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So, too, when idiocy is classified by known or probable pathological conditions underlying it, such distinctions are of little practical value in devising modes of obviating the resulting mental states or in predicting results of such methods.

Take one of the latest of these classifications that has fallen under my eye. It is found in a paper read before the British Medico -- Psychological Association on the Classification and Prognosis of Idiocy. The author divides idiocy into ten groups or classes:

1. Hydrocephalic idiocy.
2. Eclampsic idiocy.
3. Epileptic idiocy.
4. Paralytic idiocy.
5. Inflamatory idiocy.
6. Traumatic idiocy.
7. Microcephalic idiocy.
8. Congenital idiocy.
9. Cretinism.
10. Idiocy by deprivation -- that is, by the loss of two or more of the senses.

With more than twenty-five years of observation of idiots and engaged during the whole period in the effort to ameliorate their condition, I am constrained to say, that I have seen almost every shade of mental deficiency in connection with each of these groups enumerated. But the essential thing in idiocy is the mental deficiency, no matter upon what physical cause depending. The last two groups have positive and easily detected characteristics, and so a clear significance. But examine for a moment the others. The eighth group or congenital may also include any one, or, in fact almost all of the preceding. Of several of them it may be said that they are not only not incompatible with certain others, but very commonly associated with them. In other words, many idiots could be properly ranked in two or more of the categories named.

Then as to the results of management and treatment or training and instruction, or as it is put, the prognosis, I see no guide in such a system of classification for determining this. The very basis of the classification is upon secondary pathological conditions, that in turn rest upon organic lesions, the nature and extent of which can only be a matter of surmise or inference.

A pathological classification may however be used to indicate the ordinary and immediate causes which produce idiocy. From such a study, it would be seen to occur first as a form of human degeneracy, the result of congenital or post-natal influences; or, secondly as a consequence of accidental causes, that have interrupted or checked the laws of normal human growth.

Of the former, a majority may be classed as the result of hereditary neuroses in one or both families. That is to say, there may have been in the ancestral line insanity or idiocy, or some of the protean forms in which disease of the nervous system manifests itself. Not necessarily in the immediate progenitors, for physical traits, whether normal or abnormal, sometimes skip a generation or two, to appear again in remoter descendants. Not necessarily in the same form of nervous defect or derangement, for with impaired function of the nervous system generally, accidental circumstances and influences may determine the precise mode of manifestation.

The intermarriage of near relatives is not an infrequent cause of idiocy, because it intensifies, in the offspring, the family defects and vices. Again ill-health, any serious constitutional affection, or the intemperance of one or both parents at the time of conception, insufficient food, continued ill-health, depressing influences or any sudden shock to the mother during gestation may induce idiocy in the child. In the latter form of causation may be classed all injuries to the brain during infancy, whether the result of primary or secondary disease, or from strictly accidental causes. Thus, on the one hand, there may be the ill-effects of convulsions, epilepsy, hydrocephalus or any primary disease or inflammatory process; or the translation of eruptive or remote organic disease to the brain or central nervous masses. On the other hand, there may be injuries to the brain, in parturition, from instrumental interference or otherwise; from blows on the head or concussion in infancy; and in rare instances, from fright.

The laws of hereditary transmission are but imperfectly understood by the wisest of our scientists, and still more imperfectly acted upon by ordinary persons in the formation or exercise of their social relations. But the roundabout way in which the violation of natural laws or any overstepping the natural limits of the exercise of the normal powers and faculties of the parent, acts to destroy or diminish the vitality of the offspring, may be learned by the study of even these last-named, or so-called accidental causes of idiocy. Thus, an excessive or protracted exercise of the mental faculties, to the exclusion of a proper amount of physical exercise, may result in a general and disproportionate increase in the size of the brain the organ and instrument of mental action. Abnormal development or undue functional activity in any organ is commonly at the expense of other and correlated organs. Increase in the relative volume of the brain in the parents tells, perhaps, in the make-up of the offspring even in embryo, and then occur difficulties in the way of parturition, interfering with the natural course and progress of that function. Among the ascribed causes of insanity, as well as idiocy, of not infrequent occurrence, according to late professional writers, are injuries to the infant skull in the process of birth.