of furthering this object,
graciously consented to preside at a Festival Dinner, at the Hotel
Metropole, London, which resulted in an immediate contribution of
£6,000. This fund, started under such happy auspices, has already
reached the sum of £25,334 12s. 8d., which it is hoped may eventually
reach £50,000, the amount which the Directors think indispensable to
insure the efficient maintenance of the Asylum.

Now let us bring this matter home to ourselves. Where are the 3,000
unhappy blighted individuals that claim the Eastern Counties for their
home? It is true that some of them are in the homes of the affluent,
but the greater number are in the cottages of the poor, where the
trouble of providing for one such member often reduces a working
family to pauperism; the poor child beloved by its parents, is,
perhaps, loathed by their neighbours, is avoided by other children,
hidden from visitors, a constant care and sorrow to the mother, a
source of anxious foresight to the father; in fact, the poor idiot
child is like a Upas tree, that poisons the whole atmosphere around
it, and the burden of his presence in a poor man's family is a new
weight added to the load that was already sinking them down. Perhaps
you may say, we agree with you, we lament as you do, that the narrow
home of the humble artisan should be rendered intolerable
by the presence of these stricken members of our race; but, we have
been given to understand, that if not absolutely incurable, but very
little can be done for them, that they baffle the efforts of the most
zealous educators, and are almost beyond the reach of human sympathy.

Now this was the language generally used half a century ago, and a
celebrated French authority on the subject, Esquirol, considered that
idiots were what they must remain for the rest of their lives; that
there was no possibility of ameliorating their condition, and that no
means were known by which a larger amount of intelligence could be
developed in them.[40] In fact, an effort to ameliorate the condition
of the congenital imbecile was regarded by psychologists and
physicians as absolutely hopeless, and the standard "Dictionnaire de
Médecine," published in 1837, broadly stated that it was useless to
attempt to combat idiotism; in order that the intellectual exercise
might be established, it would be necessary to change the conformation
of organs which are beyond the reach of all modification. So great was
the pessimism prevalent on this subject, that it was insinuated that
the idea of teaching an idiot could only enter the brain of one
somewhat closely allied to that class!

Now, I am happy to tell you, that in the broad daylight of the
nineteenth century, science gives an emphatic denial to this
statement. Yes, the results obtained at our own Asylum and elsewhere,
show that much, very much, may be done for the unhappy idiot, who in a
private house is an intolerable incubus, but who, under proper
training in a suitable asylum, becomes sociable, affectionate, and
happy. It has been shown that in the majority of cases, the idiot may
not only cease to be a source of annoyance and danger to those around
him, but by care and training he may be made able to contribute to his
own sustenance; the knowledge of simple trades of a mechanical kind,
such as that of a carpenter, shoemaker, or tailor, has been reached by
some, and household industrial pursuits have fitted others for
domestic usefulness.

A celebrated German authority, Herr Saeger, of Berlin, has stated that
in his establishment he had indubitable cases of idiocy, in which the
head was small and malformed, yet in which the results of education
were so triumphant, that they were ultimately able to mix with the
world without being recognised as idiots. Further, he tells us that
in one instance a young man underwent confirmation without the priest
suspecting that he had been delivered from idiocy.

Dr. Shuttleworth records the case of an inmate of the Royal Albert
Asylum, who became, under instruction, an expert joiner, and from
being a very imp of mischief, grew up into a well-conducted,
self-reliant youth, and ultimately emigrated to one of our colonies,
and when he was last heard of, he was practising his trade in a
leading city.[41]

Equally satisfactory results have been obtained in our own Asylum. A
few years ago, a boy of eight was admitted into our Asylum, who was
quite unmanageable at home, a terrible incubus in the household of
which he formed part, and the constant subject of jeers and derisions
on the part of the other juveniles of the village. After about six
months' systematic training, one of the officials of the Asylum wrote
to inform me that the boy had so much improved that he was afraid the
Commissioners of Lunacy, at their next visit, would consider the boy
no longer a fit subject for detention in the Asylum. Being on a short
visit to his relatives, who reside near Norwich, he was brought to me
for inspection, when I was struck with the miraculous transformation
that had been effected; from a restless, destructive boy, he had been
changed into a well-conducted lad, and he had actually been taught to
write. At my request, he wrote very legibly his name and address, with
the date, "James Smith, Colchester;" but he made a little mistake in
the date, writing backwards, in the Chinese fashion--it being
September 29th, he wrote "September 92nd!" This same boy was regularly
employed as one of the gardeners to the institution, and has recently
been discharged, and is now earning his own living as gardener in a
private family. This case illustrates a peculiarity not infrequently
remarked in the inmates of an idiot asylum, that is the remarkable
propensity they have for imitation and shamming. This boy came to stay
with his relatives in Norfolk for a few weeks, when every few days he
would have an epileptic fit. When his holiday was over and he had
returned to the Asylum, these fits recurred, and were, of course,
reported to the medical attendant, who had a shrewd suspicion the boy
was shamming. He thereupon said to the attendant: "The next time a fit
comes on, I must apply a redhot iron to the soles of the feet, it will
hurt him, but it will cure him." From that time the boy had no
epileptic fits!


_Thyroid Treatment of Idiocy._--My sketch of the treatment of Idiocy
would be incomplete without an allusion to the injection or internal
administration of a preparation of the thyroid gland of the sheep, a
method of treatment brought into notoriety by Professors Kocher and
Schiff, on the continent, and by Professor Victor Horsley, Dr. Murray,
and others in this country. Numerous cases have been published
claiming successful results, and the thyroid treatment has been spoken
of as a cure for at least one of the forms of idiocy.

Without quite endorsing this sweeping and enthusiastic statement,
there cannot be a doubt that this method opens up a hopeful vista in
the treatment of idiocy; in fact, Dr. Ireland has furnished me with
the particulars of a girl, aged five years, treated by thyroid juice,
in whom "the improvement was so decided that it seemed an escape from
idiocy into normal intelligence."[42]

A striking instance of the good results of thyroid treatment has
lately occurred in the Eastern Counties' Asylum, the particulars of
which have been kindly furnished to me by Mr. Kirkby, the Resident
Medical Officer. Esther C., aged 19, was admitted Nov. 8th, 1894, with
marked symptoms of Sporadic Cretinism. She was at once put on thyroid
treatment, beginning with half a five-grain tabloid gradually
increased to a tabloid once, twice, and sometimes three times a day,
intermitting them for short periods. Latterly, she has been taking one
tabloid a day. Under this treatment, she has gained 10 lbs. in weight,
and has grown 5 inches; the features are not so coarse, the previous
myxœdematous condition of the subcutaneous tissues has subsided, the
outline of the features having become more defined, and the skin which
was formerly dry and rough, has become soft and naturally moist,
having lost a great deal of its puffiness; but the most obvious change
in the patient is the disappearance of the two prominent elastic
swellings (pseudo-lipomata) which formerly occupied the posterior
triangle of the neck on each side. The mental condition has also
improved, she takes more interest in amusements, and her voluntary
movements are much more rapid. This patient is still under
observation, and the results hitherto attained afford a favourable
illustration of the beneficial effects of this mode of treatment.

At a meeting of the New York Academy of Medicine of March 12th, 1896,
Dr. Emily Lewi reported the history of a very marked case of Cretinism
in a girl, aged 13 months, who was put on thyroid treatment;
improvement was noted in a week, and the child grew gradually
intelligent. At this same meeting, Dr. G.M. Hammond expressed the
opinion, that for thyroid treatment to be effectual, it must be begun
in early life.[43]

My colleague, Dr. Burton-Fanning, has recently shown me a case of
Cretinism under his care, at the Lind Infirmary for Children, in which
thyroid treatment produced the most favourable results, not only of a
physical, but of a psychical character. Although the child was four
years old, he had not previously spoken a word, and understood
nothing; but during the treatment, his expression became much less
vacant, and the faculty of speech was roused into action.

Several valuable contributions have lately been made to our knowledge
of the effects of thyroid feeding, more especially in the treatment of
insanity, not however the less valuable as a guide to its probable
benefit in idiocy. I wish more especially to allude to the researches
of Dr. Lewis C. Bruce, at the Royal Asylum, Edinburgh, as reported in
the "Journal of Mental Science" for January and October, 1895. There
is much in the above essay that I could profitably comment upon, but I
will content myself with saying that the outcome of these researches,
which intimately concern the treatment of idiocy, is that Dr. Bruce
has established the fact that thyroid feeding acts as a direct
cerebral stimulant, which he thinks "may prove advantageous in cases
where the higher cortical cells remain in an anergic condition." Dr.
Bruce mentions the case of a patient who had not spoken for several
months; one day, during the administration of the thyroid extract, he
suddenly began to talk, and soon became quite communicative.

Whilst these pages are passing through the press, M. Auguste Voisin,
Physician to La Salpêtrière, has had the courtesy to send me detailed
particulars of a case of insanity in which the success of the thyroid
treatment was phenomenal. The patient was a female, aged 25, and her
mental derangement assumed the form of religious monomania, insomnia,
and aural hallucinations; there was great emaciation, dryness of the
skin, and cold extremities.[44]

No benefit having resulted from six months' treatment, including
hypnotism, M. Voisin determined to try the subcutaneous injection of
sterilised thyroid juice. After a few weeks of this treatment, a
notable amelioration was observed; shortly afterwards all her
unfavourable symptoms disappeared, and she was discharged cured.

One of the most interesting features in this case is the result of the
analysis of the blood, as to its corpuscular richness. Before thyroid
treatment was commenced, the number of corpuscles was only 2,225,000
per cubic millimetre; after the cure by the thyroid juice, the number
was more than doubled, being 4,774,000 per cubic millimetre. In Dr.
Lewis Bruce's cases, to which I have already referred, the result was
the reverse of that observed by M. Voisin; for in the eight
uncomplicated cases recorded by Dr. Bruce, with one exception, there
was in all of them a diminution in the number of red corpuscles.

At the discussion on Myxœdema, at the Edinburgh Medico-Chirurgical
Society, to which I have already alluded, Dr. Alexander Bruce showed a
case of myxœdema under the care of Professor Fraser, in the Royal
Infirmary, in which, as the result of thyroid feeding, a condition of
relative anæmia had been developed. The patient had no murmurs when
admitted, but since the administration of thyroid preparations, basal
and mitral systolic bruits had developed themselves. It is further
stated that the blood corpuscles had fallen from 4,600,000 to
3,700,000, and hæmoglobin from 78 per cent. to 59 per cent.[45]

Further researches would therefore seem to be necessary, before we can
arrive at a satisfactory conclusion as to what effect the thyroid
treatment has upon the blood.

Possibly the dose of the thyroid preparation may be an important
factor in the result, for Dr. Byrom Bramwell, in an important and
exhaustive monograph upon this subject, says, that anæmia is apt to be
produced by large doses of the remedy; and he mentions a case where
the red blood corpuscles and the hæmoglobin underwent a marked
diminution during the period of acute thyroidism, but rapidly
increased under the subsequent administration of small doses of the
remedy.[46]

The subject of blood analysis is most important, as tending to throw
some light upon a matter at present but little understood, namely the
physiological effect of thyroid preparations upon the blood.

Dr. Telford-Smith has reported four cases of Sporadic Cretinism
treated by thyroid extract at the Royal Albert Asylum, Lancaster, when
a well-marked improvement was noticed in each case. The clinical
history of these cases is given with minute detail by Dr.
Telford-Smith, and is well worthy of close study by those interested
in this subject.[47]

Quite recently, at the Annual Meeting of the British Medical
Association, held at Carlisle in August of the present year,
communications were read on the Thyroid Treatment of Cretinism and
Imbecility, by Dr. Rushton Parker, Dr. Telford-Smith, Dr. John
Thomson, and others. An animated discussion ensued, the tendency of
which pointed to the undoubted advantages both physically and mentally
of the use of this remedy.

Although the physiological effects of thyroid feeding may not be
definitely recognised and understood, there is overwhelming evidence
to show that it produces marked psychical results, that it acts as a
direct cerebral stimulant, and we have every reason to rely upon it as
a valuable adjuvant to our treatment of idiocy; and it is not too much
to say that the treatment of this infirmity, as well as of other
mental defects, by thyroid extract or some other preparation of the
thyroid gland, is one of the greatest triumphs of modern medicine; but
much still remains to be learnt, as Professor Victor Horsley remarks,
"So definite and pronounced is the cachexia thyroidectomica, that few
subjects in the range of pathology offer a more fruitful and inviting
field of research."[48]


_Craniectomy._--The operation of Craniectomy (that is the cutting of
strips of bone from the cranium) has been recommended and practised in
cases of microcephalic idiocy, an operation suggested upon the theory
of premature synostosis, or closure of the cranial sutures, thus
causing an arrest in the development of the subjacent cerebral tissue.
Although I could not omit a reference to this operation, it has not
met with general acceptance, and one of the most recent writers on
this subject, M. Bourneville, physician at Bicêtre, discourages it
altogether; and from his examination of the skulls of a number of
idiots, he affirms that "in the immense majority of cases, there was
no premature synostosis, and that neither normal anatomy,
pathological anatomy, or physiology, justified the operation of
Craniectomy."[49] The late Sir George Humphry was of the same opinion,
as, after an examination of 19 microcephalic skulls, he said, "There
is nothing to suggest that the deficiency in the development of the
skull was the leading feature in the deformity, or anything to give
encouragement to the practice lately adopted in some instances of a
removal of a part of the bony case, with the idea of affording more
space and freedom for the growth of the brain."[50]

At a recent meeting of the New York State Medical Society, Professor
Dana read a paper on Craniectomy for Idiocy and Imbecility, and he
gave the following result of 81 cases:--In 35, there was improvement;
in 22, no improvement; and death ensued in 24 cases. The conclusion at
which Professor Dana arrives is that "it is largely through its
pedagogic influence that an improvement takes place, and that the
operation is allied in its effect to a severe piece of castigation!"
Dr. Dana freely admits that this view of craniectomy for idiocy and
imbecility lends itself readily to humour, and it would seem that he
intended to kill the operation by ridicule.[51]

Of course, Dr. Ireland has something to say upon this point, and after
a brief review of the literature of the subject, he says: "So many
cases have been collected of microcephales with open sutures, that it
is not likely that anyone will continue to hold that the small size of
the brain is owing to the sutures closing in, and thus hindering their
growth. Even in those cases where the sutures have closed in before
birth, the question still remains whether the brain ceased to grow
because the sutures are closed, or whether the sutures closed in
because the brain ceased to grow; or, lastly, whether both the brain
and its coverings ceased to grow under a common cause."[52]

The benefits to be derived in apparently hopeless cases of idiocy,
from the systematic and persevering use of all the modern adjuvants
and appliances now available for treatment, are now so universally
recognised, that it would be superfluous to dwell further on this
point. Science has done much for the idiot, and she will do more, for
her motto is "Excelsior," and her votaries are not content to linger
with complacency on the heights already attained, but they look for
the period when, by the powerful lever of an enlightened philanthropy,
this benighted race shall be raised from the grovelling level of the
brute, to the highest attainable pitch of bodily perfection.

       *       *       *       *       *

I trust that I have said enough to justify an earnest appeal for
sympathy with this unfortunate branch of the human family. I have
endeavoured to show that a great social evil exists amongst us, and
that duty and interest should alike concur to induce us to face this
evil and to master it. I have endeavoured to point out how the care
and training of the idiot has become one of the recognised obligations
of a philanthropic public. At the Eastern Counties' Asylum, we are
trying to mitigate as far as we can this great social calamity, and
our efforts have hitherto been crowned with unlooked-for success. We
are doing a grand and glorious work, and I ask you to come and help
us; the Board of Directors, a noble band of philanthropists, who
devote a considerable amount of time to the objects of this charity,
ask you to come and help us; nay, more, from the cottage homes in East
Anglia rendered miserable by the presence of these unhappy beings, a
thousand voices cry to you with trumpet tongue, "Come and help us."

We have in the Eastern Counties' Asylum an institution admirably
adapted for the care and treatment of the idiot; standing in its own
grounds of seven acres, it is furnished with all the machinery
necessary to grapple with this great social calamity, and by the
judicious combination of medical, physical, moral, and intellectual
agencies, we are enabled to develop and regulate the bodily functions
of the idiot, to arouse his observation, to quicken his power of
thought, and thus develop the sensitive and perceptive faculties; and
we have not only succeeded in raising these poor creatures from a
state of hopeless degradation to a state of comfort and usefulness,
but we have, in many instances, succeeded in kindling up in their
dark and twilight minds some dim anticipations of a brighter world;
the veil which obscured their intellect has been rendered transparent,
and to use the language of the bard of Avon, we have been privileged
to observe that--

    "As the morning steals upon the night,
    Melting the darkness, so their rising senses
    Begin to chase the ignorant fumes that mantle
    Their clearer reason."

In addition to the Asylum proper, the Board has lately purchased a
farm-house with 32 acres of land, immediately adjoining the main
building. By means of this welcome acquisition, increased
accommodation is afforded, and facilities are given for drafting off
some of the most tractable patients who require less supervision than
the majority of the inmates; moreover, farm work has proved very
useful in training some of the patients who come from agricultural
districts.


_Crossley House._--Our area of usefulness has recently been extended
by the munificent gift of Sir Savile Crossley, Bart., of a
Convalescent Home, at Clacton-on-Sea. The building has accommodation
for twenty patients; it stands facing the sea, in its own grounds of
nearly an acre, and its privacy is secured by a walled-in garden, in
which the inmates are able to take ample exercise. As a large number
of our patients suffer from scrofula, or from some tubercular disease,
the want has been long felt of a seaside adjunct, where such patients
could be treated in the initial stage. Thanks to Sir Savile Crossley's
princely gift, we now possess this valuable addition to our medical
resources, the advantages of which cannot be too highly estimated.


_The Ladies' Association._--The valuable additions that have recently
been made to the Asylum, thus largely increasing the accommodation for
patients, have necessarily entailed a largely increased expenditure,
which could not have been met by the current income, had not the
ladies of East Anglia come forward with great earnestness to help the
objects of this Asylum by individual and energetic efforts; and one of
the most interesting events of the last few years has been the
formation of a Ladies' Association, the establishment of which is
entirely due to the earnest and devoted efforts of the Marchioness of
Bristol. Its object is to disseminate information respecting the
working of the Asylum, to secure admission for necessitous cases, and
to organise and carry out annually house to house collections for its
funds. H.R.H. the Princess of Wales has given her countenance to this
movement by graciously accepting the office of Patroness, several
influential ladies have consented to act as presidents over the
various districts into which the four counties have been divided, and
as many as 1,400 ladies are engaged in this philanthropic work.

[Illustration: CROSSLEY HOUSE, CLACTON-ON-SEA.]

The success attending this movement has been phenomenal. During the
first year of its operation, the substantial sum of £1,868 6s. 10d.
was handed over to the general fund, this amount having been obtained
from upwards of 20,000 contributors, who had thus the opportunity of
joining in this good work, and whose aid could not have been secured
in any other way. The efforts of these charitable ladies have been
crowned with such signal success, that the large sum of £9,473 5s. 9d.
has been added to the funds of the Asylum.[53] This substantial help
is very gratifying to the Directors of the Institution, who now rely
upon the Ladies' Association for nearly a fourth part of their income;
and it is not too much to say that the future success of the Asylum is
intimately connected with the continuance of the efforts of these
philanthropic ladies, who seem to me to be influenced by the noble
sentiments lately expressed by one of their number, that "The simple
obligation of all thoughtful women, is that of making the world within
our reach the better for our being, and gladder for our human speech.
It is a work such as this that I am sure stirs us up to feel that we
must also give our help, our sympathy, our lives for other people, and
in this work lies the elements of unselfishness."[54]

All honour to these ladies, who, having learnt the elementary truth
that privileges involve responsibilities, instead of hiding their
talents in the napkin of selfishness, prefer to go forth as messengers
of mercy, to try and flash the electric fire of philanthropy into the
slumbering hearts of others, and to induce them to join in their
grand and good work. They thus become a force and a factor of
influence with all around them, and their reward will be the
satisfaction of feeling that they are contributing their part in the
great work of elevating these stricken members of our race, from their
present unhappy and degraded condition to a higher position in the
scale of created intelligence.

       *       *       *       *       *

I trust I have said enough to show that the idiot ought and must be
cared for; and in asking for your support, I will also ask you whether
anything can be more gratifying than, as the result of scientific
treatment, to see the idiot standing erect, asserting his birthright,
and claiming brotherhood with the rest of the human family.

True philanthropy never stops short of the remotest boundary of human
want, and in urging upon you the claims of the Eastern Counties'
Asylum for Idiots, I would have you remember that I am pleading for a
class who cannot plead for themselves, and whose very silence is
eloquent with an appeal for your merciful aid.

Remember that these poor stricken individuals are members of the human
family. They are heirs with us of all that human beings may hope for
from the hands of a common Father. They possess the rudiments of all
human attributes, especially the distinctive attribute of educability
and of progressive improvement; their bodies are the vehicles which
carry souls never destined to perish, through the series of ages, and
when the walls of the cottages of clay in which their better part has
sojourned collapse, and they mingle with their kindred dust, the freed
inhabitants shall wing their way to brighter regions and to a more
enduring home, and will thus illustrate the beautiful sentiment of one
of our modern poets, when he said:

    "In death's unrobing room we strip from round us
      This garment of mortality and earth,
    And breaking from the embryo-state which bound us,
      Our day of dying is our day of birth."

Each person here belongs to one of two classes. Either you have one of
these unhappy beings in your own immediate circle, or you have not. If
you have, you can feel all the more for those who are similarly
afflicted with yourselves, but have not your means for mitigating
their dire distress, and you will think of the narrow home of the
humble artisan or labourer, rendered intolerable by the constant
presence of one of these afflicted members of our race. If, on the
other hand, you have been spared this overwhelming calamity in your
own family, and have had the joy of watching the dawn of infant
intelligence, and have experienced the delight of seeing the
capacities shown in the early life of your own children gradually
ripen and develop into the intelligence of manhood, you will look with
an eye of pity on the numerous households rendered miserable by the
intolerable incubus of the presence in their midst of an idiot child,
and will, I am sure, consider any assistance you can render to so good
a cause in the light of a thank-offering.

The wear and tear of an excitable idiot child has wrecked many a
family and reduced it to pauperism, for not only is such child a dead
weight on the material prosperity of the family, but the hands of
those who have to work for their livelihood, are sadly tied and
hampered, when such an inmate has to be constantly looked after in the
home; the labour by which the household is supported is often
interrupted by one who can contribute nothing to the common stock, and
the time which is so precious to hard-working people must, in part at
all events, be occupied in caring for the one, who, if uncared for
and neglected, must sink lower in the social scale and fall into a
still more degraded condition. The care and treatment of the idiot,
therefore, becomes a vital question of Political Economy; for by
relieving a household of the burden and anxiety incident to the care
of the afflicted child, the parents are enabled to devote all their
energies to the support of their family. Moreover, there is often a
moral aspect corresponding with the mental aspect of this question,
and the presence of an idiot often becomes a source of real danger.
Our able superintendent, Mr. Turner, in his interesting report for the
year 1895, has illustrated the terrible anxiety caused by the presence
of an idiot child in the homes of the poor, by the history of an
inmate of our Asylum, who, when at home, being left to mind the baby,
blacked its face all over with soot, so that when his mother returned,
she might think she had a black baby. On another occasion, his little
sister wanted some water, and he told her to drink out of the kettle
on the fire, by which she nearly lost her life. This boy, who was
evidently a type of the mischievous class of idiots, was once turned
out of the Parish Church during service, for pricking another boy with
a pin, so that he yelled out and disturbed the whole congregation. Two
cases of murder by idiots have been recorded in a report of the
Commissioners on Idiocy to the General Assembly of Connecticut; an
idiot girl, being left alone with an infant, killed it by striking it
on the head with a flat iron; and another vicious idiot killed a man
who was working with him, by striking him on the head with a shovel.
Esquirol also records the case of an idiot in the Salzburg Hospital,
who killed a man by severing his head from his body with a hatchet,
and then calmly seated himself by the side of the dead body.[55]

Philanthropists of the Eastern Counties of England, many of you have
been long accustomed to sympathise with suffering and want; here is
another outlet for your charitable efforts. The most illustrious
landowner in East Anglia has recently extended his Royal patronage to
this institution, especially established for the care of idiots from
the four counties of Norfolk, Suffolk, Essex, and Cambridgeshire; and
his Royal Consort the Princess of Wales has most graciously consented
to accept the position of Patroness of the Ladies' Association, thus
showing the deep interest that is felt by their Royal Highnesses in
this important Eastern Counties' Charity. I ask you to follow their
noble example; I ask you to come and help us in our attempts to rescue
a large section of the human family from the worse than Cimmerian
darkness in which they have been hitherto enshrouded; come and help us
to awaken faculties hitherto dormant, to restore lost minds, to arouse
these unhappy beings from a moral death to a new birth of perception
and feeling; come and help us in arousing the slumbering power to
utterance, and you shall hear the once silent tongue eloquent with the
outgushings of a liberated spirit.

In conclusion, I wish to reiterate and to emphasise the statement,
that these unfortunate members of the human family possess the
tripartite nature of man--body, soul, and spirit--σωμα, ψυχη, πνευμα;
they have the _germ_ of intellectual activity and of moral
responsibility, and this germ, cherished and nourished by the genial
warmth of human kindness, fenced round and protected from the blasts
and buffetings of the world by the cords of true philanthropy, watered
by the dew of human sympathy, although possibly only permitted to bud
here, is destined hereafter to expand into a perfect flower, and
flourish perennially in another and a better state of being.

    "Eternal process moving on,
    From state to state the spirit walks.
    All these are but the shattered stalks
    Or ruined chrysalis of one."

FOOTNOTES:

[39] A society has lately been formed under the name of "The National
Association for promoting the welfare of the Feeble-minded," the
object of which is to establish homes for defective and feeble-minded
children of a class more highly-endowed with intelligence than those
who would be received into an ordinary idiot asylum; statistics having
shown that ignorance and mental dulness tend to crime in various
forms. Without expressing any very decided opinion upon the above
project, it seems to me that the unnecessary multiplication of
charitable institutions is itself an evil, and is not calculated to
promote efficiency or economy; and if special provision is made for
those just above the highest class of idiots, as is proposed, the
present Idiot Asylums must necessarily suffer. Without, therefore, in
any way disparaging the above scheme, I would suggest great caution in
reference to it, as it is impolitic and unwise to make fresh demands
upon a philanthropic public, unless the need for it is clearly
established, as the result must inevitably be the diversion of funds
from existing institutions already doing a good and charitable work.

[40] Maladies Mentales, Tome ii., p. 76, par E. Esquirol, médecin en
chef de la maison royale des aliénés de Charenton. "Les idiots sont ce
qu'ils doivent être pendant tout le cours de leur vie. On ne conçoit
pas la possibilité de changer cet état. Rien ne saurait donner aux
malheureux idiots, même pour quelques instants, plus de raison, plus
d'intelligence."

[41] "Mentally deficient children," page 110.

[42] This painstaking observer has investigated this subject in an
interesting communication on Sporadic Cretinism in the "Edinburgh
Medical Journal" for May, 1893. Dr. Ireland considers Sporadic
Cretinism to be a congenital or infantile form of myxœdema, and
bearing in mind the increasing mental torpor which has followed the
ablation of the thyroid gland performed by Kocher, and the cretinoid
condition induced in monkeys by the removal of the thyroid by Horsley,
he is drawn to the conclusion that this gland secretes and pours
something into the blood which has a powerful effect upon the
nutrition and function of the brain, and of the whole organism, and
these views receive a certain amount of confirmation from the fact
that in most cases of Sporadic Cretinism the thyroid gland is totally
wanting. Dr. Ireland also expresses the opinion, in which I fully
concur, that there is too much solidism in our pathology, and that the
vital powers of the blood have been too much overlooked.

Although the effect of thyroid treatment in the idiot is still _sub
judice,_ there is overwhelming testimony of its value in Myxœdema, an
allied affection; and I would refer those who desire further
information upon this matter to an important discussion at the
Edinburgh Medico-Chirurgical Society, in February, 1893, arising out
of papers read by Professor Greenfield, Dr. Byrom Bramwell, Dr.
Lundie, Dr. Dunlop, and Dr. John Thomson, when important additions
were made to the literature of this affection by Dr. Affleck, Dr.
George Murray, and others, whose matured views will form a valuable
contribution to our knowledge of this somewhat obscure subject.

[43] "Pediatrics," May, 1896, p. 460.

[44] I give M. Voisin's description of the symptoms in his own words.
"Elle est arrivée dans mon service en état d'extase mystique,
exécutant continuellement des mouvements de ses deux mains, surtout de
la droite, semblables à ceux d'une personne en prière; elle porte
souvent les mains à son front comme pour faire le signe de la croix.
Elle murmure des mots, entre autres, _Ave Maria_. La physiognomie
exprime la douleur mêlée d'extase."

[45] "Edinburgh Medical Journal," May, 1893, p. 1053.

[46] "Edinburgh Hospital Reports," Vol. 3, 1895, p. 245. "This is the
most complete monograph on thyroid treatment that has come under my
notice. Dr. Bramwell has recorded, in minute detail, the clinical
history of twenty-three cases of myxœdema, and five cases of sporadic
cretinism."

[47] "Journal of Mental Science," April, 1895, p. 280.

[48] "British Medical Journal," Jan. 30th, and Feb. 6th, 1892,
"Remarks on the Function of the Thyroid Gland." I recommend a careful
perusal of this important and exhaustive essay of Professor Horsley to
all those who desire to acquaint themselves with what is known about
the structure and functions of the thyroid gland; for it will be
remembered that it is to the experiments on animals by this learned
and accomplished scientist, that we are principally indebted for our
knowledge of the connection between myxœdema and loss of function of
the thyroid gland.

[49] "Traitement et Education des Enfants Idiots et Dégénérés," p.
241, par M. Bourneville, Médecin de Bicêtre, Paris, 1895. The author
of the above treatise is one of the most prolific French writers on
Idiocy, and I desire to call especial attention to that part of the
work which embraces the Medico-Pedagogic Treatment of Idiocy. In this
section, M. Bourneville describes in minute detail the gymnastic and
physical training adopted at Bicêtre, the description being copiously
illustrated by plates, which cannot fail to interest those engaged in
the treatment of idiocy.

[50] "Journal of Anatomy and Physiology," January, 1895, p. 304.

[51] "Pediatrics," March, 1896, p. 243.

[52] "On Idiocy and Imbecility," page 91.

[53] As showing the result of individual effort, I may mention that in
the year 1894, as much as £155 0s. 7d. was collected in the N. Walsham
District, £89 12s. 9d. in the Norwich District, and £80 15s. 6d. in
the Diss District, under the presidentship respectively of Mrs. Petre,
Lady Lade, and Mrs. Sancroft Holmes.

[54] The Countess of Warwick, at the "Young Helpers' League."

[55] Des Maladies Mentales, Tome ii., p. 103.



INDEX.


  Affleck, Dr., 93

  Alcoholic stimulants as a factor in the genesis of idiocy, 26
    abuse of, in Sweden, 29
    effects of, in France, 31
    Sir B.W. Richardson on, 30

  Anæmia, as the result of thyroid feeding, 97

  Anderson, Mrs. Garrett, on Sex in Education, 37

  Andriessen, on the cerebral convolutions of idiots, 51

  Animals, relation between
    their intelligence and the
    size of their brain, 49

  Association of idiots with
    the insane, a disadvantage
    to both classes, 19

  Aveyron, the savage of the, 18


  Beach, Fletcher, 25, 27, 28

  Besant, Sir Walter, 76

  Birth, injuries of the head at, 48

  Blood, analysis of, in
    thyroid feeding, 96
    supply of, varies in the two sexes, 37

  Bourneville, on Craniectomy, 101

  Brain, average weight of, in men and women, 46
    chemistry of the, 52
    difference between that of a senior wrangler and that of an idiot, 43
    difference in the two sexes, 37
    microscopical appearance of, in idiots, 51
    of gorilla and ourang-outang, 75
    size and weight, in proportion to intellectual power, 43
    structure of, in men of genius, 44

  Bramwell, Byrom, 93, 98

  Browne, Sir J. Crichton, on Sex in Education, 36

  Browne, Sir Thomas, 79

  Bruce, Lewis C., on thyroid feeding, 95

  Burton-Fanning, 94


  Caird, Mrs. Mona, 39

  Causes of idiocy, 23

  Cicero, 69

  Classification, 17

  Consanguine marriages, 32

  Convolutions of the brain
    in men of genius, and in those of low culture, 45
    in idiots, 51

  Couerbe, on the rôle of phosphorus in the brain, 52

  Craniectomy, 101
    statistics of, 103

  Cranium, early closure of the sutures of, 101

  Cranium, form of the, and
    its connection with
    idiocy, 43

  Cross, Lord, on habitual
    drunkards, 31

  Crossley House, 107

  Cuvier, brain of, 46


  Dahl, Ludwig, 25, 29

  Dana, on Craniectomy, 102

  Definition of idiocy, 15

  Dunlop, 93


  Edinburgh Medico-Chirurgical
    Society, discussion at, 92

  Educational Overpressure, on, 35
    has induced suicide in children, 41

  Esquirol, 85, 118


  Faculty a, must not be
    confounded with its
    material organ, 63

  Forceps, use of, as a cause
    of idiocy, 48

  Fraser, Professor, anæmia
    following thyroid feeding, 97

  Frere, Bartle, 20

  Froude, 77


  Gambetta, the brain of, 46

  Genius, a neurosis, 53
    its relation to cerebral structure, 44

  Goethe, 69

  Greenfield, Professor, 93

  Gynagogues, 40


  Hammond, G.M., 93

  Hammond, Prof. W.A., 49, 60

  Heredity, its rôle in idiocy, 25

  Horsley, Victor, Prof., 90, 100

  Howe, 26, 33

  Humphry, Sir George, on
    Craniectomy, 102


  Idiocy, causes of, 23
    classification of, 17
    definition of, 15
    its bearing on Evolution, 72
    moral aspect of, 117
    pathological anatomy of, 43
    should not be confounded with insanity, 19
    social aspect of, 116

  Idiot, the, description of, 22
    his association with the insane a disadvantage, 19
    his claims on society, 12, 114
    phosphorus in the brain of, 52
    possesses the tripartite nature of man, 120

  Intellectual differences
    between men and women, 36

  Intemperance of parents,
    a factor in idiocy, 26

  Ireland, W.W., 18, 25, 34, 42, 47, 90, 103


  Janet, Paul, on phosphorus
    in the brain, 53


  Kerlin, 27

  Kirkby, 91

  Kocher, 90


  Ladies' Association, 108

  Langdon-Down, 17, 30, 33, 48

  Lassaigne, 53

  Lelut, on the cranium of
    idiots, 44

  Lewes, G.H., 63

  Lewi, 93

  Lunatic Asylums, not
    adapted for idiots, 19

  Lundie, 93

  Lunier, 31

  Luys, on the brain of idiots, 51

  Lynn Linton, Mrs., on
    women's sphere of usefulness, 38


  Massachussetts report on idiocy, 26

  Matter and mind, 55

  Mierzejewski, on the brain of idiots, 58

  Millard, W., 78

  Mind, independent of its material organ, 66

  Mingazzini, on the cerebral convolutions, 44

  Moleschott, 52

  Moreau, on hereditary predisposition, 25
    his ideas on genius, 53

  Murray, G., 90, 93


  New York Academy of Medicine, discussion at, 93

  Norway, prevalence of idiocy in, 28


  Odium theologicum, 73


  Parental intemperance, 27

  Parker, Rushton, 99

  Pathological anatomy of idiocy, 43

  Permanent Endowment Fund, 82

  Phosphorus, its relation to intellectual vigour, 52

  Plato, 22, 64

  Pneuma, an attribute of the idiot, 71

  Psychological Congress in Paris, 58

  Richardson, Sir B.W., on the effects of alcohol, 30


  Saeger, 87

  Schiff, 90

  Science and Theology should not be antagonistic, 74

  Séguin, 15, 35

  Sex in Education, on, 36

  Shakespeare, his definition of idiocy, 15

  Shuttleworth, 28, 33, 50, 87

  Sidney, 80

  Strahan, 41

  Sweden, alcoholic abuse in, 31


  Telford-Smith, on sporadic cretinism, 99

  Thomson, J., 93, 99

  Thucidides, 21

  Thyroid feeding, 90
    psychical effects of, 100

  Toussenel, 29

  Toxic idiocy, 28

  Treatment of idiocy, 81
    medico-pedagogic, 102
    satisfactory results of, at the Eastern Counties' Asylum, 88

  Trousseau, on consanguine marriages, 35

  Turner, J.J. C., 33, 117


  Vacherot, 58

  Voisin, Auguste, 51, 95


  Wagner, 45

  Westcott, 41

  Westfelt, on the influence of alcohol on progeny and race, 31

  Wilbur, 28

  Wilmath, 44

  Winn, 67



EASTERN COUNTIES'

ASYLUM FOR IDIOTS,

COLCHESTER.

_Instituted 1st February, 1859._


Patron:

H.R.H. THE PRINCE OF WALES, K.G.


Presidents:

    THE MOST NOBLE THE DUKE OF NORFOLK, E.M., K.G.
    THE MOST HON. THE MARQUIS OF LOTHIAN, K.T.
    THE MOST HON. THE MARQUIS OF BRISTOL.
    THE RIGHT HON. THE EARL OF WARWICK.
    THE RIGHT HON. THE EARL CADOGAN, K.G.
    THE RIGHT REV. THE LORD BISHOP OF ST. ALBANS.
    THE RIGHT REV. THE LORD BISHOP OF NORWICH.
    THE RIGHT HON. LORD WALSINGHAM.
    THE RIGHT HON. LORD BRAYBROOKE.
    THE RIGHT HON. LORD GWYDYR.
    THE RIGHT HON. LORD HENNIKER.
    THE RIGHT HON. LORD RENDLESHAM.
    THE RIGHT HON. LORD RAYLEIGH.
    THE RIGHT HON. LORD DE SAUMAREZ.
    THE RIGHT HON. LORD CARLINGFORD.
    THE RIGHT HON. LORD TOLLEMACHE.
    THE HON. AND REV. CANON NEVILLE.
    THE LORD LIEUTENANT OF CAMBRIDGESHIRE.
    WILLIAM BIRKBECK, ESQ.


Vice-Presidents:

    The Hon. W.F. D. Smith, M.P.
    The Rev. Sir W. Hyde Parker, Bart.
    Sir Reginald P. Beauchamp, Bart.
    Sir Alfred Sherlock Gooch, Bart.
    Sir Charles C. Smith, Bart.
    Sir Brydges Powell Henniker, Bart.
    Sir Francis G.M. Boileau, Bart.
    Sir Fowell Buxden, Bart., K.C.M.G.
    Sir Savile B. Crossley, Bart.
    Sir Edward Green, Bart.
    Sir Walter Gilbey, Bart.
    Sir Weetman Pearson, Bart., M.P.
    The Very Rev. Dean Goulburn.
    The Very Rev. the Dean of Norwich.
    The Very Rev. the Dean of Ely.
    Charles H. Berners, Esq.
    Lieut-Colonel Bramston
    Henry E. Buxton, Esq.
    Professor Duncan, F.R.S.
    Robert T. Gurdon, Esq.
    Colonel Lockwood, M.P.
    Rev. Charles John Martyn, M.A.
    Captain Pretyman, M.P.
    Arthur Pryor, Esq.
    W. Cuthbert Quilter, Esq., M.P.
    Hector John Gurdon Rebow, Esq.
    H.C. Wells, Esq.


Board of Directors:

_Chairman_--THE MOST HON. THE MARQUIS OF BRISTOL.

_Vice-Chairman_--ADMIRAL W.G. LUARD, C.B.

_Treasurer_--HORACE G. EGERTON GREEN, ESQ.

    ALEXANDER, WILLIAM, ESQ.
    BACK, PHILIP, ESQ.
    BARNARD, WILLIAM, ESQ.
    BARNARDISTON, COLONEL
    BATEMAN, SIR F., M.D., LL.D.
    BATEMAN, JOHN, ESQ.
    BEVAN, BECKFORD, ESQ.
    BULLARD, SIR HARRY, M.P.
    BURKE, LIEUT.-COLONEL
    BURTON, SAMUEL C., ESQ.
    CADGE, W., ESQ.
    CHAMBERLIN, A. R., ESQ.
    CHANCELLOR, F., ESQ.
    COLMAN, J.J., ESQ.
    COURTAULD, GEORGE, ESQ.
    DAKIN, W. H, ESQ.
    DUCKETT, REV. CANON, D.D.
    EDWARDS, H.W. B., ESQ.
    EGERTON-GREEN, CLAUDE, ESQ.
    GARRETT, HENRY N., ESQ.
    GODFREY, CHARLES, ESQ.
    GREENE, E. WALTER, ESQ.
    HARVEY, E.K., ESQ.
    HOARE, CHARLES R.G., ESQ.
    HUNT, E.A., ESQ.
    IMAGE, W.E., ESQ.
    IND, CAPTAIN
    KELSO, CAPTAIN, R.N.
    MACANDREW, W., ESQ.
    MARTYN, REV. C.J.
    MERRIMAN, W., COLONEL, C.I.E.
    MONTAGU, GENERAL., C.B., R.E.
    PACKARD, EDWARD, ESQ.
    PAPILLON, PHILIP O., ESQ.
    PATTESON, H.S., ESQ.
    PAXMAN, JAMES, ESQ.
    ROWLEY, SIR JOSHUA T., BART.
    RUCK-KEENE, REV. B.
    RUGGLES-BRISE, A.W., ESQ.
    SAVILL-ONLEY, C.A. O., ESQ.
    STRADBROKE, THE EARL OF
    SYMMONS, R.F., ESQ.
    TOWER, CHRISTOPHER J.H., ESQ.
    TRACY, N., ESQ.
    TUFNELL, W.M., ESQ.
    WELLS, F., ESQ.
    WINTER, J.J., ESQ.
    WOOD, CHARLES PAGE, ESQ.


_Hon. Consulting Physicians_--

    SIR FREDERIC BATEMAN, M.D., LL.D., F.R.C.P.
      Consulting Physician to the Norfolk and Norwich Hospital.

    T. CLIFFORD ALLBUTT, M.D., LL.D., F.R.S., F.R.C.P.
      Regius Professor of Physic, University of Cambridge.


_Hon. Consulting Surgeons_--

    R.F. SYMMONS, ESQ., Consulting Surgeon to Essex & Colchester Hospital.
    E.A. HUNT, ESQ., Surgeon to Essex and Colchester Hospital.

    _Hon. Ophthalmic Surgeon_--DR. S. JOHNSON TAYLOR, Norwich.

    _Hon. Medical Officer, Crossley House, Clacton-on-Sea_--

    WALTER MAINE, ESQ.

    _Hon. Dentist_--N. TRACY, ESQ.
    _Hon. Solicitor_--A.M. WHITE, ESQ.
    _Hon. Architect_--F. CHANCELLOR, ESQ.
    _Auditor_--MR. ROBERT L. IMPEY (Chartered Accountant).

    _Resident Medical Attendant_--

    R.C. KIRKBY, M.R.C.S., Eng., L.R.C.P., Lond.

    _Resident Superintendent and Secretary_--JOHN J.C. TURNER.

    _Bankers_--MESSRS. BARCLAY & CO., Limited.



LADIES' ASSOCIATION.


Patroness:

HER ROYAL HIGHNESS THE PRINCESS OF WALES.


Vice-Patroness:

THE MARCHIONESS OF BRISTOL.


Presidents:

    THE COUNTESS OF ALBEMARLE.
    THE COUNTESS OF WARWICK.
    THE COUNTESS CADOGAN.
    THE COUNTESS OF STRADBROKE.
    LADY EVELYN COBBOLD.
    LADY FLORENCE BARNARDISTON.
    LADY IDA LEIGH HARE.
    LADY SUSAN BYNG.
    THE LADY RAYLEIGH.
    THE LADY BATEMAN.
    THE LADY AMHERST OF HACKNEY.
    THE HON. LADY ROWLEY.
    THE HON. ETHEL HENNIKER.
    THE HON. MRS. PRETYMAN.
    LADY FFOLKES.
    LADY AFFLECK.
    LADY DURRANT.
    LADY RICH.
    LADY THORNHILL.
    THE MAYORESS OF NORWICH.
    THE MAYORESS OF KING'S LYNN.
    THE MAYORESS OF BURY ST. EDMUND'S.
    MRS. ADEANE.
    MRS. ARKWRIGHT.
    MRS. AUSTEN-LEIGH.
    MISS BUXTON.
    MRS. CATOR.
    MRS. RUSSELL COLMAN.
    MRS. CRAWLEY.
    MRS. CROWFOOT.
    MRS. DE CHAIR.
    MRS. DOWSETT.
    MRS. EGERTON-GREEN.
    MISS FARRER.
    MISS E. BLANCHE HAMMOND.
    MRS. SANCROFT HOLMES.
    MRS. INGLEBY.
    MRS. JOHNSON.
    MRS. SIDNEY LACON.
    MRS. LOCKER-LAMPSON.
    MRS. LE STRANGE.
    MRS. LITTLEWOOD.
    MRS. LOCKWOOD.
    MISS MABEL LOWTHER.
    MRS. BERKELEY MANSEL.
    MRS. MCINTOSH.
    MRS. EDWARD PACKARD, JUN.
    MRS. VICTOR PALEY.
    MISS OXLEY PARKER.
    MRS. PETRE.
    MRS. HOWELL PRICE.
    MRS. ERNEST RANSOM.
    MRS. ROUND.
    MISS ROUND.
    MISS FLORENCE RUGGLES-BRISE.
    MRS. HENRY SHARPE.
    MRS. STANLEY.
    MRS. TOWNLEY.
    MRS. VAIZEY.
    MISS MARGARET WATERS.
    MRS. WEDD.
    MISS WOOD.
    MRS. FRANK WORTHINGTON.


     The Eastern Counties' Asylum has been established for the care,
     education, and training of Idiots and Imbeciles of all classes
     residing in the Counties of Norfolk, Suffolk, Essex, and
     Cambridge.

In these Counties there are upwards of 3,000 cases of Idiocy and
Imbecility, and the Asylum at Colchester is _the only one_ in the
District. It stands in its own grounds of six acres, near the Railway
Station, and is supported by voluntary contributions. There is a small
Farm attached to the Asylum and a Sea-side Branch at Clacton-on-Sea,
and there is accommodation for 250 patients. Those whose friends are
unable to pay for their care and maintenance, are elected to the
benefits of the Asylum by the votes of the Subscribers, and, subject
to the rules and regulations, are admitted for five years. It is
expected, however, that some contribution should be made if possible.
After residence in the Asylum for 3-1/2 years, and if it is found that
patients are unable to be taught wholly or partly to maintain
themselves, they may be re-elected for additional terms of five years,
and a small proportion are allowed to be re-elected for life. Insane
persons, and cases suffering from confirmed Epilepsy, are not eligible
for admission. Paying Patients are admitted by the Board of Directors,
without election, at any time, the charges varying according to the
circumstances of the friends and their requirements. Separate sitting
and bedroom accommodation, with the advantage of a special Attendant
or Nurse, is provided when wished, such an arrangement combining the
quietude and comfort of a private residence with the hygienic,
educational, and training resources of a Public Institution. The
Asylum is under the personal charge of Mr. and Mrs. J.J. C. Turner,
Superintendent and Matron, and there is likewise a Resident Medical
Attendant.

The Elections occur in the Spring and Autumn, and are held in the
principal towns of the Eastern Counties. Donors of Five Guineas are
entitled to a Life Vote, and Annual Subscribers of Half-a-Guinea to
two votes annually, the right of Voting as regards higher sums being
increased in the same proportion. Contributors may individually
exercise the right of Voting, or transfer the same to the House
Committee of the Asylum or to any Local Committee.

Reports, Forms of Application for Admission, and any other information
will be supplied by the Secretary, Mr. John J.C. Turner, Asylum,
Colchester.

The Board of Directors earnestly appeal for Annual Subscriptions and
Donations to enable them to carry on this important work. Since 1884
the Annual Subscriptions have been reduced, owing to deaths and
discontinuance, by upwards of £1,000. The applications for admission
are numerous and urgent, and the present expenditure exceeds £7,000
annually, towards which only £800 is forthcoming from invested
Capital. Only those who are brought into close contact with mental
affliction can adequately realise the sad trial and immense anxiety of
having an Idiot child, and where this affliction has not been
experienced, it is hoped that some sum, however small, will be given
as a thank-offering.

    JOHN J.C. TURNER,
    _Secretary_.



By the Same Author. Demy 8vo, 16/- Second Edition, Greatly Enlarged.

_Prize Essay of the Academy of Medicine of France._

ON

APHASIA,

OR

Loss of Speech,

AND

THE LOCALISATION OF THE FACULTY OF ARTICULATE LANGUAGE.

_Ouvrage couronné par l'Académie de Médecine de France (Prix
Alvarenga, 1891)._


OPINIONS OF THE PRESS.

From the _British Medical Journal_.

"We feel quite sure the profession will gladly welcome the second
edition of Dr. Bateman's well-known and valuable work. It teems with
illustrative cases, and is essentially one for the student of Aphasia
always to have by him, in order that he may readily refer to it from
time to time; any case he may have under his care will indeed be rare
if he cannot find an allusion to a parallel one in Dr. Bateman's book.

"We think that the author was very well advised in extending chapter
xii., for there are grouped together a number of interesting facts on
important topics, such as the difference between the convolutions of
criminals and of intellectual men, the difference in the microscopic
structure of the brain, the cranial capacity, and other subjects of
which it is usually difficult to find any mention."

    From the _London Medical Recorder_.

"The numerous clinical cases form a valuable feature in this book.
These illustrative records have been gathered from a wide range of
reading and experience, and hardly any case of importance bearing on
the subject appears to have escaped notice. As a work of reference,
then, this volume will be indispensable to all who are interested in
the study of nervous diseases."

    From _Nature_.

"A useful part of this work is a chapter on the Medical Jurisprudence
of Aphasia. This is a subject which we believe has not been touched
upon in any previous English text-book, and it is of the greatest
importance. To summarise briefly, we may say that Dr. Bateman's work
is one that should be read by everyone interested in the faculty of
language, or in diseases of the nervous system. It contains an
enormous amount of valuable material, which has been put together by
great labour, and is written by one who has devoted many long years to
his subject."

    From the _Solicitor's Journal_.

"This book is a second and greatly-enlarged edition of a treatise
published some years since by Dr. Bateman. It gained a prize, on the
recommendation of the French Academy of Medicine, in 1891, and its
author has recently received the honour of knighthood, in recognition
of his distinguished labours.

"While the whole work possesses great scientific interest, chapters v.
and x. are of peculiar value to general and legal readers. In the
latter, the Jurisprudence of Aphasia is dealt with. This question has
not hitherto been treated by any British author, although it involves
issues of such frequent occurrence and general importance as the
capacity of speechless persons to make a will and to manage their
affairs, and their civil and criminal responsibility. Having examined
this part of Dr. Bateman's treatise with the utmost care, we have no
hesitation in commending it heartily to our readers as an able
exposition of a difficult subject, enriched by illustrations from
Continental Jurisprudence."

    From the _Norfolk Chronicle_.

"In the goodly volume of over 400 pages before us, we have substantial
proof of the perfection that may be attained by Theory and Practice,
walking and working hand in hand. An eminent physician, whose great
energies and rare knowledge of therapeutics are apparently absorbed in
the everyday exercise of his noble profession, has yet found time for
deep research and original speculation in one of the most fascinating
regions in the whole range of Neuro-pathology. The result is such as
only the well-directed devotion of a life-time could have produced.
Here, in one, we have a student's text-book, a scientist's guide and
companion, and, lastly, a psychological treatise certain to attract a
large share of attention at the hands of the intelligent general
reader. For the medical profession it possesses, without doubt, a
primary interest--yet, withal, it is replete with interest to the
general reader."


CONTINENTAL NOTICES.

_Les Archives de Neurologie_, Vol. xx.

"Ce livre est la deuxième édition considérablement augmentée du traité
publié il y a vingt ans et bien connu de nos lecteurs.

"N.B.--Ce livre est parfaitement au courant de la science actuelle."

    _La Revue de l'Hypnotisme._

"L'ouvrage du docteur Bateman a déjà reçu un accueil favorable de
l'Académie des sciences et de l'Académie de médecine de Paris. En le
présentant à la Société de Biologie, le Président, M. Brown-Séquard, a
fait un éloge mérité de ce remarquable ouvrage aussi savant
qu'original.

"Le livre du docteur Bateman apporte une contribution précieuse à la
médecine psychologique. M. Bateman a compulsé toute la littérature
scientifique de l'Europe et de l'Amérique sur le sujet qu'il a traité,
et ses études faites pendant plus de vingt années sur les cas qu'il a
rencontrés à l'hôpital de Norwich et dans sa clientèle privée, lui ont
permis d'arriver a des conclusions véritablement pratiques."

    _Annales d'Hygiène Publique et de Médecine Légale_,
    Tome xxvi., p. 583.

"La première édition du traité de M. Bateman avait été très
favorablement accueillie du public médical. La seconde édition,
augmentée d'observations nouvelles, tenue au courant des progrès de la
science, n'aura pas moins de succès.

"Les premiers chapitres du volume sont consacrés a l'historique de
l'aphasie et de la localisation de la faculté du langage articulé:
l'auteur y rend pleine justice aux auteurs français, Broca, Trousseau,
Charcot, &c., qui ont les premiers soulevé cette question délicate. Le
chapitre iv. contient les observations personnelles de M. Bateman dont
beaucoup ont été recueillies dans son service à l'hôpital de Norfolk
et Norwich. Dans le chapitre suivant M. Bateman étudie et analyse la
faculté de parler, la parole articulée, résume les opinions de Max
Muller, de Whitney, de Parchappe, &c. La parole est un acte
physico-psychique, composé de deux éléments, l'un somatique et
matériel, le mouvement, l'autre psychique, la parole interne, le
λογος. Le langage est donc une fonction à la fois impressive
et expressive. La fonction impressive nécessite l'action de l'ouïe, de
la vue ou d'un des sens, c'est la fonction sensorielle du langage;
l'autre résulte d'une action musculaire, et constitue la fonction
motrice. Le langage articulé est l'apanage de l'homme seul.

"L'auteur décrit ensuite le mécanisme du langage, les organes de la
voix, le larynx; il étudie plus loin les différents types de langage;
il montre que le langage articulé n'est pas le seul moyen que l'homme
ait d'exprimer sa pensée, il oppose le langage naturel au langage
artificiel ou acquis, &c.

"Avec les chapitres suivants nous entrons dans la pathologie; M.
Bateman y décrit l'agraphie, l'aphasie dans toutes ses formes et
variétés. Il étudie ses causes, son diagnostic, son pronostic, son
traitement, son importance en médecine légale; enfin dans les derniers
chapitres, M. Bateman s'occupe plus généralement de la localisation de
la parole, et il résume les opinions des physiologistes les plus
célèbres depuis Gall jusqu'à Barnard Davis, Flower, Broca, &c."

    _Comptes Rendus de la Société de Biologie_, Tome ii., No. 30.

"Au nom de l'auteur, le Dr. Frédéric Bateman, je présente à la Société
un exemplaire de la seconde édition de son célèbre ouvrage sur
l'aphasie. Les progrès considérables de nos connaissances, durant les
vingt dernières années, sur les diverses espèces d'aphasie, sont
exposés avec une grande clarté dans ce remarquable ouvrage aussi
savant qu'original, le plus complet qui existe sur la matière dont il
traite. L'auteur lui a consacré toute sa vie, déjà longue, de penseur
et de praticien."

    "LE PROFESSEUR BROWN-SÉQUARD,
    "_Président de la Société de Biologie_."

    _Gazzetta Degli Ospitali, Milano._

"È una monographia importante su questa affezione tanto studiata ai
nostri tempi. L'A conosce tutto ciò che fu scritto in proposito e lo
sottopone ad una critica sensata e profonda. Egli raccolse un gran
numero di casi, e, avendo cosi avuto a sua disposizione un vasto
materiale, ha potuto studiare accuratamente la malattia.

"Il quarto capitolo contiene le esperienze cliniche dell'A, in una
serie di X Casi dettagliati alcuni dei quali furono da lui osservati
come medico del Norfolk and Norwich Hospital. Interessante quello di
una afasia puerperale in una signora il cui vocabolario era limitato
ad una frase: the other day--l'altro giorno."

    _Neurologisches Centralblatt._

"Im 1.--3, Kapitel wird die Litteratur und Bibliographie der Aphasie
ausführlich berichtet, indem die betreffenden Arbeiten aller Länder in
gleichem Maasse gewürdigt werden. Im 4. Kapitel finden wir einige
eigene Beobachtungen des Autors. Kapitel 5 bringt die Definition der
Aphasie und die Entwickelungsgeschichte der Sprache. In Kapitel 6 und
7 wird die Klassification der Sprache abgehandelt. Mitunter fehlen dem
Sprechenden nur die Substantiva, oder ganz bestimmte Worte, oder eine
bestimmte Landessprache; in anderen Fällen von Aphasie werden nur
bestimmte Phrasen beständig wiederholt etc. Auch die Schriftstörungen
und die Anomalien der Mimik und Zeichensprache bei der Aphasie werden
besprochen; ferner die Affectausdrücke, Bedeutung der Injectionen, der
hysterische Mutismus u. s. w. Im 8. Kapitel werden die ätiologischen
Factoren der Aphasie hervorgehoben: Angeborene Stummheit,
Sprachstörungen der Idioten; Aphasie in Folge von Exostosen der
Schädelknochen; Thrombose, Embolie der Gehirnarterien; ischämische
Erweichung, etc. Kapitel 9 behandelt die Diagnose, Prognose, Therapie,
während im folgenden Kapitel die Rechtsfragen der Aphasischen erörtert
werden. In den letzten Kapiteln 11 und 12 geht der Verf., soweit die
betreffenden Gegenstände zur Aphasie in Beziehung treten, auf den
Hypnotismus ein, den anatomischen Sitz, die mikroskopischen Befunde,
auf die Physiologie und Psychologie der Sprache, die experimentelle
Pathologie, die allgemeine Anthropologie, auf die Hirnchemie etc."


AMERICAN & COLONIAL NOTICES.

From the _Montreal Medical Journal_.

"The learned author of this work was the first to publish in English a
treatise on Aphasia. Not the least interesting part of the work is
that referring to the author's own contributions. The subject of
Aphasia is treated in all its relations, and in all its forms and
modifications.

"There is certainly no work in the English language which gives such a
full and accurate account of this abstruse subject. The author is to
be congratulated on having produced a work that will be a standard
authority on loss of speech."

    From the _American Journal of Insanity_.

"Perhaps the most remarkable thing about this book of Dr. Bateman's is
the singular spirit of scientific fairness that characterizes its
every utterance, so conspicuous and so anomalous is this, that it is
worthy of special mention.

"It is a book which no student of medicine, of language, or of
psychology can afford to be without."

    From the _New York Medico-Legal Journal_.

"This is a book which will interest all neurologists, and reflects
great credit on its author, for the research and care, as well as
fairness of the discussion, which is raised between the several
schools of thought.

"That part of the work most interesting to us is the chapter on the
Medical Jurisprudence of Aphasia, the hints on criminal Anthropology,
the Chemistry of the Brain, and the question of Localisation of the
Faculty of Speech.

"The work on the whole is a very valuable contribution to the
literature of Aphasia, and will be welcomed by all Neurologists."

    From the _Alienist and Neurologist_.

"This is a valuable contribution to the history and literature of the
subject, a subject not yet too old to have lost its interest to either
professional or lay reader.

"No library of the literature of Aphasia, however, would be complete
without this book. The author is elaborate without complexity."


_London: Jarrold and Sons, 10 and 11, Warwick Lane, E.C._


       *       *       *       *       *



Transcriber's Notes


  Obvious punctuation and spelling errors repaired.

  Italic text is denoted by _underscore_ and bold text by =equal signs=.

  Inconsistent hyphenation has been repaired.

  The oe and ae ligatures in the text has been left as it appears in the
  original book.

    On page 47 "genetous" replaced with  "genetic".
    On page 59 "demostand" replaced with "demonstrants".
    On page 81 "artizan" replaced with "artisan".

  Greek translations:

    sôma, psychê, pneuma
    σωμα, ψυχη, πνευμα

    idiotês
    ιδιοτης

    iatros kaì ìdiôtês
    ιατρος καì ìδιωτης

    Ho de nous eoiken enginesthai ousia tis ousa, kai ou phtheiresthai.
    Ὁ δε νους εοικεν εγγινεσθαι ουσια τις ουσα, και ου φθειρεσθαι.

    nous
    νους

    ousia
    ουσια

    logos
    λογος

    en métrô hôs poiêtês, hê haneu métrou hôs idiôtês
    εν μéτρω ὡς ποιητης, ἡ ἁνευ μéτρου ὡς ιδιωτης

    iatros kahi hisiôtês
    ιατρος καἱ ἱσιωτης

  In ambiguous cases, the text has been left as it appears in the
  original book. In particular, many mismatched quotation marks have
  not been changed.

  The following numerous errors were left as is:
    endquote missing punctuation
    wrong spaced quotes
    long line errors appear only with Greek lettering





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