A greater source of fallacy, however, is in the want of fixed standards for estimating the comparative capacity of children affected with cretinism, when placed under treatment, and the degree of intellectual and physical development which constitutes a “perfect cure,” in the opinion of such men as Dr. Guggenbuehl.  It is a fact, which all who have long had charge of either cretins or idiots well understand, that a great degree of physical deformity and disorder, a strongly marked rachitic condition of the body, complicated even with loss of hearing and speech, may exist, while the intellectual powers are but slightly affected; in other words, that a child may be in external appearance a cretin, and even one of low grade, yet with a higher degree of intellectual capacity than most cretins possess.  On the other hand, the bodily weakness and deformity may be slight, while the mental condition is very low.  In the former case, we might reasonably expect, on the successful treatment of the rachitic symptoms, a rapid intellectual development; the child would soon be able to pursue its studies in an ordinary school, and a “perfect cure” would be effected.  In the latter case, though far more promising, apparently, at first, a longer course of training would be requisite, and the most strenuous efforts on the part of the teacher would not, in all probability, bring the pupil up to the level of a respectable mediocrity.

From a great number of cases, narrated in the different Reports of Dr. Guggenbuehl before us, we select one as the type of a large class, in which the development of the intellect seems to have been retarded by the physical disorder, but proceeded regularly on the return of health.

“C. was four years old when she entered, with every symptom of confirmed rachitic cretinism.  Her nervous system was completely out of order, so that the strongest electric shocks produced scarcely any effect on her for some months.  Aromatic baths, frictions, moderate exercise, a regimen of meat and milk, were the means of restoring her.  Her bones and muscles grew so strong, that, in the course of a year, she could run and jump.  Her mind appeared to advance in proportion to her body, for she learned to talk in French as well as in German.  The life and spirits of her age at length burst forth, and she was as gay and happy as she had before been cross and disagreeable.  She was particularly open-hearted, active, kind, and cleanly.  She learned to read, write, and cipher, to sew and knit, and above all she loved to sing.  It is now two years since she left, and she continues quite well, and goes to school.”

We think our readers will perceive that this was not a case of confirmed intellectual degradation, but only of retarded mental development, the result of diseased bodily condition.  These diseases are distressing to parents and friends, and he who succeeds in restoring them to health, intelligence, and the enjoyment of life, accomplishes a great and good work; but it does not necessarily follow that the cases where the mental degeneration is as complete as the physical would as readily yield to treatment; and we are driven to the conviction that the enthusiasm and zeal of Dr. Guggenbuehl have led him to exaggerate the measure of success attained in these cases of low grade, and thus to excite hopes which could never be fulfilled.[A]