The Mental Defective
REVIEWS
- Author:
Richard J. Berry, M.D., and R. G.
Gordon, M.D. New York: Whittlesey House, McGraw-Hill Co., 1931, xiii -f- 225 pp. $2.50.
The authors of this work, who are on the staff of Stoke Park Colony, Stapleton, Bristol, England, were asked by several persons to epitomize something of the real achievements in the recent study of mental deficiency and the basis of this condition in the underdevelopment of the nervous system. The book, as written, is addressed to the medical man, and also to the general reader. It is not written from the psychological point of view, nor does it appear to be intended for the psychologist. The latter, nevertheless, may read it with profit, for while little new material is presented, the book serves well as a general introduction to the problem of mental deficiency in its physiological and social aspects.
The material in the book falls into three parts. (This division is made for convenience and clarity by the reviewer, and not by the authors.) The general problem of mental deficiency is considered first. There is an instructive account of the development of English law in respect to the control of the mentally deficient. It should be borne in mind that there is a difference between the English and the American terminology in this field. While in America the term ‘feebleminded’ is applied to all grades of mental defectives, in England the term is restricted to only the higher grades who are called in this country morons or high grade imbeciles. The technical term amentia describes what is known in England as mental deficiency and in America as feeblemindedness. Speaking in neurological terms, as our authors always do, amentia is due to a failure in brain development; dementia is due to the deterioration of brain development already attained. In this book there is introduced a new term which we believe should take its place in the terminology of abnormal psychology. “We have ventured,” say the authors, “to coin the term dysmentia … to describe an aberration of neuronic function without there being necessarily any failure of neuronic development, or permanent destruction of neurons.” There are two forms of amentia, primary and secondary. The primary form is attributable “to causes operative on the fertilized ovum.” In the secondary form the “causative factor is to be sought at, or after, birth.” We do not believe this distinction is a valid one. It would be better to confine the term primary amentia to those cases in which the defect can be attributed to defective germ plasm, and the secondary amentia to those cases in which the cause is to be sought in the environment whether before or after birth, for after all birth is only a change in environment.
The second division of the material considers the neurological basis of mental deficiency. It is the most thorough part of the book. There is an extensive discussion of the evolution of the brain and the functions of its 158 REVIEWS 159 various parts. The activity which distinguishes the mind of the normal man is dependent upon the presence of numerous internuncial neurons which make possible differentiated reactions to stimuli. It is the failure of these neurons to develop which to a large extent accounts for mental deficiency. Growth and education are explained by means of the conditioned reflex of Pawlow. Generally in the mental defective there is not only a deficiency of the nervous system but of the body as a whole so that he is subject to numerous diseases, his vitality is low, and his energy limited. The only criticism of this section which we venture is that it tends to over-simplification and speaks a bit too certainly.
Thirdly, while mental deficiency rests upon a physical basis, it is a social problem. The authors agree with Karl Pearson, “It appears to me that the term ‘mental defective’ ought to be replaced by some such term as ‘social inefficient.’ ” Mental deficiency is inherited as a recessive Mendelian characteristic, although the authors admit that the problem is not quite so simple. For the great majority of mental defectives little can be done therapeutically. Mental deficiency can not be cured, but must be endured. The presence of large numbers of mental defectives is a heavy burden upon the normal members of the community. Again and again the authors express their dissatisfaction with modern democracy and its glorification of the mediocre. Their point is no doubt well taken, but they betray some confusion in failing to distinguish between the mentally deficient in the technical sense and the lower levels of the normal population.
The closing chapter of the book is devoted to the outline of a policy to meet the situation presented. The opinions advanced here are strongly to be recommended to all who have anything to do with the social treatment of the mentally deficient. Treatment looking toward a cure is of course excluded. Attempts to train the defectives so that they can be placed back in the community, a practice widely advocated, is condemned as futile. It is important that the mentally deficient should be recognized as early as possible. Then they should be placed in colonies where they will be segregated from the community and allowed to live the life of which they are capable. These colonies should be erected simply and with the least possible capital expense. The erection of expensive and architecturally impressive buildings for the mentally deficient is ridiculous. As far as possible these colonies should be self-supporting, which, with proper management, can be approximated. One of the practices of many institutions is rightly condemned?the modelling of training upon the regular school with instruction in reading, writing and arithmetic. The children never learn anything, and would have no use for it if they did. The following statement will gratify the many friends of the institution concerned: “The training school at Yineland, New Jersey, has directed much of its research in the problems incidental to the education and life work of the metally defective on more rational and infinitely more useful lines than the biochemical investigations which pass for research in some English institutions.” Finally there is recommended a new type of institution in which borderline cases can be placed for observation and study. It is often very difficult to determine whether these cases are normal or defective, and such an institution should prove valuable. A criticism of the book as a whole should be mentioned. There is no bibliography and not even a reference. Although numerous authorities are cited in no case is there a specific reference. Such references might have frightened the general reader, but they would have added to the value of the book for students and for all serious readers. There are eight photographs showing different types of mental defectives, and ten drawings.
Miles Muephy
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