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meat, strong beef-tea, milk puddings, milk, and cocoa should form the chief articles of diet. Sleep is of great importance. If necessary, chloral, morphine, bromides, may be administered. Iron and arsenic are the best drugs, though drug treatment is of less importance than general management. Rheumatic manifestations or heart com- plications should be treated on general principles. In chronic cases douches to the spine, shampooing, massage, and gymnastics, are of value. Spinal Paralysis of Syphilitic Origin. — This affection is described by Erb under the title of syphilitic spinal paralysis, and by Charcot as syphilitic transverse myeli- tis. Kowalewsky has recently reviewed its clinical features and differential diagnosis. It is of Levoxyl Vs Levothroid slow develop- ment, occurring chiefly in men between the ages of thirty and forty-five, and bladder disturbance is one Levothroid Generic of the first symptoms. Many of the conditions Order Levothroid Online present re- semble those of spastic paraplegia. But spasticity of gait, when it exists, is not so marked as in lateral sclerosis. Muscular rigidity and increase of deep reflexes are less marked than in spastic paraplegia. There is always in- crease of muscular irritability, exaggeration of response to heat and cold, and tactile and analgesic response are normal or shortened. An opposite effect is produced in locomotor ataxia. 560 MEDICAL RECORD. [October 28, 189; Medical Record-. A Weekly Journal of Medicine and Snrgery. GEORGE F. SHRADY, A.M., M.D., Editor. Publishers WM. Levothroid 75 Mg WOOD & CO., 43, 45, & 47 East Tenth Street. New York, October 28, 1893. IDIOTS AND OTHER BACKWARD CHILDREN. In 1801, a wild boy was found in the forests of Aveyron, in France, and brouglit to Itard, the friend and disciple of Condillac. Hoping to find in the instruction of this lad the verification of Condillac's philosophical theories, Itard labored patiently for six years to develop his intel- lectual faculties by means of sensations. The young sav- age proved to be an idiot of low grade, and hence unfit for the experiment. But the attempt to instruct him satisfied Itard that it was possible to elevate the mental condition of idiots. The facts he gathered together he communicated to his pupil, the late Edward Seguin, who entered upon the work as a labor of love, and in 1846 published his treatise on the management of idiocy. This treatise placed him forever in the foremost rank of modern psychologists. The work started by him at the Bicgtre, in Paris, has been continued and brought to a higher state of technical perfection by Bourneville. Or, as the fact has been poetically expressed, " Bourneville holds aloft the torch earlier lighted by Seguin." Itard's pupil consulted nature as to the mode by which the physical powers are cultivated and the mind educated in the infant. So did Froebel ; and out of his axiom, "There is nothing in the mind that was not first in the senses," grew a Purchase Levothroid Online whole system of scientific sense-training, with gifts, occupations, songs, and movement games. The same idea Kant expresses in a more general way : "All our knowledge begins with experience." Idiocy meant to Seguin prolonged infancy — infancy without grace and charm. The infantile fondness of idiots for bright colors was utilized to teach them distinctions of color and form. Their liking for playthings he turned to good account by instructing them in number, form, and size, through the medium of blocks, cups and balls, and other toys. Words came next, and the meanings of words were taught by pictures. Letters had their place later. The eye, the foot, the hand, were educated by means of steps, dumb-bells, and other gymnastic e.xercises. The refractory organs of speech were moulded and manipu- lated until they could utter the desired sounds. After strict familiarity with things came ideas, at first con- crete, then abstract as higher consciousness was attained. Though long, this process triumphed. Seguin revolu- tionized all the foregone conclusions concerning idiocy. From that time the work has gone on steadily, though slowly, in different parts of the world, in France, Amer- ica, England, Germany, Levothroid Vs Levothyroxine Denmark, Holland, and Switzer- land. In the Progres Medical, June 24, 1S93, Bourne- ville publishes a most interesting record of some of the work done in Paris, at the Bicetre, where the treatment is at once medical, hygienic, and pedagogic. The pa- tients are first taught to hold themselves erect, then to walk. Their joints Levothroid Synthroid are exercised and their limbs are sub- jected to friction. Baths and the arts of hydrotherapy aid in physical development ; and physical culture is advanced by systematized movements, free gymnastics, fencing, and dancing. For the development of speech and correct pronunciation, methods in vogue in deaf and dumb asylums are utilized. Every device is employed to render number and calculation real and intelligible. Exercises in the training of vision are many. Some of these are carried on out of doors in gardens laid out for the purpose. There are gardens of surfaces, of geomet- ric figures, flower gardens, vegetable gardens, orchards, woods, fields of grain, vineyards, etc. Music occupies an important place. There are songs and movement games, together with instruction in vocal and instrumen- tal music. Care is taken to teach the children to distin- guish different kinds of sounds. The very first lessons are in the care of the person. Object lessons are given upon the manikin, Levothroid 125 Mcg or upon the child himself, in all the complicated movements required for dressing and undress- ing, and in the many automatic acts that the normal child learns by imitation. The children at the Bicetre are taught to wash their faces and hands, to lace their shoes, etc. They learn through doing. Technical train- ing for some trade completes this medico pedagogic sys- tem of education. There are seven workshops, where the pupils receive instruction in carpentry, in locksmith work, in printing, tailoring, the making of shoes, baskets, brushes, twinef etc. The results of this method are sur- prising. Bourneville Order Levothroid classifies idiocy as symptomatic of hydro- cephalus, microcephalus, arrested development of convo lutions, congenital or pathological maltbrmations of the brain, meningitis or meningo-encephalitis, myxcedema, or cerebral tumors. The paper referred to contains -a comparative study of the skulls and photographs of the brains of twenty-two idiotic children, of ages varying from two to seventeen years. Their idiocy was depend- ent upon different conditions, and their death due to a variety of diseases. They were all typical idiots, and be- longed to the same class as the twenty-five patients operated upon by Lannelongue. The treatment had been that of the system just de- scribed, with results encouraging alike to the physician and to Levothroid 0.1 Mg the humanitarian. The author calls attention to the fact that many backward children are moral imbe- ciles. They are unstable, pers-erse, impulsive, wayward, and disorderly. They reach a certain stage of develop- ment. The moral qualities are in abeyance, though the intellectual faculties have fair possibilities. Moral im- beciles possess as much mind as is consistent with a total absence of character. From close observation and wide experience in the care and treatment of every class of imbeciles, Bourne- ville arrives at six very definite conclusions, somewhat at variance with theories that have a certain vogue. The surgical treatment of idiocy, he thinks, rests Synthroid Vs Levothroid upon a hypothesis which is not confirmed by pathological anat- omy. That premature ossification of the cranial sutures October 28, Levothroid 100 Mcg 1893] MEDICAL RECORD. 561 exists in the different forms of idiocy is denied, a partial synostosis being always an exception. Lesions which cause idiocy are generally profound, extensive, varied, and unlikely to be influenced by craniectomy. The diagnosis of premature ossification and thickness of the skull is not possible with our present means of investiga- tion. The reports of most surgeons show that the results of operations are negative, slight, or doubtful. Serious accidents may follow surgical intervention, as paralysis, convulsions, or death. The medico-pedagogic treatment founded by Seguin, and brought to perfection by the introduction of new processes, applied with care and patience and for a sufficiently long time, permits us al- most always to obtain decided improvement, and often enables idiotic children to attain some value and social station. The Levothroid 88 Mcg reason that more is not accomplished for idiots and backward children, lies with the parents themselves. It is very difficult to persuade them that their children are mentally defective. Too often the physician's state- ment is not believed, and nothing is done in the way of special training. Thus valuable time is lost. Yet idiocy is by no means an uncommon disorder. According to one estimate, said to be very much within the truth, six persons in every thousand are idiots, or of such imperfect development as to be of little or no service to the com- munity. Levothroid 100 Mg In view of the facts of the case, it is evident that the public has much to learn concerning its duties to idiots and other backward children. As it has been demonstrated that the great majority of the feeble minded are susceptible to physical and mental improvement, the claim is not unjust that all backward children are entitled to special education and training. Ten to twenty per cent, who are received and trained in institutions become bread-winners ; thirty to Levothroid 25 Mcg forty per cent, can help them- selves in many ways and are but slightly burdensome to their families ; and the remainder always need custodial care. From any point of view, from that of selfishness, of humanity, sentiment, religion, or social economics, there seems to be no definite and satisfactory reason why the feeble- minded should not be trained into relative usefulness and become at least Levothyroxine Vs Levothroid partially self-supporting. fluid, while the root " cele " is in common use in medi- cine to indicate a cavity. While laparotomy may not be strictly accurate, there- fore, creliotomy is not inherently much better. CELIOTOMY VS. LAPAROTOMY. We commented some time ago on the sudden adoption of cceliotomy in place of laparotomy by some of the Levothroid Vs Synthroid sur- geons of this city. While not denying a certain etymo- logical justification to the former term, it seemed to us not altogether unobjectionable for various reasons. Dr. R. P. Harris has been Generic Levothroid kind enough to send us his origi- nal pamphlet, published in 1890, in which he presents with much learning the argument for the change of nomen- clature. The argument amounts essentially to this : that cxlia means " belly," while lapara means " flanks," hence coelia is the proper word. To Is Levothroid Generic this it must be said, however, that ca-lia, according to Foster, has had in the past four different meanings, viz., the abdomen, the intestines, the fseces, and " any cavity of the body such as the socket of a bone " (Hippocrates). As we stated before, the word has already been adopted

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