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THE IDIOT;
_HIS PLACE IN CREATION_,
AND
_HIS CLAIMS ON SOCIETY_.
[Illustration: THE EASTERN COUNTIES' ASYLUM FOR IDIOTS AND
IMBECILES.]
THE IDIOT;
_HIS PLACE IN CREATION_,
AND
_HIS CLAIMS ON SOCIETY_.
BY
SIR FREDERIC BATEMAN, M.D., LL.D.,
_Fellow of the Royal College of Physicians_;
_Consulting Physician to the Norfolk and Norwich Hospital, and to
the Eastern Counties' Asylum for Idiots_;
_Associé et Lauréat de l'Académie de Médecine de Paris_;
_Citation de l'Institut de France_;
_Corresponding Member of the Psychiatrical Society of St. Petersburg_;
_Hon. Member of the New York Neurological Society_;
_Foreign Associate of the Medico-Psychological Society of Paris_.
_Author of "Aphasia, or Loss of Speech";
"Darwinism tested by Language," &c._
SECOND EDITION.
LONDON:
JARROLD & SONS, 10 & 11, WARWICK LANE.
1897.
PREFACE
TO
THE SECOND EDITION.
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 heaven
Upon 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 Down[1] 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 ιδιοτης[4]) 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.
FOOTNOTES:
[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 μéτρω ὡς ποιητης, ἡ ἁνευ μéτρου ὡς ιδιωτης" (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.
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]
The above views of Sir J.C. Browne have not remained unchallenged, and
the eminent psychologist has found uncompromising opponents in Mrs.
Garrett Anderson and others, who stoutly refuse to recognise the
position of the "_Tacens et placens uxor_" of old-time dreams. Mrs.
Anderson, who, I need scarcely add, writes most temperately upon this
matter, in alluding to Sir J.C. Browne's assumption of the
intellectual difference between men and women, remarks, "All I would
venture to say is that, if it could be proved that an average man
differs from an average woman as much as Newton differed from a
cretin, it would still be well to give the cretin all the training
which he was capable of receiving.... When we hear it said that women
will cease to be womanly if they enter professions or occasionally
vote in parliamentary elections, we think that those who conjure up
these terrors should try to understand women better, and should rid
themselves of the habit of being frightened about nothing."[14]
The limits of this essay will not permit me to dwell at any great
length on the important question under consideration. There cannot be
a doubt that the tendency of the present age is to encourage women to
choose careers and to accept burdens unfitted for them. In thus
expressing myself, I distinctly deprecate any hostility to the woman's
movement of the present day, which rests on the claim for women for an
open career; and I should be glad to see our universities ignore the
ancient and exploded prejudices, which led to the long subjection of
women to hardship and inequality. They ask for the same facilities as
are enjoyed by men, and they have amply shown that they can compete
with men in intellectual pursuits, and all they ask is to be allowed
to compete on equal terms. I therefore cordially welcome the gradual
emancipation of women from comparative subjection to comparative
freedom; but the multifarious fields of energy and usefulness open to
modern women, have brought with them disadvantages as well as gains.
Whilst, therefore, unreservedly admitting the claims of the _fin de
siècle_ woman to freedom of action and to intellectual equality, I
must think there are certain branches of study, described by a modern
writer as belonging to the "gynagogue" class, which are less suited to
women than some others; and amongst these, I would name the abstruse
study of mathematics, for although success in this branch of knowledge
may lead to a brilliant career as a high wrangler, I think that a
female mathematical athlete is not suited for the duties and
responsibilities of maternity, and that the mental endowments of her
children are likely to be below the average.
I am quite aware that I am treading on dangerous and delicate ground,
but although I would not discourage the highest aspirations of women,
whether of an intellectual, social, or æsthetic character, I must
think that a word of caution is necessary against the overpressure of
the present day in the direction above indicated.[15] With every
desire to treat this question from a liberal point of view, I desire
to emphasise the fact that men and women have different parts to play
on the stage of life, and should be trained differently; but provided
mental overpressure is guarded against, I have no fear of women
engaging in certain occupations which custom has not hitherto
recognised as feminine, and experience has shown us that they may be
safely left to follow the promptings of their own powers and
instincts.
* * * * *
Amongst the various other predispositions to idiocy, I would mention
scrofula, which, according to Dr. Ireland, is the remote cause of
two-thirds of all cases; phthisis and epilepsy in the parents are also
potent factors in the development of idiocy in their offspring.
* * * * *
Before quitting the question of the cause of idiocy, I should like to
say a word or two about what is technically called its histology and
its pathological anatomy. What is there in the brain that makes one
man a senior wrangler and another an idiot? What is it that unfits one
person for the discharge of the ordinary duties of domestic and social
life, and endows another with capacities adapted for a statesman, a
mathematician, or a philosopher? Is it a defect in the quantity or in
the quality of the nervous matter of the brain? Does it depend on a
malformation of the cranium, on the size or shape of the head? does
the form of a cranium illustrate the quality of the mind whose
cerebral substratum it encloses, or can genius of a high order
enshrine itself in a comparatively narrow and malconstructed
tenement?[16] Does mental capacity depend on the size or weight of the
brain, or on the degree of complexity of the cerebral convolutions, or
on their symmetry in each hemisphere?[17] Upon this point, I am bound
to tell you that science speaks with a somewhat uncertain sound,
volumes having been written upon it without any definite solution or
tangible result.
An eminent Italian psychologist, Dr. Mingazzini, in a recent work on
the study of the cerebral convolutions, shows that in men of genius,
the brain offers no certain indications of intellectual eminence,
either by the greater richness of the frontal or the parietal lobes;
and in support of this opinion he cites the researches of Wagner,
which showed that, in the development and richness of the
convolutions, the brains of many celebrated Gottingen professors were
inferior to those belonging to individuals of low intellectual
capacity.[18]
The average brain weight in man may be said to range from 40 to 52-1/2
ounces, and in women from 35 to 37-1/2 ounces; the question of the
increase in size and weight of the brain, in proportion to
intellectual power, is by no means determined; statistics exist of the
weight of 23 eminent men, the list being headed by Cuvier, the
naturalist, whose brain weighed 64-1/2 ounces, whilst that of the
orator, Gambetta, weighed only 39 ounces, being much below the average
weight in the adult male; an imbecile died at the Montrose Asylum,
whose brain weighed 63 ounces, and the heaviest brain on record, which
weighed 67 ounces, was that of a bricklayer, who could neither read
nor write; it must therefore be conceded that no definite statement
can be made as to the relation that brain weight has to
intelligence.[19]
It was formerly supposed that idiots always presented some obvious
malformation of the cranium or skull. This is by no means necessarily
the case; one of the most remarkable cases of idiocy that has come
under my notice was that of a child with a well-formed head,
remarkably handsome face, and a well-proportioned body.
Dr. Ireland says, "the principal anomalies met with in the skull of
genetic idiots are flatness of the head behind, a rapid
slope of the clivus, an osseous rim round the foramen magnum,
unsymmetrical size of the cavities on each side, irregularities in the
wings of the sphenoid, and differences in the size and shape of the
jugular and other foramina; but these appearances are not constant,
and often the skull is quite regular, both in structure and
capacity."[20]
One of the most noted writers on the subject, after stating that a
number of scientific men had spent thirty years in measuring and
weighing the heads of idiots, sums up their conclusions as follows:--
1st. There is no constant relation between the development of the
cranium and the degree of intelligence.
2nd. The dimensions of the anterior part of the cranium, and
especially of the forehead, are, at least, as great among idiots as
others.[21]
3rd. Three-fifths of idiots have larger heads than men of ordinary
intelligence.
4th. There is no constant relation between the degree of intelligence
and the weight of the brain.[22]
5th. Sometimes the brain of idiots presents no deviation in form,
colour, and density from the normal standard; it is, in fact,
perfectly normal.
After such a statement as this, I can readily imagine that some of you
may say, it seems to us that you doctors really know but little about
the genesis of idiocy. I am afraid this is, to some extent, true. We
are only on the threshold of inquiry, and science of to-day is unable
to bridge over the gulf that separates matter from mind.
Modern investigation, however, does not quite bear out the above
sweeping statements in their integrity, although the most conflicting
theories have been enunciated. Doubtless, attention has been too much
concentrated on the gross morphology of the brain, without taking into
account microscopical appearances. Dr. Shuttleworth, in giving the
result of his long experience at the Royal Albert Asylum says, "We
have occasionally found, when least expected, extraordinary defects in
brain conformation;... microscopic examination will discover in many
instances some abnormality of structure, such as the preponderance of
simply formed braincells devoid of processes, denoting persistence of
fœtal structures; or, on the other hand, degenerative changes
resulting from inflammatory atrophy."[23]
Professor Luys, of Paris,[24] gives the result of the examination of
the brain of 14 idiots, the anomalies observed being want of symmetry
in the frontal lobes, and partial atrophy of the cortical folds
especially of the frontal convolutions.[25]
Quite recently, Dr. Andriessen, at a meeting of the Leeds and West
Riding Medico-Chirurgical Society, exhibited specimens of the brains
of epileptic idiots, which showed conditions of microgyria with
atrophy and sclerosis of the convolutions.
In considering the pathology of idiocy, I think sufficient attention
has not been given to the chemical constitution of the cerebral
substance. The most extravagant notions were at one time prevalent as
to the rôle played by phosphorus in the animal economy; the Dutch
naturalist, Moleschott, maintaining that "without phosphorus there was
no thought." A celebrated chemist, Couerbe, also considered
phosphorus to be the exciting principle of the brain, and according to
him, the brain of ordinary men contained 2-1/2 per cent. of
phosphorus, that of the idiot 1-1/2, and that of the madman 4 to
4-1/2; from these data he concluded, "that the absence of phosphorus
in the brain reduced man to the condition of the brute; that a great
excess of this element irritated the nervous system and plunged the
individual into the frightful delirium which we call madness; and that
a medium proportion re-established the equilibrium and produced the
admirable harmony which is none else than the soul of the
spiritualists."[26] Professor Janet, in criticising the above theory,
remarks that the brain of fishes, who do not pass for great thinkers,
contains a large amount of phosphorus, also that the statistics of M.
Lassaigne have shown that the brain of madmen does not contain more
phosphorus than that of sane individuals.[27]
The late Bishop of Carlisle, in rebutting this phosphorus theory,
remarks, "Why should we not go further and assert that there could be
no thought without carbon or without any other element of which the
human body is composed; for you can have no actual thought without a
living creature, and no living creature without a body, and no body
without carbon."[28]
I have treated the subject of the Chemistry of the Brain at
considerable length in my treatise on "Aphasia and the Localisation of
Articulate Language," to which book I would refer those who desire
further information in reference to the connection between the amount
of phosphorus and intellectual vigour.
FOOTNOTES:
[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).
[19] Further information as to brain weight and cranial capacity, will
be found in the author's treatise on "Aphasia and the Localisation of
Articulate Language," chapter xii. (_Prize Essay of the Academy of
Medicine of France._)
[20] Op. cit., page 64.