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During the course of the cases to be reported, it seemed striking to me that a number of children who suffered from chronic otitis media were hard to manage and were labeled as inferior. It became more striking when the otitis was surgically corrected and an extradural infection was discovered and treated; for the children's behavior showed marked improvement.
There is little relating to this subject to be found in the literature. In fact, it seems to be taken for granted that toxic processes in any part of the body will produce lethargy and dulness and to a considerable extent backward mindedness. It also seems to be the prevailing opinion that this is a field for the psychiatrist, who will unearth some hidden phobia to explain the behavior of these children. Yet it is possible that intracranial pressure and paracerebral infection produce a lethargic, moronic child who cannot seem to