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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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Another point to be studied in the new pupils with no less attention, but of more general import, is the relation of their need and power of assimilation to their deperdition of force under the friction of newly imposed labor. Prior to entering in training, these children derived a bare sustenance from their food, abundant or scanty, rich or meagre. In their new status they will need food; 1st, as previously, to support life; but besides, 2d, to furnish the elements of a larger growth; 3d, to increase their vital powers; and 4th, to spend in their new activity. Who will not admit that great change must be made in the food, and great change must take place in the result of feeding, to obtain great changes in the constitution, habits, and functional manifestations of the newcomer? And who does not foresee that if the use of the best means of nutrition does not go further than feeding the idiotic constitution in the idiot, he will never emerge from idiocy? Therefore the first struggle between the Superintendent and his pupil does not consist in showing him letters that he will not look at, but in generating by food and hygenic measures a given force to be spent and renovated in increasing ratio: this is the A, B, C. If, in spite of these means, be does not gain, or actually fails, in his strength during the period of observation, Nostalgia has taken possession of him, or he has entered into his age of senility, which begins for some idiots at the time ordinarily marked for virility; or he may be impervious to any of the modes of rejuvenating the circulation. Prudence reserves the final decision on the nature of the causes of this failure; whilst observation notes, calculates, weighs, measures the vital forces; and if these tests show any gradual decrease under a treatment intended to invigorate, the child must be turned over to the parents, at least temporarily.


But how could we restrict to the new pupils this double survey of the effects of food and diet on the forces, and of the influence of the production of forces on the treatment? Does not every pupil every day require the same watchfulness? Does not the whole movement of the institution depend upon the sum total of force produced by the regulation of said equilibrium; and does not the superintendent stand in regard to this harmony in the same relation as the engineer in regard to the proportion of heat to steam, of steam to weight to be displaced? In this respect he will not allow himself to be imposed upon by reports of ignorant subordinates, or by written prejudices.


The products of alimentation being the ultimate means relied upon to raise the children from idiocy, they must be fed, not to be filled, but to produce by nutrition the desired force. But so far, any interference of science in the arts accessory to feeding have produced only sophistication and crime. Erostratus was a saint next to the chemist who has taught millions how to adulterate wine and bread, the two staples of civilized life. The theoretical division of food into nitrogenized and nonnitrogenized is not so firmly established as to authorize a Superintendent to risk upon it the future of his children; and the uncertainty of other hypotheses must satisfy him conclusively that alimentation is not a science but an art. Of this art we know thus much. Nourishment is the result, not so much of bulk, as of variety; the reason of this is, that man is omnivorous. Consequently, that which nourishes the most is not always the richest food, but the one most relished; because being desired, it produces an abundant secretion of salivary and gastric fluids, by which the food is more thoroughly assimilated than when it is indifferently swallowed. Another consequence of this remark is that, setting apart the cases of perverted tastes or Pica, the children themselves are pretty sure judges of what is good for them; and will tell it to any one who will take the trouble of reading their tastes on their countenances while they eat. As to quantity, they are not so good judges, their appetence often wishing more than is required by their appetite; this is a matter to be regulated by experience.


But the future of the children does not depend only on their feeding. Seasons, epidemics, accidents, individual deficiencies, bring their unavoidable share of sickness -- of death even:


"Et la garde qui veille aux barrieres du Louvre,
N'en defend pas les rois


But disease or impending death comes rarely upon idiots in the open manner in which it ordinarily assails men. They feel it more by a negation of feeling than positively; so that questioning them is useless, and their answers, if they can speak, are deceptive. In this emergency, nothing will do to settle the diagnosis, if not precisely as to the disease, at least as to its lenient or dangerous nature, so well as the use of the tests of vital forces already referred to. (9) It is not in our plan to follow the idiot to his sick-bed; the Superintendent who does it knows more than we do on the subject. One thing only we mark: let us remember that in sickness as in health, the idiot is always laboring more or less under his primary deficiency of nutrition. But constant reference to the state of heat, circulation, and respiration, will warn against the danger of asthenia. We do not mean to say that the superintendent is to put these tests aside as soon as life is no longer in peril. We mean, on the contrary, that he must use them for all the pupils. These vital tests and the chemical microscopical, and other examinations of the condition of the functions and secretions, are to be made and recorded monthly, and oftener in special cases.

(9) See Aitken on Wunderlich's practice; and E. C. Seguin on the New York Hospital practice, in the Chicago Medical Journal for May, 1866

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