56 On Idiocy. [Jan., 



The third case is a male, aged eleven years. He is a slim, 

 long-limbed boy, with a long and narrow head. The following are 

 the head measurements : — 



Inches. 



Circumference .. , .. .. 19*5 



Nasal spine to occipctal protuberance .. .. 12*5 



Mastoid to mastoid 14 * 



Great diameter 6*5 



Small diameter 5*5 



The face is hideous, and is peculiarized by its constant contortions. 

 The mouth being opened, shut, and twisted, the brow knit, and 

 the whole head turned in the oddest manner. The skin is sallow, 

 and is usually moist from the quantity of saliva flowing from 

 the mouth. There is an expression of happiness when he is spoken 

 to and noticed. He squints and suffers from fixity of vision, 

 and also from restless movement of the eyes. He has a little 

 power of directing his vision, but he looks at things out of the 

 corners of the eyes, and lifts his chin obliquely in doing so. The 

 ears, nose, and mouth are well formed. He hears, and can be made 

 to listen slightly ; moreover he notices music. He cannot speak, 

 but howls, cries, and laughs. The muscles of the body and limbs 

 are flabby. His arms are long, and the right wrist is bent upon 

 the fore-arm. He is club-footed, can balance himself on his toes if 

 held, and has much power over his limbs. He cannot walk nor 

 stand alone. He balances himself when sitting, thrusts out his 

 legs and arms, and presents a very singular appearance. He has 

 but slight power of attention ; he can discriminate between persons 

 and different things, and he has therefore slight evidences of intel- 

 lectual perception and memory. The emotions are easily excited. 

 He knows his mother, his attendants, and those who often notice 

 him. His habits are those of a child a few months old. He cannot 

 do anything for himself. His meat has to be cut up small, and 

 placed on the back of the tongue. The chin is then oddly rotated 

 upwards, and the morsel is swallowed with difficulty. He knows 

 his food. He rolls his head a good deal. In six years he learned 

 to stand alone, and gained a little more intelligence, but he is still 

 silent and a solitary. 



These cases are those of congenital idiots, and the first is evi- 

 dently lower than the last in the mental and physical scale. The 

 gradation towards the more highly developed amongst the feeble- 

 minded is pretty well exemplified in the following cases : — 



A girl, aged fifteen years, is high-shouldered, has a large body, 

 short limbs, and a small head. She sits with her head on one side, 

 looking over one shoulder. The eyes are fixed upwards on vacancy, 

 and the chin is poked forward and upward. When she moves from 

 this position the chin is not lowered, and the attitude assumed is 

 terribly simian. She walks badly, and she steps short, being lame. 



