t will be better. Except in the most
spastic states, a certain degree of relaxation is possible by effort,
though not without practice, and this has to be constantly inculcated
and encouraged. After a period varying in length according to the case,
lessons in co-ordinating movements are begun. It is best for the
patient's encouragement to start with the least affected muscles, so
that, seeing the good results, he may be stimulated to persistent
effort. The lessons differ only in detail from those given in the list
under tabes. Improvement is slower than in ataxia.

In birth-palsy cases not much can be accomplished in the way of
education, beyond the attempt by such means as ordinary gymnastics and
lessons in drill and walking offer, until the child shall have reached
an age when he is able to comprehend what is being attempted. For the
imbecile, idiotic, or backward a training-school is the proper place,
where mental and bodily functions may both receive attention and where
constant intelligent supervision is available.

Many children the subjects of cerebral diplegia are credited with less
intelligence than they really possess, partly because they are
necessarily backward, and partly because of their difficulty in
expressing themselves, the speech-muscles sharing in the disease. These
muscles need to be carefully educated, and this might almost be made the
subject of a treatise by itself. Each case will require study as to the
special difficulties in the way of speech. Some experience most trouble
with the vowel sounds, more find the consonants the worst obstacles.
Patient practice in forming the sounds soon produce some results; the
pupil must be taught, like the deaf mute, to watch and imitate the
movements of the lips and tongue.

Seguin's books and the numerous special works should be consulted by the
physician or parent desiring to pursue these methods to their fullest
development.

When once the control of muscular movement begins to improve, more
elaborate exercises may be set. In speech, if the patients be
intelligent, they will sometimes be amused and profitably trained at the
same time by the effort to learn and repeat long words or nonsensical
combinations of difficult sounds, like the "Peter Piper" nursery rhymes.

B.M., aet. fourteen, an intelligent lad, of Jewish parentage, suffered a
forceps-injury at birth, and had convulsive seizures later. He began to
make futile attempts at walking when five or