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To this enterprise Dr. S. G. Howe, long identified with the education of the blind and other works of philanthropy, lent his name. Thence followed the establishment of institutions in other states, a list of which is here given.

The history of systematic efforts to benefit idiots having thus been briefly given, attention may now be called to the form which such efforts have necessarily taken.

Whatever the accepted theory of the relation of body and mind, generally; whatever the nature of the supposed prevailing causes that may have produced that default of intelligence, or natural condition known as idiocy, for those who propose in any manner to remedy it, one thing is practically true, that is, it is the immediate result of a defect or infirmity of the brain or other portions of the nervous system; or, at least very intimately associated with such physical states.

As a defect, there may be want of size or want of brain capacity, from whatever cause arising; a want of proper relation or connection between its elementary parts, or various abnormal modifications of its more intimate structure or organization.

As an infirmity there may be default of normal functional activity in that organ or its appendages. This statement includes a variety of subtile conditions or influences, that may be suggested or inferred rather than demonstrated; originating in the brain itself or derived from impairment of function of remote but correlated organs. Their nature is beyond our knowledge. This is a pathological state that is thus described, and we are restricted in speculating about it, to the use of forms of expression (like abnormal), that are simply negative; and that of activities, which are in turn merely subjects of speculation. For given a penetrating power in the microscope that should reveal the ultimate secret of cerebral organization (of which it now stops very far short) what then should we know of the subtle changes and movements, vaguely called molecular action, except the product of surmise or fancy. Something, doubtless, may be learned of the crude conditions that attend sleep; but how the dormant faculties and powers of the animal kingdom are renewed while sleeping; the daily succession of consciousness active and consciousness suspended -- can this be solved?

Of the physical causes first named, that is, changes of structure, it will be seen that from the very nature of the case they cannot absolutely be removed. They have their origin and seat in congenital organic defect, or in abnormal organic conditions induced by disease, in a region and in tissues not susceptible of much modification by remedial measures. Absorption and regeneration are nature's processes for remedying such conditions, but these forces cannot be rendered active and operative under such circumstances.

Of the second class of influences, some degree of reformation, under favoring circumstances may be predicated. Thus hygienic and remedial means may be undertaken, with a reasonable hope of success to establish a healthy functional activity of the nervous system and other bodily organs. If not at the outset, there comes a time when to bring the brain and the nerves of relation into exercise is indispensable. This is the work of education.

Rational efforts then for the amelioration of the condition of idiocy resolve themselves into measures of management, training and education.

In institutions for this purpose the same general features are everywhere seen. A gymnasium, to develop muscular power, dexterity and a proper carriage; for idiots, as a class, are deficient in strength; their muscles are not under the control of the will to that extent of individualizing the action of the various muscles that ordinary persons possess. Thence arises, in part, the uncertain and clownish trait, one of their marked characteristics. But the gymnasium has another use. It is the school for the first step in the development of the will. The natural order in the development of the will is first in the direction of the muscles, then over the senses in watching the movements or heeding the directions of the drill master. The experience thus gained of self-determination can than be applied to the mastery of other powers and faculties.