ture has been normal for at least two or three days. If the temperature is normal, you may reasonably conclude that you have pretty well gotten rid of the infection. When I return to cow's milk, I begin on a low percentage of fat, and if the preparation agrees with the child, I increase the strength of the food gradually.

Another important point in treating these infants is to see that the feet are kept warm. I do not believe there is anything that tends to cause enterocolitis in children, besides the changes in temperature, more than cold feet. You remember the old adage, "Keep the feet warm and the head cool," and I think it applies especially to infants in all diseases. It is well-known that infants can not resist the two extreme temperatures, that is, extreme cold or extreme heat, for in the winter we have bronchitis and pneumonia in children, and in the summer we have intestinal disorders. They are both disorders of extreme temperature, with bacteria added to them.

Dr. McArthur (closing the discussion): In the first place, I want to thank the gentlemen for discussing my paper so freely.

I do not know that I can add anything of interest to what I have already said. With regard to returning to cow's milk after withdrawing it, I would like to say that each case, being an individual one, should be governed by the circumstances and conditions. In considering prophylaxis, I stated that if a child was artificially fed, especially if milk was given it, it should be withheld for twenty-four or forty-six hours, or longer. Twenty-four hours, I think, in some cases is long enough, where I see the patient in time, and can withhold the milk soon enough. In other cases that are more violent, which have lasted longer, it may be necessary to withhold the milk longer.

With regard to the use of stimulants, I believe that all cases do not require alcoholic stimulants. I believe I

stated in my paper that most cases did require stimulants. I mean by that, most cases that go on for a few weeks. There are a few cases that only last for a few days, where the system is not depressed by the toxemia, by the frequent discharges, and tenesmus, and it may not be necessary to administer alcoholic stimulants to any of the cases that last for several days, or even for a few weeks. However, I think many of these cases will require the administration of some form of alcohol.

In preparing a paper on this subject, I found it was impossible to mention all of the items of interest in the time allotted to the reading of papers, and when I began to prepare this paper, I saw that I had to cut it down to within the time limit.

As regards sterile water, of course we should always restrict the patient to the use of water that has been sterilized.

With regard to dieting the patient at intervals, each case is an individual one, and we must be governed very largely by the circumstances. If there is considerable nausea, I am sure, sometimes it may be necessary to lengthen the intervals of feeding to four hours. At other times, with a good deal of nausea, we may get in the required amount of nourishment by giving small quantities, frequently repeated. However, we should be governed by the circumstances in each case.

The question of malaria is always an important one in a malarial district, and I am sure that all of us who practice medicine in Southwest Georgia have learned to look for malaria as a complication in every disease we have to deal with. We look for it in accidents, during the lyingin period, also in cases of pneumonia, bronchitis, grippe, and everything else, and we may look for it in this disease we have been discussing, and these complications and symptoms are to be met.

THE TRAINING OF EPILEPTIC AND FEEBLE

MINDED CHILDREN.

BY WESLEY TAYLOR, M.D., ATLANTA.

Just how great a responsibility and how heavy a cross has been placed upon a family into whose midst providence has seen fit to send one who, through enfeebled mentality, is unable to appreciate his obligations to society or to adapt himself to its demands, no one who has not had such an affliction laid at his immediate doorstep can fully realize. He who has had a loved one to protect from the unscrupulous, to shield from the mockery of prying eyes or who with embarrassment has offered apologies for the maladroit pranks of a dear one, can sympathize and appreciate. In this broad land of ours there is no family so high or so mighty but that in a few generations will number among its members some unfortunates belonging to this class. You can scarcely look back on any family you know without finding such a luckless one under the protecting shadow of some stray branch, if you know them well. Rich or poor, high or low, weak or strong, all bear some blighted or imperfect blossoms. It can't be helpedit's a part of nature and governed by that remorseless law, "The survival of the fittest." If all of us were equally endowed, the struggle for existence would be turned into one horrible carnage. It is perhaps better as it is, and we take conditions as they are, but it is our duty to make the best of them. We turn with horror from the old Spartan law which condemned the weak, the crippled and the imperfect to destruction in the beginning. There may be some who from a distance stand and say, "A good idea, I ap

prove," but let the blow fall within their own family circle, and they can not cry out too quickly. The poor unfortunates are not responsible for their existence. Their being was thrust upon them and they can not well help but live, though doubtless many of them, if their wishes could be consulted, would prefer otherwise. They are here, and they complicate a household more or less wherever they are. They must be looked after, cared for, protected, fed, clothed and sometimes nursed. In many cases they require a special room or an attendant. They can not be left alone or permitted to meet the guests of the house. There are many who require all the attentions of a baby, or more, as long as they live. Frequently they remain a skeleton in the closet for the entire family, and the mere mention of their existence is tacitly understood to be a painful and tabooed subject. Every medical man in this audience must have run across numerous instances like this in the course of his career. In the families of the rich they are, possibly, only an encumbrance. They send them off to high-priced sanitariums, and the matter is settled. Those in moderate circumstances find them a serious embarrassment, and usually solve the matter by an attendant. The poor-alas, and the enormous majority of us are poor-it is for them that we are especially sorry. In the families of the destitute such an affliction is a terrible calamity. Haunted incessantly by the problem of mere existence, compelled to toil unceasingly for their daily bread, even the children look forward to that time when they can help to lessen the strain of necessity which surrounds their domestic circle. Under these conditions it is that the luckless, helpless ones really suffer. Unable to afford even the humblest sort of an attendant or anything more than the barest necessities, and compelled frequently by circumstances to leave an unfortunate and

helpless creature alone, it is inevitable. I remember well when a boy and out hunting in the country, I came to an humble cabin where, during the absence of father and mother, a feeble-minded youth was chained to a staple in the wall, just far enough from the stove to avoid danger to self or surroundings. And there he was obliged to remain all day, waited upon by his smaller brothers and sisters. It was humane and sensible, but revolting.

One could go on all day describing and enumerating the sufferings endured by the family, as well as by the child, who has fallen in destitute quarters, but our imagination needs no such stimulating.

There are all grades of mental deficiency, from the merely backward and inefficient to the most extreme forms of idiocy. Degeneracy manifests itself in many forms. It may be mental or physical, but it not infrequently is a combination of both. The merely odd person may be a mild example of the degenerate. If we were to start to number them we would know neither where to begin nor where to stop. Satisfactory statistics to show how many such children come within the scope of this article, or need such teaching, are all but impossible to obtain. It is a matter of opinion on which no two people are likely to be of accord. Every school, however small, has several children, at least, who are dull or backward in their studies. Just where the normal ends and where the abnormal begins is difficult to say. Which ones are beyond the reach of domestic tutelage depends on the family. No statistics can be had for our own State, but taking the average of statistics for other States and cities that are obtainable, one child out of about 1,200 is in need of special teaching, and one out of 4,700 is a positive burden to its family. These figures are for this country and are for backward children only, and do not include the lame.