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and in mentally defective children is probably the chief cause in producing the excessive proportion
of mouth breathers amounting to perhaps 50 per cent., a condition without other defects which is
comparatively uncommon in the mentally normal children. This catarrhal condition often
results in infection of the lymphatic tissues, and in children of low vitality the infection sets
up chronic inflammation. Thickening of the soft palate leads to impaired tones in the nasal
sounds. Discharges sometimes start pharyngitis, which gives the child the appearance of
having nasal trouble, and an excoriated upper lip. A remote result not uncommon is persistent
conjunctival troubles and blepharitis, which requires treatment at a throat rather than an eye hospital
if a cure is to be hoped for. For some reason apart from the organs of the special senses, the
existence of hypertrophied structures in this nasopharyngeal region, adenoids especially, is associated
with a peculiar mental condition of great importance educationally, sometimes called aprosexia. Every
teacher should be acquainted with this condition. Such children are often submitted for examination
as mentally defective, and the condition has been classed as spurious mental defect. Apperception is
greatly lowered and the attention cannot be maintained, The nutrition of the frontal areas of the
brain seems affected, whether by interference with the lymphatic drainage, or in more subtle ways
is not known, but these children are common. The condition is remarkable for variability ; they may
be quite sharp and intelligent at times, and again dreamy, absent-minded and wool-gathering. The
variations depend on the condition of the structures of the nasopharynx, being more obvious when
these are swoollen from catarrh or humidity. The children are always mouth-breathers, and often have
other sequelae of the adenoids from which they suffer, not the least important of which is said to be
the development of a character which in later life is timid, fearful and doubting. The great change of
importance, however, in most cases, is the chronic thickening started in the tissues about the eustachian
tubes leading to the middle ears,often causing subsequent aural changes and very intractable deafness
in later life. Sometimes during childhood the grosser form of suppuration of the ears takes place, and
this is more likely to happen from scarlatina or measles in these children than in others. All the dangers
of suppuration of the ears, blood-poisoning and meningitis are much more disposed to in mouth-breathers
than in other children, and many lives are cut short from neglect of this condition. Even in the
inspection of children sitting in their classes the majority of mouth-breathers are at once apparent.
It is also obvious how they tend to gravitate to the bottom classes.
Dr. Niall has compiled the following table from notes in thirteen infant schools in Lambeth and
Norwood :—

Similarly Mr. Elmslie, in examining the newly admitted infants at Campbell-street,found in
104 infants 13 mouth-breathers, 12 having adenoids ana 5 discharging ears.
The breathing drills of the infant school which require the children to breathe both in and out
through the nose should have some effect in calling attention to the condition when existing, and any
teacher who notices the condition should make the parents aware of it. If, in addition, the child is
noticed to snore much at night it may be confidently asserted that operation is required to clear the
nasopharynx.
Mr. Rowntree and Dr. Squire, who have reported on these conditions, insist on the necessity
of children in the infant schools being taught to use their handkerchiefs as a means of diminishing the
chronic catarrh. It is quite possible that constrained attitudes, especially in the attempts to do some
of the fine work of the infant departments may aid the development of mouth-breathing habits.
ACUITY OF HEARING.
The testing of the hearing power in children is always a difficult matter. It is increased in them
by the mental factor being very evident. The younger any group of children probably the better do
they hear, but it is only at a comparatively late period, when they pass from the infant schools, that
the mental reaction to hearing tests is reliable without much care and many precautions being taken.
Any complicated method of testing will fail for school purposes, and further any simple test of a
rigorous nature will probably depend on a few single sounds and the reaction of an individual often
varies considerably to differing sounds.