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With as large an experience in the observation of idiots as perhaps any of my professional brethren, I am even now disposed to leave the subject of classification on this physiological basis where Dr. Seguin left it more than thirty years ago. I recognize, as he has recognized, two forms of physical degeneracy, one symptom of each of which is a greater or less degree of impairment of the mental faculties. I refer to cretinism as it occurs endemically as a rule, in some parts of Europe and in a few districts in this country; and also to that modified form of cretinism quite common in this country and in Great Britain, which has been called the Mongolian, or Kalmuc, type of idiocy. Under this latter class five per cent of the pupils admitted into American asylums would fall, I should judge. I am also convinced that the proportion would be still larger but for the fact that many of them die before the customary age of admission in our institutions; and the attention of physicians has not yet been called to their peculiarities.

Except in the oblique direction of their eye, I find little constant resemblance to the Mongolian race in these degenerate beings, any more than in the case of Albinos to any other race. The form of their skulls is rather incidental than racial. The hair and complexion, the skin and mucous membrane, the clumsy bodies and the shortness of the extremities, their respiration and temperature, the feeble vitality and the diseases they are subject to, all give evidence of their degeneracy. I have known but few who survived to adult life.

A recent writer, for whom I have great respect, has lately offered a classification based upon pathology, which should receive our attention. I refer to the classification of Dr. Ireland, first presented in a medical journal, and since elaborated and illustrated in his work on idiocy.

He introduces the subject by saying that, "coming to the study of idiocy after having gained some experience in medicine, I have from the beginning viewed it from the stand-point of pathology, and my idea of idiocy is compounded of the following classes, which are generalized from individual existing idiots, who resemble one another by having the same or similar diseases, as they resemble the type of idiocy by having mental deficiency along with a corporeal disease.

"1. Genetous Idiocy.
"2. Microcephalic Idiocy.
"3. Eclampsic Idiocy.
"4. Epileptic Idiocy.
"5. Hydrocephalic Idiocy.
"6. Paralytic Idiocy.
"7. Cretinism.
"8. Traumatic Idiocy.
"9. Inflammatory Idiocy.
"10. Idiocy by Deprivation."

It should be borne in mind that the essential fact of idiocy is the mental deficiency. That the point of interest for us is the degree to which this condition can be obviated. Furthermore, it is dependent upon physical conditions, whether physiological or pathological, that are chronic or organic, -- slowly produced structural changes, when pathological, -- and so, as a rule, beyond the reach of remedial means. The sphere of these, when used in the treatment, is almost exclusively confined to ameliorating the accessory maladies.

The actual work of obviating the condition of idiocy is an educational one, using the term in a broad sense; and if any favorable effect is produced upon abnormal organic states, it will ordinarily be through the reflex action of properly adjusted mental exercises.

I have thus gone over hastily some of the forms of classification that have been suggested in the case of idiocy. Without venturing to propose another I open the inquiry for your consideration, whether there is not room for a supplementary one.

Taking my experience as a guide, I should say that we all have some practical tests that we use consciously or unconsciously in determining the relative degree of idiocy of any case brought to our notice, or when confronted with a new pupil. We have some basis for the decision we make as to the location of the new-comer in our scale of exercises in training and education; some reasons for the opinions we express to the friends of such pupil of the probable result of our system of management and training in each individual case. Incidentally, we notice the associated pathological conditions or complications, less from their supposed relation as causes of the idiocy, but as interfering, to a greater or less degree, with our efforts at instruction or training. The manifestations upon which we base our prognosis are more subtile -sic- than the accompanying conditions of microcephalus or paralysis, or others that form the basis of any pathological classification.

Can we not, then, by thought and consultation, give some practical order and distinctness to these data and indications, as a foundation for a tolerably clear and correct prognosis?

Finally, do we not need some effective form of description of our cases; some generally recognized tests of physical and mental condition that will show, in the first place, the starting-point in the pupil's career, to which reference can be made from time to time to test their absolute or relative progress? Do we not need some mile-posts along in the educational path to the same end? This would be, in one sense, a form of classification, namely, in relation to the growth and development of the pupils.