As stated in the preface to the first edition, the arguments contained in this essay formed the nucleus of an address advocating the claims of the Idiot upon the philanthropists of East Anglia, at a public meeting held in Norwich, in support of the Eastern Counties' Asylum for Idiots, under the presidency of His Grace the Duke of Norfolk, K.G., Earl Marshal of England.

In acceding to the request of the Board of Directors to publish a second edition, I have thought it right to retain the form of a public oration, as requiring less modification in the phraseology of the appeal for help, than would otherwise have been necessary.

Much additional matter has been added, especially in reference to Consanguine Marriages, Parental Intemperance, Overpressure in Education, and other factors in the causation of Idiocy.

I have tried to show how the study of the Idiot is calculated to throw light upon the abstruse question of the connection between Matter and Mind, and that it is a subject fraught with interest not only to the Philanthropist, but to the Theologian, and to the Political Economist.

Although I have endeavoured to explain my views in popular language, I trust it has not been at the sacrifice of strict scientific accuracy.

FREDERIC BATEMAN.Norwich,January, 1897.

THE IDIOT; HIS PLACE IN CREATION, AND HIS CLAIMS ON SOCIETY

As Consulting Physician to the Eastern Counties' Asylum for Idiots, it is my privilege to advocate the claims of one of the most important charities connected with the Eastern District of England, and which, as such, is calculated to excite an especial interest amongst the philanthropists of East Anglia.

The Eastern Counties' Asylum for Idiots is an institution founded specially for the reception of patients from Norfolk and the three other Eastern Counties, just in the same way as the Royal Albert Asylum, at Lancaster, is intended for patients from the seven northern counties. It is, therefore, essentially an East Anglian Charity, and I dwell especially on this point, because, being situated at Colchester, I think there is an impression in certain quarters, that this institution is less intimately connected with this locality than some other charities, the claims of which are periodically brought under our notice. I feel that the managing body themselves have been to blame for this impression, from having in the first instance adopted the ill-advised name of Essex Hall – a name, however, now abandoned, as tending to convey the impression that it was an Essex charity, whereas, as I have before said, it is an institution intended for the care and treatment of Idiots from the four Eastern Counties of Norfolk, Suffolk, Cambridge, and Essex.

I have so often been called upon to plead the cause of this charity before a Norfolk audience, that I should have preferred that some other person had been selected to represent the Asylum at this meeting; for when the subject of the appeal is always the same, it is difficult to prevent one's thoughts from occasionally running in a similar channel as on former occasions; the Board of Directors having, however, invited me to act as one of their deputation, I acceded to their request with the greater readiness, as it affords me the opportunity, on the part of the authorities of the Asylum, of expressing our grateful thanks to his Grace the Duke of Norfolk for the honour he has done us by his presence here to-day, thus evincing the interest he takes in the charitable institutions of the county, by consenting to preside over a public meeting in the historical city of Norwich.

In the few words that I shall address to you, I wish particularly to avoid falling into the error common to many speakers – that of exaggerating the importance of the subject they are treating. Many a good cause has been damaged by the indiscretion of its own advocates, who, in their undue zeal, endeavour to impress their audiences with the notion that the particular charity for which they plead is the one above all others that has a paramount claim on the support of a philanthropic public. Now, I have no desire to produce a sensational effect, or to create an artificial interest in my subject by indulging in the language of hyperbole. I have a plain unvarnished tale to tell, that requires no meretricious adornment to arrest your attention, for I am here to plead the cause of an unfortunate branch of the human family, who, by the very nature of their infirmity, are unable to say a single word for themselves, and whose mute appeal must excite universal sympathy.

Happily, we live in an age when the spirit of philanthropy is abroad, and all that Christian sympathy can suggest is being done to relieve the sick and suffering poor. Amidst all the boasted culture of antiquity there existed no hospital; go to Athens and to Rome, those seats of early civilization, and you will find at the former the ruins of the Acropolis, and those of the Coliseum at the latter, but no trace of the remains of a hospital or asylum; whereas in the present day, hospitals and asylums are springing up in every locality, and East Anglia is certainly no exception to the rule, abounding, as it does, in charitable institutions of every description, the object of which is to improve the condition of the labouring class, and to lessen the ills that flesh is heir to; and it may truly be said, as far as this country is concerned, that —

"The quality of mercy is not strain'd;It droppeth, as the gentle rain from heavenUpon the place beneath; it is twice bless'd:It blesseth him that gives, and him that takes."

Whilst admitting all this, I maintain that there is an unfortunate class – that of idiots – which has not hitherto received that share of attention to which it is entitled. Why is this? Is it due to a pampered selfishness which has chosen to draw a curtain of indifference around this unfortunate branch of the human race? Is the fountain of charity frozen up in East Anglia? Nothing of the kind, and I think this apparent neglect is mainly due to a misconception as to the nature of idiocy, and as to the amount of amelioration of which the subjects of this unfortunate infirmity are susceptible. It is with the view of removing this erroneous impression, that I have been requested to say a few words to you about idiocy, from a scientific point of view, my desire being to instruct the mind of the public as to the nature and character of the evil to be contended with, as to the probability of alleviating it, and as to the means best adapted to the attainment of this object.

In the few remarks that I shall make, I hope to show you that the study of idiocy is fraught with interest, not only to the man of science and the philanthropist, but to the political economist, the statesman, and the theologian. If it be asked what possible connection there can be between theology and idiocy, I would say, that if time permitted, I could show that the study of the nature and attributes of the idiot has a striking bearing on the much-disputed question of the connection between matter and mind, and also that it points to a conclusion directly opposed to the materialistic tendencies of the day.

DEFINITION OF IDIOCY

Great confusion exists in the public mind as to the nature of idiocy. What is an idiot? Dr. Séguin, a celebrated writer on this subject, has described idiocy as a "specific infirmity of the cerebro-spinal centre," a definition which I need not say applies to a variety of infirmities to which flesh is heir, and such a definition only serves as a cloak for ignorance. Shakespeare, that wonderfully accurate observer of human nature, in several of his dramas has given a very good description of the acts of the idiot, who, he says, is "one who holds his bauble for his God;" and again, as "one who tells a tale full of sound and fury, signifying nothing." But neither he nor the psychologists of his day knew enough of the natural history of the idiot to attempt a logical definition.

As I have spent a great deal of time in the investigation of obscure points of cerebral pathology, of course the question of the idiot has not escaped my attention, and I submit the following definition: —

An idiot is a human being who possesses the tripartite nature of man – body, soul, and spirit, σωμα, ψυχη, πνευμα, but who is the subject of an infirmity consisting, anatomically, of a defective organisation and want of development of the brain, resulting in an inability, more or less complete, for the exercise of the intellectual, moral, and sensitive faculties. There are various shades and degrees of this want of development, from those whose mental and bodily deficiencies differ but slightly from the lowest of the so-called sound-minded, to those individuals who simply vegetate, and whose deficiencies are so decided as to isolate them, as it were, from the rest of nature.

Dr. Langdon Down1 divides Idiocy into three primary groups: Congenital, Developmental, and Accidental. The Congenital includes all cases which at the period of birth manifest signs of the defective mental power. The Developmental group includes cases where the child manifests an average intelligence through infancy, but he is born with a proclivity to a mental break-down during one of the developmental crises, such as the first dentition, the second dentition, and puberty; the brain and nervous power are sufficient for their early years, but are insufficient to carry them through evolutional stages. The Accidental group includes cases where the child has been born with a normal nervous system, when unfortunately a fall, a fright, epilepsy, or some other cause may lead to a mental break-down, not of a genetic, but of a purely accidental origin. The various forms of idiocy are described in minute detail by Dr. Ireland,2 to whose classical work I would refer those who may desire further information on this subject.

The first idiot that attracted the attention of scientific men was looked upon as a savage man, and every treatise on the subject contains some allusion to the so-called savage of the Aveyron, who excited so much curiosity, speculation, and interest among the psychologists of Paris in the early part of the present century.

In old books on medical nomenclature idiocy was classed amongst the varieties of insanity, and the visitor to a lunatic asylum half a century ago, would find the idiot skulking in the corner of a courtyard chained to a staple, and lying on a litter of straw; in fact, he was considered and treated more like a wild beast than a human being. He had but little talent given, and by neglect or abuse that little was lost; until, growing more and more brutal, he sank unregetting and unregretted into an early grave, without ever being counted as a man. Now, idiocy is not a form of insanity, and it is most important that no confusion should exist in the public mind upon this point, as the association of idiots and insane patients in the same asylum is a positive disadvantage to both classes. It is always a painful thing to see idiot children, whose mental faculties and physical powers, as I shall presently show, are capable of much development and improvement, wandering, without object or special care, about the wards of a Lunatic Asylum. They cannot receive there the training and supervision they specially require, and they often seriously interfere with the comfort of the other inmates, and meet in return, with ridicule and unkindness; moreover, their presence is a serious obstacle to the complete recovery of convalescent lunatics. I desire especially to press this point upon the legislators of the country, and, as in this county, our union houses are far too large for the requirements of the age, I would suggest that one or more of them might, with advantage, be devoted to the care and treatment of pauper idiots.3

Insanity is a loss more or less complete of faculties formerly possessed, it consists of a perturbation of the mental faculties after their complete development, it begins with average intelligence which gradually diminishes; whereas idiocy begins with a low amount of intelligence, which, in many instances, gradually increases; the difference has been thus beautifully described by a French psychologist, "L'homme en démence est privé des biens dont il jouissait autrefois, c'est un riche devenu pauvre. L'idiot a toujours été dans l'infortune et la misère." (The man that is mad is deprived of possessions which he formerly enjoyed, it is a rich man become poor; whereas the idiot has always been in misfortune and misery.) The distinction between the idiot and the insane is clear and marked. The madman suffers from abnormal development of brain, the idiot from an ill-developed brain – the mind of the madman is not in proper balance, in the idiot it is not in proper power.

The poor idiot (the word being derived from the Greek ισιοτης4) is alone in the world; isolated as it were from the rest of nature, he sees but does not perceive, he hears but does not understand or appreciate; the organs of sight and hearing may be perfect and yet useless; the impressions formed upon the optic and auditory nerves are duly transmitted to the sensorium, but no idea is there excited; he cares for nothing, and is alike indifferent to the grandeur as to the beauties of Nature; he stands unmoved at the thunder clap, the foam of the rushing cataract, or the roar of the mighty ocean; he heeds not the hum of the insect world or the song of the early lark, that winged chorister of the air; the star-bejewelled canopy of heaven, the mountain landscape lighted up with all the purple splendour of the setting sun, all these are nothing to him – he is a soul shut up in imperfect organs.

CAUSES OF IDIOCY

It will be utterly impossible in the short time allotted to me, to enter at any length upon the various causes of idiocy, a study of which is, however, fraught with many a useful lesson. Suffice it to say that as the cause is always antecedent to any personal history of the child, idiocy is never dependent on the idiot himself, who has never become so through any vices of his own; he being in many instances the feeble expression of parental defects, and sometimes of parental vices, and is therefore more an object for commiseration than certain lunatics, who, in many instances, have become so through faults of their own. As to the social aspect of idiocy, it recognises no distinction of rank; it may occur in the homes of the affluent, or in the hovels of the most indigent. It is found in all civilised countries, but it is not an evil necessarily inherent in society, and is the result of the violation of natural laws, in some way or other, and at some time or other, and the effect may not show itself for two or three generations. A very large class of persons ignore the conditions upon which health and reason can co-exist; they pervert the natural appetites of the body, and the natural emotions of the mind, and thus bring down the awful consequences of their own ignorance upon the heads of their unoffending children.

Idiocy may be a congenital infirmity, or may be developed in early infancy. In the first category, the cause must necessarily be traced to intra-uterine life, and must be sought for in the history of the parents; in the second class, the cause may sometimes depend upon parental defects, and sometimes is due to a cerebral affection occurring soon after birth, but even in this class of cases, hereditary predisposition must be considered as a powerful factor in the genesis of the disease. In fact, the development of idiocy, whether congenital or otherwise, is in most instances to be attributed to an hereditary morbid vice, and it is one of the most common and striking forms of the degeneration of the human species.

Hereditary tendencies have much to do with the development of physical defects and bodily ailments, and this result is especially apparent in diseases of the nervous system; and there can be no doubt that heredity is a potent factor in the production of idiocy. Dr. Ireland says, "idiocy is, of all mental derangements, the most frequently propagated by descent;" and the statistics of Ludwig Dahl, of Christiana, showed that fifty per cent. of idiots had insane relations, those of Dr. Fletcher Beach showed a history of hereditary predisposition in 76 per cent., whilst those of Moreau, of Tours, give a proportion as high as 90 per cent.

In thus expressing myself, I should be sorry that my remarks should be construed as intended to cast any imputation upon those who have unfortunately an idiot in their family; the cause of the evil may be in some remote progenitor, for the transmission of the infirmity is not always direct, and the neurotic tendency may skip a generation, or be traced even further back.

Intemperance. One of the most fruitful causes of idiocy is the abuse– mark, I do not say the proper use– of alcoholic stimulants, which tends to bring families into a low and feeble condition, which thus becomes a prolific cause of idiocy in their children. From a report on idiocy, by Dr. Howe and other Commissioners appointed by the Governor of Massachusetts to ascertain the causes of this calamity in that State, it is stated that "out of 359 idiots, the condition of whose progenitors was ascertained, 99 were the children of inveterate drunkards;" and the report goes on to say further, "that when the parents were not actually habitual drunkards, yet amongst the idiots of the lower class, not one quarter of the parents could be considered as temperate persons. From a table drawn up by the late Dr. Kerlin, an American physician, in which the causes of the infirmity are given in 100 cases of idiotic children, I observe that in 38 of the number, intemperance on the part of the parents is traced as an accessory, main, direct, or indirect cause.

At the annual meeting of the British Medical Association, held at Cambridge, Dr. Fletcher Beach read a paper on the Intemperance of Parents as a predisposing cause of idiocy in children. In 430 patients, he was enabled to trace a history of parental intemperance in 138 cases, or 31·6 per cent.; of this number, 72 were males and 66 females."5

Other observers lay less stress upon parental intemperance as a cause of idiocy. Dr. Wilbur found that out of 365 cases in the State of Illinois, only eight cases were assigned to the abuse of drink in the parents; and Dr. Shuttleworth could trace this cause in only 16·38 per cent. of the cases observed by himself and by Dr. Fletcher Beach;6 the same writer, under the head of toxic idiocy, mentions the case of an idiot boy, who was said to have been brought up on porter instead of milk. It will therefore be seen that there exists a great difference of opinion about the influence of intemperance of the parent in the causation of idiocy; but although statistics may vary upon this point, there cannot be a doubt that the children of drunken parents inherit an unhealthy nervous system, which in many cases culminates in idiocy.

Idiocy is especially prevalent in Norway, and Ludwig Dahl, a Norwegian writer, says that to the abuse of brandy, especially in the fathers, but also in the mothers during pregnancy, may be assigned an important, perhaps the most important, influence in the production of the large number of idiots in that country.

In considering this question, we must bear in mind that intemperance is only a relative term; for in the early part of the century we read of our ancestors indulging in a bottle of port wine to each individual, without, it seems, incurring the charge of drunkenness. There cannot be a doubt, however, that the habitual use of alcohol, without being carried to the extent of actual intoxication, is calculated to cause a low and feeble condition of the body, and thus conduce to the production of idiocy in the offspring; for we may fairly assume that what too severely tries the nervous system in one generation will appear in their descendants.7 Without, therefore, exaggerating the influence of alcohol on the genesis of idiocy, I think I shall not be deviating from the path of strict scientific accuracy, if I say that over indulgence in alcoholic beverages is calculated to produce a low state of vitality, and a degeneration of nerve tissue which may culminate in the development of idiocy in subsequent generations.8

Just now that the attention of the Legislature is being prominently called to the treatment of habitual drunkards, it cannot be too widely known that their innocent offspring are but too frequently the victims of the brutish excesses of their parents, who, a few years ago, were well described by the then Secretary of State for the Home Department, when receiving a deputation on the subject, as not quite criminals nor quite lunatics, although nearly approaching both classes in many cases. The above statistics fully corroborate the pertinency of Lord Cross's remarks.

I do not allude to these facts with the view of casting any reflection upon the poor, honest, and temperate East Anglian labourer, who may be afflicted with the calamity of having an idiot child; but I merely mention them in order that they may serve as an additional caution against habits of intemperance, and may strengthen the hands of that noble band of philanthropists who are endeavouring to check the torrent of this hideous vice so prevalent in the present day.

Consanguine Marriages. There is no point connected with the causation of idiocy that has given rise to so much controversy as the marriage of near relations; formerly one of the most popular notions was that consanguineous marriages were among the most common causes of idiocy, whereas the researches of later observers have tended to modify, to a considerable extent, this sweeping assertion.

Different observers have furnished different results, as to the proportion of idiots found to be the offspring of consanguine marriages; thus Dr. Grabham's statistics give the proportion as about 2 per cent., Dr. Langdon Down's rather more than 5 per cent., and Dr. Shuttleworth's less than 5 per cent. The statistics of the Eastern Counties' Asylum, kindly supplied to me by Mr. Turner, the Resident Superintendent, show that about 6·5 per cent. were the offspring of cousins.

Of 359 cases observed by Dr. Howe, 17 were known to be the children of parents nearly related in blood. The history of these 17 families, the heads of which being blood relatives intermarried, showed that there were other causes to increase the chances of an infirm offspring, besides that of intermarriages, as most of the parents were intemperate or scrofulous; some were both the one and the other. There were born unto them 95 children, of whom 44 were idiotic, 12 others were scrofulous and puny, one was deaf, and one was a dwarf! In one family of 8 children, 5 were idiotic.9

Dr. Ireland, who has investigated this point with great minuteness, pertinently remarks that it has been the custom to collect instances of cousins who have married, and have had unhealthy children, as if this never happened to anyone else; and he adds that "the proper way to examine the question clearly, is to find what is the proportion of marriages of blood relations in a given population, and then to inquire if there be in the issue of such marriages a larger percentage of insane, idiotic, or otherwise unhealthy children."10

There cannot be a doubt that consanguinity has hitherto been considered too great a factor in the production of idiocy, and that in weighing the evidence, we must not lose sight of the fact that in many cases recorded, other factors beside intermarriage of relatives have contributed concurrently to the development of the mental defect.11

Educational Overpressure. There is one cause of idiocy which has been pointed out by Dr. Séguin, and which he says is due to the unsatisfactory social conditions under which women of the present day exist. "As soon," he says, "as women assumed the anxieties pertaining to both sexes, they gave birth to children whose like had hardly been met with thirty years ago."12

Great prominence has lately been given to this subject by an oration on "Sex in Education," by Sir James Crichton Browne, at the Medical Society of London, in which he called attention to the "growing tendency to ignore intellectual distinctions between the sexes, to assimilate the education of girls to that of boys, and to throw men and women into industrial competition in every walk of life." Elsewhere, he adds, that "to throw women into competition with men is to insure to them a largely increased liability to organic nervous disease… Woe betide the generation that springs from mothers amongst whom gross nervous degenerations abound." Sir J.C. Browne supports his views by showing that there are organic cerebral differences between men and women, and that therefore they must be educated in different ways, being destined to play different parts on the stage of human life.13

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