Idiocy
91 Art. IV.? :Author: Frederic Bateman, M.D., F.R.C.P., Physician to the Norfolk and Norwich Hospital, &c.
As the Consulting Physician to the Essex Hall Asylum, I beg the favour of your attention for a few moments whilst I endea- vour to plead the cause of that useful institution, in the hope that I may excite an interest in its objects amongst the inhabit- ants of Lynn and its immediate neighbourhood. In the few words that it is my privilege to address to you, I do not propose limiting my remarks to the claims which the Eastern Counties Asylum for Idiots has upon your support, but I desire to take a wider view pf my subject, and to advocate the cause of the 30,000 stricken members of the human family in England and “W ales, who, by the very nature of their infirmity, are unable to say a single word for themselves. I feel considerable diffidence in addressing you this morning?a diffidence not arising from any feeling of weakness in the cause I am espousing, but rather from fear that my imperfect advocacy may not do full justice to the paramount importance of my subject. It is a common practice for speakers to try and produce a sensational effect, and to create an artificial interest in their subject, by grossly exag- gerating the wants of those for whom they plead. Now, I have a plain unvarnished tale to tell, and without indulging in the language of hyperbole, I trust I may rouse a chord of sympathy in your hearts, and induce you to lend us a helping hand in oni endeavours to grapple with one of the most direful calamities to which the human race is liable.
In making an appeal to the public, it is most impoitant accurately to define the object, aim, and end of such appeal. ” e are met here to-day to consider what can be done to raise a portion of the human family from the slough of despond and object misery into which it has fallen. England is proverbially a land marked by the benevolence and philanthropy of its inhabit- ants, and a large amount of money annually flows into the coffers of our charitable institutions, and in no country in the world is so much sympathy evinced towards the sick and suffer- *ng poor as in this highly favoured land. But whilst fully acknowledging this, I feel that there is one class of the com- munity which has been, at all events till quite lately, singularly an nil “t”n address delivered at tlio Town Hall, Lynn, on January 30, 1879, at the meeting of the Eastern Counties’ Asylum for Idiots.
neglected, and which has not received that share of British sympathy and British support, to which, from the peculiar nature of its infirmity, it is entitled. The class to which I allude is that commonly known as Idiots; and I think that popular ignorance as to the nature of idiocy, and misconception as to its capacity for treatment, have been the sole cause of this apparent neglect. I hope I shall be able to show you that a great social evil exists amongst us, that its effects are sorely afflicting our population, that much may be done to remedy this evil, that the Essex Hall Asylum is successfully grappling with it, and that our efforts have been attended with signal and unexpected results. The indefatigable superintendent of the asylum, Mr. Millard, will probably enter into some details as to the internal arrange- ments of the institution, and the task has been deputed to me to say a few words about the Natural History of the idiot and his place in creation; and as this is the fourth time, within a comparatively recent period, that I have had occasion to speak about idiocy from a scientific point of view, it is scarcely possible but that my thoughts must occasionally run in a similar channel as on former occasions; for, although practical science is ever advancing, scientific truths remain the same.
Let me now try and give a definition of idiocy. What is an idiot ? This is a question about which some difference of opinion exists in the scientific world. The word ” idiot” is derived from the Greek t&ios, solitary, and expresses the condition of an individual isolated, as it were, from the rest of nature. Yes, he is indeed alone in the world ; it is true he sees and hears, but he fails to perceive and appreciate; the beauties of nature and of art are nothing to him; he is indifferent to the splendour of the rising and the setting sun, and he stands unmoved at the sight of the starry firmament with those mighty orbs which are sus- pended over the great pavilion of space?the moon in her gentle pale serenity gliding through the sky, the stars, those bright gems that gleam and sparkle on the crown that encircles the sable brow of night,?all this is nothing to him, for the pall of a universal night has fallen upon him. Shakespeare, that great delineator of character, in several of his dramas gives a descrip- tion of idiocy. In ” Titus Andronicus,” he speaks of the idiot as ” one who holds his bauble for his God,” and elsewhere he speaks of ” a tale told by an idiot, full of sound and fury, and signifying nothing.” One of the best definitions, and one that I accept with some slight reservation, is that of I)r. Bucknill, one of the leading psychologists of the day:?” Physiologically an idiot is a human being, who, from defect or disease of the brain, at a period of life before the mind has become developed, has suffered an arrest of mental development to such an extent that he is incapable of the ordinary functions and duties of social existence.”
” Idiocy,” says Dr Ireland, one of the most recent writers on the subject, ” bears much resemblance to the ordinary conditions of infancy. In idiots the mental state may be said to be fixed in the infantile state, or very slowly to move towards the efficiency and maturity of the motor and reasonable powers which charac- terise the normal adult.” In old books on medical nomenclature, idiocy has been classed amongst the varieties of insanity, and in most of our lunatic asylums of the present day you will find a certain number of idiots. Idiocy, however, is not a form of insanity, and has no right to be so classed. In fact, the asso- ciation of idiots with the insane is a great disadvantage to the former ; and in a communication I have lately received from Dr. Hills, the experienced superintendent of the Norfolk County Asylum, I find that he strongly urges the necessity of separate establishments for the care and treatment of idiots. Having been informed that it is contemplated to introduce a Bill into Par- liament next session for the proper care of pauper idiots, I desire to press this point upon the legislators of the country, of whom I have the honour to see one amongst us to-day; and as in this county, our union houses are far too large for the require- ments of the age, I would suggest that one or more of them might, with advantage, be devoted to the care and treatment of pauper idiots. The distinction between idiocy and insanity is clear and marked. The madman suffers from an abnormal de- velopment of the brain, the idiot from an ill-developed brain. In the one, the mind is not in proper balance, in the other it is not in proper power. Idiocy has a superficial resemblance to dementia, much in the same way that the dotage of old age sometimes resembles the weakness of childhood. Dementia begins with average intelligence, which gradually diminishes; idiocy begins with a low amount of intelligence, which gradually increases.
Time will not permit me to enter minutely into the causes of idiocy. An excellent and exhaustive monograph has been written on the subject by Dr Howe, a great American authority, in which he says that idiocy in not an evil necessarily inherent in society, but that it is merely the result of a violation of natural laws, which are simple, clear, and beautiful, and which, if strictly observed for two or three generations, would totally remove from any family, however strongly predisposed to idiocy, all possibility of its recurrence. In treating of the hereditary transmission of idiocy, Dr Howe lays great stress on the habitual use of alcoholic drinks as tending to bring families into a low and feeble condition, which thus becomes a prolific cause of idiocy in their children. He substantiates this statement by tables, in which he shows that out of 359 idiots, the condition of whose progenitors had been ascertained, 99 were the children of inveterate drunkards ; and the report goes on to say further, that when the parents were not actually habitual drunkards, yet, amongst the idiots of the lower class, not one quarter of the parents could be considered as temperate persons. Just now that the attention of the Legislature is being prominently called to the treatment of habitual drunkards, it cannot be too widely known that their innocent offspring are but too frequently the victims of the brutish excesses of their parents, who, some years since, were described by Mr. Cross, the Secretary of State for the Home Department, when receiving a deputation on the subject, as not quite criminals nor quite lunatics, although nearly ap- proaching both classes in many cases. Dr Howe’s statistics fully corroborate the pertinency of Mr. Cross’s remarks. 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 ? Is it a defect in the quantity or 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, or on the fineness and degree of complexity of the convolutions ? Upon this point, I am bound to tell you that science speaks with a somewhat un- certain sound, volumes having been written upon it without any definite solution or tangible result. It is a subject, however, of extreme interest, not only to the man of science, but especially to the theologian ; and, if this were the time and place, I could show that the study of idiocy points to conclusions directly opposed to the materialistic tendencies of the day. A great many idiots cannot be recognised as such by the mere examina- tion of their skulls; and although there is undoubtedly a mini- mum size of head, below which the possessor is necessarily an idiot, yet no constant relation exists between the general develop- ment of the cranium and the degree of intelligence, and some- times the brain of idiots presents no deviation in form, colour, or density from the normal standard.
I had the privilege last summer of attending an International Congress held in Paris for the study of mental disease, and for the solution of obscure psychological problems. At one of the sittings of this Congress, a Russian Professor, Dr Mierzejewski, read a most elaborate paper on the causes of idiocy, illustrated by casts of the brains of idiots and of certain animals. The learned Professor laid great stress on the histological or micro- scopical examination of the brain of idiots, which he said revealed most minute and interesting lesions and anomalies in the struc- ture of the nerve centres of these degraded beings. In order to understand the great value of Dr Mierzejewski’s investigations, I must remind you that there is a certain school of modern philosophers who are trying to materialise everything. They utterly ignore any spiritual attribute in man, they regard meta- physics as a relic of mediseval superstition, and they assert that mind, thought, and consciousness 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 complicated act of mechanics; that there is no real distinction between living and dead matter, and that vitality is a metaphysical ghost (ein metaphysisches Gespenst). As I have in my published researches endeavoured to show how these mere assertions are totally unverified by scien- tific inductions, I need not dwell upon them here. As the manifestation of the intellectual powers is supposed to be in some way connected Avitli the development of the grey mattei of the cerebral convolutions, one would expect to find in idiots a deficiency of this element of brain tissue. But Dr Mierzejewski s researches show that this is by no means the case, and he men- tioned 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 and intellectual Power, for richness of grey substance and abundance of nerve cells may be accompanied by idiocy. Now these startling state- ments were not made in a hole and corner, but were enunciated in the presence of leading psychologists from all parts of the world; they must therefore be faced by the materialists. With- out unduly exaggerating the importance of Dr Mierzejewski’s experiments, it must be admitted that very great interest at- taches 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 Pro- fessor’s researches tend to shroud it in a still deeper mystery, and show that what has been termed the ” slippery force ot thought?the vis vivida animai”?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 demon- stration, and the demonstrand.” To those who may wish to Pursue this subject further, I recommend a perusal of an essay on “Materialistic Physiology,” by Dr Winn, in the Journal of { syphological Medicine for 1877. I make no apology for intro- ducing this much-disputed question, for I believe that the Essex Hall Asylum and other kindred institutions are destined to become the battlefield where this difficult problem of mental philosophy is to be fought out and definitely settled. At present, although the pseudo-philosophers of the day have bewildered the public with the wild flights of their imagination, they seem to me to be no wiser than the Latin poet of 2,000 years ago, when he said :?
Spiritus intus alit, totamque infusa per artus Mens agitat molem, et magno se corpore miscet. One thing we can positively assert?that idiocy is the result of defective physical organisation ; but we must take care not to confound thought, mind, and consciousness, with the instrument by which these attributes become externally manifested. The idiot, says Dr Howe, has so far violated the natural laws, so far marred the beautiful organisation of the body, that it has become an unfit instrument for the manifestation of the powers of the soul. This idea has been aptly illustrated by comparing the brain to a musical instrument, the soul to an invisible player. If the harp have a thousand strings and they all keep in tune, then the soul discourses sweet and varied music; but the idiot’s instrument is a wretched thing, and its few strings are so sadly awry, that even in a seraph’s hands, it could give nothing but jarring and discordant strains.
According to the Census of 1871, there are in England and Wales 30,000 idiots, or thirteen in every 10,000 individuals ; but as the returns are probably defective, owing to the sensitive- ness of parents, who naturally desire to conceal the fact of idiocy in their families, it is considered that the above estimate is below the mark. It is only within a comparatively recent date, that these unfortunate creatures have been treated as belonging to the human family. In the middle ages, it was a common custom for our feudal lords to have one or more of them as butts in their retinue; and Addison tells us that as late as 1710, idiots were still in request in most of the courts of Germany, where there was not a prince of any magnificence who had not two or three in his retinue, whom the courtiers were always breaking their jests upon, and Addison aptly adds:?
Thus one fool lolls liis tongue out at another, And shakes his empty noddle at his brother. They were formerly considered to be beings without souls; and it is even related of the great reformer Luther, that when asked by a father what should be done with his idiot boy, Luther replied that the child might be drowned, as he possessed no soul! Times are happily changed, and a revolution has taken place in the treatment of these benighted members of the human family, who have ceased to be the butt of scorn and ridicule. We also now concede to the idiot the possession of the Tripartite Nature of Man, for he has not only the aw/jlci or material part, and the or principle of animal life, but he also undoubtedly possesses the 7rvev/^a or principle of immortal life; and the result of treatment at Essex Hall will show that there may be kindled up in their dark and twilight spirits some dim anticipations of a brighter world. We do not drown idiots at Essex Hall, 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. I ask you to help us in our attempts 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.
A noble example has been set by the most illustrious landowner in the county, who has this day intimated his gracious intention to extend his royal patronage to an institution especially estab- lished for the care of idiots from the four counties of Norfolk, Suffolk, Cambridgeshire, and Essex. It is, therefore, essentially the cause of a Norfolk charity that I am pleading to-day; and I beg of you, when you leave this hall, not to allow the con- dition of the 700 poor idiots of Norfolk to fade from your minds. I appeal to you who have had the joy of watching the dawn of infant intelligence, and have experienced the delight ?f seeing the capacities shown in the early life of your own children gradually ripen and develop into the intelligence of manhood, to look with an eye of pity on the numerous house- holds rendered miserable by the intolerable incubus of the presence in their midst of an idiot child. At Essex Hall, we are trying to mitigate, as far as we can, this ‘great social ca- lamity, and our efforts have hitherto been crowned with unlooked- for success; but our means of usefulness are limited, we want more help, and I earnestly press the claims of the Eastern Counties Asylum for Idiots on the sympathy, benevolence, and philanthropy of the inhabitants of Lynn, and of the county of Norfolk generally. PART I. VOL. V. NEW SERIES. H
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