Early in the month of August, 1888, I received a letter from a lady residing in the interior of California, stating that she desired to consult me concerning her infant, then nearly 9 months of age, which presented signs of mental imbecility. At the time appointed for the consultation, the lady presented herself with her infant. The child, otherwise in good health and well nourished, was decidedly microcephalic. The cranium was symmetrical, and only deviated from normal type in the smallness of its volume. The mother stated that at birth the anterior fontanelle was wholly closed, and the posterior one nearly so. The mother was especially solicitous to learn whether er the child's brain was otherwise healthy; and on being assured that there were no evidences to the contrary, she asked if an operation were not possible whereby the brain could enlarge; or, in her own remarkable words, she said,