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
See an interesting article on Idiocy, by Dr. Langdon Down, "Quain's Dictionary of Medicine." Vol. I., p. 926.
"Idiocy and Imbecility," by W.W. Ireland, M.D. P. 36.
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.
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.
