The Backward Baby

The Backward Baby. By Herman B. Sheffield, M.D. New York: Rebman Co., 1915. Pp. vi+186 (illustrated). This "treatise on idiocy and the allied mental deficiencies in infancy and early childhood," was awarded the Alvarenga prize of the College of Physicians of Philadelphia, July 14, 1914. The author's aim "is to present to the profession a practical survey of the etiology, pathology, diagnosis, and treatment of the diverse mental deficiencies as they occur in children under five years of age. The existing monographs and textbooks on the'subject are almost exclusively devoted to the study of feeblemindedness in children of school age and adults," he remarks, and it has seemed to him, "that with a more thorough knowledge of idiocy and the cognate affections in infants, the physician would be very much better prepared to ameliorate, or possibly cure, these conditions before the underlying lesions have permenantly destroyed the cerebral functions." Amentia he defines as "not an affection sui generis, a precise morbid entity, but merely a symptom of a large group of congenital and acquired pathologic conditions, principally of the brain and the ductless glands." He notes a fact which is not sufficiently understood by physicians, and hardly at all by the public, who expect to see any and every kind of mental defect cured by an operation,?"Profound idiocy is frequently encountered with seemingly insignificant structural changes in the brain or elsewhere, and vice-versa, gross brain lesions may occasionally be accompanied by only slight feeblemindedness. As a rule, however," he says, "the predominance of characteristic lesions in certain types of cases" permits "the classification of idiocy and the allied mental deficiencies into distinct groups." The lesions are by no means confined to the brain. "The