There are four other institutions in Germany devoted wholly or in part to the treatment of cretins; they are located at Bendorf, Mariaberg, Winterbach, and Hubertsburg. There are also two in Sardinia. All together they may contain three hundred children. The success of these institutions has not been equal to that of the Abendberg, although the teachers seem to have been faithful and patient. The statistics of the latest census of the countries of Central and Southern Europe render it certain that those countries contain from seventy-five to eighty thousand cretins, and as the cretin seldom passes his thirtieth year, the number under ten years of age must exceed thirty thousand. The provision for their training is, of course, entirely inadequate to their needs.
The limited experience of the few institutions already established warrants, we think, the conclusion, that too high expectations have been raised in regard to the complete cure of cretinism; that only a small proportion (cases in which the bodily disease is the principal difficulty, and the mental deterioration slight) can be perfectly cured; but that these institutions, regarded as hospitals for the treatment and training of cretins, are in the highest degree important and beneficial; and that, under proper care and medication, the physical symptoms of the disease may be greatly diminished and in many cases entirely eradicated, and the mental condition so far improved, that the patient shall be able, under proper direction, to support himself wholly or in part by his own labor. The hideous and repulsive condition of the body can be cured; the mental deformity will yield less readily; yet in some instances this, too, may disappear, and the cretin take his place with his fellow-men.
Let us now turn our attention to another class, in whom, as a people, we have a deeper interest; for though cretinism does undoubtedly exist in the United States, yet the cases are but few; while idiocy is fearfully prevalent throughout the country.
The possibility of improving the condition of the idiot is one of those discoveries which will make the nineteenth century remarkable in the annals of the future for its philanthropic spirit. Idiots have existed in all ages, and have commonly vegetated through life in utter wretchedness and degrading filth, concealed from public view.
During the early part of the present century, a few attempts were made to instruct them; the earliest known being at the American Asylum for the Deaf and Dumb, in Hartford, in 1818. In 1824, Dr. Belhomme, of Paris, published an essay on the possibility of improving the condition of idiots; and in 1828, a few were instructed for a short time at the Bicêtre, one of the large insane hospitals of Paris. In 1831, M. Falret attempted the same work at the Salpêtrière, another of the hospitals for the insane in the same city. Neither of these efforts was continued long in existence. In 1833, Dr. Voisin, a distinguished French physiologist and phrenologist, attempted the organization of a school for idiots in Paris. In 1839, aided by Dr. Leuret, he revived the School for Idiots in the Bicêtre, subsequently under the charge of M. Vallée. The "Apostle to the Idiots," however, to use a French expression, was Dr. Edward Seguin. The friend and pupil of Itard, the celebrated surgeon and philanthropist, he had in early youth entered into the views of his master respecting the practicability of their instruction; and when, during his last illness, Itard, with a philanthropy which triumphed over the terrible pangs of disease, reminded him of the work which he had himself longed to undertake, and urged him to devote his abilities to it, the young physician accepted the sacred trust, and thenceforth consecrated his life to the work of endeavoring to elevate the helpless idiot in the scale of humanity.
Previous teachers of the imbecile had not attempted to master the philosophy of idiocy. They had gone to work at hap-hazard, striking at random, hoping somehow, they knew not exactly how, to get some ideas into the mind of the patient, and, by exciting the faculty of imitation, perhaps improve his condition. They succeeded in making him more cleanly, and in inducing him to perform certain acts and exercises, as a well-trained dog, monkey, or parrot might perform them.
Seguin adopted an entirely different course. By a long and careful investigation he satisfied himself as to what idiocy consisted in, and then adopted such measures as he deemed most judicious, for the development of the intellect, and the elevation of the social, mental, moral, and physical character of the idiot.
In his view idiocy is only a prolonged infancy, in which the infantile grace and intelligence having passed away, there remains only the feeble muscular development and mental weakness of that earliest stage of growth. He proposes to follow Nature in his processes of treatment; to invigorate the muscles by bathing and exercise, using some compulsion, if necessary, to effect this; to fix the attention by bright colors, strong contrasts, military manoeuvres, etc.; to strengthen and develope the will, the imagination, the senses, and the imitative powers, by a great variety of exercises; and at each step, to impress the mind with moral principles. The mere acquisition of a few facts, more or less, and the capacity to repeat these, parrot-like, he regards as an attainment of very little consequence; the great object should be to make the child do his own thinking, and this once attained, he will acquire facts as he needs them.
Dr. Seguin met with a high degree of success in the instruction of idiotic and imbecile children, and in 1846 published a treatise on the treatment of idiocy, which will, for years to come, be the manual of every teacher of this unfortunate class.
While Seguin was demonstrating the truth of his theory of instruction at Paris, Herr Saegert, a teacher of deaf mutes at Berlin, having attempted, unsuccessfully, the instruction of a deaf and dumb idiot, was led to inquire into the reasons of his failure. Without any knowledge of Seguin's labors, he arrived substantially at the same conclusions, and devoted his leisure to medical study, in order to grapple more successfully with the problem of the instruction of idiots. In 1840 he commenced receiving idiotic pupils, and has maintained a school for them in Berlin up to the present time. Herr Saegert is inclined to regard idiocy as dependent upon the condition of the brain and nervous system, to a greater extent, perhaps, than Dr. Seguin, and to rely upon medication to some extent; though in his writings he professes to consider it a condition, and not a disease.