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THE AMERICAN MUSEUM JOURNAL 



region) there are also no ribs, but their 

 representative vestiges are even more 

 marked than in the neck. 



Asymmetry rules chiefly in the inter- 

 nal organs. Most of the heart lies to 

 the left of the mid-line of the body. As 

 already stated it begins as two separate 

 halves, which soon fuse into one heart 

 with four cavities, two auricles and two 

 ventricles. Each of these four cham- 

 bers has a different function but all 

 four are coordinated into one beauti- 

 fully regulated organ. The heart is 

 one of the most wonderful pieces of 

 mechanism in the world, more powerful 

 in proportion to its weight than any 

 Baldwin locomotive, more delicately 

 constructed than the finest watch; an 

 organ, which must do, and — mirahih 

 dictu! — does do its own repairs while 

 busy at its work. It knows no Fourth 

 of July or Christmas or Easter holiday, 

 never even can know the joy and relief 

 of sleep, "^tired nature's sweet restorer." 

 It begins its orderly, reiterated contrac- 

 tions and relaxations long before birth, 

 and they cease only at death. It must 

 continue them in health and in sick- 

 ness, when its function is often sadly 

 disturbed. In mid-career let it stop for 

 but a few moments and death comes 

 swiftly, almost instantly. 



Sometimes, oddly enough, by a very 

 early irregular development, asym- 

 metrical organs are transposed, and 

 then, as in "Le Malade imaginaire," 

 "nous avons change tout cela" is liter- 

 ally true. This is very rare, so much 

 so that in a long and active professional 

 life, I personally have never seen a case. 

 When it occurs, the heart, stomach, 

 and spleen lie on the right side, the 

 liver and appendix on the left, and the 

 large bowel reverses its course, running 

 upward on the left side. 



In this enormously complex machine, 

 far more complex than any of man's 

 making, a machine, all parts of which, 

 like the heart, must be repaired without 

 the omission of an hour's or even a mo- 

 ment's work, it is not surprising that 



things sometimes go awry. The wonder 

 is rather that they almost always de- 

 velop aright. Nature is persistently 

 conservative. To this conservatism we 

 owe it that most people are practically 

 normal. Especially fortunate is this 

 conservatism during the early develop- 

 ment of the embryo. Then, every cell 

 is working feverishly and at top speed, 

 and a minute divergence of, it may 

 be, even a single cell, followed by a 

 progressively greater and greater di- 

 vergence from the normal in its de- 

 scendants, would produce an arrest of 

 development here, or an error of de- 

 velopment there; but only occasionally 

 is there such a failure of orderly or of 

 complete development. The result is 

 a local, or even, it may be, a general 

 failure in normal growth. If there is 

 one deformity, therefore, there are very 

 apt to be others. 



The saddest of all of these errors of 

 development are those cases in which 

 there has been a defective development 

 of the brain and hence a mentally de- 

 fective child. How many scores, or I 

 might even say hundreds, of such chil- 

 dren have been brought to me with the 

 fond delusion that, "He is naturally an 

 unusually bright child, you know, but 

 with a pressure on the brain." How 

 often have I had to dash unfounded 

 hopes to the ground ! The children 

 have been brought to me in the confi- 

 dent expectation that I could cure them 

 by a surgical operation that "would re- 

 move the pressure on the brain." An 

 explanation that the defective develop- 

 ment was by no possibility to be laid 

 at the door of either the father or the 

 mother, but that the defect was pre- 

 natal, and had long preceded birth has 

 often afforded the distressed parents 

 some little comfort, although it can 

 never wholly remove the heartache. 

 The only hope for such children is in 

 educating the more or less blighted fac- 

 ulties ; a long continued, expensive bus- 

 iness, and often with but a slight im- 

 provement as a reward for years of 



