What, then, are the first problems to be solved? Let us consider just exactly where we are in the examination. Here are the children picked out by the teachers. The inspectors themselves have checked the selection and referred back some of those selected, but very few, if they have carefully directed the methods of choice from the beginning. The children presented are backward in their studies. Inquiries regarding their school attendance have shown that the retardation is not due to irregular attendance. The examination of their intelligence has confirmed this judgment. It still remains to discover whether, amongst all these children who are unable to follow the ordinary school curriculum, there do not exist some who are not, properly speaking, mentally deficient, but who are suffering from some illness. May we not find amongst them some who require medical treatment rather than special teaching--_e.g._, cretins? And, lastly, may there not be some children whose mental deficiency complicates some other disease, such as epilepsy? These are problems which are essentially medical, and which it is necessary to solve before admitting a child to a special school. Let us consider them in order. =1. Is the Case one of Mental Deficiency, or of an Intercurrent Mental Affection?=--To tell the truth, there is not often any doubt. However, there are two circumstances in which doubt may arise. In the first place, an arrest in a child's mental development may be the expression of a state of depression which indicates a psychosis in the course of evolution, or it may be the first sign of decadence in one of those degenerates of whom Morel speaks, who seem to have "a limited mental existence." Such cases, which some authors describe under the name of "dementia precox," require a medical regimen. In the second place, it is possible that the etiological factor is alcohol. Alcoholism in the parents is frequently the cause of mental deficiency. But the effects of drinking do not always stop there. The child itself may be made to drink, and consequently the doctor may sometimes find symptoms resulting from direct intoxication--nightmares, or tremor of the hands. Such intoxication may be responsible partly, if not entirely, for the want of progress at school, and also for the irritable temper which the child shows in class. It would be necessary in such cases to see the parents, and to advise a different hygiene for their child at any rate, if they themselves cannot be persuaded to give up their bad habits. In this way one may be able to avoid sending the child to a school for defectives. It is apparent that even if the child were sent to such a school, it would be necessary to put a stop to the administration of alcohol. The rarity of such cases makes their exposition of almost theoretical interest.