Indication for the treatment is determined by the likelihood of permanent unfitness for productive life. Every case has to be considered on its own merits. For instance, bilateral blindness or bilateral deafness alone, are insufficient indications for the treatment. In meningomyelocele it should be investigated whether palsies are present. Among deformities, only really severest cases with extensive deformities are to be treated, in mongolism, only severest cases which are combined with mental deficiency of a high degree.
All cases are to cleared up diagnostically to the last detail.
In addition to a complete history, including history of heredity, special examinations such as encephalography, arteriography, X-ray studies and others are to be performed. In mongolism, mere mongoloid habitus should be differentiated from mongoloid idiocy. Also the question of heredodegenerative developmental disturbances and diseases are to be cleared up in every case. Apparently there was some snag about disposing of the children quickly enough, because of the shortage of suitable poison. It is a case of idiocy of severest kind with great erratic unrest, see-saw movements and outspoken destructive drive.