On the Education and Training of the Feeble in Mind
- Author:
Langdon Down, M.D. Lond., Fellow of the Koyal College of
Physicians of London; Physician to and Lecturer on Clinical Medicine at the London Hospital; Physician to the Normansfiekl Training Institution, &c.; formerly Lecturer on Medicine, Materia Medica, and Comparative Anatomy at the London Hospital, and Physician to the Earlswood Asylum. London : Lewis, 136 Gower Street.
From this interesting pamphlet we learn that the largest proportion of idiocy is to be found amongst the lower orders, where the struggle for existence is frequently desperate, and the unhappy victims in conse- quence almost entirely neglected. The first thing to be done must be to rescue the child from a solitary life, and surround him or her by influences calculated to render existence joyous. Great improvement may be obtained by a happy combination of treatment?medical, physical, moral and intellectual.
The medical should form the basis of all treatment having reference to what is known of hygiene, physiology, chemistry, and therapeutics. The highest possible health is the great desideratum. Many racial types, such as Mongolian imbeciles, lose considerable intellectual energy in the winter. Morbid anatomy tells us that, in addition to grave defects in the cerebral mass, we may often find a symmetry of central nervous ganglia and pallor of vesicular neurine. Our dietary, there- fore, must contain a fair supply of nitrogenous elements, and at the same time be rich in oleaginous and phosphatic substances. The daily use of the sponge and other baths is of paramount importance, especially Avhen wre bear in mind the peculiar exhalation so common from the skin of imbeciles. The residence should be on gravel soil, surrounded by well made walks, in order that no opportunity of daily outdoor exercise should be lost.
As regards physical training, the attenuated muscles should be carefully and fully exercised, to obviate the simple automatic move- ment so common to the imbecile.
The moral education is of great moment. He must learn obedience ; must understand that right is productive of pleasure, wrong followed by the reverse. Corporal punishment should be strictly prohibited. The tact of the teacher will be called into play. A study of the peculiarities of the patients will in most cases reveal a ready access to his moral control.
The intellectual training will have reference to a cultivation of the senses. The qualities, form, and relation of objects should be taught by the sense of touch ; colour, size, and shape by the sense of sight; the varieties of sound by the ear. Nothing must be left to the imagination. The patient must be taught habits of neatness. The defective speech is best overcome by a well-arranged plan of tongue gymnastics. Varied amusement should be furnished, especially theatrical representations which are not only amusing but educational. We quite concur in the opinions so aptly afforded by Dr Down, and we think that were only the work of caring for the idiot poor undertaken in the same way as it is for the lunatic poor a great step would be taken in the right direction.
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