“Dick”: A Case of Atavism
A clinical lecture reported by the recorder of the Psychological Clinic. The following list of physical anomalies will show immediately that Dick is an obvious case of arrested development. He is microcephalic; at nine years his head girth is 47.1 cm., the minimum for five years being 50.37 cm. His ears are a-symmetrical. He has a cleft palate, the extreme opening of the fissure being three-eighths of an inch. The uvula is missing. He is unable to open his mouth for more than about an inch, as he does not use the proper muscles for this purpose. His hands are also most significant. The boy was born with one thumb attached to the third joint of the first finger, and this was removed by operation. On the other hand the thumb does not resemble that of a human hand, but rather that of one of the apes, and it is not opposible, except occasionally. He grasps with all of his fingers as a unit, instead of using them separately as does a human being.
His performance level with the tests just made is about eighteen months. This does not mean that his performance is that of a normal eighteen-months-old child. This is not a case of simple retardation. The boy is qualitatively feebleminded. He is able to pick up a block and put it into one of three similar spaces, as with the Seguin Circles A, but he is unable to make a choice between three slightly dissimilar spaces, as with the Seguin Circles B. He apparently did learn to do the three-block formboard, but his memory is not retentive as appears from the fact that when he was given this same test after a brief interval he failed to do it. There is no evidence that his reactions are above the level of senso-motor reflexes. He shows no imageability, no associability, and no attention as we usually use the word. He is, however, not at all like the Mongolian in attention. He is too lethargic to give a typical Mongoloid performance. His parents say that he has never been a troublesome child, and this is no doubt true. The fact is that he is probably too lacking in energy to have any initiative. This brief analysis shows that his behavior is in no sense that of a normal eighteen-months-old child?in other words he does not conform in behavior to the type of a normal child of that age or of any age.
This non-conformity does not show in his moral conduct, he is not brutal or destructive, and there is certainly no evidence that he has immoral or criminal intentions. There are no symptoms of dementia or emotional disorder?it is not a case of insanity. The sort of non-conformity to type which we find in this child suggests atavism, i. e., retardation on the species scale. He isd efinitely a case of incomplete uterine development?witness the cleft palate, the missing uvula, the microcephaly, and the non-human hand. The mother gives as a possible cause, an injury due to breech presentation at birth, but the child bears upon his body definite proofs that the trouble is of earlier origin than that, and is to be sought for either in heredity or in an arrest of uterine development. The mother reports a fall in the third month of the period of gestation, and it is possible that this may have produced a tendency to, or an incomplete, miscarriage, the result being this monster. The parents absolutely deny any attempt at abortion. There is no other child. This latter fact may be of significance as it is just possible that the trouble in Dick’s case may be due either to an attempt at abortion, resulting from a lack of desire for children, or to a lack of procreative energy in the mother. In the latter case the lack of procreative energy may have caused mal-nutrition in utero, and therefore a child monster. It is, of course, possible that the cause is syphilis. The family history given by the parents, both of whom seem perfectly normal, and in fact rather intelligent, is absolutely negative as regards etiology.
Whatever the cause may be, this child is a case of arrested development, on the species scale an atavistic monster and on the growth scale an idiot.
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