1870.] On Idiocy. 65 



had not the spontaneousness of an infant a week old ; and six years 

 of care only produced the ability to sit up and to notice a very 

 little. That the idiocy was congenital there can be no doubt. It 

 was evidently so in the next case. 



A female child, aged six years. The child is small, with a thin 

 long body, high shoulders and extremities. The shape and size of 

 the head may be gathered from the following measurements : — 



Inches. 



Circumference 17-5 



Nasal spine to occipital protuberance .. .. 11 5 



Mastoid process to mastoid process 12-75 



Great diameter 6 - 75 



Small diameter 4*75 



The forehead is very small. The face is small and pale. When 

 quiet, there is nothing idiotic about the expression, but when, as is 

 usually the case, she is restless, the mouth is noticed to be widely 

 open, and the entire hand is often stuffed into it, the aspect being 

 very silly. Considering her age, the expression of the face is very 

 vacant. The eyes are large, and vision is imperfect. She looks 

 about in a vacant listless manner, stares fixedly for a long time, 

 and possesses barely any power of fixing the eyes to examine an 

 object. The ears are large. She hears, but does not listen. The 

 nose is well formed, and its sense is perverted. The mouth is very 

 large, and the lips also ; the teeth are irregular and the tongue is 

 swollen. The saliva runs in quantity from the mouth, and there 

 is much discharge from the nose. She makes unmeaning sounds, 

 screams, and cries, but rarely laughs. She can sit up of her own 

 accord, lie down, turn round, and stand in a curious stooping 

 posture. She cannot walk slowly in a straight direction, but sets 

 off one shoulder first, and, like a tipsy man, takes a staggering run 

 to the left, then to the right, and so on. She usually brings her 

 elbow close to the side, elevates the wrists, and allows the back of 

 the hands to drop forward in running. The whole proceeding 

 gives her the appearance of a. rat. She cannot employ her hands 

 in any useful manner. Automatic movements of the body, see-saw 

 of the head from side to side, and of the hands before the eyes, are 

 frequent. Constantly in motion, when not erect she twists her 

 body and agitates her arms. She does not recognize those who are 

 kind to her, does not care about her food. She cannot be made to 

 attend, to listen, or to do anything. Her emotions are easily 

 excited, and she will scream, open-mouthed, by the hour. Every- 

 thing placed in the hand goes to the mouth without discrimination. 

 The scalp is tender to the touch. She is quite infantile in her 

 habits. She sleeps badly, and has great thirst. She can move 

 about, and thus has more nervous force than the first case, but she 

 has not the intelligence of a child a month old. 



