25S THE TREATMENT OF DISEASES. 



is the conversation-tube. It may be stated that as a rule the simpler forms of 

 hearing apparatus are by far the best. The so-called " invisible " tubes which are 

 worn in the passage of the ear usually prove of little or no value. Should your 

 own efforts to obtain relief prove of no avail, it must be remembered that a consul- 

 tation with an experienced surgeon or physician, who has made diseases of the ear 

 a speciality, may be attended with the happiest results, although often enough, it 

 must be confessed, it ends in nothing but disappointment. 



Deaf-mutism. Deaf-mutism may be dependent on several different conditions, 

 but in the great majority of cases it is caused by total or partial deafness, the result 

 either of congenital defect or of disease occurring during early life. A child who 

 has never heard cannot acquire language in the ordinary way, and is consequently 

 dumb. It is not at all necessary that there should be a complete absence of hearing 

 power, for a very moderate degree of deafness is quite enough to give rise to this 

 misfortune. When it is remembered that children acquire language by hearing each 

 word frequently repeated, and that every new word they learn is imitated imper- 

 fectly at first, the articulation being corrected only after many successive efforts, it 

 will be understood that, in the case of a child partially deaf, the only way in which 

 he could be taught to talk would be by repeating every word over and over again in 

 a loud voice close to the ear, and correcting the articulation until it was perfect, 

 A child may be born with good hearing power and lose it either totally or in a great 

 measure before it has learned to speak. This often results from scarlet fever. A 

 child who has learned to talk may become deaf when four or five years old, and then 

 often enough gradually loses the faculty of speech. When children are in process of 

 becoming dumb, their articulation gets more and more indistinct, until, after a time, 

 it becomes impossible to make out what they say. They have not practised the art 

 of speaking sufficiently long for it to have become with them a second nature ; and 

 when they can no longer hear what is said, the remembrance of how to produce the 

 different articulate sounds is gradually lost. It is exactly parallel to the case of a 

 child losing one language whilst acquiring another. It is well known that a boy or 

 girl of four or five years of age, who has been brought up in India with a native 

 nurse, and taught as a first language Hindostanee, will have completely forgotten it 

 in six months if brought to England. The first point to be ascertained in any case 

 in which the speech has been lost or not acquired in consequence of deafness, is 

 whether any treatment is likely to improve the hearing, and, if so, to what extent. 

 If a fair amount of hearing can be restored, no further treatment or management 

 will be required, and the child will learn to talk all in good time. When nothing 

 can be done, and the child is totally or partially or incurably deaf, it becomes a 

 question of grave moment how he is to be educated. Until recently the deaf and 

 dumb have always in this country been taught to express themselves manually in 

 other words, to talk on their fingers. Another system has for many years prevailed 

 on the Continent, and is now rapidly making progress with us. The finger alphabet 

 is not employed, but the children are taught to use articulate speech, and to under- 

 stand by watching the lips of others what is being said. This power can be achieved 

 nly by diligent cultivation of the powers of observation and imitation. The space 

 at our disposal will not permit of our entering fully into the merits of this system, 



