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diff --git a/.gitattributes b/.gitattributes new file mode 100644 index 0000000..6833f05 --- /dev/null +++ b/.gitattributes @@ -0,0 +1,3 @@ +* text=auto +*.txt text +*.md text diff --git a/39670-0.txt b/39670-0.txt new file mode 100644 index 0000000..9aca345 --- /dev/null +++ b/39670-0.txt @@ -0,0 +1,3528 @@ +The Project Gutenberg EBook of The Idiot, by Frederick Bateman + +This eBook is for the use of anyone anywhere 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/license + + +Title: The Idiot + His Place in Creation, and His Claims on Society + +Author: Frederick Bateman + +Release Date: May 11, 2012 [EBook #39670] + +Language: English + +Character set encoding: UTF-8 + +*** START OF THIS PROJECT GUTENBERG EBOOK THE IDIOT *** + + + + +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) + + + + + + + + + + + + THE IDIOT; + + _HIS PLACE IN CREATION_, + AND + _HIS CLAIMS ON SOCIETY_. + + + + + + [Illustration: 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. + +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._ + + + + +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 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 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 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 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 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 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 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. + +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 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 unregretted 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 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 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 ιδιοτης[4]) is +alone in the world; 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 +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. + +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 μéτρω ὡς ποιητης, ἡ ἁνευ μéτρου ὡς ιδιωτης" (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. + + + + +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 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 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 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 drunkards, 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] + +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, 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, +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 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. + +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 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 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 intermarriage 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] + +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 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 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. 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 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 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] 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 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 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 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] + +The average brain weight in man may be said to range from 40 to 52-1/2 +ounces, and in women from 35 to 37-1/2 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 64-1/2 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] + +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 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] + +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. + +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 +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. + +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 2-1/2 per cent. of +phosphorus, that of the idiot 1-1/2, and that of the madman 4 to +4-1/2; 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 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 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. + +FOOTNOTES: + +[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. + + + + +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 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 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 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 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 +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. + +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. + +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 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, 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 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 +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 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] + +However tempting it might be, I feel I must not trespass any further +by dwelling on the mysterious connection between 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 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. + +FOOTNOTES: + +[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. + + + + +THE PNEUMA, OR SPIRITUAL ATTRIBUTE OF THE IDIOT. + + Ὁ δε νους εοικεν εγγινεσθαι 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 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 improvement_ 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 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 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 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 +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 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 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 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. + +FOOTNOTES: + +[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. + + + + +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' 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 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. + +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 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 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 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 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 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 redhot 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 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 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 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 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" 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 hallucinations; 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 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] + +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 understood, 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 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] + + +_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] 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 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 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 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 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." + +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 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 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. + +[Illustration: 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] 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] + +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 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 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 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 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 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 +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. + +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." + +FOOTNOTES: + +[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. + + + + +INDEX. + + + Affleck, Dr., 93 + + Alcoholic stimulants as a factor in the genesis of idiocy, 26 + abuse of, in Sweden, 29 + effects of, in France, 31 + Sir B.W. Richardson on, 30 + + Anæmia, as the result of thyroid feeding, 97 + + Anderson, Mrs. Garrett, on Sex in Education, 37 + + Andriessen, on the cerebral convolutions of idiots, 51 + + Animals, relation between + their intelligence and the + size of their brain, 49 + + Association of idiots with + the insane, a disadvantage + to both classes, 19 + + Aveyron, the savage of the, 18 + + + Beach, Fletcher, 25, 27, 28 + + Besant, Sir Walter, 76 + + Birth, injuries of the head at, 48 + + Blood, analysis of, in + thyroid feeding, 96 + supply of, varies in the two sexes, 37 + + Bourneville, on Craniectomy, 101 + + Brain, average weight of, in men and women, 46 + chemistry of the, 52 + difference between that of a senior wrangler and that of an idiot, 43 + difference in the two sexes, 37 + microscopical appearance of, in idiots, 51 + of gorilla and ourang-outang, 75 + size and weight, in proportion to intellectual power, 43 + structure of, in men of genius, 44 + + Bramwell, Byrom, 93, 98 + + Browne, Sir J. Crichton, on Sex in Education, 36 + + Browne, Sir Thomas, 79 + + Bruce, Lewis C., on thyroid feeding, 95 + + Burton-Fanning, 94 + + + Caird, Mrs. Mona, 39 + + Causes of idiocy, 23 + + Cicero, 69 + + Classification, 17 + + Consanguine marriages, 32 + + Convolutions of the brain + in men of genius, and in those of low culture, 45 + in idiots, 51 + + Couerbe, on the rôle of phosphorus in the brain, 52 + + Craniectomy, 101 + statistics of, 103 + + Cranium, early closure of the sutures of, 101 + + Cranium, form of the, and + its connection with + idiocy, 43 + + Cross, Lord, on habitual + drunkards, 31 + + Crossley House, 107 + + Cuvier, brain of, 46 + + + Dahl, Ludwig, 25, 29 + + Dana, on Craniectomy, 102 + + Definition of idiocy, 15 + + Dunlop, 93 + + + Edinburgh Medico-Chirurgical + Society, discussion at, 92 + + Educational Overpressure, on, 35 + has induced suicide in children, 41 + + Esquirol, 85, 118 + + + Faculty a, must not be + confounded with its + material organ, 63 + + Forceps, use of, as a cause + of idiocy, 48 + + Fraser, Professor, anæmia + following thyroid feeding, 97 + + Frere, Bartle, 20 + + Froude, 77 + + + Gambetta, the brain of, 46 + + Genius, a neurosis, 53 + its relation to cerebral structure, 44 + + Goethe, 69 + + Greenfield, Professor, 93 + + Gynagogues, 40 + + + Hammond, G.M., 93 + + Hammond, Prof. W.A., 49, 60 + + Heredity, its rôle in idiocy, 25 + + Horsley, Victor, Prof., 90, 100 + + Howe, 26, 33 + + Humphry, Sir George, on + Craniectomy, 102 + + + Idiocy, causes of, 23 + classification of, 17 + definition of, 15 + its bearing on Evolution, 72 + moral aspect of, 117 + pathological anatomy of, 43 + should not be confounded with insanity, 19 + social aspect of, 116 + + Idiot, the, description of, 22 + his association with the insane a disadvantage, 19 + his claims on society, 12, 114 + phosphorus in the brain of, 52 + possesses the tripartite nature of man, 120 + + Intellectual differences + between men and women, 36 + + Intemperance of parents, + a factor in idiocy, 26 + + Ireland, W.W., 18, 25, 34, 42, 47, 90, 103 + + + Janet, Paul, on phosphorus + in the brain, 53 + + + Kerlin, 27 + + Kirkby, 91 + + Kocher, 90 + + + Ladies' Association, 108 + + Langdon-Down, 17, 30, 33, 48 + + Lassaigne, 53 + + Lelut, on the cranium of + idiots, 44 + + Lewes, G.H., 63 + + Lewi, 93 + + Lunatic Asylums, not + adapted for idiots, 19 + + Lundie, 93 + + Lunier, 31 + + Luys, on the brain of idiots, 51 + + Lynn Linton, Mrs., on + women's sphere of usefulness, 38 + + + Massachussetts report on idiocy, 26 + + Matter and mind, 55 + + Mierzejewski, on the brain of idiots, 58 + + Millard, W., 78 + + Mind, independent of its material organ, 66 + + Mingazzini, on the cerebral convolutions, 44 + + Moleschott, 52 + + Moreau, on hereditary predisposition, 25 + his ideas on genius, 53 + + Murray, G., 90, 93 + + + New York Academy of Medicine, discussion at, 93 + + Norway, prevalence of idiocy in, 28 + + + Odium theologicum, 73 + + + Parental intemperance, 27 + + Parker, Rushton, 99 + + Pathological anatomy of idiocy, 43 + + Permanent Endowment Fund, 82 + + Phosphorus, its relation to intellectual vigour, 52 + + Plato, 22, 64 + + Pneuma, an attribute of the idiot, 71 + + Psychological Congress in Paris, 58 + + Richardson, Sir B.W., on the effects of alcohol, 30 + + + Saeger, 87 + + Schiff, 90 + + Science and Theology should not be antagonistic, 74 + + Séguin, 15, 35 + + Sex in Education, on, 36 + + Shakespeare, his definition of idiocy, 15 + + Shuttleworth, 28, 33, 50, 87 + + Sidney, 80 + + Strahan, 41 + + Sweden, alcoholic abuse in, 31 + + + Telford-Smith, on sporadic cretinism, 99 + + Thomson, J., 93, 99 + + Thucidides, 21 + + Thyroid feeding, 90 + psychical effects of, 100 + + Toussenel, 29 + + Toxic idiocy, 28 + + Treatment of idiocy, 81 + medico-pedagogic, 102 + satisfactory results of, at the Eastern Counties' Asylum, 88 + + Trousseau, on consanguine marriages, 35 + + Turner, J.J. C., 33, 117 + + + Vacherot, 58 + + Voisin, Auguste, 51, 95 + + + Wagner, 45 + + Westcott, 41 + + Westfelt, on the influence of alcohol on progeny and race, 31 + + Wilbur, 28 + + Wilmath, 44 + + Winn, 67 + + + + +EASTERN COUNTIES' + +ASYLUM FOR IDIOTS, + +COLCHESTER. + +_Instituted 1st February, 1859._ + + +Patron: + +H.R.H. THE PRINCE OF WALES, K.G. + + +Presidents: + + THE MOST NOBLE THE DUKE OF NORFOLK, E.M., K.G. + THE MOST HON. THE MARQUIS OF LOTHIAN, K.T. + THE MOST HON. THE MARQUIS OF BRISTOL. + THE RIGHT HON. THE EARL OF WARWICK. + THE RIGHT HON. THE EARL CADOGAN, K.G. + THE RIGHT REV. THE LORD BISHOP OF ST. ALBANS. + THE RIGHT REV. THE LORD BISHOP OF NORWICH. + THE RIGHT HON. LORD WALSINGHAM. + THE RIGHT HON. LORD BRAYBROOKE. + THE RIGHT HON. LORD GWYDYR. + THE RIGHT HON. LORD HENNIKER. + THE RIGHT HON. LORD RENDLESHAM. + THE RIGHT HON. LORD RAYLEIGH. + THE RIGHT HON. LORD DE SAUMAREZ. + THE RIGHT HON. LORD CARLINGFORD. + THE RIGHT HON. LORD TOLLEMACHE. + THE HON. AND REV. CANON NEVILLE. + THE LORD LIEUTENANT OF CAMBRIDGESHIRE. + WILLIAM BIRKBECK, ESQ. + + +Vice-Presidents: + + The Hon. W.F. D. Smith, M.P. + The Rev. Sir W. Hyde Parker, Bart. + Sir Reginald P. Beauchamp, Bart. + Sir Alfred Sherlock Gooch, Bart. + Sir Charles C. Smith, Bart. + Sir Brydges Powell Henniker, Bart. + Sir Francis G.M. Boileau, Bart. + Sir Fowell Buxden, Bart., K.C.M.G. + Sir Savile B. Crossley, Bart. + Sir Edward Green, Bart. + Sir Walter Gilbey, Bart. + Sir Weetman Pearson, Bart., M.P. + The Very Rev. Dean Goulburn. + The Very Rev. the Dean of Norwich. + The Very Rev. the Dean of Ely. + Charles H. Berners, Esq. + Lieut-Colonel Bramston + Henry E. Buxton, Esq. + Professor Duncan, F.R.S. + Robert T. Gurdon, Esq. + Colonel Lockwood, M.P. + Rev. Charles John Martyn, M.A. + Captain Pretyman, M.P. + Arthur Pryor, Esq. + W. Cuthbert Quilter, Esq., M.P. + Hector John Gurdon Rebow, Esq. + H.C. Wells, Esq. + + +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. + + ALEXANDER, WILLIAM, ESQ. + BACK, PHILIP, ESQ. + BARNARD, WILLIAM, ESQ. + BARNARDISTON, COLONEL + BATEMAN, SIR F., M.D., LL.D. + BATEMAN, JOHN, ESQ. + BEVAN, BECKFORD, ESQ. + BULLARD, SIR HARRY, M.P. + BURKE, LIEUT.-COLONEL + BURTON, SAMUEL C., ESQ. + CADGE, W., ESQ. + CHAMBERLIN, A. R., ESQ. + CHANCELLOR, F., ESQ. + COLMAN, J.J., ESQ. + COURTAULD, GEORGE, ESQ. + DAKIN, W. H, ESQ. + DUCKETT, REV. CANON, D.D. + EDWARDS, H.W. B., ESQ. + EGERTON-GREEN, CLAUDE, ESQ. + GARRETT, HENRY N., ESQ. + GODFREY, CHARLES, ESQ. + GREENE, E. WALTER, ESQ. + HARVEY, E.K., ESQ. + HOARE, CHARLES R.G., ESQ. + HUNT, E.A., ESQ. + IMAGE, W.E., ESQ. + IND, CAPTAIN + KELSO, CAPTAIN, R.N. + MACANDREW, W., ESQ. + MARTYN, REV. C.J. + MERRIMAN, W., COLONEL, C.I.E. + MONTAGU, GENERAL., C.B., R.E. + PACKARD, EDWARD, ESQ. + PAPILLON, PHILIP O., ESQ. + PATTESON, H.S., ESQ. + PAXMAN, JAMES, ESQ. + ROWLEY, SIR JOSHUA T., BART. + RUCK-KEENE, REV. B. + RUGGLES-BRISE, A.W., ESQ. + SAVILL-ONLEY, C.A. O., ESQ. + STRADBROKE, THE EARL OF + SYMMONS, R.F., ESQ. + TOWER, CHRISTOPHER J.H., ESQ. + TRACY, N., ESQ. + TUFNELL, W.M., ESQ. + WELLS, F., ESQ. + WINTER, J.J., ESQ. + WOOD, CHARLES PAGE, 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 COUNTESS OF ALBEMARLE. + THE COUNTESS OF WARWICK. + THE COUNTESS CADOGAN. + THE COUNTESS OF STRADBROKE. + LADY EVELYN COBBOLD. + LADY FLORENCE BARNARDISTON. + LADY IDA LEIGH HARE. + LADY SUSAN BYNG. + THE LADY RAYLEIGH. + THE LADY BATEMAN. + THE LADY AMHERST OF HACKNEY. + THE HON. LADY ROWLEY. + THE HON. ETHEL HENNIKER. + THE HON. MRS. PRETYMAN. + LADY FFOLKES. + LADY AFFLECK. + LADY DURRANT. + LADY RICH. + LADY THORNHILL. + THE MAYORESS OF NORWICH. + THE MAYORESS OF KING'S LYNN. + THE MAYORESS OF BURY ST. EDMUND'S. + MRS. ADEANE. + MRS. ARKWRIGHT. + MRS. AUSTEN-LEIGH. + MISS BUXTON. + MRS. CATOR. + MRS. RUSSELL COLMAN. + MRS. CRAWLEY. + MRS. CROWFOOT. + MRS. DE CHAIR. + MRS. DOWSETT. + MRS. EGERTON-GREEN. + MISS FARRER. + MISS E. BLANCHE HAMMOND. + MRS. SANCROFT HOLMES. + MRS. INGLEBY. + MRS. JOHNSON. + MRS. SIDNEY LACON. + MRS. LOCKER-LAMPSON. + MRS. LE STRANGE. + MRS. LITTLEWOOD. + MRS. LOCKWOOD. + MISS MABEL LOWTHER. + MRS. BERKELEY MANSEL. + MRS. MCINTOSH. + MRS. EDWARD PACKARD, JUN. + MRS. VICTOR PALEY. + MISS OXLEY PARKER. + MRS. PETRE. + MRS. HOWELL PRICE. + MRS. ERNEST RANSOM. + MRS. ROUND. + MISS ROUND. + MISS FLORENCE RUGGLES-BRISE. + MRS. HENRY SHARPE. + MRS. STANLEY. + MRS. TOWNLEY. + MRS. VAIZEY. + MISS MARGARET WATERS. + MRS. WEDD. + MISS WOOD. + MRS. FRANK WORTHINGTON. + + + 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 3-1/2 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. + + Italic text is denoted by _underscore_ and bold text by =equal signs=. + + Inconsistent hyphenation has been repaired. + + The oe and ae ligatures in the text has been left as it appears in the + original book. + + On page 47 "genetous" replaced with "genetic". + On page 59 "demostand" replaced with "demonstrants". + On page 81 "artizan" replaced with "artisan". + + Greek translations: + + sôma, psychê, pneuma + σωμα, ψυχη, πνευμα + + idiotês + ιδιοτης + + iatros kaì ìdiôtês + ιατρος καì ìδιωτης + + Ho de nous eoiken enginesthai ousia tis ousa, kai ou phtheiresthai. + Ὁ δε νους εοικεν εγγινεσθαι ουσια τις ουσα, και ου φθειρεσθαι. + + nous + νους + + ousia + ουσια + + logos + λογος + + en métrô hôs poiêtês, hê haneu métrou hôs idiôtês + εν μéτρω ὡς ποιητης, ἡ ἁνευ μéτρου ὡς ιδιωτης + + iatros kahi hisiôtês + ιατρος καἱ ἱσιωτης + + 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: + endquote missing punctuation + wrong spaced quotes + long line errors appear only with Greek lettering + + + + + + +End of the Project Gutenberg EBook of The Idiot, by Frederick Bateman + +*** END OF THIS PROJECT GUTENBERG EBOOK THE IDIOT *** + +***** This file should be named 39670-0.txt or 39670-0.zip ***** +This and all associated files of various formats will be found in: + http://www.gutenberg.org/3/9/6/7/39670/ + +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) + + +Updated editions will replace the previous one--the old editions +will be renamed. + +Creating the works from public domain print editions means that no +one owns a United States copyright in these works, so the Foundation +(and you!) can copy and distribute it in the United States without +permission and without paying copyright royalties. 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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/license + + +Title: The Idiot + His Place in Creation, and His Claims on Society + +Author: Frederick Bateman + +Release Date: May 11, 2012 [EBook #39670] + +Language: English + +Character set encoding: ISO-8859-1 + +*** START OF THIS PROJECT GUTENBERG EBOOK THE IDIOT *** + + + + +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) + + + + + + +</pre> + + + + + +<h1>THE IDIOT;</h1> + +<h3><i>HIS PLACE IN CREATION</i>,</h3> +<p class="cen"><span class="smcap">AND</span></p> +<h3><i>HIS CLAIMS ON SOCIETY</i>.</h3> + + + +<hr style="width: 65%;" /> + +<div class="figcenter" style="width: 400px;"> +<img src="images/frontispiece.jpg" width="400" height="600" alt="THE EASTERN COUNTIES' ASYLUM FOR IDIOTS AND IMBECILES." title="" /> +<span class="caption">THE EASTERN COUNTIES' ASYLUM FOR IDIOTS AND IMBECILES.</span> +</div> + + + + +<hr style="width: 65%;" /> +<h1>THE IDIOT;</h1> + +<h3><i>HIS PLACE IN CREATION</i>,</h3> +<h5><span class="smcap">AND</span></h5> +<h3><i>HIS CLAIMS ON SOCIETY</i>.</h3> + +<h3>BY</h3> + +<h2>SIR FREDERIC BATEMAN, M.D., LL.D.,</h2> + +<p class="cen"><b><i>Fellow of the Royal College of Physicians</i>;<br /> +<i>Consulting Physician to the Norfolk and Norwich Hospital, and to the<br /> +Eastern Counties' Asylum for Idiots</i>;<br /> +<i>Associ et Laurat de l'Acadmie de Mdecine de Paris</i>;<br /> +<i>Citation de l'Institut de France</i>;<br /> +<i>Corresponding Member of the Psychiatrical Society of St. Petersburg</i>;<br /> +<i>Hon. Member of the New York Neurological Society</i>;<br /> +<i>Foreign Associate of the Medico-Psychological Society of Paris</i></b>.</p> + +<p class="cen"><b><i>Author of "Aphasia, or Loss of Speech";<br /> +"Darwinism tested by Language," &c.</i></b></p> + +<h4>SECOND EDITION.</h4> + +<h4>LONDON:</h4> +<h4>JARROLD & SONS, 10 & 11, WARWICK LANE.</h4> +<h5>1897.</h5> + + + + + +<hr style="width: 65%;" /> +<h2>PREFACE</h2> + +<h4>TO</h4> + +<h2>THE SECOND EDITION.</h2> + + +<p>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.</p> + +<p>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.<span class="pagenum"><a name="Page_8" id="Page_8">[ 8]</a></span></p> + +<p>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.</p> + +<p>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.</p> + +<p>Although I have endeavoured to explain my +views in popular language, I trust it has not been +at the sacrifice of strict scientific accuracy.</p> + +<p class="quotsig">FREDERIC BATEMAN.</p> + +<p class="noin"><i>Norwich</i>,<br /> +<span style="margin-left: 2em;"><i>January, 1897.</i></span></p> +<p><span class="pagenum"><a name="Page_9" id="Page_9">[ 9]</a></span></p> + + + +<hr style="width: 65%;" /> +<h2>THE IDIOT;</h2> + +<h3>HIS PLACE IN CREATION,</h3> + +<h5>AND</h5> + +<h3>HIS CLAIMS ON SOCIETY.</h3> + + +<p>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.</p> + +<p>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<span class="pagenum"><a name="Page_10" id="Page_10">[ 10]</a></span> +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.</p> + +<p>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<span class="pagenum"><a name="Page_11" id="Page_11">[ 11]</a></span> +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.</p> + +<p>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<span class="pagenum"><a name="Page_12" id="Page_12">[ 12]</a></span> +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.</p> + +<p>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<span class="pagenum"><a name="Page_13" id="Page_13">[ 13]</a></span> +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—</p> + +<div class="poem"><div class="stanza"> +<span class="ni">"The quality of mercy is not strain'd;</span> +<span class="ni">It droppeth, as the gentle rain from heaven</span> +<span class="ni">Upon the place beneath; it is twice bless'd:</span> +<span class="ni">It blesseth him that gives, and him that takes."</span> +</div></div> + +<p>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<span class="pagenum"><a name="Page_14" id="Page_14">[ 14]</a></span> +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.</p> + +<p>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<span class="pagenum"><a name="Page_15" id="Page_15">[ 15]</a></span> +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.</p> + + + + +<hr style="width: 65%;" /> +<h2>DEFINITION OF IDIOCY.</h2> + + +<p>Great confusion exists in the public mind +as to the nature of idiocy. What is an +idiot? Dr. Sguin, 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<span class="pagenum"><a name="Page_16" id="Page_16">[ 16]</a></span> +enough of the natural history of the idiot +to attempt a logical definition.</p> + +<p>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:—</p> + +<p>An idiot is a human being who possesses +the tripartite nature of man—body, soul, +and spirit, <ins class="edcorr" title="Greek: sma, psych, pneuma,">σωμα, ψυχη, πνευμα</ins>, 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.<span class="pagenum"><a name="Page_17" id="Page_17">[ 17]</a></span></p> + +<p>Dr. Langdon Down<a name="FNanchor_1_1" id="FNanchor_1_1"></a><a href="#Footnote_1_1" class="fnanchor">[1]</a> 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<span class="pagenum"><a name="Page_18" id="Page_18">[ 18]</a></span> +detail by Dr. Ireland,<a name="FNanchor_2_2" id="FNanchor_2_2"></a><a href="#Footnote_2_2" class="fnanchor">[2]</a> to whose classical +work I would refer those who may desire +further information on this subject.</p> + +<p>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.</p> + +<p>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<span class="pagenum"><a name="Page_19" id="Page_19">[ 19]</a></span>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<span class="pagenum"><a name="Page_20" id="Page_20">[ 20]</a></span> +would suggest that one or more of them +might, with advantage, be devoted to the +care and treatment of pauper idiots.<a name="FNanchor_3_3" id="FNanchor_3_3"></a><a href="#Footnote_3_3" class="fnanchor">[3]</a></p> + +<p>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<span class="pagenum"><a name="Page_21" id="Page_21">[ 21]</a></span> +low amount of intelligence, which, in many +instances, gradually increases; the difference +has been thus beautifully described +by a French psychologist, "<i>L'homme en +dmence est priv des biens dont il jouissait +autrefois, c'est un riche devenu pauvre. +L'idiot a toujours t dans l'infortune et +la misre.</i>" (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.</p> + +<p>The poor idiot (the word being derived +from the Greek <ins class="edcorr" title="Greek: isiots">ισιοτης</ins><a name="FNanchor_4_4" id="FNanchor_4_4"></a><a href="#Footnote_4_4" class="fnanchor">[4]</a>) is alone in the world;<span class="pagenum"><a name="Page_22" id="Page_22">[ 22]</a></span> +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<span class="pagenum"><a name="Page_23" id="Page_23">[ 23]</a></span> +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.</p> + + + + +<hr style="width: 65%;" /> +<h2>CAUSES OF IDIOCY.</h2> + + +<p>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<span class="pagenum"><a name="Page_24" id="Page_24">[ 24]</a></span> +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.</p> + +<p>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<span class="pagenum"><a name="Page_25" id="Page_25">[ 25]</a></span> +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.</p> + +<p>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.</p> + +<p>In thus expressing myself, I should be +sorry that my remarks should be construed<span class="pagenum"><a name="Page_26" id="Page_26">[ 26]</a></span> +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.</p> +<p> </p> + + +<p><i>Intemperance.</i> One of the most fruitful +causes of idiocy is the <i>abuse</i>—mark, I do +not say the <i>proper use</i>—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<span class="pagenum"><a name="Page_27" id="Page_27">[ 27]</a></span>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.</p> + +<p>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 316 per +cent.; of this number, 72 were males and +66 females."<a name="FNanchor_5_5" id="FNanchor_5_5"></a><a href="#Footnote_5_5" class="fnanchor">[5]</a><span class="pagenum"><a name="Page_28" id="Page_28">[ 28]</a></span></p> + +<p>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 1638 per cent. of the +cases observed by himself and by Dr. +Fletcher Beach;<a name="FNanchor_6_6" id="FNanchor_6_6"></a><a href="#Footnote_6_6" class="fnanchor">[6]</a> 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.</p> + +<p>Idiocy is especially prevalent in Norway,<span class="pagenum"><a name="Page_29" id="Page_29">[ 29]</a></span> +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.</p> + +<p>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.<a name="FNanchor_7_7" id="FNanchor_7_7"></a><a href="#Footnote_7_7" class="fnanchor">[7]</a> Without, therefore,<span class="pagenum"><a name="Page_30" id="Page_30">[ 30]</a></span> +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.<a name="FNanchor_8_8" id="FNanchor_8_8"></a><a href="#Footnote_8_8" class="fnanchor">[8]</a></p> + +<p>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<span class="pagenum"><a name="Page_31" id="Page_31">[ 31]</a></span> +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.<span class="pagenum"><a name="Page_32" id="Page_32">[ 32]</a></span></p> + +<p>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.</p> + +<p><i>Consanguine Marriages.</i> 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<span class="pagenum"><a name="Page_33" id="Page_33">[ 33]</a></span> +to modify, to a considerable extent, this +sweeping assertion.</p> + +<p>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 65 per cent. were the offspring +of cousins.</p> + +<p>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<span class="pagenum"><a name="Page_34" id="Page_34">[ 34]</a></span> +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.<a name="FNanchor_9_9" id="FNanchor_9_9"></a><a href="#Footnote_9_9" class="fnanchor">[9]</a></p> + +<p>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."<a name="FNanchor_10_10" id="FNanchor_10_10"></a><a href="#Footnote_10_10" class="fnanchor">[10]</a></p> + +<p>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<span class="pagenum"><a name="Page_35" id="Page_35">[ 35]</a></span>marriage +of relatives have contributed +concurrently to the development of the +mental defect.<a name="FNanchor_11_11" id="FNanchor_11_11"></a><a href="#Footnote_11_11" class="fnanchor">[11]</a></p> +<p> </p> + + +<p><i>Educational Overpressure.</i> There is one +cause of idiocy which has been pointed out +by Dr. Sguin, 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."<a name="FNanchor_12_12" id="FNanchor_12_12"></a><a href="#Footnote_12_12" class="fnanchor">[12]</a><span class="pagenum"><a name="Page_36" id="Page_36">[ 36]</a></span></p> + +<p>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<span class="pagenum"><a name="Page_37" id="Page_37">[ 37]</a></span> +destined to play different parts on the +stage of human life.<a name="FNanchor_13_13" id="FNanchor_13_13"></a><a href="#Footnote_13_13" class="fnanchor">[13]</a></p> + +<p>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 "<i>Tacens +et placens uxor</i>" 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<span class="pagenum"><a name="Page_38" id="Page_38">[ 38]</a></span> +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."<a name="FNanchor_14_14" id="FNanchor_14_14"></a><a href="#Footnote_14_14" class="fnanchor">[14]</a></p> + +<p>The limits of this essay will not permit +me to dwell at any great length on the +important question under consideration.<span class="pagenum"><a name="Page_39" id="Page_39">[ 39]</a></span> +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<span class="pagenum"><a name="Page_40" id="Page_40">[ 40]</a></span> +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.</p> + +<p>Whilst, therefore, unreservedly admitting +the claims of the <i>fin de sicle</i> 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.</p> + +<p>I am quite aware that I am treading +on dangerous and delicate ground, but<span class="pagenum"><a name="Page_41" id="Page_41">[ 41]</a></span> +although I would not discourage the highest +aspirations of women, whether of an intellectual, +social, or sthetic character, I +must think that a word of caution is necessary +against the overpressure of the present +day in the direction above indicated.<a name="FNanchor_15_15" id="FNanchor_15_15"></a><a href="#Footnote_15_15" class="fnanchor">[15]</a><span class="pagenum"><a name="Page_42" id="Page_42">[ 42]</a></span> +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.</p> + +<hr style="width: 45%;" /> + +<p>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<span class="pagenum"><a name="Page_43" id="Page_43">[ 43]</a></span> +also potent factors in the development of +idiocy in their offspring.</p> + +<hr style="width: 45%;" /> + +<p>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?<a name="FNanchor_16_16" id="FNanchor_16_16"></a><a href="#Footnote_16_16" class="fnanchor">[16]</a> Does mental<span class="pagenum"><a name="Page_44" id="Page_44">[ 44]</a></span> +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?<a name="FNanchor_17_17" id="FNanchor_17_17"></a><a href="#Footnote_17_17" class="fnanchor">[17]</a> 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.</p> + +<p>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<span class="pagenum"><a name="Page_45" id="Page_45">[ 45]</a></span> +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.<a name="FNanchor_18_18" id="FNanchor_18_18"></a><a href="#Footnote_18_18" class="fnanchor">[18]</a><span class="pagenum"><a name="Page_46" id="Page_46">[ 46]</a></span></p> + +<p>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.<a name="FNanchor_19_19" id="FNanchor_19_19"></a><a href="#Footnote_19_19" class="fnanchor">[19]</a><span class="pagenum"><a name="Page_47" id="Page_47">[ 47]</a></span></p> + +<p>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.</p> + +<p>Dr. Ireland says, "the principal anomalies +met with in the skull of <ins class="mycorr" title='Correction: text was "genetous"'>genetic</ins> 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."<a name="FNanchor_20_20" id="FNanchor_20_20"></a><a href="#Footnote_20_20" class="fnanchor">[20]</a></p> + +<p>One of the most noted writers on the +subject, after stating that a number of +scientific men had spent thirty years in<span class="pagenum"><a name="Page_48" id="Page_48">[ 48]</a></span> +measuring and weighing the heads of idiots, +sums up their conclusions as follows:—</p> + +<p>1st. There is no constant relation between +the development of the cranium and +the degree of intelligence.</p> + +<p>2nd. The dimensions of the anterior part +of the cranium, and especially of the forehead, +are, at least, as great among idiots as +others.<a name="FNanchor_21_21" id="FNanchor_21_21"></a><a href="#Footnote_21_21" class="fnanchor">[21]</a><span class="pagenum"><a name="Page_49" id="Page_49">[ 49]</a></span></p> + +<p>3rd. Three-fifths of idiots have larger +heads than men of ordinary intelligence.</p> + +<p>4th. There is no constant relation between +the degree of intelligence and the +weight of the brain.<a name="FNanchor_22_22" id="FNanchor_22_22"></a><a href="#Footnote_22_22" class="fnanchor">[22]</a></p> + +<p>5th. Sometimes the brain of idiots presents +no deviation in form, colour, and +density from the normal standard; it is, in +fact, perfectly normal.<span class="pagenum"><a name="Page_50" id="Page_50">[ 50]</a></span></p> + +<p>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.</p> + +<p>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<span class="pagenum"><a name="Page_51" id="Page_51">[ 51]</a></span> +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."<a name="FNanchor_23_23" id="FNanchor_23_23"></a><a href="#Footnote_23_23" class="fnanchor">[23]</a></p> + +<p>Professor Luys, of Paris,<a name="FNanchor_24_24" id="FNanchor_24_24"></a><a href="#Footnote_24_24" class="fnanchor">[24]</a> 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.<a name="FNanchor_25_25" id="FNanchor_25_25"></a><a href="#Footnote_25_25" class="fnanchor">[25]</a></p> + +<p>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.<span class="pagenum"><a name="Page_52" id="Page_52">[ 52]</a></span></p> + +<p>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 rle 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<span class="pagenum"><a name="Page_53" id="Page_53">[ 53]</a></span> +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."<a name="FNanchor_26_26" id="FNanchor_26_26"></a><a href="#Footnote_26_26" class="fnanchor">[26]</a> 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<span class="pagenum"><a name="Page_54" id="Page_54">[ 54]</a></span> +the brain of madmen does not contain more +phosphorus than that of sane individuals.<a name="FNanchor_27_27" id="FNanchor_27_27"></a><a href="#Footnote_27_27" class="fnanchor">[27]</a></p> + +<p>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."<a name="FNanchor_28_28" id="FNanchor_28_28"></a><a href="#Footnote_28_28" class="fnanchor">[28]</a></p> + +<p>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.<span class="pagenum"><a name="Page_55" id="Page_55">[ 55]</a></span></p> + + + + +<hr style="width: 65%;" /> +<h2>MATTER AND MIND.</h2> + +<blockquote><p>"Quare frustra sudaverit, qui cœlestia +religionis arcana nostr rationi adaptare +conabitur." <i>Bacon, "De Augmentis Scientiarum."</i></p></blockquote> + + +<p>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.<a name="FNanchor_29_29" id="FNanchor_29_29"></a><a href="#Footnote_29_29" class="fnanchor">[29]</a> In my<span class="pagenum"><a name="Page_56" id="Page_56">[ 56]</a></span> +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.</p> + +<p>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<span class="pagenum"><a name="Page_57" id="Page_57">[ 57]</a></span> +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 +medival 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;"<a name="FNanchor_30_30" id="FNanchor_30_30"></a><a href="#Footnote_30_30" class="fnanchor">[30]</a> that there<span class="pagenum"><a name="Page_58" id="Page_58">[ 58]</a></span> +is no real distinction between living and +dead matter, and that vitality is a metaphysical +ghost (<i>ein metaphysisches Gespenst</i>).<a name="FNanchor_31_31" id="FNanchor_31_31"></a><a href="#Footnote_31_31" class="fnanchor">[31]</a></p> + +<p>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<span class="pagenum"><a name="Page_59" id="Page_59">[ 59]</a></span> +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.</p> + +<p>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<span class="pagenum"><a name="Page_60" id="Page_60">[ 60]</a></span> +idiots a deficiency of this element of brain +tissue.<a name="FNanchor_32_32" id="FNanchor_32_32"></a><a href="#Footnote_32_32" class="fnanchor">[32]</a> 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.<span class="pagenum"><a name="Page_61" id="Page_61">[ 61]</a></span></p> + +<p>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.<span class="pagenum"><a name="Page_62" id="Page_62">[ 62]</a></span></p> + +<p>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 <i>vis vivida +anim</i>"—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 <ins class="mycorr" title='Correction: text was "demonstand"'>demonstrants</ins> ."</p> + +<p>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<span class="pagenum"><a name="Page_63" id="Page_63">[ 63]</a></span> +no distinction between thought, mind, consciousness, +and the <i>instrument</i> 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."<a name="FNanchor_33_33" id="FNanchor_33_33"></a><a href="#Footnote_33_33" class="fnanchor">[33]</a></p> + +<p>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,<span class="pagenum"><a name="Page_64" id="Page_64">[ 64]</a></span> +and require to be operated on <i>ab extra</i>, +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.</p> + +<p>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.</p> + +<p>Let me further illustrate this point by an +allusion to the electric telegraph, by means +of which ideas and words are transmitted<span class="pagenum"><a name="Page_65" id="Page_65">[ 65]</a></span> +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 ons 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<span class="pagenum"><a name="Page_66" id="Page_66">[ 66]</a></span> +streaks of morning cloud into the infinite +azure of the past."</p> + +<p>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 +<i>externally</i> 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;<a name="FNanchor_34_34" id="FNanchor_34_34"></a><a href="#Footnote_34_34" class="fnanchor">[34]</a> there is no<span class="pagenum"><a name="Page_67" id="Page_67">[ 67]</a></span> +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 +<i>Ego</i>—is independent of the material organ +by which its external manifestation is alone +possible.<a name="FNanchor_35_35" id="FNanchor_35_35"></a><a href="#Footnote_35_35" class="fnanchor">[35]</a><span class="pagenum"><a name="Page_68" id="Page_68">[ 68]</a></span></p> + +<p>However tempting it might be, I feel I +must not trespass any further by dwelling +on the mysterious connection between<span class="pagenum"><a name="Page_69" id="Page_69">[ 69]</a></span> +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."</p> + +<p>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:—</p> + +<p>"Latent ista omnia, Luculle, crassis +occultata et circumfusa tenebris, ut nulla +acies humani ingenii tanta sit, qu penetrare +in cœlum, terra intrare possit."</p> + +<p>These lines of Cicero would seem to be +peculiarly applicable to certain modern<span class="pagenum"><a name="Page_70" id="Page_70">[ 70]</a></span> +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.</p> + +<p>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.<span class="pagenum"><a name="Page_71" id="Page_71">[ 71]</a></span></p> + + + +<hr style="width: 65%;" /> +<h2>THE PNEUMA, OR SPIRITUAL ATTRIBUTE OF</h2> +<h2>THE IDIOT.</h2> + +<div class="poem"><div class="stanza"> +<span class="ni"><ins class="edcorr" title="Greek: Ho de nous eoiken enginethai ousia ">Ὁ δε νους εοικεν εγγινεθαι ουσια</ins></span> +<span class="ni"><ins class="edcorr" title="Greek: tis ousa, kai ou phtheiresthai.">τις ουσα, και ου φθειρεσθαι</ins>.</span> + +<p class="quotsig">Aristot. <i>De Anima</i>, I. 4.</p> +</div></div> + + +<p>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 <ins class="edcorr" title="Greek: sma">σωμα</ins>, or material part of +our nature; they also conceded to them the +<ins class="edcorr" title="Greek: psych">ψυχη</ins>, or principle of animal life, but they +considered that the <ins class="edcorr" title="Greek: pneuma">πνευμα</ins>, 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<span class="pagenum"><a name="Page_72" id="Page_72">[ 72]</a></span> +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.</p> + +<p>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 <i>the capacity for progressive im<span class="pagenum"><a name="Page_73" id="Page_73">[ 73]</a></span>provement</i> +which exists in the idiot, gives +the lie to this absurd and purely sensational +hypothesis.</p> + +<p>Here let me add that I strongly deprecate +introducing the <i>odium theologicum</i> +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.<a name="FNanchor_36_36" id="FNanchor_36_36"></a><a href="#Footnote_36_36" class="fnanchor">[36]</a> Moreover, I should not reject<span class="pagenum"><a name="Page_74" id="Page_74">[ 74]</a></span> +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<span class="pagenum"><a name="Page_75" id="Page_75">[ 75]</a></span> +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. <i>Magna est +veritas et prevalebit.</i></p> + +<p>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<span class="pagenum"><a name="Page_76" id="Page_76">[ 76]</a></span> +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 <i>instrument</i> by which the high +psychological attributes peculiar to man +become <i>externally</i> manifested.<a name="FNanchor_37_37" id="FNanchor_37_37"></a><a href="#Footnote_37_37" class="fnanchor">[37]</a> Thought<span class="pagenum"><a name="Page_77" id="Page_77">[ 77]</a></span> +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 <ins class="edcorr" title="Greek: nous">νους</ins>, the +intellectual spirit, being an <ins class="edcorr" title="Greek: ousia">ουσια</ins>—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<span class="pagenum"><a name="Page_78" id="Page_78">[ 78]</a></span> +only the <ins class="edcorr" title="Greek: sma">σωμα</ins> or material part, and the <ins class="edcorr" title="Greek: psych">ψυχη</ins> +or principle of animal life, but he also +undoubtedly possesses the <ins class="edcorr" title="Greek: pneuma">πνευμα</ins> or principle +of immortal life.</p> + +<p>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<span class="pagenum"><a name="Page_79" id="Page_79">[ 79]</a></span> +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."<a name="FNanchor_38_38" id="FNanchor_38_38"></a><a href="#Footnote_38_38" class="fnanchor">[38]</a></p> + +<p>In an interesting essay published many +years ago, entitled, "A Morning at Essex<span class="pagenum"><a name="Page_80" id="Page_80">[ 80]</a></span> +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."</p> + +<p>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.<span class="pagenum"><a name="Page_81" id="Page_81">[ 81]</a></span></p> + + + + +<hr style="width: 65%;" /> +<h2>TREATMENT AND RESULTS.</h2> + + +<div class="poem"><div class="stanza"> +<span class="ni">"Distinguish'd link in being's endless chain,</span> +<span class="ni">Midway from nothing to the Deity.</span> +<span class="ni">Though sully'd and dishonour'd, still divine,</span> +<span class="ni">An heir of glory, a frail child of dust.</span> +<span class="ni">Helpless immortal!"—<i>Young</i>.</span> +</div></div> + + +<p>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'<span class="pagenum"><a name="Page_82" id="Page_82">[ 82]</a></span> +Asylum, whereas, our present accommodation +is limited to 250 cases.<a name="FNanchor_39_39" id="FNanchor_39_39"></a><a href="#Footnote_39_39" class="fnanchor">[39]</a></p> + +<p>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<span class="pagenum"><a name="Page_83" id="Page_83">[ 83]</a></span> +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.<span class="pagenum"><a name="Page_84" id="Page_84">[ 84]</a></span></p> + +<p>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 +<ins class="mycorr" title='Correction: text was "artizan"'>artisan</ins> should be rendered intolerable by +the presence of these stricken members of +our race; but, we have been given to<span class="pagenum"><a name="Page_85" id="Page_85">[ 85]</a></span> +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.</p> + +<p>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.<a name="FNanchor_40_40" id="FNanchor_40_40"></a><a href="#Footnote_40_40" class="fnanchor">[40]</a> 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 Mdecine," published in 1837, broadly<span class="pagenum"><a name="Page_86" id="Page_86">[ 86]</a></span> +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!</p> + +<p>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<span class="pagenum"><a name="Page_87" id="Page_87">[ 87]</a></span> +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.</p> + +<p>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.</p> + +<p>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<span class="pagenum"><a name="Page_88" id="Page_88">[ 88]</a></span> +one of our colonies, and when he was last +heard of, he was practising his trade in a +leading city.<a name="FNanchor_41_41" id="FNanchor_41_41"></a><a href="#Footnote_41_41" class="fnanchor">[41]</a></p> + +<p>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<span class="pagenum"><a name="Page_89" id="Page_89">[ 89]</a></span> +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<span class="pagenum"><a name="Page_90" id="Page_90">[ 90]</a></span>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!</p> +<p> </p> + + +<p><i>Thyroid Treatment of Idiocy.</i>—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.</p> + +<p>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<span class="pagenum"><a name="Page_91" id="Page_91">[ 91]</a></span> +escape from idiocy into normal intelligence."<a name="FNanchor_42_42" id="FNanchor_42_42"></a><a href="#Footnote_42_42" class="fnanchor">[42]</a></p> + +<p>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<span class="pagenum"><a name="Page_92" id="Page_92">[ 92]</a></span> +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<span class="pagenum"><a name="Page_93" id="Page_93">[ 93]</a></span> +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.</p> + +<p>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<span class="pagenum"><a name="Page_94" id="Page_94">[ 94]</a></span> +expressed the opinion, that for thyroid +treatment to be effectual, it must be begun +in early life.<a name="FNanchor_43_43" id="FNanchor_43_43"></a><a href="#Footnote_43_43" class="fnanchor">[43]</a></p> + +<p>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.</p> + +<p>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"<span class="pagenum"><a name="Page_95" id="Page_95">[ 95]</a></span> +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.</p> + +<p>Whilst these pages are passing through +the press, M. Auguste Voisin, Physician +to La Salptrire, 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<span class="pagenum"><a name="Page_96" id="Page_96">[ 96]</a></span>tions; +there was great emaciation, dryness +of the skin, and cold extremities.<a name="FNanchor_44_44" id="FNanchor_44_44"></a><a href="#Footnote_44_44" class="fnanchor">[44]</a></p> + +<p>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.</p> + +<p>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<span class="pagenum"><a name="Page_97" id="Page_97">[ 97]</a></span> +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.</p> + +<p>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 anmia 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 hmoglobin from 78 per +cent. to 59 per cent.<a name="FNanchor_45_45" id="FNanchor_45_45"></a><a href="#Footnote_45_45" class="fnanchor">[45]</a><span class="pagenum"><a name="Page_98" id="Page_98">[ 98]</a></span></p> + +<p>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.</p> + +<p>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 anmia is apt to be +produced by large doses of the remedy; +and he mentions a case where the red +blood corpuscles and the hmoglobin underwent +a marked diminution during the period +of acute thyroidism, but rapidly increased +under the subsequent administration of +small doses of the remedy.<a name="FNanchor_46_46" id="FNanchor_46_46"></a><a href="#Footnote_46_46" class="fnanchor">[46]</a></p> + +<p>The subject of blood analysis is most +important, as tending to throw some light +upon a matter at present but little under<span class="pagenum"><a name="Page_99" id="Page_99">[ 99]</a></span>stood, +namely the physiological effect of +thyroid preparations upon the blood.</p> + +<p>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.<a name="FNanchor_47_47" id="FNanchor_47_47"></a><a href="#Footnote_47_47" class="fnanchor">[47]</a></p> + +<p>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.</p> + +<p>Although the physiological effects of +thyroid feeding may not be definitely<span class="pagenum"><a name="Page_100" id="Page_100">[ 100]</a></span> +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."<a name="FNanchor_48_48" id="FNanchor_48_48"></a><a href="#Footnote_48_48" class="fnanchor">[48]</a><span class="pagenum"><a name="Page_101" id="Page_101">[ 101]</a></span></p> +<p> </p> + + +<p><i>Craniectomy.</i>—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 Bictre, 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."<a name="FNanchor_49_49" id="FNanchor_49_49"></a><a href="#Footnote_49_49" class="fnanchor">[49]</a><span class="pagenum"><a name="Page_102" id="Page_102">[ 102]</a></span> +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."<a name="FNanchor_50_50" id="FNanchor_50_50"></a><a href="#Footnote_50_50" class="fnanchor">[50]</a></p> + +<p>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<span class="pagenum"><a name="Page_103" id="Page_103">[ 103]</a></span> +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.<a name="FNanchor_51_51" id="FNanchor_51_51"></a><a href="#Footnote_51_51" class="fnanchor">[51]</a></p> + +<p>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<span class="pagenum"><a name="Page_104" id="Page_104">[ 104]</a></span> +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."<a name="FNanchor_52_52" id="FNanchor_52_52"></a><a href="#Footnote_52_52" class="fnanchor">[52]</a></p> + +<p>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.</p> + +<hr style="width: 45%;" /> + +<p>I trust that I have said enough to justify +an earnest appeal for sympathy with this<span class="pagenum"><a name="Page_105" id="Page_105">[ 105]</a></span> +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."</p> + +<p>We have in the Eastern Counties' +Asylum an institution admirably adapted<span class="pagenum"><a name="Page_106" id="Page_106">[ 106]</a></span> +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—</p> + +<div class="poem"><div class="stanza"> +<span class="ni">"As the morning steals upon the night,</span> +<span class="ni">Melting the darkness, so their rising senses</span> +<span class="ni">Begin to chase the ignorant fumes that mantle</span> +<span class="ni">Their clearer reason."</span> +</div></div> +<p><span class="pagenum"><a name="Page_107" id="Page_107">[ 107]</a></span></p> + +<p>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.</p> +<p> </p> + + +<p><i>Crossley House.</i>—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<span class="pagenum"><a name="Page_108" id="Page_108">[ 108]</a></span> +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.</p> +<p> </p> + + +<p><i>The Ladies' Association.</i>—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<span class="pagenum"><a name="Page_111" id="Page_111">[ 111]</a></span> +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.</p> + +<div class="figcenter" style="width: 400px;"><span class="pagenum"><a name="Page_109" id="Page_109"></a></span> +<img src="images/i109.jpg" width="400" height="600" alt="CROSSLEY HOUSE, CLACTON-ON-SEA." title="" /> +<span class="caption">CROSSLEY HOUSE, CLACTON-ON-SEA.</span> +</div> + +<p>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.<a name="FNanchor_53_53" id="FNanchor_53_53"></a><a href="#Footnote_53_53" class="fnanchor">[53]</a><span class="pagenum"><a name="Page_112" id="Page_112">[ 112]</a></span> +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."<a name="FNanchor_54_54" id="FNanchor_54_54"></a><a href="#Footnote_54_54" class="fnanchor">[54]</a><span class="pagenum"><a name="Page_113" id="Page_113">[ 113]</a></span></p> + +<p>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.</p> + +<hr style="width: 45%;" /> + +<p>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<span class="pagenum"><a name="Page_114" id="Page_114">[ 114]</a></span> +brotherhood with the rest of the human +family.</p> + +<p>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.</p> + +<p>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<span class="pagenum"><a name="Page_115" id="Page_115">[ 115]</a></span> +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:</p> + +<div class="poem"><div class="stanza"> +<span class="ni">"In death's unrobing room we strip from round us</span> +<span class="i1">This garment of mortality and earth,</span> +<span class="ni">And breaking from the embryo-state which bound us,</span> +<span class="i1">Our day of dying is our day of birth."</span> +</div></div> + +<p>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<span class="pagenum"><a name="Page_116" id="Page_116">[ 116]</a></span> +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.</p> + +<p>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<span class="pagenum"><a name="Page_117" id="Page_117">[ 117]</a></span> +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<span class="pagenum"><a name="Page_118" id="Page_118">[ 118]</a></span> +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.<a name="FNanchor_55_55" id="FNanchor_55_55"></a><a href="#Footnote_55_55" class="fnanchor">[55]</a></p> + +<p>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<span class="pagenum"><a name="Page_119" id="Page_119">[ 119]</a></span> +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.<span class="pagenum"><a name="Page_120" id="Page_120">[ 120]</a></span></p> + +<p>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—<ins class="edcorr" title="Greek: sma, psych, pneuma">σωμα, ψυχη, πνευμα</ins>; they have the +<i>germ</i> 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.</p> + +<div class="poem"><div class="stanza"> +<span class="ni">"Eternal process moving on,</span> +<span class="ni">From state to state the spirit walks.</span> +<span class="ni">All these are but the shattered stalks</span> +<span class="ni">Or ruined chrysalis of one."</span> +</div></div> +<p><span class="pagenum"><a name="Page_121" id="Page_121">[ 121]</a></span></p> + + + +<hr style="width: 65%;" /> +<h2>INDEX.</h2> + + + +<ul><li>Affleck, Dr., <a href="#Footnote_42_42">93</a></li> + +<li>Alcoholic stimulants as a factor in the genesis of idiocy, <a href="#Page_26">26</a></li> +<li><span style="margin-left: 1em;">abuse of, in Sweden, <a href="#Footnote_8_8">29</a></span></li> +<li><span style="margin-left: 1em;">effects of, in France, <a href="#Footnote_8_8">31</a></span></li> +<li><span style="margin-left: 1em;">Sir B.W. Richardson on, <a href="#Footnote_8_8">30</a></span></li> + +<li>Anmia, as the result of thyroid feeding, <a href="#Page_97">97</a></li> + +<li>Anderson, Mrs. Garrett, on Sex in Education, <a href="#Page_37">37</a></li> + +<li>Andriessen, on the cerebral convolutions of idiots, <a href="#Page_51">51</a></li> + +<li>Animals, relation between their intelligence and the size of their brain, <a href="#Footnote_22_22">49</a></li> + +<li>Association of idiots with the insane, a disadvantage to both classes, <a href="#Page_19">19</a></li> + +<li>Aveyron, the savage of the, <a href="#Page_18">18</a></li> + + +<li>Beach, Fletcher, <a href="#Page_25">25</a>, <a href="#Page_27">27</a>, <a href="#Page_28">28</a></li> + +<li>Besant, Sir Walter, <a href="#Footnote_37_37">76</a></li> + +<li>Birth, injuries of the head at, <a href="#Page_48">48</a></li> + +<li>Blood, analysis of, in thyroid feeding, <a href="#Page_96">96</a></li> +<li><span style="margin-left: 1em;">supply of, varies in the two sexes, <a href="#Footnote_13_13">37</a></span></li> + +<li>Bourneville, on Craniectomy, <a href="#Page_101">101</a></li> + +<li>Brain, average weight of, in men and women, <a href="#Page_46">46</a></li> +<li><span style="margin-left: 1em;">chemistry of the, <a href="#Page_52">52</a></span></li> +<li><span style="margin-left: 1em;">difference between that of a senior wrangler and that of an idiot, <a href="#Page_43">43</a></span></li> +<li><span style="margin-left: 1em;">difference in the two sexes, <a href="#Footnote_13_13">37</a></span></li> +<li><span style="margin-left: 1em;">microscopical appearance of, in idiots, <a href="#Page_51">51</a></span></li> +<li><span style="margin-left: 1em;">of gorilla and ourang-outang, <a href="#Page_75">75</a></span></li> +<li><span style="margin-left: 1em;">size and weight, in proportion to intellectual power, <a href="#Page_43">43</a></span></li> +<li><span style="margin-left: 1em;">structure of, in men of genius, <a href="#Page_44">44</a></span></li> + +<li>Bramwell, Byrom, <a href="#Page_93">93</a>, <a href="#Page_98">98</a></li> + +<li>Browne, Sir J. Crichton, on Sex in Education, <a href="#Page_36">36</a></li> + +<li>Browne, Sir Thomas, <a href="#Page_79">79</a></li> + +<li>Bruce, Lewis C., on thyroid feeding, <a href="#Page_95">95</a></li> + +<li>Burton-Fanning, <a href="#Page_94">94</a></li> + + +<li>Caird, Mrs. Mona, <a href="#Page_39">39</a></li> + +<li>Causes of idiocy, <a href="#Page_23">23</a></li> + +<li>Cicero, <a href="#Page_69">69</a></li> + +<li>Classification, <a href="#Page_17">17</a></li> + +<li>Consanguine marriages, <a href="#Page_32">32</a></li> + +<li>Convolutions of the brain in men of genius, and in those of low culture, <a href="#Page_45">45</a></li> +<li><span style="margin-left: 1em;">in idiots, <a href="#Page_51">51</a></span></li> + +<li>Couerbe, on the rle of phosphorus in the brain, <a href="#Page_52">52</a></li> + +<li>Craniectomy, <a href="#Page_101">101</a></li> +<li><span style="margin-left: 1em;">statistics of, <a href="#Page_103">103</a></span></li> + +<li>Cranium, early closure of the sutures of, <a href="#Page_101">101</a><span class="pagenum"><a name="Page_122" id="Page_122">[ 122]</a></span></li> + +<li>Cranium, form of the, and its connection with idiocy, <a href="#Page_43">43</a></li> + +<li>Cross, Lord, on habitual drunkards, <a href="#Page_31">31</a></li> + +<li>Crossley House, <a href="#Page_107">107</a></li> + +<li>Cuvier, brain of, <a href="#Page_46">46</a></li> + + +<li>Dahl, Ludwig, <a href="#Page_25">25</a>, <a href="#Page_29">29</a></li> + +<li>Dana, on Craniectomy, <a href="#Page_102">102</a></li> + +<li>Definition of idiocy, <a href="#Page_15">15</a></li> + +<li>Dunlop, <a href="#Page_93">93</a></li> + + +<li>Edinburgh Medico-Chirurgical Society, discussion at, <a href="#Page_92">92</a></li> + +<li>Educational Overpressure, on, <a href="#Page_35">35</a></li> +<li><span style="margin-left: 1em;">has induced suicide in children, <a href="#Page_41">41</a></span></li> + +<li>Esquirol, <a href="#Page_85">85</a>, <a href="#Page_118">118</a></li> + + +<li>Faculty a, must not be confounded with its material organ, <a href="#Page_63">63</a></li> + +<li>Forceps, use of, as a cause of idiocy, <a href="#Page_48">48</a></li> + +<li>Fraser, Professor, anmia following thyroid feeding, <a href="#Page_97">97</a></li> + +<li>Frere, Bartle, <a href="#Page_20">20</a></li> + +<li>Froude, <a href="#Page_77">77</a></li> + + +<li>Gambetta, the brain of, <a href="#Page_46">46</a></li> + +<li>Genius, a neurosis, <a href="#Page_53">53</a></li> +<li><span style="margin-left: 1em;">its relation to cerebral structure, <a href="#Page_44">44</a></span></li> + +<li>Goethe, <a href="#Page_69">69</a></li> + +<li>Greenfield, Professor, <a href="#Page_93">93</a></li> + +<li>Gynagogues, <a href="#Page_40">40</a></li> + + +<li>Hammond, G.M., <a href="#Page_93">93</a></li> + +<li>Hammond, Prof. W.A., <a href="#Page_49">49</a>, <a href="#Page_60">60</a></li> + +<li>Heredity, its rle in idiocy, <a href="#Page_25">25</a></li> + +<li>Horsley, Victor, Prof., <a href="#Page_90">90</a>, <a href="#Page_100">100</a></li> + +<li>Howe, <a href="#Page_26">26</a>, <a href="#Page_33">33</a></li> + +<li>Humphry, Sir George, on Craniectomy, <a href="#Page_102">102</a></li> + + +<li>Idiocy, causes of, <a href="#Page_23">23</a></li> +<li><span style="margin-left: 1em;">classification of, <a href="#Page_17">17</a></span></li> +<li><span style="margin-left: 1em;">definition of, <a href="#Page_15">15</a></span></li> +<li><span style="margin-left: 1em;">its bearing on Evolution, <a href="#Page_72">72</a></span></li> +<li><span style="margin-left: 1em;">moral aspect of, <a href="#Page_117">117</a></span></li> +<li><span style="margin-left: 1em;">pathological anatomy of, <a href="#Page_43">43</a></span></li> +<li><span style="margin-left: 1em;">should not be confounded with insanity, <a href="#Page_19">19</a></span></li> +<li><span style="margin-left: 1em;">social aspect of, <a href="#Page_116">116</a></span></li> + +<li>Idiot, the, description of, <a href="#Page_22">22</a></li> +<li><span style="margin-left: 1em;">his association with the insane a disadvantage, <a href="#Page_19">19</a></span></li> +<li><span style="margin-left: 1em;">his claims on society, <a href="#Page_12">12</a>, <a href="#Page_114">114</a></span></li> +<li><span style="margin-left: 1em;">phosphorus in the brain of, <a href="#Page_52">52</a></span></li> +<li><span style="margin-left: 1em;">possesses the tripartite nature of man, <a href="#Page_120">120</a></span></li> + +<li>Intellectual differences between men and women, <a href="#Page_36">36</a></li> + +<li>Intemperance of parents, a factor in idiocy, <a href="#Page_26">26</a></li> + +<li>Ireland, W.W., <a href="#Page_18">18</a>, <a href="#Page_25">25</a>, <a href="#Page_34">34</a>, <a href="#Page_42">42</a>, <a href="#Page_47">47</a>, <a href="#Page_90">90</a>, <a href="#Page_103">103</a></li> + + +<li>Janet, Paul, on phosphorus in the brain, <a href="#Page_53">53</a></li> + + +<li>Kerlin, <a href="#Page_27">27</a></li> + +<li>Kirkby, <a href="#Page_91">91</a></li> + +<li>Kocher, <a href="#Page_90">90</a></li> + + +<li>Ladies' Association, <a href="#Page_108">108</a></li> + +<li>Langdon-Down, <a href="#Page_17">17</a>, <a href="#Page_30">30</a>, <a href="#Page_33">33</a>, <a href="#Page_48">48</a></li> + +<li>Lassaigne, <a href="#Page_53">53</a></li> + +<li>Lelut, on the cranium of idiots, <a href="#Page_44">44</a></li> + +<li>Lewes, G.H., <a href="#Page_63">63</a></li> + +<li>Lewi, <a href="#Page_93">93</a></li> +<li><span class="pagenum"><a name="Page_123" id="Page_123">[ 123]</a></span></li> + +<li>Lunatic Asylums, not adapted for idiots, <a href="#Page_19">19</a></li> + +<li>Lundie, <a href="#Page_93">93</a></li> + +<li>Lunier, <a href="#Page_31">31</a></li> + +<li>Luys, on the brain of idiots, <a href="#Page_51">51</a></li> + +<li>Lynn Linton, Mrs., on women's sphere of usefulness, <a href="#Page_38">38</a></li> + + +<li>Massachussetts report on idiocy, <a href="#Page_26">26</a></li> + +<li>Matter and mind, <a href="#Page_55">55</a></li> + +<li>Mierzejewski, on the brain of idiots, <a href="#Page_58">58</a></li> + +<li>Millard, W., <a href="#Page_78">78</a></li> + +<li>Mind, independent of its material organ, <a href="#Page_66">66</a></li> + +<li>Mingazzini, on the cerebral convolutions, <a href="#Page_44">44</a></li> + +<li>Moleschott, <a href="#Page_52">52</a></li> + +<li>Moreau, on hereditary predisposition, <a href="#Page_25">25</a></li> +<li><span style="margin-left: 1em;">his ideas on genius, <a href="#Page_53">53</a></span></li> + +<li>Murray, G., <a href="#Page_90">90</a>, <a href="#Page_93">93</a></li> + + +<li>New York Academy of Medicine, discussion at, <a href="#Page_93">93</a></li> + +<li>Norway, prevalence of idiocy in, <a href="#Page_28">28</a></li> + + +<li>Odium theologicum, <a href="#Page_73">73</a></li> + + +<li>Parental intemperance, <a href="#Page_27">27</a></li> + +<li>Parker, Rushton, <a href="#Page_99">99</a></li> + +<li>Pathological anatomy of idiocy, <a href="#Page_43">43</a></li> + +<li>Permanent Endowment Fund, <a href="#Page_82">82</a></li> + +<li>Phosphorus, its relation to intellectual vigour, <a href="#Page_52">52</a></li> + +<li>Plato, <a href="#Page_22">22</a>, <a href="#Page_64">64</a></li> + +<li>Pneuma, an attribute of the idiot, <a href="#Page_71">71</a></li> + +<li>Psychological Congress in Paris, <a href="#Page_58">58</a></li> + +<li>Richardson, Sir B.W., on the effects of alcohol, <a href="#Page_30">30</a></li> + + +<li>Saeger, <a href="#Page_87">87</a></li> + +<li>Schiff, <a href="#Page_90">90</a></li> + +<li>Science and Theology should not be antagonistic, <a href="#Page_74">74</a></li> + +<li>Sguin, <a href="#Page_15">15</a>, <a href="#Page_35">35</a></li> + +<li>Sex in Education, on, <a href="#Page_36">36</a></li> + +<li>Shakespeare, his definition of idiocy, <a href="#Page_15">15</a></li> + +<li>Shuttleworth, <a href="#Page_28">28</a>, <a href="#Page_33">33</a>, <a href="#Page_50">50</a>, <a href="#Page_87">87</a></li> + +<li>Sidney, <a href="#Page_80">80</a></li> + +<li>Strahan, <a href="#Page_41">41</a></li> + +<li>Sweden, alcoholic abuse in, <a href="#Page_31">31</a></li> + + +<li>Telford-Smith, on sporadic cretinism, <a href="#Page_99">99</a></li> + +<li>Thomson, J., <a href="#Page_93">93</a>, <a href="#Page_99">99</a></li> + +<li>Thucidides, <a href="#Page_21">21</a></li> + +<li>Thyroid feeding, <a href="#Page_90">90</a></li> +<li><span style="margin-left: 1em;">psychical effects of, <a href="#Page_100">100</a></span></li> + +<li>Toussenel, <a href="#Page_29">29</a></li> + +<li>Toxic idiocy, <a href="#Page_28">28</a></li> + +<li>Treatment of idiocy, <a href="#Page_81">81</a></li> +<li><span style="margin-left: 1em;">medico-pedagogic, <a href="#Page_102">102</a></span></li> +<li><span style="margin-left: 1em;">satisfactory results of, at the Eastern Counties' Asylum, <a href="#Page_88">88</a></span></li> + +<li>Trousseau, on consanguine marriages, <a href="#Page_35">35</a></li> + +<li>Turner, J.J. C., <a href="#Page_33">33</a>, <a href="#Page_117">117</a></li> + + +<li>Vacherot, <a href="#Page_58">58</a></li> + +<li>Voisin, Auguste, <a href="#Page_51">51</a>, <a href="#Page_95">95</a></li> + + +<li>Wagner, <a href="#Page_45">45</a></li> + +<li>Westcott, <a href="#Page_41">41</a></li> + +<li>Westfelt, on the influence of alcohol on progeny and race, <a href="#Page_31">31</a></li> + +<li>Wilbur, <a href="#Page_28">28</a></li> + +<li>Wilmath, <a href="#Page_44">44</a></li> + +<li>Winn, <a href="#Page_67">67</a></li></ul> + + + + +<div class="footnotes"><h3>FOOTNOTES:</h3> + +<div class="footnote"><p><a name="Footnote_1_1" id="Footnote_1_1"></a><a href="#FNanchor_1_1"><span class="label">[1]</span></a> See an interesting article on Idiocy, by Dr. Langdon +Down, "Quain's Dictionary of Medicine." Vol. I., +p. 926.</p></div> + +<div class="footnote"><p><a name="Footnote_2_2" id="Footnote_2_2"></a><a href="#FNanchor_2_2"><span class="label">[2]</span></a> "Idiocy and Imbecility," by W.W. Ireland, M.D. +P. 36.</p></div> + +<div class="footnote"><p><a name="Footnote_3_3" id="Footnote_3_3"></a><a href="#FNanchor_3_3"><span class="label">[3]</span></a> 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.</p></div> + +<div class="footnote"><p><a name="Footnote_4_4" id="Footnote_4_4"></a><a href="#FNanchor_4_4"><span class="label">[4]</span></a> 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 <ins class="edcorr" title="Greek: iatros kahi hisits">ιατρος καἱ ἱσιωτης</ins>; 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, "<ins class="edcorr" title="Greek: en mhetr hs poits, h haueu mhetrou hs isits">εν μἑτρω ὡς ποιητης, ἡ ἁυευ +μἑτρου ὡς ισιωτης</ins>" (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.</p></div> + +<div class="footnote"><p><a name="Footnote_5_5" id="Footnote_5_5"></a><a href="#FNanchor_5_5"><span class="label">[5]</span></a> 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.</p></div> + +<div class="footnote"><p><a name="Footnote_6_6" id="Footnote_6_6"></a><a href="#FNanchor_6_6"><span class="label">[6]</span></a> "Mentally-deficient Children, their treatment +and training." By G.E. Shuttleworth, M.D. Page +36.</p></div> + +<div class="footnote"><p><a name="Footnote_7_7" id="Footnote_7_7"></a><a href="#FNanchor_7_7"><span class="label">[7]</span></a> Toussenel, a French writer, says "La plupart des +idiots sont des enfants procrs dans l'ivresse bacchique. +On sait que les enfants se ressentent gnralement de +l'influence passionelle qui a prsid leur conception." +At a discussion at the Obstetrical Society, Dr. +Langdon Down is reported to have entertained similar +views.</p></div> + +<div class="footnote"><p><a name="Footnote_8_8" id="Footnote_8_8"></a><a href="#FNanchor_8_8"><span class="label">[8]</span></a> 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. +</p><p> +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. +</p><p> +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.</p></div> + +<div class="footnote"><p><a name="Footnote_9_9" id="Footnote_9_9"></a><a href="#FNanchor_9_9"><span class="label">[9]</span></a> "On the Causes of Idiocy." By S.G. Howe, +M.D. Page 35.</p></div> + +<div class="footnote"><p><a name="Footnote_10_10" id="Footnote_10_10"></a><a href="#FNanchor_10_10"><span class="label">[10]</span></a> "Op cit," page 19.</p></div> + +<div class="footnote"><p><a name="Footnote_11_11" id="Footnote_11_11"></a><a href="#FNanchor_11_11"><span class="label">[11]</span></a> 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 +Mdicale de l'Htel-Dieu de Paris." Tome ii., page +87.</p></div> + +<div class="footnote"><p><a name="Footnote_12_12" id="Footnote_12_12"></a><a href="#FNanchor_12_12"><span class="label">[12]</span></a> "New Facts and Remarks concerning Idiocy," by +E. Sguin, M.D., p. 28. Dr. Sguin 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.</p></div> + +<div class="footnote"><p><a name="Footnote_13_13" id="Footnote_13_13"></a><a href="#FNanchor_13_13"><span class="label">[13]</span></a> 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.</p></div> + +<div class="footnote"><p><a name="Footnote_14_14" id="Footnote_14_14"></a><a href="#FNanchor_14_14"><span class="label">[14]</span></a> 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 <i>raison d'tre</i> of a woman +is maternity ... the cradle lies across the door +of the polling booth and bars the way to the +senate." +</p><p> +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.</p></div> + +<div class="footnote"><p><a name="Footnote_15_15" id="Footnote_15_15"></a><a href="#FNanchor_15_15"><span class="label">[15]</span></a> 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. +</p><p> +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.</p></div> + +<div class="footnote"><p><a name="Footnote_16_16" id="Footnote_16_16"></a><a href="#FNanchor_16_16"><span class="label">[16]</span></a> One of the most distinguished French psychologists, +has thus expressed himself on this point:—"Dans des runions +ou l'idiotisme tendait son triste +niveau, il m'est arriv plusieurs fois de rencontrer +des crnes, qui dans leur partie frontale eussent fait +honneur aux hommes les plus justement clbres, et +o l'on et pu trouver avec avantage les organes de +toutes les sortes d'esprit, de celui mme qui apprend + rire des mystifications et des sots."—<i>Rejet de +l'Organologie Phrnologique</i>, par F. Lelut, p. 196.</p></div> + +<div class="footnote"><p><a name="Footnote_17_17" id="Footnote_17_17"></a><a href="#FNanchor_17_17"><span class="label">[17]</span></a> 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.—<i>Notes on the +Pathology of Idiocy.</i></p></div> + +<div class="footnote"><p><a name="Footnote_18_18" id="Footnote_18_18"></a><a href="#FNanchor_18_18"><span class="label">[18]</span></a> Il Cervello in Relazione con i Fenomeni Psichici. +Studio sulla morfologia degli emisferi cerebrali +dell'uomo, Torino, 1895. P. 89. +</p><p> +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 pu inferire quasi con certezza che +differenze essenziali non esistono).</p></div> + +<div class="footnote"><p><a name="Footnote_19_19" id="Footnote_19_19"></a><a href="#FNanchor_19_19"><span class="label">[19]</span></a> 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. (<i>Prize Essay of the Academy of +Medicine of France.</i>)</p></div> + +<div class="footnote"><p><a name="Footnote_20_20" id="Footnote_20_20"></a><a href="#FNanchor_20_20"><span class="label">[20]</span></a> Op. cit., page 64.</p></div> + +<div class="footnote"><p><a name="Footnote_21_21" id="Footnote_21_21"></a><a href="#FNanchor_21_21"><span class="label">[21]</span></a> 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 21 to 09. +This was probably due to the larger size of the head +giving rise to the prolonged and difficult parturition, +continued pressure, and suspended animation."—<i>Obstetrical +Journal</i>, vol. iv., p. 681.</p></div> + +<div class="footnote"><p><a name="Footnote_22_22" id="Footnote_22_22"></a><a href="#FNanchor_22_22"><span class="label">[22]</span></a> 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."</p></div> + +<div class="footnote"><p><a name="Footnote_23_23" id="Footnote_23_23"></a><a href="#FNanchor_23_23"><span class="label">[23]</span></a> Clinical Lecture on Idiocy, p. 14.</p></div> + +<div class="footnote"><p><a name="Footnote_24_24" id="Footnote_24_24"></a><a href="#FNanchor_24_24"><span class="label">[24]</span></a> L'Encphale, March 1881, p. 82.</p></div> + +<div class="footnote"><p><a name="Footnote_25_25" id="Footnote_25_25"></a><a href="#FNanchor_25_25"><span class="label">[25]</span></a> 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.</p></div> + +<div class="footnote"><p><a name="Footnote_26_26" id="Footnote_26_26"></a><a href="#FNanchor_26_26"><span class="label">[26]</span></a> 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 gnie est une nvrose"; 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'originalit de ses penses et de ses conceptions, par +son excentricit on l'nergie de ses facults affectives, +par la transcendance de ses facults intellectuelles, +prennent leur source dans les mmes conditions +organiques que les divers troubles moraux, dont <i>la +folie et l'idiotie</i> sont l'expression la plus complte."</p></div> + +<div class="footnote"><p><a name="Footnote_27_27" id="Footnote_27_27"></a><a href="#FNanchor_27_27"><span class="label">[27]</span></a> Le Cerveau et la Pense, 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.</p></div> + +<div class="footnote"><p><a name="Footnote_28_28" id="Footnote_28_28"></a><a href="#FNanchor_28_28"><span class="label">[28]</span></a> "Nineteenth Century," March, 1880, p. 509.</p></div> + +<div class="footnote"><p><a name="Footnote_29_29" id="Footnote_29_29"></a><a href="#FNanchor_29_29"><span class="label">[29]</span></a> "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.</p></div> + +<div class="footnote"><p><a name="Footnote_30_30" id="Footnote_30_30"></a><a href="#FNanchor_30_30"><span class="label">[30]</span></a> "Das Leben ist nur ein besonderer, und zwar +der complicirteste Act der Mechanik; ein Theil der +Gesammtmaterie tritt von Zeit zu Zeit aus dem +gewhnlichen Gange ihrer Bewegungen heraus in +besondre organisch-chemische Verbindungen, und +nachdem er eine Zeit lang darin verharrt hat, kehrt +er weider zu den allgemeinen Bewegungsverhltnissen +zurck."— +</p><p> +<i>Gesammte Abhandlungen zu wissenschaftlicher +Medicin</i> s. 25.</p></div> + +<div class="footnote"><p><a name="Footnote_31_31" id="Footnote_31_31"></a><a href="#FNanchor_31_31"><span class="label">[31]</span></a> 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! +</p><p> +A clever French writer, commenting on these purely +hypothetical statements of the "mechanistic school," +makes the following appropriate remarks:— +</p><p> +<i>"Quand on nous dit que l'organisme des tres vivants +n'est qu'un laboratoire o tout se passe en combinaisons +et en compositions des lments matriels primitifs, on +oublie que ce laboratoire est habit par un hte intime, le +principe vital qui ne fait qu'un avec les lments en fusion. +Ici la combinaison chimique ne se fait pas toute seule; +elle s'opre sous l'action d'une cause qui en transforme +les lments de faon en faire un produit d ordre nouveau +qui s'appelle la vie."—"La Vie et la Matire," par E. +Vacherot, Revue des Deux Mondes,"</i> 1878.</p></div> + +<div class="footnote"><p><a name="Footnote_32_32" id="Footnote_32_32"></a><a href="#FNanchor_32_32"><span class="label">[32]</span></a> 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 <i>grey nerve tissue</i>, in which respect +we shall find man stands pre-eminent, although, as we +have already seen, his brain, <i>as a whole</i>, 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."</p></div> + +<div class="footnote"><p><a name="Footnote_33_33" id="Footnote_33_33"></a><a href="#FNanchor_33_33"><span class="label">[33]</span></a> "The Physical Basis of Mind." Page 441.</p></div> + +<div class="footnote"><p><a name="Footnote_34_34" id="Footnote_34_34"></a><a href="#FNanchor_34_34"><span class="label">[34]</span></a> 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."—<i>Nineteenth Century</i>, +March, 1880, p. 510.</p></div> + +<div class="footnote"><p><a name="Footnote_35_35" id="Footnote_35_35"></a><a href="#FNanchor_35_35"><span class="label">[35]</span></a> To those who may wish to pursue this subject +further, I recommend a perusal of an essay on +"Materialistic Physiology," in the <i>Journal of Psychological +Medicine</i> 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:— +</p><p> +"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. +</p><p> +"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. +</p><p> +"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." +</p><p> +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 <i>theoretical +statements</i>, but by arguments drawn from <i>well-accredited +facts</i> in anatomy and physiology.</p></div> + +<div class="footnote"><p><a name="Footnote_36_36" id="Footnote_36_36"></a><a href="#FNanchor_36_36"><span class="label">[36]</span></a> 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 <i>odium theologicum</i> may have +inspired some of the opponents of evolution, it is undeniable +that there is strong evidence of an <i>odium +antitheologicum</i> 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.</p></div> + +<div class="footnote"><p><a name="Footnote_37_37" id="Footnote_37_37"></a><a href="#FNanchor_37_37"><span class="label">[37]</span></a> 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."—<i>Faith and Freedom.</i></p></div> + +<div class="footnote"><p><a name="Footnote_38_38" id="Footnote_38_38"></a><a href="#FNanchor_38_38"><span class="label">[38]</span></a> 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."—<i>Religio Medici</i>, p. 208.</p></div> + +<div class="footnote"><p><a name="Footnote_39_39" id="Footnote_39_39"></a><a href="#FNanchor_39_39"><span class="label">[39]</span></a> 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.</p></div> + +<div class="footnote"><p><a name="Footnote_40_40" id="Footnote_40_40"></a><a href="#FNanchor_40_40"><span class="label">[40]</span></a> Maladies Mentales, Tome ii., p. 76, par E. +Esquirol, mdecin en chef de la maison royale des +alins de Charenton. "Les idiots sont ce qu'ils +doivent tre pendant tout le cours de leur vie. On +ne conoit pas la possibilit de changer cet tat. Rien +ne saurait donner aux malheureux idiots, mme pour +quelques instants, plus de raison, plus d'intelligence."</p></div> + +<div class="footnote"><p><a name="Footnote_41_41" id="Footnote_41_41"></a><a href="#FNanchor_41_41"><span class="label">[41]</span></a> "Mentally deficient children," page 110.</p></div> + +<div class="footnote"><p><a name="Footnote_42_42" id="Footnote_42_42"></a><a href="#FNanchor_42_42"><span class="label">[42]</span></a> 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. +</p><p> +Although the effect of thyroid treatment in the idiot +is still <i>sub judice,</i> 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.</p></div> + +<div class="footnote"><p><a name="Footnote_43_43" id="Footnote_43_43"></a><a href="#FNanchor_43_43"><span class="label">[43]</span></a> "Pediatrics," May, 1896, p. 460.</p></div> + +<div class="footnote"><p><a name="Footnote_44_44" id="Footnote_44_44"></a><a href="#FNanchor_44_44"><span class="label">[44]</span></a> I give M. Voisin's description of the symptoms in +his own words. "Elle est arrive dans mon service en +tat d'extase mystique, excutant continuellement des +mouvements de ses deux mains, surtout de la droite, +semblables ceux d'une personne en prire; elle porte +souvent les mains son front comme pour faire le +signe de la croix. Elle murmure des mots, entre +autres, <i>Ave Maria</i>. La physiognomie exprime la +douleur mle d'extase."</p></div> + +<div class="footnote"><p><a name="Footnote_45_45" id="Footnote_45_45"></a><a href="#FNanchor_45_45"><span class="label">[45]</span></a> "Edinburgh Medical Journal," May, 1893, p. 1053.</p></div> + +<div class="footnote"><p><a name="Footnote_46_46" id="Footnote_46_46"></a><a href="#FNanchor_46_46"><span class="label">[46]</span></a> "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."</p></div> + +<div class="footnote"><p><a name="Footnote_47_47" id="Footnote_47_47"></a><a href="#FNanchor_47_47"><span class="label">[47]</span></a> "Journal of Mental Science," April, 1895, p. 280.</p></div> + +<div class="footnote"><p><a name="Footnote_48_48" id="Footnote_48_48"></a><a href="#FNanchor_48_48"><span class="label">[48]</span></a> "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.</p></div> + +<div class="footnote"><p><a name="Footnote_49_49" id="Footnote_49_49"></a><a href="#FNanchor_49_49"><span class="label">[49]</span></a> "Traitement et Education des Enfants Idiots et +Dgnrs," p. 241, par M. Bourneville, Mdecin de +Bictre, 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 Bictre, the description being +copiously illustrated by plates, which cannot fail to +interest those engaged in the treatment of idiocy.</p></div> + +<div class="footnote"><p><a name="Footnote_50_50" id="Footnote_50_50"></a><a href="#FNanchor_50_50"><span class="label">[50]</span></a> "Journal of Anatomy and Physiology," January, +1895, p. 304.</p></div> + +<div class="footnote"><p><a name="Footnote_51_51" id="Footnote_51_51"></a><a href="#FNanchor_51_51"><span class="label">[51]</span></a> "Pediatrics," March, 1896, p. 243.</p></div> + +<div class="footnote"><p><a name="Footnote_52_52" id="Footnote_52_52"></a><a href="#FNanchor_52_52"><span class="label">[52]</span></a> "On Idiocy and Imbecility," page 91.</p></div> + +<div class="footnote"><p><a name="Footnote_53_53" id="Footnote_53_53"></a><a href="#FNanchor_53_53"><span class="label">[53]</span></a> 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.</p></div> + +<div class="footnote"><p><a name="Footnote_54_54" id="Footnote_54_54"></a><a href="#FNanchor_54_54"><span class="label">[54]</span></a> The Countess of Warwick, at the "Young +Helpers' League."</p></div> + +<div class="footnote"><p><a name="Footnote_55_55" id="Footnote_55_55"></a><a href="#FNanchor_55_55"><span class="label">[55]</span></a> Des Maladies Mentales, Tome ii., p. 103.</p></div> +</div> + + +<hr style="width: 65%;" /> + + + +<h2>EASTERN COUNTIES'</h2> + +<h1>ASYLUM FOR IDIOTS,</h1> + +<h2>COLCHESTER.</h2> + +<h4><i>Instituted 1st February, 1859.</i></h4> + +<hr style="width: 35%;" /> +<h4>Patron:</h4> + +<h3><span class="smcap">H.R.H. The PRINCE OF WALES, K.G.</span></h3> + + +<h3>Presidents:</h3> + + +<ul><li><span class="smcap">The Most Noble The Duke of Norfolk, E.M., K.G.</span></li> +<li><span class="smcap">The Most Hon. The Marquis of Lothian, K.T.</span></li> +<li><span class="smcap">The Most Hon. The Marquis of Bristol.</span></li> +<li><span class="smcap">The Right Hon. The Earl of Warwick.</span></li> +<li><span class="smcap">The Right Hon. The Earl Cadogan, K.G.</span></li> +<li><span class="smcap">The Right Rev. The Lord Bishop of St. Albans.</span></li> +<li><span class="smcap">The Right Rev. The Lord Bishop of Norwich.</span></li> +<li><span class="smcap">The Right Hon. Lord Walsingham.</span></li> +<li><span class="smcap">The Right Hon. Lord Braybrooke.</span></li> +<li><span class="smcap">The Right Hon. Lord Gwydyr.</span></li> +<li><span class="smcap">The Right Hon. Lord Henniker.</span></li> +<li><span class="smcap">The Right Hon. Lord Rendlesham.</span></li> +<li><span class="smcap">The Right Hon. Lord Rayleigh.</span></li> +<li><span class="smcap">The Right Hon. Lord de Saumarez.</span></li> +<li><span class="smcap">The Right Hon. Lord Carlingford.</span></li> +<li><span class="smcap">The Right Hon. Lord Tollemache.</span></li> +<li><span class="smcap">The Hon. and Rev. Canon Neville.</span></li> +<li><span class="smcap">The Lord Lieutenant of Cambridgeshire.</span></li> +<li><span class="smcap">William Birkbeck, Esq.</span></li></ul> + + +<h3>Vice-Presidents:</h3> + +<ul><li>The Hon. W.F. D. Smith, M.P.</li> +<li>The Rev. Sir W. Hyde Parker, Bart.</li> +<li>Sir Reginald P. Beauchamp, Bart.</li> +<li>Sir Alfred Sherlock Gooch, Bart.</li> +<li>Sir Charles C. Smith, Bart.</li> +<li>Sir Brydges Powell Henniker, Bart.</li> +<li>Sir Francis G.M. Boileau, Bart.</li> +<li>Sir Fowell Buxden, Bart., K.C.M.G.</li> +<li>Sir Savile B. Crossley, Bart.</li> +<li>Sir Edward Green, Bart.</li> +<li>Sir Walter Gilbey, Bart.</li> +<li>Sir Weetman Pearson, Bart., M.P.</li> +<li>The Very Rev. Dean Goulburn.</li> +<li>The Very Rev. the Dean of Norwich.</li> +<li>The Very Rev. the Dean of Ely.</li> +<li>Charles H. Berners, Esq.</li> +<li>Lieut-Colonel Bramston</li> +<li>Henry E. Buxton, Esq.</li> +<li>Professor Duncan, F.R.S.</li> +<li>Robert T. Gurdon, Esq.</li> +<li>Colonel Lockwood, M.P.</li> +<li>Rev. Charles John Martyn, M.A.</li> +<li>Captain Pretyman, M.P.</li> +<li>Arthur Pryor, Esq.</li> +<li>W. Cuthbert Quilter, Esq., M.P.</li> +<li>Hector John Gurdon Rebow, Esq.</li> +<li>H.C. Wells, Esq.</li></ul> + + + + +<h3>Board of Directors:</h3> + +<p class="cen"><i>Chairman</i>—<span class="smcap">The Most Hon. The</span> MARQUIS OF BRISTOL.<br /> + +<i>Vice-Chairman</i>—<span class="smcap">Admiral</span> W.G. LUARD, C.B.<br /> + +<i>Treasurer</i>—HORACE G. EGERTON GREEN, <span class="smcap">Esq.</span></p> + + +<ul><li><span class="smcap">Alexander, William, Esq.</span></li> +<li><span class="smcap">Back, Philip, Esq.</span></li> +<li><span class="smcap">Barnard, William, Esq.</span></li> +<li><span class="smcap">Barnardiston, Colonel</span></li> +<li><span class="smcap">Bateman, Sir F., M.D., LL.D.</span></li> +<li><span class="smcap">Bateman, John, Esq.</span></li> +<li><span class="smcap">Bevan, Beckford, Esq.</span></li> +<li><span class="smcap">Bullard, Sir Harry, M.P.</span></li> +<li><span class="smcap">Burke, Lieut.-Colonel</span></li> +<li><span class="smcap">Burton, Samuel C., Esq.</span></li> +<li><span class="smcap">Cadge, W., Esq.</span></li> +<li><span class="smcap">Chamberlin, A. R., Esq.</span></li> +<li><span class="smcap">Chancellor, F., Esq.</span></li> +<li><span class="smcap">Colman, J.J., Esq.</span></li> +<li><span class="smcap">Courtauld, George, Esq.</span></li> +<li><span class="smcap">Dakin, W. H, Esq.</span></li> +<li><span class="smcap">Duckett, Rev. Canon, D.D.</span></li> +<li><span class="smcap">Edwards, H.W. B., Esq.</span></li> +<li><span class="smcap">Egerton-Green, Claude, Esq.</span></li> +<li><span class="smcap">Garrett, Henry N., Esq.</span></li> +<li><span class="smcap">Godfrey, Charles, Esq.</span></li> +<li><span class="smcap">Greene, E. Walter, Esq.</span></li> +<li><span class="smcap">Harvey, E.K., Esq.</span></li> +<li><span class="smcap">Hoare, Charles R.G., Esq.</span></li> +<li><span class="smcap">Hunt, E.A., Esq.</span></li> +<li><span class="smcap">Image, W.E., Esq.</span></li> +<li><span class="smcap">Ind, Captain</span></li> +<li><span class="smcap">Kelso, Captain, R.N.</span></li> +<li><span class="smcap">Macandrew, W., Esq.</span></li> +<li><span class="smcap">Martyn, Rev. C.J.</span></li> +<li><span class="smcap">Merriman, W., Colonel, C.I.E.</span></li> +<li><span class="smcap">Montagu, General., C.B., R.E.</span></li> +<li><span class="smcap">Packard, Edward, Esq.</span></li> +<li><span class="smcap">Papillon, Philip O., Esq.</span></li> +<li><span class="smcap">Patteson, H.S., Esq.</span></li> +<li><span class="smcap">Paxman, James, Esq.</span></li> +<li><span class="smcap">Rowley, Sir Joshua T., Bart.</span></li> +<li><span class="smcap">Ruck-Keene, Rev. B.</span></li> +<li><span class="smcap">Ruggles-Brise, A.W., Esq.</span></li> +<li><span class="smcap">Savill-Onley, C.A. O., Esq.</span></li> +<li><span class="smcap">Stradbroke, The Earl of</span></li> +<li><span class="smcap">Symmons, R.F., Esq.</span></li> +<li><span class="smcap">Tower, Christopher J.H., Esq.</span></li> +<li><span class="smcap">Tracy, N., Esq.</span></li> +<li><span class="smcap">Tufnell, W.M., Esq.</span></li> +<li><span class="smcap">Wells, F., Esq.</span></li> +<li><span class="smcap">Winter, J.J., Esq.</span></li> +<li><span class="smcap">Wood, Charles Page, Esq.</span></li></ul> + + + + +<p class="cen"><i>Hon. Consulting Physicians</i>—</p> + +<p class="cen"> +<span class="smcap">Sir</span> FREDERIC BATEMAN, M.D., LL.D., F.R.C.P.<br /> +<span style="margin-left: 1em;">Consulting Physician to the Norfolk and Norwich Hospital.</span><br /> +T. CLIFFORD ALLBUTT, M.D., LL.D., F.R.S., F.R.C.P.<br /> +<span style="margin-left: 1em;">Regius Professor of Physic, University of Cambridge.</span><br /> +</p> + + +<p class="cen"><i>Hon. Consulting Surgeons</i>—</p> + +<p class="cen"> +R.F. SYMMONS, <span class="smcap">Esq.</span>, Consulting Surgeon to Essex & Colchester Hospital.<br /> +E.A. HUNT, <span class="smcap">Esq.</span>, Surgeon to Essex and Colchester Hospital.<br /> +<i>Hon. Ophthalmic Surgeon</i>—<span class="smcap">Dr.</span> S. JOHNSON TAYLOR, Norwich.<br /> +<i>Hon. Medical Officer, Crossley House, Clacton-on-Sea</i>—<br /></p> + +<p class="cen">WALTER MAINE, <span class="smcap">Esq.</span><br /> + +<i>Hon. Dentist</i>—N. TRACY, <span class="smcap">Esq.</span><br /> +<i>Hon. Solicitor</i>—A.M. WHITE, <span class="smcap">Esq.</span><br /> +<i>Hon. Architect</i>—F. CHANCELLOR, <span class="smcap">Esq.</span><br /> +<i>Auditor</i>—<span class="smcap">Mr.</span> ROBERT L. IMPEY (Chartered Accountant).<br /></p> + +<p class="cen"><i>Resident Medical Attendant</i>—<br /> +R.C. KIRKBY, M.R.C.S., Eng., L.R.C.P., Lond.<br /> +<i>Resident Superintendent and Secretary</i>—JOHN J.C. TURNER.<br /> +<i>Bankers</i>—<span class="smcap">Messrs.</span> BARCLAY & CO., Limited.<br /> +</p> + + + +<hr style="width: 65%;" /> +<h2>LADIES' ASSOCIATION.</h2> + + +<hr style="width: 35%;" /> +<h3>Patroness:</h3> + +<h4>HER ROYAL HIGHNESS THE PRINCESS OF WALES.</h4> + + +<h3>Vice-Patroness:</h3> + +<h4><span class="smcap">The Marchioness of Bristol.</span></h4> + + +<h3>Presidents:</h3> + + +<ul><li><span class="smcap">The Countess of Albemarle.</span></li> +<li><span class="smcap">The Countess of Warwick.</span></li> +<li><span class="smcap">The Countess Cadogan.</span></li> +<li><span class="smcap">The Countess of Stradbroke.</span></li> +<li><span class="smcap">Lady Evelyn Cobbold.</span></li> +<li><span class="smcap">Lady Florence Barnardiston.</span></li> +<li><span class="smcap">Lady Ida Leigh Hare.</span></li> +<li><span class="smcap">Lady Susan Byng.</span></li> +<li><span class="smcap">The Lady Rayleigh.</span></li> +<li><span class="smcap">The Lady Bateman.</span></li> +<li><span class="smcap">The Lady Amherst of Hackney.</span></li> +<li><span class="smcap">The Hon. Lady Rowley.</span></li> +<li><span class="smcap">The Hon. Ethel Henniker.</span></li> +<li><span class="smcap">The Hon. Mrs. Pretyman.</span></li> +<li><span class="smcap">Lady Ffolkes.</span></li> +<li><span class="smcap">Lady Affleck.</span></li> +<li><span class="smcap">Lady Durrant.</span></li> +<li><span class="smcap">Lady Rich.</span></li> +<li><span class="smcap">Lady Thornhill.</span></li> +<li><span class="smcap">The Mayoress of Norwich.</span></li> +<li><span class="smcap">The Mayoress of King's Lynn.</span></li> +<li><span class="smcap">The Mayoress of Bury St. Edmund's.</span></li> +<li><span class="smcap">Mrs. Adeane.</span></li> +<li><span class="smcap">Mrs. Arkwright.</span></li> +<li><span class="smcap">Mrs. Austen-Leigh.</span></li> +<li><span class="smcap">Miss Buxton.</span></li> +<li><span class="smcap">Mrs. Cator.</span></li> +<li><span class="smcap">Mrs. Russell Colman.</span></li> +<li><span class="smcap">Mrs. Crawley.</span></li> +<li><span class="smcap">Mrs. Crowfoot.</span></li> +<li><span class="smcap">Mrs. De Chair.</span></li> +<li><span class="smcap">Mrs. Dowsett.</span></li> +<li><span class="smcap">Mrs. Egerton-Green.</span></li> +<li><span class="smcap">Miss Farrer.</span></li> +<li><span class="smcap">Miss E. Blanche Hammond.</span></li> +<li><span class="smcap">Mrs. Sancroft Holmes.</span></li> +<li><span class="smcap">Mrs. Ingleby.</span></li> +<li><span class="smcap">Mrs. Johnson.</span></li> +<li><span class="smcap">Mrs. Sidney Lacon.</span></li> +<li><span class="smcap">Mrs. Locker-Lampson.</span></li> +<li><span class="smcap">Mrs. Le Strange.</span></li> +<li><span class="smcap">Mrs. Littlewood.</span></li> +<li><span class="smcap">Mrs. Lockwood.</span></li> +<li><span class="smcap">Miss Mabel Lowther.</span></li> +<li><span class="smcap">Mrs. Berkeley Mansel.</span></li> +<li><span class="smcap">Mrs. Mcintosh.</span></li> +<li><span class="smcap">Mrs. Edward Packard, Jun.</span></li> +<li><span class="smcap">Mrs. Victor Paley.</span></li> +<li><span class="smcap">Miss Oxley Parker.</span></li> +<li><span class="smcap">Mrs. Petre.</span></li> +<li><span class="smcap">Mrs. Howell Price.</span></li> +<li><span class="smcap">Mrs. Ernest Ransom.</span></li> +<li><span class="smcap">Mrs. Round.</span></li> +<li><span class="smcap">Miss Round.</span></li> +<li><span class="smcap">Miss Florence Ruggles-Brise.</span></li> +<li><span class="smcap">Mrs. Henry Sharpe.</span></li> +<li><span class="smcap">Mrs. Stanley.</span></li> +<li><span class="smcap">Mrs. Townley.</span></li> +<li><span class="smcap">Mrs. Vaizey.</span></li> +<li><span class="smcap">Miss Margaret Waters.</span></li> +<li><span class="smcap">Mrs. Wedd.</span></li> +<li><span class="smcap">Miss Wood.</span></li> +<li><span class="smcap">Mrs. Frank Worthington.</span></li></ul> + + + + +<blockquote><p>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.</p> + +<p>In these Counties there are upwards of 3,000 cases of Idiocy and Imbecility, +and the Asylum at Colchester is <i>the only one</i> 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.</p> + +<p>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.</p> + +<p>Reports, Forms of Application for Admission, and any other information +will be supplied by the Secretary, Mr. John J.C. Turner, Asylum, Colchester.</p> + +<p>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.</p></blockquote> + +<p class="quotsig">JOHN J.C. TURNER,<br /> +<i>Secretary</i>.</p> + + + +<hr style="width: 65%;" /> +<h2>By the Same Author. Demy 8vo, 16/- Second Edition, Greatly Enlarged.</h2> + +<p class="cen"><i>Prize Essay of the Academy of Medicine of France.</i></p> + +<p class="cen">ON</p> + +<h1>APHASIA,</h1> + +<h5>OR</h5> + +<h2>Loss of Speech,</h2> + +<p class="cen">AND</p> + +<p class="cen"><span class="smcap">The Localisation of the Faculty of Articulate</span><br /> +<span class="smcap">Language</span>.</p> + +<p class="cen"><i>Ouvrage couronn par l'Acadmie de Mdecine de France</i><br /> +<i>(Prix Alvarenga, 1891).</i></p> + + +<h3>OPINIONS OF THE PRESS.</h3> + +<p class="cen">From the <i>British Medical Journal</i>.</p> + +<p>"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.</p> + +<p>"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."</p> + +<p class="cen">From the <i>London Medical Recorder</i>.</p> + +<p>"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."</p> + +<p class="cen">From <i>Nature</i>.</p> + +<p>"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."</p> + +<p class="cen">From the <i>Solicitor's Journal</i>.</p> + +<p>"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.</p> + +<p>"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."</p> + +<p class="cen">From the <i>Norfolk Chronicle</i>.</p> + +<p>"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."</p> + + +<p class="cen"><b>CONTINENTAL NOTICES.</b></p> + +<p class="cen"><i>Les Archives de Neurologie</i>, Vol. xx.</p> + +<p>"Ce livre est la deuxime dition considrablement augmente +du trait publi il y a vingt ans et bien connu de nos lecteurs.</p> + +<p>"N.B.—Ce livre est parfaitement au courant de la science +actuelle."</p> + +<p class="cen"><i>La Revue de l'Hypnotisme.</i></p> + +<p>"L'ouvrage du docteur Bateman a dj reu un accueil favorable +de l'Acadmie des sciences et de l'Acadmie de mdecine de Paris. +En le prsentant la Socit de Biologie, le Prsident, M. Brown-Squard, +a fait un loge mrit de ce remarquable ouvrage aussi +savant qu'original.</p> + +<p>"Le livre du docteur Bateman apporte une contribution prcieuse + la mdecine psychologique. M. Bateman a compuls +toute la littrature scientifique de l'Europe et de l'Amrique sur le +sujet qu'il a trait, et ses tudes faites pendant plus de vingt annes +sur les cas qu'il a rencontrs l'hpital de Norwich et dans sa +clientle prive, lui ont permis d'arriver a des conclusions vritablement +pratiques."</p> + +<p class="cen"><i>Annales d'Hygine Publique et de Mdecine Lgale</i>,<br /> +Tome xxvi., p. 583.</p> + +<p>"La premire dition du trait de M. Bateman avait t trs +favorablement accueillie du public mdical. La seconde dition, +augmente d'observations nouvelles, tenue au courant des progrs +de la science, n'aura pas moins de succs.</p> + +<p>"Les premiers chapitres du volume sont consacrs a l'historique +de l'aphasie et de la localisation de la facult du langage articul: +l'auteur y rend pleine justice aux auteurs franais, Broca, Trousseau, +Charcot, &c., qui ont les premiers soulev cette question dlicate. Le +chapitre iv. contient les observations personnelles de M. Bateman +dont beaucoup ont t recueillies dans son service l'hpital de +Norfolk et Norwich. Dans le chapitre suivant M. Bateman tudie +et analyse la facult de parler, la parole articule, rsume les +opinions de Max Muller, de Whitney, de Parchappe, &c. La +parole est un acte physico-psychique, compos de deux lments, +l'un somatique et matriel, le mouvement, l'autre psychique, la +parole interne, le <ins class="edcorr" title="Greek: logos">λογος</ins>. Le langage est donc une fonction la +fois impressive et expressive. La fonction impressive ncessite +l'action de l'oue, de la vue ou d'un des sens, c'est la fonction sensorielle +du langage; l'autre rsulte d'une action musculaire, et +constitue la fonction motrice. Le langage articul est l'apanage +de l'homme seul.</p> + +<p>"L'auteur dcrit ensuite le mcanisme du langage, les organes +de la voix, le larynx; il tudie plus loin les diffrents types de +langage; il montre que le langage articul n'est pas le seul moyen +que l'homme ait d'exprimer sa pense, il oppose le langage naturel +au langage artificiel ou acquis, &c.</p> + +<p>"Avec les chapitres suivants nous entrons dans la pathologie; +M. Bateman y dcrit l'agraphie, l'aphasie dans toutes ses formes +et varits. Il tudie ses causes, son diagnostic, son pronostic, +son traitement, son importance en mdecine lgale; enfin dans +les derniers chapitres, M. Bateman s'occupe plus gnralement +de la localisation de la parole, et il rsume les opinions des +physiologistes les plus clbres depuis Gall jusqu' Barnard +Davis, Flower, Broca, &c."</p> + +<p class="cen"><i>Comptes Rendus de la Socit de Biologie</i>, Tome ii., No. 30.</p> + +<p>"Au nom de l'auteur, le Dr. Frdric Bateman, je prsente la +Socit un exemplaire de la seconde dition de son clbre ouvrage +sur l'aphasie. Les progrs considrables de nos connaissances, +durant les vingt dernires annes, sur les diverses espces d'aphasie, +sont exposs avec une grande clart dans ce remarquable ouvrage +aussi savant qu'original, le plus complet qui existe sur la matire +dont il traite. L'auteur lui a consacr toute sa vie, dj longue, +de penseur et de praticien."</p> + +<p class="quotsig">"<span class="smcap">Le Professeur Brown-Squard</span>,<br /> +"<i>Prsident de la Socit de Biologie</i>."</p> + +<p class="cen"><i>Gazzetta Degli Ospitali, Milano.</i></p> + +<p>" una monographia importante su questa affezione tanto +studiata ai nostri tempi. L'A conosce tutto ci 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.</p> + +<p>"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."</p> + +<p class="cen"><i>Neurologisches Centralblatt.</i></p> + +<p>"Im 1.—3, Kapitel wird die Litteratur und Bibliographie der +Aphasie ausfhrlich berichtet, indem die betreffenden Arbeiten +aller Lnder in gleichem Maasse gewrdigt 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 Fllen von Aphasie +werden nur bestimmte Phrasen bestndig wiederholt etc. Auch +die Schriftstrungen und die Anomalien der Mimik und Zeichensprache +bei der Aphasie werden besprochen; ferner die Affectausdrcke, +Bedeutung der Injectionen, der hysterische Mutismus +u. s. w. Im 8. Kapitel werden die tiologischen Factoren der +Aphasie hervorgehoben: Angeborene Stummheit, Sprachstrungen +der Idioten; Aphasie in Folge von Exostosen der Schdelknochen; +Thrombose, Embolie der Gehirnarterien; ischmische Erweichung, +etc. Kapitel 9 behandelt die Diagnose, Prognose, Therapie, +whrend im folgenden Kapitel die Rechtsfragen der Aphasischen +errtert werden. In den letzten Kapiteln 11 und 12 geht der +Verf., soweit die betreffenden Gegenstnde 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."</p> + + +<h3>AMERICAN & COLONIAL NOTICES.</h3> + +<p class="cen">From the <i>Montreal Medical Journal</i>.</p> + +<p>"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.</p> + +<p>"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."</p> + +<p class="cen">From the <i>American Journal of Insanity</i>.</p> + +<p>"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.</p> + +<p>"It is a book which no student of medicine, of language, or of +psychology can afford to be without."</p> + +<p class="cen">From the <i>New York Medico-Legal Journal</i>.</p> + +<p>"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.</p> + +<p>"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.</p> + +<p>"The work on the whole is a very valuable contribution to the +literature of Aphasia, and will be welcomed by all Neurologists."</p> + +<p class="cen">From the <i>Alienist and Neurologist</i>.</p> + +<p>"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.</p> + +<p>"No library of the literature of Aphasia, however, would be +complete without this book. The author is elaborate without +complexity."</p> + + +<hr style="width: 35%;" /> +<p class="cen"><i>London: Jarrold and Sons, 10 and 11, Warwick Lane, E.C.</i></p> + + + +<hr style="width: 95%;" /> +<div class="tr"> +<h2>Transcriber's Notes</h2> + +<p>Obvious punctuation and spelling errors repaired.</p> + +<p>Page numbers for blank pages, pages consisting entirely of illustration, are not visible.</p> + +<p>Inconsistent hyphenation has been repaired.</p> + +<p>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.</p> + +<p>Greek translations are indicated by dotted blue lines. Scroll the mouse over the Greek words +and the translation will be displayed.</p> + +<p>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.</p> + +<p>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.</p> + +<p>The following numerous errors were left as is:</p> +<ul><li>endquote missing punctuation </li> +<li>mismatched quotes</li> +<li>missing paragraph breaks</li> +<li>double punctuation</li> +</ul> + + +</div> + + + + + + + +<pre> + + + + + +End of the Project Gutenberg EBook of The Idiot, by Frederick Bateman + +*** END OF THIS PROJECT GUTENBERG EBOOK THE IDIOT *** + +***** This file should be named 39670-h.htm or 39670-h.zip ***** +This and all associated files of various formats will be found in: + http://www.gutenberg.org/3/9/6/7/39670/ + +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) + + +Updated editions will replace the previous one--the old editions +will be renamed. + +Creating the works from public domain print editions means that no +one owns a United States copyright in these works, so the Foundation +(and you!) can copy and distribute it in the United States without +permission and without paying copyright royalties. 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