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 - Des Maladies Mentales, Tome ii., p. 103.]
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 stalks
Or ruined chrysalis of one."
notes
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).
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