The Project Gutenberg eBook of The Idiot: His Place in Creation, and His Claims on Society

This ebook is for the use of anyone anywhere in the United States and most other parts of the world at no cost and with almost no restrictions whatsoever. You may copy it, give it away or re-use it under the terms of the Project Gutenberg License included with this ebook or online at www.gutenberg.org. If you are not located in the United States, you will have to check the laws of the country where you are located before using this eBook.

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

Author: Sir Frederick Bateman

Release date: May 11, 2012 [eBook #39670]

Language: English

Credits: Produced by Jana Srna, Mark Young, Bryan Ness and the
Online Distributed Proofreading Team at http://www.pgdp.net
(This file was produced from images generously made
available by The Internet Archive/Canadian Libraries)

*** START OF THE PROJECT GUTENBERG EBOOK THE IDIOT: HIS PLACE IN CREATION, AND HIS CLAIMS ON SOCIETY *** 


THE IDIOT;


HIS PLACE IN CREATION,


AND


HIS CLAIMS ON SOCIETY.





THE EASTERN COUNTIES' ASYLUM FOR IDIOTS AND IMBECILES.
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.[ 8]


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.


[ 9]




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[ 10]
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[ 11]
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[ 12]
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[ 13]
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[ 14]
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[ 15]
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[ 16]
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.[ 17]


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[ 18]
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 unre[ 19]gretted
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[ 20]
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[ 21]
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 ισιοτης[4]) is alone in the world;[ 22]
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[ 23]
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[ 24]
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[ 25]
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[ 26]
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 drunk[ 27]ards,
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][ 28]


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,[ 29]
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,[ 30]
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[ 31]
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.[ 32]


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[ 33]
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[ 34]
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 inter[ 35]marriage
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][ 36]


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[ 37]
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[ 38]
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.[ 39]
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[ 40]
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[ 41]
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][ 42]
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[ 43]
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[ 44]
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[ 45]
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][ 46]


The average brain weight in man may
be said to range from 40 to 52½ ounces,
and in women from 35 to 37½ 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 64½ 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][ 47]


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[ 48]
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][ 49]


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.[ 50]


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[ 51]
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.[ 52]


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
2½ per cent. of phosphorus, that of the
idiot 1½, and that of the madman 4 to 4½;
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[ 53]
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[ 54]
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.[ 55]




MATTER AND MIND.


"Quare frustra sudaverit, qui cœlestia
religionis arcana nostræ rationi adaptare
conabitur." Bacon, "De Augmentis Scientiarum."


I have already stated that the study of
idiocy was of great interest to the theologian,
for I can imagine no more powerful weapon
for combating the materialistic tendencies
of the day than is furnished by a consideration
of the natural history of the idiot.
This is neither the time nor the place for
me to enter into the question of the mysterious
connection between matter and mind,
a subject which I have developed at some
length in my published works.[29] In my[ 56]
various public appeals on behalf of the
Asylum for Idiots, I have also usually taken
the opportunity of pointing out how the
experience afforded by the study of idiocy
is utterly opposed to the extravagant
dogmas of the materialistic school, and to
the crude notions which pseudo-science has
engendered; and I have also shown how
the results of idiot training furnish a forcible
demonstration of the dualistic theory of
mind and matter, upon which science
reposed till the times of Spinosa, Laplace,
Haeckel, Huxley, and others.


The pseudo-philosophers of our time
have bewildered the public mind by the
wild flights of their imagination; thought,
the so-called spiritual attributes of man,
are merely a function of brain protoplasm;
the brain, say they, secretes thought, just
as the liver secretes bile, or as oxygen and[ 57]
sulphur produce sulphuric acid, and all the
varied phenomena of nature are nothing
more than the molecular changes of matter;
the operations of the mind are but the
products of the caudate cells of the brain,
and volition and consciousness are mere
physical manifestations. They see only
the physio-chemical side of nature, they
utterly ignore any spiritual attribute in
man, they regard metaphysics as a relic of
mediæval superstition, and they assert that
all mental operations are bodily functions,
and simply the result of some molecular or
atomic change in the brain; indeed, the
German philosophers go so far as to say
that life itself is only a "special and most
complicated act of mechanics;"[30] that there[ 58]
is no real distinction between living and
dead matter, and that vitality is a metaphysical
ghost (ein metaphysisches Gespenst).[31]


At the International Psychological Congress
held in Paris, in 1878, at which it
was my privilege to be present, Professor
Mierzejewski, of St. Petersburg, laid before[ 59]
the congress the result of his elaborate
experiments on the brains of idiots, his
communication being illustrated by casts of
the brains of idiots, and also of certain
animals, and the learned Russian professor's
conclusions strongly militated against the
theories of the philosophers of whom I
have been speaking.


In order to understand the great value
and import of Dr. Mierzejewski's investigations,
I must remind you that the human
brain is composed of two kinds of nerve
structure, of an essentially different nature,
grey matter and white matter. Examined
microscopically, the grey matter is found
to be composed of cells, while the white
matter consists of fibres; their function also
is different, the former being regarded as the
generator of nerve force, while the latter
simply serves as the medium by which this
force is transmitted. As the manifestation
of the intellectual powers is supposed to be
in some way connected with the development
of the grey matter of the cerebral
convolutions, one would expect to find in[ 60]
idiots a deficiency of this element of brain
tissue.[32] Dr. Mierzejewski maintained that
this is by no means the case, and he
mentioned an instance of an idiot in whose
brain the surface of grey matter was enormous.
So it would seem that there is no
fixed relation between the amount of grey
matter of the brain and intellectual power,
for richness of grey substance and abundance
of nerve cells may be accompanied
by idiocy.[ 61]


Now, as these startling statements of the
Russian professor were not made in a hole
and corner, but were enunciated in the
presence of leading psychologists from all
parts of the world, I felt myself justified in
telling the materialists that they must be
faced, and either answered or admitted as
correct; and as my comments upon these
experiments were subsequently published
in a leading London periodical and widely
circulated, I am now justified in assuming
that the inferences I then drew from these
remarkable experiments cannot be controverted,
and that the time has not yet
arrived when the broad distinctions between
mind and matter are to be obliterated, and
man reduced to a mere automaton, a creature
of a blind necessity.[ 62]


Without unduly exaggerating the importance
of Dr. Mierzejewski's experiments, it
must be admitted that very great interest
attaches to them at this juncture, when
attention is so widely directed to the
mysterious connection between matter and
mind. Unhappily, instead of solving the
question, the Russian professor's researches
tend to shroud it in a still deeper mystery,
and show that what has been termed the
"slippery force of thought—the vis vivida
animæ"—cannot be weighed in the balance;
and they fully justify the eloquent language
of a recent writer when he says, "Far
more transcendent than all the glories of
the universe is the mind of man. Mind is
indeed an enigma, the solution of which is
apparently beyond the reach of this very
mind, itself the problem, the demonstrator,
the demonstration, and the demonstrants ."


Those who maintain that the brain is the
organ of the mind, do not tell us what we
are to understand by organ, brain, or mind;
they seem to me to confound two things,
the one with the other. In fact, they make[ 63]
no distinction between thought, mind, consciousness,
and the instrument by which
these attributes become externally manifested.
It is true, we have no evidence to
show that the mind can operate independently
of the nervous system; on the contrary,
all physiological data bearing upon
the question of this mutual relation, go to
prove that where there is no nervous
system there are no mental manifestations.
Moreover, as G.H. Lewes says, "It is
the man, and not the brain, that thinks:
it is the organism as a whole, and not one
organ, that feels and acts."[33]


Every faculty manifests itself by means of
matter, but it is important not to confound
the faculty with the corporeal organ upon
which the external manifestation of such
faculty depends. The word organ is the
name given to a part of the human frame
by which we have sensation, and by means
of which we do a certain act or work; such
are the organs of sight, sound, smell, taste,
and touch. All these organs are passive,[ 64]
and require to be operated on ab extra,
precisely in the same way as the musical
organ, which is an instrument constructed
by man, requires man's interference for the
production of musical sounds.


When a musician sits down to a piano, the
music cannot be said to be in the instrument,
but in the soul of the performer. If the
instrument be in good order, the inspiration
of a Thalberg or of a Liszt will become
apparent; break the cords or otherwise
damage the instrument, and nothing but
discordant strains are produced, the musical
faculty of the performer, however, remaining
unaffected. We are all familiar with
Plato's celebrated dialogue on the Immortality
of the Soul, where a disputant with
Socrates inquires if the soul is not like the
harmony of a lyre, more beautiful, more
divine than the lyre itself, but yet is nothing
without the lyre, vanishing when this instrument
is broken.


Let me further illustrate this point by an
allusion to the electric telegraph, by means
of which ideas and words are transmitted[ 65]
from mind to mind with a rapidity to which
ordinary language cannot attain. Now,
the electrical battery may be not inaptly
compared to the brain, and the telegraph
wires to the nerves which emanate from it.
If the battery be out of order, or the telegraph
wires be broken, this lightning
language, by which mind speaks to mind,
becomes impossible. In the same way,
idiocy may be considered as a disease of
the instrument rather than of the performer;
the idiot's brain is damaged and has
become an unfit instrument for the outward
manifestation of the powers of the
mind, but the lowest idiot possesses the
germs of intellectual activity and moral
responsibility; and within his malconstructed
organism, there lies concealed in its fragile,
fleshly casket, a precious jewel of immortality—an
imperishable essence that is
destined to live on for ever and for aye,
through countless æons of time, when the
dicta of these dreamers of whom I have
been speaking, to use the language of one
of them, "shall have melted away like[ 66]
streaks of morning cloud into the infinite
azure of the past."


I repeat it, we must take care not to
confound the organ with the person who
possesses this organ: the eye is not that
which sees, it is only the organ by which
we see; the ear is not that which hears, it
is only the organ by which we hear.
Precisely in the same way and in the same
sense, the brain is the organ of mind, the
organ by which our mental faculties become
externally manifested. That it cannot be
otherwise is shewn by the results of
memory. The brain is of a perishable
nature, its atoms are constantly changing;
the body is continually throwing off old
particles and appropriating new ones, every
breath that is drawn, and every exertion
that is made, cause some minute change
in the bodily frame-work, so that it is
never entirely the same;[34] there is no[ 67]
person, therefore, who has the same brain
that he had 20 years ago; and the vivid
impressions of the past are utterly inexplicable
on the supposition that mental
activity is a mere function of any perishable
organ like the brain, but they necessitate
the conclusion that mind and body, spirit
and matter, are two entirely heterogeneous
substances, and that mind—the concrete
Ego—is independent of the material organ
by which its external manifestation is alone
possible.[35][ 68]


However tempting it might be, I feel I
must not trespass any further by dwelling
on the mysterious connection between[ 69]
matter and mind, a subject the complete
comprehension of which is beyond the limits
of our finite capacities. As Goethe philosophically
remarks, "We are eternally in
contact with problems. Man is an obscure
being, he knows little of the world, and of
himself least of all."


It would seem that the great Roman
orator, nearly 2,000 years ago, with prescient
eye, foresaw the attempts that would
hereafter be made to pry into the hidden
mysteries of Nature, when he said:—


"Latent ista omnia, Luculle, crassis
occultata et circumfusa tenebris, ut nulla
acies humani ingenii tanta sit, quæ penetrare
in cœlum, terra intrare possit."


These lines of Cicero would seem to be
peculiarly applicable to certain modern[ 70]
philosophers, who, in their attempts to
bridge over the gulf—the impassable gulf—which
separates matter from mind, persistently
ignore the fact that there are
certain things which, from their very
nature, are beyond the pale of precise
knowledge, and which cannot be determined
by physical investigation—which, in
fact, lie outside the sphere of man's
intellect. I believe the question I am
discussing is one of these, and that,
although we may grope with the taper of
science into the dark caverns whence seem
to issue the springs of humanity, we shall
probably fail to understand the mysterious
connection between matter and mind, a
theme essentially beyond the grasp of
human intelligence, and which cannot be
fathomed by the puny plummet of human
thought or touch.


The study of the idiot is calculated to
elucidate this overwhelmingly important
subject, and I believe the Idiot Asylum is
destined to become the arena and battlefield
on which this great question will have
to be fought out.[ 71]




THE PNEUMA, OR SPIRITUAL ATTRIBUTE OF


THE IDIOT.



Ὁ δε νους εοικεν εγγινεθαι ουσια
τις ουσα, και ου φθειρεσθαι.

Aristot. De Anima, I. 4.




Inasmuch as the instrument by which the
manifestation of mind is alone possible is
undoubtedly damaged in idiots, they were
formerly supposed not to belong to the
human family, and their place in the order
of creation was disputed. All admitted
that they had the σωμα, or material part of
our nature; they also conceded to them the
ψυχη, or principle of animal life, but they
considered that the πνευμα, or spirit of
immortal life—that which essentially
differentiates man from the brute—was
absent in the idiot. This idea seemed to
have been entertained by a great theologian
of the 16th century, who, on being asked
by a father what he was to do with his[ 72]
idiot boy, replied that the child might be
drowned as he possessed no soul! Times
are happily changed. We don't admit the
lawfulness of drowning idiots in these days,
but we teach them to swim against the
adverse currents to which they are exposed;
we buoy them up on the tempestuous waves
of life; we pilot them through the rocks
and shoals of their ill-starred career till their
chequered race is run, and they are safely
landed in the haven of everlasting rest.


Not only in the 16th century, but certain
philosophers of a later date have questioned
the idiot's place in creation, and have disputed
his right to be classed among the
human family; and some scientists—believers
in the so-called doctrine of Evolution,
as applied to the Descent of Man—have
gone so far as to pretend that the
brain of the microcephalic idiot is so far
removed from the human type, as to constitute
him a connecting link between man
and the anthropoid apes! Now, the interesting
results of our training institutions,
showing the capacity for progressive im[ 73]provement
which exists in the idiot, gives
the lie to this absurd and purely sensational
hypothesis.


Here let me add that I strongly deprecate
introducing the odium theologicum
into the discussion of this subject, being
fully conscious of the futility of attempting
to check an unwelcome or distasteful theory
by means of ecclesiastical censures; and I
further admit that in anything like a scientific
demonstration of truth, an appeal to
the affections would be absurdly out of
place.[36] Moreover, I should not reject[ 74]
the Darwinian theory from any sensational
notion that its adoption was derogatory
to Man's dignity, and I fully echo
the sentiment of the naturalist who said
that he would prefer being descended
from a good honest monkey, than to be
obliged to avow himself the offspring of
certain fanatical enemies of scientific knowledge
and progress; but I do complain of
the tendency of the present day to accept
new ideas without knowing or caring how
to sift them. Everything is hypothetical,
and allowed to enter the mind through the
ivory gate of fancy; and on purely hypothetical
premises, an attempt is made to
found conclusive arguments. Strip the
assertions of all their vagueness and superficial
varnish, and reduce them to a skeleton[ 75]
of logical statement, and we shall see how
much is assumed and how little is proved;
and we shall find that we are asked to accept
a chain of hypotheses, as if it were an
induction founded on ascertained and indisputable
facts. In thus expressing myself,
I wish to add that the ultimate goal of
the scientist is the establishment of truth,
and I should as soon attempt to stop the
progress of the avalanche that has become
dislodged from the mountain top, as to try
to bar the path of scientific progress, or
to extinguish the torch of discovery. The
tide of scientific truth will continue to flow
on in spite of the modern Canutes, who
may utter from time to time their imperial
commands to stay its course. Magna est
veritas et prevalebit.


The supporters of evolution base their
arguments upon the remarkable resemblance
between the brain of man and
that of certain other animals. Now, I
admit this striking analogy; I admit that
every chief fissure and fold in the brain of
man has its counterpart in that of the gorilla[ 76]
and the ourang-outang; and I am not prepared
to deny the statement, that as far
as the organ of intelligence is concerned,
there is no very striking physical difference
between him who weighs the stars and
makes the light tell its secrets as to the
constitution of distant worlds, and the
howling senseless brute, who lives merely to
satisfy his animal appetites. All animals
of the vertebrate type are constructed on
a plan which is essentially similar, not only
as regards their skeleton, but as regards
their brain. I don't deny that man is an
animal, and that he has the essential properties
of a highly organised one; but what
I do maintain is, that the brain, after all, is
merely an instrument by which the high
psychological attributes peculiar to man
become externally manifested.[37] Thought[ 77]
is not phosphorus, as some would have
us believe; the human mind is not the
result of a mere molecular arrangement of
cerebral matter. There is something over
and above all this, and the very resemblance
of man's physical nature to that of
some members of the brute creation, proves
beyond all doubt that his superiority to them
is hyperphysical, and I fully endorse Mr.
Froude's philosophical remarks, when he
says, "It is nothing to me how the Maker
of me has been pleased to construct the
organised substance which I call my body.
It is mine, but it is not I. The νους, the
intellectual spirit, being an ουσια—an essence—I
believe to be an imperishable something
which has been engendered in me
from another source." The unhappy idiot,
that stricken member of our race, possesses
the tripartite nature of man—for he has not[ 78]
only the σωμα or material part, and the ψυχη
or principle of animal life, but he also
undoubtedly possesses the πνευμα or principle
of immortal life.


The above statement could be amply
borne out by a reference to cases which
have been observed in idiot asylums. I
will, however, mention but three:—An idiot
boy has been known to retire alone, when
there was a thunderstorm, to ask God to
take care of his father, who was a sailor.
A former superintendent of our Asylum,
the late Mr. Millard, noticed one of the
inmates praying in private, and on saying
to the boy, "God hears prayer," he quietly
observed, "Yes, and answers it, too."
A little boy in the Massachussetts Asylum
for Idiots was in declining health, and
became, during his dying illness, an object
of great interest to the matron and attendants.
Unbidden, he said his prayers
frequently, and putting up his little hand,
he muttered, "Me want to go up! me
want to go up!" Surely he was thinking
of some sort of hereafter, because he added[ 79]
distinctly, "They'll say, here comes one
of the boys from the Boston School for
Idiots." The approach of death seemed
to awaken his spiritual life; out of the
decaying body appeared to rise the growing
soul, for, after repeating the verse of a
hymn, the spirit of this simple child became
liberated from its earthly tenement—its
material habitat—the connection between
matter and mind was severed, and, to use
the touching language of his biographer,
"this poor little idiot boy bade a long adieu
to his sorrowing friends, and doubtless
there was then joy in heaven, as the recording
angel wrote in the Book of Life
the name of George Tobey."[38]


In an interesting essay published many
years ago, entitled, "A Morning at Essex[ 80]
Hall, Colchester," its author, the Rev.
Edwin Sidney, in describing his visit to
the Asylum, remarked that, "The conduct
of those who go to Church on Sunday is
very decorous. One of the most cheering
things in connection with these objects of
benevolent solicitude, is the capability some
of them manifest in receiving and being
comforted by religion. There are amongst
them instances of high conscientiousness
and piety, which might be examples to such
as are gifted with unimpaired faculties."


If any apology be due for pointing out
how the mysterious connection between
mind and matter may be illustrated by a
study of idiocy, I will observe that the
subject is of such absorbing interest that it
is well that it should occasionally be removed
from the heated arena of biological
bias, into the calmer and more judicial
atmosphere of the class of readers who may
be interested in the important subject I am
endeavouring to elucidate.[ 81]




TREATMENT AND RESULTS.



"Distinguish'd link in being's endless chain,
Midway from nothing to the Deity.
Though sully'd and dishonour'd, still divine,
An heir of glory, a frail child of dust.
Helpless immortal!"—Young.



According to the census of 1881, there
were about 32,717 idiots and imbeciles in
England and Wales; the Census Commissioners,
however, ascertained that owing
to the reticence of parents, the returns
were far from trustworthy, and, after careful
inquiry, they estimated the total number
of idiots and imbeciles at 41,940; of these,
it is calculated that about 3,000 cases
belong to the four Eastern Counties. Of
this number, it is estimated that, after
deducting pauper and other cases not considered
suitable for this charity, there
remain at least 1,000 idiots who need
the benefits of the Eastern Counties'[ 82]
Asylum, whereas, our present accommodation
is limited to 250 cases.[39]


The Board of Directors being forcibly
impressed with their inability adequately
to supply the wants of the district, have
recently instituted a Permanent Endowment
Fund. As the institution is mainly
supported by voluntary contributions, the
fluctuating nature of which has often caused
considerable anxiety, the Board has felt[ 83]
the desirability of placing a considerable
portion of their resources on a more solid
basis; and it is with the view of giving
stability and permanence to the work of
the Asylum, that the Endowment Fund
has been started, which it is proposed
shall be inalienable, the interest only being
used for the purposes of the Institution.
In the year 1891, H.R.H. the Prince of
Wales, with the view of furthering this
object, graciously consented to preside at a
Festival Dinner, at the Hotel Metropole,
London, which resulted in an immediate
contribution of £6,000. This fund, started
under such happy auspices, has already
reached the sum of £25,334 12s. 8d.,
which it is hoped may eventually reach
£50,000, the amount which the Directors
think indispensable to insure the efficient
maintenance of the Asylum.[ 84]


Now let us bring this matter home to
ourselves. Where are the 3,000 unhappy
blighted individuals that claim the Eastern
Counties for their home? It is true that
some of them are in the homes of the
affluent, but the greater number are in the
cottages of the poor, where the trouble of
providing for one such member often reduces
a working family to pauperism; the
poor child beloved by its parents, is,
perhaps, loathed by their neighbours, is
avoided by other children, hidden from
visitors, a constant care and sorrow to the
mother, a source of anxious foresight to
the father; in fact, the poor idiot child is
like a Upas tree, that poisons the whole
atmosphere around it, and the burden of his
presence in a poor man's family is a new
weight added to the load that was already
sinking them down. Perhaps you may
say, we agree with you, we lament as you
do, that the narrow home of the humble
artisan  should be rendered intolerable by
the presence of these stricken members of
our race; but, we have been given to[ 85]
understand, that if not absolutely incurable,
but very little can be done for them, that
they baffle the efforts of the most zealous
educators, and are almost beyond the reach
of human sympathy.


Now this was the language generally
used half a century ago, and a celebrated
French authority on the subject, Esquirol,
considered that idiots were what they must
remain for the rest of their lives; that there
was no possibility of ameliorating their
condition, and that no means were known
by which a larger amount of intelligence
could be developed in them.[40] In fact, an
effort to ameliorate the condition of the
congenital imbecile was regarded by psychologists
and physicians as absolutely
hopeless, and the standard "Dictionnaire
de Médecine," published in 1837, broadly[ 86]
stated that it was useless to attempt to
combat idiotism; in order that the intellectual
exercise might be established, it
would be necessary to change the conformation
of organs which are beyond the
reach of all modification. So great was
the pessimism prevalent on this subject,
that it was insinuated that the idea of
teaching an idiot could only enter the brain
of one somewhat closely allied to that
class!


Now, I am happy to tell you, that in the
broad daylight of the nineteenth century,
science gives an emphatic denial to this
statement. Yes, the results obtained at
our own Asylum and elsewhere, show that
much, very much, may be done for the
unhappy idiot, who in a private house is
an intolerable incubus, but who, under
proper training in a suitable asylum, becomes
sociable, affectionate, and happy. It
has been shown that in the majority of
cases, the idiot may not only cease to be a
source of annoyance and danger to those
around him, but by care and training he[ 87]
may be made able to contribute to his own
sustenance; the knowledge of simple trades
of a mechanical kind, such as that of a
carpenter, shoemaker, or tailor, has been
reached by some, and household industrial
pursuits have fitted others for domestic
usefulness.


A celebrated German authority, Herr
Saeger, of Berlin, has stated that in his
establishment he had indubitable cases of
idiocy, in which the head was small and
malformed, yet in which the results of
education were so triumphant, that they
were ultimately able to mix with the world
without being recognised as idiots.
Further, he tells us that in one instance a
young man underwent confirmation without
the priest suspecting that he had been
delivered from idiocy.


Dr. Shuttleworth records the case of
an inmate of the Royal Albert Asylum,
who became, under instruction, an expert
joiner, and from being a very imp of mischief,
grew up into a well-conducted, self-reliant
youth, and ultimately emigrated to[ 88]
one of our colonies, and when he was last
heard of, he was practising his trade in a
leading city.[41]


Equally satisfactory results have been
obtained in our own Asylum. A few years
ago, a boy of eight was admitted into our
Asylum, who was quite unmanageable at
home, a terrible incubus in the household
of which he formed part, and the constant
subject of jeers and derisions on the part
of the other juveniles of the village. After
about six months' systematic training, one
of the officials of the Asylum wrote to inform
me that the boy had so much improved
that he was afraid the Commissioners of
Lunacy, at their next visit, would consider
the boy no longer a fit subject for detention
in the Asylum. Being on a short visit
to his relatives, who reside near Norwich,
he was brought to me for inspection, when I
was struck with the miraculous transformation
that had been effected; from a restless,
destructive boy, he had been changed into
a well-conducted lad, and he had actually[ 89]
been taught to write. At my request,
he wrote very legibly his name and
address, with the date, "James Smith,
Colchester;" but he made a little mistake
in the date, writing backwards, in the
Chinese fashion—it being September 29th,
he wrote "September 92nd!" This same
boy was regularly employed as one of
the gardeners to the institution, and has
recently been discharged, and is now earning
his own living as gardener in a private
family. This case illustrates a peculiarity
not infrequently remarked in the inmates
of an idiot asylum, that is the remarkable
propensity they have for imitation and
shamming. This boy came to stay with his
relatives in Norfolk for a few weeks, when
every few days he would have an epileptic
fit. When his holiday was over and he
had returned to the Asylum, these fits
recurred, and were, of course, reported to
the medical attendant, who had a shrewd
suspicion the boy was shamming. He thereupon
said to the attendant: "The next
time a fit comes on, I must apply a red[ 90]hot
iron to the soles of the feet, it will
hurt him, but it will cure him." From
that time the boy had no epileptic fits!


 


Thyroid Treatment of Idiocy.—My sketch
of the treatment of Idiocy would be
incomplete without an allusion to the
injection or internal administration of a
preparation of the thyroid gland of the
sheep, a method of treatment brought into
notoriety by Professors Kocher and Schiff,
on the continent, and by Professor Victor
Horsley, Dr. Murray, and others in this
country. Numerous cases have been published
claiming successful results, and the
thyroid treatment has been spoken of as a
cure for at least one of the forms of idiocy.


Without quite endorsing this sweeping
and enthusiastic statement, there cannot be
a doubt that this method opens up a hopeful
vista in the treatment of idiocy; in fact,
Dr. Ireland has furnished me with the
particulars of a girl, aged five years, treated
by thyroid juice, in whom "the improvement
was so decided that it seemed an[ 91]
escape from idiocy into normal intelligence."[42]


A striking instance of the good results
of thyroid treatment has lately occurred in
the Eastern Counties' Asylum, the particulars
of which have been kindly furnished
to me by Mr. Kirkby, the Resident
Medical Officer. Esther C., aged 19, was
admitted Nov. 8th, 1894, with marked
symptoms of Sporadic Cretinism. She was
at once put on thyroid treatment, beginning
with half a five-grain tabloid gradually
increased to a tabloid once, twice, and
sometimes three times a day, intermitting
them for short periods. Latterly, she has[ 92]
been taking one tabloid a day. Under
this treatment, she has gained 10 lbs. in
weight, and has grown 5 inches; the
features are not so coarse, the previous
myxœdematous condition of the subcutaneous
tissues has subsided, the outline of
the features having become more defined,
and the skin which was formerly dry and
rough, has become soft and naturally moist,
having lost a great deal of its puffiness;
but the most obvious change in the patient[ 93]
is the disappearance of the two prominent
elastic swellings (pseudo-lipomata) which
formerly occupied the posterior triangle of
the neck on each side. The mental condition
has also improved, she takes more
interest in amusements, and her voluntary
movements are much more rapid. This
patient is still under observation, and the
results hitherto attained afford a favourable
illustration of the beneficial effects of this
mode of treatment.


At a meeting of the New York Academy
of Medicine of March 12th, 1896, Dr.
Emily Lewi reported the history of a very
marked case of Cretinism in a girl, aged 13
months, who was put on thyroid treatment;
improvement was noted in a week, and
the child grew gradually intelligent. At
this same meeting, Dr. G.M. Hammond[ 94]
expressed the opinion, that for thyroid
treatment to be effectual, it must be begun
in early life.[43]


My colleague, Dr. Burton-Fanning, has
recently shown me a case of Cretinism
under his care, at the Lind Infirmary for
Children, in which thyroid treatment produced
the most favourable results, not only
of a physical, but of a psychical character.
Although the child was four years old, he
had not previously spoken a word, and
understood nothing; but during the treatment,
his expression became much less
vacant, and the faculty of speech was
roused into action.


Several valuable contributions have lately
been made to our knowledge of the effects
of thyroid feeding, more especially in the
treatment of insanity, not however the less
valuable as a guide to its probable benefit
in idiocy. I wish more especially to allude
to the researches of Dr. Lewis C. Bruce,
at the Royal Asylum, Edinburgh, as reported
in the "Journal of Mental Science"[ 95]
for January and October, 1895. There is
much in the above essay that I could profitably
comment upon, but I will content
myself with saying that the outcome of
these researches, which intimately concern
the treatment of idiocy, is that Dr. Bruce
has established the fact that thyroid feeding
acts as a direct cerebral stimulant, which
he thinks "may prove advantageous in
cases where the higher cortical cells remain
in an anergic condition." Dr. Bruce mentions
the case of a patient who had not
spoken for several months; one day, during
the administration of the thyroid extract, he
suddenly began to talk, and soon became
quite communicative.


Whilst these pages are passing through
the press, M. Auguste Voisin, Physician
to La Salpêtrière, has had the courtesy to
send me detailed particulars of a case of
insanity in which the success of the thyroid
treatment was phenomenal. The patient
was a female, aged 25, and her mental
derangement assumed the form of religious
monomania, insomnia, and aural hallucina[ 96]tions;
there was great emaciation, dryness
of the skin, and cold extremities.[44]


No benefit having resulted from six
months' treatment, including hypnotism,
M. Voisin determined to try the subcutaneous
injection of sterilised thyroid juice.
After a few weeks of this treatment, a
notable amelioration was observed; shortly
afterwards all her unfavourable symptoms
disappeared, and she was discharged cured.


One of the most interesting features in
this case is the result of the analysis of
the blood, as to its corpuscular richness.
Before thyroid treatment was commenced,
the number of corpuscles was only 2,225,000
per cubic millimetre; after the cure by the
thyroid juice, the number was more than[ 97]
doubled, being 4,774,000 per cubic millimetre.
In Dr. Lewis Bruce's cases, to
which I have already referred, the result
was the reverse of that observed by M.
Voisin; for in the eight uncomplicated
cases recorded by Dr. Bruce, with one
exception, there was in all of them a
diminution in the number of red corpuscles.


At the discussion on Myxœdema, at the
Edinburgh Medico-Chirurgical Society, to
which I have already alluded, Dr. Alexander
Bruce showed a case of myxœdema under
the care of Professor Fraser, in the Royal
Infirmary, in which, as the result of thyroid
feeding, a condition of relative anæmia had
been developed. The patient had no murmurs
when admitted, but since the administration
of thyroid preparations, basal and
mitral systolic bruits had developed themselves.
It is further stated that the blood
corpuscles had fallen from 4,600,000 to
3,700,000, and hæmoglobin from 78 per
cent. to 59 per cent.[45][ 98]


Further researches would therefore seem
to be necessary, before we can arrive at a
satisfactory conclusion as to what effect the
thyroid treatment has upon the blood.


Possibly the dose of the thyroid preparation
may be an important factor in the
result, for Dr. Byrom Bramwell, in an important
and exhaustive monograph upon
this subject, says, that anæmia is apt to be
produced by large doses of the remedy;
and he mentions a case where the red
blood corpuscles and the hæmoglobin underwent
a marked diminution during the period
of acute thyroidism, but rapidly increased
under the subsequent administration of
small doses of the remedy.[46]


The subject of blood analysis is most
important, as tending to throw some light
upon a matter at present but little under[ 99]stood,
namely the physiological effect of
thyroid preparations upon the blood.


Dr. Telford-Smith has reported four
cases of Sporadic Cretinism treated by
thyroid extract at the Royal Albert Asylum,
Lancaster, when a well-marked improvement
was noticed in each case. The
clinical history of these cases is given with
minute detail by Dr. Telford-Smith, and
is well worthy of close study by those interested
in this subject.[47]


Quite recently, at the Annual Meeting
of the British Medical Association, held at
Carlisle in August of the present year,
communications were read on the Thyroid
Treatment of Cretinism and Imbecility,
by Dr. Rushton Parker, Dr. Telford-Smith,
Dr. John Thomson, and others. An animated
discussion ensued, the tendency of
which pointed to the undoubted advantages
both physically and mentally of the use
of this remedy.


Although the physiological effects of
thyroid feeding may not be definitely[ 100]
recognised and understood, there is overwhelming
evidence to show that it produces
marked psychical results, that it acts
as a direct cerebral stimulant, and we have
every reason to rely upon it as a valuable
adjuvant to our treatment of idiocy;
and it is not too much to say that the
treatment of this infirmity, as well as of
other mental defects, by thyroid extract or
some other preparation of the thyroid
gland, is one of the greatest triumphs of
modern medicine; but much still remains
to be learnt, as Professor Victor Horsley
remarks, "So definite and pronounced is
the cachexia thyroidectomica, that few
subjects in the range of pathology offer a
more fruitful and inviting field of research."[48][ 101]


 


Craniectomy.—The operation of Craniectomy
(that is the cutting of strips of
bone from the cranium) has been recommended
and practised in cases of microcephalic
idiocy, an operation suggested upon
the theory of premature synostosis, or
closure of the cranial sutures, thus causing
an arrest in the development of the subjacent
cerebral tissue. Although I could not
omit a reference to this operation, it has
not met with general acceptance, and one
of the most recent writers on this subject,
M. Bourneville, physician at Bicêtre, discourages
it altogether; and from his
examination of the skulls of a number of
idiots, he affirms that "in the immense
majority of cases, there was no premature
synostosis, and that neither normal anatomy,
pathological anatomy, or physiology,
justified the operation of Craniectomy."[49][ 102]
The late Sir George Humphry was of the
same opinion, as, after an examination of
19 microcephalic skulls, he said, "There is
nothing to suggest that the deficiency in
the development of the skull was the leading
feature in the deformity, or anything
to give encouragement to the practice
lately adopted in some instances of a removal
of a part of the bony case, with the
idea of affording more space and freedom
for the growth of the brain."[50]


At a recent meeting of the New York
State Medical Society, Professor Dana
read a paper on Craniectomy for Idiocy
and Imbecility, and he gave the following[ 103]
result of 81 cases:—In 35, there was improvement;
in 22, no improvement; and
death ensued in 24 cases. The conclusion
at which Professor Dana arrives is that
"it is largely through its pedagogic influence
that an improvement takes place, and
that the operation is allied in its effect to a
severe piece of castigation!" Dr. Dana
freely admits that this view of craniectomy
for idiocy and imbecility lends itself readily
to humour, and it would seem that he
intended to kill the operation by ridicule.[51]


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[ 104]
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[ 105]
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[ 106]
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 senses
Begin to chase the ignorant fumes that mantle
Their clearer reason."



[ 107]


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[ 108]
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[ 111]
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.



CROSSLEY HOUSE, CLACTON-ON-SEA.
CROSSLEY HOUSE, CLACTON-ON-SEA.



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][ 112]
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][ 113]


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[ 114]
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[ 115]
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 us
This 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[ 116]
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[ 117]
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[ 118]
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[ 119]
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.[ 120]


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."



[ 121]




INDEX.



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 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] Op. cit., page 64.


[21] The attention of the medical profession has lately
been called to the obstetric aspect of idiocy, and I
would refer those who take an interest in this subject
to the valuable statistics of Dr. Langdon Down, which
contain the result of his inquiries into the history of
2,000 cases of idiocy that have come under his
observation; from which it would seem that primogeniture
plays an important part, as no less than 24
per cent. of all the idiot children observed were primiparous.
The increased difficulty of parturition seemed
to be an important factor. In reference to the use of
the forceps in delivery as an assigned cause of idiocy,
Dr. Down says, "there is no evidence that instrumental
interference has any injurious influence on
the mental condition of the children, but he thinks
that those who delay the use of the forceps incur a
much greater risk from the prolongation of pressure,
resulting in suspended animation, which condition
should be especially avoided. Of Dr. Down's 2,000
cases, the ratio of males to females was 2·1 to 0·9.
This was probably due to the larger size of the head
giving rise to the prolonged and difficult parturition,
continued pressure, and suspended animation."—Obstetrical
Journal, vol. iv., p. 681.


[22] Dr. Hammond, Professor of Diseases of the
Nervous System at Bellevue College, New York, has
published some interesting statistics in reference to
the relative weight of the brain, as compared with that
of the body, in various classes of vertebrate animals,
by which he shows that there is no definite relation
between the intelligence of animals and the absolute
or relative size of the brain. Thus, he says, "the
canary bird and the Arctic sparrow have brains
proportionately larger than those of any other known
animals, including man, and yet no one will contend
that these animals stand at the top of the scale of
mental development. Man, who certainly stands at
the head of the class of mammals, and of all other
animals, so far as mind is concerned, rarely has a
brain more than one-fiftieth the weight of the body, a
proportion which is much greater in several other
mammals, and is, as we have seen, exceeded by many
of the smaller birds."


[23] Clinical Lecture on Idiocy, p. 14.


[24] L'Encéphale, March 1881, p. 82.


[25] At a meeting of the Medico-Psychological Society
of Paris, my friend M. Auguste Voisin exhibited plates
of the brains of idiots who had only begun to speak
at the age of from three to five years, in which the
frontal and first parietal convolutions were rectilinear
without secondary folds, resembling the fœtal condition
of the convolutions at the sixth month of intra-uterine
life.


[26] The imagination of certain psychologists seems
to have gone rampant upon this subject; one writer,
M. Moreau, of Tours, maintained that genius was a
nervous disease—"le génie est une névrose"; and
in order that there may be no mistake about his
meaning, he adds that "the constitution of many men
of genius is in reality the same as that of idiots!"
M. Moreau's doctrine may thus be summarised in
his own words:—"Les dispositions d'esprit qui font
qu'un homme se distingue des autres hommes par
l'originalité de ses pensées et de ses conceptions, par
son excentricité on l'énergie de ses facultés affectives,
par la transcendance de ses facultés intellectuelles,
prennent leur source dans les mêmes conditions
organiques que les divers troubles moraux, dont la
folie et l'idiotie sont l'expression la plus complète."


[27] Le Cerveau et la Pensée, par Paul Janet
Membre de l'Institut. Paris, 1867, p. 58. This
learned treatise contains an immense deal of information
in reference to the mysterious connection between
matter and mind, and I have found it of great service
to me in my psychological researches.


[28] "Nineteenth Century," March, 1880, p. 509.


[29] "Darwinism Tested by Language," Rivington,
1877; "Aphasia or Loss of Speech, and the Localisation
of the Faculty of Language," 2nd edition,
Churchills, 1890. The reader is referred to these
treatises, and especially to his work on Darwinism, for
a fuller exposition of the author's views, here only incidentally
sketched; and also for a more complete
knowledge of the scientific facts and different authorities
quoted in support of the position here taken in
reference to the connection between Matter and Mind.


[30] "Das Leben ist nur ein besonderer, und zwar
der complicirteste Act der Mechanik; ein Theil der
Gesammtmaterie tritt von Zeit zu Zeit aus dem
gewöhnlichen Gange ihrer Bewegungen heraus in
besondre organisch-chemische Verbindungen, und
nachdem er eine Zeit lang darin verharrt hat, kehrt
er weider zu den allgemeinen Bewegungsverhältnissen
zurück."—


Gesammte Abhandlungen zu wissenschaftlicher
Medicin s. 25.


[31] One of the leaders of scientific thought in this
country tells us that "Life is composed of ordinary
matter, differing from it only in the manner in which
its atoms are aggregated," and it has been gravely
stated that the production of man in the chemist's
retort may be recorded as one of the future discoveries
of the age!


A clever French writer, commenting on these purely
hypothetical statements of the "mechanistic school,"
makes the following appropriate remarks:—


"Quand on nous dit que l'organisme des êtres vivants
n'est qu'un laboratoire où tout se passe en combinaisons
et en compositions des éléments matériels primitifs, on
oublie que ce laboratoire est habité par un hôte intime, le
principe vital qui ne fait qu'un avec les éléments en fusion.
Ici la combinaison chimique ne se fait pas toute seule;
elle s'opère sous l'action d'une cause qui en transforme
les éléments de façon à en faire un produit d ordre nouveau
qui s'appelle la vie."—"La Vie et la Matière," par E.
Vacherot, Revue des Deux Mondes," 1878.


[32] In an original and very remarkable essay, entitled
"The Brain not the Sole Organ of the Mind," Dr.
Hammond, of New York, says, "There is no exception
to the law that mental development is in direct
proportion to the amount of grey matter entering into
the composition of the nervous system of any animal
of any kind whatever; and that in estimating mental
power, we should be influenced by the absolute and
relative quantity of grey nerve tissue, in which respect
we shall find man stands pre-eminent, although, as we
have already seen, his brain, as a whole, is relatively
much smaller than that of many other animals; and it
is to this preponderance of grey matter that Man owes
the great mental development which places him so far
above all other living beings. As this grey tissue is
not confined to the brain, but a large proportion of it
is found in the ganglia of the sympathetic and some
other nerves, and as an amount second only to that of
the brain in quantity—and, indeed, in some animals
larger—is present as an integral constituent of the
spinal cord, Dr. Hammond infers, and he cites
numerous experiments in support of this inference,
that mental power must be conceded to the spinal
cord, and that the brain can no longer be considered
as the sole organ of the mind."


[33] "The Physical Basis of Mind." Page 441.


[34] The late Bishop of Carlisle illustrates the independence
of the Ego, by an allusion to moral feelings.
"A murderer," he says, "is convicted twenty years
after the offence had been committed, or he gives
himself up after so many years, because his memory
and his conscience make his life miserable. He has
no doubt as to the fact that the person who did the
deed of darkness years ago, is the same person as he
who feels the pangs of remorse to-day. Every material
particle in his body may have changed since then,
but there is a continuity in his spiritual being out of
which he cannot be argued, even if any ingenious
sophist should attempt the task."—Nineteenth Century,
March, 1880, p. 510.


[35] To those who may wish to pursue this subject
further, I recommend a perusal of an essay on
"Materialistic Physiology," in the Journal of Psychological
Medicine for April, 1877. In this article, the
writer, Dr. Winn, seems to share my views as to the
paramount importance of boldly facing this matter,
when he says:—


"The unphilosophical and extravagant dogma, that
matter can think, is now so loudly and confidently
asserted, and so widely spread by a numerous class of
medical men and physiologists, both in this country
and abroad, that the time has arrived when a doctrine
so fallacious, and so fraught with danger to the best
interests of society, should be fairly and carefully
scrutinised. It is not by mere assertion, or the use of
obscure and pedantic language, that such a theory can
be established; and if it can be shown that the arguments
on which it is based are shallow and speculative,
words can scarcely be found too strong to censure the
recklessness and folly of those who promulgate views
so subversive of all morality and religion.


"The physicists have utterly failed to establish their
position. They were asked to prove by inductive
reasoning the truth of their theory, that the universe
is the mere outcome of molecular force, and their
defence has been clearly proved to be of the most
evasive and inconclusive character.


"The doctrines of the modern school of materialistic
physiology are permeating all classes of society, and it
is these doctrines, based on the assumption that mind
is a mere function of the brain—an assumption that, if
true, would reduce man to the level of the beasts that
perish—that we are offered as a substitute for the
belief in the immateriality of the mind."


The essay from which the above quotations are
taken is full of sound and logical reasoning, and the
writer's position is not supported by mere theoretical
statements, but by arguments drawn from well-accredited
facts in anatomy and physiology.


[36] I strongly deprecate, as lamentably wrong and
needless, the violent language sometimes used by
writers on both sides of this great controversy of the
origin of man. If the odium theologicum may have
inspired some of the opponents of evolution, it is undeniable
that there is strong evidence of an odium
antitheologicum amongst not a few of the supporters of
this doctrine, who indulge in abusive epithets, launching
into personalities of a most objectionable kind;
for instance, we are informed that "orthodoxy is the
Bourbon of the world of thought; it learns not,
neither can it forget." Now I protest against the
attempt to obscure argument by appeals to the passions
and to prejudice. Science and Theology should not
be regarded as two opposing citadels, frowning defiance
upon each other, but their votaries should look upon
each other as co-labourers in the cause of truth, and
they should welcome light and knowledge from whatever
quarter it may come, being fully convinced that all
systems and theories irreconcilable with truth, are
built upon the sand, and must ultimately be swept
away.


[37] One of our popular novelists, Sir Walter Besant,
has philosophically said, "there is between the condition
of Man and the Brute an interdependence
which cannot but be recognised by every physician.
So greatly has this connection affected some of the
modern physicians, as to cause doubt in their minds
whether there be any life at all hereafter; or if when
the pulse ceases to beat, the whole man should become
a dead and senseless lump of clay. In this they confuse
the immortal soul with the perishable instruments
of brain and body, through which in life it manifests
its being and betrays its true nature, whether of good
or evil."—Faith and Freedom.


[38] Cases like this would seem to illustrate the truth
of the statement of that great philosopher, Sir Thomas
Browne, when he says, "Thus it is observed that men
sometimes, upon the hour of their departure, do speak
and reason about themselves. For then the soul,
being more freed from the ligaments of the body,
begins to reason like herself, and to discourse in a
strain above mortality."—Religio Medici, p. 208.


[39] A society has lately been formed under the
name of "The National Association for promoting
the welfare of the Feeble-minded," the object of
which is to establish homes for defective and feeble-minded
children of a class more highly-endowed with
intelligence than those who would be received into
an ordinary idiot asylum; statistics having shown
that ignorance and mental dulness tend to crime in
various forms. Without expressing any very decided
opinion upon the above project, it seems to me that
the unnecessary multiplication of charitable institutions
is itself an evil, and is not calculated to promote
efficiency or economy; and if special provision is made
for those just above the highest class of idiots, as is
proposed, the present Idiot Asylums must necessarily
suffer. Without, therefore, in any way disparaging
the above scheme, I would suggest great caution
in reference to it, as it is impolitic and unwise to
make fresh demands upon a philanthropic public,
unless the need for it is clearly established, as the
result must inevitably be the diversion of funds from
existing institutions already doing a good and charitable
work.


[40] Maladies Mentales, Tome ii., p. 76, par E.
Esquirol, médecin en chef de la maison royale des
aliénés de Charenton. "Les idiots sont ce qu'ils
doivent être pendant tout le cours de leur vie. On
ne conçoit pas la possibilité de changer cet état. Rien
ne saurait donner aux malheureux idiots, même pour
quelques instants, plus de raison, plus d'intelligence."


[41] "Mentally deficient children," page 110.


[42] This painstaking observer has investigated this
subject in an interesting communication on Sporadic
Cretinism in the "Edinburgh Medical Journal" for May,
1893. Dr. Ireland considers Sporadic Cretinism to be
a congenital or infantile form of myxœdema, and bearing
in mind the increasing mental torpor which has
followed the ablation of the thyroid gland performed
by Kocher, and the cretinoid condition induced in
monkeys by the removal of the thyroid by Horsley,
he is drawn to the conclusion that this gland secretes
and pours something into the blood which has a
powerful effect upon the nutrition and function of the
brain, and of the whole organism, and these views
receive a certain amount of confirmation from the
fact that in most cases of Sporadic Cretinism the
thyroid gland is totally wanting. Dr. Ireland also
expresses the opinion, in which I fully concur, that
there is too much solidism in our pathology, and
that the vital powers of the blood have been too
much overlooked.


Although the effect of thyroid treatment in the idiot
is still sub judice, there is overwhelming testimony of
its value in Myxœdema, an allied affection; and I
would refer those who desire further information
upon this matter to an important discussion at the
Edinburgh Medico-Chirurgical Society, in February,
1893, arising out of papers read by Professor Greenfield,
Dr. Byrom Bramwell, Dr. Lundie, Dr. Dunlop,
and Dr. John Thomson, when important additions
were made to the literature of this affection by Dr.
Affleck, Dr. George Murray, and others, whose matured
views will form a valuable contribution to our knowledge
of this somewhat obscure subject.


[43] "Pediatrics," May, 1896, p. 460.


[44] I give M. Voisin's description of the symptoms in
his own words. "Elle est arrivée dans mon service en
état d'extase mystique, exécutant continuellement des
mouvements de ses deux mains, surtout de la droite,
semblables à ceux d'une personne en prière; elle porte
souvent les mains à son front comme pour faire le
signe de la croix. Elle murmure des mots, entre
autres, Ave Maria. La physiognomie exprime la
douleur mêlée d'extase."


[45] "Edinburgh Medical Journal," May, 1893, p. 1053.


[46] "Edinburgh Hospital Reports," Vol. 3, 1895,
p. 245. "This is the most complete monograph on
thyroid treatment that has come under my notice.
Dr. Bramwell has recorded, in minute detail, the
clinical history of twenty-three cases of myxœdema,
and five cases of sporadic cretinism."


[47] "Journal of Mental Science," April, 1895, p. 280.


[48] "British Medical Journal," Jan. 30th, and Feb.
6th, 1892, "Remarks on the Function of the Thyroid
Gland." I recommend a careful perusal of this
important and exhaustive essay of Professor Horsley
to all those who desire to acquaint themselves with
what is known about the structure and functions of
the thyroid gland; for it will be remembered that it is
to the experiments on animals by this learned and
accomplished scientist, that we are principally indebted
for our knowledge of the connection between myxœdema
and loss of function of the thyroid gland.


[49] "Traitement et Education des Enfants Idiots et
Dégénérés," p. 241, par M. Bourneville, Médecin de
Bicêtre, Paris, 1895. The author of the above treatise
is one of the most prolific French writers on Idiocy,
and I desire to call especial attention to that part of
the work which embraces the Medico-Pedagogic Treatment
of Idiocy. In this section, M. Bourneville
describes in minute detail the gymnastic and physical
training adopted at Bicêtre, the description being
copiously illustrated by plates, which cannot fail to
interest those engaged in the treatment of idiocy.


[50] "Journal of Anatomy and Physiology," January,
1895, p. 304.


[51] "Pediatrics," March, 1896, p. 243.


[52] "On Idiocy and Imbecility," page 91.


[53] As showing the result of individual effort, I may
mention that in the year 1894, as much as £155 0s. 7d.
was collected in the N. Walsham District, £89 12s. 9d.
in the Norwich District, and £80 15s. 6d. in the Diss
District, under the presidentship respectively of Mrs.
Petre, Lady Lade, and Mrs. Sancroft Holmes.


[54] The Countess of Warwick, at the "Young
Helpers' League."


[55] Des Maladies Mentales, Tome ii., p. 103.






EASTERN COUNTIES'


ASYLUM FOR IDIOTS,


COLCHESTER.


 Instituted 1st February, 1859.




Patron:


 H.R.H. The PRINCE OF WALES, K.G.


Presidents:



Vice-Presidents:



Board of Directors:


Chairman—The Most Hon. The MARQUIS OF BRISTOL.

Vice-Chairman—Admiral W.G. LUARD, C.B.

Treasurer—HORACE G. EGERTON GREEN, Esq.



Hon. Consulting Physicians—



Sir FREDERIC BATEMAN, M.D., LL.D., F.R.C.P.

Consulting Physician to the Norfolk and Norwich Hospital.

T. CLIFFORD ALLBUTT, M.D., LL.D., F.R.S., F.R.C.P.

Regius Professor of Physic, University of Cambridge.




Hon. Consulting Surgeons—



R.F. SYMMONS, Esq., Consulting Surgeon to Essex & Colchester Hospital.

E.A. HUNT, Esq., Surgeon to Essex and Colchester Hospital.

Hon. Ophthalmic Surgeon—Dr. S. JOHNSON TAYLOR, Norwich.

Hon. Medical Officer, Crossley House, Clacton-on-Sea—


WALTER MAINE, Esq.

Hon. Dentist—N. TRACY, Esq.

Hon. Solicitor—A.M. WHITE, Esq.

Hon. Architect—F. CHANCELLOR, Esq.

Auditor—Mr. ROBERT L. IMPEY (Chartered Accountant).


Resident Medical Attendant—

R.C. KIRKBY, M.R.C.S., Eng., L.R.C.P., Lond.

Resident Superintendent and Secretary—JOHN J.C. TURNER.

Bankers—Messrs. BARCLAY & CO., Limited.






LADIES' ASSOCIATION.




Patroness:


HER ROYAL HIGHNESS THE PRINCESS OF WALES.


Vice-Patroness:


 The Marchioness of Bristol.


Presidents:



The Eastern Counties' Asylum has been established for the care, education,
and training of Idiots and Imbeciles of all classes residing in the
Counties of Norfolk, Suffolk, Essex, and Cambridge.


In these Counties there are upwards of 3,000 cases of Idiocy and Imbecility,
and the Asylum at Colchester is the only one in the District. It stands in
its own grounds of six acres, near the Railway Station, and is supported by
voluntary contributions. There is a small Farm attached to the Asylum and
a Sea-side Branch at Clacton-on-Sea, and there is accommodation for 250
patients. Those whose friends are unable to pay for their care and maintenance,
are elected to the benefits of the Asylum by the votes of the
Subscribers, and, subject to the rules and regulations, are admitted for five
years. It is expected, however, that some contribution should be made if
possible. After residence in the Asylum for 3½ years, and if it is found that
patients are unable to be taught wholly or partly to maintain themselves,
they may be re-elected for additional terms of five years, and a small proportion
are allowed to be re-elected for life. Insane persons, and cases
suffering from confirmed Epilepsy, are not eligible for admission. Paying
Patients are admitted by the Board of Directors, without election, at any
time, the charges varying according to the circumstances of the friends and
their requirements. Separate sitting and bedroom accommodation, with the
advantage of a special Attendant or Nurse, is provided when wished, such
an arrangement combining the quietude and comfort of a private residence
with the hygienic, educational, and training resources of a Public Institution.
The Asylum is under the personal charge of Mr. and Mrs. J.J. C. Turner,
Superintendent and Matron, and there is likewise a Resident Medical
Attendant.


The Elections occur in the Spring and Autumn, and are held in the
principal towns of the Eastern Counties. Donors of Five Guineas are entitled
to a Life Vote, and Annual Subscribers of Half-a-Guinea to two
votes annually, the right of Voting as regards higher sums being increased
in the same proportion. Contributors may individually exercise the right
of Voting, or transfer the same to the House Committee of the Asylum or
to any Local Committee.


Reports, Forms of Application for Admission, and any other information
will be supplied by the Secretary, Mr. John J.C. Turner, Asylum, Colchester.


The Board of Directors earnestly appeal for Annual Subscriptions and
Donations to enable them to carry on this important work. Since 1884
the Annual Subscriptions have been reduced, owing to deaths and discontinuance,
by upwards of £1,000. The applications for admission are
numerous and urgent, and the present expenditure exceeds £7,000 annually,
towards which only £800 is forthcoming from invested Capital. Only
those who are brought into close contact with mental affliction can adequately
realise the sad trial and immense anxiety of having an Idiot child,
and where this affliction has not been experienced, it is hoped that some
sum, however small, will be given as a thank-offering.


JOHN J.C. TURNER,

Secretary.




By the Same Author. Demy 8vo, 16/- Second Edition, Greatly Enlarged.


Prize Essay of the Academy of Medicine of France.


ON


APHASIA,


OR


Loss of Speech,


AND


The Localisation of the Faculty of Articulate

Language.


Ouvrage couronné par l'Académie de Médecine de France

(Prix Alvarenga, 1891).


OPINIONS OF THE PRESS.


From the British Medical Journal.


"We feel quite sure the profession will gladly welcome the second
edition of Dr. Bateman's well-known and valuable work. It teems
with illustrative cases, and is essentially one for the student of
Aphasia always to have by him, in order that he may readily refer
to it from time to time; any case he may have under his care will
indeed be rare if he cannot find an allusion to a parallel one in Dr.
Bateman's book.


"We think that the author was very well advised in extending
chapter xii., for there are grouped together a number of interesting
facts on important topics, such as the difference between the
convolutions of criminals and of intellectual men, the difference
in the microscopic structure of the brain, the cranial capacity, and
other subjects of which it is usually difficult to find any mention."


From the London Medical Recorder.


"The numerous clinical cases form a valuable feature in this
book. These illustrative records have been gathered from a wide
range of reading and experience, and hardly any case of importance
bearing on the subject appears to have escaped notice. As
a work of reference, then, this volume will be indispensable to all
who are interested in the study of nervous diseases."


From Nature.


"A useful part of this work is a chapter on the Medical Jurisprudence
of Aphasia. This is a subject which we believe has not
been touched upon in any previous English text-book, and it is of
the greatest importance. To summarise briefly, we may say that
Dr. Bateman's work is one that should be read by everyone
interested in the faculty of language, or in diseases of the nervous
system. It contains an enormous amount of valuable material,
which has been put together by great labour, and is written by
one who has devoted many long years to his subject."


From the Solicitor's Journal.


"This book is a second and greatly-enlarged edition of a treatise
published some years since by Dr. Bateman. It gained a prize,
on the recommendation of the French Academy of Medicine, in
1891, and its author has recently received the honour of knighthood,
in recognition of his distinguished labours.


"While the whole work possesses great scientific interest, chapters
v. and x. are of peculiar value to general and legal readers.
In the latter, the Jurisprudence of Aphasia is dealt with. This
question has not hitherto been treated by any British author,
although it involves issues of such frequent occurrence and general
importance as the capacity of speechless persons to make a will and
to manage their affairs, and their civil and criminal responsibility.
Having examined this part of Dr. Bateman's treatise with the
utmost care, we have no hesitation in commending it heartily to
our readers as an able exposition of a difficult subject, enriched
by illustrations from Continental Jurisprudence."


From the Norfolk Chronicle.


"In the goodly volume of over 400 pages before us, we have
substantial proof of the perfection that may be attained by Theory
and Practice, walking and working hand in hand. An eminent
physician, whose great energies and rare knowledge of therapeutics
are apparently absorbed in the everyday exercise of his
noble profession, has yet found time for deep research and
original speculation in one of the most fascinating regions in the
whole range of Neuro-pathology. The result is such as only the
well-directed devotion of a life-time could have produced. Here,
in one, we have a student's text-book, a scientist's guide and
companion, and, lastly, a psychological treatise certain to attract
a large share of attention at the hands of the intelligent general
reader. For the medical profession it possesses, without doubt, a
primary interest—yet, withal, it is replete with interest to the
general reader."


CONTINENTAL NOTICES.


Les Archives de Neurologie, Vol. xx.


"Ce livre est la deuxième édition considérablement augmentée
du traité publié il y a vingt ans et bien connu de nos lecteurs.


"N.B.—Ce livre est parfaitement au courant de la science
actuelle."


La Revue de l'Hypnotisme.


"L'ouvrage du docteur Bateman a déjà reçu un accueil favorable
de l'Académie des sciences et de l'Académie de médecine de Paris.
En le présentant à la Société de Biologie, le Président, M. Brown-Séquard,
a fait un éloge mérité de ce remarquable ouvrage aussi
savant qu'original.


"Le livre du docteur Bateman apporte une contribution précieuse
à la médecine psychologique. M. Bateman a compulsé
toute la littérature scientifique de l'Europe et de l'Amérique sur le
sujet qu'il a traité, et ses études faites pendant plus de vingt années
sur les cas qu'il a rencontrés à l'hôpital de Norwich et dans sa
clientèle privée, lui ont permis d'arriver a des conclusions véritablement
pratiques."


Annales d'Hygiène Publique et de Médecine Légale,

Tome xxvi., p. 583.


"La première édition du traité de M. Bateman avait été très
favorablement accueillie du public médical. La seconde édition,
augmentée d'observations nouvelles, tenue au courant des progrès
de la science, n'aura pas moins de succès.


"Les premiers chapitres du volume sont consacrés a l'historique
de l'aphasie et de la localisation de la faculté du langage articulé:
l'auteur y rend pleine justice aux auteurs français, Broca, Trousseau,
Charcot, &c., qui ont les premiers soulevé cette question délicate. Le
chapitre iv. contient les observations personnelles de M. Bateman
dont beaucoup ont été recueillies dans son service à l'hôpital de
Norfolk et Norwich. Dans le chapitre suivant M. Bateman étudie
et analyse la faculté de parler, la parole articulée, résume les
opinions de Max Muller, de Whitney, de Parchappe, &c. La
parole est un acte physico-psychique, composé de deux éléments,
l'un somatique et matériel, le mouvement, l'autre psychique, la
parole interne, le λογος. Le langage est donc une fonction à la
fois impressive et expressive. La fonction impressive nécessite
l'action de l'ouïe, de la vue ou d'un des sens, c'est la fonction sensorielle
du langage; l'autre résulte d'une action musculaire, et
constitue la fonction motrice. Le langage articulé est l'apanage
de l'homme seul.


"L'auteur décrit ensuite le mécanisme du langage, les organes
de la voix, le larynx; il étudie plus loin les différents types de
langage; il montre que le langage articulé n'est pas le seul moyen
que l'homme ait d'exprimer sa pensée, il oppose le langage naturel
au langage artificiel ou acquis, &c.


"Avec les chapitres suivants nous entrons dans la pathologie;
M. Bateman y décrit l'agraphie, l'aphasie dans toutes ses formes
et variétés. Il étudie ses causes, son diagnostic, son pronostic,
son traitement, son importance en médecine légale; enfin dans
les derniers chapitres, M. Bateman s'occupe plus généralement
de la localisation de la parole, et il résume les opinions des
physiologistes les plus célèbres depuis Gall jusqu'à Barnard
Davis, Flower, Broca, &c."


Comptes Rendus de la Société de Biologie, Tome ii., No. 30.


"Au nom de l'auteur, le Dr. Frédéric Bateman, je présente à la
Société un exemplaire de la seconde édition de son célèbre ouvrage
sur l'aphasie. Les progrès considérables de nos connaissances,
durant les vingt dernières années, sur les diverses espèces d'aphasie,
sont exposés avec une grande clarté dans ce remarquable ouvrage
aussi savant qu'original, le plus complet qui existe sur la matière
dont il traite. L'auteur lui a consacré toute sa vie, déjà longue,
de penseur et de praticien."


"Le Professeur Brown-Séquard,

"Président de la Société de Biologie."


Gazzetta Degli Ospitali, Milano.


"È una monographia importante su questa affezione tanto
studiata ai nostri tempi. L'A conosce tutto ciò che fu scritto in
proposito e lo sottopone ad una critica sensata e profonda. Egli
raccolse un gran numero di casi, e, avendo cosi avuto a sua disposizione
un vasto materiale, ha potuto studiare accuratamente
la malattia.


"Il quarto capitolo contiene le esperienze cliniche dell'A, in
una serie di X Casi dettagliati alcuni dei quali furono da lui
osservati come medico del Norfolk and Norwich Hospital.
Interessante quello di una afasia puerperale in una signora il cui
vocabolario era limitato ad una frase: the other day—l'altro
giorno."


Neurologisches Centralblatt.


"Im 1.—3, Kapitel wird die Litteratur und Bibliographie der
Aphasie ausführlich berichtet, indem die betreffenden Arbeiten
aller Länder in gleichem Maasse gewürdigt werden. Im 4.
Kapitel finden wir einige eigene Beobachtungen des Autors.
Kapitel 5 bringt die Definition der Aphasie und die Entwickelungsgeschichte
der Sprache. In Kapitel 6 und 7 wird die Klassification
der Sprache abgehandelt. Mitunter fehlen dem Sprechenden
nur die Substantiva, oder ganz bestimmte Worte, oder
eine bestimmte Landessprache; in anderen Fällen von Aphasie
werden nur bestimmte Phrasen beständig wiederholt etc. Auch
die Schriftstörungen und die Anomalien der Mimik und Zeichensprache
bei der Aphasie werden besprochen; ferner die Affectausdrücke,
Bedeutung der Injectionen, der hysterische Mutismus
u. s. w. Im 8. Kapitel werden die ätiologischen Factoren der
Aphasie hervorgehoben: Angeborene Stummheit, Sprachstörungen
der Idioten; Aphasie in Folge von Exostosen der Schädelknochen;
Thrombose, Embolie der Gehirnarterien; ischämische Erweichung,
etc. Kapitel 9 behandelt die Diagnose, Prognose, Therapie,
während im folgenden Kapitel die Rechtsfragen der Aphasischen
erörtert werden. In den letzten Kapiteln 11 und 12 geht der
Verf., soweit die betreffenden Gegenstände zur Aphasie in Beziehung
treten, auf den Hypnotismus ein, den anatomischen Sitz,
die mikroskopischen Befunde, auf die Physiologie und Psychologie
der Sprache, die experimentelle Pathologie, die allgemeine Anthropologie,
auf die Hirnchemie etc."


AMERICAN & COLONIAL NOTICES.


From the Montreal Medical Journal.


"The learned author of this work was the first to publish in
English a treatise on Aphasia. Not the least interesting part of
the work is that referring to the author's own contributions. The
subject of Aphasia is treated in all its relations, and in all its
forms and modifications.


"There is certainly no work in the English language which gives
such a full and accurate account of this abstruse subject. The
author is to be congratulated on having produced a work that will
be a standard authority on loss of speech."


From the American Journal of Insanity.


"Perhaps the most remarkable thing about this book of Dr.
Bateman's is the singular spirit of scientific fairness that characterizes
its every utterance, so conspicuous and so anomalous is
this, that it is worthy of special mention.


"It is a book which no student of medicine, of language, or of
psychology can afford to be without."


From the New York Medico-Legal Journal.


"This is a book which will interest all neurologists, and reflects
great credit on its author, for the research and care, as well as
fairness of the discussion, which is raised between the several
schools of thought.


"That part of the work most interesting to us is the chapter on
the Medical Jurisprudence of Aphasia, the hints on criminal
Anthropology, the Chemistry of the Brain, and the question of
Localisation of the Faculty of Speech.


"The work on the whole is a very valuable contribution to the
literature of Aphasia, and will be welcomed by all Neurologists."


From the Alienist and Neurologist.


"This is a valuable contribution to the history and literature of
the subject, a subject not yet too old to have lost its interest to
either professional or lay reader.


"No library of the literature of Aphasia, however, would be
complete without this book. The author is elaborate without
complexity."




London: Jarrold and Sons, 10 and 11, Warwick Lane, E.C.






Transcriber's Notes


Obvious punctuation and spelling errors repaired.


Page numbers for blank pages, pages consisting entirely of illustration, are not visible.


Inconsistent hyphenation has been repaired.


The oe and ae ligatures in the text has been left as it appears in the original book.
If they do not display properly, you may have an incompatible browser or unavailable fonts.
Make sure that the browser's "character set" or "file encoding" is set to Unicode (UTF-8).
You may also need to change your browser's default font.


Greek translations are indicated by dotted blue lines.  Scroll the mouse over the Greek words
and the translation will be displayed.


The remaining corrections made are indicated by red dotted lines under the
corrections.  Scroll the mouse over the word and the original text
will be displayed.


In ambiguous cases, the text has been left as it appears in the original book. In particular, many mismatched quotation marks have not been changed.


The following numerous errors were left as is: