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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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These alterations are not observable in the following forms of complicated idiocy:


Infantile convulsions may produce idiocy; epileptic seizures strike with idiocy in the first age, with imbecility in the second, later with dementia. Idiocy receives a deleterious influence from epilepsy; attacks of which sometimes obliterate the faculties gradually and steadily; at other times they carry away at one sweep all mental acquirements for a time, or permanently.


Chorea acts in like manner, less suddenly but with more steadiness, by the incessant shaking of the whole frame, through the nervous "dance." That is the way in which it gives unsteadiness to every movement, to every impression, to every expression, keeping the subject in a state of tremulousness, unfit to be the starting-point of physical and intellectual operations, and of forming or transmitting correctly the orders of the will. Hence the difficulty of improving idiocy before curing chorea; and if we do not succeed in this, shattered nerves, a tendency to tetanic horrors, epilepsy and paralysis may be expected.


Extensive paralysis or contractures, particularly when affecting the upper limbs, act by depriving the child of important means of communication and of knowledge, producing the symptoms of superficial and aggravating those of profound idiocy, where this latter co-exists with these accessory infirmities.


Deafness and blindness from birth have the same effects as paralysis on ungifted children, by depriving them of the cognizance of a whole series of phenomena. But it is a fact curious enough to be noted, that partial obliteration of One of these channels of knowledge will produce the symptoms of superficial idiocy surer than its complete destruction. One must not forget that those two infirmities, cecity and deafness from birth, leave in the best educated an idiosyncrasy dreaded in the workshops where the deaf or blind might otherwise compete with other mechanics.


We note as important that idiocy is more frequently met with epilepsy and chorea, less with paralysis and contractures, least of all with deafness and blindness; and that its decreasing severity is quite in the same ratio.


We come now to unmixed or simple idiocy.


Idiocy without complication presents itself under various aspects; and we have shown that it could not be otherwise, since some of the circumstances already known as favoring its production are themselves so varied. This diversity of character will be fully exposed in the following division of idiocy, in the analysis of its symptoms, and in subsequent observations.


Idiocy is called profound when the ganglia are altered, and superficial when the peripheral termini of contractility and sensation only seem to be affected. It is called organic when the organs are sensibly altered, and functional when our imperfect instruments and observations do not permit us to trace the organic lesion as we do the functional disorder. It is called sthenic when it gives the child nervous impulses without object; and asthenic when it leaves him without them, when they are wanted for some object. Though we are ready to acknowledge these last apparently contradictory symptoms as simple manifestations of the same low type of vitality, produced by difference of circumstances, nevertheless, these symptoms give too precious an indication of the different treatment required for each, to be omitted; since the division founded upon them has a practical, if not a truly scientific import. Other divisions might be devised, but as they bear on the psychological symptoms exclusively, and repose more on degrees than on differences, they are more apt to disclose the ingenuity of their framers than to prove new and beneficial.


In regard to the pathology of our subject, we will divide it into organic and physiological.


Organic pathology related to shape, size, proportions and other characteristics observable on the living; and to alterations of internal structures which diagnosis may suspect, but anatomy alone can disclose.


The pathological symptoms of idiocy have, unfortunately, been ascribed only by men who never knew or never taught anything about the subjects of their post-mortems; so that we have descriptions, masterly or not, of organic anomalies, without a word of their corresponding psycho-physiological symptoms. Such a thing could not be done for any other pathological condition than idiocy, without meeting with the most merited censure. If we, personally, deserve the contrary disapprobation for having studied the physiology of idiocy more than its pathology, the exceptional difficulties we encountered, and the novelty of the undertaking are our excuses.


Though idiocy does not stamp children with any particular shape of the body, still, be it the effect of unequal nutrition, of want of normal activity of will in the gathering up of the limbs to the body to form the various attitudes, the great majority of idiots seem to be not so much ill-shaped as ill-proportioned; the exceptions of splendid build covered with rich integuments, belong particularly to cases in which may be detected a tendency to insanity, or some complication, such as paralysis of the organs of speech.

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