:>yx\'- ';:.'.':••:«!.'.! :•:•:...:;•:::':■::=' m:servations on periods of growth; their significance. Normal and sub-normal children. Hard work at adolescence. Older boys; their conditions and training. The older girls injchool. Delicate girls. Anremia. Hysteria. CHAPTER XI The Care of Children and their Training .... 198 Training should be founded on knowledge of the children. Classification of pupils: age-basis; grouping children imitative and nervous. Brain-training gives strength. Physical training; fatigue to be avoided; spontaneity to be trained. Kindergarten. Training the attention. Inattention and fidgetiness. Phvsical exercises : various kinds, their employment. Exercises in brain- training. Imitation: uniform repetition. Increasing number of parts moving : small parts and larger parts moved. Finger-exer- xiv CONTExMTS PAGE cises. Eye-movements. Sense of weight. How to deal with frowning and facial expression. Mental states : untruthfulness. Nervous children. Fixed mental impressions. Absent-minded- ness. Training delicate and nervous children; removal of nerve- signs, usefulness of a description of the child. Precocious chil- dren. Control and discipline through eye and ear. Teaching description of natural objects. Description in terms implying what is seen. CHAPTER Xn Hygiene and Health Management during Spjeot-UFE Health management guided by observation. Advice to parents through children. Health culture and early detection of its fail- ure, or of disease. Cleanliness. Air breathed, at home and in school; ventilation. Looicing at pupils arriving in school. Com- mon illnesses. Food : milk, water, bread, meat. Feeding infants : flour food leads to rickets. Clothing. Ophthalmia. Ulcer on the eye. Summer diarrhoea. Chicken-pox. Measles. Scarlet fever. Diphtheria. Taking the temperature : clinical thermometer. Con- tagion. Disinfection. Chorea. Epilepsy. Rickets. Lighting the room. Cloak-room and lavatories. Sight and hear- ing. Delicate children. Mental hygiene as a science. Laws of mental fatigue. CHAPTER XHI Propositions concerning Childhood 238 Proposition L The main classes of defect among school children include a larger proportion of boys than girls. Proposition IL The main classes of defect among school children are much associated in the groups of cases. Such asso- ciations vary with sex, age, and environment. Proposition in. Children with developmental defects often present also abnormal nerve-signs, and are delicate and dull. Proposition IV. Children with indications of brain-disorderli- ness — that is, abnormal nerve-signs — are often dull pupils. CONTENTS XV PAGE Proposition V. Dull pupils are often delicate with indications of hraiii-disordLrliiicss; that is, ahnornial nerve-signs. Proposition VI. Girls with developmental defect or hrain- disordcrliness are more apt to receive harm and less good from their environment than boys. Proposition VII. The eflects of good physical training in school arc to diniiiiish the number of cases with signs (jf brain- disordcrliness and the nuiul)er of dull children. Tables showing the results of the examination of 100,000 children. INDEX 251 \ LIST OF ILLUSTRATIONS The muscles of expression in the face. After Sir Charles Bell . 21 The spine, chest, and bones of the upper extremity. After Sir Charles Bell 23 Bones of the forearm : the radius and ulna. After Sir Charles Bell 24 Diagrammatic representation of the brain and its nerves in connection with the eye, the ear, and the muscles ... 37 5. Hand in straight balance ........ 68 6. Hand in nervous balance ........ 80 Diana. British Museum ........ 81 Hand in energetic balance ....... 82 9. Hand in straight balance with thumb drooped .... 83 10. Hand in balance of rest ........ 84 Hand in fright 85 12. Convulsive hand ......... 85 13. Cain. Museum, Florence ....... 86 14. Face: showing complete paralysis on the right side . . . 108 15. Face: showing partial paralysis of the right side from brain disease ........... 109 16. Face: showing partial paralysis on the left side . . . no 17. Hand in feeble balance . . . . . . . .111 18. Imbecile, smiling . . . . . . . . .112 19. The same : quiescent and expressionless . . . . -US LIST OF TABLES TABLE * PAGE I. Showing periods of dentition *: . . . .18 II. Showing average hciglits and weights of children. After Dr. Bowditch 31 III. Showing the annual increase in height and weight of children at ages stated ........ IV. Showing measurements of chest girth in chihlrcn. Afte Dr. Roberts ........ V. Showing the average weight of the brain of children at age periods. yVfter Dr. Boyd ....... 33 VI. Cases of children with headaches, arranged according to age, 151 VII. Number of children with each class of defect, and the per- centage on the numbers seen. Also showing, for each class, the proportion of boys and girls respectively. Based on fifty thousand children seen by author .... 249 VIII. Showing for each class of defect the percentage of cases asso- ciated with another class of defect as named. .Vrranged in age-groups for boys and girls respectively. Dealing with some children, as Table VII 250 LIST OF CASES CASE PAGE 1. Bright boy, dull at Latin. Eyes moved badly .... 2 2. Mental confusion; corrected by observing its signs ... 3 3. Child bright at school, but fractious at home, with signs of fatigue ........... 4 4. Boy with cleft lip and heart defect; mentally dull ... 4 5. Arithmetical mistake; hand not guided by eyes ... 8 6. A well-made boy, action good, but dull mentally ... 9 7. Mental confusion, accompanying wandering eyes and restless movements .......... 10 8. A big, dull boy; developmental defects with nerve-signs . . 13 9. A small, fidgety, playful boy. Rickets 14 10. A boy exhausted but bright; signs of fatigue .... 14 11. A tired, dull, fidgety boy 14 12. Delayed expression or thought, seen in action of child at three years old .......... 46 13. Action adapted by circumstances, in a child under three years . 50 14. A well-made boy, but exhausted and overworked • • • 55 1 5. Boy who stammers : muscular spasm commences in the forehead, 117 16. Boy who stammers: muscular spasm commences about the mouth. An intelligent boy. Rickets . . . . • n? 17. Delayed expression of an impression produced, in a child four years old . . . . . . . . . -125 18. A dumb boy, who showed acquired experience as to temperature, 129 19. A very dull boy: short-sighted and deaf. He could compare weights. . . . . . . . . . .129 20. A boy, exhausted and very dull ...... 144 21. A girl, tired in home life ........ 146 22. A boy, showing signs of mental excitement . . . • 151 23. Headaches in a nervous child; previous chorea . . . 153 24. Schedule describing a normal child . . . . . • '57 25. A nervous child described in schedule; also a card, describing the defects in the same case . .' . . . . .160 LIST OF CASES XIX CASK 26. Schedule : a dull and backward boy, defects in make and in nerve-signs . ...... 27. Schedule: a normal !)iiy, hut dull .... 28. A small boy, very backward 29. A i)oy overworked, not deficient; inert and solitary . 30. A small girl, exhausted and placed too high in school 31. A backward girl; head small, eye-movements faulty 32. A boy bright at arithmetic, dull at Euclid; did not look at the blackboard 33. A clever boy; a thief and incendiary 34. A clever girl; character bad, criminal inlieritance 35. An uncontrollable boy; mother insane (epilepsy?) 36. Schedule: describing a child feebly gifted mentally 37. A girl mentally feeble, without speech, but with some social and moral sense ..... 38. A deaf boy without speech, but educable . 39. A boy with increasing deafness, short-sight, and accompanying mental dulness 40. Schedule, describing a delicate, small-headed, fidgety girl; mentally bright, headaches, needs spectacles 41. Schedule, describing a boy delicate and dull, with defect of development and nerve-signs. He needs special care and training. ........ 42. Girl: epileptic fits at home, none in school; very dull 43. Boy: epileptic fits in school, deficient mental power; a boy 44. Boy: fits at home and in school; a clever boy and good 45. Boy: fits at home and in school; intelligent 46. Girl : mentally defective and epileptic 47. Frowning, quieted by interesting work 48. Headache, leading to confused mental action . 49. Illusions in a boy, leading to untrue statements 50. A girl with chorea or St. Vitus's dance good THE STUDY OF CHILDREN CHAPTER I ^ Introductory An educational system has been introduced, and made available for all classes, in order that young people may grow up with their faculties well devel- oped, fitting them to become useful men and women in their future social life. But, while looking at the scope and the public usefulness of a system of edu- cation, we must remember that children differ greatly in health and strength and in mental faculty ; educa- tion should therefore be adapted to the special needs of the individuals. Children of school age, i.e. from throe to fourteen years, form about one-fourth part of the population. We shall see that there are many classes and varieties of children, whose needs must be studied ; while the bodily strength and mental faculty of an individual will be shown to vary at dif- ferent age-periods, and according to the environment. Hence, child study must be a matter of priuKiry interest B I 2 THE STUDY OF CHILDREN to the teacher and others engaged in the care of children, as affording a basis for the methods of edu- cation ; giving a source of perpetual interest to work in school, an interest in the individual child, and a reasonable means of working out, in practice, the best that can be done with the child in various phases of life. Without an intimate knowledge of children the teacher may have difficulty in the pres- ence of a peculiar pupil. Case I. A boy, eight years of age, in a prepara- tory school, was said to be so dull at learning Latin, that it was thought impossible to continue the at- tempt to teach him. He was healthy and well made ; he showed no signs of mental defect, and was, other- wise, quick and bright. He had learned to read well and read story-books for pleasure. I noticed that, in reading, he followed the words on the printed line by moving his head, not moving his eyes in their orbits ; this did well enough for story-reading, when he skipped much of the page. Moving the head, in place of turning the eyes, did not admit of sufficient accuracy for studying Latin. Some attention to eye- drill soon removed all the difficulty complained of, and the boy made good progress. This cause of mental dulness will be referred to again; the case serves to illustrate the usefulness to teachers of per- sonal observation. Children in a school class usually vary ; each has INTRODUCrORY 3 his own peculiarities. A rough classification may be made of the temperament, disposition, and mental characteristics of each, and still there remain itulivid- ual peculiarities, which should be recognised as a guide to training. Some children are active in tem- perament, kindly in disposition, and quite up to average for their age in mental ability ; an individual of that class may give trouble by outbursts of passion and periods of mental confusion ; such pupils will need careful consideration and management. Case 2. A girl was doing a sum, simplifying a compound fraction quietly and correctly, line by line : then the forehead puckered and the eyebrows were knit together, while the face flushed and the angles of the mouth became depressed ; at the same time, the fingers of the right hand, which held the pen, twitched, and she wrote 114— 16 = 24. Writing quickly 114 .... on a piece of paper ^ and puttmg it before her was immediately followed by the face clearing, while the figure 98 was at once filled in ; the work was continued without a word said ; thus a storm was prevented by rapid observation of the signs accom- panying mental confusion. Observation and study of children as to their mental status will add power to the position of the teacher, to be exercised for the benefit of children. To ob- serve and to think does not suffice to complete the 4 THE STUDY OF CHILDREN method of child study ; we should be able to describe in words what we see, both as an aid to accurate thinking, and as a means of expressing the grounds of an opinion, formed as to the status of the child and the effects of training. Accuracy in thus form- ing an opinion may do much to save friction between the school and the parent, and to establish a good understanding. Case 3. A boy was sent to Kindergarten ; on return- ing home at m.idday, it was always difficult to make him take his dinner ; he talked much, turned away from his food, was cross, nothing was pleasing to him ; he was restless and looked full under the eyes ; at night he talked in his sleep, in the morning he was tired and did not want to get up. He was a healthy, well-made child. In school he was reported as bright and eager, did as he was told, liked the games, and did not seem tired. The teacher saw him bright and happy, when occupied and under the stimulus of school and companions ; the parents saw him after such stimulus was removed. Each account of the child was true ; they were taken under different circumstances. Case 4. A boy attending an elementary school was brought to me by his mother, because he was trouble- some, did not do his work, and was always in disgrace and punishment, and she did not know what to do with him. I observed at once that he had a cleft upper lip, which had been closed by a surgeon, but the scar INTRODUCTORY 5 remained. Knowing the frequency of several defects in the same child, and that the brain in such cases is often, but not always, badly made, I examined him with care. The boy had a defect of his heart, and his brain was ill-developed. Advice was given that he should continue at school, and that the teacher should be informed as to his condition, that he might be kindly treated, and not expected to pass examinations. This boy has a right to the benefits of education ; they afford the best chance of his improvement, and of preventing him from becoming a failure in life. Such cases are common. As to method of observation and study, I have to explain, as shortly and clearly as possible, how you can observe children for yourselves, and think about your observations with advantage. The observations you make for yourselves will always be of use to you ; in making observations we can all agree ; the inferences drawn therefrom may differ according to the aspects in which they are considered, and the special experience brought to bear. The points to be defined for observa- tion are grounded upon my personal observation of 100,000 children who were seen individually. Some principles which underlie accurate observation and description will be explained, to help you in planning what you will do and what to look at. A certain amount of training is necessary to make a good observer ; the teacher who has to give object THE STUDY OF CHILDREN lessons or teach natural history needs not only to be an accurate observer himself, but also to be capable of training children to observe, i.e. to see and to think about what they see. Looking at a buttercup flower, you may name it and say where it grows ; that it is of no particular use to the farmer, but is a very pretty flower ; that it is a yellow flower and without scent. Then you will show the parts of the flower, the five parts that are coloured, showing that they are separate from one another, and all alike in size and in form. So you proceed to look at all the parts of the flower, their num- ber, size, form, the proportions of the parts, and you compare them. Occasionally you will find a flower in which the coloured parts (petals) are not all of the same size, and with some variation of colour ; points a little different from the usual and below the normal. Now look at a kitten : it may be more difficult to demonstrate than the flower, because it is alive and full of movement ; but more interesting, because it does move, and shows some instinct or intelligence. You proceed, as with the flower, to look at its body, each limb and its parts, the ears and the tail, the claws, etc. We look at each part of the kitten. Its movements are more interesting points : movement indicates its play- fulness, the instinct, and something like intelligence in the cat: movements tell you more of the disposition and character of the cat than its colour, the length of its hair, and its ears and tail. In studying a living INTRODUCrORY thing we observe its parts, and in a living animal we observe movements in its parts : we must study the child in the same way.^ I shall call your attention to the body of the child, its height, weight, and proportions as a whole, and to the physiognomy or proportioning of the head and separate features and parts. Over and above the observation of the body, as a still object, you must look at the movements of its parts, which are the direct outcome of action in the brain and nerve-system ; thus you may study growth of body and action of brain, as you look at the child and think about ills mental action and the interaction of the mind and body. In studying a child, to ascertain all you can c'.bout his mental disposition, you must look at him for the purpose of seeing all possible signs of his brain action, and how it is controlled and affected by circum- stances : by studying individual pupils continuously you will acquire valuable experience and be able to form generalisations from your observations, as a basis of mental study. When you have learnt to recognise and describe the points, seen in the well-developed but ner- vous child, examples will remain in your memory, and in your note-book, and you will find that they are usu- ally quick in mental action ; affectionate, but some- times passionate, gregarious in social habit, and give difficulty in school on account of their over-mobility, 1 See " Anatomy of Movement : A Treatise on the Action of Nerve- Centres and Modes of Growth," by the author. The Macmillan Company. 8 THE STUDY OF CHILDREN excitability, fidgetiness, and liability to fatigue and head- aches. These facts will stimulate your interest in these "troublesome children " and show the origin of some of their faults. I have seen such children in school sit together at the back-desks of the classroom, where their quick wits enabled them to complete their sums or exer- cise quickly ; while their spontaneous mobility predis- posed them to be the playful, talkative, laughing pupils of the class. I shall put before you the points, in detail, which you may see and describe in the child. Besides describing what you see in the child, I think you will gain much by giving a general description in your own words, indicating the mental action you may observe in the pupil's words and work, and compare this with points seen in the body and action of the child. Case 5. I have seen a well-built, intelligent child, who was interested in and quick at arithmetic, make an absurd mistake. The sum was to reduce six million inches to miles, yards and feet : it was written thus : 12 1 6,000 ,000 inches 3 1 500 feet i66"2 yards Aus. 166 yd. 2 ft. The purely mental work is correct ; the first line was drawn wrongly, the eye did not correctly guide the hand. It was, doubtless, extremely careless of the child ; but if you scold her, she will wriggle and flush and look like crying ; that does but little good. Rather look at the child as you work out a sum on the black- INTRODUCTORY 9 board, note if the eyes are moved accurately and steadily towards the figures and lines of the sum ; again, note if she move her hands and fingers accu- rately in imitation of )()urs when doing physical exer- cises. Want of control of the hand through the eyes may produce mistakes taken for mental faults. Making an observation is, primarily, an act of seeing, and appreciating what you see ; after observing you need to describe what you have seen. Seeing teaches much ; describing what you see will add accuracy to your work and enable you to acquire a sound experi- ence, which you can compare with that of others and correct from time to time. The points most commonly observed in the body and brain action of children are described in Chapters II., III., VI., while to aid the description of points below the normal a list of such signs is given and a schedule form is added which may be conveniently used in recording observations. As the studies before us deal largely with the body and mind or the mental action of the brain, chapters will be devoted to the observation of mental expression and movement. This leads me to speak of the differ- ences between signs which indicate general brain status, its health and power on the one hand, and mental expression on the other. Case 6. A boy well made, healthy, and well grown in body, head, and features : his movements are quick and exact, he turns his eyes towards objects steadily and lO THE STUDY OF CHILDREN imitates movements well, while his speech is good. His body and brain appear well made and active. On testing his mental ability it appeared that, though he could count coins, he was not able to add their value or calculate the change : he could read and write, but both slowly and badly. The boy's brain was good enough for the action and general activities of life and labour, but the purely mental processes were performed very indifferently. The general conditions of make and power of brain are ascertained by observation of the "nerve-signs," which are movements, action, balance, gestures, or other motor acts ; they may be normal or below the normal. Mental signs are mainly obtained in speech, expression of judgment in making a choice, memory. You will often find that modes of mental action, whether good or faulty, correspond to the manner of movement and action. The child who, when spoken to, suddenly goes through a number of extra-movements, excited but not controlled by the spoken word, is liable, at the same time, to mental confusion and may make some absurd mental error. Case 7. A boy whose eyes are wandering every- where, with the head moving and the fingers twitching, is asked to say what he knows about King Charles I., and replies that he had his head cut off at the battle of Waterloo. Such mental confusion often accompanies IN 1 KODUCrORV 1 1 excessive nervous movements, and its removal may be helped by good physical training. I shall not speak of Mind, Consciousness, Feeling, Will, and Judgment as something imj)lanted in the body, — that is apart from and outside the scope of this work, — but I shall describe for you, as clearly as pos- sible, in detail, with examples, all the points we can observe as indicating mental action in the brain, and analyse many modes of action and some verbal expres- sions, showing facts and faults in mental action. Childhood presents so many varieties, that to deal with the subject concisely and in form convenient for study, it will be necessary to present certain classes and groups of children as we find them in the child population. Children may be classed as mentally bright or dull, as weak and delicate or nervous ; that is, according to certain difficulties we find in them : again, they may be grouped according to points seen in them, as quick and exact in all movements or slow in response and inexact in imitation ; as ill-proportioned in head and features, as over-mobile or motionless, or as deaf and of defective sight. In an elementary school I saw 447 boys and 445 girls, of whom the teachers reported 41 boys and 23 girls as dull or backward pupils. Of these dull chil- dren only 6 boys and 1 1 girls were free of all faults that could be seen in the body and in action. Twenty- nine of these boys and 8 of these girls, found to be dull 12 THE STUDY OF CHILDREN at lessons, showed " abnormal nerve-signs," or indica- tions of brain-disorderliness — slouching, listlessness, inaccuracy in action and in looking, — points that may generally be removed by good physical training, whereupon improved mental action would probably follow. There were in all, 83 boys and 30 girls grouped, as presenting these nerve-signs, showing how much that school needed more attention to physical training. The method of observing what may be seen in each child, and then grouping the children, according to the points seen in them, may give much useful informa- tion. The group " nerve-cases " was more than two per cent above the average in this school. A knowledge of the signs of the condition of the brain will also be useful. I have seen a young woman, who presented the complete type of nervous exhaus- tion, standing before her class, truly an object for sympathy, but a bad impression must have been pro- duced thereby upon the pupils. Let me present to you a report of what was seen at a high-class school I was invited to visit. Third class. Twenty-nine boys present at a lecture on geometry, 2.30 o'clock. The lesson proceeded as usual. I observed the boys during the lecture, first from the master's desk, afterwards from a side-table, so as to get a good profile view. This group of boys appeared generally healthy and INTRODUCTORY I 3 well. As I looked at each boy at his desk, eight of them attracted my attention : — A, B. Two used spectacles. C, D. Two did not use spectacles, but appeared to be short-sighted. E, F. Two showed some developmental defects. G, H. Two appeared somewhat exhausted in the nerve-system, and are likely to be subject to headaches ; this is probably not a tempo- rary condition. No detailed examination of individual boys was made, but the grounds of the opinion given in the cases of E, F and G, H may be stated. E, F showed no signs of brain-exhaustion or of headaches. The following signs of defective development are probably of long standing, or from birth : — Case 8. E. One of the biggest boys in the class ; he must weigh heavy, and speaks with a loud voice. As signs of defective development I observed that the ears were ill-shapen, the head too round in form and wanting in characteristic points. As a sign of defect (probably permanent) in the nerve-system, there was excessive and coarse action of the muscles in the fore- head, causing horizontal and vertical furrows. Evi- dence that he was not exhausted was seen in the symmetry of nerve-muscular action on the two sides of the body. It was observed that the over-muscular 14 THE STUDY OF CHILDREN action of the face lessened as the lecture proceeded. He lost places in class. Case 9. F. A small boy with a badly shapen head, though it was not small ; this may have been due to rickets in early life. As to the nerve-system, he was too mobile, and there was a little over-action of the frontal muscles. He was distinctly fidgety or playful, and lost places in class. Case 10. G. A boy of fair complexion, with light hair, rather under the average size, but placed second in class. The following signs of nerve-exhaustion were seen : too little general mobility in the limbs and in the mobile features of the face, producing a dull ex- pression ; in the forehead, however, there were fine horizontal lines or furrows, due to recurrent over-action of the frontal muscles. A further sign of exhaustion and probable liability to headaches was observed in marked fulness under the eyes. No signs of devel- opmental defects were apparent. Case II. H. A boy of fair complexion, with light hair, placed twenty-fourth in the class; he lost places. The signs of nerve-exhaustion were : over-mobility ; the arms were several times thrown about, often with the left hand clenched ; he was decidedly fidgety. There was fulness under each eye, indicating that probably he is a sufferer from headaches. In addi- tion, a slight sign of developmental defect was seen ; the left ear was ill-formed. INTRODUCTORY 1 5 Examples might easily be multiplied. Of all the points to be indicated for your use in the observation and description of children, the " nerve-signs " will, I am sure, prove to be the most important and interesting, because it is the move- ments and balance, the gestures, action, and response, observed in the child that indicate or express his brain state. Here we have some new work, and these signs will, I hope, be of interest to you, be- cause each depends upon the mode of action of some piece of the brain at the time you make your observation. Such signs of brain-disorderliness are much associated with the causes of mental dulness ; as soon as the teacher recognises this, he will try, by further physical training, to improve the child in each aspect, and remove the signs of motor and mental disorder one by one. CHAPTER II The Body of the Child, its Construction and Growth A BRIEF sketch of the infant will be useful to a full understanding of the development of the brain, as it quickly acquires some of those characters which give the child capacity for mental life. The infant at birth weighs from seven to ten pounds. Average height or length in inches .... Average weight in pounds Average girth of chest in inches Average circumference of head in inches . . The head of the infant differs in many particulars from that of the child of school age, and these are important to the proper understanding of its growth and some of the later defects. The bones of the skull are very thin, the size of the head very nearly corresponds with that of the brain which it contains ; the bones are not united at their edges to form a rigid bony case as in the adult, but are separate at their margins so as to be movable on one another; this allows for a rapid increase in the size of the i6 Male Female 19-34 18.98 7-55 7-23 13-25 12.65 13-95 13-57 THE BODY OF THE (HII.D 1 7 head as the brain grows. The size of the head is of interest, for small-headed infants are less likely to live ; the brain is the principal seat of vitality. The corners of four of the bones are incomplete towards the top of the head, thus leaving an open space, called the soft spot or fontanelle, covered by a membrane and the scalp, where there is no bone ; here the brain may be felt pulsating and swelling up when the infant cries. The nose of the young infant is but little developed, and is flat and sunken in comparison with that of an older child. At nine months old the fontanelle can .still be felt, the head is still open and growing fast, it measures about lyl inches in circumference; at twelve months, 19 inches; and at seven years, 20 to 21 inches. You must not, however, expect always to find the head as large as here given, even in healthy children ; but after three years old a circumference of 19 inches is too small. Teething usually begins at the seventh or eighth month, the lower front teeth being the first to appear, then the corresponding ones in the upper jaw; the sharp-pointed canines come through at about the eighteenth month, and the others follow till the full number of twenty milk teeth appear, which is accom- plished during the second year. At the age of six or seven years children begin to lose their first teeth, 1 8 THE STUDY OF CHILDREN and the permanent ones appear. It is hardly neces- sary to say that children's teeth should be kept care- fully clean at all ages. TABLE L — OF DENTITION PERIODS Temporary Set or Milk Teeth First Group — Two lower central incisors appear . 6th to 8th month Second Group — Four upper incisors appear . . Sth to loth " Third Group — Lower lateral incisors, upper and lower front molars, appear I2th to 14th " Fourth Group — Canines, upper usually first, appear i Sth to 20th " Fifth Group — Posterior molars appear .... 2 years to i\ years Molars Canines Incisors r Upper 2-2 i-i 2-2-) Full Set^ ^ V20 •- Lower 2-2 i-i 2-2 > Permanent Teeth Molars, first appear at 6 years Incisors, central " 7 " lateral " 8 Bicuspids, anterior .... " 9 " posterior .... " 10 Canines " 11 to 12 Molars, second " 12 to 13 " third " 17 to 25 Molars Bicuspids Canines Incisors f Upper . ' . . . . 3-3 2-2 I-I 2-2 1 Full Set I ^' ^^ [32 I Lower 3-3 2-2 I-I 2-2 J We are now mainly concerned with the child of school age ; the head has grown rapidly since infancy and should present neither ridges nor lumps, and the brain has attained within a little of its full weight. THE i]onv OF THE cnn.i) 19 See Table V. The head has acquired a distinctive shape, expanding from the base at the level of the ears, its widest diameter being behind the situation of the ears, but with good expanse of forehead. The head contains the bony skull, the upper part of which forms the brain-case. The lower jaw is the only part of the skull that can move separately from the rest. This bone is jointed on to the skull; it is depressed when the teeth are separated, and brought up again by the muscles when the mouth is closed ; the lower jaw can be moved up and down as well as laterally jfl. mastication. The eyeballs are set in their sockets or cavities in the skull, called the orbits, resting among the fatty tissue which supports them. The movements of the eyes are produced by small muscles attached to the eyeball and arising from the walls of the orbit. These muscles are supplied by three different pairs of nerves from the brain. If the fat in the orbit be diminished in quantity, the eyeball sinks further into the orbit ; if it receives more blood, it swells up and pushes the eyeball more forward. The coloured portion of the eye is called the iris ; it is a muscular curtain with a hole in the centre which appears black : this aperture is called the pupil, and may contract or become very large. In description we must not con- fuse the eyeballs with the eyelids, which frame the openings for the eyes. The face consists of the soft parts which lie in 20 THE STUDY OK CHILDREN front of the skull ; under the skin there is a layer of fat, and muscles passing in various directions which, being attached to the skin, move it and produce the expression of the face. A circular muscle surrounds each of the openings of the face : the circular muscle around each eye-opening is called the orbicularis oculi ; when it contracts, the eyelids are closed : the mouth is closed in the same way. These muscles, when stimulated by the nerves from the brain, move the face, as will be explained in the next chapter. Two pairs of muscles in the forehead are of special interest to us : the frontal muscles are placed verti- cally and by their contraction raise the eyebrows and produce horizontal creases in the skin of the forehead ; the corrugators are two small muscles, placed in a horizontal position in the middle part of the forehead which, when they contract, draw the eyebrows together, producing vertical creases in the mid-frontal region. Two pairs of muscles seen in the face are concerned in mastication, rather than with expression : these are called the masseters — they are situated about the angle of the jaw on either side ; and the temporals, which are placed at the side of the head, in those parts called the temples. If you strongly clench your teeth, you will feel these mu.scles become hard. as they contract and swell out. All these structures which make up what is called the face are supplied with THE BODY OF THE CHILD 21 ."%f M Fig. I. — MUSCLES OF Facial Expression. — From Sir Charles Bell's ^«a/- orny and Philosophy of Expression, Third Edition (Bohn Library). AA The frontal muscle. DB The corrugator muscle. It is inserted into the integument under the eye- brow. It lies nearly transversely, and its office is to knit and draw the eyebrows together. CC The circular muscle of the eyelids (orbicularis palpebrarum). DEL Muscles moving the nostrils. KK The circular muscle of the mouth and lips. Its office is to close the lips; in excessive action it produces pouting. HH The zygomatic muscle. It is inserted at the angle of the mouth : by its action its widens the mouth, as in grinning. A'A'^ Depressor labiorum. . It depresses the angles of the mouth; other mus- cles of expression are also represented. 22 THE STUDY OF CHILDREN blood-vessels, and the quantity of blood in them is also under brain control, through a nerve called the sympathetic. When much blood rushes to the face, the child is said to blush ; when the sympathetic nerve allows but little blood to pass into it, the face is pale. The openings for the eyes (palpebral fissures) are placed between the upper and the lower eyelids ; the line joining the angles of the openings is horizontal. The nose has been referred to as a feature in the face. It is necessary to understand its importance as the proper entrance for the air breathed ; a free en- trance of air by the nose is important to the child, and a knowledge of some points in the structure of the nose, throat, and organ of hearing is necessary to our purpose. Air entering by the nose passes above the hard and soft palate to the back of the throat, where a tube (eustachian) leads air into the portion of the ear which is concerned in hearing. If there is any obstruc- tion to this free entrance of air, the child becomes deaf or dull of hearing. The nose is the proper way of entrance and exit for the air breathed, and the child should be able to breathe easily with the mouth closed and the lips together. If the child cannot breathe thus, but habitually keeps the lips parted, there is probably something wrong with the throat or nose. Such habitual mouth-breathing is very important; mouth-breathers need medical examination. THE BODY OV THK CHILD 23 The external ears should be alike in form, and stand out but slightly from the head. The external ear con- sists of parts each of which should be present : the rim or margin curls over slightly ; in front of this is the pleat of the ear (antehelix) jutting out in front, and you will find it is thrust forward from the back ; the lobe or drooping portion of the ear should come below the point of attach- ment to the head. The trunk or body has a bony frame- work, of which the spine is the main prop or support. The spine consists of a number of small bones, united by pads of cartilage or soft material, which allow of a certain amount of movement in the column formed Fig. 2. — Bones of thk Spine. Chest, Shoulder, Arm, and Hand. — From Sir Charles Bell's work on 7'/if Hand. 24 THE STUDY OF CHILDREN by the bones, so that the spine can be bent to some degree forwards and backwards or laterally. The skull is jointed to the top of this column. The ribs are attached to the spine behind and to the breast bone in front, forming the walls of the chest. The chest and the important organs, the heart and the lungs, which it contains, grow as the child grows. The average chest girth for children at various ages is given in Table IV. It is very important that the chest should be free to move in breathing : it should never be compressed by the dress. Fig. 3. —The Radius and Ulna. — In this sketch, the upper bone of the forearm is the radius, and in revolving on the lower bone, the ulna, it carries the hand with it. — C. Bell. The arm or upper extremity consists of the blade bone placed over the back of the trunk ; the collar bone stretches horizontally from the blade bone to the breast bone, and helps to keep it in its proper place ; the arm is hung from this blade bone. The upper arm contains the bone called the humerus jointed at the shoulder to the blade bone. The forearm has two bones — the radius on the outer or thumb side, and the ulna on the inner side : these two bones are jointed THE BODY OF THE CHILD 2$ to the humerus at the elbow, and allow of two kinds of movement. The elbow can be bent or, as we say, flexed, and it can be straightened or extended : a rota- tory movement or half a circle can also be performed at the elbow. When the palm of the hand is brought forward or laid upward, the forearm is said to be supine, and this movement is called supination ; when the back of the hand is brought forward, the movement is called pronation. This rotatory action at the elbow is due to movements of the radius on the humerus. The wrist is composed of eight small bones, and this joint allows of movements in all directions. The hand has four fingers and a thumb, spoken of collectively as the digits ; these are united to five bones, which form the palm of the hand and are jointed at the \Yrist. The palm of the hand can be moved at the wrist in flexion or extension as well as laterally ; it can also be contracted or screwed up by bringing the bones together, so as to form the hand like a cone. The digits can be flexed or ex- tended, and they can be moved laterally. These parts have been particularly mentioned be- cause we are concerned with their separate movements. When we look at a child we see these parts clothed with their muscles and soft tissues, and covered with skin ; we observe the members, their form and pro- portions, and in some degree we judge of the develop- ment and state of nutrition of the child by such facts. 26 THE STUDY OF CHILDREN When examining" a child, you should, if possible, weigh him and measure his height and chest girth, and also test sight and hearing. In taking a chest measurement let the child stand with his arms hanging by his sides, and make him count aloud the while to assure he is not holding in his breath. The measur- ing tape is then passed horizontally round the child on a level with the breast, and the number of inches in girth is recorded. With growth from infancy the child becomes taller and increases in weight; this is shown in Table II., copied from Dr. Bowditch's article on the growth of children whom he measured in Boston.^ It is here necessary to consider the boys and the girls separately and to compare them in age groups. It is interesting to note that, though at earlier ages the boys are on the average taller and heavier than the girls, yet at 13 to 14 years the girl outgrows the boy in each par- ticular : after this age the boy again grows quicker to the stage of full development. Children are best weighed in the morning in their ordinary indoor clothes, and measured in their stock- ings, without boots. The average increase in height and weight is given in Table III., to which reference will again be made in Chapter X. Growth, however, is not simply indicated by the 1 See the Annual Report of the State Board of Health, Massachusetts, 1877. THE 150DV OF THE CHILD 2/ height, chest measurenieiit, and weight of the child ; he may grow well developed or badly developed. A boy may be tall and heavy, yet not well developed in body and in features. It will be shown upon ample evidence from my observations, that defective physi- ognomy in make and proportioning of the features is apt to be accompanied by low brain-power with de- fective nutrition in after life. To study the general character of the development of the child's body the separate features of the face must be observed. You want to know, as to the child's body, not only whether it is well grown and well developed for his age, but also whether he shows the indications of a well- nourished and healthy body in his physii^al life, as apart from his brain condition and mental power. Do not be guided in making your observations by indications of poverty, but satisfy yourself by what you see, that the child is not pale, thin, or delicate. The following points may help you : look at the face as to colour ; do not mistake a fair complexion with light hair and blue eyes for paleness, or a dark complexion for its absence. Look also at the colour of the lips, and the colour seen through the finger-nails, which disappears upon pressure. A pale child may flush in the face, but such flushing is temporary. When you note the colour of the lips and skin, as signs of the general nutrition, observe also the hair and the eyes ; when these are dark, it is owing to the amount of pigment 28 THE STUDY OF CHILDREN in these structures, and then the skin is usually darker in its tint. Observe whether the colour comes and o-oes • such chancres are due to the action of the nerve- system on the blood-vessels. If there be permanent paleness, it may be due to a poor state of the blood, called anaemia; then the child is out of health. A pale child may flush much. Defective colour may be due to ill feeding, to living in rooms badly ventilated, hot and close, or too dark. The fulness, fatness, or plumpness of the child may not be alike all over the body. The face may be fairly full, while the limbs are thin. This is particularly the case in the nervous children, in whom the body weight may at times fall rapidly, dropping one or two pounds a week without any disease or even any failure of ap- petite ; this is a condition in which a child commonly develops chorea (St. Vitus's dance) ; as the body weight drops, the face may continue to be the best nourished part, but the child is apt to become more infantile and over-mobile ; this is specially apt to occur in girls. Weigh- ing the child will add accuracy to your observations. The eye may have a wrong focus. The eyeball is an optical instrument, which if properly arranged produces a clear picture of objects upon the retina, which is the sensitive layer at the back of the eye ; it is something like the camera of the photographer, but its focus must be properly adjusted to produce clear sight: if the eye is out of focus, sight will be defective. There are THE BODY OF THE CHILD 29 two principal forms of badly built, badly proportioned eyes : — 1. The small flat eye. (Hypermetropia.) 2. The long eye, which causes short sight. (Myopia.) The small flat eye is irregularly developed or propor- tioned at birth, the condition is congenital ; it is under- sized and the condition is often inherited. It does not produce clear pictures on the retina, and the focussing apparatus (muscle of accommodation) is strained, to pro- duce clear vision of the letters in a book. This may lead to headaches or to squinting. Squinting is usually due to the eye being small and flat ; such children, when old enough, should be provided with proper spec- tacles, and they should always use them when reading or writing. The eye too long from front to back leads to such bad focussing that vision is indistinct and the child near-sighted. This condition is not found at birth, though the tendency to short sight may be inherited ; it usually develops during school life, and is in part preventable by the use of glasses and attention to the position of the child when at work. Do not let chil- dren bend over their desks ; still, remember that the short-sighted child cannot sit up and see his book on a flat desk. To save children from becoming short- sighted, prevent them from using their eyes too long and too closely on near objects. The boy should sit up well, with his head upright and his eyes at least twelve 30 THE STUDY OF CHILDREN inches from his book ; the desk should have a sloping top, and the seat must be properly adjusted to his height : books of bad type should always be avoided, and the light should be sufficient, especially at night. Each child should be tested as to sight when he enters the school and at least once a year afterwards. A set of printed type should be provided for the pur- pose : such are published, and arranged as to the size of the letters so that with clear vision each line can bt; seen at the distance named on the sheet; this should be hung on the wall in a good light. A child, standing;' at the proper distance, should be able to read the letters readily : test each eye separately, covering the other with a card in front of it ; if the child cannot thus see the letters with each eye, there is some defect of sight. Again : let the child stand and look at a small coin held before his face two feet from his nose ; if you see that his eyes then turn inwards with the appearance of a slight temporary cast or squint, he probably has flat eyes (hypermetropia) and requires convex glasses. You may test hearing by your watch or by your voice. In using your watch ascertain previously how far from the head it can be heard by persons with good hearing ; use a measuring tape, holding one end against the ear and the other at the watch. Direct the child to close his eyes, and hold a sheet of paper or a fan to prevent him from seeing the watch, while you make THE BODY OF THE CHILD 31 him close the opening of the other ear, which you are not testing. Carry your watch to different distances from the side of his head, square with it, not in front of him. When he says he hears the watch, note the distance, move it to a further distance, and then back again to the former place, and see if he adheres to what he said before : test him thus several times and examine each ear separately, noting the greatest distance of hearing with each ear. TABLE n. Showing Average Heights and Weights of Boston School Children ok American Parentage After Dr. Bowditch. See Annual Report of the State Board of Health, Massachusetts, 1877. Height taken without shoes ; weight in ordinary dress. Age Last Birthday Bovs Girls Inches Pounds Inches Pounds 5 years 41.74 41.20 41.47 39.82 6 " 44.10 45.14 43.66 43.81 7 " 46.21 49-47 45-94 48.02 8 " 48.16 54-43 48.07 52.93 9 " 50.09 59-97 49.61 57-52 10 " 52.21 66.62 51.78 64.09 II " 54.01 72-39 53-79 70.26 12 " 55-78 79.82 57.16 81.35 13 " 58.17 88.26 58-75 91.18 14 " 61.08 99.28 60.32 100.32 '5 " 62.96 110.S4 61.39 108.42 16 " 65.58 123.67 61.72 112.97 17 " 66.29 128.72 61.99 115.84 18 " 66.76 132-71 62.01 115.80 32 THE STUDY OF CHILDREN Testing with your voice has the advantage that if the child repeats what you say you know that he heard you. You should stand a distance of several yards from the child, while he keeps his eyes shut ; he must not see your face, as he might read the sound from your lips ; test first both ears together, then one at a time. An audible whisper may be heard much farther than the ticking of the watch ; according to Mr. T. Mark Hovell, whispered speech should be heard at about twenty-five yards. To pronounce single words is better than to ask a question, which may be guessed at. TABLE HL Showing the Annual Increase in Hp:ight and Weight After Dr. Bowditch. I'ide ante. Age Last Birthday Boys Girls Inches Pounds Inches Pounds 5 years — — — — 6 " 2.36 3-94 2.19 3-99 7 " 2. II 4-33 2.28 4.21 8 " 1-95 4.96 2.13 4.91 9 " 1-93 5-54 1.54 4-59 lO " 2.12 6.65 2.17 6-57 II " 1.80 5-77 2.01 6.17 12 " 1.77 743 3-37 11.09 13 " 2.39 8.44 1.59 9-83 14 " 2.91 1 1.02 1-57 9.14 '5 " 1.88 11.56 1.07 8.10 i6 " 2.62 12.83 •33 4-55 17 " ■71 5-05 .27 2.87 18 " •47 3-99 .02 0.04 THE BODY OF THE CHILD 33 TABLE IV. Showing Mt:LAsuRRMENTs of Chest Girth in Chh.dren at Ages Corresponding After Dr. C. Roberts' observations on the English artisan class. Age Last Average Chest Age Last Average Chest Birthday Girth in Inches Birthday Girth in Inches 5 years 21.40 13 years 25.24 6 " 21.68 14 " 26.28 7 " 22.54 15 " 27-51 8 " 23.09 16 " 28.97 9 " 23-79 17 " 29.38 ID " 24.0S 18 " 30.07 II " 24-34 19 " 30.56 12 " 2493 20 " 30.86 TABLE V. Showing the Average Weight or the Brain of Children in Ounces Avoirdupois After Dr. Boyd, as observed by him in 2030 cases, London. .See Dr. Thurman's article on Weight of the Brain, Jou7-nal of Mental Science, 1866. Females New born .... Under 3 niuntlis . From 3 to 6 months From 6 tc3 12 months From I to 2 years . From 2 to 4 years . From 4 to 7 years . I'rom 7 to 14 years . From 14 to 20 years . CHAPTER III The Brain : Its Development and Evolution We now pass on to consider the brain itself, its func- tions, and the signs of its action. The brain is a part of the body hidden from our view, and enclosed in its bony case in the head. The brain of the child is care- fully protected from injury, being surrounded by deli- cate membranes and a slight layer of fluid ; it is well supplied with blood, which circulates and supplies it with needful nourishment. The brain is a soft and delicate structure, seated in the brain-case, and carefully protected ; it consists es- sentially of two kinds of material, the nerve-cells and the nerve-fibres. The nerve-cells are the makers of nerve-force when duly nourished ; for their proper nutrition they need a good supply of blood in their vessels. A nerve-fibre passes off from each cell and conveys the force generated in it, which is then called a nerve-current ; there are millions of such cells in the structure of the brain. When the nerve-force generated by a nerve-cell is carried by a fibre to a muscle, say in the face, or in the limbs, this nerve- current causes the muscle to contract or shorten, and 34 THE BRAIN 35 visible movement results ; the movement being pro- duced by the force sent from the nerve-cell. The movement seen indicates to us the time and quantity of the discharge of force from the nerve-cell : such a movement is conveniently called a nerve-muscular movement. The substance of the brain is thus mainly made up of groups of nerve-cells, many of which are connected with one another by nerve-fibres, while many of them are connected with the muscles of the body, and send jierve-currents to them, thus causing the movements of the face and limbs. The nerve-cell generates force as the outcome 'of its nutrition, and may be compared to a galvanic cell which generates electrical force as the outcome of chemical action taking place in it. The electrical force formed in the galvanic cell may be conducted to a distance by a wire, and if this end be connected with a galvanometer, it may produce movement of its needle at a distance from the bat- tery. If several electrical cells be connected together in series by means of wires, the force generated by one cell is communicated to the next, and increases the strength of the current circulating in the wire that passes off from the battery ; this force may be dis- tributed to parts at a distance from its origin. As time goes on, the strength of the battery will run down, the chemical action in it lessens, the mate- rial in the battery is used up, and no more force is sent 36 THE STUDY OF CHILDREN out till the materials in the cell are renewed. Simi- larly : while the brain is giving out force, it must be replenished by nutrition, or it will run down and be less capable of producing energy after a short time; it will then need food and rest, and the stimulus which aids brain-nutrition. I have spoken of the nerve-cells of the brain as being connected with one another, and with the muscles of the body, which produce movements of its parts. It must now be explained that there are other nerve- fibres which connect the organs of special sense — the eye and the ear, etc., and the skin all over the body — with the cells of the brain, and convey cur- rents of force from these parts, respectively, to the cells of the brain ; such nerve-fibres are called afferent, because they convey currents upwards to the nerve- system ; in distinction from these, the fibres which convey currents from the nerve-cells to the muscles are called efferent. The fibres, which pass in both directions, are collected into bundles or strings, and are commonly called the nerves of the body; the in- going or afferent nerves convey stimuli to the brain, the outcoming or efferent nerves carry motor currents from the nerv^e-cells to the muscles. Figure 4 may explain further what has just been said : the brain is represented by the shading as divided into areas A, B, C, D, E, which can act more or less independently; each area or section of THE BRAIN 37 brain is represented as connected by nerve-fibres with a muscle corresponding. Each section of brain may receive a stimuhis from the eye or the ear. The representation is purely diagrammatic, for the B C O^ Fig. 4. — Diagrammatic Representation of the Brain and its Nerves in connection with the Eye, the Ear, and the Muscles. sake of clearness of description. The brain-areas A, B, C, D, E each receive nerve-fibres carrying im- pressions from the eye and the ear, so that they can separately be stimulated by sight and sound. 38 THE STUDY OF CHILDREN Fibres pass from each brain-area to the muscles a, b, c, d, e, respectively ; when A is stimulated, the muscle a contracts ; if the centre E be stimulated, the corresponding muscle c contracts, and so for each centre and muscle respectively ; the muscle is the visible index of nerve-currents proceeding from its own centre. If we see the muscles a, b, contract at the same moment, that indicates that the centres A, B acted together. If you see my arm move, you know this means that the muscles of my arm are contracting, and that this is due to currents of nerve-force passing out to them from certain nerve-cells by means of the efferent or motor nerves. Place an orange in front of a child ; then you will see his head and eyes turn towards it, next his hand is moved over the orange, his fingers are closed over it, and it is seized. This series of movements is due to a series of nerve-currents passing from the nerve-cells to the muscles of the parts moving ; this series of nerve- currents from the nerve-cells to the muscles follows the impression produced upon the brain, by the sight of the orange, or, by the afferent currents passing from the eye to the brain, and these are stimulated by the light reflected from the orange. Many parts of the brain can act separately : every movement corresponds to the action of a certain portion of the nerve-system, or, as we call it, nerve- THE BRAIN 39 centre. It is probable that every movement indi- cates the discharge of force from a certain area of nerve-substance, and that such discharge of force necessitates not only a supply of good blood to that piece of nerve-tissue, but also that the nerve-tissue shall be stimulated by some force. Stimulation is necessary to movement as well as a supply of blood to the nerve-centre ; sights and sounds are the more common stimuli to movements. Important as the functions of the brain are, and much as we desire to study its action, there is only one way in which we can watch the effects of its working, and that is, by the movements which it produces in the parts of the body by its action on the muscles. All movements in the body are pro- duced by the action of the nerve-system upon the muscles ; this is very important to remember. Hence, we shall have much to say about movements, the outcome of movements, and mobile expression as signs of brain-action and the brain-condition.^ It may occur to you that, as much has been said by physiologists about the connection between the mind and the brain, wc might study mental action as signs of brain-action. Let me make an assertion, and then support it by illustrations. All expression of the action of nii?id is by movement, and tJie rcsnlts of movement. A child is at lessons, he repeats what ^ See author's work on " Anatomy of Movement." 40 THE STUDY OF CHILDREN he has been taught, accompanied by gestures or movements ; his speech is produced by the movements of his chest, larynx, and the parts used in articula- tion. The written exercise is the outcome of the movements of his hand acting upon the pen. His intelligence may be shown in a game, in the house he builds with his bricks, or in the paper-folding which he does so neatly with his fingers; in all such cases the signs of the action of mind are the move- ments produced by the brain. The general condition of the nerve-system is ex- pressed by motor signs — freshness, fatigue, irritabil- ity, may all be indicated to us by the movements of the child, the absence of movements, or by the atti- tudes or postures of the body, which depend upon motor action. Examples will be given in Chapter V. The expression of the emotions is by the action of the brain upon the muscles of the body, and their contractions produce the signs which indicate to us what are called the emotions of the mind. We shall here study movements produced by the brain, not mind itself, in the child. Look at a child before he wakes in the morning. The body is quiet; if you raise his hand gently, it falls lifeless — no muscular energy is being expended. The body is motionless in full sleep, except for the movements of breathing, which are quiet, regular, uniform. If sleep is full and complete, on raising THE BRAIN 41 the eyelids the puj^ils are seen to be very small or contracted. The body and brain are in complete rest; in a healthy, well-fed child the whole system is in the state of quiet nutrition of organic life ; no currents are being generated by the brain in perfect, dreamless sleep. As time goes on, you hear sounds in the house which send currents from the child's ear to his brain ; we then see some movements of the limbs — the elbows, wrists, and fingers move. Soon all is seen to be quiet again in the limbs — sleep continues, and the brain rests and grows without expending force. As sounds grow stronger in the house, and the light I^ours in between the opened curtains, you may again see movements in the limbs, and the eyelids open ; the pupils now dilate ; the brain becomes active, indicated by movements in the limbs and face, as the child sits up. Nerve-currents are now passing from the brain to the muscles. Before school he is full of movement ; limbs, fingers, head, eyes, are all moving, owing to spon- taneous brain-activity. As he stands in his place, and the teacher calls for attention, we see him still and quiet (or at least that is desired), and the teacher tries to control his brain-action under instruction. Spon- taneous brain-action will be shown to be the basis upon which you work in producing mental aptitude ; it must be coordinated or regulated, but so as not to destroy spontaneity. Two circumstances are necessary in order that a 42 THE STUDY OF CHILDREN nerve-centre may produce action of the muscles and movement, — it must be nourished by good blood, and it must receive some stimulus. This gives us the clue as to how we must act upon the brain of the child : there are two ways, — by feeding it and by stimulating it through the organs of sense. Brains do not gro.w by feeding only ; they must be impressed or stimu- lated from without ; hence the importance of good education as an aid to brain-development. Feeding the child often lessens spontaneous movements, when they are in excess ; fresh air may have a similar effect ; various modes of stimulating a child through the eye and ear may control spontaneous movements, but these must be used with due caution. Do not stop a child's movements unless you know why you do so. You should no more wantonly arrest a child's movements with- out due cause than throw a stone at an animal without cause, or destroy a flower because you do not see any use in it. This should be known by those who con- fine the hands and feet of little infants under bulky and cumbersome clothes. Children should have their hands free, and not carry bags and books, and should not be compelled to stand in class with their hands behind them. Common observation of a healthy young infant shows abundant spontaneous movement in all parts of the body while he is awake. Look at a well-nour- ished baby, say seven days old, as he lies on his nurse's THE BRAIN 43 lap, unfettered by clothes. Movements are seen in the limbs, especially in the fingers and toes ; the move- ments are slower than most of those seen in adults, and are apparently spontaneous and irregular, occur- ring in no special order, uncontrolled by external stimu- lation, and are not directly useful to the child. A short period of wakefulness is, at this early age, usually followed by sleep, indicated by subsidence of all move- ments except those of breathing, and the eyelids are closed. The movements of the chest in breathing are estab- lished at birth, and continue without interruption. The child cries when cold, and when food has been with- held more than two hours. Contact of an object with the lips stimulates the movements of sucking ; a strong light causes closure of the eyelids ; and if the eyelid be raised, the pupils are contracted by the light. In an infant a few hours old, the attempt to straighten the elbow, when flexed, may be strongly resisted. Spontaneous movements may likewise be seen in young animals. Charles Darwin has shown that in young seedling plants the root, the seedling leaves, and the head of the plant move much, as growth takes place, though the movement is slow. This is due to unequal growth of the cells of which the young plant is built up. Spontaneous movements, thus universal at birth, must have some important signification ; they do not 44 THE STUDY OF CHILDREN appear to produce any direct effect upon the body of the infant and do not supply him with food or minister to his wants. Each movement seen corresponds to action in a nerve-centre of the brain ; the mass of movements cor- responds to a mass of nerve-centres in action. Further, these movements, as far as we can see, are not at birth controlled through the senses. We conclude that in the very young infant the brain-centres act separately and independent of special stimulation, if he is healthy, well made, and well nourished. It may be said that at birth the infant does not show the faculties of mind, because we do not see that he is controlled through the senses by sight and by sound : his hands do not move towards objects placed within his field of vision. When a month old, movements appear in the face, first about the mouth, later in the forehead. The limbs move with more force, they are moved in a greater degree, and begin to effect some mechanical results : an object placed in the hand is grasped by the fingers, and movements of the elbow carry the object to the mouth, but soon spontaneous movements return, the fingers open, and the object falls from the hand. When the infant is three months old, we may observe some control of movements through the senses, and the ' head may turn towards a bright light ; still we do not see the hand move straight towards an object Vvrithin the field of vision, and when a part of the body is THE BRAIN 45 irritated the hand does not move towards it. I have known a child in whom one leg was irritated, and the hand was not moved to scratch it, but the other leg moved up, and did so with the foot. Spontaneous movement remains as a marked character at this age, but sight of a bright object may temporarily arrest it ; this is the earliest indication of a brain-faculty that may develop into the power of attention. Later we see associated movements in such an act, as transferring an object from one hand to the other: as the muscles grow stronger the head is held up, when the body is supported, and the eyes are moved. At four or five months we find commencing signs of im- pressionability to stimulation through the senses; sound and the sight of objects begin to control and regulate the spontaneous movement. At five months, further indications of the control of brain-action may be seen; the sight of a red box may momentarily stop all movements, and this may be fol- lowed in a few seconds by turning the head, eyes, and hands towards the object seen ; that is called a coordi- nated movement ; movement controlled through the eyes occurs after momentary arrest of spontaneous action in the brain. At three years of age much change has taken place in the brain as the body has grown : the child runs and talks or chatters. Spontaneous movement continues to a great extent, but action controlled through the senses 46 THE STUDY OF CHILDREN is established, complex actions are performed, an im- pression received at one time may be retained and lead to special action at a later period. Case 12. A boy of three years went to sit on the bed of his mother, who was tired and ill. He played with some reins fastened to the end of the bedstead, which pleased him : next day he said to his mother, " You go and be nice ill ; I play horses." A brain-impression had been retained (memory), leading to his action. I dwell on the simple signs of brain-action in the infant, because they seem to afford a foundation for observation of the more complex functions of the brain of the child, as the processes of development or evolu- tion proceed. The infant at the earliest ages does not walk or talk, or turn his head and eyes towards objects ; movements are not modified in any marked degree by the action of light or of sound. The infant's brain is, in some respects, less impressionable than that of the adult, and the impressions are less retained. During the early months of infant life movements are the only signs of mental development. Compare the action seen at five months with that seen at birth ; spontane- ous movement continues, but is capable of some control through the senses. It may be temporarily arrested by sight or sound, and this, after many repetitions, may be followed by new series of movements, occurring upon less and less stimulation, and with increasing quickness and accuracy, as time goes on. We infer a correspond- THE BRAIN 47 ing change in the nerve-centres or parts of the brain : it appears that, at birth, they act slowly and inde- pendently of one another, as far as we know without any order in their acting — and, at this time, this action is not determined through the senses. At the age of five months movement may be temporarily suspended, and during the time when no (efferent or motor) cur- rents are passing from the nerve-centres, they undergo some change, indicated subsequently by special combi- nations and series of movements, such as are commonly spoken of as commencing voluntary action. This appears to be a great advance in the infant's brain-evolution.^ When a year old, action well adapted by impressions received becomes very marked, and the child makes certain characteristic sounds on sight of certain objects; its spontaneous brain-action becomes more and more capable of coordination. It appears that, whereas at birth the most marked character of the nerve-centres is the spontaneous action of individual loci of nerve-tissue, this spontaneity is not lost, but remains in advancing evolution as the foun- dation of so-called voluntary and intellectual action, becoming more controlled by circumstances. Apti- tude for mental action appears to depend upon the capacity of nerve-cells for control through the senses, such impressions temporarily inhibiting their spontane- 1 The Study of Cerebral Inliihition, " r.rain," XLIII., published by The Macmillan Company. 48 THE STUDY OF CHILDREN ity and arranging them functionally for coordinated action. In the imbecile infant action does not show this spontaneous movement (microkinesis) in the nor- mal degree ; its nerve-centres are wanting in sponta- neity, and later in capacity for coordination. It is not my intention here to branch off into the study of physiological psychology, but it is quite pos- sible to follow the apparent grouping of action in nerve-cells corresponding to many well-known modes of mental action. It may be shown that well-co- ordinated visible movements usually accompany well- controlled mental action, and that a spreading area of movement, not controlled, often accompanies men- tal confusion. This spontaneous movement, slightly under control, is the character of healthy brain-action of children in the infant school, so that postures are less available as signs among these very young children, and spon- taneous movement of their fingers is the normal action. The parts of the infant are then full of spontaneous movements ; an exception is in the eye movements, which are not frequent in many cases. One of the endeavours of infant training should be to encourage eye movements, then to control them. The most interesting signs of brain-condition are those which indicate to us the action of mind. One method of determining the signs of mind is to com- pare subjects, possessed of mind, with others, devoid THE BRAIN 49 of mind or nearly so. It will be granted that an infant at birth does not show well-marked signs of mind. The principal signs of mind are absent. An infant at birth may be said to possess none of the actual facidties of mind, although he is healthy; he may possess potentialities, but he shows no actual present signs of mind. An idiot, in growing up from infancy, does not show those signs, appropriate to his age, which indicate the functions of mind. The infant is said not to show actual signs of mind, though he may show potentialities. The infant at birth does not walk, talk, or turn his eyes and head towards a bright object within his field of vision ; movements are not modified, in any marked degree, by the action of light or sound, except that the eyelids contraq.t spasmodi- cally in the light. The infant is, in some respects, less impressionable, and the impressions are less perma- nent than in the adult. We say that the new-born infant does not give ex- pression to the faculties of mind, because he does not present signs showing that he is impressed, even temporarily, by the sight of surrounding objects ; he does not move his hands towards objects within his field of vision, and no movements indicate that he is impressed thereby. Reflexes of sight and sound are almost entirely absent. The muscles of the face are seen to act earliest in the lower zone, those about the mouth causing expression before those on the fore- 50 THE STUDY OF CHILDREN head (corrugators), which seem to be specially con- nected with expression of mind. Now as to the child when four months old, we say that the attention is easily attracted, because the sight of objects and sounds causes the head to be moved (by reflex action) towards the light or source of sound. More than this, after the stimulus of the sight of an object has caused the head and eyes to be turned towards the object, the further stimulation of the brain may arrest all movement : this often happens when the attention is attracted. On the other hand, the sight of an object, after it has caused the head and eyes to be turned towards it, may increase the amount of movement in the child. Playfulness is probably the result of spontaneous movement, together with an increased susceptibility to reflex action. The " playful child " has a happy face, owing to the healthy tone of the facial muscles and their nerve-centres. The following observation of a child eighteen months old, illustrates how the dawning intellectuality is indi- cated by the complication and fitness of certain sets of movements : — Case 13. The child, having both hands full of toys, desired to grasp a third ; he then put the toy from one hand quickly between his knees, and thus set one hand free to take hold of the desired object. The following kinds of movements as signs of a TIIK liRAIX 51 healthy infant brain deserve separate attention : move- ments following^ certain external agencies, light, sound ; movements, the outcome of the essential (untrained) properties of the nerve-mechanism ; movements result- ing from (training) the acquired association of nerve-cen- tres ; movements, similar to those previously occurring from a like cause, showing retentiveness ; movements in different areas, such as the small joints in contrast with large joints, or a different condition of movement of adjacent parts, such as the fingers. There may also be a symmetry of movements. ^ CHAPTER IV Observing the Child : What to look at and what to look for The training of children and the improvement in methods of education have become so important that there has arisen a general demand for exact knowledge as to the conditions of children at home and in the school. It is necessary that we should learn to study children in a scientific manner, that we may know how best to train their development in mind and body, and take our part in aiding them to grow up with a sound constitution and full mental power. The care of all classes of children is a very respon- sible work, demanding intelligent study and earnest care. It is not enough to study methods of education and school practice, the subjects to be taught and the methods of teaching them. Some knowledge of physi- ology is very useful ; but it is also necessary to observe and study the children themselves individually, and collectively in groups, that we may know their indi- vidual tendencies, good and bad, and that their ever- varying condition may be at once perceived. We should see the signs of fatigue before exhaustion and 52 OBSEKVINCJ Tin; ( IIII.l) 53 irritability are obvious in imperfect lessons and bad behaviour ; hence the necessity for an intelligent and precise knowledf^e of children enabling us to detect early signs of failure of strength and to classify them for the purpose of study. It seems to me very desirable, if not essential to the proper study of children, that we should form a judg- ment by the signs which we observe, not by the answers to questions put to the child as to his thoughts and re- specting health. I seldom ask a child if he has a head- ache, but often look for the signs of healthy brain strength and activity ; or of exhaustion, and direct indications of headache. Such observations may be made by any one who is in personal contact with children, by the mother among her children, or the teacher in the schoolroom. Let me give a few examples. At an elementary school I visited the girls in its highest standard, or grade, in company with some friends, and asked the teacher to point out. unknown to the children, those who gave most trouble. Among them were two small, but well- made children — the nerve-system in each was exhausted. Had this been known by those in authority, might not these children have been exempted from examination, and the teacher from the necessity to press them on, though still requiring their attendance at school ? Case 14. In a high-class school, a boy presented a general good development, but his nerve-system was exhausted ; he had far too much movement, showing 54 THE STUDY OF CHILDREN brain irritability. The master said he worked well, but his father often expressed his desire that the lad might do more work, and rise in the school quickly ; the head- master wished the same. Here is a case where know- ledge of a precise kind, possessed by the master, would necessarily put power in his hands to act for the boy's real good. On the other hand, where development is slightly defective, but nutrition good, it is for the child's benefit that he should not be excused from due work, except when knowledge shows that the work is harmful. Regular and appropriate work is essential to due brain development and healthy growth. There are many points of view from which we may study children ; many lines of thought which may be followed. The method I would urge upon you is that of systematic observation, — that which I want you to study is that which you actually see, apart from any in- ferences drawn from facts : it is essential, in scientific work, not to confuse what you see and what you believe to exist. Let us study the child as we see him, with the best powers of our mind, and careful earnest thought. To see the child well you need a good light ; do not touch him, but look without stating your purpose. It is desirable to prevent the child from looking straight at you, i.e. at your eyes ; for this purpose fix the child's eyes by telling him to look at some small object held in your hand, such as a shilling. Then you proceed to observe the head and the physiognomy of the individual OBSERVINC; rilK CHILD 55 features and their parts, the facial condition and expres- sion, the eye-movements and other points in action. Let him hold out his hands in front, with the palms downwards, showing him the position for a moment ; thus you can see how he responds to command and imitates your action, while you can observe the points described as " nerve-signs," indicating his brain status. Judging from the various points thus seen, and without asking questions or speaking to the children, it is easy to group their conditions in various classes thus : — A. As to Development of the body and features. B. As to the Brain condition indicated by nerve-signs. C. As to Nutrition and health of body. Such observations may give new knowledge for your use. Those who acquire the most practical knowledge of childhood will, in the end, acquire power and success in the work of education and training. Here is a schedule form for use in describing sys- tematically what you see in a child : three headings, A, B, C, group the classes of points to be looked for. Under A, describe signs of development in the sepa- rate parts, and any special characteristics. Under B, note nerve-signs in parts of the body. Under C, the state of physical health and nutrition. Under School Report the mental and general char- acter is described ; and in the Report on the Child his mental and physical condition is briefly summarised. 56 THE STUDY OF CHILDREN SCHEDULE FOR REPORT ON A SCHOOL CHILD Nutnber. Name. Age last birthday. Place in school. A. Body: Development, features, etc. Head. Face. Ears. Nose. Palate. Growth. B. Nerve-signs : Postures, movements, action. Expression. General balance of body. Expression. O. Oculi. Eye-movements. Head-balance. Hands. C. Physical health and Nutrition. School Report. Report on Child. OBSERVING THE CHILD 57 As you look at the child, bear in mind the normal or healthy type of development ; fix in your mind an ideal of good form, so that your attention may be arrested by the sight of any point in form or action that is below the normal. Now, as to what to look at : there is each part of the body named in the schedule and described in Chapter II. The Head. — Look at the head full-face, carrying your eyes from ear to ear over the top of the head, following its curve and estimating its size ; again carry your eyes from one ear to the other in a horizontal line, looking first at the right ear and its parts, then at the right eye-opening, the bridge of the nose, the left eye- opening, and the ear. Looking at the profile, follow the bridge of the nose up the forehead, noting if it be nearly vertical, or slope backwards, then over the curve of the top of the head and down to the nape of the neck. You may thus inspect the head in its configura- tion and estimate its volume by inspection. Place your hand flat upon the child's head, with your fingers spread, and thus estimate its volume by feeling it, noticing its form and any lumps or ridges of bone. Then, if you think necessary, you can measure the head round with a tape. Measure carefully the greatest hori- zontal circumference round the forehead : take a trans- verse measurement from one ear-opening to the other over the top of the head ; and again from the bridge of 58 THE STUDY OF CHILDREN the nose over the top of the head to a projection you will feel at the back of the head just above the nape of the neck ; such measurements taken at intervals of a few months will enable you to appreciate growth and increase of volume of the head. As you look at children, observing their form, you will see some with a shapely, well-moulded head of good size, while others are ill-shapen or small ; the features may be well-cut or defective in form. Physiognomy is defined by Lavater as "the art or science of discerning the character of the mind from the features of the face." Such modes of study in- clude notice of such proportions of the head as the following : the height and width of the forehead, or its narrowness from temple to temple, and the shallow- ness from the hair margin to the eyebrows ; the great- est circumference of the head, which is something like 21 inches at eight years old, the measurement from ear to ear over the vertex being about 12 inches. The greatest transverse diameter of the head in a child is behind the ears; and the outline of face and head as seen full-face should give the greatest trans- verse diameter high up, well above the cheek-bones in the part forming the brain-case. The facial angle is seen best in profile. In estimating the volume of the head, first look at it; note its form, and not solely the circumference or other measurements. A further idea of its volume OBSEKVINC; rilE CHILD 59 may be gained by placing your hand on the head with your fingers open. Heads may be too large or too small ; the forehead may present a lump on each side, or a ridge down its centre ; it may be shallow from above downwards, or narrow laterally. These defects of the head are of great importance, often being accompanied with a tendency in the child to be thin, delicate, and dull : much depends upon how he is treated at home and in school. At every possible opportunity observe the outline, form, and size of people's heads, i)aying special at- tention to the points mentioned ; study the physiog- nomy of children and persons known to you, and draw your own conclusion as to the value of your observations. Study also well-selected art representations of the human figure, in rest and in action, and learn from them the rule of perfection. In some school-rooms, photographs, engravings, and casts of the best an- tique statues are to be seen. I wish it were so in all cases, that we might learn from those who have long observed the human body what is excellent in form and outline, as well as graceful in movement and attitude. The Face. — Looking at different types of faces, we are at once struck with the fact that the passive appearance of some expresses intellectuality, while others are marked by inborn vulgarity, apart from any special mobile expression. Elements contributing 6o THE STUDY OF CHILDREN to the low vulgar type are a narrow and receding forehead, a large, prominent under-jaw, thick lips, and a thick immobile make of skin. Such signs are, however, not to be trusted too far. The features, separately, may be well made with- out being proportioned to one another or rising well from the surface of the face. If the openings for the eyes and mouth are small in proportion to the face, it imparts a blank look. The size of the jaw- bones gives an appearance of firmness to the physi- ognomy, while either the upper or lower jaw-bones may be too small. If the upper-jaw is too small, the cheeks at this part are too close together, the palate is often narrow, and the teeth overcrowded. The Nose and the Palate are very noteworthy ; they are described in Chapter II. As a sign of develop- ment or make of body the form of the bony palate is only second to the head in importance. The mouth should be noted, when at rest, as to its size. A small mouth is a defect, and often accompanies throat obstruction leading to mouth-breathing. The Ears should be observed separately, noting their size and symmetry ; see if they lie fairly against the head and that all parts are present in the ear as they are described in Chapter II. The Growth of Body is estimated by the height and weight of the child as compared with the normal (see Table II.). OBSERVING THE CHILD 6 1 Passing from the observation of points indicating development in the body, we have to consider the nerve-signs, which indicate the make, status, and action of the brain and nerve-system : these are mainly post- ures or attitudes of the body or action and movement of its parts. Following the sub-headings of the Schedule, look at the general balance of the body, the face, eyes, head, and hands. The General Balance of the body of the child, when standing quietly, should be symmetrical, equal on the two sides, so that the shoulders are at the same level and the spine balanced straight ; while the feet are equally planted on the ground with the knees straight. When the arms are held out in front, symmetry should be maintained in the equal height at which they are placed with the elbows straight : no slouching or listless attitude. The Face and Expression. — The human face in its expression and movements is a most accurate index of the brain and of the nerve-changes in it, which corre- spond to the emotions, feelings, and thoughts. When we look at a face, we may observe its form, colour, and conditions of mobility. The general form and outline of the face are largely determined by the shape of the skull beneath. Either side of the face can move separately ; hence the necessity of observing whether a facial expression is symmetrical. The muscles that move the face are sufficiently ex- 62 THE STUDY OF CHILDREN plained in Chapter II. ; their action in producing move- ment is caused by nerve-currents coming to them from the brain. The healthy normal face of a child is calm, without wrinkling or puckering in the forehead, and is alike in its action and expression on the two sides. It is convenient, for the purpose of description, to divide the face into three zones ; the frontal above the line of the eyebrows, with a middle zone separated from the lower by a line at the level of the lower margin of the orbits. To observe each in turn, hold a sheet of paper with one margin horizontal, leaving the forehead above the eyebrows uncovered — this shows the upper zone; next view only that part of the face which is below the lower margin of the orbits, or sockets for the eyes, showing the mouth, the greater part of the cheeks, and the openings of the nose — this is the lower zone. Lastly the middle zone may be demonstrated alone by holding the horizontal margin of one sheet of paper so as to cover all above the eyebrows, and another sheet so as to cover all below the orbits, thus leaving to view the eyebrows, the eyelids, and eyeballs, with the bridge of the nose. By these methods you may readily examine the symmetry of a face, both as regards form and action, and you may also define the particular zone in which any mode of expression is seen. The greatest degree of expression is, I think, seen in OBSERVING THE CHILD 63 the frontal region, mainly produced by action of the frontal and corrugator muscles. In looking at the mid-zone of the head and face, the observer's eye traverses it from ear to ear, noting these features, the palpebral fissures, and the tone of the large orbicularis oculi muscles, the bridge of the nose both in its bone and soft tissues, as well as the eyeballs and their movements. Signs are given for each of the three zones. There are some special movements in each of the facial zones worthy of notice. In the upper or frontal zone the movements are almost always symmetrical or equal on both sides ; they may produce horizontal fur- rows, or vertical furrows with a drawing of the eye- brows together — the former is a movement not of an intellectual kind ; the latter is often highly expressive of mental action. In the middle zone the opening of the eyelids is usually equal on either side ; we shall find that in this region we may have marked indications of exhaustion of brain-action. The parts in the lower zone about the mouth move in eating and in speaking. The mouth can be widened, its angles may be drawn upwards or down- wards, and the upper lip may be raised at a point a little within the angle, so as to uncover the canine tooth, as in sneering. Widening of the mouth is seen in laughter, when the angles are drawn some- 64 THE STUDY OF CHILDREN what upwards, so also, to a less degree, in smiling. The circular muscle of the mouth contracts in clos- ing the lips, and its action is excessive in pouting. The Eye-movements are of great interest. In ex- amining a child, notice whether the eyes follow ac- curately a small object you hold two or three feet in front of his face, as you move it from side to side, and up and down. The two eyes move together, so that, when one turns to the right, so does the other ; or, when one eye turns upwards, they both turn up equally. In looking at near objects, say at lo inches from the face, the eyes turn slightly but equally towards one another. Movements of the eyes are not equally common in all directions — more movements are horizontal than vertical; in turning the eyes to the right or left, there is no necessary movement of the eyelids ; the eyes turn towards objects, their muscles being stimulated by brain-currents which are generated by the sight of objects around. In observing movements of the eyes, notice whether they are obviously guided by the sight or sound of objects around, or whether it be not so. Movements of the eyes, not controlled as to their number and direction by obvious circum- stances, must be looked upon as signs of nervous- ness. Irregular movements of the eyes are common in children, and are very indicative of their brain- OBSERVING THE CHILD 6$ condition : they may be looked upon as analogous to spontaneous tvvitchings of the fingers. In these wandering, irregular movements of the eyes we find an illustration of a common law, that excessive movement is often an indication of weakness, not of strength ; the same thing is seen in the twitching movements of nervous children. Movements of the eyes in the vertical direction are accompanied by movements of the uj^per eyelids, and very often the eyes and head move upwards together. The movements of the eyeballs are effected by small muscles attached to the eye and arising from the wall of the orbit ; these small muscles are sup- plied by three different pairs of brain-nerves. The iris, or coloured portion of the eye, is a muscular curtain, with an aperture in its centre called the pupil, which may enlarge or contract. Light causes the pupil to contract ; the pupil also contracts, when the eye is looking at near objects, dilating when looking into the distance. A widely dilated pupil may indicate a state of mental excitement ; it is con- tracted in sleep. The Head, its Postures and Movements. — It is con- venient, for the }nirposes of description, to speak of three modes of movement of the head : flexion and extension, i.e. bending forwards and backwards, as in nodding; rotatiofi in a horizontal plane, the head re- F 66 THE STUDY OF CHILDREN maining erect, but the face turning to the right or the left side ; inclination, i.e. lowering one or other side of the head, so that the two ears are not on the same level and the eyes not in the same hori- zontal plane — inclination is said to be towards that side on which the ear is lowest. The only sym- metrical movements of the head are those of nod- ding and bending back the head. In a strong and healthy child the head is held erect unless some- thing changes its posture. A slight sound may cause rotation of the head ; a slight condition of weakness of the nerve-centres is indicated by drooping of the head. The posture or balance of the head may in- dicate the brain-condition. The simplest postures of the head are those called flexion and extension ; they involve equal action of both sides of the brain. The weight of the head makes it fall forward, if the muscles do not hold it up ; hence, as fatigue comes, and passes on to sleep, the head may fall more and more forward, till it is bowed on the breast. This bowed position of the head indicates something about the condition of the brain, but the posture is not solely caused by the brain-action. Do not let children, when writing, bend much over their desks — the face should be as nearly vertical as may be, and as far as possible removed from the horizontal. You may notice the drooped head and the stooping and spiritless gait of OBSERVING liri; ( UILIJ dy a tired man, as compared with that of the same in- dividual when rested and refreshed. The head is seen firmly upri