is a dog," repeating the words many times, allowing the pupils to watch the movements of the lips and tongue as closely as possible. Soon the child associates the sound of the spoken word with the object itself, as he perhaps would never do in the infrequent and casual use of the word at home. After the sound of the word is recognized the class are asked to name the object, the children being placed in a small circle so that they can see each other's lips and faces. One after another the class may learn to pronounce the word. Then another object and word are used in the same way, always taking an object of interest to the child. After names of things are acquired, descriptive and action words are introduced in the same way. These lessons are disguised as play, and are really very interesting to the children. Much tact and patience on the part of the teacher are required, but the final results are well worth the effort.

The extraordinary fondness of the feeble-minded of all grades for music, has already been mentioned. In the school exercises and other assemblies, children who cannot speak six words distinctly, will sing or hum song after song in fairly perfect time and tune, approximating the correct pronunciation of the words as they are able. They undoubtedly acquire the use of many new words in this way. We have taken advantage of this by arranging a series of musical articulation exercises, taking many of these same familiar melodies and substituting for the usual words of the songs, the different vocal sounds of our language.

The common properties, qualities, varieties, sources and uses of familiar things are taught them successfully only by exhibiting actual samples of the fabrics, food products, metals, etc., and allowing them to see, feel, smell or taste for themselves. We have a very comprehensive collection of these objects; also, many minature utensils and implements, articles of furniture, vehicles, life-like models of animals, etc., for daily observation and study. These are supplemented by many large, bright colored pictures and graphic charts, cov

ering the same ground, for comparison with the actual objects. This object teaching, or practical instruction in every day matters, is one of the most necessary and valuable parts of our school work. Memory exercises are of little benefit to the feeble-minded. They do not study as normal children are supposed to do. "The mentally feeble child is specially incapable of comprehending abstractions; all instruction, therefore, must be presented in concrete form which he can not only see or hear, but when possible grasp in the hand as well as in the mind."

The instruction of the higher grade children in the school rooms proper, does not essentially differ from that now given in the lower grades of the public schools. The graphic and attractive methods of the "new education," now so fully appreciated and adopted in the early training of normal children, are especially adapted to the education of the feebleminded. Object teaching has a wide application in the teaching of pupils of every grade. Boys and girls of twelve or fourteen, who have been in the public schools for years, and who have not been able to distinguish or remember the names of the arbitrary characters that we call the alphabet, after their power of attention and observation has been properly cultivated, may soon learn to recognize the word "horse" when they see it in large letters pinned on a picture or model of a horse, and so on with other words. We generally expect these higher grade cases to learn to read and spell, and perhaps they go as far as the Third or Fourth Reader.

They can be taught to write, and tell time by the clock. In geography, as a rule, they understand only what can be shown them from the school room windows or graphically illustrated in a sand garden, or shown them in a picture. In arithmetic they are dull. It is almost impossible to give them much of an idea of number in the abstract. All number lessons are worked out v.ith actual objects, such as buttons, pins, blocks, etc. They may learn to count consecutively, but few can practically compute above ten. A boy who cannot tell

you how many 5 and 5 are, will slowly count out 5 blocks, and then another 5 blocks, and placing them together will laboriously count them all, probably keeping tally on his fingers, and at last triumphantly give you the correct answer. The brightest may learn to add, subtract and multiply, but division is usually beyond them.

Education, as applied to the development of these feebleminded children, is now understood in the broadest sense, not as mere intellectual training, but as uniform cultivation of the whole being, physically, mentally, and morally. The end and aim of all our teaching and training is to make the child helpful to himself and useful to others. As compared with the education of normal children, it is a difference of degree, and not of kind. With these feeble-minded children the instruction must begin on a lower plane; the progress is slower and the pupil cannot be carried so far.

These principles of physiological training of the senses and faculties, of exercising and developing the power of attention, perception and judgment by teaching the qualities and properties of concrete objects, instead of expecting the child to absorb ready-made knowledge from books, of progressively training the eye, the hand, and the ear, these were the methods formulated by Seguin, and elaborated and applied by Richards, Wilbur and Howe, years before the era of the kindergarten and the dawn of the new education. It would be difficult to properly estimate the influence of these original and successful methods of instructing the feeble-minded in suggesting and shaping the radical changes that have been made in the methods of modern primary teaching of normal children.

HORDEOLUM AND CHALAZION: A DIFFERENTIATION. By J. M. HINSON, M.D.

[Read before the Boston Homœopathic Medical Society.]

In considering these conditions it is essential that we have a general idea of the anatomy of the eyelid. If we make a section of the upper lid at right angles to its long axis, we shall find it consists of four layers:

1. Skin.

2. Orbicularis muscles.

3. The tarsus, a dense plate of connective tissue, wrongly termed the tarsal cartilage, and the septum orbitale, which connects the inner edge with the wall of the orbit.

4. The conjunctiva.

Between the layers enumerated, toward the free edge of the lid, there is very little connective tissue. This fact accounts for the minimum amount of swelling, and the intense pain, sometimes associated with inflammatory processes in this region. Beyond the inner edge of the tarsal cartilage, so called, and on either side of the membrane connecting it with the orbital wall, there is a large amount of connective tissue. This permits of the excessive edema, which at times causes total closure of the eyelids in very trifling inflammatory or traumatic conditions. Patients will often present themselves with an eye bandaged. On removing bandages you will find the eye completely closed, and the upper lid bulging so that it will overlap the commissure of the lids. Visions of some startling calamity present themselves. On further investigation the case proves to be nothing more than a simple hordeolum, usually situated toward the nasal end of lid.

At the lid edge most anteriorly, we have the hair follicles containing the roots of the lashes. Of these there are two or three rows. There are also some sebacious and modified sweat glands. Between the conjunctiva and tarsal cartilage, and imbedded on the under surface of the tarsus, we have the meibomian glands and their ducts. On everting the lid they

may be distinctly seen extending inward at right angles to lid edge. It is to the hair follicles and meibomian glands that our attention is directed. We have found that the hair follicles lie on the anterior portion of the lid edge, while the meibomian glands and ducts are situated at the posterior or inner edge, being separated from the hair follicles by the tarsus. From this we see that hordeolum occurs above the tarsal cartilage and chalazion beneath it.

A hordeolum is a circumscribed, purulent inflammation of a hair follicle and surrounding connective tissue. A chalazion is not, as was once thought, a mere retention cyst, but has its origin in an inflammation of the gland and connective tissue around it. Its contents are gelatinous, and in the later stages may become purulent. The process consists of a hyperplasia of epithelium, proliferation of connective tissue, and retention of secretion.

Hordeolum runs an acute course and is of short duration. The inflammatory symptoms are pain, swelling, and frequently marked edema of the surrounding tissues, and increase in local temperature. A chalazion is slow of growth and of long duration, and is characterized by absence of pain, edema, and increase of temperature.

In hordeolum the swelling is uniform, and involves the lid edge. Chalazion, when of any size, is apt to be irregular in outline, if not lobulated. It is situated as a rule above the lid edge. If very close to, or involving the lid edge, we can still make out a line of demarcation between the growth and edge of lid.

The skin does not move over a hordeolum. Over a chalazion the skin moves freely except in some few cases where inflammatory adhesions have taken place between the growth and the skin.

On everting the lid, with hordeolum you will find an even, diffuse congestion of the conjunctiva; with chalazion there will be a distinctive bluish, or bluish yellow area, usually ele