The Idiot: His Place in Creation, and His Claims on Society

Of course, Dr. Ireland has something to say upon this point, and after a brief review of the literature of the subject, he says: "So many cases have been collected of microcephales with open sutures, that it is not likely that anyone will continue to hold that the small size of the brain is owing to the sutures closing in, and thus hindering their growth. Even in those cases where the sutures have closed in before birth, the question still remains whether the brain ceased to grow because the sutures are closed, or whether the sutures closed in because the brain ceased to grow; or, lastly, whether both the brain and its coverings ceased to grow under a common cause."52

The benefits to be derived in apparently hopeless cases of idiocy, from the systematic and persevering use of all the modern adjuvants and appliances now available for treatment, are now so universally recognised, that it would be superfluous to dwell further on this point. Science has done much for the idiot, and she will do more, for her motto is "Excelsior," and her votaries are not content to linger with complacency on the heights already attained, but they look for the period when, by the powerful lever of an enlightened philanthropy, this benighted race shall be raised from the grovelling level of the brute, to the highest attainable pitch of bodily perfection.

I trust that I have said enough to justify an earnest appeal for sympathy with this unfortunate branch of the human family. I have endeavoured to show that a great social evil exists amongst us, and that duty and interest should alike concur to induce us to face this evil and to master it. I have endeavoured to point out how the care and training of the idiot has become one of the recognised obligations of a philanthropic public. At the Eastern Counties' Asylum, we are trying to mitigate as far as we can this great social calamity, and our efforts have hitherto been crowned with unlooked-for success. We are doing a grand and glorious work, and I ask you to come and help us; the Board of Directors, a noble band of philanthropists, who devote a considerable amount of time to the objects of this charity, ask you to come and help us; nay, more, from the cottage homes in East Anglia rendered miserable by the presence of these unhappy beings, a thousand voices cry to you with trumpet tongue, "Come and help us."

We have in the Eastern Counties' Asylum an institution admirably adapted for the care and treatment of the idiot; standing in its own grounds of seven acres, it is furnished with all the machinery necessary to grapple with this great social calamity, and by the judicious combination of medical, physical, moral, and intellectual agencies, we are enabled to develop and regulate the bodily functions of the idiot, to arouse his observation, to quicken his power of thought, and thus develop the sensitive and perceptive faculties; and we have not only succeeded in raising these poor creatures from a state of hopeless degradation to a state of comfort and usefulness, but we have, in many instances, succeeded in kindling up in their dark and twilight minds some dim anticipations of a brighter world; the veil which obscured their intellect has been rendered transparent, and to use the language of the bard of Avon, we have been privileged to observe that —

"As the morning steals upon the night,Melting the darkness, so their rising sensesBegin to chase the ignorant fumes that mantleTheir clearer reason."

In addition to the Asylum proper, the Board has lately purchased a farm-house with 32 acres of land, immediately adjoining the main building. By means of this welcome acquisition, increased accommodation is afforded, and facilities are given for drafting off some of the most tractable patients who require less supervision than the majority of the inmates; moreover, farm work has proved very useful in training some of the patients who come from agricultural districts.

Crossley House.– Our area of usefulness has recently been extended by the munificent gift of Sir Savile Crossley, Bart., of a Convalescent Home, at Clacton-on-Sea. The building has accommodation for twenty patients; it stands facing the sea, in its own grounds of nearly an acre, and its privacy is secured by a walled-in garden, in which the inmates are able to take ample exercise. As a large number of our patients suffer from scrofula, or from some tubercular disease, the want has been long felt of a seaside adjunct, where such patients could be treated in the initial stage. Thanks to Sir Savile Crossley's princely gift, we now possess this valuable addition to our medical resources, the advantages of which cannot be too highly estimated.

The Ladies' Association.– The valuable additions that have recently been made to the Asylum, thus largely increasing the accommodation for patients, have necessarily entailed a largely increased expenditure, which could not have been met by the current income, had not the ladies of East Anglia come forward with great earnestness to help the objects of this Asylum by individual and energetic efforts; and one of the most interesting events of the last few years has been the formation of a Ladies' Association, the establishment of which is entirely due to the earnest and devoted efforts of the Marchioness of Bristol. Its object is to disseminate information respecting the working of the Asylum, to secure admission for necessitous cases, and to organise and carry out annually house to house collections for its funds. H.R.H. the Princess of Wales has given her countenance to this movement by graciously accepting the office of Patroness, several influential ladies have consented to act as presidents over the various districts into which the four counties have been divided, and as many as 1,400 ladies are engaged in this philanthropic work.

The success attending this movement has been phenomenal. During the first year of its operation, the substantial sum of £1,868 6s. 10d. was handed over to the general fund, this amount having been obtained from upwards of 20,000 contributors, who had thus the opportunity of joining in this good work, and whose aid could not have been secured in any other way. The efforts of these charitable ladies have been crowned with such signal success, that the large sum of £9,473 5s. 9d. has been added to the funds of the Asylum.53 This substantial help is very gratifying to the Directors of the Institution, who now rely upon the Ladies' Association for nearly a fourth part of their income; and it is not too much to say that the future success of the Asylum is intimately connected with the continuance of the efforts of these philanthropic ladies, who seem to me to be influenced by the noble sentiments lately expressed by one of their number, that "The simple obligation of all thoughtful women, is that of making the world within our reach the better for our being, and gladder for our human speech. It is a work such as this that I am sure stirs us up to feel that we must also give our help, our sympathy, our lives for other people, and in this work lies the elements of unselfishness."54

All honour to these ladies, who, having learnt the elementary truth that privileges involve responsibilities, instead of hiding their talents in the napkin of selfishness, prefer to go forth as messengers of mercy, to try and flash the electric fire of philanthropy into the slumbering hearts of others, and to induce them to join in their grand and good work. They thus become a force and a factor of influence with all around them, and their reward will be the satisfaction of feeling that they are contributing their part in the great work of elevating these stricken members of our race, from their present unhappy and degraded condition to a higher position in the scale of created intelligence.

I trust I have said enough to show that the idiot ought and must be cared for; and in asking for your support, I will also ask you whether anything can be more gratifying than, as the result of scientific treatment, to see the idiot standing erect, asserting his birthright, and claiming brotherhood with the rest of the human family.

True philanthropy never stops short of the remotest boundary of human want, and in urging upon you the claims of the Eastern Counties' Asylum for Idiots, I would have you remember that I am pleading for a class who cannot plead for themselves, and whose very silence is eloquent with an appeal for your merciful aid.

Remember that these poor stricken individuals are members of the human family. They are heirs with us of all that human beings may hope for from the hands of a common Father. They possess the rudiments of all human attributes, especially the distinctive attribute of educability and of progressive improvement; their bodies are the vehicles which carry souls never destined to perish, through the series of ages, and when the walls of the cottages of clay in which their better part has sojourned collapse, and they mingle with their kindred dust, the freed inhabitants shall wing their way to brighter regions and to a more enduring home, and will thus illustrate the beautiful sentiment of one of our modern poets, when he said:

"In death's unrobing room we strip from round usThis garment of mortality and earth,And breaking from the embryo-state which bound us,Our day of dying is our day of birth."

Each person here belongs to one of two classes. Either you have one of these unhappy beings in your own immediate circle, or you have not. If you have, you can feel all the more for those who are similarly afflicted with yourselves, but have not your means for mitigating their dire distress, and you will think of the narrow home of the humble artisan or labourer, rendered intolerable by the constant presence of one of these afflicted members of our race. If, on the other hand, you have been spared this overwhelming calamity in your own family, and have had the joy of watching the dawn of infant intelligence, and have experienced the delight of seeing the capacities shown in the early life of your own children gradually ripen and develop into the intelligence of manhood, you will look with an eye of pity on the numerous households rendered miserable by the intolerable incubus of the presence in their midst of an idiot child, and will, I am sure, consider any assistance you can render to so good a cause in the light of a thank-offering.

The wear and tear of an excitable idiot child has wrecked many a family and reduced it to pauperism, for not only is such child a dead weight on the material prosperity of the family, but the hands of those who have to work for their livelihood, are sadly tied and hampered, when such an inmate has to be constantly looked after in the home; the labour by which the household is supported is often interrupted by one who can contribute nothing to the common stock, and the time which is so precious to hard-working people must, in part at all events, be occupied in caring for the one, who, if uncared for and neglected, must sink lower in the social scale and fall into a still more degraded condition. The care and treatment of the idiot, therefore, becomes a vital question of Political Economy; for by relieving a household of the burden and anxiety incident to the care of the afflicted child, the parents are enabled to devote all their energies to the support of their family. Moreover, there is often a moral aspect corresponding with the mental aspect of this question, and the presence of an idiot often becomes a source of real danger. Our able superintendent, Mr. Turner, in his interesting report for the year 1895, has illustrated the terrible anxiety caused by the presence of an idiot child in the homes of the poor, by the history of an inmate of our Asylum, who, when at home, being left to mind the baby, blacked its face all over with soot, so that when his mother returned, she might think she had a black baby. On another occasion, his little sister wanted some water, and he told her to drink out of the kettle on the fire, by which she nearly lost her life. This boy, who was evidently a type of the mischievous class of idiots, was once turned out of the Parish Church during service, for pricking another boy with a pin, so that he yelled out and disturbed the whole congregation. Two cases of murder by idiots have been recorded in a report of the Commissioners on Idiocy to the General Assembly of Connecticut; an idiot girl, being left alone with an infant, killed it by striking it on the head with a flat iron; and another vicious idiot killed a man who was working with him, by striking him on the head with a shovel. Esquirol also records the case of an idiot in the Salzburg Hospital, who killed a man by severing his head from his body with a hatchet, and then calmly seated himself by the side of the dead body.55

Philanthropists of the Eastern Counties of England, many of you have been long accustomed to sympathise with suffering and want; here is another outlet for your charitable efforts. The most illustrious landowner in East Anglia has recently extended his Royal patronage to this institution, especially established for the care of idiots from the four counties of Norfolk, Suffolk, Essex, and Cambridgeshire; and his Royal Consort the Princess of Wales has most graciously consented to accept the position of Patroness of the Ladies' Association, thus showing the deep interest that is felt by their Royal Highnesses in this important Eastern Counties' Charity. I ask you to follow their noble example; I ask you to come and help us in our attempts to rescue a large section of the human family from the worse than Cimmerian darkness in which they have been hitherto enshrouded; come and help us to awaken faculties hitherto dormant, to restore lost minds, to arouse these unhappy beings from a moral death to a new birth of perception and feeling; come and help us in arousing the slumbering power to utterance, and you shall hear the once silent tongue eloquent with the outgushings of a liberated spirit.

In conclusion, I wish to reiterate and to emphasise the statement, that these unfortunate members of the human family possess the tripartite nature of man – body, soul, and spirit – σωμα, ψυχη, πνευμα; they have the germ of intellectual activity and of moral responsibility, and this germ, cherished and nourished by the genial warmth of human kindness, fenced round and protected from the blasts and buffetings of the world by the cords of true philanthropy, watered by the dew of human sympathy, although possibly only permitted to bud here, is destined hereafter to expand into a perfect flower, and flourish perennially in another and a better state of being.

"Eternal process moving on,From state to state the spirit walks.All these are but the shattered stalksOr ruined chrysalis of one."

1

See an interesting article on Idiocy, by Dr. Langdon Down, "Quain's Dictionary of Medicine." Vol. I., p. 926.

2

"Idiocy and Imbecility," by W.W. Ireland, M.D. P. 36.

3

I am glad to find that this question of the depletion of our workhouses is engaging the attention of Boards of Guardians, as shown by a meeting lately held in Norwich, to consider the propriety of reducing the number of workhouses in the district. At this conference, which was attended by delegates from various unions, Mr. Bartle H.T. Frere stated that the Aylsham workhouse, originally built for 619 persons, had never had more than 117 inmates during the past eleven years; and that in other unions, not more than a quarter of the actual workhouse accommodation was utilized, although a complete staff of officials was kept in each union. Mr. Frere pointed out the folly of keeping up such elaborate machinery, for such totally inadequate results, and that an enormous saving would be effected by the amalgamation of two or more unions for the purpose of housing their pauper population.

4

This term is applied by the Greek writers to a person unpractised or unskilled in anything – one who has no professional knowledge, whether of politics or any other subject, and it seems to have corresponded with our word layman; thus, Thucydides, in describing the plague that broke out at Athens during the Peloponnesian War, in speaking of a physician and a layman, uses the phrase ιατρος καἱ ἱσιωτης; Plato also uses the word in the same sense (Legg. 933 D), and the same author, in contrasting a poet with a prose-writer, uses the phrase, "εν μἑτρω ὡς ποιητης, ἡ ἁυευ μἑτρου ὡς ισιωτης" (Phaedr. 258 D). I doubt very much the appropriateness of the word idiot as applied to these unfortunate creatures, and I think the American term of Feeble-minded more correctly represents their condition.

5

The question of the influence of alcoholic stimulants on the development of mental disease formed a prominent feature in the proceedings of this congress, and it is also a subject which is just now engaging the attention of pathologists in all parts of the world.

6

"Mentally-deficient Children, their treatment and training." By G.E. Shuttleworth, M.D. Page 36.

7

Toussenel, a French writer, says "La plupart des idiots sont des enfants procréés dans l'ivresse bacchique. On sait que les enfants se ressentent généralement de l'influence passionelle qui a présidé à leur conception." At a discussion at the Obstetrical Society, Dr. Langdon Down is reported to have entertained similar views.

8

I would refer those who may wish to pursue the inquiry as to the baneful influence of alcohol on the human frame, to the celebrated Cantor Lectures on Alcohol, by my friend Sir B.W. Richardson, in which he introduces the physiological argument into the temperance cause, asserting that alcohol cannot be classified as a food; that degeneration of tissues is produced, that it neither supplies matter for construction nor production of heat, but, on the contrary, militates against both. Sir B.W. Richardson's latest views upon this subject are developed in the pages of the "Hospital" for February 1st and March 14th, of this present year.

In France, M. Lunier, Inspector of Asylums, has shown that the departments in which the consumption of alcohol had increased most, were those in which there had been a corresponding increase of insanity, and this was shown most strikingly in regard to women, at the period when the natural wines of the country gave way to the consumption of spirits.

In Sweden, Dr. Westfelt has lately made a communication to the Stockholm Medical Society, containing the statistics of alcoholic abuse and its results in Sweden. He calculates that at least from 7 to 12 or 13 per cent. among males, and from 1 to 2 per cent. among females, of all cases of acquired insanity, are due to the abuse of alcohol; and in reference to its influence on progeny and race, he shows that a steady diminution of the population was coincident with a period when drunkenness was at its greatest height.

9

"On the Causes of Idiocy." By S.G. Howe, M.D. Page 35.

10

"Op cit," page 19.

11

That eminent clinical observer, the late Professor Trousseau, in treating of the influence of consanguine marriages, gives the history of a Neapolitan family, in which an uncle married his niece. There had previously been no hereditary disease in the family; of the four children, the issue of this marriage, the eldest daughter was very eccentric; the second child, a boy, was epileptic; the third child very intelligent; and the fourth was an idiot and epileptic. "Clinique Médicale de l'Hôtel-Dieu de Paris." Tome ii., page 87.

12

"New Facts and Remarks concerning Idiocy," by E. Séguin, M.D., p. 28. Dr. Séguin has been a voluminous contributor to the literature of Idiocy, and for many years his writings were the only available source of information on the management and education of idiots.

13

Sir J.C. Browne, in speaking of the brain of men and women, says there can be no question of inferiority or superiority between them any more than there can be between a telescope and a microscope; but they are differentiated from each other in structure and function, and fitted to do different kinds of work in the world. He maintains that the weight of the brain is less in women than in men, that the specific gravity of the grey matter is less, that the distribution of the blood varies in the two sexes to a considerable extent, and that the blood going to the female brain is somewhat poorer in quality than that going to the male brain, and contains four millions and a half corpuscles to the cubic millimetre, instead of five millions in the case of the male.

14

It seems that one of their own sex is of a different opinion, as in a series of articles in the "Nineteenth Century" for 1891 and 1892, Mrs. Lynn Linton strongly deprecates any departure from the comparatively restricted area of usefulness hitherto open to women, and she even baldly states that it is for maternity that women primarily exist! She also adds, "be it pleasant or unpleasant, it is none the less an absolute truth – the raison d'être of a woman is maternity … the cradle lies across the door of the polling booth and bars the way to the senate."

In a powerful article in the same serial, entitled "Defence of the so-called Wild Women," Mrs. Mona Caird severely criticises Mrs. Lynn Linton's views as to the restrictions she would impose upon the freedom of women to choose their own career.

15

Although the injurious effects of overpressure in education have been principally referred to in the education of girls, the same pernicious results may accrue in the case of boys. Dr. Wynn Westcott, in his work on "Suicide," states that during the last few years there have been several English cases of children killing themselves because unable to perform school tasks. He also says that child-suicide is increasing in England and in almost all Continental states, and that the cause in many cases is due to overpressure in education. Dr. Strahan, writing upon the same subject, in his treatise on "Suicide and Insanity," corroborates Dr. Westcott's views, and remarks that fifty years ago, child-suicide was comparatively rare; but that during the last quarter of a century it has steadily increased in all European states, and that the high-pressure system of education is generally considered as the cause of it.

If any apology be needed for dwelling at such length on the evils of the educational overpressure so prevalent in our days, I would observe that it has an indirect bearing upon the causation of idiocy; for although the sinister results recorded by Drs. Westcott and Strahan may be comparatively rare, still, consequences of a more remote character may ensue, for the injury done to the nervous system is cumulative and transmissible from generation to generation, and a neurotic tendency may be engendered in the offspring of those who have been exposed to this evil, which may manifest itself in the appearance of idiocy or some lesser form of mental defect.

16

One of the most distinguished French psychologists, has thus expressed himself on this point: – "Dans des réunions ou l'idiotisme étendait son triste niveau, il m'est arrivé plusieurs fois de rencontrer des crânes, qui dans leur partie frontale eussent fait honneur aux hommes les plus justement célèbres, et où l'on eût pu trouver avec avantage les organes de toutes les sortes d'esprit, de celui même qui apprend à rire des mystifications et des sots." —Rejet de l'Organologie Phrénologique, par F. Lelut, p. 196.

17

Dr. Wilmath, of the Pennsylvania Institution for Feeble-minded, reports that in six brains the island of Reil was exposed through defective development of the 3rd frontal convolution; in four cases, on both sides; in two cases, on one side only. —Notes on the Pathology of Idiocy.

18

Il Cervello in Relazione con i Fenomeni Psichici. Studio sulla morfologia degli emisferi cerebrali dell'uomo, Torino, 1895. P. 89.

This is a work of great merit, in which the author compares the structure of the brain of man with that of other primates; he then treats of the morphology of the brain in different races, in criminals, in the insane, in deaf mutes, and in microcephales. An extremely interesting chapter is that devoted to the assumed difference of the cerebral hemispheres in the two sexes, containing statistical tables constructed by Dr. Mingazzini himself and others. Although he mentions certain minor differences that have been noticed by different observers, he summarises his own opinion by the statement that, "from the numerous but incomplete observations upon this subject, it may be concluded with certainty that essential differences do not exist" (si può inferire quasi con certezza che differenze essenziali non esistono).