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Idiocy: And Its Treatment By The Physiological Method

Creator: Edward Seguin (author)
Date: 1907
Publisher: Teachers' College, Columbia University
Source: Available at selected libraries

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229  

The absolute or complete abolition of the movements of relation dependent on the absence of the impulse of the encephalon, and leaving to the idiot only the involuntary contractions of organic life, dependent on good spinal and sympathetic system, must not be hastily attributed to paralysis. No doubt there are idiots paralyzed, but their immobility is more a cause than an effect of idiocy. On the contrary, the incapacity of movement here considered is a psycho-physiological phenomenon, whose incomplete analogue is found in the condition of a child who, having been kept in bed for months, tries to walk. He attempts to transmit the orders of his will to the distant organs of locomotion, but in vain, till his mother forwards his foot and teaches the nerves and muscles the lost art of walking. The idiot does not learn to walk so fast as this convalescent child, for several reasons: He never did walk; his immobility has lasted all his life instead of a few months, and we must create in him the desire that he never had of walking; and second, his will, far from being ready to command anything, has never yet suspected nor tried its wonderful powers.

230  

Infantile paralysis, even complicated with extensive contractures and chorea, as it is often, is not necessarily beyond the resources of our art. As means of treatment we would suggest general and special nutrition of the affected limbs, general and special excitors of heat and electricity, general and special gymnastics, sea-bathing, shampooing, kneading the parts, commanding, exacting the movements, and a few select medicinal agents unnecessary to suggest to confreres.

231  

We meet more frequently with the partial loss of movement expressed by the fixedness of the child where and as he is placed, standing, lying, seated any way, or by the impossibility of his hands taking hold of anything, even carrying food to the mouth; he is immovable of his own will, movable only by another's as by an external spring.

232  

This relative immovability of the idiot, of the demented, too, the result of inertia, has no parentage whatever with the immobility by which a man or an animal assembles his forces to throw them into action; this is a positive, the other a negative attitude. From positive immobility springs an active determination; in negative immovability resides the power to nearly neutralize any external inducement or any internal motive to action. This immovability is therefore the first expression we meet with of the radical elements of idiocy, the negative will. Henceforth we shall find many and the most varied incapacities, all doubled, made nearly indomitable by the silent protean " I will not" of the negative will. Impossible now to forget it, and whenever found it has to be treated, as we will do presently, where it would perpetuate, with incapacity of motion, the whole train of idiocy.

233  

But we are often prevented from at once overcoming this obstacle by the interposition of another already mentioned, under the head of automatic, mechanical or spasmodic motions. As long as these motions exist with or without negative immobility of the rest of the body, we cannot expect to see the child improve in willed action nor in active immobility; therefore it is our duty to try to overcome it all at once when we can, or as soon as possible.

234  

These anomalous movements have their seat, not always, but mostly in the wrist and fingers. We have described their various characters, and shall say no more here than is necessary to the rationale of their treatment. In automatic movements, the child uses one part of himself, one finger or one eye, as if it were an automaton whose recurrent movements produced his beatitude. In mechanical movements the child uses, besides paper, thread, metals, anything whose breaking, touching, ringing, pleases exclusively one of his senses; not the best -- on the contrary, the most diseased. In spasmodic movements the child has no object, or if he has any, such as striking something or at somebody, it is prompted by a blind, sickly impulse.

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Each of these movements is best combated by exercises which offer the strongest contrast to the bad habit. Automatism is best done away with by constant employment of the general forces; mechanism, by the intelligent occupation of the delinquent parts and the avoidance of the things worked at mechanically; spasmodism, by raising obstacles, the painful contact of which will cause recollections sufficient to prevent its recurrence. But if each of these disorders of contractility recedes before the employment of particular means, they disappear only under its steady continuance corroborated by the long application of moral training. Nevertheless, we must expect, and may reasonably promise to cure the mechanical sooner than the automatic or spasmodic motions: the latter being generally subordinate to an accessory disease, variation of the choreic type.

236  

Happily the exercises undertaken in view of destroying the disordered motions, may be at the same time calculated to promote willed immobility and orderly movements; consequently, both objects may be attained at once, and described at the same time.

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