Dr. W. A. Hanchett, of Omaha, Neb., in an able paper read before the American Institute discusses the use and abuse of the kindergarten work. He maintains that a normal child is, in the full sense of the word, a rare specimen, claims that there is danger of over pressure of the young mind, and that the very exercises which are given to strengthen and train and educate may very easily be made a burden and a disturbing element in the child's mental development. He discusses also the age at which children should begin this work and maintains that age alone is not the proper guide in the commencement of their kindergarten of school work. The following extract is well worthy of perusal by any teacher, and many educators would be wise to heed some of the truths, he has here laid down:

How early should children begin mental work?

The dangers of overpressure.

The child begins mental growth with the moment of birth, and in a sense at least, this is mental work, i. e., the activity of the faculties with added power, as the end. The scheme conceived by the founder of the kindergarten, provides for the child's mental work from the beginning; but it always provides a natural activity; such as the children call "fun." It is fun to do such things as afford an expression of the life which is within. Thus it is great joy to a small boy to make a snow man, but not always fun to shovel the paths. The line that might be drawn here, you will say, is between work and play; and for the present discussion let us so consider it.

The mental work of the kindergarten is then mental play; but it is

as valuable in its results to the child's mind as the other forms of mental activity, which we grown-ups call work-aye, it is more valuable-it is, you know, actually easier to develop muscle by playing ball than by chopping wood.

To speak broadly, any mental work in the kindergarten which is not play, should be handled with great care. But even if it is play, activity flowing through natural channels, unmindful of ultimate results, let us not rest too easy. Danger is here. Intelligence is required. A perfectly normal child will not easily be led to play too long, or too hard, or in a harmful manner--but the normal child is a most uncommon specimen.

As before stated, mental growth begins way back where the little one first kicks out against his mother's hand, and kicks again because he feels her resistance and his own strength. Unconscious mothering is a great element in the child's mental development, and conscious mothering may be still greater, for, if he be the nervous child, the weakling, even here may overpressure begin. Babies are frequently cuddled, tossed and excited too much, and the less nearly normal their condition, the greater their danger.

As the child grows older and gets into the nursery, he is still busy with his mental play and needs the same careful guidance against excess, the same building up where he is weak and guiding where he is strong; in short, the same intelligent mothering as when a little baby. It is about. the time that he passes his third birthday that he generally begins to claim some of the rights of citizenship-wants to get with some other big boys like himself, longs to be a member of a community. This is the scope of the kindergarten proper. The too nervous child may be unfit to take his place with a dozen other children at three or three and a half, and the precocious may possibly be ready for it a little earlier.

This small community is a rather delicate organization. The most serious results may arise here if the teacher does not realize the tenderness and susceptibility of these little minds, especially those of the type so common among us, the tense, nervous, precocious child. Overstimulation is the great danger. Over-stimulation through music, through color, through games. But a woman, fit for the responsibility she has undertaken, will view each separate child as an especial study and regard his unmolested development as the one thing needful in his case. Thus the nervous may be calmed, the phlegmatic stirred, the flighty concentrated, and the slow quickened; because, here are all sorts of mental helps to the mental play which each child needs to lead him back to the normal.

The public school kindergarten will receive him at five years of age. Here the danger increases in proportion as he is not a normal child. The kindergarten is a child garden, but the public child garden is so big, that we are trying to cultivate it like our gigantic western cornfields with double X patent, eight bladed steam gang plows.

Individual plants, especially the weak ones, off color, do not flourish as well, as by less complicated modes of "tending."

The usual form of overpressure, discernible among children, who have no kindergarten training, or only the experience of the mass kindergarten has resulted from the decrease of their natural allowance playwork, and the increase of their share of work per-se, that is, work in which the process has no interest to them and the result of the work, only a remote interest. (As for example, a boy learning the multiplication table that he may keep accurate accounts when he is a man.) This form of abuse tends to leave the children unimaginative and dull, nervous and irrascible, or still more commonly makes the do-less good-fornaught character, as it may chance to effect different children.

But you say, in effect at least, the multiplication table must be learned--the boy may make the snow-man, but he must shovel the paths. So when should real mental work begin?

In the mental play-stage the child gains a great amount of power. He can think clearly, imagine vividly, and concentrate for a considerable time. Now these attributes are his to use. Now, he may will to do mental work, because he wishes a result. The success of his working depends more upon his accumulated power than upon his will. Just as the amount you give a beggar, depends, in the ultimate, upon the amount you have in your pocket, rather than the times you put your hand in.

This willingness to work or make continuous application when it is not fun, is a habit to be cultivated after a certain amount of power is gained, and all must admit it to be a habit of indispensable value, to which all successful men must attain. In the advanced work, the kindergarten may begin to cultivate this habit, but it must always be done with intelligence, lest the legitimate function of the kindergarten be destroyed. The primary school is its natural field, but no child should enter the primary school, or begin to do mental drudgery until he has reached such a development as will insure his safety from the stupidity of nerve wreckage, which is the inevitable result of premature mental work.

In closing, we would say, the child begins mental work at the beginning, the mother being his inspiration and guide; he continues with her in the nursery, and passes at three and a half into the kindergarten, where he finds another play-mother as sympathizer and friend, and others of his own age. These have an influence much needed for his own social development. He is ready for the beginning of so-called mental work when his condition and not his age so declare, usually at about six and a half or seven years.

Much attention should be given at all times to posture and comfort of each individual; to ventilation, temperature, and all hygenic and sanitary conditions.

CHOREA.

BY WM. H. JENNEY, M. D., KANSAS CITY, MO.

Chorea is classed as a functional disease. There are two forms, the minor and the major. The major form produces great disturbance of the motor nerve centers and the nutrition of the nerves is greatly affected so that great pathological changes take place, particularly in the heart. The disease is usually limited. It affects the co-ordination of the nerves producing weakness of the muscles, also mental weakness. One sixth of the cases can be traced to heredity, the parents or friends having epilepsy, insanity or chorea itself.

Chorea is a disturbance of the latter part of child life, the earliest authenticated case that I found quoted in works on nervous diseases being three and one-half years of age. I shall now present one at the age of two years.

Without going into the symptoms of chorea I will recite my case at once. The subject of this paper is now two years old. When she was born there was nothing unusual about her except that she was very well developed. She continued to thrive until a year old when she began to get more nervous than usual. I thought this was due to the teething process as she was unusually fretful and sleepless. I gave Chamomilla with good effect for a while when she got to starting and jerking at trifling noises, etc. This called for Ignatia which seemed to act well and she recovered. I thought it was all reflex from teething. At about one year old and several times after that the child had severe falls from her bed, once or twice producing nausea and vomiting from striking the back of her head but seemed to suffer no bad results such as would be produced from concussion. Arnica always seemed to cure her.

At about eighteen months she commenced having more jerking spells and slept badly when the usual remedy, Ignatia, helped her. For several months I did not hear from her when one day the mother brought her to my office and she was in continual motion, swaying back and forth, throwing her arms and legs, continuous motion, did not sleep but a little while at a time but when she did sleep she remained quiet. She had weakened in mind and did not recognize her parents or grand parents. She did not say her baby words, papa, mama, kitty, etc., but seemed perfectly blank as far as any intelligence was observed. She did not attempt to stand alone by a chair as she could do by her parents taking her hands she could bear her weight and her ankles were strong. All that was lacking was the twisting of the mouth that is usually found in chorea. I diagnosed the case chorea and have been treating her for this disease for the past two months so that she sleeps beautifully. The motions are less severe and at intervals during the day she is quiet. At times she plays with her toys. She now stands by chairs and when she is aided walks mechanically. Her intellect is still a blank almost.

I will speak of one remedy that has benefited her the most. Passiflora has been so successful in making her sleep that the mother told me to-day that now she did not give a dose oftener than once in three nights. Her present remedies are Cicuta 30 and Ignatia.

The history of the case is that of heredity. Her mother is very nervous and her aunt has had epilepsy for years. Her father is nervosanguine and not robust so that I am safe to place the disease as of neurotic origin rather than to any injury producing concussion. It has been to me a most interesting case as being so young I can make nothing of it but chorea. There is nothing about it like epilepsy, she has had no fits, but the mental side might show a tendency to epilepsy in the future and I fear it.

I would like to say in conclusion that I am a great believer in Passiflora. I have used it for several years with good success in spasms for children and adults. It has never failed me. I gave it to one child two weeks old that had had so many spasms that when I got to it at least six hours after they had commenced I thought the child dead as I could detect no heart action or respiration. I stirred it up to see if I could find any life when another spasm came on and that was all the life I found. I gave Passiflora. The child is now two years old and a daisy. I never use anything else in spasms now. Excuse me for my divergence from the

subject of Chorea to spasms.

EXTRA UTERINE PREGNANCY.

BY D. M GIBSON M. D., ST. LOUIS.

By the above mentioned term is meant the product of conception, developing to a greater or less extent of perfection in the human subject, outside the uterus. Clinically it is known only in such cases as develop to a degree that makes them clearly recognizable or causes interference by surgical measures.

Contention is made by standard authors, that all Hamatocele arise from the breaking loose of enlarged ova and that but few cases, if any, have their origin in aught else than extra uterine pregnancies; usually in the very early period of gestation, and claim that such an occurrence is by no means infrequent; absorption, removing all traces of the bleeding or remains of the ova.

Others equally prominant, scoff at such a theory, and deride the idea of any case being termed, extra uterine pregnancy, if a well developed foetus is not discovered, and that is comparatively speaking seldom done. From the limited experience of the writer, he inclines to the former theory, and this the more from the fact of three cases met with and positively identified as pregnancy extra uterine, "the symptoms were by no means clear, and in one case, the woman, the mother of three children, and nursing her infant, had not the least idea that she was pregnant at all, and