The Biology of Mental Defect
- Author:
Lionel S.
Penrose, M.D. Sidgwick & Jackson. 21s.
Many people hold very definite views which they do not hesitate to propound on this subject. For example a leading dignitary of the church recently advocated wholesale sterilization of mental defectives in an article published in a daily newspaper. Those who are interested in the social problem of mental inferiority would do well to study this new book on the subject by Professor Penrose. By so doing they will gain an insight into the extreme complexity of the problem and realize that it is one which cannot be solved by any single piece of dictatorial legislation. On the contrary, mental defect is an inevitable part of our social structure as it stands to-day. This is not to say that the dimensions of the problem may not be much reduced and the lot of particular individuals (whether patients or their relatives) much eased by proper social provision. Penrose quotes Arkansas, Arizona and Nevada as states in which no provision is made for mental defectives and shows that in those states there is an equivalent rise in the number of persons admitted to prison and he notes that in general it costs more to keep a citizen in prison than it does in an institution for mental defectives. Throughout his book Penrose brings to bear an accumulation of scientific erudition in contrast to the moralising tone which permeates the older text-books of mental deficiency. He shows that modern psychiatry has little use for the legal concept of moral defect and points out that in general mental defectives are not less but more receptive in point of character training than ordinary individuals. He suggests that the origin of faulty habits which highgrade defectives may acquire, lies not so much in any innate propensity for wickedness as in a faulty social environment, and points out that the purpose of institutional care of such cases is re-equipment for a useful life in the community. In general he does not favour the mixing of high-grade delinquents and “psychopathic personalities” with well-behaved patients of a lower level. He shows that the result may be bad for both groups inasmuch as the bad behaviour of the delinquents may serve as a model for their less gifted fellows whilst the more intelligent patient who is committed to an institution from court or prison is contemptuous of the imbeciles with whom he is confined and so prejudiced against any advice and instruction which he may be offered. Penrose also deals admirably with the alleged threat to the national intelligence which arises in popular imagination from the alleged fertility of mental defectives. He explains that idiots and most imbeciles are sterile (though in fact some American states have been to some pains to reduplicate nature’s work by sterilising many thousands of such patients). Apart from this the feeble-minded are also less fertile than the average, and it is among the dull and backward group who are not legally recognized as mental defectives that a really high reproductive rate is found. He gives grounds for believing that this phenomenon may not be so undesirable as is generally believed. He suggests that just as most defectives are the children of ordinary people, so too those who have made great contributions to civilization may come from parents in no way specially gifted apart from their ability to endow their children with special characters.
As to what constitutes mental defect Penrose explains that there is no such thing as ” intelligence ” in the abstract and that what the defective suffers from is a lack of various abilities which are more or less reliably assessed by standardized intelligence tests. He shows that in the main these tests were devised by those whose prime need was for verbal ability and that they do not necessarily give a reliable estimate of the practical ability of the subject. By the same token, he quotes with approval the opinion that formal education should be incidental to the training of the imbecile rather than its prime purpose. He does not adhere to the view that the intelligence of a child is fixed and unalterable throughout his life and views with the suspicion which it deserves, any estimate of intelligence formed before the age of five. On the basis of observations made on adopted children together with other facts he puts forward the tentative hypothesis that nature and nurture are of approximately equal importance in determining the intelligence level of an individual. Elsewhere he points out that whereas the share of ” nature ” is largely predetermined, the share of ” nurture ” is socially determined and therefore readily influenced so that the ultimate level of performance and social usefulness of the defective is profoundly affected by his upbringing.
In discussing the causation of mental defect, Penrose mentions a number of factors which have already attracted medical attention and some of which it may be possible to modify, by suitable measures of personal and social hygiene. These include the effect of German measles, mumps and other infectious fevers during pregnancy, incompatibility of parental blood groups, hitherto little studied errors of body chemistry which give rise to gargoylism and phenylketonuria. He mentions a number of interesting possibilities for research which include the effect on certain mental defectives of various pituitary hormones. Professor Penrose’s book is essential reading for all of those who have to deal with mental defect (a term which can be extended to cover at least 1 per cent, of humanity). The mathematical sections may be skipped by those whose talents do not lie in that direction, with little detriment to the main argument. It is to be hoped that a second edition will see an amplification of the clinical presentation for those unversed in the subject. B.H.K.
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