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 h COURSE OF LECTURES ON THE 
 STUDY OF CHILDREN. 
 
 GIVING THE RESULTS OF OBSERVATIONS.
 
 WORKS BY THE SAME AUTHOR. 
 
 MENTAL FACULTY : A Course of Lectures on the Growth and Means 
 of Training the Mental Faculty. Delivered in the University of Cam- 
 bridge. 4S. 6d. 
 
 Cambridge: at the UNIVERSITY PRESS. 
 
 THE ANATOMY OF MOVEMENT : A Treatise on the Action of 
 Nerve-Centres and Modes of Growth. Three Lectures delivered at 
 the Royal College of Surgeons. Cr. 8vo, cloth, 2S. 6d. 
 
 INTERNATIONAL SCIENTIFIC SERIES. 
 
 PHYSICAL EXPRESSION : ITS MODES AND PRINCIPLES. 
 
 KEGAN PAUL, TRENCH, & CO. 
 
 REPORT ON THE SCIENTIFIC STUDY OF THE MENTAL 
 AND PHYSICAL CONDITIONS OF CHILDHOOD, with par- 
 ticular reference to those of Defective Constitution ; also containing 
 Recommendations as to Education and Training. 2s. 6d. 
 
 Published bv the Committee, 72 Margaret Street, W. 1896.
 
 All Eights reserved. 
 
 THE CHILDREN: 
 
 HOW TO STUDY THEM. 
 
 A COURSE OF LECTURES. 
 
 BY 
 
 FRANCIS WARNER, M.D. (Lond.), F.R.C.P., 
 
 PHYSICIAN TO, AND LECTURER AT, THE LONDON HOSPITAL ; 
 FORMERLY PHYSICIAN TO THE EAST LONDON HOSPITAL FOR CHILDREN. 
 
 These Lectures were delivered at the request of the Council of 
 the Frobel Society. i88-/. 
 
 LONDON : 
 
 FRANCIS HODGSON, 
 
 89 FARRINGDON STREET, E.G. 
 
 1S96.
 
 U' 
 
 p: 
 
 I no 
 
 PREFACE. J^^(o 
 
 These lectures are addressed to all who, as parents 
 or teachers, are responsible for the care of children, 
 in the hope that they may help to a better under- 
 standing of them. 
 
 For several years I have been engaged in an incjuiry 
 as to the visible signs by which we may study mental 
 states and brain-action. In these lectures I desire to 
 present a portion of this work, and shall point out 
 what to observe, and how to describe the facts seen. 
 In selecting material from my MS., it appeared best to 
 put forward that portion of the work which indicates 
 practical points, likely to be of use to all concerned in 
 any way with young people. 
 
 To study is to observe, describe, and think ; and, in 
 studying children by scientific methods, we may hope 
 not only to gain useful knowledge as to methods of 
 educating and training boys and girls, but also to 
 train ourselves to scientific accuracy in observing and 
 thinking. 
 
 The child and his brain-action are here studied 
 as other living things in nature have been studied ; 
 the philosophic significance of the signs described has 
 been fully given and published elsewhere. This work 
 is not undertaken in a spirit of mere discussion, but as 
 
 8171 :". 8
 
 VI PREFACE. 
 
 a part of progressive scientific work which it is hoped 
 may assist those in charge of children. 
 
 I think that much useful knowledge is likely to 
 result from the careful and systematic study of facts 
 seen in children. I have employed the methods here 
 proposed for several years, both in medical practice 
 and in frequent visits to schools. It is possible and 
 practicable to look at the children in the school, and, 
 without asking questions, to note the signs of nutrition, 
 the conditions of development, and the present acting 
 condition of the nerve-system of the children. We 
 may observe the form and proportions of the body, the 
 absence or presence of defects of development, fulness 
 of form in face and limbs, the colour, &c. The nerve- 
 system may be studied by systematic observation of 
 the attitudes or postures, and the movements seen in 
 the body and its parts. The rapidity and precision of 
 movement, special movements controlled by the eye 
 and the ear, and the like, are important signs of mental 
 action and capacity for training. The head, face, eyes, 
 the spine, and the arms are the parts specially studied. 
 Such signs have been here employed in describing 
 various conditions such as consciousness, fatigue, rest, 
 &c., and the facts indicated can be observed with our 
 eyes. 
 
 Many other points for observation might be given, 
 and may be added on future occasions ; but I desire to 
 impress a few principles, and not to weary the reader 
 with many details.
 
 PREFACE. 
 
 I should be grateful to any who will communicate 
 
 to me their observations on children, and suggestions 
 
 for the further prosecution of this work. 
 
 F. VV. 
 
 PREFACE TO SECOND EDITION. 
 
 Since these lectures were published in 1887, an 
 
 extended inquiry as to the conditions of child-life has 
 
 been conducted by a Committee ; and, in conjunction 
 
 with other medical men, I have had the opportunity 
 
 of examining 100,000 children individually in schools. 
 
 The Committee has recently published a Report with 
 
 Recommendations as to Education and Training. 
 
 I have thought it well not to alter the text to any 
 
 great degree, but it has been revised throughout, with 
 
 some additions, while further illustrations have been 
 
 inserted. 
 
 The concluding chapter is entirely new, and gives 
 
 an account of recent investigations. A large amount 
 
 of information which cannot here be given will be 
 
 found in the Report referred to. 
 
 The work is republished in the hope that it may 
 
 further stimulate the growth of child-study on scientific 
 
 principles ; and aid teachers and others in giving 
 
 descriptions of the children under their observation, 
 
 as well as afford practical suggestions for the building 
 
 up of child-character. 
 
 r. W. 
 
 Prince of Wales Terrace, IV.
 
 LIST OF ILLUSTRATIONS. 
 
 Fie;. I- — Diagrammatic representation of the l)rain and its 
 nerves in connexion with the eye, the ear, and 
 the muscles. 
 2. — Hand in straight balance. 
 3. — Hand in feeble balance. 
 4. — Nervous hand balance. 
 5. — Diana — British Museum. 
 6. — Energetic hand balance. 
 7. — Hand straight with thumb drooped. 
 8. — Hand in rest. 
 9. — Hand in fright. 
 10. — Convulsive hand. 
 II. — Cain — Museum, Florence. 
 
 12. — Paralysis of right side of face, from brain disease. 
 13. — Paralysis of left side of face, from brain disease. 
 14. — Complete paralysis of the right side of the face. 
 15. — Imbecile, smiling. 
 ,, 16. — The same ; quiescent and expressionless.
 
 CONTENTS. 
 
 LECTURE I. 
 
 I'AGE 
 
 The Child as we see him i 
 
 Our common interest in children, our desires and aims. — 
 The child as a study.— Definite and exact knowledge of 
 child-nature essential. — Methods of inquiry ; scientific 
 study by observation and thought. — The body of the 
 child, height, weight, and colour ; its parts and structure. — 
 The head, trunk, legs, arms, and hands.— Form and signs 
 of development. — Physiognomy, Lavater's work. — Fea- 
 tures of head and face. — Definite laws of form cannot be 
 given. — Value of study of works of art. — Children of the 
 East and West. — Fixed expression and mobile expression. 
 Brain action is expressed by movements. — Law of coin- 
 cident development. 
 
 The head and face, the features, the skin, their common 
 
 defects The case of a schoolboy. — Studious observation 
 
 required by the observer. — Note shape of head, low, 
 narrow forehead, hairy forehead, diameters, angles, and 
 measurements of head. — Mouth. — Epicanthis. — Nose.— 
 Ears. — The face and features. 
 
 Eyes, testing sight. — Signs of nutrition. — Observe for 
 yourselves by the methods of science. 
 
 LECTURE II. 
 
 Organization and Functions of the Brain, and 
 THE Signs of its Action 19 
 
 The brain is hidden from view, its function is known by the 
 movements which it produces. — Mind manifested only by 
 movements. Emotions and conditions of brain expressed
 
 Xn CONTENTS. 
 
 PAGE 
 
 in speech, games, <S;c.— The brain : nerve-cells, nerve- 
 fibres, nerve-force, and nerve-currents. — Analogy to a 
 galvanic cell. — Afferent and efferent nerve-fibres and 
 currents. — Nerve-centres, or parts of brain acting separ- 
 ately. — Every movement due to action of a nerve-centre. 
 — Diagram of brain, muscles, eye, and ear. — A child 
 asleep. — Spontaneous movements ; movements directly 
 stimulated through the senses ; reflex movements. — Spon- 
 taneous movements of an infant. 
 Every nerve-centre must be nourished and stimulated. — 
 Each set of movements implies action of one set of brain- 
 centres. 
 
 Postures imply a certain balance of action in nerve-centres. 
 
 Postures of free parts indicate brain condition and mental 
 state. — Defect in body and a dull brain. 
 
 LECTURE III. 
 The Arm, the Hand, and the Spine 34 
 
 The upper extremity, its parts ; large parts and small parts. 
 — How to examine a child ; the hand to be left free. — 
 Signs of strength ; the " straight hand." — Awkward 
 postures. — Postures and defects of growth. — The " Venus 
 de Medici " and the " Diana " compared — The " nervous 
 hand" posture, its reproduction in art ; its opposite, " the 
 energetic hand." — Straight hand with thumb drooped, 
 examples seen in schools. — The "hand at rest." — The 
 "feeble hand"; contraction of the palm. — The "hand 
 in fright " ; " Cain," and the " Niobe " at Florence. — The 
 " convulsive hand," seen in passion. — Modifications of 
 typical postures. 
 
 In examining children look for movements of fingers, bend- 
 ing or lateral : take both full-face and profile view. — 
 Close observation and study necessary. 
 
 Postures and movements as signs of brain action. — Asym- 
 metry of postures, and curvature of spine, due to weak- 
 ness. — Hand balance and dulness.
 
 CONTEXTS. 
 
 LECTURE IV. 
 
 PAGE 
 
 Thk Head, the Face, and the Eyes 50 
 
 The head as an index of the child, its development and 
 movements. — Sir Charles Bell's essay. — Movements and 
 postures of the head defined, flexion, extension, rotation, 
 and inclination ; symmetrical movements. — Rotation 
 effected by sight. The lower jaw, its movements and 
 muscles. — Tooth-grinding ; children who bite. — Bending 
 of the head, importance of preventing stooping. — The head 
 erect : backward bending in disease, in emotion. — A weak 
 posture. 
 The human face ; its structure ; muscles of expression and 
 of mastication ; their nerves ; blushing. — Examination of 
 a face, upper, middle, and lower zones, and its halves ; 
 inspection of each zone ; signs in the face. — Expression of 
 mental anxiety contrasted with bodily suffering. — Mental 
 terrors in children. — Asymmetrical expressions. — Fatigue 
 and exhaustion ; the signs of headache. — Conflict of 
 muscles in the face. — Signs of previous action in a face. — 
 A true story. — Check bad expression in face. — Types of 
 faces. — Nutrition of face, a dull face. 
 
 The eyeballs and parts around. Anatomy of the eye, its 
 movements — Harmonious movements of eyes : horizontal 
 and vertical movements. — Lateral movements controlled 
 by light and sound ; spontaneous movements. — Squint, 
 its prevention. 
 
 LECTURE V. 
 
 Signs of General Conditions of the Brain, and 
 Expression of Mind ' 68 
 
 Signs of consciotisness, and observation of children during 
 sleep ; depths of sleep. — Fatigiie, signs in the hand, head, 
 and face. — Exhaustion indicated in hand, face, speech, 
 twitching movements. Irritability, excessive reflex 
 action.
 
 XIV CONTENTS. 
 
 PAGE 
 
 Nuintion, its signs, structural and motor ; an ill-nourished 
 infant ; altered appearance. — Signs of brain nutrition. — 
 Nutrition indicated by proportions of growth. — Rest 
 known by subsequent activity ; a child impressionable 
 during rest, not when unconscious. Activity of brain, 
 joy and laughter. Expression of mind in children ; no 
 direct signs at birth.— Comparison of an idiot and an in- 
 telligent child. — Description of a healthy infant, its body 
 and its brain action ; its movements controlled by sights 
 and sounds ; its reflexes. — Growth of the child, its play- 
 fulness. Study of a nervous child, his body, and signs of 
 brain action. 
 
 LECTURE VI. 
 
 Observation of Children and Education 80 
 
 Observation of children a study open to every one, and a 
 duty. — How to look over a school : observe signs of 
 development, nutrition, and state of the nerve-system. — 
 What is the condition of English children ? — Knowledge 
 required alike by parents, teachers, and school managers. 
 — Selection of teachers. — Reports of schools : illustrative 
 cases. — Nervous children : headaches. — Troublesome 
 children. — An exhausted child.— Small children in high 
 classes. — Defective development and exhaustion. — Dull- 
 brained, feeble-minded children : what becomes of them ? 
 Exemptions. — How to retain feeble children in our schools. 
 — Our future failures, paupers and criminals. — Honour to 
 the teacher who saves a feeble child. — The brain can be 
 improved by education. — Deterioration of neglected 
 children. — Education must embrace the whole nation. — 
 It is our self-protection. — All should help. 
 
 CONCLUDING CHAPTER. 
 
 Examination of 100,000 school-children. — Report of Com- 
 mittee. — Value of signs observed and indications of mental 
 dulness. — Importance of nerve-signs. — Dull and delicate
 
 CONTENTS. XV 
 
 PAGE 
 
 children. — Reconimendation of Royal Commission. — 
 Children fcebl) -gifled mentally. — Children who appear to 
 require special care and training. — The child material in a 
 school. — Poor Law schools. — Schools of special difficulty. 
 — School Boards and feeble children. — Special classes of 
 instruction. — Developmental cases. — Nerve cases. — Deli- 
 cate children. — Dull and backward pupils : their conditions 
 at various ages. — Associations of defects. — Boys and girls. 
 — Value of scientific observation. — Physical and metaphysi- 
 cal descriptions of children. — Physiological psychology. — 
 Imitation. — The school population. — School organization. 95
 
 THE CHILDREN: 
 HOW TO STUDY THEM. 
 
 LECTURE I. 
 
 THE CHILD AS WE SEE HIM. 
 
 IT may be presumed that we are all interested in 
 obtaining knowledge as to the best methods of 
 training children, and of so dealing with them as to 
 encourage and help on the develoi)ment and growth 
 of their moral and mental faculties, in order that after 
 some years of training they may pass out into the 
 working and struggling world, fitted as best we can 
 make them for the duties and labours of life. 
 
 In educational work the child should be the 
 primary consideration ; it is concerning the study of 
 children that I want to speak, urging you to observe 
 them on every occasion, noting and thinking about 
 what you see. In such work the teacher and the 
 l)hysician may well join hands. Having conversed with 
 many teachers as to their knowledge of children, it 
 must be confessed that some study only their faculty 
 of i)roducing lesson work ; but many thoughtful 
 teachers have expressed their desire to know how to
 
 judge for themselves what kind of child they have 
 before them, in his bodily or physical condition, and 
 as to his brain-power, both for school work and as a 
 basis of future action and character, and potential 
 mental ability. How can we judge by what we see 
 whether the child is bright or dull? What signs 
 should we look for as indicating fatigue, irritability of 
 brain, or headaches, or whether he is only lazy ? 
 These are questions that much concern the parent, 
 the teacher, the friend of the child. 
 
 Much that I have seen in schools, and much that 
 teachers have said to me, shows the importance of 
 defining our knowledge with exactness, and not trust- 
 ing simply to what is called intuitive knowledge. That 
 a certain amount of knowledge as to studying children 
 in the school and the home does exist among us there 
 is no doubt, but it needs to be collected, defined, and 
 systematized. Knowledge of children is power to the 
 school manager or teacher; but, to be available, the 
 knowledge must be definite and precise. 
 
 Many who have the charge of young children, as 
 well as those of us who have children of our own at 
 home, are anxious fully to understand the little ones, 
 in order that we may the better fulfil the educational 
 duties which we have undertaken ; and we know how 
 difficult it is to understand the exact condition of the 
 children and their mental characteristics. 
 
 There are many different points of view from which 
 we may study children, many lines of thought may be 
 followed in this matter ; the method I would urge upon 
 you in this course of lectures is that of systematic
 
 observation — that which I want youtostudyis thatwhich 
 you actually see, apart from any inferences you draw 
 from facts ; it is most important 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. 
 
 In the course of these lectures I may sometimes 
 speak very dogmatically, stating that such and such 
 things are the results of certain causes, without giving 
 any reason for the assertions. I must ask you to 
 accept these statenients, as it would be impossible for 
 me to enter into details in a short course of lectures. 
 
 Children may be studied in many ways — we may 
 read about them and think about them ; we may study 
 the results of their work at school, or the methods by 
 which others teach and train them. We may study 
 books on physiology, which show how the circulation, 
 digestion, and respiration are carried on. \\'e may 
 study the structure and uses of the organs of special 
 sense, their connexion with the brain, and how they 
 influence its action. All such studies are of value to 
 you ; still there remains the (juestion, "How may we, 
 as individuals interested in children, best study them 
 for ourselves ? " 
 
 In speaking of my own methods of examining and 
 studying children, it is with the full acknowledgment 
 that other means may be used ; but it is my purpose 
 to speak of what I have seen, and the methods em- 
 ployed in reporting on one hundred thousand children 
 I have had opportunities of examining in one hundred 
 -and sixty-eight schools since writing the first edition of
 
 this work. These methods I was gradually led to 
 systematize in my own studies, and I have used them 
 now for some years ; they are founded upon scientific 
 and physiological facts, and necessitate observing in- 
 dividual children, and thinking about the facts observed. 
 Such mode of study requires that facts shall be ob- 
 served by you, recorded, and thought over; still, be 
 not discouraged — a little steady practice will make all 
 easy, and the effort will, I think, teach you much, give 
 pleasant study, and place a real power in your hands. 
 
 It will at once be obvious that the facts we are to 
 observe must be physical facts— we cannot directly 
 observe the action of the child's mind with our eyes 
 and ears ; but we can observe the child's body, its 
 make, its movements, and the signs of its nutrition ; 
 these can be seen and recorded in words ; they can be 
 thought over and studied. 
 
 To observe children with success, we must learn 
 what to look at in an individual child, and how to 
 describe what we see. To know how to describe what 
 is seen is almost as important to our purposes as to 
 know what to look for ; such descriptions aid our 
 memory ; they enable us to compare observations, to 
 think about them, and to see their meaning. 
 
 When we proceed to study a child, we look at him 
 and observe his body, and note his height, the separate 
 features and the head as a whole, his colour, and the 
 movements and action in the child. It is necessary 
 to observe such facts before we try to determine their 
 meaning and their causes ; hence I shall say more 
 about the description of facts that may be observed
 
 than as to their meaning ; you must, to some extent, 
 learn for yourselves the significance of the signs seen. 
 
 There is an average height and weight for children 
 at each time of life ; these averages have been deter- 
 mined and recorded. Mr. C. Roberts' book* on 
 Anthropometry gives these proportions in detail, and 
 his printed schedules have been used in some schools 
 by intelligent teachers. Looking at the hair and the 
 eyes, we note their colour— this is due to pigment in 
 their structure ; looking at the face and neck, we 
 notice a light or dark complexion, which, in as far as 
 it is fixed, is also due to pigment. In the face we 
 may see variations in colour due to the amount of 
 blood circulating in it from time to time — thus the 
 cheeks and lips may have a full colour or be pale ; 
 look also at the ears, as well as under the semi-trans- 
 parent nails. In a healthy, robust child the colour is 
 due to the active circulation of red blood ; the fixed 
 colour is due to granules of pigment in the skin itself. 
 
 We now pass on to speak of the parts of the body — 
 the head, trunk, and limbs ; each of these divisions of 
 the body consists of smaller parts, which will be briefly 
 described. It is important to understand something 
 on these points, because we shall have to describe the 
 movements of various parts. 
 
 In observing a child, we have his body before us, we 
 must look at it carefully, and try to describe what we 
 see, not what we think we ought to see. Study and 
 
 * "A Manual of Anthropometry." Mr. Charles Roberts, 
 F.R.C.S. 1878.
 
 describe for yourselves the child as you see him while 
 he is present, and think over what you have seen 
 afterwards. 
 
 It is best to look at the child from two points of 
 view, so as to see him full-face and in profile — different 
 outlines of the head and face are thus seen ; it is very 
 desirable that such observations be made in a good light. 
 
 The head consists of the bony skull, the upper part 
 of which forms the brain-case. The eyes are set in 
 two sockets or cavities in the skull, and are moved by 
 muscles. The lower jaw is a separate bone jointed to 
 the skull, so that it can be moved by muscles in eating 
 and in talking, &c. The face is composed of a layer 
 of many small muscles placed in front of the skull ; 
 this layer is covered by fat and skin. It is these 
 muscles that produce expression in the face when 
 acted on by the brain above. In a well-developed 
 child the head circumference at nine months old is 
 1 7 "5 inches; at twelve months, 19 inches; at seven 
 years, 20 to 21 inches. You must not, however, ex- 
 pect always to find the head as large as here given, 
 even in normal children ; but after three years of age 
 a head-circumference of 19 inches is too small. 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 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
 
 7 
 
 head are of great importance, often being accompanied 
 with a tendency in the child to be thin, dehcate, and 
 dull ; much depends upon how he is treated at home 
 and in school. 
 
 The trunk or body has a bony framework, 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 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. Some children are 
 small and short for their age, and many of these are 
 small-headed as well as small in body ; many of these 
 children have had rickets in early life, indicated by 
 bent legs and a narrow, pigeon-breasted chest; rickets 
 is largely due to feeding babies with bread and other 
 farinaceous food in place of milk ; it often leads to 
 stunted growth, a badly-made head, and a dull pupil. 
 
 The tipper extremity consists of the blade bone or 
 scapula, placed over the back of the trunk ; the collar 
 bone or clavicle stretches horizontally from the scapula 
 to the breast bone and helps to keep it in its proper 
 place ; and 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 fore- 
 arm has two bones — the radius on the outer or thumb 
 side, and the ulna on the inner side ; these two bones 
 are jointed 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
 
 8 
 
 extended ; a rotatory movement of half a circle can 
 also be performed at the elbow. When the palm of 
 the hand is brought forward or laid upward, the fore- 
 arm 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. These 
 rotatory movements at the elbow are 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 
 metacarpal bones, which form the palm of the hand 
 and are jointed at the wrist. 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 move- 
 ments. 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 
 proportions, and in some degree we judge of the 
 development and state of nutrition of the child by 
 such facts. 
 
 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 
 include notice of the proportions of the head such as
 
 the following : the height and width of the forehead, or 
 its narrowness from temple to temple, and shallowness 
 from the hair margin to the eyebrows ; the greatest 
 circumference of the head, which is something like 
 2iyi inches at eight years old, the measurement from 
 ear to ear over the vertex being about 12 inches. 
 The greatest transverse diameter of the skull in a child 
 is behind the ears ; and the outline of face and head 
 as seen full-face should give the greatest transverse 
 diameter high up, well above the cheek bones in the 
 part forming the brain-case. The facial angle is seen 
 best in profile. 
 
 The colour, length, and growth of the hair are note- 
 worthy, as well as its arrangement. 
 
 In observing the face the separate features must be 
 described — the eyes, ears, nose, mouth, and lips, the 
 forehead, the position of the cheek bones, the chin, 
 and lower jaw. 
 
 The forehead may be shallow, the surface covered 
 with a fine down, the hairy scalp nearly meeting the 
 eyebrows at their outer angles. The openings between 
 the eyelids may be too narrow ; the transverse axis of 
 the openings should be horizontal — in place of this they 
 may slope outwards and downwards ; the size of the 
 openings may be too small. 
 
 The mouth, as seen when the face is at rest, 
 may be too small ; this often accompanies small 
 eye-openings. There may be an appearance of 
 great width between the eyes, which, in some cases, 
 is due to a fold of skin, continuous with the lower 
 fold of the upper eyelid, placed across the inner
 
 angle of the opening ; it is called an epicanthic 
 fold. 
 
 The bony nose may be wide, sunken, or indented. 
 This is not unnatural in very young children, but when 
 it persists to the age of eight or ten years is often 
 accompanied by defect of nose and throat, leading to 
 deafness, and calling for medical treatment. 
 
 The face as a whole may be small, including the 
 upper and lower jaws, and that independent of the size 
 of the upper part of the head which contains the brain. 
 The features may be coarse, heavy, flat, and lips 
 thick. The features may be large and ill-proportioned. 
 The separate features may not be individually mal- 
 formed, but disproportionate one to another, or to the 
 size of the face ; thus the nose may be small, the face 
 large, round, flat, the features rising from the plane of 
 the face. The lips may be thick and protuberant. 
 
 The externa/ ear is often defective in its size, form, 
 or parts, especially in boys. The ear may be out- 
 standing, with great convexity behind, and cave-like 
 in front, in place of lying flat against the head. The 
 rim of the ear, or the pleat in front of it (antehelix) 
 may be absent ; the skin of the ear may be tightly 
 stretched, coarse, red, and liable to chilblains. Such 
 defects have no necessary connexion with dull hearing. 
 
 The movements and mobile expression of the face 
 will be described in Lecture IV. The outward 
 appearance of the body or the passive expression has 
 been studied from ancient times, and much has been 
 written on the subject. The laws of form and pro- 
 portions of the body have been laid down by many
 
 authorities who differ much among themselves. Such 
 studies have been undertaken from the philosophical 
 and artistic points of view rather than as a part of the 
 study of physiology. 
 
 As you look at children, observing their form, you 
 will see some with a shapely, well-cut head of good 
 size, while others are ill-shapen or small ; the features 
 may be defective, and as such show us signs of faulty 
 development. You may desire definite directions as 
 to what may be considered the standard of excellence 
 in the development of the head and body. I cannot 
 give you such definite instructions, hut will advise you 
 how to obtain a general knowledge as to the signs of 
 perfection for yourselves. At every possible oppor- 
 tunity observe the outline, form, and size of people's 
 heads, paying special attention to the points men- 
 tioned; study the physiognomy of children and persons 
 known to you, and draw your own conclusions 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 schoolrooms, 
 photographs, engravings, and casts of the best antique 
 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. 
 
 Much has been written on the subject of physio- 
 gnomy that may interest you. Compare the writings 
 of Lavater, and those who followed in his steps, with 
 the later work of Sir Charles Bell on the " Philosophy
 
 and Anatomy of Expression." The knowledge and 
 the methods of the two authors differ. Lavater de- 
 scribed the size and form of the head together with 
 the character of the man — he did not know the signs 
 of brain action ; he observed the immobile signs — we 
 shall see their significance presently. Sir Charles Bell 
 described not only the anatomy of the brain and nerve- 
 system, and the muscles which produce movement ; 
 he showed that the brain by its action, as it sits hidden 
 from view in the skull, sends out currents of force to 
 the muscles all over the body, producing those move- 
 ments which we call mobile expression. Bell showed, 
 further, that currents are constantly passing from the 
 surface up to the brain, guiding and controlling its 
 action. 
 
 We want to study the signs of brain action — you 
 will ask what is the connexion between physiognomy 
 and brain action ? As to tlie size of the head in 
 connexion with the brain, it is certain that the brain 
 can be no larger than the bony case which contains it, 
 and the brain is often badly made when the skull is 
 badly shapen ; we shall see more about this further 
 on. Experience shows that when the head and 
 features are badly shapen the brain is often, but not 
 necessarily, poorly developed. Defect in physiognomy 
 and, in proportion, of the parts of the body is often 
 associated with mental dulness, but the occurrence ot 
 brain disorderliness, indicated by abnormal nerve-signs 
 (incoordination), is a more general and direct cause. 
 It should then be an object in training children to 
 remove their nerve-signs or irregular or bad modes of
 
 13 
 
 action in movements which are the direct indications 
 of brain state. This subject will be dealt with later on. 
 The most important signs of brain action that we can 
 observe are the movements which it produces in the 
 body. It is by observing the action and the attitudes 
 of the child that we find means of describing its brain 
 condition; such signs we shall study in Lectures III., 
 IV. The signs of brain action, and the most valuable 
 signs of its condition, are the movements and results 
 of the movements which it produces in the parts of 
 the body ; these will be described in the succeeding 
 lectures. It is of great importance clearly to under- 
 stand the difference between the two modes of expres- 
 sion — passive immobile expression indicated by the 
 size and proportions of the head and other parts, and 
 the mobile exj^ression or movements which are the 
 direct outcome of brain action upon the muscles. 
 The most important signs of brain action are the 
 movements, and results of the movements which it 
 produces, such as the postures and attitudes of the 
 body and speech ; they are the direct outcome of brain 
 action, and can be observed and studied by all. 
 
 A boy attending a Board school was brought to me 
 by his mother because he was troublesome, did not 
 do his work, and was always in disgrace and punish- 
 ment, 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 remained. 
 Knowing the frequency of several coincident 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 examina- 
 tions. This boy has a right to the benefits of 
 education ; they afford the best chance of his im- 
 provement, and of preventing him from becoming a 
 failure in life. Such cases are common ; illustrative 
 examples will be given in the sixth lecture. 
 
 After looking at the child to see the signs of his 
 development, we want to determine his probable 
 condition at the time we see him. The signs of the 
 general nutrition of the body are important, and may 
 well be considered here before we deal with the child 
 in action. His plumpness, fat, and colour are the 
 most obvious signs : a caution must be given — the face 
 may be fat while the limbs and body are thin ; hence 
 I generally feel a child's arm and look at his legs. 
 When you note the colour of the lips and skin, as 
 signs of general nutrition observe also the hair and 
 the eyes ; when these are dark it is owing to the 
 amount of pigment in these structures, and then the 
 skin is usually darker in its tint. Observe whether 
 the colour comes and goes ; such changes 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. De- 
 fective colour may be due to ill -feeding, to living in 
 rooms badly ventilated, hot and close, or too dark.
 
 15 
 
 A southern aspect is very desirable for children's 
 rooms. 
 
 We shall have much to say hereafter about the 
 signs of mobile expression, but, before we pass away 
 from the study of the body in its immobile or passive 
 condition, a few more words may be said as to the 
 means of training the eye to recognise the perfect 
 outline and form, and to observe any slight departures 
 therefrom. I'or the purpose of training your eyes to 
 ai)prcciate perfections of form and accuracy of move- 
 ment and balance, so that any deviations therefrom 
 may be readily observed, use your powers of observa- 
 tion at every opportunity, observe your friends and 
 acquaintances and all round you ; specially observe 
 children according to the rules laid down ; try to 
 form a general opinion in each case whether they be 
 intelligent and well-bred children, then describe their 
 form for yourselves as best you can, and fix those 
 examples in your memory that are of high-class type ; 
 go into schools in poor districts, and study the less 
 well-born children. The types of perfection of form 
 should be seen in art — they are seen in much of the 
 antique and in some modern statuary ; works of art 
 may thus be useful to you. To study perfection and 
 beauty of form you should contrast the most perfect 
 with the least perfect — examples of low development 
 in contrast with more perfect productions will throw 
 nmch light upon your studies ; the contrast of marked 
 perfection with imperfection throws each into greater 
 relief and prominence. Leonardo da \'in( i, we are 
 told, searched for ugliness.
 
 i6 
 
 In all that may be said in these lectures I want to 
 help and encourage you to observe for yourselves, 
 and this for several reasons. Continuously observing 
 gives a pleasant personal interest to the observer, and 
 all who have charge of little children need intellectual 
 encouragement and help in such work. To give 
 descriptions of what you see in the children will add 
 accuracy to your observations, and enable you to 
 classify them, and to record their progress in relation 
 to their mental and bodily power ; further, it will give 
 you knowledge of the utmost use as a basis of physio- 
 logical psychology, and add power and dignity to your 
 professional work. Parents also see their children, 
 though they may in some instances study their minds 
 less than you do, and look at them from a different 
 point of view — a common link between you may be 
 the child as we see him ; people believe what they see. 
 The observations you make for yourselves will be of 
 more use to you than facts that have been observed 
 for you, or that you have heard or read of, and the 
 personal effort will give you a deeper and truer insight 
 into child-mind and its dependence on brain action 
 than anything that can be taught to you. Lastly, I 
 much hope that in a little time we may benefit much 
 in our scientific work by the record of your experience, 
 and that knowledge of high social value may result 
 from our joint efforts for the children. The parent, 
 the teacher, and the guardian of the child will study 
 him not only for his body's health and development, 
 but also for the sake of helping and understanding his 
 mind, and his capacity for the development of moral
 
 17 
 
 and intellectual faculty. This is my own desire, this 
 has been the animus of much labour during several 
 years, the outcome of which is now offered to the 
 children through you. 
 
 The methods b)- which we here proceed in our 
 studies of children are those of physical science, the 
 same methods as we use in studying physiology, 
 botany, chemistry, or physics. We therefore here 
 make the same primary assumptions as in other 
 scientific work : we assume that every physical fact has 
 a physical antecedent or cause, and that every move- 
 ment we see, and every result of growth or movement, 
 are effects of physical causes. We do not say that the 
 child is a mere machine — it is not so ; but we do say 
 that his movements are produced by physical causes, 
 and that they are within the domain of scientific study. 
 
 Now a few words must be said about eye conditions 
 in children, though time will not allow me to enter 
 into the details of so wide a subject. Teachers ought 
 to know the signs of those manifest diseases of the 
 eyes which make the child unfit for school life, and 
 call for prompt application to the doctor ; this especi- 
 ally applies to ophthalmia, which is very destructive 
 to eyesight and highly contagious. Many cases of 
 defective eyesight are due to " short-sightedness," and 
 these might be found out by periodical examination 
 of the children by the master of the school. Mr. 
 Priestly Smith* says : " It is the simplest thing in the 
 
 * Lectures on Health : " Eyesight, and how we lose it." By 
 IViestiy Smith, Esq. Hamilton, Adams, & Co., 32 Pater- 
 ndster Row.
 
 world, and would not take half a minute for each 
 child. A set of test letters is hung on the wall ; a 
 line is drawn upon the floor at a certain distance from 
 it ; each child in turn is made to toe the line, and to 
 read the letters. Any child who cannot read the 
 letters has a defect of sight of some kind or another." 
 There are other detects of eyes which may pro- 
 duce headaches in children, and are remediable by 
 spectacles.
 
 19 
 
 LECTURE II. 
 
 ORGANIZATION AND FUNCTIONS OF THE 
 
 RRAIN, AND THE SIGNS OF ITS ACTION. 
 
 IN the first lecture we studied the child as we see 
 him, looking at the external parts of his body 
 while at rest in the passive state, and certain signs 
 were described which you may observe as indicating 
 good development, or defects in the development, of 
 the body. It was shown that, when defects are seen in 
 the features or parts of the body, there is often coin- 
 cident defect in the organization or make of the brain. 
 We now pass on to consider the brain itself, its 
 functions, 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 carefully protected from injury, being 
 surrounded by delicate meml>ranes and a slight layer 
 of lluid ; it is well supplied with Ijlood, which circulates 
 and supplies it with needful nourishment. 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 produced by the action of 
 the nerve-system upon the muscles : this is very
 
 portant 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 connexion between the mind 
 and the brain, we might study mental action as signs 
 of brain action. Let me make an assertion, and then 
 support it by illustrations. All expressum of the action 
 of mind is by movement, and the results of movement. 
 A child is at lessons, he repeats what 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 articulation. 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 movements produced by the brain. 
 
 The general condition of the nerve-system is ex- 
 pressed by motor signs — freshness, fatigue, irritability, 
 may all be indicated to us by the movements of the 
 child, the absence of movements, or by the attitudes 
 or postures of the body which depend upon motor 
 action. Examples will be given in Lecture 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 
 
 * See author's work on " Anatomy of Movement."
 
 what are called the emotions of the mind. We shall 
 in these lectures study movements produced by the 
 brain, not mind itself, in the child. 
 
 A few words may be said as to the structure and 
 modes of action of the brain ; then we shall proceed 
 to describe the signs which we can see as indications 
 of its functions and its condition. 
 
 The brain is a soft and delicate structure, seated in 
 the brain -case, and carefully protected; it consists 
 essentially 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 
 visible movement results ; the movement being pro- 
 duced by the force sent from the nerve-cell. The move- 
 ment seen indicates to us the time and quantity of the 
 discharge of force from the nerve-cell ; such 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, and many of them 
 are connected with the muscles of the body, and send 
 nerve-currents to them, thus causing the movements 
 of the members. 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 battery. 
 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 distri- 
 buted 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 
 material in the battery is used up, and no more force 
 is sent out till the materials in the cell are renewed. 
 Similarly : 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, &c., and the skin all over the 
 body — with the cells of the brain, and convey currents 
 of force from these parts, respectively, to the cells of 
 the brain ; such nerve-fibres are called affff€7it, because
 
 23 
 
 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 efferefit. 
 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 out-coming or efferent 
 nerves carry motor currents from the nerve-cells to the 
 muscles. 
 
 B C __^, 
 
 li.;. I.
 
 24 
 
 Figure i may explain further what has just been 
 said : the brain is represented by the shading as 
 divided into areas A, B, C, D, jE, which can act more 
 or less independently ; each area or section of brain 
 is represented as connected by nerve-fibres with a 
 muscle corresponding. Each section of brain may 
 receive a stimulus from the eye or the ear. The repre- 
 sentation is purely diagrammatic, for the sake of clear- 
 ness of description. The brain areas A, B, C, D, E 
 each receive nerve-fibres carrying impressions from 
 the eye and the ear, so that they can separately be 
 stimulated by sight and sound. Hbres 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 e 
 contracts, and so for each centre and muscle respec- 
 tively : 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
 
 ■ 25 
 
 muscles follows the impression produced upon the 
 brain by the sight of the orange, or by the afferent 
 currents passing from the eyes to the brain, and these 
 are stimulated by the liglit reflected from the orange. 
 
 Many parts of the brain can act separately : every 
 movement corresponds to the action of a certain por- 
 tion of the nerve-system, or, as we call it, nerve-centre. 
 It is probable that every movement indicates the dis- 
 charge 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. 
 
 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 
 eyelids the pupils are seen to be very small or con- 
 tracted. 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 — 
 
 * See " Anatomy of Movement."
 
 26 
 
 the elbows, wrists, and fingers move. Soon all is seem 
 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 
 pours in between the opened curtains, you may again 
 see movements in the Hmbs, and the eyelids open y 
 the pupils now dilate ; the brain becomes active, indi- 
 cated 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 spontaneous brain activity. As he stands in 
 his place and 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 instruc- 
 tion. Spontaneous brain action will be shown to be 
 the basis upon which you work in producing mental 
 aptitude ; it must be co-ordinated or regulated, but so- 
 as not to destroy spontaneity. 
 
 Movements may conveniently be divided into two- 
 classes — those which we observe as directly following 
 stimulation acting on the child from without ; and 
 movements called spontaneous, which are not so 
 clearly the direct result of stimulation of his organs 
 of sense, but appear to be the outcome of brain nutri- 
 tion. Movements following sight and sound belong 
 to the former class. Typical examples of movements- 
 stimulated by impressions received from outside the 
 body are seen in what the physiologist calls refle.x 
 actions. When the eyeball is touched, a stimulus is 
 sent to a nerve-centre, with the result that a nerve-
 
 27 
 
 current is quickly sent back from the nerve-cells to 
 the muscles, closing the eyelids. 
 
 Spontaneous movements are seen in a marked 
 degree in the young infant. Observe a healthy, well- 
 nourished infant, say seven months old, unfettered by 
 clothes, on his mother's knees. He is full of move- 
 ment while awake — -the arms, fingers, and toes are 
 constantly moved, apparently spontaneously, or with- 
 out stimulation from without ; movements, apparently 
 irregular and effecting in themselves no apparent pur- 
 pose directly useful to the child, are almost constant 
 in all the parts of the body. Spontaneous movements 
 may likewise be seen in all young animals ; and it has 
 been shown that in seedling plants the little root, the 
 seedling leaves, and all young growing parts are con- 
 stantly moving.* Such is the universal method of 
 Nature in young and growing creatures. We shall 
 describe some spontaneous movements in children as 
 signs of fatigue and other states in Lecture V. 
 
 When the infant is about three months old, we may 
 observe some control of its movements through the 
 senses — spontaneous movement remains as a marked 
 character of the healthy brain ; but the nerve-action 
 may be temporarily arrested by showing a bright 
 object ; this is the earliest indication of a brain faculty 
 that may develop into the power of attention. When 
 Jive months old, further evidence is obtained of control 
 of the spontaneous action of the nerve-centres through 
 the senses ; the sight of an object may momentarily 
 
 * See C. Darwin on *' Movements of Plants."
 
 28 
 
 stop the movements, and this may be followed by- 
 turning the head, eyes, hands towards the object seen, 
 i.e., coordinated movement ; movement controlled 
 through the eye occurs after momentary arrest of 
 spontaneous action. When a year old, action well 
 adapted l)y impressions of sight and sound becomes 
 very marked, and the child makes certain characteristic 
 sounds on sight of certain objects ; its spontaneous 
 brain action becomes gradually more and more capable 
 of control. 
 
 Two circumstances are necessary in order that a 
 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 grow by 
 feeding only — they must be impressed or stimulated 
 from without ; hence the importance of good educa- 
 tion as an aid to brain development. Let me make 
 an arbitrary statement without giving my reasons here. 
 Feeding the child often lessens spontaneous move- 
 ments 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 without 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
 
 29 
 
 known by those who confine the hands and feet of 
 little infants under bulky and cumbersome clothes. 
 Children should have their hands free, and not carry 
 bags and hooks, and should not l)e compelled to stand 
 in class with their hands behind them. 
 
 In observing movements as signs of brain action, 
 and in describing them, it is most important to note 
 the parts moving. Movements may be seen princi- 
 pally in the digits, more in these small parts than in 
 larger parts, such as the elbow and shoulder ; they 
 may be seen principally in the muscles about the 
 mouth, or in certain other parts about the face. In 
 any case, the movement of a part corresponds to action 
 in a certain group of nerve-cells corresponding. Re- 
 member this physiological fact — it is the basis of much 
 that is important in the management of children. 
 One series of movements long continued means long- 
 continued action of one portion of brain ; change the 
 action of the child, and you thereby change the portion 
 of brain acting ; thus you may help to avoid fatigue 
 and exhaustion. 
 
 I spoke just now of movements of small parts of the 
 body in contrast to movements of large parts ; the fine 
 movements of small parts more directly indicate brain 
 action ; these should not only be carefully described 
 by the observer, but also cultivated by the teacher, as 
 in paper cutting, folding, and similar occupations. I 
 think the same kind of brain culture may be given by 
 calisthenic exercises, which should be arranged not 
 only to strengthen large muscles, but also to develop 
 slight and independent movements of small parts of
 
 3° 
 
 the body, and the ready action of small portions of 
 brain produced by imitation of your movements. 
 
 I now ask your attention to the signs indicating the 
 brain condition of children which are probably new to 
 you — that is, the study of postures or attitudes of the 
 body and limbs. Such signs will, I think, be most 
 useful to you, as they have been to me, and, with a 
 little practice, they are easily observed and described. 
 
 When the hand is held out, the posture or attitude 
 seen is brought about by the last movements that 
 ■occurred in the parts of the hand. Postures are, so to 
 speak, stationary results of movement ; the posture is 
 the outcome of the balance of the muscles which pro- 
 duce it ; and this is the outcome of the balance or 
 ratio of action in the nerve-centres which stimulate the 
 muscles to contract. Without going into theoretical 
 matters, let me say that postures of the parts of the 
 body are important signs of the brain state at the time. 
 The postures you see are most commonly due to, and 
 are signs of, the condition of the nerve-system. 
 
 When I began to make the expression of conditions 
 •of the brain a definite study, I frequently looked at 
 my patients, especially the children, after I had found 
 out what their condition was, and I noted down any 
 visible expression of their nerve condition. My atten- 
 tion was soon attracted to the frequent occurrence of 
 certain postures of the body indicative of conditions 
 of the nerve-system. It is often more easy to describe 
 postures than to describe movements : postures are 
 conditions of quiescence, they can be watched during 
 a space of time ; they can be drawn, photographed,
 
 31 
 
 or represented by casts in plaster ; movements are 
 •evanescent. 
 
 To study postures as signs of the mental brain state 
 of the child, look at his parts and members when free 
 or disengaged. To observe the hand for this purpose 
 it should not be engaged in holding a pen, but be free 
 that all the fingers may move as the brain will move 
 them ; that the brain state, not the pen, may govern 
 tlic posture of the hand. The hand of a labourer* is 
 seen engaged in digging with his spade; his nerve 
 muscular energy is expended in holding and driving 
 his spade. It would, under such circumstances, re- 
 <iuire a very strong nerve-current sent to those muscles 
 to alter this forcible brain stimulus. Hence, the hand, 
 while engaged in digging, is not very impressionable 
 and expressive of the finer motor actions of the nerve- 
 mechanism. When the man puts aside his spade and 
 talks, especially if at rest, his hand gesticulates and 
 expresses his emotions. The hand may be said to be 
 free when it is held out at the word of command, when 
 hanging over the arm of a chair, or when it is moving 
 towards an object. 
 
 The face may usually be considered free to be acted 
 on only by the brain, except when eating. When a 
 strong cold wind blows on the face it is too strongly 
 stimulated thereby to be very impressionable to force 
 originating in the brain. The eyes are free when not 
 strongly stimulated by the sight of some object, or 
 bright litjht or colour. 
 
 * See "Physical Expression," p. 144.
 
 We have now considered three different classes of 
 signs indicating the condition of the child : the form 
 and proportions of the body and its parts ; the postures 
 or attitudes ; and the movements of parts. Of these, 
 movements are the most important signs, though the 
 most difficult to record on account of their temporary 
 character. 
 
 Defects in development of the body are frequently 
 accompanied by a dull brain : they are more common 
 in boys than in girls. Of the children with such 
 defects, the teachers reported 38 per cent, of the boys, 
 and 41 per cent, of the girls, as dull or backward in 
 lessons. The relation between " defect in develop- 
 ment" and mental dulness finds some explanation 
 when it is said that of these children 54 per cent, of 
 the boys, and 49 per cent, of the girls, showed also the 
 awkward or ill-balanced kind of brain action indicated 
 by the " nerve-signs " that will be described in the 
 next lecture. This shows how important it is in 
 dealing with dull children to train them by the use of 
 physical exercises to move with exactness and pre- 
 cision. I have found that in schools with good 
 physical training the teachers had fewer dull pupils to 
 report. 
 
 It will be shown that children with " defect in 
 development " are also often pale, thin, delicate. This 
 statement involves the fact that delicate children often 
 have more need than others of good teaching to pre- 
 vent them from growing up mentally dull. Defect in 
 development of the body and " nerve - signs " are 
 both much associated with mental dulness ; but the
 
 33 
 
 nerve-signs are more largely and directly associated 
 with the causes of dulness ; they can, to a great 
 extent, be removed by appropriate management of the 
 pupils — and this should be an aim in school-training. 
 Finally, let me direct your attention to the import- 
 ance of observing symmetry or asymmetry of postures 
 and movements ; we shall see some examples in the 
 next lecture. Equal power and equal action of the 
 two sides of the brain usually mean a higher condition 
 of strength than asymmetry.
 
 34 
 
 LECTURE III. 
 
 THE ARM, THE HAND, AND THE SPINE. 
 
 WE shall now consider the signs of brain action 
 that may be observed in the body, commencing 
 with the upper extremity, and we must enter into many 
 details illustrating the principles of study given in the 
 first two lectures. 
 
 The upper extremity is composed of parts which 
 have been described. It is in a very direct manner 
 under the control and guidance of the brain. The 
 nerve-centres which produce its movements are very 
 easily stimulated by the currents passing up from the 
 eye and the ear. Postures and movements of the 
 hand are very expressive of the condition and action 
 of the brain and of its mental function. The hand 
 may be an index of the condition and action of mind. 
 
 When we wish to examine a child as to the con- 
 dition of his nerve-system, we may request the child 
 to stand up and hold out his hands with the palms 
 down, spreading the fingers. It may be necessary to 
 explain to him first what the palm of the hand means, 
 and to show him the action momentarily. It is desir- 
 able that you should use the same word of command, 
 the same stimulus to action, on all occasions. This 
 action of the child is convenient, leaving the arms and
 
 35 
 
 hands free, and ready for your observation and descrip- 
 tion. It is desirable that the upper extremities, when 
 thus under observation, should be free and unoccupied ; 
 they must not be engaged in doing anything. If I hold 
 this lump of chalk in my hand, it is not free to express 
 the condition of the brain. Clasping the hand on the 
 chalk is partly a reflex act following the pressure of the 
 chalk ; only in part is it due to the direct action of 
 the brain upon the muscles of the limb. 
 
 If you see the hand of the child thus occupied, and 
 you wish to observe it as a sign of brain condition ; 
 either cause the hand to drop what it holds, or wait 
 and watch for the favourable opportunity for your 
 observations when the spontaneous action of the child 
 shall set the hand free. The hand may be free when 
 passing to reach an object, not so when it has seized 
 it ; it may be free when hanging over the arm of a 
 chair, less so when resting on the table. 
 
 In observing a child, I would say to him : "Put out 
 your hands with the palms downwards, and spread the 
 fingers." The movements and balance of action in 
 the parts of the arm can thus be seen under favourable 
 circumstances. A strong and healthy child, say of five 
 years old and upwards, will hold out his hands fairly 
 straight with the arm and shoulder ; the limbs may 
 not be held quite at the same level — the left is often a 
 little weaker and is held a little lower than the right. 
 The typical sign of strength is that the hand be straight 
 extended, as in Fig. 2, the fingers straight with the 
 metacarpal bones and the forearm and shoulder ; 
 the palm of the hand, or metacarpus, straight, not
 
 36 
 
 contracted laterally, as in the feeble hand (see Fig. 3) ; 
 all parts are in the same horizontal plane ; the arms 
 should be parallel to one another, straight at the 
 elbow, and both on a level with the shoulder. A slight 
 deviation from this rather stiff and exactly balanced 
 position is not to be considered necessarily a departure 
 from health ; however, the posture above described is 
 the standard of the normal, and indicates a robust, 
 well-balanced nerve-system. 
 
 Fig. 2. — Straight Hand. 
 
 Fig 3. — Feeble Hand.
 
 37 
 
 Looking at a body of children, say in the third or 
 fourth standard of a primary school, you will see, 
 perhaps, 5 or lo per cent, of the children who do not 
 present this perfect balance and typical posture. The 
 appearance of certain deviations from this standard of 
 the normal marks the child to me at once as probably 
 nervous, excitable, or exhausted. The observation of 
 certain groups or signs tells us something of the 
 character or kind of child and his tendencies. It may 
 be a matter of interest and importance to those 
 responsible for children to look at them, study them, 
 and observe the presence of signs which indicate their 
 present condition and probable tendencies in future 
 development. 
 
 I am going to speak of what you may observe in 
 looking at the hand, the arm, and the spine, and I 
 shall say something as to the significance of such 
 signs. In thus trying to give you such knowledge 
 I must warn you not to be too dogmatical or rash in 
 expressing an opinion upon a few signs only, especially 
 as I must here give them in empirical form — their 
 fuller meaning you must look for elsewhere.* 
 
 Among a large body of young children we may see 
 many presenting awkward attitudes far departing from 
 the normal type of strength ; the form and propor- 
 tions of the body may also be defective in the same 
 children. These unusual attitudes are due to want of 
 balance in the action of parts, a state of growth often 
 accompanied by a want of due proportions in the 
 
 * See "Anatomy of Movement."
 
 growth of the parts of the body ; nervous weakly 
 children are often too tall and thin. 
 
 It may possibly add some interest to our work if I 
 explain how my attention became directed to the 
 study of postures as signs of brain conditions. 
 Having during some years given special study to the 
 conditions of the nerve-system in children, I began to 
 note the various postures presented by children 
 brought for examination at the Children's Hospital, 
 and from 1878 I kept notes of the spontaneous pos- 
 tures observed. The children were requested to hold 
 out their hands, and the passive condition or posture 
 of the hand was noted. At first it was difficult to 
 describe the posture seen in precise language, though 
 some were seen to be characteristic of certain nerve- 
 conditions. In 1879, while visiting Florence, it 
 struck me that the posture of the hands of the Venus 
 
 P"iG. 4. — Nervous Hand. 
 
 de Medici was exactly similar to the posture I had so 
 often seen in nervous children. Later, at the British 
 Museum, I saw the English Venus side by side with the 
 Diana (Fig. 5), feminine coyness and nervousness repre-
 
 39 
 
 sented side by^side with the expression of energy and 
 strength, andjthe contrast of the hand postures showed 
 them to be in direct antithesis. While looking at the 
 
 Fig. 5. 
 .marble hands it became easy to describe their postures 
 in precise language. In the hands of the nervous
 
 40 
 
 woman, the wrist is slightly flexed or bent, the 
 knuckles are moderately extended back beyond the 
 straight line, the finger joints being slightly bent. The 
 thumb is extended backwards, and somewhat drawn 
 away from the fingers. This posture I have called the 
 " nervous hand " ; it is that so commonly seen in 
 weak, excitable, nervous children, such as are hot- 
 tempered but affectionate, tooth-grinders, and very 
 liable to recurrent headaches. Here is the cast of a 
 hand carved by Canova, an art-model of beautiful 
 workmanship. This hand represents exactly the 
 nervous posture. Art often presents us with the 
 expression of weakness in place of strength, beauty in 
 place of perfectness. 
 
 In the Diana of the British Museum we see the 
 figure of a strong energetic woman. Our common 
 
 Fig. 6. — Energetic Hand. 
 experience tells us that it is such. Her right hand is 
 lifted, and is engaged in holding a spear or dart which 
 she is about to hurl ; this hand is therefore not 
 available as a sign indicating the mental condition. 
 The left hand, however, hangs down, and is free or
 
 41 
 
 unoccupied, and by its posture affords us evidence of 
 the active or mentally energetic condition of the brain. 
 The balance of the parts of the body indicates to us 
 the balance of the action of the nerve-centres. This 
 is the posture termed " the energetic hand " (Fig. 6). 
 
 The wrist is extended backwards, the fingers and 
 thumb are flexed. 
 
 If we compare this energetic hand with the hand in 
 the nervous posture, we see the former to be the 
 direct antithesis of the latter. In the weak woman 
 the hand is flexed at the wrist, the fingers and thumb 
 being bent back at the knuckles ; in the strong woman 
 the wrist is extended backwards and the digits are 
 flexed. This is an example of one posture being the 
 antithesis or direct opposite of the other ; Mr. C. 
 Darwin made much use of the principle of antithesis 
 in his work on Expression. 
 
 I have described the straight extended hand as the 
 normal type, and two postures as deviations there- 
 from : one, the energetic hand, a perfectly normal and 
 healthful condition ; the other, the nervous hand, which 
 indicates weakness and excitability. An example of 
 the energetic hand in real life may often be seen in 
 the attitude of little children, say between three and 
 four years old : you call them to come to you, and 
 show them something they like ; they run with arms 
 stretched out and hands in the energetic posture, the 
 wrist extended, and the fingers slightly flexed. 
 
 An incident which happened the other day may 
 serve to illustrate the value of studying postures as 
 signs of the nerve-condition. I was asked to observe
 
 42 
 
 some young people, and noticed three in whom the 
 hands, when held out free, showed the wrists flexed 
 with the knuckle-joints extended backwards. I imme- 
 diately pointed out to the teacher that they showed 
 some signs of nerve-muscular excitability ; the correct- 
 ness of this opinion I was afterwards able to confirm. 
 
 One of the first departures from the signs of perfect 
 strength is the posturewe are about to describe under the 
 name of " the straight hand with the thumb drooped." 
 
 Fig. 7. — Straight Hand with Thumb Drooped. 
 This may commonly be observed in conditions of 
 health when fatigue or slight weakness occurs. It is 
 similar to the straight hand, but the thumb, with its 
 metacarpal bone, falls slightly, thus approximating the 
 latter towards the palm. I was once able to point 
 out this sign to the headmaster of a large school. I 
 had looked over the lower classes of the school without 
 noticing any unusual signs among the boys. When, 
 however, we came to the first class, and these boys 
 held out their hands, I observed that every boy, with 
 two exceptions, held the hands straight, with the 
 thumbs drooped. This class had recently been en- 
 gaged in their annual examinations. 
 
 If you notice people's hands, you will often see that 
 early in the morning the hand is held quite straight ;
 
 43 
 
 while in the latter part of the day the thumb tends to 
 droop. In such cases, food, and a little rest, will usually 
 restore the normal posture, and this, the first sign of fa- 
 tigue, will passaway. Thisposturcis,in fact, the first stage 
 towards the feeble hand which we shall soon describe. 
 Here is a cast which shows the natural position of 
 the free hand when at rest, as it may be seen hanging 
 over the side of a chair, or lying in the lap. The hand 
 in rest is a natural position, with slight flexion of the 
 wrist and fingers, and slight arching of the metacarpus 
 or palm of the hand. It is also common in slight 
 
 Fig. S. — Hand in Rest. 
 fatigue without exhaustion, and may be seen in healthy 
 sleep, when no energizing nerve-currents are passing 
 from the brain to the muscles. If you are in doubt 
 as to whether a child is asleep, raise the arm by the 
 wristband and let the hand free ; if the child be asleep, 
 the hand will assume the posture of rest. 
 
 The " feeble hand " is an exaggerated form of the 
 "hand in rest." The degree of flexion of all parts is 
 greater, and the metacarpus is much arched or con- 
 tracted. This is seen in conditions of exhaustion.
 
 44 
 
 Two typical postures of the hand still remain to be 
 described. The " hand in fright " is a posture not 
 often seen ; it is a modification of the energetic hand, 
 the wrist and fingers being all extended. It is well 
 
 Fig. 9. — Hand in Fright. 
 
 Fig. 10. — Convulsive Hand.
 
 45 
 
 represented in the statue of Cain (Fig. ii) and in 
 several members of the Niobe Group at Florence. 
 
 Fig. II. 
 
 Here I have a cast of the hand of a child who was 
 in a convulsion, and the typical posture is called the
 
 46 
 
 "convulsive hand" (Fig. lo). The thumb is strongly 
 flexed on the palm of the hand, while the fingers are 
 closed over it, thus forming a closed fist, while the 
 palm is arched or contracted by bringing its sides 
 together. This position is never normal, but in a few 
 cases may occur as a simple matter of habit. The 
 convulsive hand may be seen in a child in passion, 
 and it sometimes occurs during a strong effort of self- 
 control, and I have often seen it in people when about 
 to have a tooth drawn. 
 
 These eight types of hand postures will help you to 
 describe what you see, but various deviations from 
 these types will often occur. 
 
 While observing a child you may describe his 
 postures and his movements ; in speaking of the latter, 
 the part moved and the direction of its movement 
 must be noted. When the child stands up and holds 
 out his hands, it is well to get both a full-face and a 
 profile view ; there may be slight movements in the 
 fingers. We have already spoken of the incessant and 
 spontaneous movements of the infant, and these to 
 some extent continue during the early years of life. 
 The finger movements may be in two directions — 
 they may be in flexion and extension, or they may be 
 lateral ; these latter are the most important as indi- 
 cating irritability of brain. The flexor-extensor move- 
 ments can be seen in the full-face or in the profile 
 view ; the lateral movements of fingers are best seen 
 when in front of the child. In looking at movements 
 of the digits, note whether the separate parts move 
 together or not ; the constant repetition of one series
 
 47 
 
 of movements is often very senseless. In nen-ous 
 twitching it is more common to see one or two fingers 
 only moving. 
 
 In looking at the upper limb as an index of the 
 brain we may observe postures and movements ; 
 practice in observing these will teach you much as to 
 the nerve-system of children. It is my work to point 
 out what you should look for, to define certain typical 
 conditions, and explain their meaning in some slight 
 degree, but you can learn much more than this by 
 practice and observation. 
 
 In making such examination of a child you may 
 find response in action defective. Response follow- 
 ing a command, or in imitation of your movements, 
 may be accurate or uncertain, prompt or slow. There 
 may be an interval between the command and the 
 response, or the action may be continued unduly long. 
 Response may be better stimulated through the eye 
 than through the ear ; hence children often learn 
 good action from imitating one another. 
 
 You must observe many children of various ages, 
 under varying circumstances, to form an idea for your- 
 selves as to what amount of movement is indicative of 
 health. This you must study for yourselves just as 
 you would try to learn how much mental work a child 
 is capable of. Observe and study these points ; in 
 these matters there is no rule, except that derived from 
 personal observation. Looking at the arms of the 
 child, observe the hands, wrists, elbows, shoulders, on 
 either side ; look not only to the postures, but also to 
 the movements. Postures and movements may be
 
 alike on either side, or they may be asymmetrical ; 
 you will find it not uncommon to have several signs 
 of weakness on the same side of the body. When the 
 two sides of the body do not move alike, it is com- 
 monly due to the diminished force or energy of brain, 
 as seen in a tired child who leans on a table or chair. 
 
 Asymmetry of the postures of the body is usually 
 accompanied by a slight tendency to lateral curvature 
 of the spine. Postures of the spine are well worthy of 
 study. As I have shown you, the spine is a column 
 composed of many small bones, and is capable of 
 being bent in various directions. Lateral curvature of 
 the spine may be suspected if a child, when at work, 
 constantly bends to one side, making one shoulder 
 higher than the other. This may be due to weakness, 
 and may be accompanied by finger twitching, and 
 weak hand-postures unequal on the two sides. Stoop- 
 ing, or lateral bending of the spine, may be due to 
 short sight or other eye defects, which should be 
 looked for in such cases. When you notice a child 
 bending over his work, get the test-type and examine 
 him for short sight. 
 
 There are forms of weakness and fatigue indicated 
 by weakness of the muscles of the spine. Take a 
 weakly child of seven years old ; let him stand with 
 heels together, head up, and hands by his side. 
 Observe the child in profile, so as to get a view of the 
 curves of the spine ; let him hold out his hands in 
 front, and notice, as he does so, that the shoulders are 
 thrown backwards, and the spine becomes more 
 arched forward in the loins. Such alteration of the
 
 49 
 
 outline of the back is in excess in the weak child, as 
 compared in one that is strong. 
 
 If the muscles which support the head and spine 
 arc not strongly energized, the head falls forward, and 
 the spine becomes arched backwards ; such conditions 
 are best seen in the profile view, and give an appear- 
 ance indicating powerlessness. Watch a man go to 
 sleep in a chair ; as the brain sends out less nerve 
 force, the muscles of the spine become relaxed, the 
 head falls forward on the chest, and the back bends. 
 
 That these conditions of ill-balance in the body 
 concern your work as teachers is shown by the follow- 
 ing facts: — Taking loo boys and loo girls, with each 
 nerve-sign as given, we find the following numbers of 
 pupils among them reported by the teachers as dull : — 
 
 Boys. (iirls. 
 
 With the Hand weak balance ... 40 35 
 
 „ „ Nervous Hand 34 33 
 
 „ Finger Twitches 2,2 30 
 
 „ Bent Spine (Lordosis) ... 39 3°
 
 5° 
 
 LECTURE IV. 
 THE HEAD, THE FACE, AND THE EYES. 
 
 THE head and face are parts of the body pecuHarly 
 characteristic of man, and here we see the 
 greatest number of those signs which indicate to us 
 the make of the individual and his condition. The 
 head and face are also easily observed, and very 
 interesting to study. 
 
 When studying expression in the head, as in other 
 parts of the body, we must look to the conditions of 
 its development, or size and form, and also to its 
 movements and the postures which result from those 
 movements. The title of Sir Charles Bell's first essay* 
 is : "Of the Permanent Form of the Head and Face, 
 in contradistinction to Expression." He goes on to 
 say : "A face may be beautiful in sleep, and a statue 
 without expression may be highly beautiful ; on the 
 other hand, expression may give charm to a face the 
 most ordinary. Hence it appears that our inquiry 
 divides itself into the permanent form of the head 
 and face, and the motion of the features, or the 
 expression." Bell uses the term " expression " as 
 
 * Op. cii., p. 20.
 
 51 
 
 confined to mobile modes of expression, and carefully 
 distinguishes between them and conditions of de- 
 velopment indicated by form. 
 
 It is convenient, for the purposes of description, to 
 speak of three modes of movement of the head ; flexion 
 and extension^ i.e., bending forwards and backwards, 
 as in nodding ; rotation in a horizontal plane, the 
 head remaining 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 horizontal 
 plane — inclination is said to be towards that side on 
 which the ear is lowest. The only symmetrical move- 
 ments of the head are those of nodding and bending 
 back the head. In a strong and healthy child the 
 head is held erect, unless something 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. 
 
 If a child is seated at a table, properly hungry, 
 bringing a plate of food towards him will, as soon as 
 the plate comes within his view, cause rotation of his 
 head towards the plate, and the food will be said to 
 have attracted his attention. If, however, the child 
 is in a very irritable, cross, peevish state of mind 
 (brain), rotation of the head may occur away from the 
 plate of food ; it may be repelled by it, not attracted. 
 
 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 separ- 
 ated, and brought up again by the muscles when the
 
 52 
 
 mouth is closed ; the jaw can be moved both up and 
 • down, as well as laterally in mastication. The muscles 
 which move the lower jaw are called the muscles of 
 mastication ; they are not supplied by the nerves 
 which send motor power to the muscles of the face, 
 but by a pair of nerves called the fifth nerves of the 
 brain ; this same pair of nerves has fibres which pass 
 to its nerve-centre from all parts outside the head and 
 face, and also from the membranes which cover the 
 brain. Please remember that the nerve which moves 
 the teeth is stimulated by impression on any part 
 of the head, and also by the state of the membranes of 
 the brain. This is the nerve which produces tooth- 
 grinding in children. Tooth-grinding is very common 
 at night, less common in the day ; when it has often 
 occurred, it leaves a flattened appearance of the tips 
 of some of the teeth, and is a sign of irritability of 
 brain in children. If I find such ground teeth, and 
 am told that the child sleeps quietly and always well, 
 I suspect it is the nurse who sleeps soundly, not the 
 child. 
 
 A much worse sign with regard to movements of 
 the jaw is when a child bites its playfellows ; this is a 
 very grave condition, and the meaning of it should 
 always be inquired into, as it often indicates a very 
 defective condition of the brain. Let me here remind 
 you how frequently young puppies and kittens bite 
 and gnaw, to our great inconvenience. 
 
 The head itself may have various positions or 
 postures with regard to the trunk ; these have been 
 described and named when speaking of the move-
 
 53 
 
 ments of the head. The posture, or balance, of the 
 head may indicate 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 a tired 
 man, as compared with that of the same individual 
 when rested and refreshed. The head is seen firmly 
 upright in defiance, drooping in shame, and held on 
 one side in nervous girls. 
 
 We have spoken of certain postures of the hand as 
 being the opposite or antithesis of one another, and 
 as representing opposite states of the nerve-system. 
 We saw that the "nervous hand" was a posture the 
 very opposite of that called the "energetic hand," and 
 that these postures represent very different brain states; 
 so, with regard to the head, flexion or drooping indicates 
 conditions the opposite of those expressed by extension 
 or throwing backwards of the head. 
 
 I have shown you that sight and sound may cause 
 rotation of the head; extension, or bending up, of the
 
 54 
 
 head often occurs apparently from other causes — in 
 some states of emotion and excitement the head is 
 seen to become extended, as when a child is excited 
 by " aesthetic feeling." The observation of movements 
 and postures of the head, in association with other 
 signs, often gives much information. 
 
 Let me tell you of some conditions of brain disease 
 in which the head is drawn backwards. This is 
 commonly seen in cases of inflammation of the brain ; 
 also in infants during the brain irritation due to 
 teething, when it may be accompanied by the con- 
 vulsive posture of the hands, and precede an attack of 
 convulsions. Now as to this posture of the head in 
 healthy people : I have stood near a much-admired 
 picture, and watched a crowd of visitors coming to look 
 at it ; in some the sight of such picture is followed by 
 extension of the head, accompanied by upturning 
 of the eyes to such a degree as to remove the 
 picture from their field of vision. I cannot see 
 the mind or feeling, but can see the extension ot 
 the head. 
 
 A considerable degree of extension of the head may 
 sometimes be seen in children. I have seen it in a girl 
 when repeating poetry, and it seemed to me to indicate 
 an amount of excitement that should not be prolonged 
 or often allowed. This posture is used in art to indi- 
 cate intense admiration and ecstatic feeling; it is 
 presented in some paintings of S. Cecilia. 
 
 There is a posture of the head indicating weakness 
 of the nerve-system ; you may see the head partially 
 bent or flexed, and rotated and slightly inclined to the
 
 55 
 
 same side; this is common in weak children — the head 
 bends away from the weakest side. 
 
 We have spoken of the physiognomy of the head, 
 and good and low-class types ; we now proceed to 
 describe the face and the features as an index of brain, 
 telling you how it is working. 
 
 The face is that part which lies in front of the skull. 
 If you could remove the skin of the face, and then the 
 fat that lies beneath it, you would see the muscles 
 passing in various directions. There is a circular 
 muscle surrounding each of the openings of the face ; 
 such muscle, when contracting, closes the eyelids, or 
 the mouth, as the case may be ; there are other 
 muscles which can open the eyelids, and widen the 
 mouth. The muscles of the face are supplied with 
 motor nerve-currents from the brain by a nerve called 
 the facial. 
 
 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 muscles become hard as they contract 
 and swell out. A schoolmaster knows these muscles, 
 and when he sees them at work knows that the boy is 
 eating, without asking the question. These muscles 
 of mastication are supplied with nerve-currents from 
 the brain by the fifth pair of nerves which we spoke 
 of before. 
 
 All these structures which make up what is called
 
 56 
 
 the face are supplied with 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 ; this mobile colour of the 
 face is very expressive. 
 
 When we look at a human face we may observe its 
 form, colour, and conditions of mobility. The general 
 form and outline of the face is 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. 
 
 To examine a face in detail, hold a sheet of paper 
 in front of it, with one edge vertical and opposite the 
 middle of the face ; either half of the face can then be 
 covered in turn, while the other half is examined. 
 
 Again, the face may be divided into three zones, or 
 horizontal areas — the upper, middle, and lower. To 
 observe each in turn, hold the 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
 
 57 
 
 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. 
 
 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 
 furrows, or vertical furrows with a drawing of the 
 eyebrows 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 ec^ual 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 somewhat up- 
 wards, so also to a less degree in smiling. The 
 circular muscle of the mouth contracts in closing the 
 lips, and its action is excessive in pouting. 
 
 Examine a face showing signs of " mental anxiety." 
 Making a physical examination of the expression by 
 the methods suggested, we find it equal and similar on 
 either side — therefore the expression is symmetrical. 
 We "see the signs of anxiety more when observing the
 
 58 
 
 upper zone than when looking at the middle and lower 
 parts of the face — hence the expression is symmetrical, 
 and principally located in the forehead or upper zone. 
 
 The expression of mental anxiety may be contrasted 
 with that of bodily suffering. Mental anxiety is ex- 
 pressed mainly in the upper zone of the face, by 
 vertical furrows. In the facial expression of pain 
 originating in the limbs or body, we see the signs 
 mainly in the lower zone, the angles of the mouth 
 being drawn down. In the face of a mother who has 
 just lost her child, the mother's pain is shown by 
 depression of the angles of the mouth ; some years 
 after the loss, when memory has idealized the child, 
 reference to the sorrow causes the expression of mental 
 pain in the forehead. 
 
 I have often seen a fixed expression of mental 
 anxiety in young children, and, when questioning the 
 parents showed no apparent cause, have in some cases 
 gained the child's confidence and drawn out its story 
 of "terrors in darkness," visions, or mental trouble, 
 which the little child would not before speak of 
 because it was not understood. 
 
 I know of only three forms of facial expression that 
 are not symmetrical — snarling, winking, and one-sided 
 grinning ; certainly these asymmetrical expressions are 
 neither intellectual nor beautiful. It is not uncom- 
 mon to see awkward, silly movements in the faces of 
 children — such as frequent frowning, and grinning on 
 one or on both sides ; such habits are not intellectual, 
 and should be checked, if possible, in early life. They 
 often depend upon causes which can be removed.
 
 59 
 
 Fatigue and exhaustion are indicated in the face by 
 a relaxed, toneless condition of the muscles and too 
 little mobility or change of expression ; the play of the 
 features is lost, and the face falls or elongates slightly. 
 A special sign of exhaustion is seen in those who have 
 suffered habitually from recurrent headaches. It is 
 not uncommon to observe that a child looks as if he 
 had a headache. Analysing such faces, you may soon 
 observe a look of depression, heaviness, fulness about 
 the eyes, especially about the under eyelids ; this sign 
 is usually bilateral, and is due to a relaxed condition 
 of the muscle (orbicularis) which surrounds the eyelids. 
 If the patient can be made to laugh, the muscle be- 
 comes energized, and the expression of headache is 
 lost for the moment. This sign is often best seen in 
 the profile view. 
 
 If strong and unequal nerve-currents are sent to 
 opposing muscles, a quivering or tremor of the part 
 moved by the muscles may result. Such action is 
 often seen about the muscles of the mouth under the 
 influence of " conflicting emotions." Suppose a child 
 has hurt his finger, but is trying hard not to cry : we 
 :shall see the muscles of the mouth quiver, until finally 
 the effect of the injury to the finger acting upon the 
 nerve-centres becomes the stronger force, the angles 
 of the mouth are depressed, and the outbreak of 
 sobbing follows. 
 
 The signs of the action of mind are seen in the 
 face. Let me tell you a true story which illustrates 
 this and some other things. An English merchant in 
 'China had lent a Chinaman money to trade with ; a
 
 6o 
 
 sudden outbreak among the native population drove 
 all Europeans from the settlement, and none of their 
 property could be saved. Three days later this China- 
 man came to the merchant, who had fied like the rest, 
 and brought him his money in full. When asked why 
 he had acted thus, knowing that the money could not 
 be recovered from him by force, he replied : " Me no 
 can spoil face." He would not have his face, the index 
 to the action of mind, marked with the expression of 
 dishonest thoughts and actions. 
 
 This story illustrates physiological fact ; another use 
 
 Fig. 12. — Paralysis of Right Side of Face from Brain 
 Disease. — The face is not symmetrical, and the muscles on 
 the right side about the mouth act weakly. The line from 
 the nose to the mouth on this side is almost lost : this is well 
 seen on comparing the two sides. Muscular action in the 
 upper and middle parts of the face is unequal on each side.
 
 6i 
 
 may be made of such knowledge in dealing with 
 •children. If by any means you can remove a bad 
 expression from the face, you help to remove a bad 
 condition or bad thoughts from the brain. Skilled 
 actors know when they have brought the right expres- 
 sion to their face by the accompanying feeling, be it 
 of anger or merriment. Do not let children play at 
 making bad faces ; when the face does not look right, 
 try and change the brain condition ; a good hearty 
 laugh is often most useful in this way to the face, the 
 mind, and the brain. 
 
 Looking at different types of faces, we are at once 
 
 P'lc. 13. — Paralysis of Left Side of Face i-rom Brain 
 Disease. — Similar differences are seen about the mouth. 
 The eyelids are a little wider open on the left side.
 
 62 
 
 struck with the fact that the passive appearance of 
 some expresses intellectuahty, while others are marked 
 by inborn vulgarity, apart from any special mobile 
 expression. Elements contributing to the low vulgar 
 type are a narrow and receding forehead, a large pro- 
 minent under-jaw, thick lips, and a thick immobile 
 make of skin. Such signs are, however, empirical, and 
 not to be trusted too far. 
 
 The condition of the nutrition of the tissues of the 
 face is an important index to the general nutrition of 
 the body and its different organs. A slight amount of 
 malnutrition makes the face look dull ; this may be 
 due to too little blood circulating, or to partial absorpn 
 tion of fat from under the skin. 
 
 When we look at the face of an adult we see its 
 inborn form, the signs of its present nutrition, the 
 marks of all the mobile expression that has passed 
 over it during the preceding years, and its present 
 mobile condition as produced by the brain. 
 
 The eyes are considered among the most important 
 features of the face. In conversational language, which 
 is not always quite precise, the term " eye," as a feature 
 of the face, is used somewhat loosely; but it is ne- 
 cessary, in our methods of study, to distinguish care- 
 fully between expression seen in the eyeball and 
 expression in the parts that surround the eyeball — the 
 eyelids, the eyebrow, &c. The eyeballs lie in their 
 sockets, the orbits of the skull, resting among the fatty 
 tissue which supports them. If that fat be diminished 
 in quantity, the eyeball sinks farther into the orbit ; if 
 the fat becomes congested and swollen up, it protrudes
 
 63 
 
 the eyeball somewhat. The movements of the eyeball 
 are eflfected by small muscles attached to the eye and 
 arising from the wall of the orbit ; these small muscles 
 are supplied 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 contracted in sleep. 
 
 Fig. 14. — Complete Paralysis ok the Right Side'^of 
 THE Face. — The muscles of the face act only on the left 
 side. In the forehead the frontal muscles produce horizontal 
 furrows ; the muscles about the mouth draw the left angle 
 upwards ; the eyelids are more widely separated on the 
 right side.
 
 64 
 
 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 ten 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. 
 
 Fig. 15. — Imbecile. — Head well shapen and of fair size; he 
 often smiled, thus moving parts around the eyes and mouth.
 
 Movements of the eyes not controlled as to their 
 number and direction by obvious circumstances must 
 be looked upon as signs of nervousness. Irregular 
 movements of the eyes are common in children, and 
 are very indicative of the brain condition ; they may 
 be looked upon as analogous to spontaneous twitchings 
 of the fingers. In these wandering, irregular move- 
 ments 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 upper eyelids, and 
 very often the eyes and head move upwards together. 
 
 Fig. i6.— Imiu.i h r. 
 
 J lie same case quiescent ; ftice wanting 
 expression. 
 F
 
 66 
 
 There are many modes of expression and abnormal 
 nerve-signs that may be observed in the face : all good 
 and healthy expression is symmetrical. 
 
 Defective expression. — Want of changefulness, va- 
 cancy, fixed expression — a face may show twitches 
 or ill-action of the muscles such as will be described, 
 and yet carry a good expression. In the forehead 
 froivning may be produced, with horizontal creases 
 which become deep if the muscles producing them 
 overact strongly. This is a bad sign, and is most 
 usual in children of unoccupied mind, often subsiding 
 when the attention is attracted and the interest en- 
 gaged. It is far more frequently seen in boys than in 
 girls. Knitting the eyebrows, drawing the eyebrows 
 together with vertical creases — this is often expressive 
 of mental action, especially a puzzled mind. 
 
 Orbicularis Ociili relaxed. — There is a thin muscle 
 which encircles the eyelids. Its tone gives sharpness 
 to the lower lid, so that its convexity is seen. When 
 this muscle is relaxed, there is a fulness or bagginess 
 under the eyelids which disappears on laughter. 
 
 Eye movements. — When an object is moved at a 
 distance two feet in front of the face, the eyes should 
 move towards the object ; in some children the head 
 always turns towards the object, while the eyes are 
 kept still in their orbits. In other cases fixation of 
 the eyes is bad ; there may be restless, uncontrolled 
 movements of the eyes ; the child's eyes may con- 
 stantly turn towards your eyes instead of the object he 
 is told to look at. Eye movements need training in 
 the kindergarten. In the lower part of the face you
 
 67 
 
 may see grinning or over-sniiling. This may be spon- 
 taneous, or may occur on any stimulation to effort. 
 The hnes thus formed in the face may be shght or 
 deep. The mouth may be kept open ; this may be 
 from feebleness and drooping of the jaw. Many 
 children are always mouth breathers, and cannot 
 breathe through the nose on account of conditions of 
 the throat requiring medical attention ; in such children 
 test the hearing, which is apt to become very dull if 
 the case is neglected. 
 
 A few words must be said about squinting in 
 children. When you see the eyes not turned in the 
 same direction, this should at once attract your 
 attention. A squint may be permanent, or it may 
 come and go ; in any case advice is required for the 
 child. Such conditions often lead to headaches and 
 worse conditions, but these may be prevented by the 
 early use of appropriate glasses.
 
 68 
 
 LECTURE V. 
 
 SIGNS OF GENERAL CONDITIONS OF THE 
 BRAIN, AND EXPRESSION OF MIND. 
 
 THE most important condition of a child's brain is 
 that indicated by the signs of consciousness. 
 Something can be learnt by direct observation of 
 children who are in possession of consciousness as 
 contrasted with those asleep. You will find that the 
 movements accompanying and indicating conscious- 
 ness are such as are stimulated by circumstances 
 around, by speaking to the child, or showing him 
 things. If speaking to a child is followed by his 
 running to you, or doing what you tell him to do, he 
 is conscious. On the other hand, if you stand by his 
 bedside while he is sound asleep and unconscious, you 
 see general absence of all movements except those of 
 breathing ; speaking to him in a low voice, or putting 
 pictures in front of him, does not make him move or 
 speak. There may be some spontaneous movements 
 of his limbs, but they are not controlled by things 
 around — they are the mere outcome of spontaneous 
 brain action, not of impressions produced upon it from
 
 69 
 
 without at the time of observation. In healthy sleep 
 the tone of the circular muscle of the eyelids is 
 sufficient to keep them closed, but sometimes in weak 
 children the lids are half open, showing a part of the 
 white portion of the eye. We commonly say there 
 may be different depths of sleep ; sleep may be full 
 and complete, with loss of most forms of impression- 
 ability. Observation of a child during sleep does not 
 necessarily give us evidence as to whether there be 
 any impressionability or not ; it may be that the out- 
 come or expression of impressions received is long 
 delayed. Things said before a child when apparently 
 asleep may not produce any visible result at the time, 
 but we may subsequently learn that he had been 
 impressionable to sound at the time of observation ; 
 the child may repeat what had been said before him. 
 Here we know the impressionability by its effects in 
 subsequent speech. 
 
 Fatigue is indicated by the slight amount of force 
 expended in movement, and by the small number of 
 movements. In the latter character we see some dis- 
 tinction between fatigue and irritability, in which con- 
 dition there is often an excess of movement, and, in 
 particular, an excess of speech. Fatigue and irritability 
 often coexist. The free hand assumes the " straight 
 extended posture with the thumb drooped," or the 
 posture of the feeble hand. The head is often in an 
 asymmetrical posture and flexed. The direct effects 
 of gravity determine the position of the body to a 
 greater extent than in the condition of strength ; hence 
 the spine is bent. If this condition tends to pass on
 
 7° 
 
 into sleep, it is expressed by the preponderance of the 
 circular muscles over the elevator of the upper lid, and 
 the other signs of sleep supervene. 
 
 Exhaustion is an extreme condition of fatigue in 
 which movement is lessened. The face becomes 
 toneless and devoid of fine mobile expression, the 
 circular muscle of the eye is relaxed, the face may be 
 lengthened from relaxation of its muscles and slight 
 falling of the jaw ; the ordinary movements of ex- 
 pression are not excited by the ordinary stimuli, and 
 such movements as do occur are slow and laboured. 
 A strong stimulus is required to induce the child to 
 hold out his hands, and then the posture is the feeble 
 hand. Sighing and yawning are common. Speech is 
 slow, and the tone of the voice is altered. In some 
 cases finger twitching, especially of separate fingers, 
 indicates extreme exhaustion and irritability. 
 
 Irritability is expressed in a child when a slight 
 noise makes him start ; this is a reflex movement in 
 excess, a reflex action that does not occur in perfect 
 health on so slight a stimulus. In irritability other 
 stimuli besides sound may produce excessive reflex 
 action ; a touch upon the shoulder causes a sudden 
 movement. Not only is the amount of reflex move- 
 ment excessive and out of proportion to the stimulus, 
 but the kind of movement may differ from that usually 
 following such a stimulus in health. A child three 
 years of age, when irritable, may turn away his head 
 from a familiar object, or from the sight of his food, 
 and say " No, no" ; here the sight of the object, instead 
 of causing a reflex movement of the head, eyes, and
 
 7' 
 
 hands towards the object, moves all from it. The 
 irritability of the nerve-centres is indicated by move- 
 ments in the opposite direction from that which the 
 same stimulus would produce in health. Besides 
 these reflex signs we find the voice altered — when 
 spoken to he may answer sharply ; the motor force 
 generally is lessened and irregular in kind ; twitching, 
 irregular movements are not uncommon. Nervous 
 children often show marked signs of irritability ; the 
 spontaneous postures assumed are those of fatigue, 
 with the addition of slight irregular twitching move- 
 ments. If this condition lasts long, nutrition is lowered 
 and wasting occurs. Abnormal conditions in the 
 body, particularly in the stomach, may render the 
 child irritable ; so may fever or illness. 
 
 The sig//s of nutrition are of the highest importance 
 and interest. The first point I wish to insist on is 
 that nutrition may be expressed by (i) form or growth, 
 and (2) by motion which is due to nutrition. 
 
 As evidence that motor signs, or movements and 
 the results of movements, may express nutrition, let us 
 examine a few examples. 
 
 (i.) In an ill-nourished infant spontaneous move- 
 ment is much lessened, or the child may lie almost 
 motionless instead of being constantly full of movement 
 while awake. The return of spontaneous movement 
 is a sign of the improved nutrition. 
 
 (2.) In a man after a severe illness, such as a fever, 
 the tone of the voice is usually altered so that we can 
 no longer recognise the individual by his voice ; this 
 motor sign, as well as the worn countenance, indicates
 
 72 
 
 the man's lowered nutrition. Returning health is 
 shown by the patient "looking like himself," and 
 " recovering his old voice." 
 
 (3.) In a child seven years old emaciation and ill- 
 nutrition, indicated by loss of weight, may be accom- 
 panied by St. Vitus' dance or finger twitching, which 
 disappears when weight increases and nutrition is 
 improved. 
 
 (4.) A strong, well-nourished man is less fidgety 
 than a weak one. 
 
 Now as to the expression of nutrition by form and 
 growth. Proportions of growth often indicate con- 
 ditions of nutrition, 
 
 A seedling pea-plant, if kept in a room with deficient 
 light, is not well-nourished, and the ill-nutrition is 
 indicated by the small yellow leaves and the long 
 white stem. That good nutrition has not occurred 
 during the life of the plant is demonstrated by the fact 
 that the plant, when dry, weighs less than the seed 
 from which it grew. Here ill-nutrition is expressed by 
 the relative growth of leaves and stem — the leaves 
 being very small, the stem very long. In children we 
 often see growth for a time occur in height without 
 lateral development ; then the proportions of growth 
 change, and the child fattens. 
 
 Rest is probably a condition of nutrition leading to 
 the signs of recreation indicated by subsequent activity. 
 The most essential element in the expression of the 
 condition rest is the subsequent activity. During rest 
 there is still impressionability, which affords a dis- 
 tinguishing character between simple rest and sleep;
 
 73 
 
 arising out of this we have the fact that in rest un- 
 complicated by sleep the eyelids usually remain open. 
 
 One of the special characters of rest is the absence 
 of movement, although impressionability is retained. 
 Rest is usually preceded by fatigue, and is followed by 
 activity ; the seciuential signs of recreation and activity 
 indicate that during the period in which movement 
 was absent there was rest. Rest is expressed by the 
 present signs of rest, followed by the signs of recreation 
 and activity. 
 
 As a matter of interest it may be noted that forces, 
 such as the sound of soothing music, may affect move- 
 ments. Music may cause a. man to keep quiet and 
 rest. 
 
 In contradistinction to the state of rest w^e have 
 activity. The condition of activity is indicated by 
 actions. In activity with strength, the movements are 
 probably fewer in number than in the state of irrita- 
 bility, and the kinds of movement differ in the two 
 conditions. 
 
 One sign of healthy activity is a quick response of 
 movement upon stimulation — for e.xample, the move- 
 ment follows quickly upon the sight of an object, or 
 on hearing a sound. If such movements are looked 
 upon as reflex actions, the quick and ready answer is 
 a reflex series of movements where the period of 
 latency is short ; this of course implies also that 
 impressionability is good. 
 
 What good, what advantage, is there in these special 
 modes of describing what we see? Our modes of 
 ■description are such as allow of comparisons being
 
 74 
 
 made. We translate abstract qualities, such as "joy,"' 
 into concrete terms, such as movements or conditions 
 of form or development. AVe translate the terms used 
 to describe the abstract property into other terms, the 
 expression of the abstract. The term "happiness" is 
 intended to indicate a certain condition of feeling 
 which we all more or less understand. The thing 
 happiness is an abstraction ; but, if we can define an- 
 expression of happiness in man, we can deal with 
 the material expression of happiness, analyse and 
 study it. 
 
 Having these descriptions before us, we can make 
 some comparisons or analogies. In laughter, which 
 is an expression of joy, or happiness, the angles of the 
 mouth are drawn upwards ; this is the very opposite 
 to the expression of physical suffering. By defining 
 the expression of the abstract thing happiness in terms 
 of motor signs, we find problems to deal with capable 
 of physical investigation. 
 
 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 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 
 faculties of mind, although it is healthy ; it may 
 possess potentialities, but it shows no actual present 
 signs of mind. An idiot, in growing up from infancy,, 
 does not show those signs appropriate to his age
 
 75 
 
 which indicate the functions of mind. The infant is 
 said not to show actual signs of mind, though it may 
 show potentiahties ; the infant at birth does not walk, 
 talk, or turn its eyes and head towards a bright object 
 within its field of vision^ — its movements are not 
 modified in any marked degree by the action of light 
 or sound, except that the eyelids contract spasmodi- 
 cally to light. The infant is, in some respects, less 
 impressionable, and the impressions are less perma- 
 nent than in the adult. 
 
 The signs of its i)rain development arc identical 
 with the signs of its mental development; we may 
 proceed to recount them. 
 
 The healthy infant at birth weighs between 6 and lo 
 lbs. ; its limbs and members are complete in all parts^ 
 fingers, toes, nails, cS:c. ; the head measures in circum- 
 ference II to 12 inches; the junctions of the bones 
 of the vault of the skull are not closed or ossified, and 
 the anterior fontanellc is open. We may also observe 
 the form, size, and proportions of the body, and 
 particularly of the head, as signs which indicate to 
 some extent the degree and condition of tjrain develop- 
 ment. Respiratory movements in the infant are 
 established at birth, and continue without interruption ; 
 the child cries when its skin is cold or wet, and when 
 the stomach has been empty more than two hours. 
 
 An object placed in the mouth stimulates the move- 
 ments of sucking; cold to the skin is followed by 
 crying ; light causes closure of the eyelids ; and, if the 
 eyelids are raised, the pupil contracts to light. 
 
 Frequent spontaneous movements may be seen
 
 76 
 
 while the infant is awake ; movements, apparently 
 irregular, are almost constant in the hands, fingers, and 
 toes. A short period of wakefulness is usually followed 
 by sleep, indicated by subsidence of movement in the 
 limbs and closure of the eyelids. We say that the 
 new-born infant does not give expression to the faculties 
 of mind because it does not present signs showing that 
 it is impressed, even temporarily, by the sight of sur- 
 rounding objects ; it does not move its hands towards 
 objects within its field of vision, and no movements 
 indicate that it 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 forehead (corrugators), which seem to be 
 specially connected 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 cause 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 
 movements, together with an increased susceptibility 
 to reflex action. The "playful child" has a happy
 
 77 
 
 face, owing to the healthy tone of the facial muscles 
 and their nerve-centres. 
 
 The following observation in a child eighteen 
 months old illustrates how the dawning intellectuality 
 is indicated by the complication and fitness of certain 
 sets of movements : — "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 
 healthy infant brain deserve separate attention : — 
 Movements following certain external agencies, light, 
 sound. Movements the outcome of the essential 
 (untrained) properties of the nerve-mechanism. Move- 
 ments resulting from (training) the acquired association 
 of nerve-centres. Movements similar to those pre- 
 viously occurring from a like cause, showing retentive- 
 ness. 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. 
 
 We may now give a description of a nervous child 
 in terms of nerve-muscular action ; and proportion of 
 growth. A typical case may be found among children 
 who sleep badly, talk at night, grind their teeth, 
 emaciate without disease of organs — such children are 
 apt to be irritable and passionate, and to suffer from 
 headaches and hacking cough without lung disease. 
 
 Let such a child stand up, and observe him. 
 
 As to his conditions of giowth: defects of pro- 
 portional growth are commonly seen. The shape of
 
 78 
 
 the bones, the make of the skin, the form of the 
 features, may all be good. The height of the child in 
 relation to circumference, or to his weighty is defective ; 
 the child is too tall and too thin ; either fat or muscle 
 may be defective in quantity. The emaciation may be 
 unequally distributed ; often it is less in the face than 
 in the limbs and trunk. 
 
 Now as to the motor signs indicating the state of 
 the nerve-system. 
 
 Let the hands be held out with the palms downwards, 
 and the fingers separated. The left upper extremity 
 is often at a lower level than the right ; " the nervous 
 hand" is seen on either side, perhaps more marked on 
 the left ; there may be finger twitching, separate digits 
 moving in flexion and extension, or laterally in 
 adductor and abductor movements. The spine is 
 arched too forward in the loins, often with inequality 
 in the level of the shoulders and slight lateral curva- 
 ture. The face, as a whole, is usually too immobile, 
 although there may be some over-action of the muscles 
 widening the mouth, on one or on both sides. The 
 tongue when protruded is too mobile. The eyes move 
 mostly in the h')rizontal direction ; their movements 
 not being fully controlled by the sight and sounds of 
 objects around, except under strong stimulation. The 
 head is sometimes partially flexed, with inclination and 
 slight rotation towards the same side. 
 
 Some of the teeth are usually found ground at their 
 ti{)s. This is most commonly the case with the canines ; 
 the grinding action is produced by the masticatory 
 muscles during sleep, and is owing to irritation of the
 
 79 
 
 fifth pair of brain nerves. We may here call to mind 
 the fact that the sensory division of the fifth nerve is 
 distributed to parts inside the skull as well as to those 
 outside it. 
 
 Other examples might be given of defects in ratios 
 of growth in the body coinciding with defects in the 
 nerve-system ; such coincidences are very common in 
 idiots. 
 
 Speech is the most important mode of mental 
 expression ; it is a faculty that needs cultivation in all 
 children. Indistinctness of speech is very common, 
 and defects of speech are frequently met with, both 
 in children generally healthy and well-made, and in 
 others of defective constitution.
 
 So 
 
 LECTURE VI. 
 
 OBSERVATION OF CHILDREN AND 
 EDUCATION. 
 
 IN the preceding lectures I have explained to you 
 how children may be studied, and have put before 
 you methods which you may employ without asking 
 questions or entering into any medical details. If you 
 look back over what was said in the early lectures, you 
 will find that we considered many signs of brain power 
 in children, avoiding all questions of metaphysics. It 
 seems to me very desirable, if not essential to the 
 proper study of children, that we should judge by the 
 signs which we observe, not by the answers to questions 
 put to the child respecting his health. I seldom ask a 
 child if he has headache, but often look for the signs 
 of strength, or exhaustion, and the direct indications of 
 headache. Such observations may be made by any one 
 who is in personal contact with children, l)y the mother 
 among her children, or the manager or teacher in the 
 school. I was led to undertake these studies, and 
 finally to put them before you, in the hope and belief 
 that children may be benefited thereby through you. 
 The care of children and the improvement of
 
 8r 
 
 methods of education concern us all alike, and through 
 many years I have had abundant evidence that there 
 is great need for exact knowledge as to the condition 
 of children in the home and in the school. It is right 
 that we should all learn to study children in a scientific 
 manner, that we may know how best to aid their 
 development in mind and body and take our part in 
 causing them to grow up as healthy, good, useful men 
 and women. The care of children of all classes is a 
 very responsible work, demanding intelligent and 
 earnest care ; it is not enough for teachers to study 
 methods of education and school practice, the subjects 
 to be taught, and the methods of teaching them. 
 Some knowledge of physiology is very useful, but it is 
 a direct duty to study the children thetnselves, that we 
 may know their individual tendencies, and that their 
 ever-varying condition may be at once perceived. We 
 should see the signs of fatigue before exhaustion and 
 irritability are obvious in imperfect lessons and bad 
 behaviour ; hence the necessity for an intelligent and 
 precise knowledge of children, enabling us to detect 
 early the signs of failure of strength. 
 
 On going into a school to study and note the con- 
 dition of the children, it is my custom first to observe 
 each child while the lesson continues. If the light in 
 the schoolroom be good, there is no difificulty in noting 
 such points as the size and general conformation of the 
 body and the head, and looking at the separate features 
 of the face, the signs of nutrition, and the apparent 
 age of the child. Then, in the second place, having 
 requested the teacher to ask the children to stand up 
 
 G
 
 82 
 
 and hold out their hands, I notice the postures of the 
 body, the head and the spine, the arms and the hands, 
 as well as the movements of these parts. The signs 
 visible in the face and eyes can be seen at the same 
 time ; these have all been described in preceding 
 lectures. Judging from the various signs thus seen, 
 and without asking questions or speaking to the children 
 of our purposes, it is easy to report upon them thus : 
 
 1. As to their development, whether good-class or 
 low-class. 
 
 2. As to the present state of their nutrition, both of 
 body and brain. 
 
 3. As to the present condition of the nerve-system, 
 including such points as its probable healthiness, 
 weakness, exhaustion, the signs of headaches, or slight 
 St. Vitus' dance (chorea). Dulness of the nerve- 
 system, together with other signs of born imper- 
 fections or defects, is formidable from the point of 
 view of further success, and should always attract 
 attention and stimulate the teacher's energy. 
 
 Can this knowledge be made of use? The good of 
 the children is the motor power by which we work, 
 and those who acquire the most knowledge of children 
 will, in the end, acquire power and success in edu- 
 cation, despite any temporary difficulties 
 
 Let me give a few practical examples. At a Board 
 school I visited the sixth standard girls in company 
 with some friends, and requested the teacher to point 
 out, unknown to the children, those who gave the 
 most trouble. Among them were two small but 
 well-made children — the nerve-system in each was
 
 83 
 
 exhausted ; had this been known on authority Toy the 
 managers, might not these children have been ex- 
 empted from examination, and the teacher from the 
 necessity to press them on, though still requiring their 
 attendance at school ? 
 
 In a high-class school, a boy presented a general 
 good development, but his nerve-system was ex- 
 hausted ; he had far too much movement, showing 
 brain irritability. The master said he worked well, 
 but his father often wrote letters to the school ex- 
 pressing his desire that the lad might do more work, 
 and move up in the school quickly ; the headmaster 
 wished the same. Here is a case where knowledge of 
 a precise kind, possessed by the master of the class, 
 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 show-s 
 that the work is harmful. Regular and appropriate 
 work is essential to due brain development and 
 healthy growth. 
 
 Looking over the classes of a well -arranged large 
 primary school, and comparing the condition of the 
 children with that of those of all ages who had only 
 recently commenced school attendance, I have been 
 struck with the marked improvement of the nerve- 
 system which seems to occur under good education. 
 
 Many statements have been made, both here and in 
 other countries, as to the present condition of children 
 in the primary and higher schools, and some not
 
 84 
 
 unreasonable anxiety has been raised in the pubhc 
 mind in this matter. It seems to me that it is highly 
 desirable to separate the question of the actual con- 
 dition of the children from the probable causes of any 
 defects which may be found to be common among 
 them ;. we should endeavour to determine the two 
 questions, the actual condition and its causation : the 
 latter is a very complex question. As far as I am able 
 to express any opinion from my own observations in 
 Board schools in London and elsewhere, I think that 
 probably about six per cent, or more of the children 
 show defects or exhaustion of the nerve-system, and 
 the number of cases of eye defects appears to be large. 
 
 It is very desirable to obtain some certain know- 
 ledge as to the average condition of the children in 
 our primary schools, and this can only be done by 
 direct observation of the children, independent of 
 questions asked. Statements should not be dependent 
 upon the answers to questions put to parents or 
 teachers, and the signs to be observed must be clearly 
 defined and scheduled. It is generally acknowledged 
 that children are not all alike, they are not all cast in 
 the same mould ; but, before children can be classified 
 as to their make and their condition, we must have 
 precise knowledge as to what is to be observed, and 
 how to proceed in the matter. In these lectures I have 
 endeavoured to give such knowledge. 
 
 A knowledge of children concerns us all in the dis- 
 charge of our duties, whether they be those of the 
 parent, the teacher, or the school manager. The 
 child is sent to school to be submitted to the beneficent
 
 85 
 
 influences of education. We will not attempt here to 
 define what is meant by the term education, but we 
 mean those processes which are designed not only for 
 giving knowledge; but, further, to draw out and 
 organize all the latent powers of the child, that he may 
 become good, active, and intelligent, as well as be 
 possessed of learning. 
 
 Parents have often consulted me as to whether a deli- 
 cate child may, with advantage, enter upon or continue 
 school life, or, with regard to older boys, whether they 
 may with safety prepare for competitive examinations 
 and submit to the strains involved thereby. When 
 the development and nutrition are good, and when 
 no signs of exhaustion are seen, I always advise that 
 the effort be made, but the child should be watched 
 while undergoing any prolonged strain from hard 
 work. Many an effort may be wisely allowed 
 when those around are capable of watching the 
 effects. 
 
 Again, to give practical illustration. It is common 
 in Board schools to find in the lowest standard 
 children of defective make, trying to the teacher no 
 doubt, little boys and girls whose make and inherited 
 conditions cause them to tend to badness rather than 
 to learn to be good. Such children, if known to the 
 managers, might be specially commended to the 
 teacher's care, and honour and reward should be 
 given to the teacher who honestly and laboriously tries 
 to benefit them. Such boys and girls could not be 
 expected to pass the successive standards, but they 
 should be kept in some school for their own good and
 
 86 
 
 the public good. Knowledge as to the physical con- 
 dition of children is necessary to distinguish those 
 slightly defective from those merely stupid and lazy, 
 who ought to be made to work and not exempted or 
 spared from punishment. On the subject of the eye 
 conditions of children I say nothing ; facts have been 
 ably put together by Mr. Brudenell Carter, Mr. Priestley 
 Smith, and others. It only remains for me to say on 
 that subject that eye defects are common sources of 
 headache in school-children. 
 
 I do not hesitate to urge the importance of appre- 
 ciating the physical condition of our children, for it 
 is among the slightly wrong-headed children that we 
 have a large proportion of our future men and women 
 who will prove social failures, paupers, and criminals. 
 Let us then pick out and save such children, not 
 necessarily making the teacher press them through 
 successive standards, but holding him in honour and 
 in duty bound to cultivate them, and strictly to require 
 their continued attendance at school, if practicable, 
 as the only hope of their moral and social welfare. 
 
 The blind and the dumb are now specially cared 
 for ;. so should those children be who are weak or born 
 a little wrong-headed, and, for similar reasons, it is 
 their; right and to the public advantage. 
 
 While thus endeavouring to impress my own 
 opinions and estimate of the value of knowledge as 
 to the physical condition of school-children, I am 
 very desirous of gaining information from managers 
 and teachers, in order that we may all work together 
 with a common object, with unity of purpose, liberality
 
 8? 
 
 where we differ or see differently, and in a spirit of 
 charity to all. 
 
 A knowledge of the signs of the condition of the 
 brain will also be useful to school managers in their 
 supervision of the younger teachers. I have seen a 
 young woman, who presented the complete type of 
 nervous exhaustion, standing before her class, truly an 
 object for sympathy, but a bad impression must have 
 been produced thereby upon the little ones. 
 
 Let me present to you a report of what was seen at 
 a high-class school I was invited to visit. 
 
 Third class, seen 1885. Twenty-nine boys present 
 at a lecture on geometry, 2.30 o'clock. 
 
 No questions were asked, and 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 
 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 develoj^mental defects. 
 
 G, H. — Two appeared somewhat exhausted in the 
 nerve-system, and are likely to be sub- 
 ject to headaches ; this is probably not 
 a temporary 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
 
 88 
 
 no signs of brain-exhaustion or of headaches. The 
 following signs of defective development are probably 
 of long standing, or from birth. 
 
 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 forehead, 
 causing horizontal and vertical furrows. Evidence 
 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 action of the 
 face lessened as the lecture proceeded. He lost 
 places in class. 
 
 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. 
 
 G. A boy of fair complexion, with light hair, rather 
 under the average size, but placed second in the 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 expres- 
 sion ; in the forehead, however, there were fine hori- 
 zontal 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
 
 89 
 
 marked fulness under the eyes, due to relaxation in 
 the circular muscles. No signs of developmental 
 defects were apparent. 
 
 H. A boy of fair complexion, with light hair, placed 
 24th 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 addition, a slight sign 
 of developmental defect was seen^ — the left ear was 
 ill-formed. 
 
 Examples might easily be multiplied. 
 
 Teachers have said that exhaustion in children is 
 often due more to mismanagement at home rather 
 than to work in school. That may be so in some 
 instances. Let me sketch a case for you. A girl, 
 twelve years old, comes to school in the morning with 
 too little spontaneous movement, the head is not held 
 erect, the face is pale, the muscles around the eyes 
 are relaxed, the eyes are wandering and not fixed or 
 controlled in their movements by sights and sounds, 
 the free hand is in the feeble posture. The attention 
 is not readily fixed, she is fidgety and restless ; such 
 signs indicate exhaustion and irritability. We assume 
 that the school is well arranged, and the work suitable. 
 Later in the morning the child brightens up and works 
 better, so that at the close of morning lessons she 
 appears in better condition than when she came under 
 school influences. Now, if the teacher knows, from 
 questions put, or other sources of information, that it
 
 9° 
 
 is not the school work that produces exhaustion and 
 depression, should the matter end there? If the 
 teacher's opinion is founded on facts observed, would 
 not any reasonable loving parent allow a friendly 
 remonstrance or suggestion ? If such conditions con- 
 tinue in the child, may she not exert a harmful moral 
 influence in the school, such as may justify a stronger 
 remark on the part of the school manager ? Still, it 
 cannot be expected that parents will readily listen to 
 vague reports of their children, or to such as are not 
 founded on precise and definite grounds. 
 
 We have a system of public education supported by 
 the ratepayers, which is presumably undertaken for 
 the benefit of the children and the benefit of the 
 public. The educational processes are arranged for 
 average children ; are they adapted to all children ? 
 The deaf and the blind children are now in part 
 provided for in special class-rooms. I desire to draw 
 attention to another class — the nervous, irritable 
 children ; children who are irregular in school 
 attendance on account of frequent headaches, chorea, 
 occasional fits, habitual truants whose brain defect can 
 be proven ; children so dull that they remain among 
 the infants and learn nothing but to be good. As a 
 hospital physician I meet with many such children ; 
 doubtless they form but a small percentage of the 
 school population, but they form a social danger. 
 
 Why are the deaf and the blind educated ? A part 
 of the reason is that they may not become paupers. 
 Why, then, are the children of slight brain defect not 
 specially cared for, children tending to become
 
 91 
 
 passionate, picking up bad habits and practising them, 
 tending to criminality, or, if too feeble for that, to 
 pauperism ? They are not neglected intentionally, but 
 because they are not known to the managers ; it is 
 nobody's business to find them out ; they are not 
 classified, and take their chance. Now my argument 
 is, that we can discover such children, and pick them 
 out in a school by definite physical signs ; we can point 
 out the children not up to the average, and tending to 
 failure from want of brain power. 
 
 To say that such children are few in every school is 
 no reason for their neglect ; we rejoice that but few 
 have such inborn conditions as make them tend to 
 social failure, pauperism, or crime, but we wish that 
 none should thus fail. Let the tendencies of children 
 be detected early and pointed out to the educationalist, 
 that such children may be specially cared for, helping 
 to correct the tendencies due to defects of brain. 
 
 Neglect in these matters does lead to unintentional 
 cruelty to children, and to, what I think more impor- 
 tant, the educational neglect of wroJig-braitied children. 
 This is due to ignorance, for which the public and the 
 school managers are responsible. 
 
 Now, as to these wrong-brained children, they are 
 worth helping : in many ways a genius differs from 
 ordinary children ; the very faults and nervousness may 
 be trained to become admirable qualities — sensitive- 
 ness and mobility of mind^and the fidgety child may 
 become an active man. It is to be feared, however, 
 that too often such children escape, and are excused 
 from an educational process unsuited to them, but
 
 92 
 
 still better than no education, for such children more 
 especially need the benefits of a wise training. The 
 nervous, excitable boy, always ill with sick headaches 
 while at school, is excused from attendance, and at 
 home he is idle ; we often see him at the hospital. 
 Too often the parents are neglectful and unwise, and 
 as he grows up, when drink or passion inflames him, 
 he commits some act bringing him within the power of 
 the police. I have seen the education of many such 
 children continued with success when they are removed 
 from large schools and placed at small schools. Again, 
 the weak-brained, feeble-minded child is often so 
 teased that at last he cannot be induced to go to 
 school ; his attendance is excused on the ground of 
 health. What becomes of him after that ? Habitual 
 truants have often been brought to me at the hospital ; 
 the defective condition may be obvious. The fine is 
 paid by the father, but this does not educate the child ; 
 the mother often wishes that Johnny would go to 
 school and be a good boy, but the school is unsuited 
 to him, and she cannot help it. 
 
 We say that these wrong-headed children can easily 
 be pointed out to school managers, and can be 
 educated in special classes in day schools. At a school 
 inspection it would be easy to see who required special 
 care ; the teachers would present for examination any 
 child found specially troublesome, often complaining, 
 very passionate, morally defective, Szc. ; and the cases 
 of children excused attendance on grounds of health 
 would be considered ; advice might be given on all 
 such cases to the managers. I was recently consulted
 
 93 
 
 about a little girl who suddenly developed a tendency 
 to steal ; she had heart disease and a tendency to 
 rheumatism ; six weeks' care made her all right again, 
 and removed the causes of moral obliquity ; she was 
 not called a sinner, and was sent to school again as a 
 happy, good child ; she will be watched, and will 
 probably do very well. At a school a child was 
 presented by the teacher as " not dull but somehow 
 wrong " ; grave brain defect was obvious ; the advice 
 was given to keep the child, if possible, at school and 
 out of the gutters. 
 
 In classes for the dumb children at a London Board 
 school I have seen children very defective in brain 
 being well trained ; in the highest classes of asylums 
 for imbeciles, feeble-minded children are educated and 
 sent out into the world. Small classes and specially 
 trained teachers might be provided for the dull, the 
 excitable, the wrongly-made children, as a safety and 
 protection to society. 
 
 As to the expense of teaching a few children, say 
 fifteen in a thousand, in a special class-room, would 
 not the money be well spent in an effort to lessen 
 crime, pauperism, and social failure at its commence- 
 ment? Should the endeavour be made to educate 
 and save the child, or to reform the drunkard and 
 criminal, and redeem the pauper to society? 
 
 When a teacher takes special pains to keep a feeble 
 child in school, and save and train him, even if he 
 cannot pass the standards, that teacher should be 
 honoured and commended. Every weakly or trouble- 
 some child who now escapes from public education is
 
 94 
 
 a failure in the system, and is likely to be a public loss. 
 The brain can be improved by education, and tends 
 to degenerate when neglected. 
 
 The work I plead for is heavy to undertake and 
 carry through, but it is not impossible : all should help 
 by studying the children earnestly and patiently ; then 
 the best methods of management and classified training 
 would soon be known and applied for our common 
 good. 
 
 To seek to gain knowledge and to diffuse it is worth 
 an effort, and requires combination of efforts. Will 
 those responsible for the care of children tell us how 
 we can help them in their grave responsibilities ? 
 
 Briefly to sum up. Let us learn to observe children 
 that we may know the make of them and their con- 
 dition. Let us find out what to observe as signs of 
 their make and their condition. When we have learnt 
 to observe the condition of children, let us study how 
 best to aid their development and improvement in 
 mind and in body, for the two must go together if we 
 wish for good and healthy children growing into good, 
 useful, well-toned men and women.
 
 95 
 
 CONCLUDING CHAPTER. 
 
 SINCE the publication of these Lectures in 1887, 
 much has been accomphshed in advancing child- 
 study in a systematic manner. A Committee was 
 formed in 18S8 with the object of describing each 
 child seen in school in any way below the average in 
 mental or physical status, by means of signs indicating 
 conditions below the normal, combined with the 
 teacher's report of each child as to ability in school 
 work ; the lines of observation adopted were those 
 indicated in these lectures. The work has been con- 
 tinued ever since the formation of that Committee, 
 and a report has been issued based on the records of 
 100,000 children seen in 16S schools, whom I exam- 
 ined in conjunction with other medical men who 
 corrected or confirmed the records taken. That 
 report contains a catalogue of groups of children 
 described according to what was seen in theiv. and 
 the teacher's report ; and shows their relative distri- 
 bution under sex, age, position in school standards, 
 nationality, and circumstances. 
 
 As an experimental endeavour to carry out the 
 original object this work may now be considered com- 
 plete, so far as it is a demonstration of its practicability 
 and usefulness, both as affording new information on 
 many conditions of childhood, and as indicating the 
 needs of individual children.
 
 96 
 
 Of the children seen, 7 "8 per cent, of the boys and 
 6"S per cent, of the girls were reported by the teachers 
 as dull, backward, or below the average ; but, of the 
 children who presented none of the signs previously 
 indicated in these lectures, only 1-2^ per cent, were 
 reported as dull. This fact shows the marked associ- 
 ation of mental dulness with the points of defect 
 described, and the importance of getting a child's 
 brain in good working order as a means of cultivating 
 mental ability and building up child-character. Again, 
 of the total number of dull children, 57 per cent, of 
 the boys and 52 per cent, of the girls presented some 
 of the "nerve-signs" which it has been shown can 
 mostly be removed by good physical training. These 
 nerve-signs, whether alone or in combination with 
 other defects, indicate brain conditions which are the 
 most potent causes of mental dulness ; and, where 
 they are very frequent in a school, the proportion of 
 dull pupils has been found high. 
 
 There is a group of da// and delicate childmi with 
 abnormal nerve- signs, whose condition appears to 
 demand that they should receive special attention ; 
 the physical report and indications of mental dulness 
 agreeing to indicate them as unable to profit by the 
 ordinary modes of training suited to the average and 
 stronger children, who, at the same time, require more 
 than ordinary care to prevent their failure in adult 
 life. 
 
 Evidence, from the early portion of this inquiry, 
 was given in 1889 before the Royal Commission on 
 the Blind, Dumb, &c., and, for the first time, it was
 
 97 
 
 officially recognised that there is a class of children 
 who, while not imbecile, present a certain amount of 
 mental deficiency. 
 
 The Commission reported : — "That, with regard to 
 ' feeble-minded ' children, they should be separated 
 from ordinary scholars in public elementary schools, 
 in order that they may receive special instruction, and 
 that the attention of school authorities be particularly 
 directed towards this object." 
 
 Children Fccbly-^:;ifted Mentally. — " These children 
 arc distinctly deficient in mental power, but might not 
 be certified as imbeciles, and are therefore not fit for 
 such medical certification. No child was included in 
 this group, unless it was believed, upon evidence 
 observed and the teacher's report combined, to be 
 incapable of school work in the ordinary classes. It 
 is difficult to define what physical conditions seen, as 
 apart from mental tests, indicate the child as unfitted 
 in mental capacity for the usual methods of education, 
 and an arbitrary attempt to do so has not been made. 
 There appears, however, to be a large class of ' children 
 feebly-gifted mentally,' with defect of mental power 
 short of imbecility, but still with some deficiency. 
 I have made the estimate that the probable number of 
 such children in England is not less than one percent." 
 
 Children ivho appear to reqtdre Special Care and 
 Training. — This group includes those described above 
 as dull and delicate, as well as the children feebly- 
 gifted, and, in addition, cripples and epileptic ; making 
 in all about 15 per 1,000 of the children of school 
 age, all of whom appear to require special care on 
 
 H
 
 98 
 
 account of physical or mental infirmities. This 
 estimate does not include the blind or the dumb. 
 
 Report upon the children in a school indicates at 
 once the character of the average material submitted 
 to the teacher, which differs considerably in some 
 schools. In an Edinburgh school the proportion of 
 children with defects in development of the body was 
 lower than in London Board schools, but the propor- 
 tion of dull pupils and those with " nerve-signs " was 
 higher ; apparently this was due to the absence of any 
 attempt at physical training in the Edinburgh school. 
 Again, it appears that the teachers in the Poor Law 
 district schools have more difficult work than in the 
 elementary day schools. Taking loo children in each 
 class of schools for comparison, we find in the Poor 
 Law schools 1 5 boys and 1 2 girls with developmental 
 defects and 15 boys and 10 girls with "nerve-signs," 
 as against 12 boys and 9 girls with developmental 
 defects and 1 1 boys and 8 girls with " nerve-signs " in 
 the day schools. 
 
 In some schools of special difficulty the proportion 
 of children not up to the average in physical and brain 
 status was considerably above the average. 
 
 The Brighton School Board, following upon the 
 report which I made upon a thousand children in a 
 selected school, appointed a special teacher to a small 
 class of " feebly-gifted children." The London Board 
 were the first to institute classes of special instruction 
 for such children, and Birmingham, Leicester, Brad- 
 ford, and Bristol have taken similar action. 
 
 The work of conducting such "special classes"
 
 99 
 
 must be laborious ; but it is likely to prove very 
 interesting, presenting many distinct educational 
 problems which are quite apart from the ordinary 
 work of the school-room. Following a suggestion made 
 by the Committee who conducted the inquiry to the 
 Education Department, the Rev. T. W. Sharpe, Senior 
 Chief Inspector of the Department, was, at their 
 request, present at the inspection of some ot the 
 schools, and expressed his favourable opinion as to 
 the usefulness of the investigation, and a wish that 
 teachers might learn something of the methods of 
 observing children for the purpose of classifying them. 
 A letter was addressed by the Committee to the 
 Universities, colleges, and other educational bodies, 
 suggesting the desirability of establishing lectures on 
 the study of children. 
 
 In the report children are classed in groups ac- 
 cording to their bodily condition or health, brain 
 action, and status in school. 
 
 Chiidren7vifh Developmental Defects. — Such cases are 
 more frequent among boys than girls ; the conditions 
 of body observed may have no further significance ; 
 but, in many cases, other defective conditions are 
 associated. Taking loo boys and loo girls with such 
 defects as are described, we find : — 
 
 In children seven years and under : 23 boys, 35 
 girls also pale, thin, delicate ; 36 boys and 40 girls 
 being dull pupils. 
 
 In children eight to ten years old : 16 boys, 22 girls 
 are delicate ; while 41 boys and 46 girls were reported 
 as dull in school.
 
 In children eleven years old and over : 7 boys and 
 15 girls were delicate, whilst 37 boys and 51 girls were 
 reported as dull. 
 
 Conditions of health may improve as these children 
 grow older ; but an increasing proportion of them are 
 found by the teacher to be dull pupils. To prevent 
 such mental dulness occurring these children should 
 be recognised early in life, that they may be trained 
 appropriately from the first. 
 
 Childre?i ivith Abnormal Nerve-signs. — Taking 100 
 boys and 100 girls with such signs as described, we 
 find :— 
 
 In children seven years and under: 19 boys, 27 
 girls also delicate ; 43 boys, 47 girls being reported 
 as dull. 
 
 In children eight to ten years old: 11 boys, 15 
 girls also delicate ; 42 boys, 41 girls being dull pupils. 
 
 In children eleven years and over : 3 boys, 5 girls 
 also delicate; 25 boys, 26 girls being dull pupils. 
 
 Children, thin, pale, delicate. — Such cases are more 
 frequent among girls than boys when we take the 
 whole number of children in a school ; when, however, 
 we take only well-made boys and girls, excluding those 
 with developmental defects, the proportion of delicate 
 boys and girls is about equal. This fact may be im- 
 portant in considering questions of school method and 
 arrangements. 
 
 Taking 100 boys and 100 girls, all delicate children, 
 in school, we find : — 
 
 In children seven years and under : 52 boys, 66 
 girls also presented some signs of defect in develop-
 
 ment of the body ; 41 boys, 36 girls showed " nerve- 
 signs " ; whilst 43 boys and 43 girls were dull. 
 
 In children eight to ten years old : 51 boys and 50 
 girls presented defects of development, 5 1 boys and 
 5 1 girls showed nerve-signs ; 49 boys and 40 girls 
 were dull. 
 
 In children eleven years and over : 39 boys and 35 
 girls had development defects, 56 boys and 50 girls 
 showed " ner\-e-signs," while 37 of the boys and 35 
 girls were dull. 
 
 Delicate children are often dull and need training 
 and teaching, as well as physical care in other 
 directions. 
 
 Dull and Backward Children. — Taking 100 dull 
 boys and 100 dull girls, we find : — 
 
 In children seven years and under : 45 boys, 55 
 girls have developmental defects ; 49 boys, 44 girls 
 have nerve-signs ; 23 boys and 30 girls are delicate. 
 Note the large proportion of young dull girls that are 
 also delicate. 
 
 In children eight to ten years old : 43 boys, 42 girls 
 have developmental defects ; 63 boys, 56 girls show 
 nerve-signs ; 14 boys and 16 girls are delicate. 
 
 In children eleven years and over : 38 boys, 35 
 girls have developmental defects ; 59 boys, 56 girls 
 present "nerve-signs"; and 7 boys and 10 girls are 
 delicate. 
 
 These facts concerning the common association of 
 defects afford explanation why children are seen so 
 differently from different points of view, by the earnest 
 teacher and the equally well meaning parent. The
 
 teacher finds the child dull and backward ; the mothe 
 sees the " nerve-signs " and indications of delicac} 
 A scientific description of the facts seen indicates botl 
 points of view. 
 
 It has been said that girls are more delicate thai 
 boys ; inquiry and accurate description show tha 
 probably there is not more delicacy among perfect!; 
 well made girls than boys ; when, however, girls an 
 constitutionally weak they tend more to further condi 
 tions of disturbance and disorder in greater proportior 
 than the boys. 
 
 It has been shown that there are children to be 
 seen in the schools below the average in physical anc 
 mental power of all grades ; how does such know^ 
 ledge bear upon school organization and education ? 
 
 The scientific observation of children has othe:ji]g 
 advantages than the development of methods of public intt, 
 education ; from the careful study of recorded observa 
 
 nc:: 
 
 heoiE 
 iga: 
 
 ■hin ■ 
 
 Cor 
 
 8;2, 
 Dger. 
 
 :XUlt2r 
 
 re::: 
 
 tions we may improve the basis for research inif;-- 
 physiological psychology, r5 jr 
 
 All outward expression of mental states and mentai ^ 
 action is by visible movements and results of move; 
 ment ; it is possible then, by analysis of such modeijij,^. 
 of expression, to determine something of the modes o 
 brain action corresponding to mental states. 
 
 In sleep, or a state of healthy unconsciousness, wo 
 see that no movement is occurring in the limbs ; th(' 
 pupils are small ; the movements of breathing art 
 quiet and uniform ; low sounds do not produce action 
 or any subsequent expression. After such full dee^ 
 sleep we see many spontaneous movements. Wt 
 
 iniK: 
 
 lelivt: 
 
 xed 
 
 hodc 
 
 A: 
 lav '■ 
 
 cha:
 
 jnclude, then, that sleep is a physiological condition 
 1 which the brain does not receive stimulation from 
 )e outside ; that its tissue is simply living and grow- 
 ig in healthy manner, and storing up healthy force 
 hich we see displayed in spontaneous movements 
 "ter sleep. 
 
 Contrast this brain state with that seen in a storm 
 i" passion. Bain says (" Mental and Moral Science," 
 S72, page 261): "The physical manifestations of 
 iger, over and above the embodiment of the ante- 
 ;dent pain, are (i) general excitement; (2) an 
 itburst of activity ; (3) deranged organic functions ; 
 ) a characteristic expression and attitude ot body ; 
 id (5), in the completed act of revenge, a burst of 
 vultation." Sir Charles Bell {op. cit., page 77) gives 
 le following description : — " In rage the features are 
 nsteady. The eyeballs are seen largely ; they roll and 
 •e inflamed. The front is alternately knit and raised 
 i furrows by the motion of the eyebrows ; the nostrils 
 e inflated to the utmost ; the lips are swelled, and, 
 "tal ;ing drawn by the muscles, open the corners of the 
 outh. The whole visage is sometimes pale, seme- 
 mes turgid, dark, and almost livid ; the words are 
 jlivered strongly through the fixed teeth ; the hair is 
 ced on end like one distracted, and every joint 
 lould seem to curse and ban." 
 At the commencement of an attack of rage there 
 ay be momentary paleness : this is the best time for 
 chance of quieting the child. Then the breathing 
 seen to be quickened and the face flushes ; the 
 eathing is embarrassed, and the veins in forehead, 
 
 (leej
 
 I04 
 
 face, and neck swell out in consequence, while the 
 lips are swollen and prominent. The eyes may move 
 much, not being under control ; while the hands are 
 opened and closed and gesticulate, and the lips may be 
 seen to twitch at the angles of the mouth. The storm 
 of movement may spread to muscles moving the larger 
 joints of the limbs, the elbows, shoulders, and knees, 
 as seen in biting and stamping. The order of occur- 
 rence of the signs is then pallor, then flushing, and 
 congestion of face from impeded breathing ; this is 
 the order of events most common in an epileptic fit. 
 These movements are first in small parts, afterwards 
 in larger parts of the body. All this indicates a 
 spreading area of brain in strong action, sending out 
 force to the muscles ; such brain action not being 
 under any kind of control from without. The ex- 
 haustion that follows corresponds with the large area 
 of brain that has been discharging motor energy, and 
 wasting it. Here, as in other cases, a brain not well 
 under control wastes energy which good guidance might 
 have saved; good training is an economy of force to 
 all, and specially in the weak. 
 
 A spreading area of brain in over-action is seen in 
 stammering ; here the spasm accompanying and 
 causing the defect of speech may be seen to com- 
 mence in the muscles of the face about the angles of 
 the mouth, in depression of the lower jaw, or in 
 knitting of the eyebrows. Then the tongue is thrown 
 into spasm, and, it may be, the muscles of respiration 
 as well. The march of the spasm should be noticed ; 
 it usually recurs in the same order. On the first
 
 I05 
 
 indication of visible spasm, which usually precedes the 
 sound of the stammer, the child should be stopped in 
 his effort to speak. Most of the children who stammer 
 are boys. 
 
 A spreading area of movement may be healthy, as 
 the resumption of spontaneity of action all over when 
 children are let out to play ; but such usually removes 
 for the time the previous order or method of mental 
 action. Laughter is another example of spreading 
 area of motor brain action ; and it is apt to remove a 
 line of thought. Could you induce the expression of 
 joy and laughter in the boy in the first stage of anger — 
 say by imitation of you or of the other children — 
 much might be done to improve his mental status. 
 
 Translation of mental states from teacher to pupil 
 is largely effected by imitation of the visible expression 
 seen in the teacher by the pupil. The appearance of 
 strength, fatigue, or quiet mental attention in the 
 teacher is imitated by the children, thus placing their 
 brains in a similar attitude. Truly, the study of phy- 
 siology does not lessen our moral resposibilities. 
 
 There is one item in imitation I wish to draw 
 attention to. After telling the child to do as you do, 
 raise your right hand : probably the child will raise his 
 left, which is opposite to your right, in place of doing 
 as you do ; I believe such mode of copying should be 
 checked as being inaccurate. The principle of imita- 
 tion extends to the smallest details; in teaching speech 
 the pupil should look fixedly at the movements of the 
 teacher's mouth, and imitate them as well as the 
 sounds produced. To bring about such accurate 
 
 I
 
 io6 
 
 imitation it is necessary to cultivate in the child the 
 habit of fixing the eyes on the object he is told to 
 look at. 
 
 I think it must be evident from what has been said 
 that, in many instances, it is quite possible to observe 
 the motor signs expressing mental states, and to de- 
 duce therefrom the modes of brain action correspond" 
 ing to such mental attitudes. I have not space to 
 follow out this subject here. If you succeed by your 
 personal skill in improving the expression of the child 
 in his movement and action, you have succeeded, to 
 some extent at least, in improving his brain, removing 
 its disorderliness, increasing thereby mental and moral 
 aptitude. 
 
 I have often wished help from teachers in regard to 
 children in whom twitchings, ill-balance, slowness oi 
 response, want of due movement or fixation of the 
 eyes, awkward action, or other " abnormal nerve- 
 signs," indicated " brain disorderliness." 
 
 Training adapted to such purpose differs from many 
 of the modes of physical training commonly employed 
 in schools. To improve the action of the child's 
 brain by physical exercises he should be trained rather 
 by his sight in imitation of the teacher's movements 
 than by drill conducted by the word of command or 
 by music. Marching and exercises with dumb-bells, 
 poles or clubs, as well as with the closed fists, are very 
 useful means of increasing muscular power and im- 
 proving the chest. To co-ordinate or regulate the 
 brain by physical training, " free exercises " are needed. 
 There should be nothing in the hands as they move
 
 107 
 
 simply under guidance of the brain and directed by 
 sight of the teaclier's movements ; as far as possible 
 the fingers should be separated or open. With the 
 hands held out in front, each on a level with the 
 shoulder, and the distance of the body apart, make 
 movements of the fingers in regular order, such as 
 those performed in playing the piano — regular in time 
 and in degree of movement. 
 
 Eye movements need training ; many children and 
 some adults look towards an object by turning the 
 head in place of moving the eyes in their sockets. 
 
 It is shown by the Census that 24 out or every 100 
 persons living are children of school age. This shows 
 the magnitude of the work of public education ; its 
 results during the past twenty-five years are indicated 
 in a diminution of the numbers of paupers and of 
 the criminal classes. The effects of education having 
 been shown to be beneficent, it is important that all 
 children should be brought under its influence ; it has, 
 however, been shown that some groups of children 
 cannot profit by the ordinary methods of instruction, 
 but require special training adapted to their special 
 needs. 
 
 In some schools the dull and backward children ot 
 various ages are accumulated as Primers or in a 
 Standard o, which mostly contains the children too 
 old for the infant school and too backward for 
 Standard I. ; or in a class where older children who 
 are dull are accumulated higher up in the school. In 
 such classes the arrangements, the number of pupils 
 in each class, and the selection of the teacher, should
 
 io8 
 
 be adapted to the special difficulties of dealing w 
 those children whom it has been shown particula 
 need careful and individual attention. 
 
 It is shown in the Report of the Education Depa 
 ment for England that there were on the registers 
 infant schools : aged eight to nine, 28,839 • aged nil 
 to ten, 5,331 ; aged ten to eleven, 2,185 children. 
 
 The most important preparation for dealing wi 
 children and building up their character is to knc 
 child-nature; and, in dealing with children in any w\' 
 exceptional, it is equally necessary to know ti 
 individual child as an object of study. For this pi 
 pose special practical and theoretical instruction 
 needed in training colleges and elsewhere as to tl 
 indications of the brain condition of children — the 
 mental aptitude, weaknesses, and peculiarities. Tl 
 teacher should be enabled to give a description of tl 
 children in a class, indicating the condition of eac 
 pupil as a basis for school classification. 
 
 I hope that what has been said in the precedii 
 pages may be useful, and afford assistance and e 
 couragement to many in pursuing an interesting stuc 
 of child-life with the object of developing the characti 
 of each child. 
 
 6^ 
 
 
 London : C. F. Hodgson & Son, 2 Newton Street, High Holborn, W.C
 
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