FEEBLE-MINDEDNESS ITS CAUSES AND CONSEQUENCES BY HENRY HERBERT GODDARD, Ph.D. DIRECTOR OF THE RESEARCH LABORATORY OF THE TRAINING SCHOOL AT VINELAND, NEW JpRSKY,' i^OR fE^EBLE-MINDED |'* " » »J ) ) > J ) ' * t • • • • J • • » • \*»\ * * % » • • • • » • li^eto gorfe THE MACMILLAN 1914 ^11 rights reserved COMPANY Copyright, 1914, By the M ACM ill an COMPANY. Set 'Ip Jniiel«;trotypecC, I'iSblished July, 1914. • N- \ } i J. 8. Gushing Co. — Berwick & Smith Co. Norwood, Mass., U.S.A. G51- EDWARD R. JOHNSTONE SUPERINTENDENT OF THE TRAINING SCHOOL AT VINELAND FRIEND AND CO-WORKER, WHOSE DEVOTION TO THE INTERESTS OF THOSE WHOSE MINDS HAVE NOT DEVELOPED NORMALLY PROMPTED THE ESTABLISH- MENT OF THIS DEPARTMENT OF RESEARCH X PREFACE This book is in the nature of a report on work done at the Vineland Research Laboratory during the past five years in an attempt to discover the causes of the feeble-mindedness of the children in the Institution. No attempt has been made to treat exhaustively any of the topics that have come up for con- sideration. The report is far from complete. Our cases are still being studied and the data are so incomplete in many ways that one is tempted to withhold publication until the results of other studies now in progress could be added. Such a procedure would have given a more satisfactory product. But in view of the great popular interest in these topics and the demand for informa- tion, we have put aside personal preferences and prepared what data we had in as available form as we could. The 327 cases here presented constitute a unitary group. They have not been selected ; they are of all ages and grades of defect. They include every case that was investigated, and every child whose home was in New Jersey or near by was in- vestigated. Only those were omitted whose homes were so far away that the cost of travel for our field-workers was prohibitive. We have included in this book all the cases, so that the reader might see the entire group on which our statistics are based. Another reason for including them is because it is believed that other students with other interests will find in this material much that we have made no attempt to use. In this way the data may have a value beyond anything we our- selves have deduced from them. It is hoped that not only the scientist but the lay read6r, the parent and the teacher will find help on their particular prob- viii PREFACE lems, by discovering among the many cases some that are like the ones in whom they happen to be interested. Such readers must be warned that no two cases are exactly alike and it would be the height of unwisdom to conclude that precisely the same causes existed or results were obtainable in two cases whose descriptions might seem to tally. Nevertheless the discovery of apparently similar cases would be of value and would have considerable probability of agreement in other particulars than those described in the text. The question of form of presentation has been a difficult one to settle. The material is largely of a scientific character and will, we trust, be of interest to the scientific man. It is also of profound importance to the layman. We have, therefore, at- tempted the always difficult task of presenting scientific infor- mation in a popular form. The difficulties of such a course are so great that we cannot hope for a large measure. of success. If we have been able to spread the facts before the reader in such a way that they are intelligible and can be used, we shall be satisfied. We believe that the material has been so treated as to render it entirely impersonal. All names have been changed, dates and localities have been given with a slight variation, so that it would be impossible to identify any of the cases by these means. The photographs reproduced are those of children who either have no relatives or whose relatives have no pos- sible objection to such publication. As for conclusions from the facts presented, we have attempted to adhere closely to the facts. Any theories or hypotheses that have been presented have been merely those that were suggested by the data themselves, and have been worked out in an effort to understand what the data seem to comprise. Some of the conclusions are as surprising to the writer and as difficult for him to accept as they are likely to be to many readers. The relation of alcohol to feeble- mindedness, for example, is to the writer a complete surprise. PREFACE ix That normal intelligence seems to be a unit character and transmitted in true Mendelian fashion is a conclusion that was forced upon us by the figures, and one that is difficult to make agree with previous conceptions. It is true that in The Kallikak Fainily we hinted at this, but the preliminary exam- ination of the larger mass of material had thoroly shaken our confidence and had left us with the feeling that it would not be proved. Even now we are far from believing the case settled. The problem is too deep to be thus easily disposed of. On the other hand, if we admit that our data do not conclu- sively prove to the satisfaction of everybody that the Mendelian formula applies to the inheritance of intelligence, we are equally in doubt in regard to the conclusions of those who believe they have demonstrated the opposite. Statistical theories and meth- ods have a great value in modern science, but their application to the human problem is fraught with many and serious liabili- ties to error. In inductive science one must always make some assumptions, but too many assumptions spoil the inference. The value of the conclusion may be, perhaps, inversely propor- tional to the square of the number of assumptions. No one knows all about feeble-mindedness but some know less than others and current literature on the subject is largely based on assumptions, some of which are known to be false while others are seriously to be doubted. The chapter " Is Feeble-mindedness a Unit Character } " was written under the rather strong impression that feeble-minded- ness is not a unit character. After the data were counted and seemed to show so conclusively that it is Mendelian we were inclined to omit the first part of the discussion on the unit character, but decided to leave it, if for no other reason, to show the stages thru which our thot has developed in the course of this study. The former view may yet be correct, but here are facts that cannot be ignored. It may be that we, ^^*ke Horace, will be '* compelled to go over again the road Iready traveled." It i.j quite possible that there are laws of X PREFACE human life and mind that cannot be proved by algebra or dis- proved by calculus. In the attempt to discuss such a mass of data as is here presented, the writer has necessarily dipped into many fields where he is not thoroly at home. Here especially it is probable that he has fallen into errors. He will always welcome cor- rections and suggestions from those readers who are at home in these various fields. In conclusion the writer would acknowledge his indebtedness to the many persons who have helped him in this work. To do so by name would be to add pages to this book. It is, per- haps, not necessary to refer to our laboratory staff, for this book goes forth as a laboratory product, and every one who is, or has been during the past five years, associated with the Research Department has helped, directly or indirectly, in its preparation. Likewise the members of the Training School outside of the laboratory have thru their cooperation with the Research Department aided in the production of this study. It goes without saying that there would have been no such work without the cooperation of the Superintendent and the Trustees of the Institution. It must not be left unsaid that the very existence of the research work on its present extended plan is largely depend- ent upon one man. Many men have means ; some men appre- ciate the value of scientific research ; a few men have faith enough in the value of truth to take steps in the dark. Such a man is Mr. Samuel S. Fels, of Philadelphia, friend, adviser, inspirer and promoter of this work. CONTENTS THE PROBLEM HAPTER PAGES I. Social Problems 1-20 Feeble-mindedness Defined. The Part it Plays in the Problems of Crime, Alcoholism, Prostitution, Pau- perism, Ne'er-do-wells, and Truants. _Four Lines of Investigation. THE DATA ' II. Reliability of the Data . . ; _y. j . 21-46 Manner of obtaining the Data. Qualifications of Field Workers; their Work Tested; Reinvestigated Cases ; a Sample Report. III. The Data 47-434 Case Histories and Pedigree Charts of 327 Families with 121 Portraits of Children. Explanation of Sym-, bols. Hereditary Feeble-mindedness — Cases 1-164;, Probably Hereditary — Cases 165-198. Neuropathic Ancestry — Cases 199-235. Accident Group — Cases 236-292. No Assignable Cause — Cases 293-300. Un- classified — Cases 301-327. IV. Causes 435-465 t. Discussion of Causes of Feeble-mindedness as they appear from our Data. Causes Assigned by Parents or Physicians. Hereditary Feeble-mindedness. Probably Hereditary. Ment;^! Ao-p in Relation to Feeble-mind- edness. Neuropathic Ancestry. Accidents (including disease). Accidents before or at Birth, the Mongolian Group, Accidents after Birth, Meningitis. No Cause Discovered. Unclassified Cases. xn CONTENTS V. Discussion of the Data 466-532 Summaries of the Charts. Conditions or Diseases found accompanying Feeble-mindedness (with Tables), Alcoholism ; Paralytic, Epileptic, Insane or Syphilitic Parents ; Tuberculosis ; Sexual Immorality ; Illegiti- mate Children ; Paralysis. Insanity and Feeble-mind- edness. Genius and Feeble-mindedness. Epilepsy and Feeble-mindedness. Criminality and Feeble-minded- ness. Syphilis ; Blindness and Deafness ; Consanguin- ity ; Twins ; Neuroses^ Migraine, etc. ; Persons in Other Institutions. Tables. Summaries. VI. Mendel's Law of Inheritance ..... 533-538 Mendel's Experiments. The Law. The Explanation. Vll. Is Feeble-mindedness a Unit Character? . . . 539-547 The Negative Side Considered. The Other Side. VIII. Is the Inheritance of Feeble-mindedness in Accord- ance with the Mendelian Law? . . . 548-557 The Types of Matings Considered. Our Results. The General Intelligence Theory. CONCLUSIONS IX. Eugenics 558-5671 The Eugenic Program. Colonization and Steriliza- tion. X. Practical Applications 568-590 Must first Recognize and Treat the Feeble-minded that are in the Hands of the Law; the Pauper, the ' Criminal, the Drunkard, the Prostitute, etc. Three . Principles- -thatr-Hetermine Treatment and-^Training : Levels of Intelligence. Levels Inherited, Relation of Levels of Intelligence to Trainability. Care of Mental Defectives. Industrial Classification. Necessity of Rec- ognition of the Moron. What is to be done with People of Low Intelligence? Resume. FEEBLE-MINDEDNESS FEEBLE-MINDEDNESS: ITS CAUSES AND CONSEQUENCES CHAPTER I SOCIAL PROBLEMS In our attempt to solve the problems resulting from congre- gate life, that of crime, of pauperism, of intemperance and of the social evil, we have heretofore assumed without question, that all of the people who constitute "the problem" a're at least re- sponsible, and that what they do is done in spite of knowledge and ability to do better. Altho any thotful person might divide humanity into the responsible and the irresponsible, the sane and the insane, or the normal and the mentally defective, he would define the irresponsible as meaning the insane and the mentally defective and by these terms designate that group of persons who are incapable of taking care of themselves and are such people as we shut up in insane hospitals or idiot asylums. The inmates of these Institutions do not constitute a serious social problem. They are easily recognized and because all appreciate the necessity they are easily placed in Institutions where they are cared for with more or less success. To be sure this has been no inconsiderable task. Institutions for the insane and feeble-minded are continually increasing in size and number. But great as is the task that we have performed in caring for the insane and the feeble-minded, we have a far greater task in connection with the criminal, the pauper and the intemperate. 2 FEEBLE-MINDEDNESS With these classes it is more than a problem of building institu- tions. It is the question of recognizing the true nature of these people. This is not easy if we look only at the end product. The criminal in prison, the pauper in the almshouse, the intem- perate man in the gutter presents a spectacle which may arouse our pity or our disgust, but it tells us nothing of the original nature of the man or how he came to be in his present condition. Without knowing the answers to these questions it is impossible for our care of these persons to be satisfactory. Every social worker knows that it is not satisfactory. It is proposed in this book to consider these problems from a new standpoint. We start out with an hypothesis somewhat new altho it is recognized by those who have studied this special group. The novelty is its application to the larger problems of social life. This hypothesis may be stated as follows / there are all grades of responsibility, from zero to the highest ; or, there are all grades of intelhgence from practically none up to that of the genius or the most gifted. Responsibility varies according to the intelh- gence. Even among those people whom we have usually consid- ered tV^oroly normal and responsible, there are environments in which they are responsible and others in which they cannot be so considered. They have intelligence enough to Uve in certain environments and care for themselves but in a more complex social group it is impossible for them to function properl^ As Binet points out, normal intelligence is a relative matter and that which is sufficient for a French peasant out in the country is not sufficient for a Frenchman in Paris. That intelligence which carries a person thru life under a simpler form of society is insufficient in many of the complex situations of the present day. It is probable that it is this relativity that has disturbed us and led us to go so far without seeing the real issue. In other words the persons who constitute our social problems are of a type that in the past and under simpler environments have SOCIAL PROBLEMS 3 seemed responsible and able to function normally, but for whom the present environment has become too complex so that they are no longer responsible for their actions. We have not real- ized this, so gradual have been the changes that have come over our civilization. On this view the problem is to be solved partly by adaptation and partly by elimination. An ideal procedure would be to draw the line between responsibility and irresponsibility. Draw one line at that point below which a person of that intelligence is not desirable or useful in any environment. Those above that line must again be di\dded into persons of sufficient intelligence to function in the simplest environment, those of higher intelli- gence who can function in a more complex environment and so on to the most complex. Such a scheme is of course too mechan- ical and is impossible, nevertheless it may be held in view as something toward which we may work altho without any desire to attain to that extreme position. As a matter of fact this is what we attempt to do now but we go about it in a crude bungling way. (.The problem for society to solve is to ^^ivpytm p i|^t p] ]ip ; pnt Hirprtinn tn thic frnd inp; of responsibility so that it may be less bungling and more practical. We must measure the intelligence. Knowing the grade of intel- ligence we may know the degree of responsibility. Knowing the degree of responsibility we know how to treat.' Persons who are recognized as being below the line of normal intelligence have been at different periods called by different names. Originally called idiots they were later designated as imbeciles and still later as feeble-minded. Since more study has been put upon the problem it has become necessary to desig- nate different degrees of defect and by common consent the cus- tom has grown up of applying the term idiot to the lowest grade, imbecile to the middle grade, and feeble-minded to the highest. In England this is the common classification. As a general term for all, the expression " aments " is sometimes used. In 4 FEEBLE-MINDEDNESS America we have used the expression feeble-minded both in a specific and in a generic sense, specifically to designate the highest division, and generically the whole group. Our Institutions for these defectives are generally known as Institutions for the Feeble-minded. Since the introduction of the Binet Measuring Scale of Intel- ligence and the grading of children by their mental age, a closer classification has been followed. The American Association for the study of the feeble-minded has adopted the following scheme : The term idiot is used to designate those of mental age up to and including two years ; imbecile, those of from three to seven years, inclusive. For those from seven to twelve a new term has been invented; they are now called morons. The term moron, therefore, in America designates almost exactly what is meant by "feeble-minded" in England^^ / Feeble-mindedness has been defined as a ''state of mental defect existing from birth or from an early age and due to incom- plete or abnormal development in consequence of which, the person affected is incapable of performing his duties as a member of society in the position of life to which he is born.f If we leave out those whom society has already recognized as idiots or imbe- ciles, we have the higher group, the specifically feeble-minded or moron, which has be^njlefined by the Royal College of Physi- cians in the following terms : ''One who is capable of earning his living under favorable circumstances, but is incapable from mental defect existing from birth or from an early age (a) of competing on equal terms with his normal fellows or {b) of manag- ing himself and his affairs with ordinary prudence." This defi- nition, it is seen, would include a great many whom we have not thot of as feeble-minded ; this is because the characteristics of the moron are not those which are usually associated in the popu- lar mind with persons of sub-normal intelligence. Morons are often normal looking with few or no obvious stigmata of degen- eration frequently able to talk fluently ; their conversation while INCAPABLE OF SOCIAL ADJUSTMENT 5 marked by poverty of thought or even siUiness nevertheless commonly passes as the result of ignorance. If it is discovered that they cannot learn they are thot of as ^ dull or slow but not as actually defective and incapable of learning. So strong is their resemblance to the normal person that altho they are well understood by those who have studied them and have dealt with them in Institutions, yet there are many people even to-day who refuse to admit that they cannot be trained to function like normal people. Yet they are the persons who make for us our social problems. The emphasis here is on the word ''incapahUr This is the thing that we have heretofore ignored. We have known that these people did not v^ compete successfully and that they did not manage their affairs with ordinary prudence, but we have not recognized that they were fundamentally incapable of so doing. We have assumed rather that they could do it if they would. All of our efforts have been toward making them do that which we beUeved they were capable of doing. This incapacity once recognized, our problem takes on an entirely different aspect. But what right have we to consider that this is mcapacity? \^at evidences are there that this is a truer view than the older one of unwilhngness to do the right? The answer to this must come from experience - no theory will apply here. If we could test all these people then we would reahze their mcapacity. But some one says this is impossible - there are too many factors involved. There are so many excuses for a criminal or a pauper or an intemperate person ; he may have been badly trained, his school education nil, his home environment bad, and so on thru a long Hst, each in itself enough to account for his condition. Consequently there is no way of demonstratmg that there was no will nor materials for developing a will. The fact is, altho it is not generally reaHzed, that we have such experiments and many of them. The answer is not as doubtful as it seems. Our Institutions for the Feeble-mmded 6 FEEBLE-MINDEDNESS have in the later years received many children who belong to this higher grade group. In these Institutions children have been held and trained under ideal conditions and in many cases at least by the most approved methods. The result is always the same. The children proved to be incapable. There is no / doubt. It is not a question of wilful wrongdoing ; it is inca- pacity to do differently. As a result we have a line drawn mark- ing a degree of intelhgence to which these people do not reach ; consequently they are incapable of functioning properly in our highly organized society. The percentage of the population that belongs to the moron group is undetermined. Those who have studied the problem most deeply and who are best able to recognize the moron, usually consider that about 2 % of the school population V is feeble-minded, and the larger part of these are morons. Those of less experience, who still regard many of these people as merely backward or dull, insist that this percentage is far too large. On the other hand, some investigators in certain locaHties have made it as high as 3 %. The determination of the actual number can only come from a careful study of all dull, backward children and a careful record of how many of them actually make good later in hfe and how many prove incapable of taking their place in society. At present it is not very important to know the actual number. It is sufficient to know that there are many more of them than we have recognized in the past and that they must be cared for. Let us now consider some of the specific social problems and the part that feeble-mindedness plays in them. THE PROBLEM OF CRIME Society's attitude toward the criminal has gone thru a decided evolution, but that evolution has been in the fine of its treatment rather than of its understanding of him and of liis responsibility. Almost up to the present time there has been a practically uni- THE PROBLEM OF THE CRIMINAL 7 versal assumption of the responsibility of all except the very youngest children and those recognized as idiots, imbeciles or insane. The oldest method of treatment was in accordance with the idea of vengeance, an eye for an eye. The god Justice was satisfied if the offender suffered an equal amount with those whom he had made suffer. Later came the idea of punishing an offender for the sake of deterring others from similar crimes. This is the basis of much of our present penal legis- lation. But students of humanity have gone farther and now reaUze that the great function of punishment is to reform the offender. We have had careful studies of the offender from this stand- point. Studies have been made of his environment and of those things which have led him into crime. Attempts have been made to remove these conditions, so that criminals shall not be made, or having reformed, they shall not again be led into a criminal life. A great deal has been accompHshed along these Hnes. But we shall soon realize, if we have not already, that on this track there is a barrier which we cannot cross /^Environ- ment will not, of itself, enable all people to escape criminality. The problem goes much deeper than environment. It is the question of responsibility. Those who are bom without suffi- cient intelligence either to know right from wrong, or those, who if they know it, have not sufficient will-power and judgment to make themselves do the right and flee the wrong, will ever be a fertile source of criminality. This is being recognized more and more by those who have to do with criminals. We have no thot of maintaining that all criminals are irresponsible. Altho we cannot determine at present just what the proportion is, probably from 25 % to 50 % of the people in our prisons are mentally defective and incapable of managing their affairs with ordinary prudence. A great deal has been written about the criminal type and its various characteristics. It is interesting to see in the light of modem knowledge of the defective that these 8 FEEBLE-MINDEDNESS descriptions are almost without exception accurate descriptions of the feeble-niinde4,./' (The hereditary criminal passes out with the advent of feeble- mindedness into the problem. The criminal is not bom ; he is made. The so-called criminal type is merely a type of feeble- mindedness, a type misunderstood and mistreated, driven into "criminality for which he is well fitted by nature^ It is hereditary )feeble-mindedn£ss not hereditary criminality that accounts for the conditions. We have seen only the end product and failed jto recognize the character of the raw material. Perhaps the best data on this problem come from the prisons and the reformatories. It is quite surprising to see how many persons who have to do with criminals are coming fqrward with the statement that a greater or less percentage of the persons under their care are feeble-minded. They had always known that a certain proportion were thus affected, but since the recog- nition of the moron and of his characteristics, the percentage is found ever higher and higher. The highest of all come from the Institutions for Juveniles, partly because it is difficult to believe that an adult man or woman who makes a fair appearance but who lacks in certain lines, is not simply ignorant. We are more willing to admit the defect of children. The discrepancy is also due to the fact that the mental defectives are more apt to die young leaving among the older prisoners those who are really intelligent. The following Hst of reformatories and institutions for delin- quents with the estimated number of defectives undoubtedly gives a fair idea of the amount of feeble-mindedness. The differences in the percentages are probably due more to the standards used in estimating the defective than to actual differ- ences in numbers. It is the most discouraging to discover that the more expert is the examiner of these groups, the higher is the percentage of feeble-minded found. For example. Dr. Olga Bridgman, who has made one of the most careful studies on JUVENILE DELINQUENTS record, finds that 89 % of the girls at Geneva, Illinois, are defec- tive. Institution Per Cent Defective St. Cloud Minnesota Reformatory . Rahway Reformatory, New Jersey (Binet) * . Bedford Reformatory, New York — under 11 years Lancaster, Massachusetts (girl's reformatory) . Lancaster, Massachusetts, 50 paroled girls Lyman School for Boys, Westboro, Massachusetts Pentonville, IlKnois, Juveniles . Massachusetts Reformatory, Concord Newark, New Jersey, Juvenile Court Elmira Reformatory Geneva, Illinois (Binet) . Ohio Boys School (Binet) Ohio Girls School (Binet) ^ . Virginia, 3 Reformatories (Binet) New Jersey State Home for Girls Glen Mills Schools, Pennsylvania, Girl's Department about 54 46 80 60 82 28 40 52 66 70 89 70 70 79 75 72 The percentages above given are not in all cases the official figures given out by the examiners, but are the author's inter- pretation based on the facts given in the reports. Unfortunately we cannot average the percentages because the reports from which these figures were taken do not always state the number of persons upon whom the estimate is made. A glance will show that an estimate of 50 % is well within \ the limit. From these studies we might conclude that at least 50 % of all criminals are mentally defective. Even if a much smaller percentage is defective it is sufficient for our argu- ment that without question one point of attack for the solution of the problem of crime is the problem of feeble-mindedness. It is easier for us to reaHze this if we remember how many of the crimes that are committed seem foohsh and silly. One steals something that he cannot use and cannot dispose ♦Tested by the Binet scale. 10 FEEBLE-MINDEDNESS of without getting caught. A boy is offended because the teacher will not let him choose what he will study, and therefore he sets fire to the school building. Another kills a man in cold blood in order to get two dollars. Somebody else allows himself to be persuaded to enter a house and pass out stolen goods under circumstances where even sKght intelligence would have told him he was sure to be caught. Sometimes the crime itself is not so stupid but the perpetrator acts stupidly afterwards and is caught, where an intelligent person would have escaped. Many of the "unaccountable" crimes, both large and small, are accounted for once it is recognized that the criminal may be mentally defective. Judge and jury are frequently amazed at the Jolly of the defendant — the lack of common sense that he displayed in his act. It has not occurred to us that the folly, the crudity, the dullness, was an indication of an intellec- tual trait that rendered the victim to a large extent irresponsible. ALCOHOLISM Intemperance — Drunkenness For more than a generation the civiHzed world has been more or less vigorously fighting intemperance and drunkenness. With what result ? The answer depends largely upon the temperament of the questioner. If he is optimistic he may claim that much has been accompHshed. If he is of the pessimistic nature he will declare that there has been no result. At least we can all agree that the result is far from satisfactory. The drink-bill of the nation increases every year, and faster than the popula- tion. Why has so Httle been accomplished? Largely because the nature of the problem has been imperfectly understood. There have been enough people who believed that it was a matter of education and will-power to defeat all efforts at any more drastic method of dealing with it. We have lectured to the people, we have preached to them, we have fined them, we THE PROBLEM OF ALCOHOLISM ii have punished them, we have devoted a disproportionate time in pubHc schools to educating them on the effects of alcohol. A good proportion of our efforts have been wasted. We have not discovered until recently that a comparatively large percentage of people cannot learn ; that they have no will-power, they are the simple victims of suggestion ; a Gough can induce them to sign the pledge by scores, and to-morrow or next week they are drunk again. They can be preached to and profess conversion, only to be found in the gutter to-morrow. The children can learn to recite the things that they are told about the effects of alcohol, and then go out on the street and into the saloon. Many of them being feeble-minded have no control over their appetites or over the situation in which they are placed, and given an environment with temptation and suggestion to drink intoxicants, they easily yield. We have committed the same error here as in many of our other social problems, that of looking only at the end product and reasoning from what we know of ourselves to what has been the probable cause of this condition and consequently how it would best be prevented. We have failed to go deep into the question and investigate what we may call the raw material. Looking at the problem from the standpoint of mental defec^^ tiveness we are confronted at once by the fact that the same lack of intelHgence, the same inability to control one's actions must necessarily lead these defectives into alcohoUsm whenever the environment is suitable. We may say that ever^^ feeble-minded^^^^ person is a potential drunkard. This is only another specialized form of what might be put in a general statement that every feeble-minded person is bound to be the victim of his environment because he has not intelHgence and judgment and will-power enough to control that environment. We have therefore every reason to expect that a goodly per- centage of the feeble-minded people will become alcoholic. So much for the a priori argument. What are the facts? 1 2 FEEBLE-MINDEDNESS As in the case of criminals we are still lacking figures that will give us any accurate idea of the percentage of alcoholics that are feeble-minded. It has long been claimed that alcohoHcs were mentally weak but it was supposed that this was produced by the alcohol itself ; that in the beginning they were all strong minded ; that the alcohol has taken away that strength. There are few or no data to prove the truth or falsity of this statement. There are many considerations however that will lead the un- prejudiced person to the conviction that the number of persons in whom alcohol has produced a weakness of the will is compara- tively small. There are too many people who have gone to the farthest extreme in the abuse of alcohol who nevertheless main- tain all their mental vigor when they abstain from the cup. There are no excesses of alcohol to which man has gone, from which some men have not recovered and become thoroly vigor- ous mentally, even v/hen it has practically destroyed their phys- ical constitution. The chief source of weakness of the intemperate is in the line of habit. A habit of drinking enslaves a man as much as any other habit but it does not have any effect upon his mental processes that are not involved in the particular habit. Let anything occur to break this habit and he is practically restored to his full strength of mentaHty. Wherever there is a perma- nent and incurable weakness of will and lack of intelligence it is highly probable that there never has been a strong will or high intelligence. This statement may be challenged by some readers but it is borne out not only by the psychology of the case but by obser- vation. One has only to consider the large number of cases where persons who are strongly addicted to alcohol have suddenly reformed and maintained a high degree of integrity and mental strength. Many a man has been so strongly affected by a death in his family that he has suddenly and absolutely changed his habits and become a temperate man. Some have reformed thru THE PROBLEM OF PROSTITUTION 13 a change of environment ; some thru the stimulus given by reli- gious conversion ; some because their pride has been aroused. The following case known to the writer is typical : a man who had reached the lowest level, had become a perfect sot, after an all night's debauch appHed to a barkeeper in the morning for another drink ; the barkeeper, altho he knew him well, refused him, because he could not pay for it. This so angered the man that he said to himself — ''If that is what they think of me, I will never drink another drop." He kept his resolution. In these cases there is never any history of a weakened mind except along the one line of the habit ; these people have their normal intelHgence and the effects of their intemperance how- ever much they may appear in their physical condition do not show in the mental. The numerous cases of men who are gener- ally temperate and good business men but occasionally have to go on a spree are examples of the same principle. As soon as they have recovered from their debauch they have their normal intelligence. The question of whether alcohol causes feeble-mindedness will be discussed at length later on. The present discussion is only intended to call attention to the fact that feeble-mindedness must in the very nature of the case He at the root of much intem- perance, and that to successfully attack this problem we must begin at the beginning and discover what is the abihty of each individual, by his natural mental inheritance, to control his own actions. PROSTITUTION AND THE WHITE SLAVE TRAFFIC Perhaps there is no problem looming larger at the present time than prostitution with its attendant horror the so-called white slave traffic. Much has been made of the condition of the under-paid shop- girl who is compelled to supplement her earnings by immoral acts. Vice commissions have investigated the subject and vari- 14 FEEBLE-MINDEDNESS ous reports have appeared. There is practically no consensus of opinion as to the cause of this vice, and the emphasis is laid now here, now there. Among the different causes feeble-minded- ness has been suggested, but nowhere has it been given the promi- nence that is due it. No one who understands feeble-minded- ness, especially the moron, can expect anything else than that great numbers of these girls will fall into a hfe of prostitution. The simple fact that they have normal or nearly normal instincts, with no power of control, gives the condition for the result. Some of them seek out that kind of Hfe, others become the easy victims of the cadet, the white slaver or the madame. Even the under- paid shop-girl is in many cases a girl of low intelligence, while not perhaps a moron, yet not very many degrees from it, — a girl who has not been able to learn enough to enable her to earn a larger wage. Many of these under-paid girls seem to be merely ignorant, not mentally defective. On the other hand, where a fair degree of intelligence is present, the girl does not remain ignorant. The world is full of people who have started out with as little capital in the way of education as can be imagined, and yet the something within them has pushed them forward. Their inborn intelligence has enabled them to master the work of a trade and they have steadily forged to the front. So that it may well be contended that feeble-mindedness is indirectly as well as directly the cause of much of the prostitution. And it is these weak-minded, unintelligent girls who make the white slave traffic possible. While it is true that now and then one is forcibly kidnapped and forced into this life under circumstances which no amount of intelligence could have controlled, yet a mere read- ing of an account often shows that the girl was lacking in intelli- gence or she could not have been entrapped in the way she was. As to actual statistics on this subject we have almost none. One very significant record comes from Geneva, Illinois, made by the same Dr. Bridgman whom we have already quoted. She found that of 104 girls in that reformatory, who were com- _ OF PROSTITUTES FEEBLE-MINDED 15 mitted for immoral life, 97 % were feeble-minded. This does not by any means indicate that 97 % of prostitutes are feeble- minded, because it is only natural to expect that the feeble- minded ones would be the ones to be caught and sent to an In- stitution. This figure, nevertheless, gives some idea of the prevalence of feeble-mindedness in this traffic. Many compe- tent judges estimate that 50 % of prostitutes are feeble- \ minded. Some day a vice commission or a progressive court will arrest a typical group of prostitutes and test their mentaHty by ap- proved methods. Then the problem will begin to approach solu- tion. A large majority will be found feeble-minded ; a part of the remainder will be of low intelligence tho not what we now call feeble-minded ; a few will be sexually abnormal and the rest probably victims of circumstances.^ PAUPERISM Why is a pauper? We have answered this question in the past in some such way as this : A pauper is a person who will not work sufficiently to earn his living, — he is lazy and prefers 1 Since the above was written we have received the Report of the Massachu- setts " Commission for the Investigation of the White Slave Traffic, So Called." From this Report we learn that what we have predicted has been done, and this Commission has tested the mentality of a group of prostitutes with the follow- ing results : On page 29 we read — " Of 300 prostitutes 154 or 51 % were feeble-minded. All doubtful cases were r< -corded as normal. The mental defect of these 154 women was so pronounced and evident as to warrant the legal commitment of each one as a feeble-minded person or as a defective delinquent. " At the Massachusetts School for the Feeble-minded there are an equal num- ber of women and girl inmates, medically and legally certified as feeble-minded, who are of equal or superior mental capacity." In our judgment the Commission have been ultraconservative ; no doubt wisely so, for their purposes. But we read further — page 30 : "The 135 women designated as normal, as a class were of distinctly inferior intelligence. More time for study of these women, more complete histories of i6 FEEBLE-MINDEDNESS to live at the expense of someone else. Or, he is a person who has been overtaken by misfortune and has become a pauper because of circumstances over which he had no control. Neither of these definitions covers all the cases. We will not here contend for what might be considered an extreme view, that people overtaken by misfortune are seldom allowed to become paupers, that humanity is so kind, so phil- anthropic that it is always willing to help the person who is desirous of helping himself and that the misfortunes of Kfe are overcome by this mutual helpfulness ; nor, on the other hand, that any person who seems to be lazy and unwiUingJ:o work is by that very fact defective either physically or mentally; yet there is much truth in each of these statements. Very few of the paupers are so, solely because of misfortune. Still we have many reasons for believing that the man who is lazy has some- thing fundamentally wrong with his mind or his body. We know now of a large group of people who were thot to be good- their life in the community and opportunity for more elaborate psychological tests might verify the belief of the examiners that many of them also were feeble- minded or insane. The mental age of the 135 women rated as normal, as measured by the Binet Scale, was as follows : 17 had the mentality of a 12-year-old child. 71 had the mentality of an 11 -year-old child. 32 had the mentality of a lo-year-old child. 4 had the mentality of a g-year-old child. II were not tested. Quoting further : " Some of the women seen at the Detention House were so under the influence of drugs or alcohol as to make it impossible to study their mental condition. Others at the Detention House and in the prisons had used alcohol to excess for years, and in the time available, it was impossible to differentiate between alco- holic deterioration and mental defect. These drunken, alcoholic, and drug- stupefied women were all recorded as normal. "Of the 135 women rated as normal, only a few ever read a newspaper_or book, or had any real knowledge of current events, or could converse intelli- gently upon any but the most trivial subjects. Not more than 6 of the etu,, . number seemed to have really good mbids ." (Italics ours.) THE PROBLEM OF PAUPERISM 17 for-nothing, shiftless, lazy people, people who might earn their living if they would. We now know that the condition has been due to the hookworm disease. The lazy boy is a diseased boy or a defective boy. It is not natural for a child to be lazy. Fundamentally the child is active and industrious. If he seems to be lazy, there is a cause for it and this cause must be sought out and removed. The same is probably true in a large proportion of the adult cases. Let us now look at this matter from the standpoint of feeble- mindedness. Any person who is feeble-minded, who, according to the defi- nition, is unable to compete with his fellows in the struggle for existence, must, other things being equal, become a pauper. He is incapable of earning his own living; therefore he must live at the expense of someone else. He may take the matter somewhat into his own hands and seize upon means of a living, in which case he becomes a criminal; or he may quietly and passively submit to the conditions, and then he becomes a pauper and if he does not die of starvation it is because society takes care of him. But we are not confined to the a priori argument. Investigation of our almshouses shows that a considerable pro- portion of the inmates are mentally defective. While we have no adequate statistics on this line, it is highly probable that at least 50 % of the inmates of our almshouses are feeble-minded. Because of mental incapacity they have failed of earning enough for their own support. Nor was this a condition of later Hfe only nor of hard times. They were defective children. Their parents and grandparents were defective — some of them. They should have been looked after in these earher stages of the problem. They are where they are thru no fault of their ^wn but because their burdens — those of making a Hving — -.2re too heavy for them. Society should have protected t'lem. l8 FEEBLE-MINDEDNESS NE'ER-DO-WELLS Every community has its quota of people, who, because of their failure to act in harmony with those who are definitely working for the welfare of society, may perhaps be designated as undesirable citizens or ne'er-do-wells ; while not paupers, they often have to receive assistance from others ; while not criminal, prostitute or drunkard, are still shiftless, incom- petent, unsatisfactory and undesirable members of the com- munity. In the past the careers of such people have been accounted for by declaring that they were wilful, wayward or ignorant. In view of the proportions to which feeble-mindedness has grown, it certainly is not unwise to ask the question — may not some of these people be feeble-minded ? Is it not possible that they have not learned better manners and habits because they could not ? An intelligent person learns to adapt himself to his surroundings even tho no one tells him what he ought to do. Many times these people are the laughing stock of their com- munity because of their fooHsh actions, or they are pitied because of their lack of judgment. But whatever the feeling toward them, it has always been assumed that they could be different if they would. The time has come when we must ask in regard to such cases — is it not possible that they are incapable of doing differently? It is certainly true that such people often act just as do feeble-minded people of the moron type. It seems, therefore, highly probable that a goodly proportion of these ne'er-do-wells are of such relatively low mental level that they cannot adapt themselves to their environment ^^ the majority do.^ TRUANTS The problem of truancy is also one in which feeble-minded- ness is involved. Many a school child becomes a truant be- cause he cannot succeed in school. We need careful tests of THE MORON 19 the mentality of truants. One such study shows upwards of 80 % of them feeble-minded. It may be asked : if feeble-mindedness is such a potent factor in these great social problems, why is it that the fact has not been discovered sooner ? The answer is that feeble-mindedness itself in its higher form has not been understood. Even yet ''feeble-mindedness" in the popular mind is synonymous with idiocy or imbecility — those lower grades of mental defect which are often manifest in the faces of the individuals. Everyone recognizes the idiot or the imbecile, the fooHsh boy or the silly girl ; but if the person is not one of these he is considered to be normal and responsible. Not until we began to test intelli- gence and had secured standards showing that to be ''able to manage his affairs with ordinary prudence " a person must have intelligence beyond that of a 12 year old child, did we reaHze the type that we now call the moron, the high grade defective. It is this discovery that has opened ourjeyes. to the actual condition and enabled us to formulate working hypotheses which have proved marvelously fruitful. " It ' is j^roper here to pay tribute to the mind that gave us this key to^, t^^ituation. More than to anyone else we owe to the untiring effoSfcand the high mtelligence of Alfred Binet the method for the solution of this part of the problem. vj Having recognized this high grade type of feeble-mindedness' we see that there are four lines along which investigation must proceed — four problems to be solved. . _ First : there is the social problem to which we have already alluded, the question of the place that the feeble-minded fill in the social Hfe of to-day : their relation to crime, pauperism, in- temperance, the social evil, incompetency, and disease. Second: the psychological problem. What sort of mental processes have these feeble-minded people? What is the con- dition, for instance, of their memory, attention, sensation, per- ception, emotion, will and judgment ? 20 FEEBLE-MINDEDNESS Third : the pedagogical problem. What can they be trained to do ? How shall we train, educate and discipline them ? What moral training do they get or can they take ? Fourth : the biological problem. What is the cause of mental defectiveness? What is the physical basis of it, and what methods of prevention can be suggested ? I Since September 1906 The Vineland Training School thru its Department of Research has been studying this problem along the above lines. The work is still going on ; the psychological and pedagogical problems are still under investigation. While much has been found out and many suggestions might be made, for their final statement these problems must await further study. The social and biological problems are the subject of this book. While neither of these is completed, yet so many facts have been collected that it is already possible to draw some significant conclusions. CHAPTER II RELIABILITY OF THE DATA Any work presenting facts so new and startling as those here contained must be critically examined as to the reliabiUty of the data. Especially is this true when the data are not only new, but if true must become the basis for new scientific theories and changed social action. Our data show the large element of hered- ity in feeble-mindedness and on the basis of this fact it is pro- posed to change our treatment of delinquents. Furthermore our facts are to be examined in relation to the Mendehan hypothe- sis. Both sociologist and biologist will at once ask — is it sure that we have reliable facts, or has someone been careless in collecting the information, reHed too much upon hearsay, or drawn conclusions too hastily ? In considering this matter it must be recognized at the outset that our data are far from being as satisfactory as we could wish. There are several reasons for this. The data are incom- plete. There are always some members of the family concern- ing whom we cannot get reHable information. Sometimes nothing is known about the father, occasionally the mother is lost ; sometimes even a brother or a sister is missing, more often it is the grandparents, and more often still the cousins or the ' second-cousins. Just when it would be possible to draw valuable conclusions to confirm or overthrow some hypothesis the necessary data are missing from the family records. This difficulty can to a greater or less extent be overcome by the large number of cases, where certainly some will be found fairly complete, or where one case supplies what another lacks. 22 FEEBLE-MINDEDNESS Again, the data are unsatisfactory on account of the fallibility of human judgment. The distinction between the feeble-minded and the normal person is not always easy to make. Indeed we hold that there is no sharp and fast Hne which clearly divides the two groups ; as a result we have a large number of borderhne cases. We cannot pretend that we have always decided these cases aright. Many cases that have been left undetermined could doubtless have been easily decided had we been able to get a clear statement from persons who knew the individual in question. In solving these cases we have followed the rule of giving the benefit of the doubt to the individual; that is to say, we have never charted a person as feeble-minded unless we had ample evidence in support of that decision. Cases where we were not satisfied of this, we have dealt with in different ways. Where there is an entire lack of information we have left the squares or circles blank. If we have been able to dis- cuss the question, presenting the facts pro and con, we have used the question mark with the weight on the normal or the feeble-minded side as circumstances seemed to warrant. So that ^'F ?" means that we have deliberated over the matter and on the whole it seems highly probable tho questionable that the person is feeble-minded. In like manner "N?" means that after mature dehberation we have called the person normal, altho this may be questioned. In consequence of our having pursued this policy all charts are better than the facts. If we had complete information or perfect judgment our charts would be blacker than they are. -— MANNER OF OBTAINING THE DATA Another question in considering the rehabihty of the data is : How has it been collected ? Are the methods followed and the means adopted for securing the facts sufficiently safe-guarded to insure results that are reasonably reliable ? We must devote some time to a consideration of this point because it is MANNER OF OBTAINING THE DATA 23 fundamental to the value of the material contained in this book. Early in the work of this laboratory we turned our attention to the question of the causes of feeble-mindedness. An exami- nation of the admission blanks of the Institution showed that they did not furnish the necessary data. Often the questions had been misunderstood, sometimes unanswered thru sheer ignorance ; in other cases, it is to be feared, answered in such a way as was beheved would insure the child's being admitted. In an effort to remedy these defects a new set of questions, called for convenience an "after admission blank," was sent to the parents with the special appeal for them to cooperate with us in our efforts to benefit their child and thru him other children, by carefully answering the questions. The set of ques- tions was made out in as simple language as possible, going into the desired matter in the necessary detail. Another blank some- what similar, with medical terms substituted for the more com- mon phraseology, but in many places asking the same questions, was sent to the family physician. It was hoped that from these two questionnaires checking each other, information would be eHcited which would enable us to construct a chart of the family which would be of distinct value. This was carried out in the fall and winter of 1908-9. As the returns from these questionnaires came in, charts were prepared. Two facts were at once evident. The results were very satis- factory in many cases, and showed that parents were eager to cooperate with us. But the returns showed also that the results would inevitably be hmited by the inteUigence and education of the persons filling the blank, and that this would so often be a serious Hmitation that we could never get all that we desired by this method. The next plan evolved to supply this defect was that of emi- ploying field workers. We felt sure that a person of the right qualifications could secure the desired information. 24 FEEBLE-MINDEDNESS We realized keenly the importance of securing the right person. The qualities that we considered necessary were : a pleasing manner and address such as inspire confidence ; a deep and true interest in humanity which would enable the worker to have a genuine sympathy with the people whom she would visit; a high degree of intelligence which would enable her to comprehend the problem of the feeble-minded, to learn readily the types and characteristics of the children, and to see the bearing upon the central problem involved of various facts that might come to hand ; a general or special training such as to render her accu- rate and eihcient in reporting and recording results. Good health and resourcefulness were of course included. After much inquiry and search we secured a woman whom we believed would be satisfactory. On the eighth of November, 1909, Miss EHzabeth S. Kite came to the Training School to begin special training for the work. She devoted Tierself for a number of weeks to the study of the problem of feeble-mindedness as it could be seen here. She read and observed, asked questions, interviewed children, learned their mentaHty and their peculiari- ties until she had a good idea, not only of feeble-minded children but of the different grades and types. When this was done she made a brief list of children with whose histories she would begin. In the preparation of the cases to be investigated the field worker made the acquaintance of each child, prepared a sheet contain- ing his picture and the facts about him, so as to avoid any pos- sibility of confusion when she came later to talk to the parents. On these sheets were also all the addresses that the Institution possessed of members of the family. Her instructions as she went out were in the main those that were later embodied in Bulletin No. 2 of the Eugenics Record Office. She carried no questionnaire or blank to be filled out, but rather was given general directions as to what to inquire for. The reason for this is that a questionnaire too often elicits a definite answer, when, as matter FIELD WORKERS 25 of fact, there is no definite answer to be given. We deemed it wiser to explain to the people as well as possible the purpose we had in view, and then allow them to talk, directing their conversation along certain special lines, such as to bring out the facts in regard to any members of the family who rhight be feeble-minded, alcoholic, insane, or dependent upon charity, etc. or on the other hand who might be free from any or all of these. We may note here that later in the year provision was made for a second field worker, and early in the following year for a third. Miss Jane Grifhths and Miss Maude Moore were secured. The field workers were instructed to record so far as pos- sible the exact words of their informant, not of course the whole conversation, but the salient features. They were to do this rather than to give us their interpretation of what they heard. They of course also gave us their impressions but these were recorded as impressions. Having the original words of their informers it would be possible for any one at any time to draw his own conclusions, whereas, if we had only the field worker's interpretation we could never be certain upon what that interpretation was based. Reports were sent in to the labora- tory every few days, whenever a case was finished, or if a long case, at least every week. We felt that it was neither economi- cal nor desirable to require the field workers to make a daily report or in any way to encumber them with clerical work. They made rough family history charts in the field and sent them in with their reports. Later it was found desirable for them to make these charts on a large scale, that is, without crowding in- dividual symbols, leaving room to record on the chart beside each symbol facts in regard to the individual represented by that symbol. This is a great convenience in referring to the chart and the data. The field workers were given instruction on the nature of evi- dence so that they would recognize the kind of information that needed corroboration and the kind that was practically safe and 26 FEEBLE-MINDEDNESS reliable upon the testimony of the single informer. They were instructed to get the necessary corroboration in all cases as far as possible. In the case of contradictory statements or opinions, all statements were to be recorded and every effort made to decide between the conflicting evidence. The field worker went armed with a card of introduction from the Superintendent of the Institution. This means much. The admissions to this Institution are all voluntary. Parents ask for the privilege of sending their children here. When at last they are admitted, the parents are happy. They receive answers to all the letters they write inquiring about their children. They receive periodical reports on progress. They are allowed to come to see the child at any time desired, and altho they are urged to come on a particular day of the week, they are not refused on other days. Whenever they come they receive a friendly greeting and cheerful word from the Superin- tendent. Their attitude toward the Superintendent, the Insti- tution and its work is one characterized by a feeling of happi- ness and confidence. In consequence of this, when the field worker approaches the family, saying, "I have come from Vine- land, from Superintendent Johnstone, I bring you a message from your Willie or your Katie," she is received with the most cordial welcome. And when she sits down with them and gradually discloses the fact that we are studying Willie's case and that we want information along such and such lines, they gladly give every aid in their power. It may well be remem- bered in this connection, that the majority of these people are of the type that like to talk about their own affairs. The results have proved eminently satisfactory. Not that we have obtained all that we desired ; not that we have scien- tifically accurate information on all the phases of the problem that would be valuable to us ; but we have secured, in a large number of cases, thoroly corroborated facts which show us many conditions little understood previously. DETERMINING MENTALITY 27 As a rule, our workers have easily been able to decide the mentaUty of the persons they saw. In some cases, indeed, this was not so easy and only after much observation and ques- tioning of neighbors and friends as to the conduct and hfe of these persons was it possible to come to a reasonably satisfactory conclusion. In many cases it has been impossible to decide even after all our care; and these cases are therefore left undetermined. In regard to the persons not seen, and especially those ot earher generations who are no longer Uving, the task at first sight seems more difficult. Some even assume that it is impossible to determine the mentality of such cases unless they were commonly recognized idiots or imbeciles. That such is not the fact however will become evident from a little thotful consideration. It must be remembered that the field worker goes out with a back- ground of knowledge of four hundred feeble-mmded boys and girls men and women, of all grades of intelligence, and a great variety of temperaments and hereditary influences. With this background it is possible to project any individual mto a known crroup and decide that he is or is not like someone m the group. This of course must not be done, and is not done, by any su- perficial resemblance but on the basis of many fundamental characteristics. , i-» t The idea that it is impossible to determine the mentahty of a person who is three or four generations back of the present is partly an ill-considered one and partly the result of erroneous logic One says -"I don't know my own grandparents, and as for my great-grandparents I do not even know their names. And the implied argument is "If a person as intelhgent as I am, does not know his grandparents how can these ignorant defectives know theirs." The argument is fallacious thruout. To begm with, family ties are often much closer with these defectives than with more inteUigent people who are often too busy to keep up these relationships; the defectives are more apt to remam for 28 FEEBLE-MINDEDNESS generations in the same community, while the intelligent migrate and so leave their ancestors. This was well shown in The Kalli- kak Family where the members of the bad side are practically all to be found within a narrow area around the ancestral home, while the good side are scattered over the United States and Canada. Again, the fact that I do not know my grandparents does not prove that no one now Kving knew them. As a matter of fact there are numerous people now living who knew them well. Further, three generations back is easy and six is not impos- sible. We labor under a fallacy in regard to this point. We are apt to conclude that because a man rarely remembers his great- grandparent, no one can have known a person four generations back. It is a surprise to us to be told that there are persons now living who remember heroes of the American Revolution ! John Doe enhsted in the Continental army in 1775 at the age of twenty. He died in 1845 ^-t the age of ninety. Richard Roe was twelve years old at that time and vividly remembers hearing the old man Doe tell of the exciting experiences of '76. Richard Roe is eighty-one years old now. That is a rare occurrence ? Certainly. And we have been able to determine that a person in the sixth generation back was feeble-minded in only one family out of 327 — the Kallikak family. For the fifth generation we have made determinations in only four cases and even these are not involved in our conclusions. The ease with which it is sometimes possible to get satisfactory evidence on the fifth generation is illustrated in The Kallikak Family. The field worker accosts an old farmer — "Do you remember an old man, Martin Kallikak (Jr.), who Kved on the mountain- edge yonder?" ''Do I? Well, T guess! Nobody'd forget him. Simple, not quite right here (tapping his head) but in- offensive and kind. All the family was that. Old Moll, simple ^DETERMINING MENTALITY 29 as she was, would do anything for a neighbor. She finally died — burned to death in the chimney corner. She had come in drunk and sat down there. Whether she fell over in a fit or her clothes caught fire, nobody knows. She was burned to a crisp when they found her. That was the worst of them, they would drink. Poverty was their best friend in this respect, or they would have been drunk all the time. Old Martin could never stop as long as he had a drop. Many's the time he's rolled off of Billy Par- son's porch. Billy always had a barrel of cider handy. He'd just chuckle to see old Martin drink and drink until finally he'd lose his balance and over he'd go ! " ^ Is there any doubt that Martin was feeble-minded ? Physicians conclude upon evidence infinitely weaker than ours that Napoleon, Julius Caesar and St. Paul were epileptic. Historians reconstruct out of a few charred posts, straw, grain, etc., the habits, mode of life and almost the mental level of the Swiss Lake Dwellers. Surely the person who rejects our data on the basis that such things cannot be determined, would discard a large part of the world's history as now written. It is not difficult for one versed in the subject to tell whether or not a man was feeble-minded even tho he hved a hundred years ago, providing he made enough impression upon his time for traditions of him to have come down. As a matter of fact it is this latter proviso which cuts out most of the people back of the third generation. It is very rare that we find feeble-minded persons in the fourth generation unless they were so markedly feeble-minded that it has been a tradition in the family or among the neighbors all these years. This has sometimes happened, as will be seen from the charts. In such cases of tradition there is no doubt about the accuracy of the determination. Any person living or dead, who was so abnormal Lhat neighbors or friends or descendants always spoke of him as ''not quite right" is cer- tain to have been decidedly defective. ^See Kallikak Family, page 83, Macmillan, 191 2. 30 FEEBLE-MINDEDNESS It is not in this group that the liability of error enters, but rather in the one that we call moron, the individual of whom the people say, ''Oh, yes! he was all right, but he was never able to get along." Then the field worker pro- ceeds to ask many careful questions from which she satisfies her- self that the reason he was not able to get along was because of lack of intelligence. In these cases it is possible to err. In all such cases we have insistently maintamed that we must give the benefit of the doubt to the individual's intelligence, and we must not mark him feeble-minded unless the evidence is clear. From this pohcy which we have constantly maintained, it is al- most certain that we have left a great many individuals undeter- mined who were really feeble-minded, possibly we have even marked some normal who were feeble-minded ; so that as a con- sequence our charts are, as already stated, better than the facts. The reader will not forget that our problem is a comparatively easy one, the determining of the mentahty of the various persons, that is, whether normal or feeble-minded. When it comes to a question of determining insanity, to say nothing of the kind of insanity, or even epilepsy except the most obvious cases, or the diseases from which these persons suffered, it is an entirely different matter, and we make no pretension that our records here are absolutely accurate. We quote them as they were reported to us for whatever they may be worth. We have exercised every possible care and they probably have con- siderable value, but how much, it would be impossible for any- one to determine. We have not hesitated to test and check up the work of our field workers. This has been done in different ways. One field worker has taken a case that another field worker had worked up and she has brot in an entirely independent report. In some cases the field worker has brot in reports on families that are known to others in the Institution, such as Superintendent Johnstone, or perhaps a matron or a teacher. At times the RE-INVESTIGATED FAMILIES 31 writer himself has gone with a field worker after her report was in and interviewed the various persons on her chart and come to his own decision as to whether she had rightly or wrongly marked them. Good results have been secured by sending field workers out to go over some of their own cases to discover whether a second interview (especially after the lapse of some months and the acquiring of more experience) would result in changing the marking of any individuals. The result of all of these checkings is to establish beyond ques- tion the fact that our records are conservative. The changes that have been made have been mostly changes from ''undeter- mined" to ''feeble-minded" ; from "normal" to "questionable." CHART 255 (N>- u-^r^ m ® tt Sv O j^J§S^ [N](N)(^[N]y-y^N3(N)[N] [SSBSSi [n][n](n) ©Si DULL IN SCHOOL INFANT L PARALYSIS L backward and consequently was not declared feeble-minded. That was three years ago. Examined again recently he shows precisely the same mentality as before, which now makes him CHART 250 A O-rQ. CHART 250-REVISED (N> k XJRENCE D. I lONGOLUN r n A S> ^F?^ (N) qS N?f N?) Nl i^li .<5?)_ "JUST LIKE *• 3 VRS. FLORENCE" DIPHTHERIA. ••BRIGHT" more than three years backward and other signs clearly show that he is really mentally defective. We thus have an example of what we have found in a few other cases and suspected in many, that we often get these children RE-INVESTIGATED FAMILIES 33 soon after they have begun to slow down in their development. At the moment they do not show more than a Httle backward- ness, but as time goes CHART 264 D I T- WELL-TO-DO LIVE IN SWITZERLAND <5b o ^]-T— O' [f®S^ on that backwardness becomes so great that it is definitely feeble- mindedness. Case 250 is a Mon- golian type. Further study of this case has enabled us to add a number of individuals, some of them normal, and to fill in the un- BABY determined ones, at least to the extent of marking them normal or questionably normal. It has also added two feeble-minded. Case 264 is a case supposed to have been caused by scarlet fever. The earher account of this case suggests that since so many are unde- CHART 264_REVISED I •QUEER" WELL-TO-DO UVEIN SWITZERLAND N 2N0 WIFE th-T-O' [N] 'S) il (N) termined it would be possible that this might be an heredi- tary case. Our second study, while not en- tirely removing that doubt, has added some normal people with the effect of making it a Httle less probably an hereditary case, and therefore more prob- able that the assigned cause, scarlet fever, may be correct. Case 177 being re-investigated shows no significant change. ^"firs^ HENRY C YOUNG CHILDREN. 34 FEEBLE-MINDEDNESS It is noticeable that Byron's sister at the time of the first investigation had three children, two of whom were too CHART 177 N fNiiNirmn^n^(N)E^(r^ 47avBs 2 y d MVRS 13VRS S 18 S S 11 4> O-T-ts H^?5¥5^^5S^ ^ I p BYRON D. (^S@& ® iSnb young to be determined. She now has five children and the two undetermined ones are now old enough so that it is apparent that they are normal. CHART 177 —REVISED lNl-r-(N) (N)-r-lN][N](N)(N)[N](^[N]|Nl[N]^ ' J I I BYRON D. (N) i5W®5S> mrnrn Case 1 70 was classified as probably hereditary ; further study has enabled us to mark a number of individuals on the mother's side as normal who were before undetermined, but it has also given us Imlay's father as questionably normal. On the whole, RE-INVESTIGATED FAMILIES 35 perhaps the probabihty of hereditary feeble-mindedness is shghtly increased, for while the increase in the number of normals on the maternal side makes it a little less likely that there was feeble- CHART 170 a IT WIFE HUsVanO 3RD wife L_J 19T WIFE « 6 VHS. '^- i3"5^ ,-vii H • (53K5S) Ei/N)(+)i(N)(N) m mindedness in that family, on the other hand the questioning of the father's normahty with the addition of his parents, the father of whom was entirely unknown to his w^ife's family, makes it look suspicious. CHART 170 -REVISED (n)-k9 ^ »OWIFE liJJ 1ST WIFE d. 2NO d. 6YR3. HUSBAND HYDRO- CEPHALUS \N) a ..!,(§ 1^1^ (§^T^(o) do (N)(N) kJSYRS. 16 VRS. 17 VRS. / jNj CEPHALUS / ^ m M^ Case 189, which was recorded as probably hereditary, has been extended very much as will be seen by comparing with the original chart. The probabihty of this being an hereditary case 36 FEEBLE-MINDEDNESS seems to be a little reduced and yet by no means entirely re- moved. There are some undetermined on the maternal side who may have been defective ; while on the father's side there re- CHART 189 BESSIE T. BABY mains a good degree of probability that there was defect. The ugly and heartless disposition may be evidence of this. In Case 97 we have been able to confirm the previous findings and to add several details, including five more defectives. CHART 189— REVISED N ■~HN](^[ig[^tl \5q^ jSy 1 NERVOUS LARGE {head HEARTLESS I MELANCHOLY J r^ BOTH HAVE m I WHOLE FAMILY VERY NERVOUS LARGE HEADS I WHOLE FAMILY 6(fe0Ci)^--rt^ I ^^ LESS Jill" BOTH JOE" AUI8H0USE LAZY DEFECT ALMSV «t?^*^ ^ GLUTTON A -SHIFTLESS" HOUSEV ■ SHOT ^_ ^IL 4YRS. ^^f^- *^^^- 3YRS. mSWIFE BOTH IN OLD <"•'* 0"> OLD CHILDREN'S HOME APPEAR NORMAL NOW and consequently sent in her report. The result is shown in the upper chart. Recently Miss Florence Givens Smith, field worker for the State 40 FEEBLE-MINDEDNESS Charities Aid Association, wrote us that in the course of her in- vestigation she had studied a family, one member of which was at Vineland, and she would be glad to give us what she had found. We of course accepted this generous offer with the result that from the data thus furnished we were able to make the revised chart. The difference in the two charts is striking and confirms what was said above, namely, that when the facts are known the charts become blacker than we have usually made them. Another point is well brot out here, in regard to the question of applying to later charts, principles or laws that have been determined thru earher study. For example : it is perfectly clear that if both parents are feeble-minded all of the children are feeble-minded. This being true, we had a right to mark all of the children on our first chart in this case feeble-minded, since both parents are in this condition. But we have never done this. The markings that we have given are invariably those which came from the objective evidence, and not from any theoretical consideration. So that in this case the work of Miss Smith on this family simply fills in what the theory would call for. But perhaps someone a little more skeptical would wish to ask, ''What evidence have you that this second field worker has not had merely a little different standard, and so has marked people feeble-minded where your first field worker marked them "undetermined"? To answer this question I give extracts from Miss Smith's report. I make these somewhat extensive both because they are so convincing and also because it shows well the social side of this type of family. " The sources for the following information are : records of the Institution for Epileptics, Almshouse records. Board of Cliil- dren's Guardians, Overseer of the Poor, and eight intelHgent and responsible men and women. History of Mabel, Annie, and Mary Corner: these are nieces of Tho7nas C. Mabel the oldest of the fraternity was born at about 1905. She was committed to the Children's Home in January A SAMPLE FIELD WORKER'S REPORT 41 191 2, was returned to her father for a time but recommitted July 2, 191 2. Is considered feeble-minded. Her teacher says that she is mild and obedient ; is poor in school work but makes some progress ; is fair in hand-work. Annie Corner, born January 8, 1906, was committed to the Children's Home in January 191 2; was returned to her father and recommitted in July 191 2. She is defective. Her teacher says that she is of a different type from her sister Mabel. She is quick in taking directions, but stubborn. Makes progress more rapidly than Mabel. Mary Corner was born in about 1909. She is not attend- ing school and it is as yet too early to decide as to her mentality. The Father, Will Corner — Brother-in-law of Thomas C. Will Corner was born at but has lived for some years past in the neighborhood of . He drinks but could not in any sense be called alcohoHc. He is not inclined to work unless forced to do so by immediate necessity ; never works regularly or steadily, only by the day or week, usually the former. Is fond of fishing and trapping. He is rather unusually large, strong and able bodied. Wears his hair long and has a most unkempt appearance. Is boy-Hke in his lack of responsibihty ; good- natured, and unreHable. When in town is the butt of jokes at the corner grocery. At present is Hving with his former wife's aunt who receives a pension and assists in supporting them both. Corner's first wife came from . She was feeble-minded. Is said to have died from going out of doors barefooted soon after achild was born. By her, Corner had one child. After her death, while working in the neighborhood of , he met and eloped with Fanny C. (sister of Thomas C.) who became his second wife, taking her to to be married. During their married Hfe they lived in and -^ — . Received charity from private sources. Will Corner had a brother Ed who was a marble cutter and lived in . It is thought that he moved to several years ago. He is said to drink heavily. Another brother known as "Lying Joe" was a steady drinker. Another brother, James, was known as "Crazy Jim" and was an imbecile. He did odd jobs in return for food and tobacco and was often imposed upon on account of his lack of intelligence. Miss says that he was extremely gluttonous and that she remembers as a child seeing plates of food heaped up for him. One time when there was a 42 FEEBLE-MINDEDNESS wedding in the family they gave Jim as much as they thought he could eat in the kitchen and then sent him home with a basket to his mother. On the road he stopped to eat more, and was later found by the side of the road in great agony from cramps. He was physically strong and was a good worker when put at a simple task, but was entirely unable to plan work. He was found dead in a barn. Cause of death was thought to have been heart trouble. A brother, Paul, is said to have been a worth- less drunkard. A sister, Jennie, is remembered to have been slow in school. Another sister, Mamie, was born about 1842 and died in 1906 of general debihty. During the latter part of her life she had a rupture but continued to work out by the day. She is said to have been a fairly good housekeeper. A brother, George, is said to have been a man of industry and good habits, and to have saved some money. His two sons are said to have turned out badly, one is reported as an habitual drunkard, and the other is said to have gotten in trouble for shooting his wife. Dan, another brother, was born in 1840. He is illiterate and decidedly alcoholic. The Mother. Millie C. (sister of Thomas C.) was born in 1881. When a small child she was sent to the County Almshouse wdth her parents, her sisters, Carrie and Violet, and her brothers, Thomas and Henry. At about ten years of age she was taken from the almshouse and remained in a private home until she was sixteen years of age when she ran away with Will Corner and married him. Mrs. says that she was decidedly defective, was slow to learn in school, and was incompetent in housework. If left alone she would not finish a task. Her facial expression in- dicated mental defect and she sometimes drooled at the mouth. When her first baby was born she was still a girl in short dresses. She was entirely incapable of managing her household, and her children were badly neglected. In manner she was quiet, peaceable and dull. She could read and write a Httle. She died of tuberculosis in 19 10, when 29 years of age. Thomas C.^s Brothers and Sisters. May C. was born in 1872. When a small child, was in the Almshouse with her parents, two brothers and a sister. Twice was taken from the almshouse by Mrs. . The last time Mrs. took her, she had a small infant. After staying for A SAMPLE FIELD WORKER'S REPORT 43 eight or nine months she deserted the baby and ran away with a half-witted fellow named Smalley, and came back after several weeks saying that she had married him. For several years they have hved in , have drunk, quarreled and often been in Pohce Court. May's reputation for immoraHty is well known. She has had four children. The last one which is very dark is thought to belong to one of the ItaHans who frequented the house. The family were ordered to leave town in the fall of 191 2, and moved to . Two of the children attend school and are considered feeble-minded. Smalley is guilty of having relations with his wife's oldest child. In speaking of May's mentaHty, Mrs. says that she is not bright, is childlike, does not consider what the results of her actions will be ; is quarrel- some and immoral. She, her husband, and children have the reputation of stealing. (Smalley belongs to a degenerate faniily well known in the neighborhood.) Mazie C. was born in 1874. When about 14 years of age she went to Hve with Mrs. and remained with her for four years, when she went to her aunt. She married a man who drank, but who was superior to herself, but she does not live with him. Has Hved with various men. At the time of the investigation was hving with a man named Joe Corner. Has been caring for her sister's children since her death. Is a poor housekeeper, never stays long in one place. Has a defect of speech and is undoubtedly feeble-minded. Nell C. was born in 1876. She is said to have been brought up on Warwick mountain. Her first child Charhe, born November 2, 1906, is said by her family to belong to a son of B B . She then married a foreigner and the family claim that he deserted her after having two children by her. After that she lived with her mother. She died at child birth. This last child, which was still-born, was said to be by her mother's consort. Her children, who are thought to be by the foreigner, are Sam, born in 1908, and Mag, born 1909. Nancy C. was born at . She, with several other members of her family, was sent to the Almshouse when a child of seven. By poor officials she was placed in the family of Mr. but was returned because she was considered feeble-minded. On Tulv 12 she was committed to the care of the State Board of ■ uardians and was placed out by them. She became 44 FEEBLE-MINDEDNESS of age in 191 2, at which time she was Hving with a Mrs. . She was visited by the research worker from Vineland who considered her high grade feeble-minded. She said that she expected to marry a man whom Mr. had picked out for her. She had not seen him yet but was dehghted at the prospect. Is fond of dress and fixing up her hair. Thomas C. was born in 1892. As a baby his mother says that he was well, but when about ten years old began having "fits." He was placed out by the State Board of Children's Guardians but was found to be feeble-minded and was transferred to The Training School at Vineland in 1903. Vernon C. was in the County Almshouse with his parents in 1897, at which time he was recorded as being three years old. In 1 901 he was committed to the care of the State Board of Children's Guardians but was found to be epileptic and was committed to Skillman Village in 1907. He ran aw^ay from Skill- man and has not been returned. The records show that he has had no convulsions since 1899. He had a pronounced defect of speech and stuttered badly. Was considered a fair patient and played the trombone in the band. His mother says that he was well as a baby but that he began having ''fits" when five or six years old. (There is probably another sister.) The Father-in-law of Thomas C.^s Sister Millie. Milton Corner was bound out as a boy to Gov. . He had Kttle schooHng and was ilHterate. The Governor's family do not remember much that would throw light upon his men- taHty. The family were always wretchedly poor, always lived from hand to mouth, and none of them were to be depended upon. They always thought that Milton would have gotten along better if he had not had such an extravagant wife. They lived for many years in a Httle log cabin near the station. His son-in-law says that from the time he first knew him, beginning when Milton was 40 years of age, his mind seemed to be affected. He would sit by the stove for hours at a time and would not notice anything, often could not be persuaded to go to bed. Would not tell anyone of his plans and would sometimes wander off for several days at a time. He had delusions of sight and imagined that people were after him. During the latter part of his fife his wife had to work out to support the family. He -^cver owiitd property but rented the log cabin in which he live ■ A SAMPLE FIELD WORKER'S REPORT 45 Thomas C.^s Father. Lemuel C. was born in 1855. The field worker at Skillman believes that he was feeble-minded, she also reports that he was a laudanum fiend, and that he consumed it in large quantities. They were living on Mountain in a log house. They are described as wretchedly poor and destitute. One informer remembers seeing them seated around a table composed of boards eating out of hollow squashes and drinking from old tomato cans. Li 1897, Lemuel C, his wife and his children. May, 15, Nell, 9, Nancy, 7, Thomas, 5, and Vernon, 3, were committed to the County Almshouse. Lemuel C. died there at the age of 49 of tuberculosis. He had rheumatism severely. Thomas C.^s Mother. Phoebe E. was born about 1858. She does not know her exact age. She, as well as her sisters, were given out to be brot up. She knows nothing about her parents except that they are dead. She claims that her first husband deserted her just be- fore the birth of her first child. She told the field worker at Skill- man that she feels sure that he ran off with her sister ; at any rate her sister disappeared at the same time and neither of them have been heard of since. She then married or lived with Lemuel C. and had eleven children. The youngest, she says that she gave to a woman but she cannot remember her name. She heard later that the child died. After going to the Almshouse with C. she ran off with another man from the county house; but claims that she deserted him in the night. She never stays in one place, often tramps for miles to make a visit, stays a few days and then goes on. She claims that she married her third consort several years ago. She has been living with him for several years off and on in a place called Roaring Gulch. She is a shiftless housekeeper, is both feeble-minded and epileptic. Says that she has always had ''fainting spells," drops down any- where for no apparent reason. She feels the spells coming on and screams. Has always been immoral. In concluding this topic it may be said, that perhaps after all the best evidence of accuracy in the data will be discovered by a study of the charts themselves, and the figures that have been compiled from the charts. The internal evidence of a high 46 FEEBLE-MINDEDNESS degree of accuracy is to us very strong. We trust it will be ap- parent also to the reader. Our work has been full of surprises ; we have had no preconceived opinions ; we have had impressions and feelings that we should find such and such things. These have as often been contradicted as approved. At different times in the investigation we have thot that the figures were going to show now one thing and now another. As examples of this we may mention the question of the influence of alcohol and the Mendelian law as appHed to the heredity. Not until the last of the data were worked up did we have any idea how these mat- ters were coming out. We realize that to many people our con- clusions will be unacceptable. Such persons will, if they cannot find a flaw in the argument, be apt to question the rehability of the data. CHAPTER III THE DATA THE CHARTS Each chart represents in graphic form the history of a family. The starting point is always the child who is in The Vineland Training School, designated hereafter for the sake of brevity as our child. The following explanation will enable the reader to under- stand the charts. CLASSIFICATION Our 327 families naturally fall into six fundamental groups as follows : 1 . Where feeble-mindedness is certainly hereditary — desig- nated hereafter for brevity's sake as the Hereditary Group or Hereditary (H). 164 families. 2. A group which, while not so certainly hereditary, yet shows high degrees of probability that the feeble-mindedness is hereditary — designated as Probably Hereditary (P.H.). 34 families. 3. A group in which there is no evidence of hereditary feeble- mindedness, but in which the families show marked neuropathic conditions — designated as the Neuropathic Group or Neuro- pathic (Neu.). 37 families. 4. A group where it is clear that some accident either to mother or child, including disease, injury at birth, etc., is the cause of the feeble-mindedness — designated the Accident Group. 57 families. 5. A small group where it has been impossible to assign a 47 48 FEEBLE-MINDEDNESS cause. The family history is known and is good ; there are no accidents. We have designated this No Cause Discovered, or briefly, No Cause (N.C.). 8 famiUes. 6. A group where so Httle of a definite character could be learned that it was impossible to classify them — designated as Unclassifiable (Unci.). 27 families. This group is not counted at all in making up the percentages. One case in this group was thrown out because it proved to be a case of insanity and not of feeble-mindedness. See Chart 314. These groups will be discussed in the Chapter on Causes. Each of these fundamental groups of charts is subdivided and arranged according to mental age as determined by the Binet- Simon Measuring Scale of Intelligence. This gives the child's mentahty in terms of a normal child, e.g. mentahty 7 means like a normal or average child of 7 years in intelligence. We may speak of a man 40 years old as having a mentahty of any age from I to 12. We say he tests 7, or his mental age is 7. EXPLANATION OF SYMBOLS Male Female H ^p Feeble-minded. [n] (n) Normal. [f?| (R) Probably feeble-minded. [n?| @ Probably normal. I I r^ Mentality undetermined. L Shows the child in the Vineland Training School. I Miscarriage or still birth. ^^ Under a symbol indicates that the individual was in some public Institution. IN In the first the digit shows the number of persons represented by the symbol, i.e. two normal men. In the second the digit shows the number of children, i.e. a feeble-minded woman had three children. d. Died. d. Inf. Died in infancy (under 2 years). EXPLANATION OF SYMBOLS 49 Each chart is accompanied by a condensed description of the child. The information comes from parents, physicians and the Institution records, including the school department and the department of research. The latter are incomplete on the physical and the physiological (bio-chemical) side because we have not yet completed systematic studies of these cases. That must wait for a later report. Each chart and description is accompanied by a photograph of the child whenever it is proper to publish it. Letters used around the squares and circles are — A Alcoholic — meaning decidedly intemperate, a drunkard B Blind I Insane Sy Syphilitic C Criminalistic M Migrainous Sx Sexually immoral D Deaf Neu. Neurotic T Tuberculous E Epileptic Par. Paralytic W Wanderer, tramp G Goitre A horizontal (or oblique) line connects persons who are mated. Unless otherwise indicated, they are supposed to have been legally married. Symbols dependent from the same horizontal Hne show brothers and sisters. In the fraternity of our child these are arranged in order of birth, the first born at the left. Case 1 2 is the only exception. A vertical Hne connecting this horizontal Hne with an indi- vidual or with a Hne connecting two individuals, indicates the parent or parents of the fraternity. When the parents were not married the fact is indicated either by the expression "unmarried" or by the word "illegitimate" placed near the symbol for the child. A dotted Hne connecting two symbols may indicate incest. Large Roman Numerals on the Charts of the Hereditary group indicate the matings that have been used in the study of the MendeHan law. 50 FEEBLE-MINDEDNESS HEREDITARY FEEBLE-MINDEDNESS CASES I — 164 CHART 1 O 6b d-T-(5i^^Wp©^^5b i^S^aWS^ k CERTRUBE E. CASE I. GERTRUDE E. 16 years old. Mentality 11. Has been here 7 years. American born, nationality of parents unknown. Gertrude is a nice looking girl and when admitted at the age of nine was thought to be merely backward. She could take care of herself, read in the Primer, count to fifty, knew ordi- nary combinations in numbers and was fond of music. For two or three years we clung to the behef that she was merely a backward child. She made good progress in school work, learned to read quite well, could reproduce a story and memorize rapidly; did excellently in entertainments. Grad- ually, however, in spite of all efforts she fell behind and soon reached her Kmit in reading, writing, and number work, and apparently her mental development ceased at eleven. She shows relatively high intelligence, however, in almost everything she does; does excellent work about the cottage, sews very well, is quite a musician, helps in the kindergarten, and is gen- erally a useful, pleasing girl. She is nearly always good tempered, although very changeable, inclined to be moody, is sometimes very sober; is obedient, truthful, active and affectionate. She dances and sings and loves to appear in entertainment work. Her defect is hard to describe. Everyone who knows her feels HEREDITARY GROUP. MENTALITY ii 51 that she ought to develop and yet it is perfectly clear that she will not ; she is incapable of generalizing or having an ambition or developing any womanly qualities such as become her age. A glance at her family chart will show that it is pretty clear that there must be an hereditary taint. An older sister and an older brother are both defective ; all the rest are dead except one other brother who is undetermined. The father and mother were both alcoholic and may possibly have been mentally defective also. Unfortunately we have as yet been unable to secure data on the parents or on very many others in the family. It is hoped that we may yet be able to get hold of some facts that will help explain this remarkably inter- esting case. Gertrude is a good example of that type of girl who, loose in in the world, makes so much trouble. Her beauty and attrac- tiveness and relatively high grade would enable her to pass almost anywhere as a normal child and yet she is entirely in- capable of controlKng herself and would be led astray most easily. It is fortunate for society that she is cared for as she is. CASE 2. Florence and Byron T. (Brother and Sister.) Florence T. 23 years old. Mentality 8. Has been here 10 years. Was born in New Jersey, parentage uncertain, but probably American. Byron T. 19 years old. Mentality 11. Has been here 13 years. When admitted Florence was spoken of as always smiling and silly ; mouth open ; went upstairs sideways. Her memory and attention were fair. She was sulky, could do errands and house work, was excitable, gluttonous, affectionate, fond of children and play, indolent and vulgar ; did not know any school work and has not learned much since. At the present time, she does fancy work, house and laundry work. She is a good worker, always cheerful and happy. In the Binet Tests she can count thirteen pennies, describe the pic- tures, sees the lack in the unfinished pictures, can copy the 52 FEEBLE-MINDEDNESS square but not the diamond ; recognizes colors and names them ; can compare butterfly and fly, etc., cannot count backwards; repeats the days of the week and the months of the year. She cannot count the stamps nor repeat five figures. She is good natured and a willing worker. If not in the care of the Institu- tion she would probably be the wife of some low grade worker and the mother of many children, probably defective like herself. The brother, Byron T., is 19 years old and tests 11 ; has been here 13 years; when admitted, was excitable and nervous, cried CHART 2 I I 2NO HUSBAND 1ST HUSBAND (N> GSeS] 001 d. g^j.g Qf children, in fact, can do general housework, under direction, very satisfactorily. To-day she is pleasant and agreeable, one of the best Institution helpers, is happy, contented and useful. Perhaps no better illustration of the troublesome girl in society can be found than Nana. She is so high grade and able to present such a good appearance that very few people would be willing to consider her defective. Yet of her defect there is no question. Those who know her in the Institu- tion have learned it by experience and the same thing is shown by psychological examination. She is, for instance, unable to put three words into a sentence ; she cannot think of sixty words in three minutes — her limit is forty-three ; she cannot put dissected sentences together. These are all eleven year old tests. She cannot read well enough to remember six facts out of the selection read. She has, however, a certain shrewd- ness, and a certain good judgment in regard to simple matters, and these would deceive those who are unfamiHar with defectives. HEREDITARY GROUP. MENTALITY lo 73 The following quotations from a couple of letters will show her ability. To HER MOTHER ^'I heard some sad news about you" (the father told her the mother is feeble-minded) " and I do pity you for I know that you have a very hard life where you are . . . this would be a good home for you to live and I think you would be happy here too you would be better off." Letter to Santa Claus Vineland, N. J. Novem. 12 191 1 Sunday ''Dear Santa Claus. I would like very much if you will kindly bring me a real nice Pair of shoes for best this is the size of them, the number 550 15745. and I also would like to have three Pairs of nice fine stockings I need my shoes very badly. I hope you don't think I asked for too much. I am so glad you are coming around again, good luck to you. I will close bye thanking you kindly for your kindness each year and hope you will never die out. Good bye from your loving friend. Nana P.S. stockings size eight and a half, and a nice fine pair of shoes." The first is from a letter to her mother and shows that bit of judgment and good sense which is gratifying. The second letter is to Santa Claus and shows her naivete very nicely. Without the protection of the Institution, Nana would be the victim of anybody who came along, and would live the same miserable, unhappy Hfe that her mother has Hved and also would probably be doing as her mother has done, helping to populate the world with defectives Hke herself. As will be seen from the chart, Nana has two younger brothers, both defectives; 74 FEEBLE-MINDEDNESS an older sister is married but cannot be found, hence her men- tality is unknown to us. Two younger sisters, twins, are eking out a miserable exist- ence with the father. They are going to school and are probably of the same high grade as Nana, possibly even a Httle better; their mentality cannot be accurately determined and what will be their history remains to be seen. The father and mother are clearly feeble-minded; they have separated. The father is counted a very dangerous man. He has made several attempts to regain possession of the girl, but she has no desire to return to a home where there is insufhcient food and clothing, and where the father refuses to allow a fire, even in the dead of the winter. It will be noted that this girl came to this country when she was 12 years old and was admitted to this Institution about a year later. Here seems to be a case of a father and mother and at least three children all feeble-minded having passed the cus- toms officers and been admitted, perhaps without question. One at least has been a burden upon society for 17 years, the others are probably worse. CHART 7 dVo £h o,h5M¥5 7 VRS.ffoUC ®W®®®0i] ©BHBWil ILLEGITIMATE CASE 7. SAM G. 18 years old. Mentality 10. Has been here 11 years. At the time of admission was large and repulsive looking, did not understand language well ; only fairly obedient ; speech thick ; could not read nor count ; did not recognize colors ; sight HEREDITARY GROUP. MENTALITY lo 75 poor, hearing good; fond of other children; not truthful, profane; was in the kindergarten at first; learned to write and count lo and do simple combinations of numbers, could copy a few words and write his name from memory. After he had been here four years, it is recorded that ''all of his work is extremely poor. He seems to have the abiUty, but is too well satisfied with himself to try ; does basketry and woodwork, can do some simple arithmetical processes." He never got very far, however, with his book work. He can write a fair letter as wiU be seen from the following : Vineland, N.J. 11-30-12 Dear old Chriss I thought I would write you my Xmas letter telhng you that my trowls you sent me last Xmas was stolen by some Itahans While I was eating dinener so I thought I write and ask you to bring me i plastering trowl i brick trowl & a pr auto-gargles to keep the cement dust out of my eyes I shall take better cair of them this year as I have a box with a lock and key I shall bid you good bye fore this time yours sincerely, ^ ° Sam G. His handwriting is very poor and slovenly, but his spelUng is rather better than usual for such children. At present, he is doing industrial work entirely, is quite a fair worker and is gen- erally contented. He has quite a remarkable memory, seldom forgetting a selection that he has learned to recite. He is American born, but the birthplace of his parents is unknown. He is one of our highest grade boys, and would be considered by many more silly than feeble-mmded. Both parents are feeble-minded. The father is very high grade, so much so that for a considerable time we were very much in doubt as to how to classify him. His feeble-mmdedness takes the form which makes him noted as being pecuhar. 76 FEEBLE-MINDEDNESS He is ignorant, lives alone, but is a good workman, sober, honest and industrious. He has, however, a brother who is distinctly feeble-minded, sexually immoral and criminahstic. There are also a normal brother and a normal sister, besides a brother who died at seven years, and a sister who is wretchedly alcoholic and may be feeble-minded, although this has not been determined. The mother of our boy is also sexually immoral and has a feeble-minded sister. Their parents were both feeble-minded. Our boy has two feeble-minded brothers; two other brothers and a sister died in infancy. A half-brother is a low grade defective and criminalistic. Our boy is of the type that would pass for bright and brutal. He would get into all kinds of trouble and commit any sort of crime, but having a certain shrewdness would be considered simply as an ignorant rowdy, a very dangerous person to have in any community. The probabilities are that he would spend most of his time in jail. CASE 8. NANNIE D. 30 years old. Mentality 10. Has been here 21 years. American born, American parentage. It is reported that opium and spirits have been used by the whole family for generations. The child had whooping cough at the age of 12 and grip at 15. Upon admission at the age of 9, she knew the alphabet, but could not read, write nor count. Although she tried for a number of years, was never able to get very far in these lines. Indus- trially she did better, as they usually do. Now sews very well and takes charge of a dormitory, does some good woodwork. Is some- what queer, goes to school when she is able — is somewhat sickly. She is sober, silent and sometimes stubborn ; generally obedient and good tempered ; is truthful, excitable and very sensitive. The chart shows at a glance the large amount of alcoholism throughout the different generations. ImmoraHty and illegiti- macy, together with the mental defect, show a low grade family throughout. The father and mother of this girl were both feeble- minded and alcohoHc and the mother was immoral. HEREDITARY GROUP. MENTALITY lo CHART 8 77 CRITPLE FOR DESCENDANTS SEE SECTION 2 A FOR CRIfPLE FORDESCEI DESCENDANTS SECTION 2 SEE SECTION 2 I K HUSBAND / A Sx x^ I jA I I I I ns~L y^ A A I A ILLESITIMATE ILLECITIMATC CHART 8 SECTION 2 FOR SIBS SEE SECTION 1 A S a -r^^^^^ftjO [5?1 66^6d6i6ifi&5 dfl LOT OF CHILDREN IN AN INSTITUTION SOHEWHERE Section II of the chart shows the result of the marriage of the paternal grandfather's sister with the paternal grandmother's brother, said sister being feeble-minded and alcoholic. At least one of their children was feeble-minded and two others alcoholic and the descendants from these are alcohoHc and several are inmates of pubKc institutions. On the entire chart we find nine people, besides our girl, who were inmates of such institutions. This is surely a heavy expense to the community which should have been prevented. 78 Dr FEEBLE-MINDEDNESS CHART 9 O (N)(^(N)[t][t][t]Eg CASE 9. WIN AND WIL T. (twins). 21 years old. Mentality — Win 10, Wil 8. Here 12 years. American born. Nationality of parents unknown. These twins are not strikingly alike. They are of normal size and good proportion but Win is the better looking of the two ; is cheerful, while Wil is often sullen and morose. As stated, Win is two years higher mentally than Wil, the difference being shown throughout their Institution history. Win is a boy that would pass for normal with all but experts, and indeed will undoubtedly earn his own Uving if he does not get into tempta- tion. In the School he steadily improved up to a certain point and is quite good in many lines. His attainments in reading and writing are probably indicated by the following extracts. The first is a spelling lesson — the writing is poor but legible ; it will be noted that the words, some of them rather difficult, are spelled correctly with three exceptions. Second are some extracts from a letter written nearly a year later. The spelling is not so good as in his formal spelHng lesson. The penmanship is better. The matter is childish and his form of expression is just about that of a child of his mentahty : — conveying Asthma catarrah camphor quinine sheleton military cyclone cream ipecac magnesia congealed merchandise whiskey cadet Christmas Santa Claus snow bolls tornado croup CASE 9, WIL T., AGE 21. MENTALLY 8. CASE 10, ISAAC Q.. AGE 16. MENTALLY 10. CASE 10, PRUDENCE Q., AGE 17. MENTALLY 3. HEREDITARY GROUP. MENTALITY lo 79 Vineland, N J. July 6, 1908. Professor Johnstone Monday eve Dear sir "I have been noticing for the pass year and some months that a very direct attention has been paying to me, that is people sneaking around and watch- ing me when they though that I did not know it, and I have herd some funny tails said about me which I have not liked but I did not pay much attention to it, but for the pass 5 or 6 months those tails have switch of from small funny tails to large dirty slurs, and I have expected — ^" ''Of corse I cant stop here to tell you all of my thoughts of this truble that has been going on for years for it will take to long for me to write it, but if you dont think I am — " Win also has some capacity for drawing as is seen by the accom- panying sketch. He can weave a very nice basket after his own design, both in form and color. He could also do quite a httle independent woodwork and make some very nice articles. While Wil is inferior to his brother he is by no means a low grade defec- tive. Upon admission he was found to have imper- fect speech — his voice was somewhat thick ; but he could help himself, had good memory, could do 8o FEEBLE-MINDEDNESS errands, was obstinate — as he is still inclined to be. Like his brother, Wil is musical and plays cymbals in the first band, the bass drum in the second ; hkes the band. He writes a fairly good letter with httle help. Wil can read by spelling out the words rather slowly and can sometimes make out the entire sentence. He writes a rather childish hand but perfectly legible and fairly well put together, as the following illustration will indicate. Vineland, N J T S Nov, 14 1911 My dear Santa Claus Please give me these few things such as one pair of corduroyed pants blue cap size 6f white coat sweater. This is all I want for Xmas this time I will close now by wishing you a Merry Xmas and a Happy New Year. From your loving friend, Wil T. He is really capable of doing a great many kinds of work and of doing them very well. It is his very peculiar temperament or disposition that prevents him from being a valuable Institution helper. He is sober, inclined to be morose, stubborn, backward, obstinate, restless, excitable, sensitive, and very quick tempered. When things do not go to suit him he falls into a violent temper and uses strong language and may be destructive. He is very noisy and childish in his conversation, full of curiosity, quite mischievous at times, and plays with toys hke a small child. Outside of the Institution he would be practically helpless be- cause he would not be understood and people would not tolerate him. He would get into endless trouble through his tend- ency to become violently angry. He has no control, and makes no attempt to control himself on these occasions. There is nothing especially pecuHar about his Binet test; he cannot remember five figures but can arrange the weights, which is a HEREDITARY GROUP. MENTALITY lo 8i higher test. He never knows the date but can name the months in order. His definitions are no better than by use ; has learned to count stamps since his first test. Turning now to the family history we see again that there is abundant reason for these defective children. The mother was feeble-minded, belonging to a feeble-minded family. She was a sexual pervert of the lowest type. The father of Win and Wil was a normal man, belonging to a thoroughly respectable and high grade family, but he himself was a degenerate. Circum- stances prevented his being carefully brought up and he ac- quired bad habits and went from bad to worse until he became a sexually immoral, alcoholic and thoroughly bad, man. Appar- ently the respectable traditions of his family have led him to prefer to live in wedlock rather than otherwise, and he has accord- ingly married four different women, but this has not prevented his living with those to whom he was not married. His first wife was a normal woman and is reported to have had two normal children. On the other hand he is believed by many to be the father of one of the children that appears on Chart ii8. The sister of the mother of Win and Wil married a feeble- minded man and had a family of feeble-minded children which appears in chart 21. CASE 10. ISAAC AND PRUDENCE Q. Brother and Sister. Ameri- can born of American parents. Isaac is 16 years old. Mentality 10. Had measles, spasms — at the age of two, scarlet fever, whooping cough at the age of seven. Prudence is 17 years old. Mentality 3. Had spasms at two. Isaac has been here seven years. Prudence eleven. A remarkably interesting thing in connection with these two children is the very great difference in their intelligence. Prudence is a low grade imbecile. When admitted at the age of six she could go up and down stairs rather poorly, could not help herself, did not know color or form, was excitable, very nervous, laughed without cause. After five years' training G 82 FEEBLE-MINDEDNESS she could string beads by form and by color; could not name color, could sew on a button without help. Two years later it is recorded she could weave a mat and thread her own needle. Her attendant reports that there has been a marked improve- ment in her since she came to womanhood. She has been very helpful around the cottage with the younger children ; works in the clothes room, can sew on buttons and be generally quite helpful ; knows her brother and is very fond of him or perhaps CHART 10 6i> a- 6 fiBv<5^c 6SSi3 ia0^iW llillUili^l ^ KARL L "'- (?) ^ uL [^HHia born was feeble-minded and alcoholic and is the father of two feeble-minded children. Of the first born, the condition is unde- termined but he had two feeble-minded children, a third is per- haps defective, four others died in infancy. The mental defect has clearly come through the father's side. He himself was a defective and his mother was feeble-minded and sexually immoral and syphilitic. She had a brother who was also defective. From another marriage this woman had a great grandchild who was feeble-minded and epileptic. This is a very instructive case since a superficial knowledge of HEREDITARY GROUP. MENTALITY lo 91 the family would lead us to conclude that the premature birth or the condition of the mother was the cause of the defect, but a deeper study shows without doubt that there was hereditary feeble-mindedness in the father. CHART 13 'PROBABLY ALL DEFECTIVf • -hS5^ -"'CUE- SPEECH ^'^ " no,irpc[nj T k ISADOR 0. CASE 25. ISADOR O. Age about 25 years. Mentality 9. Has been here 10 years. This is a typical case of that great group which is socially so dangerous. Of relatively high grade, a fine looking young man, without any noticeable stigmata of degeneration, he is able to make the best appearance that his mentaHty will permit. Very prob- ably able to make his own living, now that he is trained. When admitted at about the age of 12 (his actual birthday is unknown), he could read and count, knew color and form, could do errands and housework. Was obstinate, but easily managed. Steadily improved under training until he was able to do something in a good many hues, although nearly always Hmited in his achievements. His greatest lack was that of persistent will- power. Was cheerful, active, obedient, affectionate and truth- ful. Could do excellent work in the tailor shop, was quite an efficient assistant to the electrician, did some work in the car- HEREDITARY GROUP. MENTALITY 9 III penter shop, was an excellent milking boy and was good at house- work. He could write a very fair story of some experience, could read well in about the Fourth Reader. Never got far in arith- metic but in industrial lines, as indicated, was very good. Had some little ability in drawing as is shown by the accompanying reproduction. He even assisted the teachers in school, by tak- ing charge of a little group of children. He was especially good at this in the school gardens. He could keep at work a group Original drawing by Isador. of boys younger than himself, with remarkable ability. Per- haps his greatest abihty, as it was his greatest interest, was in music. When he came, he was able to play part of the scale on the shde trombone, but had forgotten the positions. He learned the scale in about two weeks and also the bass part to "America." He steadily improved in music and came to play his part, first tenor, in the march ''Onward, Christian Soldiers" and other pieces of about the same difficulty. 112 FEEBLE-MINDEDNESS He remembered ten pictures out of a card of thirteen pictures shown to him for thirty seconds. Asked for the difference be- tween paper and cloth, said ''paper is paper" and "cloth is cloth." When the question was repeated, he said "paper is easier to tear." Asked the difference between a butterfly and a fly, said "A butterfly has big wings, a fly has small." Said "Wood is more useful for building than glass." He could re- member seven figures. Had some difficulty with rhymes, but could occasionally make one or two. As a rhyme with dim, said " sim." Could give no more. With feet ; seat, deep. Could not get another. With spring ; "sing," "thing," "tang." With money; "honey," "funny," "dunny," "dinner." The following description of his work in basketry is typical. "He is inclined to get very careless. He started a small basket using the Indian stitch and did it nicely at the beginning but his interest gave out very soon. I find the same thing whenever he weaves a basket." He was always cheerful, never quarrelsome, was active and obedient, affectionate, truthful, good tempered, not destructive ; was rather mischievous. It would take him hours to learn four lines and he would forget it rather quickly unless constantly used. This boy ran away, some time since, and his whereabouts are now unknown. It is safe to say that if he gets into trouble no judge or jury is likely to believe that he is not thoroly respon- sible for anything that he may do. No one but experts in the field of feeble-mindedness would suspect anything wrong with him. He is the kind of case that makes the skeptic believe that the Binet tests are absolutely wrong, but ten years' experience with him in the Institution proves beyond the shadow of a doubt, that he is as truly mentally defective as any boy in the School. He will undoubtedly marry or become a father and the consequences are easily guessed by reference to the chart. Here we see, on his mother's side, a thoroly defective family. HEREDITARY GROUP. MENTALITY 9 113 while on the father's side, altho there are a number of normals, there is at least something wrong since a cousin is feeble-minded, and Isador's father altho normal, was sexually imftioral ; but the boy is by no means an exception in our Institution for the feeble- minded, while among the boys on the street his pHght is only too common. It is the great problem before us to-day, to learn to recognize this high grade type of pleasant, agreeable and seem- ingly normal boys, who, nevertheless, are so defective as to be irresponsible for their acts. CHART 26 D O D HUSBAND J, DROPSY *TEr* "BRAIN ^^ ^^ SPEECH DON S. DEFECT , ll i55@®Shol]h CASE 26. DON S. 18 years old. Mentality 9. Has been here 6 years. American born, father German, mother American. Had convul- sions at the age of three, measles at eight. Assigned cause " struck with a baseball bat when six years old." This is a typical case of the good natured dull boy, found so often in the pubHc schools, whom the teacher is so loath to give up as defective. When Don came he had been in public school four and a half years; he knew about half of his alphabet and could count to twenty ; could write and draw a little, could recognize color but not form. Was heedless of danger; dangerous about fire; sly and obstinate. After six years he has gained a little in his school work, doing about what we usually find for those of the mentahty of nine. He can read fairly well, can write a very fair story. 114 FEEBLE-MINDEDNESS can make some number combinations and has a little talent for drawing, makes quite fair pictures. He is much interested in nature work and will observe and draw. All of this, however, falls short of the practical and he will never make any great use of his abiHty along these lines. He is already turning toward the industrial arts. He has done well in woodwork and now can do some carpentry work under the direction of the carpenter, and will become an excellent Institution helper in various lines. He is cheerful, active and obedient, very affectionate, willing and faithful, and generally liked by all with whom he works. He is a very attractive looking boy of about normal stature. There is no mistaking the hereditary character of the condi- tion when we look at the family chart, although, the father and mother both being dead, it is impossible to determine their mentality ; but there is so much defect in the family that there cannot be serious doubt that the mother, at least, was defec- tive. This is somewhat heightened in probability, by the fact that she married a second time and had two defective children. Her second husband was feeble-minded also, still if she had been normal it is likely that one of the two children would have been normal. A number of Don's cousins are making trouble for the pubHc school teachers, as he did. Of one it is said, ''tries his best but can't learn." Of another, "he is in the first grade at eight years." Another is in the second grade at eleven years. Don's half brother has a serious speech defect. CASE 27. DONALD U. 25 years old. Mentality 9. Has been here 13 years. American born; nationality of parents unknown. When admitted at the age of twelve he was large for his age, stoop shouldered, could not talk plainly but knew his alphabet and could read in the Second Reader ; could add and subtract, multiply by one figure and do housework. He improved in reading and learned his table of eight and did some short divi- HEREDITARY GROUP. MENTALITY 9 115 sion; learned to read and write numbers up to the thousands; knew the important things about New Jersey products ; man- aged, eventually, to get as far as the Third Reader but that seemed to be his limit and since then he has been working on the farm and he is now doing exceptionally well ; he drives a team of horses, ploughs and does other farm work very satisfactorily. He is cheerful and obedient, truthful, good tempered, gen- erally Hked by all who have anything to do with him. He has been well trained here at the School and under supervision does excellent work on the farm. He is the child of a feeble-minded prostitute, who died of syphilitic infection. She had another child, a girl, who w^as feeble-minded, and then twins who died in infancy of syphiHs. Little else is known of this family. A man of the same name has been found who has a similar history but whether related, as husband or brother, is not known. The following is the short but tragic story of Donald's mother as discovered by the Field Worker : Nancy U. went out to service. She' was employed by good famiUes who liked her very much, as she was quiet, industrious and attended to her own affairs. She had several children of whom she was extravagantly fond. No one suspected that she was not an honest woman, honorably married and leading a moral life. It was discovered, however, that there was no husband in the case, but that she took men lodgers and her house was a very bad one. The matter was brought before the Court and the children were placed out. She was feeble-minded and afterward died of syphiHs, as did two of her children. The family tree is necessarily small and imperfect. ii6 FEEBLE-MINDEDNESS CHART 28 [^^-r-(N) D (n)[nic3c1]6[^(^*iI|7-n ULIAR PECUUAR I / « « / SR. CH. / / 4 2 6 MOTHERS FAHILY CHART 29 SECTION 2 5S^ffiS^^-i-d JANE VCANCER FOR DESCEND- ANTS SEE SECTION 3 ^x "* Sx I FATHERS FAHILY Sm TUHOR I I PARALYSIS PARALYSIS PARALYS 4U 1 3 6 iiiVii9g°?6'^6<)666 I V»X JAKE I I PARALYSIS/ .urDL,,.. T I J ^^ ALMSHOUSE j J / NERVOUS I I • PARALYSIS / I Z Z _L I PATFRNAI rDAMn_ X I 00 d& CHART 29 SEaioN8 D-T-O ••BLACK DUTCH" (^SS^^m-o FOR DESCENDANTS SEE SEaiON 6 MATERNAL GRAND- MOTHER SEE SECTION I. 5W^ SEE SElTIOn I. I _ POORHOU SE I ' , I I 1 ■ I W I ILLEG I lis IttEG iMl SOME WERE MATERNAL CRANO- IINJ COLORED FATHERS FAMILY n— ISx 1^© 120 FEEBLE-MINDEDNESS CHART 29 SECTIONS D O "BLACK DUTCH" \ \ 13 DESCENDANTS \ 2 !if e' ^GIT.MA TE FO" SIBS see \ BOT„PA.A.VS,S^ T I .-L I \ \ I F 17 DESCENDANTS I T I L YOUNG ^ 2 LLEGITIMATE s;' *^vsx MATERNAL GREAT- GREAT. GRAND- FATHER'S FAMILY The hereditary character of his defect is too obvious to need any discussion. CASE 30. IVA C. 38 years old. Mentality 8. Has been here 23 years. American born, of American parentage. Iva is an epileptic, is said to have had some form of paralysis at the age of 6. Has had measles and whooping- cough. Upon admission at the age of 15, was defective in her walk and somewhat lame from the paralysis. Slightly defective in speech. Was passionate, somewhat destructive and obstinate. Attention was very poor and memory also. Could spell some words with three letters, count to a hundred but not write. Was for a while very hard to manage. Used to have violent and angry spells, perhaps from epilepsy. Never got any farther in school work or intellectual development. Became better be- haved and a good worker, especially in the laundry. At present is a decrepit old woman at 2>^, cranky, quarrelsome, stubborn, active, obedient, sometimes cheerful and affectionate, willing CASE 27, DONALD U., AGE 25. MENTALLY 9. CASE 30, IVA C, AGE 38. MENTALLY 8. CASE 31, MARCELLUS C, AGE 20. MENTALLY 8. HEREDITARY GROUP. MENTALITY 8 121 and tries, truthful, excitable, sensitive. Will take things that do not belong to her and is not now able to do much hard work. Both parents are feeble-minded, father's sister is feeble-minded, six brothers and sisters normal, the grandfather was feeble- minded and tuberculous, his wife a normal woman who died of heart trouble at the age of 57. The mother is feeble-minded T / ^®ft CHART 30 ® ® E ® U S (n) © ^ "]" i ALMSHOUSE 6 i 2 // M6b ©DHDDO 00OH N I I I I and was an illegitimate child. Her mother married a normal man and had five children, one feeble-minded, three undeter- mined, the other normal. This normal woman had among others a feeble-minded boy who is in our institution (Case No. 107). Iva has a feeble-minded brother. There were two children that died in infancy, and three miscarriages. CASE 31. MARCELLUS C. 20 years old. Mentality 8. Has been here 9 years. Born in Italy, came here when three years old, Italian parents. Struck with a cane when 10 years old, condition said to have been due to that. Marcellus is a moron of the slow phlegmatic type. Has about the usual history of boys of his age in general school work. Has now settled down to routine housework in dormitory and cottage, always under direction. Is cheerful and willing, quiet and obedient, rather affectionate ; truthful ; is fond of singing, speaking pieces, playing musical instruments and croquet. Is strong and healthy. 122 FEEBLE-MINDEDNESS Here we see that it is not necessary to call in the accident to account for the condition. A younger sister is also defective ; D UVINC IN ITALY CHART 31 -o UVINC IN ITALY D SEVERAL CHILDREN UVINC IN ITALY o aa-H^65 the mother and her sister were defective. Another child is in the Children's Home, whether defective or not has not been de- termined. We have the defect clearly marked in two generations which definitely establishes the hereditary character. This case is also interesting as showing the relation to immi- gration. The family came to this country when Marcellus was three years old. He, being a moron, probably seemed normal at that time but the mother's defect also passed unchallenged. [SliS^TB^ i MARCELLUS C (5& CHART 32 O ff^53'5S&T<55^ 6Eiy6ii6d'i^'ii-j-®g^ I I QUENTIN D. CASE 32. QUENTIN D. 28 years old. Mentality 8. Has been here 7 years. American born, of American parentage. Had measles at the age of 8 years, chills and fever at the age of 16. HEREDITARY GROUP. MENTALITY 8 123 When admitted at the age of 20, head was small, knew commor colors, could read and write a little, was fond of music ; sight and hearing good. His defect showed when he was five or six years old. At present he can read in the Fourth Reader and write a fail letter with many misspelled words. Works in the stable and keeps it in excellent condition. More recently has had some develop- ments which point to a possible insanity, although this has not yet come to a point where it is possible to make a definite diagnosis This is a family of what might be called border-Kne people many of them being difficult to determine, while some are clearly defective. Our boy has an older brother who is defective, al- though high-grade. He has married and has two children, one of whom is clearly feeble-minded. There are two normal sisters three undetermined and one miscarriage. The mother of our. boy is a normal woman and nothing oJ importance is known of her family. The father is feeble-mindec and immoral; deserted his wife. He had two brothers whc were immoral. A cousin of the father's, a woman, is feeble- minded. She was the mother of seven children, one at least oJ whom is feeble-minded. The others cannot be determined. A cousin of this woman is insane, as was her great aunt. CASE 33. KARL E. About 23 years old. Mentality 8. Has beer here 12 years. When he came at the age of about 11, he could not dress him- self or use knife and fork, did no work, could throw a ball but not catch one. Was truthful, trustful, passionate, indolent, no1 easily managed. In our school department, he gradually im- proved, learned to do some kindergarten work in the first year learned to dress himself. His improvement was very slow however, and after five years he could do such number com- binations as 3 plus 5, 4 plus 2, Nine years after admission it was reported that he did not know his right from his lefi hand. Has probably reached his Hmit in mental training. Can 124 FEEBLE-MINDEDNESS &-U o R^UTS ABUSED Ysj— 1 ^(N) ^®Sti (SSW ^©h surely needs the protection of an Institution to save both her and society. She is cheerful, active and obedient, rather affec- tionate, is very willing, good tempered. Nora belongs to a thoroughly defective family; her mother was a feeble-minded woman, sexually immoral, and belonged to a family defective like herself. Of the father Httle is known except that he was alcoholic. CASE 38. STEPHEN I. 28 years old. Mentality* 8. Has been here 2 years. American born, father German, mother American. Instruments were used at birth. Child had scarlet fever at five years ; measles at nine, whooping-cough in the same year. Has had chronic mastoiditis and epilepsy. Stephen is a large, strong, well-built, well-proportioned boy ; writes and does number work fairly ; is excitable and nervous ; 132 FEEBLE-MINDEDNESS is especially noted for destroying things, a habit to which he has been inclined since the age of eight. He is inclined to be quiet and retiring, not very sociable with the other children. He is an excellent worker and can help the mason or electrician, or do other similar work. CHART 38 D o D O Td. d. LAZY I UNTIDY ^^^ ^^ ^^^ STEPHEN I. k The following brief letter very well represents him ; his hand- writing is poor but it is the somewhat illegible writing of an adult rather than the coarse crude writing of a child, yet the structure of the letter shows the child mind. March 3 191 1 My dear Mother I hope you are all well why do you not write to me ? I did not get one letter from you since about two weeks please do write to me. I hope you will soon come to see me dear mother will you be so kind and send me again two box of candy like the one you sent me before dear mother. The weather up here was very bad on Friday nearly all day Next week I shall write to father a nice letter. Will you be so kind dear mother send me some matazines and one very month. Be sure and come to see me this month. I Hke to have the candy soon dear mother. I shall write you a longer letter soon. I am well. Please tell John to write to me soon. Love to all Yours loving son Stephen HEREDITARY GROUP. MENTALITY 8 133 The family history shows the hereditary taint as can be seen from the chart. CASE 39. TOMMY AND FANNIE M. Tommy 22 years old. Mentality 8. Has been here 7 years. Fannie 19 years old. Mentality 5. Has been here 12 years. American born and of American parentage. Condition said to be congenital. Both have had scarlet fever. Fannie has had measles, Tommy whooping-cough. Upon admission, Tommy did not speak clearly, had attended pubhc school four years but could not read; could count to 100 imperfectly. After he had been here three years, he had learned to read a little in the First Reader and write a short story. To-day he is a fairly good worker in the dining room, is quiet and obedient. CHART 39 & O & I i pr \ d. .t 30 O^ <:)' ©ODii do iSioi] i k TOHHY fc FANNIE H. willing and tries, truth- ful ; very slow, indiffer- ent to other children ; learns a new occupa- tion very slowly ; needs much supervision. Fannie was 8 years old when admitted, Httle and clumsy, very heavy set, somewhat defective in speech, memory not very good ; could dry the dishes ; liked to sew. To-day, she has improved a Httle ; is a helper in the cottage and somewhat useful, but on the whole, is very dull and phlegmatic ; is cheerful, cranky and quarrelsome, affectionate. They have a younger brother who is reported as being normal, but this is very doubtful. He is 14 years old and only in the Fifth Grade. Possibly he appears normal because he is rela- tively brighter than his brother and sister. Referring to the chart, we see that the mother is epileptic ; her father was normal; nothing else is known. On the father's side there is more defect ; he and his three sisters being all feeble- 134 FEEBLE-MINDEDNESS minded, as was their mother. An older sister married a feeble- minded man and had three feeble-minded children and one that died in infancy. i55& o 6i-r^ BURNED TO DEATH IN UHE KILN !ra-f^ aSYRS. '^ FANNIE N. I lA^/ *^ 6© u ©S"^S5a^S® P-T-O CHART 40 SECTION i SEE SECTION I t] 6 6 6 CHT^ ^^ <5 t CASE 40. FANNIE N. 21 years old. Mentality 8. Has been here 1 1 years. American born, of American parents. Had measles at the age of three, whooping-cough at the age of five. Has had paralysis. This is a case of partial paralysis, the date of which cannot be learned. It has affected the right leg which is some four or five inches shorter than the other. Upon admission at the age of ten, she was walking with a crutch, spoke clearly, was obedient, knew a few letters, could HEREDITARY GROUP. MENTALITY 8 135 count to twenty ; knew most of the colors ; her memory and attention were said to be poor ; could wash dishes and sew carpet rags ; had never been to school but had had private instruction for two years. In our School Department she made some progress until now she is able to write a fairly good letter although the spelling and the handwriting are very poor. As usual her handwork is much better, indeed it is very good. She is a careful, neat worker and does well, especially in sewing. She does well in woodwork and also in basketry. Her disposition is very uneven ; she is sometimes cheerful, at other times cranky, quarrelsome and stubborn; she is not always obedient; rather affectionate but quick tempered and excitable. The following is her story about spiders written Dec. 2, 1909 ; the writing is so poor that it is very difficult to make out ; we have retained her spelling and punctuation. Dec. 2, 1909. ''The spidres make a meb and live init they have little baby spidres I like to see the Kttle pidres the meve ther meeb with thread they put it in the green hedge they breaks very they make me mounted it they bit same times same are black and same are greay same are very big and same are very Kttle same are brown they eat fiys they make a tunnel spidres make their meeb on the nail I like to see then cone down from the meb it is fun to see them." The family chart shows a rather unusually bad state of things. Fanny is the eighth child of a large family, both parents feeble- minded. The father's brother was burned to death in a lime kiln. While this is an accident that may happen to any one, the fam- ily history arouses a strong suspicion that he may have been stupid and ''unable to avoid ordinary dangers." We note again that the father's father was killed by accident. The family is very defective. It is noticeable that a sister of the mother 136 FEEBLE-MINDEDNESS married a cousin and they had three feeble-minded children and one that died in infancy. This would formerly have been attributed to the fact that the parents were cousins, ignoring the fact that the mother was feeble-minded. The further fact, that all of the mother's sibs whom we know save one were feeble-minded, would point to the proba- bihty that one of her parents was feeble-minded. If the sup- position of the feeble-mindedness of these parents is correct, we have on this side four generations of feeble-minded people. CHART 41 ALL UVE OUT WEST *•• * J i. \h\h(^^^\h(^ i (N) BOTH DISAPPEARED "HAVE CONE TO SEE THE WORLD" I CASE 41. STEPHEN N. 18 years old. Mentality 8. Has been here 9 years. American born, of American parents. Stephen was a sickly baby, his defect showed clearly at about six years of age. He had rickets as a child, could not walk until he was three years old. At the age of eleven he was still an attractive boy, straight and erect, smiling and pleasant, with no stigmata of degeneration nor external evidences of defect; spoke distinctly; talked freely; was somewhat inclined to be lazy. He could learn to recite quickly, and was altogether very promising. He made some progress and became able to count and add by tens with objects ; without objects he cannot add more than to the sum of six. Made some improvement in his school studies, gradually however, his school jvork became poor and careless. Finally he had to be taken out of school without having achieved anything of value. He has grown coarse and rough and is a typical middle grade boy. His attainments in letter writing are indicated by the following : — HEREDITARY GROUP. MENTALITY 8 137 Vineland, N. J Oct 18, 1 9 10. Dear John You 11 stt that I an writing to you as I said I would I hope your big brother it will as I an well and happy boy. I would like to known how Reudie is I an thinking of you every day as you know I am How is your mother and father I an working in the house barn. I daret hart you to write to me as soon please dont forget Now is my sister and by brothers till them that I send my loe to them and wich then to carl cut to see me — I will close with best wich to you all you refind Stephen N. The absurd combinations of letters are due to his penmanshrp. Undoubtedly he intended in the first line, for instance, to write '' see " but he did make an '' s " and two " t's " — likewise he makes an ''n " when he means an '^m." When the writing and spelHng 138 FEEBLE-MINDEDNESS are corrected one sees the childish form in which he writes. He is much inchned to use bad and indecent language. "^He is stub- bom, untruthful and thieving, moody ; can be good tempered and cheerful at times ; sometimes mischievous. He is a boy who would get into the worst of bad habits if he were not con- stantly watched. Referring to his family chart, we see that he is the fourth bom in a family of nine ; there are three normal children and at least one other defective. There was one premature birth ; one boy has disappeared, — gone to see the world, they say ; another one has also disappeared and is believed to be dead. The mother is feeble-minded. Practically nothing definite could be learned of the rest of the family as they are hving at a great distance from New Jersey. i5a CHART 42 O Q O Q FORCED nARRUCE r55o NERVOUS L_J NERVOUS d. 4 NERVOU! DEBIUTY "NEVER I CANCER WALKED" N)6 [Nh<^[Nl-f-(N)[N[j] (ffi~i^i •V DIVORCED LLll DEUCATE NERVOUS YTTS ^'*^"'* TK -^ I [Mj NEUROTIC /l\ ILLEGITIMATE i[N](N)iii(t) \mi i&ffii (N) E li i b ^■^ d. 3YRS. THOMAS w ^"^ k GOOD FOR NOTHING WONT WORK" CASE 54. THOMAS W. 27 years old. Mentality 8. Has been here 2 years. American born, of American parents. Had whooping-cough and scarlet fever at four years. Has had measles twice. Condition is said to be congenital. Thomas did not talk nor walk until three years of age. Speech is imperfect. He has been in pubHc school two years and private school a year and a half, but made very little progress ; has a hop- ping gait, but no noticeable body deformity. He keeps his mouth sHghtly open. He is much interested in machinery and electric- ity ; cannot read or write. When excited or teased he often has a sort of collapse but does not lose consciousness. His marked nervousness is his chief characteristic but he seems to be improving a little. He helps about the school, sweeps, dusts, makes beds, helps dress the little boys. HEREDITARY GROUP. MENTALITY 8 157 The family chart is uncertain enough to be interesting. At first glance the immediate family seems to be entirely normal, but there are some defective relatives. There are two other feeble-minded persons in the family and it is difficult not to be- Heve that the case is hereditary. If such is the fact, it must run back to Thomas's maternal great-grandfather or grand- mother ; of these people we know nothing of importance. They had four children, one, the grandmother of Thomas, was con- sidered normal but very nervous ; another was alcohoHc, mental condition undetermined ; she was the mother of a feeble-minded woman who was alcoholic and immoral and was in turn the mother of the third feeble-minded person in this line. It is en- tirely possible, and one may say in view of the facts, probable, that the great grandfather or grandmother carried the defect, but this was recessive and remained dormant until something that we cannot understand brot it to the front in the case of our Thomas. In the other line we might perhaps think that the alcoholic daughter of those great-grandparents might have been the one to accentuate the defect and bring it to the surface a generation earlier; at least, as said in the beginning, one can hardly doubt that it is an hereditary condition with which we are deaHng. CASE 55. FLORENCE X. 21 years old. Mentality 8. Has been here 8 years. Parents' nationality unknown. She had measles at the age of 9 years. Did not talk until 6 years old, could not walk until 11. At time of admission she could count to nearly a hundred; knew color and form ; could not be trusted ; is still going to school, but making Kttle progress in anything but industrial work ; does nice embroidery, some hammered brass work ; does nicely in ironing ; has learned to sew and do some housework ; can tell time, count, make buttonholes and sew on buttons; is not truthful, is thieving and mischievous. The following is her letter to Santa Claus at Christmas (191 2). The penman- 158 FEEBLE-MINDEDNESS ship is very poor and irregular but can be made out. The rest speaks for itself. Vineland n J Dec, I*^^ 1912 Dear Santa Claus, I thought I would write you a let- ter to tell you what I would like for chirst- mas Please bring me kinona and fairy wiast and a bed slippers and a picturs for the cot- tage. Fron your Loving friend, Florence X Like many of these cases, Florence looks to be much younger than she is. The family tree shows a remarkable growth of defectives. The mother is feeble-minded and a prostitute ; the father is CHART 55 li &— -rO »MOS. 9M0S ALL ILLEGITIMATE supposed to have been a normal man who had four normal chil- dren by another wife. The mother had three feeble-minded brothers. They were the children of two feeble-minded parents, the father being also alcoholic although he had two normal HEREDITARY GROUP. MENTALITY 8 159 brothers. The mother was sexually immoral. She had two feeble-minded brothers, one of whom married and had two feeble-minded children. The father of this group, that is, the maternal great-grandfather of our child, was a feeble-minded man who had a brother who was also feeble-minded. Thus we have four generations of feeble-mindedness with four cases of sexual immorality, besides bad physical conditions and other disturb- ances. CASE 56. KING B. 37 years old. Mentality 7. Has been here 24 years. American born ; nationality of parents not known. King was admitted at the age of fourteen, he came from a special Reform School, was nervous and gluttonous, careless, Ot-D ISTvflFE I QUEER I 0UA8REI. QUAJiRELSOHE 5 CHART 56 SEcnoH i o ^& ST WIFE BY 2ND WIFE ®f ILLEGITIMATE SECTION 3 y\ I 2 """" * T KING a dangerous with fire ; had been in school nearly two years ; knew the alphabet and ''some words, some days"; could not write. For three years he was tried in the school department more or less, but with no success ; now he has settled down to farm work and has become a good farmer under direction. He can use the team in harrowing, plowing, hauling coal and similar work. He is usually cheerful, but once or twice a year gets a i6o FEEBLE-MINDEDNESS grumbling, unsettled spell and wants to leave. A trip to Phila- delphia or a similar privilege straightens him out for anothe] year. CHART 56 SECTION 2 0-H=h-0 «T WIFC SEE SECTION 3 • □ —A 1 I I I I . f^\ SEE SEaiON I r CHART 56sEcnoN3 O-r-n-rO 6 2ND WIFE SEE SECTION I AND SECTION Z S^ b Of late he has taken a great interest in two small boys, one a cripple, and he is almost a father to them ; he carries the cripple back and forth to entertainments and holds him in his arms HEREDITARY GROUP. MENTALITY 7 161 CHART 56 SECTION 4 Q f 1 Chr-O SEE SECTION 1 AND SECTION 2 SEE SECTION 3 lU I 4N I to I I ^V I PARALYSIS I (56M thruout the exercises. He more than earns his living, under direction, and is happy and a good, useful Institution man. CASE 57. HORACE C. About 14 years old. Mentality 7. Has been here 7 years. American born; parentage of father unknown, mother Amer- ican. Has had chorea. Assigned cause is " neglect, improper care and abuse by worthless parents." Horace is an interesting little fellow ; he came to us when about seven years old ; his actual age could never be determined. It is said that his parents fed him with narcotics. He was a dehcate boy, ate very little; was obedient and had a happy disposition ; stammered, could not recognize color or form, had never been to school. Since he has made no change of mentality in the two years that we have used the Binet tests, it would seem that he has prob- ably reached his limit. At first he made considerable improve- ment in the kindergarten and it is recorded in 19 10 that he had improved in writing. The following is a sample of his writing January 26, 1910. The upper line is the copy that was set for him and the l62 FEEBLE-MINDEDNESS other his attempt to imitate it. This is typical feeble-minded writing. 1 [ly^^flfi/ CHART 57 8EcnoM,r « B-r® Eh-r-O [5SS^ * RVRS. I| ""^ CHART 57 SECTION a O 6 iS*& [566 (5nft OITIMATt — ^ IU.CCITIMATK CASE 66, KING B., AGE 37. CASE 57, HORACE C, AGE 14. CASE 59, DAVID D., AGE 15. CASE 61, BESSIE I., AGE 13. MENTALLY 7. MENTALLY 7. MENTALLY 7. MENTALLY 7. His two brothers. HEREDITARY GROUP. MENTALITY 7 163 At present Horace does errands, polishes metal, does house- work, and goes to school ; is cheerful, active, willing, good tem- pered, destructive, rather mischievous, a httle bashful and sly. It is recorded that he is thieving, obstinate and stubborn, quick tempered, excitable. Horace was sent to us by the Children's Home Society and our first knowledge of his family came from them. The following is from their report to us, leaving out names and unessentials. *' Father's name . Mother's name . Two children that we know of, Horace about eleven years of age, James died in our Receiving Home, would now be about nine years old. They had lived prior to that at . The mother was brought up near . Do not know her maiden name but think it was . Her father had the reputation of being indolent and lazy. I remember hearing a story about him, I do not know whether it is true or not, that owing to the poverty of the family, a neigh- bor had collected potatoes and other vegetables and drove up to the home to donate the same on account of the children. Mr. R. complained because the various vegetables had not been sorted out, involving so much labor on his part. This may be exag- gerated but it shows the type of the family. On or about the first of November 1904, Horace's father who was a charcoal burner quarreled with his wife, a very frequent occurrence, and, I am in- formed, tried to kill her by firing his shot-gun at her twice. She fled into the woods, with a small child in her arms, and remained in hiding nearly all night. He, disappointed at not accomplishing his purpose, apparently took his bed out into the back yard and demolished it, and taking an axe smashed his stove into small pieces. You can judge something of the mentality of the man from that procedure. Then he disappeared, leaving Horace and Jim- mie at the house. We never heard definitely of the man again. The woman came to with her children and as I was in the locality took charge of these two boys. She kept the baby. i64 FEEBLE-MINDEDNESS The mother is a very loose, careless, shiftless, ignorant, and im- provident woman. She told me she had had nine children. She could not tell me their ages or very much about them. It was a common thing for her to take her smaller children and go away on long tramps. The children had been very poorly nourished when we received them." We quoted this report for two reasons : first, to show a very common type of report of children that find their way into the care of these Societies, and second, to show one form of evidence on which we come to the conclusion that such families are mentally defective. No one with any experience with defectives could doubt for an instant that this was a feeble- minded family. However, our history does not rely upon this alone. We were able, through the efforts of our Field Worker, to establish these facts and many more that will be seen by ref- erence to the family chart. It is not necessary to go over this in detail, a glance shows the large amount of sexual immorahty, alcohoHsm and criminalistic tendencies. Truly a terrible family and one cannot refrain from asking the question, ''Why has society allowed the parents of this child, to say nothing of the others in this generation, to Hve a life of debauchery entirely unrestricted?" We are also fortunately able to reproduce the pictures of two brothers of Horace. Although photographs are unsafe guides one can easily see the mental defect in the faces of these children. CASE 58. SAM C. 16 years old. Mentality 7. Has been here 4 years. American born, of American parentage. Has had chorea, whoop- ing-cough at the age of five, measles at six, asthma. Assigned cause, ** he- reditary." Sammy is an interesting case of a high grade imbecile with a good deal of physical disturbance. Upon admission thiee years ago, he could dress himself, but could not read, write or count ; knew color and form ; attention was poor, imitation good ; could do errands and wipe dishes ; was excitable, laughed and HEREDITARY GROUP. MENTALITY 7 165 cried without cause. He had a teacher for four months but soon forgot what he had learned. . His career here was marked in the beginning by pecuHar crazy spells at frequent intervals, in which he would suddenly rush out screaming and crawl into some narrow, close space, — probably under the seats in the school room — and continue to scream. If ignored for a while he would gradually get quiet and come out of it. After some Kttle time it was discovered that if given food he quieted at once. Acting upon this hint those who had charge of him began to watch for signs of this outbreak and by giving him a piece of bread the attack was warded off. These spells diminished in frequency until of late he has had none. CHART 58 ILLEGITIMATC 6SS^n-c55SS k SAMC, When not having one of these screaming spells he w^ould often sit as if dazed much of the time. Those dazed spells have also gradually worn off, and he has been improving ; likes to do housework and does it well. His whole disposition has improved very greatly but physically he seems to be on the downward track. He is in the hospital much of the time and is developing curvature of the spine. He is a pecuhar child, very quiet and rather cheerful; pleasant to those whom he knows. Often surprises us with an outburst of what seems Uke childish wisdom, showing considerable thought, and even reason and good judgment. A glance at the chart will perhaps offer some suggestion toward an explanation of Sam's pecuHarity. We see that his father is feeble-minded and his mother insane. It would seem as though i66 FEEBLE-MINDEDNESS he had inherited something of both conditions, for certainly many of his spells are much like insane attacks. At least four of this family are in Institutions at pubUc ex- pense. Since the foregoing was written he has shown more marked symptoms of insanity. D II CHART 59 2ND HU8B AW0 COUSINS. ik6(^6[i66 O l^lillllko o CASE 59. DAVID D. 15 years old. Mentality 7. American born; mother American, father unknown. The boy has been here seven years. He is partially paralyzed and walks with a limp. When he came, it was said that his memory and attention were good. He understood and obeyed a command, was gluttonous, fond of play and obstinate. Upon entering our school, he did not know colors by name, but could match them ; played with blocks and could follow a line. He improved somewhat after three years, and after five years was doing excellent brass work ; had improved in his Enghsh, could always count to 19, but some- times to 50. He is always pleasant and good natured, although sometimes quite stubborn ; is willing and tries. He is untruth- ful and is somewhat given to pilfering ; is a very good errand boy ; spends the afternoon in school, is doing nicely ; is usually good, but sometimes flies into terrible rages, throws anything that he can pick up, and swears. He is rather undersized, being HEREDITARY GROUP. MENTALITY 7 167 as tall and heavy as about 25% of children of his age. He can repeat the days of the week, but not the months of the year. He cannot count three one-cent and three two-cent stamps, cannot repeat five figures. When he first came, he was thought to be very nearly normal, but he has made no mental develop- ment since that time and has learned to do only a few new things. Both parents are feeble-minded and have been twice married. Our boy has three brothers and one sister, all feeble-minded. The oldest brother died young. The father's first wife was normal; they had a feeble-minded girl. The father has two sisters and a brother undetermined. One of these sisters, how- ever, has had a normal daughter and a normal grand-daughter. The mother has a feeble-minded brother and a sister who died in infancy. They were the children of a feeble-minded woman and a man whose condition is unknown. Our boy's mother had a second husband who committed suicide. They had one feeble-minded daughter. Of the fifteen feeble-minded people in this family, at least three have been in almshouses at pubhc expense. The paternal grandparents were also town charges. One man committed suicide and another was killed. David is of the type that would be a truant and an incor- rigible were he out in the world. CASE 60. KENNETH E. 39 years old. Mentality 7. Has been here 23 years. American born, of Irish parents. Has had measles, whooping- cough, scarlet fever, and convulsions during dentition. The latter is given as the cause of his mental defect. Kenneth is a prematurely old man at chart eo forty, good natured, a hard worker at what- Q}- ever he can do ; talks distinctly and much ; is sometimes quick-tempered but it does not last long ; does kitchen work, washing dishes, scrubbing, etc. His attendant re- ports that he is a good worker, doing his DESERTED HIS b i68 FEEBLE-MINDEDNESS share of the hardest work; he has occasional fits of temper but they last only for a few minutes ; his habits are good and we can only say he is a good, deserving boy. This is another case that came through the Organized Chari- ties and nothing can be learned except what is shown on the chart. The mother is feeble-minded ; the father deserted her and the children. CHART 61 a-K5 Itl I 1 Ji 53S5a rf^ ^*af^ UV -^ 'e Mos. .^SfT- k have been all right." But that such is not the case is evident from the fact that she came to the Training School when only eleven years old and experience proves that had she had the ability she could have been trained at that age. For the past nine years she has had the best environment and the best of training, yet it has been impossible to raise her grade. The environment, bad as it was, did not make Dora feeble-minded ; it is more probable that the weak-mindedness of her parents accounted for their low moral and physical condition. CASE 67. DAVID M. 23 years old. Mentality 7. Has been here 7 years. Born in England, of English parents. Had measles when one year old and whooping-cough at seven. The cause of the condition is assigned as " fall with thickening of the bone." This is a pleasant boy somewhat under size but without marked stigmata. When admitted at the age of 15 he could not talk well, understood but could not explain. Was trustworthy, active, had been in pubHc school nine years but did not know his letters. Al- though persistent efforts were made, he never "*"""* accomplished much in the book work. A year after admission the record says — ''has improved some in his English although he CHART 67 ALL LIVE IN ENGLAND 6ih4i5^^5^ k HEREDITARY GROUP. MENTALITY 7 175 is a dreamer and gives very poor attention, does very well in number work." A year later ''does not improve much in Eng- lish, forgets from one day to the next all he has learned, does not know combinations to ten." It has not been possible to train him to do more than wash windows, make beds, scrub and help a Httle with the other children, when carefully directed. He is cheerful, affectionate, truthful, rather sensitive. The heredity may possibly be considered a little doubtful in this case. The mother was clearly feeble-minded, was an Enghsh mill-worker ; of her sibs nothing can be learned except that one died at 19 from ''over-exerting his brain"; the others married and had children, one having an idiotic child. David's mother had six miscarriages, said to have been caused by her ill health. CHART 68 P-rO ALL LIVE IN SCOTLAND o i^ HAS NOT SUPPORTED d. Til FAMILY FOR YEARS I | I [5"ffS©¥5SES©0©^ 00 BABY CASE 68. ENOCH M. 21 years old. Mentality 7. Has been here II years. American born, of Scotch parents. Had whooping-cough at the age of four, serious spinal meningitis at the age of ten. " Fall in the yard at the age of two " is said to be the cause of the defect. Enoch is rather a sober, silent boy but wiUing and tries, is truthful, but very slow; never accompHshed anything worth while in the three R's nor in manual training. He does very poorly in basketry, succeeds somewhat in knitting. At present is doing simple housework, has the reputation of being kind to 176 FEEBLE-MINDEDNESS the little children, especially the cripples, and is a helper in kin- dergarten work ; inclined to be moody. His mental defect was not noticed until he was about eight years old ; this was two years before he had meningitis so that can hardly be the cause and it seems to be rather late for the supposed cause of " a fall in the yard." The family chart undoubtedly shows the hereditary character. Enoch's two sisters are defective ; six sibs died in infancy, there are three that are unknown and two that are normal. The mother is normal while the father is alcoholic and feeble-minded. CHART G9 N N EF / WIFE OR WALK WELL T — r 65S li k CASE 76. MOLLIE N. 24 years old. Mentality 7. Been here 13 years. American born, of American parents. Had measles at the age of seven. Mollie was a sickly baby, weighed two and a half pounds at birth ; has imperfect speech, is under size, has vacant looking eyes, mouth protrud- ing and open, always twitching. Upon admission at the age of eleven, could not read, did not 1 88 FEEBLE-MINDEDNESS know her letters, could count to ten, attention poor ; had been at school for four years with no effect ; had bad habits. She made a little progress in our school, learned to write and print, and to write numbers up to ten ; can make beds and sweep a Kttle, can dress and undress herself ; has long since reached her Kmit of im- provement and trainability. The family chart shows a generally low grade family. MolHe is the only Kving child, the others dying in infancy. Whether there was mental defect of so low a grade as to constitute feeble- mindedness in the father's family is hard to say ; he married for his second wife a woman of questionable mentahty and had two children who are doubtfully normal. A nephew of his was un- doubtedly feeble-minded, died at seven years and could never walk nor talk. The supposed cause was injury to the mother. That may be the cause or it may be hereditary ; we have no means of deciding. On the mother's side will be noted an unusual amount of tuberculosis. The maternal grandmother was probably defec- tive but the proof is not quite sufficient to mark her that way. She had four feeble-minded children and three that died in in- fancy, another one is questionably normal. Of the mother's three feeble-minded brothers none can walk or talk well. CASE 77. BERTHA N. 15 years old. Mentality 7. Has been here 9 years. American born, of American parents. Bertha is ataxic ; this extends to her walking and the genera] control of her muscles. This naturally interferes greatly with her abihty to do things and express herself. She has great per- sistence, which is rather characteristic of this type, so that she is gradually overcoming a great deal of her lack of control of move- ment. She is very attentive and quick to grasp ideas read to her; can count a Httle ; can write a well worded letter, although of course the chirography is bad ; her spelHng is fair. She can use a plane and saw with considerable success CASE 73, GRACE N., AGE 9. MENTALLY 7. CASE 76, MOLLIE N., AGE 24. MENTALLY 7. CASE 78, HOWARD O., AGE 21. MENTALLY 7. HEREDITARY GROUP. MENTALITY 7 CHART 77 189 mr O (N)(N)(N)6lNl-T-® D o (N)(N)[N][g[Nl-Ij-(N)|Nl[N][j](N)(i i [N|(^ i i 1 ^(n) BERTHA N k and sews fairly well. Although all of this is very awkwardly done from the standpoint of a normal person, for Bertha, it is a great encouragement to find. that she can do these things. She is a very faithful worker around the cottage with anything that comes within her possibihties. There is very clearly a weakness in the family, both nervous and mental. It would seem to be a case where there is in the family of the father a mental defect which has lain dormant for a couple of generations but which reappears, possibly as the result of the father's marrying into a family that is weak nervously. CASE 78. HOWARD O. 21 years old. Mentality 7. Has been here 7 years. American born, of German parents. Had whooping-cough at the age of six years; has had sore eyes. Howard is an interesting example of a boy who would be taken as normal by many persons who saw him at his work. He has a reticence in speech which protects him wonderfully. He keeps silent and looks wise. It is practically impossible for him to learn anything of the usual school work. Even after three years here, at the age of sixteen, he knew but a few number combinations with the aid of objects only ; copied poorly ; had very Uttle idea of form. In common with most defectives he 1 90 FEEBLE-MINDEDNESS CHART 78 D O p-rO ^^66[Nhr<^60 r5b[K! likes to be noticed, altho perhaps this is a little stronger in him than in others. He works well at whatever he undertakes, as long as the novelty of it gets him a good deal of attention and praise. For example, in 1907, he was errand boy for about six months and when the novelty wore off he was of little use in this capacity ; he would stop and talk instead of doing his errands. In 191 1 again he was made a very special errand boy with a uniform and was also a phone boy, managing the switchboard, etc. This flattered him greatly and he was a great success for some time. In 191 2, however, he had to be discharged from this because again he began to talk and loiter at the work ; since then he has been with the electrician and doing outside work and probably he will have the same experience there. He is inclined to be sober and silent, and sometimes stubborn. He is honest but forgetful. His left leg is quite a little shorter than the right, probably a congenital condition. This gives him an unsymmetrical attitude. The family chart shows at a glance the hereditary character of his mental defect ; it is noted that two of his sibs are in other Institutions at public expense. From the number of defective children it would seem probable that the father as well as the mother was feeble-minded. HEREDITARY GROUP. MENTALITY 7 CHAKT 79 191 O n-r-55n& * / I THE BRAIN" I * 4YRS. L— J « 3 VBS. DORAQ. b 1^ i 6 (N) [N] @ [!] ti ti CASE 79. DORA O. 15 years old. Mentality 7. Has been here 4 years. Birthplace unknown, nationality of parents unknown. This is a high grade child of the type very commonly seen on the street among the poorer classes. When admitted, she talked distinctly and much ; poor memory ; could sweep and dust and help around the house ; has improved a Httle under training but it is very slow ; can write a few words very illegibly ; needs con- stant watching ; has learned to do some simple sewing ; can do practically nothing in school work; has improved in basketry and some in sewing ; has a violent temper and when she gives way to it, scratches and swears. As will be seen from the chart, this is a very bad family. Wherever anything is known of its members, they are as a rule defective, very few normal people having been found. The father and mother are both feeble-minded. The father is sex- ually immoral and is serving a ten years' sentence in States Prison for carnal abuse of this child. His parents are undetermined but his maternal grandfather was called "crazy," or "always a Httle off " — probably feeble-nunded. A sister of this child's mother 192 FEEBLE-MINDEDNESS had a feeble-minded daughter who in turn had a family of ten children, of whom at least three are feeble-minded. Another sister is a moron and has'at least one feeble-minded child. None are normal. A brother was normal, but married a feeble-minded woman and had at least two feeble-minded children. It is very evident that the defect runs through the family and there would be many more black marks if more facts could be learned. CHART 80 6d-T^h D-K5fl o ISx ISx 5M^i-^. IU.EG I H.LCO 2U 20 ILuU ..?W„ I ' lE' I I Sxl SxiT J_ J^ IB CASE 80. WILLIE S. 32 years old. Mentality 7. Has been here 15 years. American born, of American parentage. He has had measles, mumps, whooping-cough, diphtheria and tonsillitis ; has never been ill since he has been here. When he came, had been at school 6 or 7 years, was below aver- age in size and weight, could wash and dress himself ; understood a command ; knew the alphabet but could not read ; wrote a few words ; was fond of horses, could harness and drive them. Parents expected him to become self-supporting. He was placed in the school department and after a year could print his first name from memory and his last name from copy. Two years later it was reported that he made no improvement. Was called a *Mon't care " boy ; could read the first page on a chart and count to 20 ; could write his name from memory ; knew color and form. HEREDITARY GROUP. MENTALITY 7 193 He is, at present, a good Institution helper, does housework and laundry work quite satisfactorily, under direction. He is generally cheerful, rather silent, sometimes quarrelsome and stubborn, but usually obedient; willing and tries; is slow. He can copy a square but not a diamond. He cannot count 13 pennies nor show his right hand nor left ear ; can repeat the days of the week, but not the months of the year ; defines by use ; cannot count three one-cent and three two-cent stamps ; can remember only four figures. His chart shows both parents feeble-minded, father alco- hoHc, mother tuberculous, and blind or at least approaching it. This is a very mixed family. Some of the children are de- cidedly defective, one is epileptic ; another one is relatively quite bright. The father's uncle was feeble-minded and epileptic. He had also a nephew that was feeble-minded. Of the rest, httle can be found. The mother had a large number of feeble-minded brothers and sisters. They suffered from tuberculosis and there is a good deal of blindness in the family, even for three genera- tions back. There is also a good deal of sexual perversity, nearly all of these people having borne or begotten children out of wedlock. The mental condition |of these defectives variei all the way from very low grade, well marked idiots up to high grade morons and border fine cases. CASE 81. FRANCES T. 27 years old. Mentality 7. Has been here 14 years. American born, of American parents. Assigned cause " menin- gitis," which she had at the age of six months. The child also had convul- sions at the same time. Has had measles, whooping-cough, scarlet fever and bronchitis. Frances is a very good girl of medium intelligence altho the teachers say it would take her months to memorize four lines. She is cheerful, affectionate, obedient ; wilhng and tries, truth- ful. The limit of her abiHty in reading and counting is the abihty to read "the apple" in the primer, to count to ten and to add by twos ; in manual training she is not very good, she spoils 194 FEEBLE-MINDEDNESS CHART 81 D-rO [5"5Tr&-r^ 6 ti tj 6 ® |3| <1< CAUDA T. I lULEtt > 'kl-EG *• k THE FATHER'S FAMILY [S[S¥516 CHART 82 SECTION 2 iS'b-r6OTSSdD=T=6 CHUBREN "^ I *— ' RAILRO, SEE SECnON I J^H aN MOTHER'S FAMILY r— I // ^^ 3 SEEMS, [n]-j-^ doubtful, but with a strong probability of defect. There is some epilepsy, some insanity, some criminality and some alcoholism in the family. There are fotty-five people represented on this chart, who are feeble-minded, and even this appalling number would be somewhat increased if we included some doubtful ones ; a number of these are, or have been, in public Institutions at public expense. 1 96 FEEBLE-MINDEDNESS CASE 83. DAVID AND NANCY X. David is 31 years old. Mentality 6. Nancy 29 years old. IMentality 6. Have been here 19 and 20 years respectively. American born and of American parentage. Of David it is recorded when he entered the institution: ''Can dress and undress himself; speech is slow; knows color; attention poor, imitation poor ; does some housework ; is indo- lent, untruthful and destructive, cannot read nor write, has been considered insane, has been in school four or five years with no improvement." After admission, he constantly improved. At one time, he was making the most progress of any boy in his group ; gradually grew less stubborn ^ and became helpful in dormitory and -Q kitchen. At present, can sweep and scrub, P — I — -j — -T polish shoes, saw wood, dig dirt, cut Q O O B grass and do things that require only a h h ' little judgment ; can write a letter, but DAVID t NANCY X. • • 1 11 11 1 i 1 11 1 it IS badly spelled and badly constructed ; is cheerful, sober, silent, stubborn, quiet, obedient, willing and tries, truthful and slow, quick-tempered. Nancy, upon admission, could neither read, write nor count. Recognized color and form, was fond of music. Memory was poor and attention fair. She could do some housework, was excitable, nervous and inclined to be indolent. In the school department her progress was slow. In one year, she had learned only to write A and print A, H, Y from memory. Five years after admission, she knew the alphabet and could get correct answers to mental arithmetic, when she had the objects before her. At present she can write about the same kind of letter as her brother; gets along well with the girls; does very good house work; is at times cheerful, sober, silent, cranky, quarrelsome, stubborn, active, quiet and obedient, obstinate, wilHng and tries, truthful, slow, quick-tempered, thieving, excitable ; has bad habits. But Httle is known, or could be found out, about the family, CASE 83, DAVID X., AGE 31. MENTALLY 6. CASE 83, NANCY X., AGE 29. MENTALLY 6. CASE 85, HERMAN C, AGE 28. MENTALLY 6. HEREDITARY GROUP. MENTALITY 6 197 but what there is, is all bad. The father and mother were both feeble-minded. A sister, feeble-minded, is in the State Home for Women. A younger brother is said to have been killed on the railroad. The father was a cripple who made and sold shoe strings, on the street, for a living. They lived in an upstairs back- room in a Httle house on an alley in Philadelphia. The girl, who is now at the State Home, was taken into a farmer's family where she did very well until they moved to the city and opened a milk- shop. It was impossible for her to make change for a pint of milk ; besides the family feared for the child as she matured, so she was sent to the State Home. CHART 84 N -(n) M -°p q „;>r^DIVORCI DIVORCED I FROM FROM HUSBAND. [NJ[^(N) ©on MM(k EDDIE B. k ®ftl(5 CASE 84. EDDIE B. 13 years old. Mentality 6. Has been here 3 years. American born, of American parents. Had measles at the age of Eddie is an ataxic case and has very poor control of his limbs and speech organs; has made considerable progress since ad- mission and can get around better ; can even weave a mat and sew cards. He is cheerful, active and obedient, very affectionate, rather excitable, very sensitive ; tries hard to talk but the ataxia ex- tends to his vocal organs and he cannot be understood. The family chart shows the hereditary character of the defect. The maternal grandmother was feeble-minded and it is clear that 198 FEEBLE-MINDEDNESS this has been transmitted thru the mother to our boy and his older brother. It might be urged that the syphiKs of the father was the cause of the defect, but how then shall we account for the two normal children, one of them being Eddie's twin ? This situation of twins, the one normal the other feeble- minded, is hardly to be explained on any other basis than hered- ity. The syphiHs of the father would most certainly act upon both aHke. There is nothing else to be noted in the family, except perhaps the very frequent number of divorces and separations which may be significant in themselves. CHART 85 ^k535 ^*^ A»n»irTV fiinrmp ^"-^ BCRMANC. OLD IN IN 3rd 3rd ^ CKADE GRADS ICE E. k CASE 87. GEORGE E. 14 years old. Mentality 6. Has been here 7 years. American born, of American parents. Had an attack of diarrhoea at the age of seven months; has had marasmus and phthiriasis capitis. Assigned cause of his condition is the diarrhoea resulting in hydrocephaloid state. George has the appearance of a bright little boy of eight years of age. He did not begin to talk until four and has never learned to talk plainly. He has never gotten beyond the kindergarten in his work and for some time has made no improvement ; can memorize the words of songs and go thru the motions of singing them. He is cheerful, but quarrelsome and stubborn; active, affectionate, quite excitable, destructive and mischievous; has rather a strong tendency to kick and bite other boys. George's condition is clearly deep seated and hereditary ; the sickness referred to was probably an incident in his early life. The family are strongly defective and have for years been ob- jects of charity in their neighborhood. HEREDITARY GROUP. MENTALITY 6 20I CHART 88 N S"5W^}-T— <5 S ^ ©liOi [Nji lir$H§^ [n](n)(n) [n](n)[n] N?l CASE 88. HOMER F. Deaf. 28 years old. Mentality 6. Has been here 18 years. Born in Germany, of German parents. Deafness supposed to be due to congestion caused by whooping-cough. He had whooping- cough at the age of two months, measles at six years, eczema at twelve years, spasms at thirteen years. Homer can say about twenty words; has learned a little in number, can subtract, for instance, four from seven, or add four and three with objects ; is a fairly good industrial worker about the cottage or in the laundry ; can do good work when he tries but gets careless and stubborn ; is cheerful but quick-tem- pered ; somewhat quarrelsome ; is fond of other children and is generally agreeable to those about him ; is fairly good at imper- sonating other boys. The deafness does not seem to be heredi- tary, at least none has been found in the family. The mother is feeble-minded as are also two of Homer's younger brothers; two sisters are perhaps normal. The father is normal but a weak, easy-going man ; he has a sister who is considered normal, but of her five children only one lived, two being still-births and two early deaths. CASE 89. JENNIE G. 20 years old. Mentality 6. Has been here 11 years. American born; father German, mother Norwegian. Has had measles, whooping-cough at the age of four, scarlet fever at seven. At the age of nine, when admitted, Jennie could partly dress herself; understood language, but not always a command; could count to ten ; recognized color and form ; was obstinate 202 FEEBLE-MINDEDNESS and passionate. A year later she was doing simple kindergarten work, was rather timid ; could sew, and cut out pictures ; liked to knit on a spool and sew on buttons. Three years later she was spelling words Uke cat, mat, etc., could form a few letters, could braid raffia, knew the value of i, 2, 3, and 4, and could count to 20 ; could sew nicely. Two years later the report is, "sl little better in basketry, is incapable of progress in English work, sewing good." Three years later ''no improvement mentally and little manually." That was in 1909 and there has been ^.^^^^J gg practically no change since. // jr ^ She is sober, rather quarrelsome, ItU I iP W seldom smiles ; is slow, obedient, altho sometimes obstinate. I I I I I j^F/^* '^^^^ ^^ almost certainly a he- U © □ 0,LJ. ..„oSo2"42,,r reditary case. Jennie is the sec- ll ond born of five children. The """""• youngest died at seven, the other three are in homes somewhere, but no one knows where. The father was probably a normal man. He was killed by a fall. The mother is feeble-minded. The mother's sister had two daughters, both of whom were immoral women. Nothing further is known of the family. CASE 90. HAROLD H. 19 years old. Mentality 6. Has been here 7 years. American born, of German parents. Has right-sided inguinal hernia. The child is a cheerful, good natured, high grade imbecile of normal height and weight, good face and physique. Although carefully trained in our School Department for several years, the child has never been able to make any great progress. He can recognize a few figures and count a little. Industrially he does a Httle better but has never been able to learn anything complicated. He is an errand boy, going from cottage to cottage and does this fairly well. He is apt to giggle when spoken to, and at times is very silly, but on the whole is a general favorite in his group. CASE 89, JENNIE G., AGE 20. MENTALLY 6. CASE 92, HARRY I., AGE 26. MENTALLY 6. CASE 94, LOTTIE I., AGE 22. MENTALLY 6. HEREDITARY GROUP. MENTALITY 6 203 The chart shows the cause of his condition. An older sister is feeble-minded and has had an illegitimate child that died. The mother and one of her sisters are feeble- CHART 90 66666[3-f<^64i i5Sa minded. The father is alcoholic and tuberculous. A paternal aunt of Harold's had three children, one of whom is criminaHstic and in jail ; another is spoken of as being lazy. It is possible there is some mental defect here also. CHART 91 PROBABLY ^K ■ HARRIED INTO I WS THE KAtXlKAK I mfl FAniLY I "^ (N> BRIGHTER THAN THE REST CASE 91. MELVIN I. 14 years old. Mentality 6. Has been her* 4 years. American born, of American parentage. Has had convulsions measles at the age of 6 years and has had scarlet fever. • When admitted two years ago, he could dress and undress, could not read, was very excitable and nervous, had no results from two years in public school. Since coming here has improved 204 FEEBLE-MINDEDNESS very much; is very fond of gardening; can sew and weave nicely; is hard to manage because he is very pecuHar; cries at the slightest correction but does not heed; is improving. An attractive Httle boy, works nicely in the kindergarten, takes direction very well. Both parents are feeble-minded, father sexually immoral, and syphilitic, with a brother who is alcohoHc and also immoral. Another brother, normal, married a normal woman and had six normal children. The mother has a feeble-minded brother and sister. The parents of these three were also feeble-minded. The mother has a feeble-minded sister who married a feeble- minded man and they have had two feeble-minded children. The father had a brother who was insane. Melvin's paternal grandfather is normal and belongs to a large normal and highly respectable family, but he married a woman who had a feeble-minded sister. That was his un- doing. She transmitted her family defect to their son, the father of our Melvin. Our boy has a feeble-minded brother, two feeble-minded sisters, two that died in infancy and one who is "brighter than the rest." The paternal grandmother's sister whose mental condition is undetermined probably married into the Kallikak family. She has the same family name and lives in the same locality, but we have been unable to make the connection. This is a striking chart eugenically, as it shows a man of excel- lent family marrying a woman who was normal, to be sure, but who had an imbecile sister whose defect was probably hereditary. Of their three children, one was normal, one certainly defec- tive, the third probably so. The defective one in turn married into a very defective family with the result that our child and his brothers and sisters are defective. CASE 92. HARRY I. 26 years old. Mentality 6. Has been here 18 years. American born, of American parentage. Had none of the children's diseases ; had convulsions once or twice when young. HEREDITARY GROUP. MENTALITY 6 205 When he came here was considered a nice looking child, seemed very bright ; did not talk, but was fond of play and company ; was reported as being double-jointed. Two years later, he had become a great talker, altho his speech was thick and somewhat indistinct, this is probably due, in part at least, to a very large, thick tongue. He is somewhat restless and difficult to manage ; stubborn. At present, he helps a little in the care of low grade children. He scrubs and dries dishes. He is considerably below any normal person of his age in height and weight, his grip and lung capacity are still ^^^^^ ^^ farther below normal. He can copy the square but not the dia- mond ; can count thirteen J HARRY I. pennies and rec- ognizes colors ; cannot tell the difference between wood and glass, or between butterfly and fly; cannot remember five figures ; is cheerful, but quarrelsome, excitable and quick- tempered, somewhat given to thieving, destructive and mis- chievous. Can repeat some songs that he has learned ; has a good memory. His habits are bad and cannot be improved. Our knowledge of his family does not cover a great many in- dividuals, but enough to estabhsh the fact of hereditary feeble- mindedness of rather a low grade type. The father, especially, is said to have been a dwarf physically and completely deformed in character. He is feeble-minded, alcohoHc and sexually im- moral; has had three wives. The first wife, the mother of Harry, was feeble-minded but had a normal brother. From this marriage there were seven children of whom five died in infancy and one is unknown. The second wife is unknown. The third 666Sb 206 FEEBLE-MINDEDNESS wife is feeble-minded, had been married before and by her first husband, had at least one feeble-minded child. Four others are undetermined. P-T-O 1«T HUSBAND CHART 93 o O-T-O 2M0 HUSBAND 6 (53SM^666666[tii6 CASE 93. KONRAD I. 32 years old. Mentality 6. Has been here 14 years. American born, of American parentage. Was a strong baby. Learned to talk at three years of age, altho his speech was defective. He had convulsions when he was two or three years old. Upon admission at the age of 18, his speech defect was notice- able. He could not read nor do any arithmetic ; knew some colors; was fond of music; could wash dishes, cut wood and care for horses ; inclined to run away ; was careless, indolent, passionate and filthy. He was placed at once in the school department but was an entire failure. He could do no school work. He could do ex- cellent gardening and a little woodwork. At present, he does fairly well helping the mason ; works in the kitchen and on the farm. He is cheerful, rather sober and silent, obedient, affectionate, somewhat timid, willing and tries, is truthful, somewhat excitable and sensitive, forgetful, gen- erally good-tempered. Konrad's father and mother are both feeble-minded, the father being also alcoholic. The mother belongs to a large family but HEREDITARY GROUP. MENTALITY 6 207 nothing could be determined as to their mentality. Konrad has had seven feeble-minded brothers and sisters, one died in in- fancy, one died of black diphtheria, and there was one mis- carriage. Some of them are of higher mentality than Konrad. CHART 94 TOd D O 0& 665B-n-d& (N)[N](N) n-T-6©©s©6 i i LOTTIE L i ® 666^6\h6\h CASE 94. LOTTIE I. 22 years old. Mentality 6. Has been here 12 years. Was born in America; father German, mother Danish. Small of stature, equal to about ten per cent of children of her age. Has microph- thalmic eyes which are in constant motion; vision probably very poor. Upon admission at the age of ten she could dress herself except- ing the buttons ; could undress ; was said to understand Eng- Hsh, German and Danish languages; understood commands but was not very obedient. Her teeth were very imperfect; talked very little; could count to ten or fifteen and copy a few words ; could sing a little ; memory poor ; could do errands, and wash dishes ; was left-handed ; not very affectionate ; fond of play ; had spent three years in public kindergarten with no results. She improved somewhat under training, was able to group pegs as high as six, could count to ten ; learned to sew a Httle ; wove a basket ; had a violent temper which made it necessary to take her out of school; was stubborn and sulky at times; 208 FEEBLE-MINDEDNESS was never able to do as much as her intelHgence seemed to war- rant, partly, perhaps, on account of her eyes which in turn may have affected her disposition, at least the latter is bad. That her mental defect is hereditary is evident from the chart, where we have at least three feeble-minded persons. Of the father's family practically nothing is known except that he him- self was alcoholic and tuberculous and died of cancer at the age of fifty- three. This is one of a number of charts that show that alcohohsm in one of the parents results in a great many early deaths. Here we have a feeble-minded mother and an alcohoHc father — two children feeble-minded, all the rest of the eight were either still births or died in infancy. It is further interesting to note that there seems to be some hereditary eye trouble — as our child's mother and grandmother are both reported to have weak eyes, while an older sister of Lottie's had eight children, one of whom is reported to have been blind. CHART 95 TFJl— r— (N) n- <5 A I A JA (N)[N](N)©(^ 2 8 vl?FE CASE 95. DAVID L. 22 years old. Mentality 6. Has been here 7 years. American born, of American parents. Has had whooping-cough. David is a curious httle fellow, very much under size, with very defective eye-sight; is very quiet, takes everything as a matter of course; has not been able to learn anything worth mentioning, in the Hne of book work ; says very comical things ; CASE 95, DAVID L., AGE 22. CASE 96, FREDA M., AGE 23. CASE 97, KARL N., AGE 29. MENTALLY 6. MENTALLY 6. MENTALLY 6. HEREDITARY GROUP. MENTALITY 6 209 is an errand boy and helps in cleaning about the cottage ; is cheerful, obedient, affectionate, sensitive, even-tempered. The family chart shows several interesting points. David is one of seven children, two sisters, twins, are feeble-minded, next two died in infancy ; the oldest and the youngest child of the family are undetermined. The father is alcoholic but prob- ably normal. His family seems to be good. David's mother is feeble-minded. Her parents, a brother and two sisters were alcoholic. The father of our boy was married earher and had 11 children by his first wife, of whom five were normal, the rest died in infancy. The first wife was a normal woman but tuber- culous and of a tuberculous family. She was always weak and sickly and died of the disease at 45. This would seem to be a strong case bearing on the problem of whether alcohol and tuberculosis of long standing can together produce mental de- fect. In this family of 11 children there is no mental defect, whereas from the second w^ife, who was feeble-minded, there are no known normal children. CHART 96 \k 6 6-r^«'"-'»! I iSx I S%rTj ^ Bhr:PO©©®B©©0O©&f® T MAR> □ bennIe q. N) [5e[n][n][n] ©(N)[t](N) ©©5 CASE 99. BENNIE Q. 14 years old. Mentality 6. Exact birthplace and that of his parents unknown — probably America. Has had measles, scarlet fever and eczema. He has been in the Institution 7 years. When he came his head was noticeably large. He was of uncertain gait, excitable, laughed without cause ; strayed from home ; was obstinate but affectionate ; fond of children and play. The following year it HEREDITARY GROUP. MENTALITY 6 213 was reported that he would improve steadily under instruction. This, however, has not proved to be the case to any great extent. He is still in the kindergarten, partly because he is small of stature and seems more Uke a kindergarten child ; does practically nothing in book work, very Kttle in hammered brass or basketry ; seems to try, but has very poor memory ; does not progress. He cannot copy either the square or the diamond ; can do the three errands, but does not know his right hand and left ear. He recognizes colors, sees the lack in the unfinished pictures, describes pictures, but cannot count 13 pennies, cannot repeat five figures ; has only 2% vision in each eye. His hearing is about normal. Asked to write his name, he makes nothing but scribbles ; is full of mischief and is always getting into trouble ; is a great talker, but his speech is very thick and indistinct ; is cheerful, quarrelsome, stubborn, active, not always obedient, restless, affectionate, excitable, quick-tempered, destructive ; has had adenoids removed, but it did not seem to improve him. In standing height, he is equal to less than 10% of normal boys of his age ; in weight, about 35%. Will-power, as shown by the dynamometer, is much below normal. Both parents are probably defective. The only doubt Hes in the fact that the mother was a prostitute, and so there is some uncertainty as to who was the father. It is generally supposed, however, that he is a certain person who is known to be defective. The mother has two sisters and a brother feeble-minded, and one sister and brother are sexually immoral. There are two brothers and a sister who are normal, and have normal children. The rest of the family, including two sets of twins, died in infancy. The oldest brother married a normal woman and they had four children, two of whom are normal and two died in infancy. The maternal grandfather's family seems to have been perfectly nor- mal. The maternal grandmother was feeble-minded and had chil- dren by two other men, one of whom was feeble-minded. By one 214 FEEBLE-MINDEDNESS of these she had a daughter who was feeble-minded and she in turn had three children, one of whom is feeble-minded and an- other died in infancy. The maternal great-grandmother was also immoral and feeble-minded. This is a charity case ; the mother herself was placed out by a Home Finding Society, and when this child was born, there was considerable uncertainty as to his parentage. He has been placed in the Institution and is provided for by a Charitable Organization. CHART 100 fOUK CENEXATIONS OF NOUUL FEOPLe oiemn) EIt® CASE 100. WARREN Q. 24 years old. Mentality 6. Has been here 7 years. American born, of American parents. Had whooping-cough at the age of four and measles at seven. Assigned cause of the defect, " serious fall of the mother." Warren was about eighteen years old when admitted. He began to talk at the age of five ; did not understand a command ; did not talk plainly ; had no knowledge of form ; memory poor ; attention fair ; was inclined to stay away from home ; was heed- less of danger. He had been in pubHc school a little, but knew no letters ; counted only to ten ; could not add ; had sold papers for CASE 99, BENNIE Q., AGE 14. MENTALLY 6. CASE 100, WARREN Q, AGE 24. MENTALLY 6. CASE 101, WILFRED Q., AGE 26. MENTALLY 6. HEREDITARY GROUP. MENTALITY 6 215 six years. Whether Warren was unusually incapable of learn- ing because of an exceptionally bad memory, or whether he was too old when he came to us, we do not know, but nothing could be done with him in the School Department, and he has never been able to learn to do anything more than the coarsest kind of work in the house or with the mason. He is rather pleasant, easily managed, with all the characteristics of children of his age, likely to be quarrelsome and stubborn, although generally willing, cannot be reHed upon, and he persists in taking things that do not belong to him. His Wassermann reaction is positive. The family chart is exceedingly interesting. It shows at a glance the strong hereditary taint and also the very low grade of morahty which characterizes the family in later generations. It is interesting to note that the paternal grandfather, whom we have called Nick on the chart, is of good family, although he himself was totally different from the rest. He was weak in every way, and by all our criteria to be considered feeble- minded. He married into a family that was much lower socially than his own, although we have no proof that it was a defective family. The children of this couple were all mentally defective and low grade, morally as well as intellectually. This is of interest because of the possibility that we have here an in- stance of the beginning of a feeble-minded strain. If Nick him- self was feeble-minded, as we now think, then it would seem to be a sporadic case, as his ancestors were normal and moral. The children of Nick all married into bad families and so brought in more defect. Warren's father Jake, a thoroughly disgraceful character, married Sal, a woman somewhat older than he, who was very religious at times ; and it is interesting that this religiosity has appeared in several members of this family. Unfortunately for any scientific determinations in this case, the doubtful ones are in such remote generations that we are unable to follow them with any degree of accuracy. 2 1 6 FEEBLE-MINDEDNESS The immorality of this family beggars description. The girl named Moll on the chart, was fifteen years old when Jake brought her into his home ; his wife, Sal, was so feeble-minded that she allowed the illicit relations between these two. Moll's child was born in the Hospital after the mother had been sent away from one Home because of her horrible syphilitic condition — from which she finally died. Our boy Warren's sister Liz, with whom the father lived in incestuous relations, was also allowed to Kve ilHcitly with a man who worked for her father. She was so simple that she talked openly about her relations with her father and with this man. When a child was to be born the man married her. At times this man gets religious and will get down on the street and pray and at other times he is correspondingly profane. This is not all, but it is enough ; and sufficient to show what feeble-mindedness leads to when it takes the direction of sexual abuses. We have marked a number of individuals here ques- tionable because we did not have any objective evidence to prove that they were either normal or defective, but one can reason in many cases that, in all probabiHty, they were mentally defective. For example, Jake's brother who married the feeble-minded woman, had a daughter that is marked questionable. Both parents being feeble-minded, that daughter also was undoubt- edly feeble-minded. Also Jake's sister married a man whom we have called Mose ; one of their children was certainly feeble- minded and the probabiHties are great that the others are like- wise and that Mose himself was defective. Again to go back to old Nick, since he had six children all defective, it is highly probable that his wife Nan was also defective, and perhaps her whole family likewise. The chart also illustrates how a good family may be closely related to one of the blackest kind. Sal's father was feeble- minded but he had a brother who was normal. That man married a normal woman and started a normal line which is HEREDITARY GROUP. MENT.\LITY 6 217 thoroly respectable and a well-known family in their commu- nity. CHART 101 65'^^Vr<^ D O ELATED TO '' ^"^ "^ T T ''' I \S£ia PARALYSIS 2«.iNr. lU i | tELATED TO ''I I ^"^ ^^" T AS£U PARJLYSIS 2-'iNr ^I'u^^ /^^ 2^ d. WILFRED la/ BRIGHTEST ^ 19' OF THE LOT ^ .4J V^BROWNED •CHART 102 a JENNIE SEE Ut SECTION 3 N N iSf^lS^^T) ^^P "SLOW, ^^KNOWn S^SdSWS Bi CASE 102. GRANT T. 37 years old. Mentality 6. Has been here 19 years. American born, of American parents. Had whooping-cough. At the age of twenty-two years Grant could print, A, P, and B. He knew ''A" when he saw it; has partial hemiplegia on the right side so that he does not walk well, but he is a rather agreeable, pleasant fellow, talks freely and is trained to do simple work; sweeps, scrubs, washes dishes; does good work in the laundry. Grant is the second child in a family of six. Three died in HEREDITARY GROUP. MENTALITY 6 219 infancy ; one was drowned at the age of nine ; one is married. There seems to be nothing wrong with the father's family. The mother was feeble-minded and had a feeble-minded sister ; also three brothers, condition unknown. The defect breaks out again in the descendants of the maternal grandfather's sister. She had two feeble-minded children ; four others are undeter- mined. In still another branch, the maternal grandmother had a feeble-minded brother who was also sexually immoral, spoken of as a "good-for-naught." He had five children, one of whom was normal, two died in infancy, one was feeble-minded, another one, undetermined, married twice, her first husband giving her a feeble-minded child. The normal son of the old man had eight children, one of whom died in infancy, four were normal and three were feeble-minded. CASE 103. HARMON T. 22 years old. Mentality 6. Has been here 7 years. Harmon is part colored and part Indian. Colored children are no longer taken at the Training School but in the early days a few were accepted and he was one. He chart 103 did not talk plainly : dragged himself along Q but became a fair worker in the laundry and *^ndun with the donkey team ; was cheerful, truth- J_^ ful, good-tempered and obedient. Harmon Q 1 « (p came to the Training School from one of the not the sa«e O FATHERS County Almshouses of New Jersey. His I mother was an Indian belonging to the ^ Q Ashpeelot tribe. She was married to a I colored man and was known as ''Indian '^*'"' Lib." She was trifling in character, drank, stole, was immoral, had spells of being peculiar and was generally disreputable, although she had some good quahties. She washed for Dr. Blank and gave her daughter, a feeble-minded girl, to Mrs. Blank to raise. The daughter lived there several years, 220 FEEBLE-MINDEDNESS off and on, and was deeply attached to them — called Mrs. Blank " mommy Blank " and once ran away from her grand- mother's home and finally reached the Blank residence. The family was startled by a furious pounding on the front door and found her in a frightful condition, her clothes torn nearly off and she seemed quite wild. She stayed with them for some time after that, but her father took her away again. He was not kind to her altho he wanted to keep her at home. She is markedly defective but is a very fair worker. "Indian Lib'' had a sister, or half sister, who was also defective. They were the children of a woman who was said to be a full blooded Indian. CASE 104. HARRY T. 20 years old. Mentality 6. Has been here 10 years. American born, of American parentage. Condition attributed to a fall at the age of 14 months. He had chicken-pox at the age of three years, mumps at five, whooping-cough at seven, measles at ten. Upon admission at the age of ten, he talked indistinctly, could not dress nor undress himself, was cheerful, active, affectionate, truthful, excitable, quick-tempered. He has never been able to do any school work except the most elementary kindergarten, nor has he been trained to very much industrial work. He works D D // fD" CHART 104 SECTION i 6^T^ FOR DESCENDANTS SEE SECTION 2 r 1^ ^f TONARRY Ml I 6 ©©h6©(n HEREDITARY GROUP. MENTALITY 6 221 6b CHART 104 SECTION t A u d-r- -^^^^fo^ cKSroS^f^ [5^WWS^K-<^S55 k -@ N EF F Isaac's mother had four brothers, one of whom was feeble- minded and the rest undetermined. One of them at least had a feeble-minded child. Of the grandparents on this side, the grandfather was normal and the grandmother feeble-minded. This grandmother had an illegitimate child who was feeble- minded and was the mother of the child in Case 30. CASE 108. KARL AND PAULINA C. Karl 21 years old. Mentality 3. Has been here 12 years. Paulina 19 years old. Mentality 5. Has been here 10 years. American born; father Russian, mother American. Pauhna had measles at the age of two. Neither of these children has been able to learn anything of the three R's. The boy is good-natured and obedient, can do spool knitting and can also knit skating caps nicely; does nothing in woodwork; can group pegs in twos; has worked in the various shops and departments; with the mason and in the barn; at present helps in the children's Q 226 FEEBLE-MINDEDNESS dining room; cannot scrub floors well, nor wash dishes, but sets the table. His sister does a little better. She can crochet and do some basket work; does very poorly at woodwork but her sewing is better and she is even learning to use the machine. She does fair housework about the cottage. One glance at the family chart shows the hereditary character of the defect and that it is of rather low grade. The paternal grandmother left her husband, after they had been married a year, because she discovered that he was defective. Their daughter, the mother of our children, is an imbecile. She was married CHART 108 N>-Vd (Sy irr HUSBAND \ L^ \2HO HUSBAND \l.» HUSBAND \ ^ B N N Mi's N)(N)CNXN)fN)(N^ iSis^Ti KARL PAUUNA C k k mM M off in the hope of improving her condition ; naturally she married a feeble-minded man with the result as shown in their children. It is noticeable that the grandmother alluded to, after leaving the defective husband, married a second man who was apparently normal and they have, so far as can be learned, only normal children and grandchildren. CASE 109. MINNIE AND FANNY C. (sisters). American born, of American parentage. Minnie 14 years old. Mentality 5. Has been here 5 years. Had convulsions at the age of 3, epilepsy at 6, measles at 8. Fanny 9 years old. MentaHty 3. Has been here 3 years. Had con- vulsion at one year ; has had acute dropsy. CASE 105, HARRY W., AGE 17. MENTALLY 6. CASE 109, FANNY C, AGE 9. MENTALLY 3. CASE 109, MINNIE C, AGE 14. MENTALLY 5. HEREDITARY GROUP. MENTALITY 5 227 These are pretty and attractive children but of low mentality. Minnie has probably reached her limit of development. She does almost nothing in the kindergarten or in any school work ; she is learning to do simple housework and is making quite marked improvement there and will perhaps make a useful little Institution helper. Fanny, the younger sister, will quite possibly make consider- able advancement before she finally ceases to develop. She is improving physically and this has a certain reaction upon her mental response to her environment. She did not walk until she CHART 109 lu €) & SPEECH DETECT <2) ' /res. SPEECH I / I \V DEFECT \ o ckr^'^^ 4©K) 1S0S& <^hS3) m CASE III. NANCY I. 22 years old. Mentality 5. Has been here 10 years. American born, of American parents. Had whooping-cough at one year, cerebro-spinal meningitis at two, chicken-pox at four, mumps at eight. Nancy is a typical imbecile of the middle grade, speaks very poorly, is hard to understand ; can do nothing in kindergarten, has made a little attempt at crocheting and basketry and does something in woodwork but with no permanent success ; ac- complishes nothing whatever with English lessons ; is at present working in the cottage and laundry and is fairly helpful. 230 FEEBLE-MINDEDNESS Nancy belongs to a family of morons ; it has been difficult to find a normal person among those that we have studied. The hereditary character of the defect is certainly clear. CASE 112. URIAH N. 1 8 years old. Mentality 5. Been here 9 years. American born; father Swiss, mother American. Assigned cause of the condidon, " frightened by dull nippers at the time of his first hair cut." The child had measles at the age of four years. Uriah is a cousin of Frank in Case 145 ; is a much higher grade of mentahty but is not nearly so intelligent in appearance. At the time of admission, at the age of eight, he could not dress him- self, had never been to school ; was excitable, rude, laughed with- out cause ; could carry in coal and wood. Under training he improved greatly and learned to do simple kindergarten work ; could not get beyond that, except a little basketry and knitting and some woodwork. Was finally taken out of the school de- partment on account of nervousness. Is doing good housework and errands; is cheerful, active and obedient, affectionate, somewhat destructive to clothing, somewhat defective in speech. His heredity chart is given under Case 145. Uriah is the third born; two older sisters are feeble-minded, two younger brothers undetermined ; the latter appear normal — more than that we cannot say. Uriah's father is normal and of normal parentage ; the mother is a sister of Frank's mother described on page 261. CASE 113. JERRY T. 46 years old. Mentality 5. Has been here 21 years. American born, of Irish parents. Has had measles and whoop- ing-cough. This is a middle grade imbecile who has the appearance of an old man. He is prematurely old. He is a httle helpful around the cottage, dressing the boys and doing simple errands around the house. He is sometimes troublesome and quarrelsome, at other times rather pleasant and good natured. One of his CASE 111, NANCY I., AGE 22. MENTALLY 5. CASE 113, JERRY T., AGE 46. MENTALLY 5. CASE 116, NORMAN D., AGE 9. MENTALLY 4. HEREDITARY GROUP. MENTALITY 5 231 chief occupations is playing horse. He is very typical for his grade. He is one of ten children, three were stillborn, at least one other is feeble-minded and the mother was feeble-minded. It CHART 113 d^n-pe that makes parents, teachers and others unfamihar with defectives hold on to the hope as long as possible that they will "come out all right." However, there is no longer any hope for either of these children. The older one tests only four, and the younger only one. They have made no appreciable improvement in mentality in five years. The older one has learned to do a few things. Other things she seems to have forgotten. She has, for instance, learned to iron A D CHART 118 o D O D (Jm JBT \ NOT MARRIED r-j I ^^^ \ MAY NOT ALL BE THE CHILDREN OF THE HUSBAWP I N 2N , >& 3U 2U / -— -_ PROSTITUTE «,r«rn.n»pn ^^ PROSTITUTE d B WAS COLORED ^ aBl (2)(b(b lUeaiTIMATC CASE 119. DELIA I. 25 years old. Mentality 4. Has been here 18 years. American born; father of unknown nationality, mother American. Had measles and chicken-pox at the age of four. DeHa is a low grade girl and has the usual history of a child of her grade. Upon admission at the age of six there was noth- ing remarkably peculiar about her; her speech was defective, memory fair. She could not dress nor undress herself ; did not know the alphabet ; was fond of music. She was placed in the kindergarten and did the simple exercises well ; gradually how- ever, she fell behind the class and at first it was said ''oftentimes pretended she did not know when she probably did." Not until she was twelve was it reported that she could dress and un- dress herself ; was very nervous, would sing with others but not alone ; could count to eight at that time. Since then there has been very Httle change. She gradually gave up the book work and was put to industrial work where she has learned to make beds nicely and to help in the general house- work. Her chief characteristic is talking, of which she does a great deal, mostly very simple and fooHsh. She is said to have CASE 118, MOLLIE I., AGE 10. MENTALLY 1. CASE 119, DELIA L, AGE 25. MENTALLY 4. CASE 120, CHARLIE M., AGE 26. MENTALLY 4. HEREDITARY GROUP. MENTALITY 4 237 gotten very silly, on one occasion, over a young lady visitor who admired her curls. She is cheerful, affectionate and good- tempered ; is truthful and obedient. She is small of stature, being as tall and heavy as about ten per cent of normal children of her age. Sometimes it takes her a minute and a half to do the form board, making many absurd mistakes with some of the blocks while other blocks are put in their proper places promptly. Her family chart shows unmistakably the hereditary character of her defect and also the very low grade character of the various individuals. Delia's mother is in an Institution for the feeble-minded and the mother's sister is the keeper of a disreputable house in a New Jersey town ; she passes for a normal woman ; she has an illegitimate daughter who was married at eighteen to a man who had no occupation. This daughter has had two miscarriages and was operated on for a "loathsome disease." She is now divorced but the man still calls upon her. Her mother tells, with much pride, that the daughter has two chances as soon as the divorce papers are signed, and she is now engaged to one of the two men. She is an energetic woman and her home is clean and neat. An uncle of the mother died in the Trenton Insane Hospital ; a cousin of the mother, a woman, is sexually immoral and criminalistic, and is in an Institution at state expense. The following taken from a Newark daily paper relates to another cousin of Delia's mother; whether such a girl can be called feeble-minded may reasonably be questioned, but some- thing is surely wrong with her development and she belongs to a family where there is much defectiveness. "Miss and Miss of this city, who have been missing from their homes for the past three weeks, were found on Wednesday night in a cheap dance hall, on W Street, Newark. " On being arraigned, they admitted that they had given wrong names. They then gave their correct names, but said that their parents knew they were in Newark. 238 FEEBLE-MINDEDNESS '' This was untrue, as the parents of both girls have been search- ing for them since they ran away from home three weeks ago. Their disappearance was reported to the local poHce. "Both girls are well educated. Miss is a graduate of W Business College, and is an expert driver of automobiles." CHART 120 4.4Wo ^xfi, N]66i^ CASE 120. CHARLIE M. 26 years old. JNIentality 4. Has been here 14 years. Born in England; father German, mother Polish. Had whooping- cough at the age of 4 and scarlet fever and measles at 8 ; has brachy- dactylism, web feet and hands. This is a dwarf of low mentality ; could not talk until he was seven ; never has been able to do much school work, is not clean, eats with his lingers, can- not dress himself. In the school department, he learned to put pegs in the board, learned some colors and could count to 10. He is now somewhat helpful in the cottage in dressing the other boys and helping with the beds. One leg has been amputated, but, with the aid of a crutch, he gets around surprisingly well on the one that is left. He is cheerful, though cranky, quarrelsome and stubborn ; sometimes destructive of clothing and mischievous. His mem- ory is poor. This case is a striking example showing how our immigration laws have failed to protect us. Here are two feeble-minded parents who should never have been allowed to land in this country. They, with their children, have given us five, probably six, defective persons to take care of. It is true this was some years ago and our facihties for detecting such cases were not as good as now. This boy in particular would to-day be held up HEREDITARY GROUP. MENTALITY 4 239 because of his physical stature, but the parents would probably get by, as they did when they came. Such cases will continue to enter our country until Congress provides the means for expert examiners and testers for these high grade mental defectives. This is also an illustration of the way in which consanguinity produces defectives. The parents were first cousins, but they were also feeble-minded. Feeble-mindedness of the children has therefore no necessary connection with the relationship of the parents. CHART 121 I '1 i«T WIFE 2N0 Wire ' NORHAN T. 1 INCORKICIBLE I o ILLECITIfclATE CASE 121. NORMAN T. 21 years old. Mentality 4. Has been here 7 years. American born, of American parents. Had measles at the age of seven, whooping-cough at eight. Assigned cause of the condition, " too strong medicine given for peculiar crying spells." This is an ordinary type of imbecility. Norman had been in public school before coming here ; never achieved anything with the three R's; speech imperfect, had no knowledge of color or form. Can do only the simplest or roughest work ; can use a saw and plane ; can knit a little but very poorly. The family history is unequivocal on the question of the heredity of the feeble-mindedness. The father was defective and probably syphilitic, according to the testimony of the phy- sician ; the mother was ''bad" and evidently belonged to a de- fective family, since her sister, altho she married a normal man, bore five feeble-minded sons. One of Norman's sisters was in- corrigible in school. 240 FEEBLE-IVaNDEDNESS CASE 122. KARL V. 17 years old. Mentality 4. Has been here 6 years. American born, of American parents. Had convulsions at five months, measles at three years, diphtheria at eight years, whooping-cough at nine, Karl is a low grade imbecile, talks indistinctly but much; understands a command, has learned to count to ten with help ; can write neatly from copy ; did a little woodwork at one time ; always cheerful /// ■ o and helpful. He is a good boy but requires watching; is contented and happy but in- clined to be sly ; does no work of any conse- quence ; can scrub or rub things a little if constantly watched and kept at it ; does not care much for his parents ; has bad habits. The hereditary factor is clearly evident in the family chart. An older sister was considered normal but ran away from home to be married. A younger sister is defective ; a younger brother is reported normal. ^"^ KARL V 2 2 NOS. MENINGITIS hS) CASE 123. FANNIE C. 14 years old. MentaUty 3. Has been here 6 years. American born, of German parentage. The child had convul- sions at three weeks. Her defect showed at one year. Assigned cause, consanguinity of the parents. She is a very low grade child with probably physical difficulties added to the mental ; can dress and undress herself with help ; understands simple commands ; is quite cheerful and affection- ate, but restless ; very destructive and nervous. In kindergarten can do nothing more than string a few beads. Does not seem HEREDITARY GROUP. MENTALITY 3 241 to be making any progress and it is not likely that she will improve. The father is feeble-minded and had two normal brothers and a normal sister. Their father was normal and the mother tuberculous. The mother had a feeble-minded half brother and CHART 123 C^^l^ (55^SqWS'6^4k§WSS0S H©0 two sisters that were tuberculous. One of these sisters was the grandmother of our Fannie, thus making Fannie's parents cousins. The mother of Fannie is normal and has five normal brothers and sisters. One of these married and had two children, one of whom is normal and the other undetermined. CASE 124. MOLLIE E. 16 years old. Mentality 3. Has been here 10 years. American born, of American parents. Child had measles at five years ; has had rickets. MolHe is a low grade imbecile, varies very little, is sometimes hard to manage ; is cheerful, affectionate, excitable, quick-tem- pered. She is untrainable except in a few simple matters, tries to help a httle but cannot do anything significant. MolHe belongs to a notorious tribe of defectives and degener- ates, a full history of which will be pubUshed later. 242 FEEBLE-MINDEDNESS CHART 124 RADIOSIBS 2 AT LEAST BEING FEEBLE MINDED AND A HOST OF F. H. DESCENDANTS ■^^ MnnnN 7 i We give here something of the immediate family to show its generally defective character. CHART 125 D O O ^^ d ^^^ IN CALIFORNIA ^ ^^ ■ELUEEi iSm'^ lUXCITIMATC CASE 140. NELLIE E. 24 years old. Mentality 2. Has been here 17 years. American born, of American parentage. She is epileptic, con- vulsions beginning at three months; had whooping-cough at the age of four years. This is a very low grade child, has almost no intelligence, does not know candy from wood, is very bad tempered and quarrel- some, although sometimes affectionate ; cries a great deal. Upon one occasion when it was necessary for her to have some teeth extracted she had a bad brain storm from which she was very slow to recover. She is inclined to fight, pinch and scratch the other children, has to be watched very carefully. Her family chart shows the hereditary character of the defect. This is a part of the large family of defectives and degenerates referred to in Case 64. The extra seriousness of Nellie's defect, the grade of idiocy, may be the result of the epilepsy, which is possibly due to a severe fall that she had when very young. There seems to be no evidence that the epilepsy itself is hereditary in her case. 25^ FEEBLE-MINDEDNESS CHART 141 (5>T-lf&-rO cH3i&-r-® (§0© c5h-4-o 1^ d DRUCFIENI* ^—^ ^^ ^^ 2NO HUsaANo irr ^,|N][N](^(N)Ul(i) (i) irr HUSBAND o a CASE 141. NORA E. 13 years old. Mentality 2. Has been here 7 years. American born, of American parents. This is a very low grade case ; is congenitally deaf ; eats gar- bage ; does not sleep well ; will play with blocks alone for a long time ; is cheerful but quick tempered ; has bad habits ; walks badly; can undress herself, but usually will not; sometimes shows some slight intelligence by taking another girl by the hand and leading her into line to march out to the hall ; will get into the bathtub with her clothes on and turn on the water full force, whenever she gets a chance. Nora has three sibs defective, and one undetermined. The father is feeble-minded, but seems to be the only one of his family that is defective, altho there is some alcoholism in the family. The mother is feeble-minded, as was her father and her father's uncle. Otherwise, we have not been able to discover any defect except that the mother had a brother who was epileptic. CASE 142. NANCY F. 21 years old. Mentality 2. Has been here 15 years. American born; father French, mother German. Has had spasms. Nancy is of the idiot grade, has a small head ; walks badly ; does not speak ; is excitable and nervous ; laughs without cause ; is unclean. CASE 140, NELLIE E., AGE 24. MENTALLY 2. CASE 141, NORA E., AGE 13. MENTALLY 2. CASE 142, NANCY F., AGE 21. MENTALLY 2. (lower left) CASE 150, IZZY P., AGE 12. MENTALLY 2. (lower right) HEREDITARY GROUP. MENTALITY 2 CHART 142 259 D O D O T TMfr^T T »«"-'■- T TT I T CH CH nOTHER-S * 10 f I | N i KANpiF. BABY The cause of Nancy's condition is perfectly clear after a glance at the family chart. She has three sisters and one brother feeble-minded and one sister and two brothers died in infancy. A younger sister is undetermined, being only an infant as yet. The father is dis- tinctly alcoholic but whether feeble-minded or not has not been determined. CHART 143 Or© Q^ IN GERMANY (£)ltl[-]|^ '"r"" (N)(N)[^(t) db^N) HUSBAND m CASE 143. GERTIE H. i6 years old. Mentality 2. Has been here 6 years. American born ; father Russian, mother American. Had diphtheria at the age of four years. Gertie is a helpless idiot, walks, eats and sleeps ; does nothing else. The father and mother are cousins ; the father is defec- tive but the mother seems to be normal. 26o FEEBLE-MINDEDNESS CASE 144. EVA I. 18 years old. Mentality 2. Has been here 11 years. American born, of German parentage. Had typhoid fever at the age of six years. Supposed cause of the condition, " fright of the mother and congenital tendencies," also " typhoid fever." Eva belongs to the excitable idiot group, is untrainable except in some of the simplest habits, is very nervous, moves oddly, cannot feed herself, speaks very little and very imperfectly ; is very fond of music and tries to hum a tune ; is very gluttonous CHART 144 IV m r MIGRAINE <• <"• •' 3» |^ T A^TaiaLLED m [n] [N][^i(N)li[N][Nli (n)[n] CASE 153. GEOFFREY T. 21 years old. Mentality 2. Has been here 6 years. American born, of American parentage. Condition said to be congenital. The child has had measles, whooping-cough, cerebro-spinal meningitis, sore ears. This is a low grade case and might possibly be attributed to the meningitis, but the family records show that the defect appeared before this illness. The mother has migraine. Geof- 270 FEEBLE-MINDEDNESS frey does not talk and his hearing is defective. He is sober, silent, stubborn, quiet, excitable, forgetful. He has no work- ing schedule and does practically nothing. The heredity in this case may be considered somewhat doubtful altho the father seems to be distinctly feeble-minded, while the mother is normal. Unfortunately we cannot deter- mine the father's parentage. His father died of asthma at seventy-five and his mother of diabetes at sixty-four, but their mentality could not be learned. The whole family, on both sides, is of rather low intelligence. It is not possible to say that they are distinctly feeble-minded and consequently the case rests on the one transmission. CHART 154 Q O QrrQ ^33rr(SWo&^^&T~^^ CIPri« CRIPPLE dja CRIPPLE ^"^ CRIPPLE CANCER i j* I | J)E,UA T. CASE 154. DELIA T. 16 years old. Mentality 2. Has been here 9 years. American born, of American parents. Has had spasms ; measles and whooping-cough at the age of two ; pneumonia at six months ; has had adenoids removed. Delia is a very low grade child ; has never been able to do anything but the simplest kind of work; does not talk, eats naturally, sleeps well, pays no attention to other children ; has very unclean habits. The family chart shows a great deal of defect both physical HEREDITARY GROUP. MENTALITY 2 271 and mental. The father was a cripple and had stigmata of degeneration in the shape of club feet and hands. There is also insanity in this family, on both sides. CHART 155 0- ^3^ 3^ 2 isi «l.87 a » I — — IRELAND IRELAND \. OTHER 2 I \tAj UPTON T. CASE 155. UPTON T. 13 years old. Mentality 2. Has been here 7 years. American born, of American parents. Instruments were used at birth ; child had convulsions at five weeks ; spasms from three years on ; measles at six months ; meningitis at seventeen months ; has had whooping- cough and paralysis. Meningitis is supposed to be the cause of the defect. Upton was an eight months child ; labor very difficult. He is a low grade, untrainable child, quarrelsome, stubborn, ac- tive, restless, excitable, quick-tempered and destructive. Upton's condition could undoubtedly have been caused by the meningitis since that is recognized as an adequate cause of feeble- mindedness, and it has probably had much to do with his low grade condition. It is interesting to note, however, that the father was alcohoHc and possibly feeble-minded also ; he is stub- born, quarrelsome, and cannot keep a job. Furthermore he had a brother who had two feeble-minded children. We know nothing of the mother of these two children, however, and so while probable, it is not sure that there is feeble-minded- ness in the family of our boy's father. On the mother's side nothing can be learned of the relatives. A younger brother of 272 FEEBLE-MINDEDNESS Upton is still doubtful. A later conception resulted in a mis- carriage. It is said that the mother used drugs for the purpose of bringing about this result. CHART 156 4 DAUGHTERS SEXUAL NEUROTICS (n)(n) [n] d— i—(S i3 \k (n) s [n] cTS rsMT^(S^ CASE 156. DANIEL U. 14 years old. Mentality 2. Has been here 4 years. American -born, of American parents. Assigned cause, an attack of acute indigestion. He had spasms at twenty-six months and whooping-cough at the age of three years. This is another case belonging to the idiot group and nothing can be done in the way of training except to make him happy. He has learned to smile and likes to look at pictures. Has learned to dress and undress himself and probably understands a com- mand as he sometimes obeys. The chart shows the undoubted hereditary taint and is inter- esting in other ways. We have here another example of a feeble- minded woman with an alcoholic husband, the result being feeble- minded children and children dying young. The mother in this case was also alcoholic. Her family possibly illustrates the other side of the picture. The father was normal, the mother is said to have had insane fits, may have been feeble-minded as she had a brother who was mentally defective. In this case we would have an instance of a feeble-minded woman with a normal husband, not alcoholic. HEREDITARY GROUP. MENTALITY i 273 They had three normal children, one feeble-minded — the mother of our boy, — another one that was alcoholic and one that died in infancy at the age of ten months with abscess on head. Many persons in this family, in different generations, are spoken of as having violent tempers and being queer. CASE 157. MORRIS W. 32 years old. Mentality 2. Has been here 18 years. American born, of German parents. Had measles at four years ; has had marasmus and had spasms at sixteen years. Morris is a typical excitable idiot; does a little kitchen and dormitory work, scrubs Hke a small child ; is sober, silent, stub- born. The family history is incomplete and unsatisfactory, but it would appear that there must be an hereditary taint since three other children are defective. We have also in this family j — -1 another case of twins where D — i — (n) one is defective and the other probably normal. The defect may have come thru the mother, who was seen by the k field worker and considered probably normal, altho there was some doubt. Of the father, nothing could be learned and it is possible that he may be the one who is defective. CASE 158. CLAUDE D. 16 years old. MentaHty i. Has been here 9 years. American born, of American parents. Had spasms and whooping- cough at four years. Assigned cause, " a fall out of bed." Claude is of the very lowest grade and is also an epileptic. He does not feed himself ; hardly knows enough to swallow ; does not talk ; walks but timidly. There seems to be no doubt of the hereditary character of the defect, since a brother and sister are also defective but not epi- r J>"l>tK^ <^6 274 FEEBLE-MINDEDNESS leptic. The parents were normal but the mother had a brother who was feeble-minded and epileptic so that it is possible that the epilepsy may be "in the blood." The father was immoral. His father was supposed to be normal but was shot as a deserter in the army. One cannot say that it is indicative of feeble-mindedness to become a deserter from the CHART 158 IM- |-i-^(n)(n)In1 EhrKN) U ^"^ ^"^ J^ KILLED m i. 70. XTE> I ACCIDENT Jsx V JL JL JL 1 J::;'"*jL [n]--tH® (S> ® (K) (n) (n) BN IN I eN (§SSS~i'S5Sii^ army, or that if he had not been feeble-minded he would not have been caught ; but one who knows the moron boy, can very well believe that such might have been the case ; and it is not comfort- ing to think of the possibility of a feeble-minded boy being shot down in cold blood for doing what his low mentality dictated. CASE 159. CURTIS D. 31 years old. Mentality about i. Has been here 20 years. This is a case of the lowest type of idiocy, probably due to some extraneous cause acting upon an already defective stock. In a word, the child would have been feeble-minded anyway, but something happened to lower the level to that of idiocy. As usual there is no change in such cases. This boy has remained the same for the twenty years that he has been here. Both parents are feeble-minded. They had five children of whom two died in infancy. The two brothers Hving are feeble- minded but of higher grade. The father was one of a family of nine, none of whom could be determined as to their mentahty, HEREDITARY GROUP. MENTALITY i 275 but two were alcoholic and one was sexually immoral and crim- inalistic. One sister was sexually immoral and had at least two feeble-minded children. Another brother had four children, all of whom were feeble-minded and the two girls were immoral. Curtis's father and mother were cousins. The mother was one of a family of nine, of whom four brothers were feeble-minded. CHART 159 sx r ALMSHOUSE o (i)(fa^ii^"ffiS¥i! « 4 2 2 Two died in infancy and two sisters are undetermined. One of the brothers married a feeble-minded woman, had five chil- dren, four of whom were certainly feeble-minded and one of these had two feeble-minded children. Two uncles of the mother were feeble-minded and one of them had a feeble-minded child. There are many others in the family whose condition could not be determined, but enough is here shown to indicate that it is a very defective and bad family. There are alcohoHsm, immo- rality and criminalistic tendencies. CASE 160. DOROTHY E. 20 years old. Mentality i. Has been here 5 years. American born; father German, mother American. Had epi- leptic attacks at three years ; had Saint Vitus' Dance and measles at the age of ten years. The assigned cause is " brain trouble after cutting her teeth." Dorothy is a typical idiot of the lowest grade ; walks, but does not talk nor have any intelligent life ; will swing in the hammock 276 FEEBLE-MINDEDNESS by the hour; bangs her head and bites herself a great deal. She is abnormally small. It is clearly a defective family. Very little could be deter- mined, but a younger sister is defective altho of higher grade ; a brother died in infancy and another sister died at three years. The mother is feeble-minded and a cripple; her two brothers, twins, are also defective. They both have children. CHART 160 D-rO D O [^-p© a-r<5S5©S^^]-n^f^ [5d& Of those of the elder, one is feeble-minded and the other is back- ward, very probably feeble-minded. The father of Dorothy is alcoholic and tuberculous. The maternal grandparents are both feeble-minded. The question arises in all of these cases of low-grade children where the hereditary taint appears in the family, whether their condition is simply an exaggeration of the defect which exists in the family, or whether they are cases of heredity plus injury in some form. That cannot, of course, generally be determined. The fact that there is a younger sister here who is defective, but a high grade case, seems to point to the latter as the true expla- nation. Such cases show us that we need much more study of this problem. CASE 161. BERTIE N. 9 years old. Mentality i. Has been here 3 years. American born ; father American, mother Irish, Had meningitis at the age of two, is epileptic, has had measles and whooping-cough. HEREDITARY GROUP. MENTALITY i 277 This is a very low grade case, helpless and hopeless ; does not talk ; cannot do anything ; has made no improvement in three years. We have traced a large number of members of this family but got very little information of importance. There is very clearly hereditary epilepsy, as it has cropped out in at least four cases as shown on the chart. There is some Httle alcohoKsm CHART 161 D ^^ ^^ <184¥RS. fm n^ m) N [ni (n) E^ (N) (N) E lYRS §566^^ih^ ' iN][N](N) [iir-p^di ^ I r BYRON I (N) iSu5 those that are connected with insanity. The father's family seems good and the mother's parents were probably normal and her uncles and aunts were normal. The cousins so far as known are also normal altho many are undetermined. The mother has a sister who was epileptic. She married a normal man, how- ever, and there are no defectives among the descendants. The mother herself is insane. Her first attack occurred shortly after the birth of her child. She recovered from that, but at the birth of the second child, the same condition again resulted. When Byron was born, however, there was no insanity. Later it developed and she is now in the State Hospital. PROBABLY HEREDITARY. MENTALITY 7 297 CHART 178 Q-rO D-rO 515n~5~~& <^ Mr 6U • [S^ iri(N)(N).(N)[!]i(N)'ii[^(N)r ^^ NEURonc 2 i i y ^^ A (N)I^(N) able to account for his condition. Nevertheless there are other indications. The father's family as far as we know is thoroughly normal. The father himself was an able man. The mother is decidedly neurotic and very probably could be called feeble- minded. She has a brother who is alcoholic and probably also feeble-minded. Another brother is alcoholic. Their father died of " water on the brain." The mother died at the advanced age of 83. Her mind failed before death. A cousin of our boy's mother was insane. There was considerable tuberculosis also on her side. So that it is fairly clear that we have a morbid heredity, if not a distinctly feeble-minded ancestry. CASE 180. THEODORA X. 36 years old. Mentality 7. Has been here 22 years. American born, of American parentage. Assigned cause, " the father treated her brutal in infancy." SEPARATED CHART 180 I (2) '^"^J"'" \n\ □ (n) PROBABLY HEREDITARY. MENTALITY 6 299 Theodora is a high grade imbecile. When admitted at the age of 14, she had not learned to read nor write, but has learned since ; can now write a fair letter but makes Uttle use of her abihty in this direction. She is a very typical girl of her class, does well in housework, can do sewing and crocheting but cannot count the stitches. She is usually sober, quiet, affectionate, willing and tries, truthful, excitable and sensitive. Does not need close supervision, is easily managed when kindness is used; is a fine Institution worker; does dressmaking and pantry work; is very cleanly. Her father is feeble- minded, her mother is in an Insane Asylum. The mother has a family of five children by a normal man to whom she was not married. These children seem to be normal and their children normal ; more than this we have been unable to determine. It is, altogether, a poor ignorant family and there is some difficulty in telling where ignorance ends and feeble- mindedness might begin. « CHOLY •— • ^^ THEODORA X. ©(N)(N) (^ CASE 181. WARREN L. 34 years old. Mentality 6. Has been here 23 years. American born, of Irish parents. Cause of condition said to be scarlatina or diphtheria. Child had spasms at three years ; has had measles, whooping-cough and scarlet fever, and had diphtheria at five years. Warren was twelve when he came to The Training School; shuffled one foot ; mouth was usually open ; could dress him- self ; understood language but was not obedient ; speech was imperfect. He had not been to school for four years and so it was said he had forgotten much that he had learned. He could be managed by persuasion but was excitable and nervous. Two 300 FEEBLE-MINDEDNESS years later he had not improved much in school and did not like the boys. A year later the report is, — ''school progress not great." Four years after that, — "no school progress but a real help in laundry and cottage." He has for some years been an excellent helper in the Institution, especially in the laundry and cottage; takes care of small children nicely. CHART 181 I I PARALYSIS I liLiNr i'a I ^^ dT vN J WARREN Lrr *» HYDKOCEPHAUC ^"-^ L 65^ 66b APPARENTLY NORIUl. He is a typical simple-minded man such as is to be found in almost any community and, relatively low grade as he is, would not be thought of as feeble-minded by a great many people. It has been difhcult to get information in regard to his family and it will be seen from the chart that many persons are left unde- termined ; there is, however, enough to indicate that there must be defect in the blood. An older brother is distinctly feeble- minded and a cousin on the mother's side is also defective. This might indicate that the defect had come through the mother, altho that is of course undetermined. CASE 182. BENNY L. 42 years old. Mentality 5. Has been here 23 years. There has been very little change in him in all that time. He could not speak at all at four years of age. Has had smallpox. He speaks very indistinctly, can hardly be understood by a stranger ; helps in the garden, is a good worker, takes care of one horse ; does not any longer need close supervision ; is easily managed ; has a very low forehead and a small head. CASE 181, WARREN L., AGE 34. MENTALLY 6. CASE 182, BENNY L., AGE 42. MENTALLY 5. PAcp 183, MATTHEW N., AGE 28. MENTALLY 5. PROBABLY HEREDITARY. MENTALITY 5 301 The heredity chart is very incomplete. The father of Benny is feeble-minded. Nothing is known of his family except that his brother and the two children of this brother died of tubercu- losis. The mother is said to have a bad temper, is excitable but very ambitious. She is certainly not of high mentaHty but cannot be called feeble-minded altho she may be a border- CHART 182 T IIP (^66 -\ttc kJE-Dt/miO t ^-T^ ':^ NERVOUS NERVOUS. CASE 195. NATHAN H. 37 years old. Mentality 2. Has been here 20 years. American born, of American parents. Had usual children's diseases, whooping-cough, scarlet fever at two and a half, ulcerated stomach. Assigned cause of condition, " mother thrown from carriage." Nathan is a profound and unimprovable idiot. Could not speak, had bad convulsions when young. He was the j&rst of seven conceptions ; the mother had two miscarriages, one nor- mal, and three undetermined. The mother was sixteen and the father forty when married ; there is some probability that the father was feeble-minded since he had a feeble-minded daughter by another wife. He and two brothers suffered from *' sleeping paralysis." A sister of the mother had, by a second husband, at least one feeble-minded child, while only two of her large family are really normal. CASE 196. FRED N. 22 years old. Mentality 2. Has been here 6 years. American born, of American parents. Has had measles and whoop- ing-cough. The assigned cause of his condition is that he was very severely frightened at the age of three months by being held against a piece of fur. He is somewhat small of stature but about the average weight ; talks very little and only in monosyllables; does not do very much, and only the simplest sort of work; can partially dress himself ; at present works around the boiler house ; has very 314 FEEBLE-MINDEDNESS CHART 196 ^ bad moral habits, has long since nqi X rh/^ A reached his hmit cf development. ^ ^w Ygj.y ^^|-jg (,a.n be learned of his family as will be seen from the chart. His mother is feeble-minded ; but his father, altho evidently nor- mal in intelHgence, is an unhappy disgruntled person who seems to have a grudge against the world in general, and his relatives in particular, both his own and his wife's. ^ titi6ii © k n CHART 197 D -O Q HEART TROUBLE <»• « |N]ilN][N]i [Nl|i[t][t] (n)(n)(n)[n] (n)(^(n)[n1 r-rr "-r* ^"^ — "^ ^r:r.,-„c ^—^ ^— ' ^-^ tall delicate [n](n)[n] ALL DELICATE I III I A • ••••• (J CASE 199. DANIEL N. 39 years old. Mentality 11. Has been here 9 years. American born, of American parents. Assigned cause, " the presence of a feeble-minded servant in the family before he was born." Daniel was thirty years old before he entered the School ; he had been well trained and was a cheerful, good-tempered, sober, affectionate, truthful, honest boy. He is inclined to be a little morose ; is quiet and obedient, rather forgetful ; sometimes seems rather lazy, but on the whole is a good worker under direc- tion, somewhat inclined to be discontented. Had learned rather more school work than most boys of his type ; can read and write quite a Httle. The following letter, which is spelled correctly, and is fairly well punctuated and paragraphed, nevertheless shows the childish way of looking at things ; it was written in a bold, heavy boyish hand, perfectly characteristic of his mental age : NEUROPATHIC ANCESTRY. MENTALITY ii 319 March 7, 1909. Miss M : Now, for goodness sake, let me stay away from that party you talked about giving to the evening class boys, because I am so dead tired out nights from my day's work that I positively can not take any interest in it ; but, if you insist for me to come to it, for pity sake let me sit on my chair all evening from the beginning to the of the party as I am too tired out to take any part in any games that may be played that night. You told me how I dressed up last year — I did it far more for respect for Miss M (and Miss B if I went to her then) , than I did for you — you said I had a nice looking pair of shoes on — they are my best ones, and I wear them to evening class nights, because they are hghter weight than my working ones, and as for my suit of clothes, it is come to evening class with those clothes on, or in my overhalls and jumper on — the ones I work with. Sometimes Mr. M gives 2nd period evening class boys whistle signal instead of commands, and I would never know what was next if some person did not give the sign on the sly. So, whatever you do, for the land's sake, let me stay home from the evening class boys' party and I have told you why I want to stay away from it. Daniel N. P.S. — I forgot to tell you before . I signed my name to this note to you that I have party enough through the day and all I want of it too. j^^^j^j ^^ Daniel comes of a good family, intelligent and respected; there is no accepted cause for his condition. Both his father and mother died of apoplexy or paralysis, losing their minds towards the last. Moreover the father's father also died of paralysis. It is interesting to note that while there are four normal boys they were all born before Daniel and after him there were two who died in infancy of marasmus. 320 FEEBLE-MINDEDNESS CHART 200 d- o PARALYSI d. d. d. fi-r^ ALL UVING ALL HAVE HEART TROUBLE } LEFT EYE RICIBLE • U ..pEcuUAR" J[| tLLEOITIMATC CASE 200. OSCAR M. i6 years old. Mentality lo. Has been here 7 years. American born, of American parents. Has had measles and whooping-cough. Oscar is an ordinary mischievous looking boy. He came here from a foster home at the age of nine ; had been in public school two years and had had instruction in the home. As usual with children of his grade he started off well with his first work here ; was in kindergarten ; read well ; did not spell as well ; could add combinations to ten. He began music, played the scale on the alto horn. Gradually, however, he reached his Kmit in the English work and made more progress in woodwork and basketry. He seems to be a very moody boy, is generally cheer- ful and happy but sometimes the opposite ; is cranky and rest- less ; is quick-tempered ; seemed to have a great deal of disturb- ance and almost apparitions at the beginning of puberty. He is at present, however, a good Institution helper, but is con- sidered rather lazy and it is said he would rather talk than work. NEUROPATHIC ANCESTRY. MENTALITY 9 321 The family history shows no other case of feeble-mindedness, but a good deal of insanity, tuberculosis and some eye trouble, also one case of epilepsy in a paternal uncle. The insanity seems to be more or less hereditary on both sides of the family and some sort of eye trouble seems hereditary through the mother's side even extending to a sister of Oscar's. It certainly is a case of Neuropathic Ancestry, if nothing else. 5h CHART D 201 O CASE 201. BYRON C. 18 years old. Mentality 9. Has been here 9 years. American born, father American, mother English. Had convul- sions soon after birth ; has had chorea, measles and whooping-cough. Byron was born blind but an operation has given him about one-fourth normal sight. He is cheerful, active, affectionate, willing and tries, good-tempered. His defective sight has un- doubtedly interfered with his school work and had he had nor- mal vision he would have done as much as any of our children who have a mentahty of nine. He learns new occupa- tions quickly, and is a very good Institution helper. The case is an interest- ing one from the stand- point of causation. We find no other case of feeble-mindedness in the family altho there are several persons whose mentahty is undetermined. The father was a laborer in the Pottery Works and suffered from lead poisoning to such an extent that he had to give up the work. This was shortly before Byron was born. Two other children born later, however, were normal altho the next younger is reported as being ^' queer." The mother, also, had (55i3^-r-(S^ I I RHEUMATISM "l- ^ L I LEAD INAR N)ii(N)[N](N)lilii[N]ii(N) *,H0S.8M0S.1 4H0S. BYRON C 322 FEEBLE-MINDEDNESS worked in the Pottery Works since she was nine years old. She suffered from rheumatism during the whole time of her pregnancy with Byron, and most of the time had to be fed. Byron was a blue baby and whether his condition was due to lead poisoning it is probably impossible to tell. If so, it is quite as hkely to have come from the mother as from the father. Therefore we do not have to consider a defect in the father's germ cells which has been transmitted, since the poison may have influenced the mother's powers of nutrition. The condition would thus be con- genital but not necessarily hereditary. T^ D-rO D TOffiHI <5%t:2 '^^omx^p^ ■(N)Ah[|](N) . 6U 16 CHILDREN >EUCATE SAIjnY B. ^ i| BABY CASE 205. SAMMY D. 13 years old. Mentality 7. Has been here 5 years. American born, of xA.merican parents. Had whooping-cough at five ; measles at six ; has had paralysis. Condition is said to be congenital. Sammy came here at the age of eight; had been in public school two years ; knew his letters and could count to twelve ; could do an errand. Two years later he could count to twelve 326 FEEBLE-MINDEDNESS and could write figures to nine; could read about twenty-five words and easy sentences ; could write his own name. Learned a little in basketry, but has probably reached his limit in the three R's ; will doubtless improve in industrial work. The family chart does not show any other feeble-mindedness, but a good deal of disease which would warrant us in calhng this case one of Neuropathic Ancestry ; for example, the father was very nervous and stuttered ; his father had Saint Vitus' dance. Sammy's grandmother on the father's side died of paralysis; the maternal grandfather died of Bright's disease and had had a stroke of paralysis ; his father was insane. CASE 206. PAUL D. 19 years old. Mentality 7, Has been here 7 years. American born, of American parents. Has had measles and whoop- ing-cough. Supposed cause, " heredity and abuse." Paul is rather an agreeable high grade imbecile, cheerful, usually obedient, but somewhat incUned to be stubborn ; has had the usual school experience which characterizes children of this type. He made some show of reading and 1— 1 /-jv writing, at first, but soon fell out ; did a ' ^-^ Httle more with the simple manual arts, such as basketry, and then after a time Sm^ 1 ^' ^ /tk A. finally ended up by doing housework or the h£\ ^ ^ ^ roughest kind of outside work. Paul, be- sides doing housework, works with the mason. He is a very strong, fairly healthy boy and quite a fair worker in his fine. ^Jf^^ If there is any hereditary defect it has not shown as feeble-mindedness but rather in what Tredgold calls ''morbid heredity," but which we have called neuropathic ancestry. The father himself is a puzzHng case until we remember that he is an epileptic, then we can probably account for what we find. We can hardly doubt that he is a normal man so far as intelli- NEUROPATHIC ANCESTRY. MENTALITY 7 32? gence is concerned, when we know that he worked as a lineman, was an expert tree trimmer, had served as a dog-catcher and was considered very normal, but on the other hand, he was shiftless and could never hold a place long, even tho he was an expert workman. He has also served a term in State's Prison. He was alcoholic and could not endure success, quarreled with his wife and she had him arrested for assault and battery. As Healey has shown, these vagaries are often produced by epilepsy in an otherwise normal man. This epilepsy was cer- tainly not transmitted to any of his children and it is unfortunate that we cannot trace his ancestors farther back to discover if possible the origin of his pecuUarity. We have nothing except the statement in the admission blank that "an uncle and two cousins are insane." CHART 207 s. — * Chr® Qt"® ALL PASS FPU WORWAl. *.3 ^ 3 j DROWNED. I 8AUJEE. k CASE 207. SALLIE E. 27 years old. Mentality 7. Has been here 14 years. American born, of unknown parentage. It has been impossible to obtain any history of SalUe's hfe previous to her entrance into the Training School. She is a quiet, sweet-faced girl with a demure and unobtrusive manner and a habitual reserve which would make her pass for normal until one had some experience with her. She came to the school when she was thirteen years old, was nervous in movement, could not read, was fond of music ; could do a little housework, was noisy and indolent. 32 8 FEEBLE -MINDEDXESS She was placed in the kindergarten and began to improve; this did not last long, however, and she seemed to lose interest in her work, was disobedient, \villful, laughed without cause, seemed unable to control herseh ; it was recorded that she showed signs of insanity. Nine months later, she is reported as greatly improved, was learning dressmaking, always happy and cheerful. In the course of a year, she learned to write a little and read a few sentences ; worked slowly but earnestly in woodwork, improved in sewing, but could not learn to use the machine. At one time she was recorded as a most satisfac- tory girl in her cottage in doing housework, obedient and in- dustrious. About three years ago, however, she began to fail and since then can do only a little dusting. One can perhaps see the explanation of all this in the fact that the mother was insane. She belonged to a rather low grade family and was always weak, and it may be that the insanity began, at least, as feeble-mindedness. The father was an immoral man as w^as his father before him, but they are supposed to have been intelHgent. There is not enough here to warrant our calHng it a hereditary case tho it is surely a neuropathic family. CASE 208. BESSIE G. 45 years old. Mentality 7. Has been here 22 years. American born, of German parents. Has had measles; scarlet fever at the age of ten. Supposed cause of condition, " scarlet fever." She was a strong baby nursed by her mother. Had first convulsions when ten years old. Her mother had convulsions after the third month of pregnancy. Bessie came here at the age of twenty-four, ha\dng previously been in the Industrial Home for Girls and later in an Institution for the Feeble-minded. She was too old to do much in school and became a cottage helper. She is very wilHng and good-natured ; has very poor eye-sight and congenital cataracts. This is another family in which it is not possible to draw any conclusion as to the hereditary character of the condition. The CASE 207, SALLIE E., AGE 27. MENTALLY 7. CASE 208, BESSIE G., AGE 45. MENTALLY 7. CASE 217, HUGH I., AGE 25. MENTALLY 5. 'iji NEUROPATHIC ANCESTRY. MENT.ALITY 7 329 n-rO 6 ^H-6 mother had epilepsy, and chart 208 her mother died of pa- ralysis ; there seems to be a morbid condition in the family but beyond that nothing is to be said. It would seem that there was some taint of he- reditary cataracts, as a nephew of Bessie has the same trouble. The scarlet fever does not seem to be the cause since it occurred when Bessie was ten, while the arrest of development came at seven. The neuro- pathic ancestry is more probable. 11 (§W5'53^ ""^ / V^ BESSIE C. [5® lOWNED ^"^ CtURT 209 CASE 209. HENRY Q. 24 years old. Mentality 7. Has been here ears. American born, of American parents. Has had spasms and in- fantile paralysis ; had pneumonia at the age of six. Henry is a high grade imbecile with paralysis of the right arm. He has never been trained in ordinary school work ; has improved n .ch since he came here, thru physical training; can use the hoe in garden work, is a good bowler ; is considered cranky, slow but good- tempered and willing, cheerful and obedient ; makes beds and runs errands ; works in the laundry and is happy. There is a probability that this is a case of he- reditary feeble-minded- ness, and yet it has been 8W®SWS) 11 330 FEEBLE-MINDEDNESS impossible to verify this ; partly because the alcoholism of the father and grandfather renders their mental condition uncertain. The family is generally of low grade with a lack of moraHty. It seems likely that the oldest and the youngest sisters of Henry are also mentally defective. The three other children are so far away, it has been difficult to get any accurate information in regard to them. Several of the family have been supported by pubHc charities and altogether they are undesirable citizens. D T •-N CHART 210 j — I <5d \?6^q^^^h-r^^^6^^ aSi k EMARC. CASE 210. EDGAR C. 13 years old. Mentality 6. Had been here 7 years. Had defective speech, commenced to walk at four years of age ; had weak knees ; commenced to talk at four years. Edgar never developed very far, had a great deal of sickness, and finally died about two years ago. No sufficiently accurate data have been obtainable in this case to give us any certainty as to cause. A younger brother is dis- tinctly normal, a paternal aunt was insane. It is probably a neuropathic family. CASE 211. XAVIER D. 11 years old. Mentality 6. Has been here 6 years. American born, of American parentage. Birth was very difficult, labor lasted 12 hours, instruments and anaesthetics were used. Child weighed eight pounds. At four years of age he had whooping-cough ; at three years, chicken-pox. His defect was noticed about the age of five. He is a school child, but does only kindergarten work. Some of this he can do pretty well ; is rather small for his age and NEUROPATHIC ANCESTRY. MENTALITY 6 331 does not speak plainly. He has made practically no improvement in the last three or four years, cannot get beyond the kinder- garten work. In the cottage he is helpful ; Ukes to take care of other children less bright than he is. Is an active, cheerful little fellow, restless, and very affectionate, mischievous, sometimes destructive ; not CHART 211 D ■® D-rO Q-r® tFAM I^©V)i-T-(N)(N)[^[J© J. j ^ i. VOUNC k XAVIERD. always obedient. He apparently has reached his Hmit, altho he may improve sHghtly. There is no evidence that this is a case of hereditary feeble- mindedness. The mother of Xavier is entirely normal and seems to be of a good family. On the father's side, there is deafness in two gener- ations, tuberculosis, alcohoHsm and paralysis. CASE 212. FORD D. 16 years old. Mentality 6. Has been here 8 years. American born, of American parents. Had pneumonia at six months, whooping-cough at five years. Condition is said to be congenital. Ford is a nice-looking boy, really of more intelHgence than he makes use of. Altho he shows a grade of six he has never been able to be trained to do anything of any value. He is very little help about the cottage. 332 FEEBLE-MINDEDNESS He was born at seven and a half month's term, but was a strong baby. He has remarkable powers of imitation and it is prob- ably thru this that he has acquired most of what he has. He is very affectionate and usually cheerful; does not talk much; CHART 212 (J) 6 (J) dD [Nl-jH -THN (§WWS"ST5^ 338 FEEBLE-MINDEDNESS ability to walk; she progressively lost her power to walk or stand, to use her legs, to hold herself up in a chair or to feed her- self, and gradually lost her mind. Since coming to The Training School, Fay has been helpless practically all the time ; she can- not feed herself, sits in a wheel chair or hes in bed. Is fond of music, is very small and thin CHART 219 ,11 r but has a pleasant, pretty face ; has continued to deteriorate mentally. There seems to be no mental defect in the family altho we have not been able to get very far because they are Italians and not able to speak Enghsh and there are not many L of them in this country. A younger sister of Fay's has the same difhculty while a still younger brother and sister are pos- sibly showing symptoms of the same type of attack. Friedreich's ataxia is a family disease, hence we have classed this as neuropathic ancestry. It is a question in the mind of the writer whether a case of this kind should be considered feeble-minded in the usual sense of that term. CASE 220. NORA L. 22 years old. Mentality 3. Has been here 17 years. American born, of American parents. Had convulsions at 17 months, whooping-cough at 15 months, has had eczema and catarrh. Nora is a low grade imbecile, excitable, and but very sKghtly trainable. It is interesting to note that, two years after admis- sion, it is reported that she had made remarkable improvement, was doing well in kindergarten ; this was apparently an imag- inary result, perhaps due to change of environment, for she never got beyond that pomt and to-day cannot even do kindergarten work. NEUROPATHIC ANCESTRY. MENTALITY 3 339 She is destructive, screams and tears clothes ; she will some- times do a few httle things about the cottage. There is no proof, in this case, that there is any hereditary feeble-mindedness ; tho there is a great deal of physical trouble of one kind or another. The mentahty is perhaps average. ' CHART 220 a CANCER I APOPLETY 8 Ik h-H§ 0~5M5a 06 £miM>6bSh "• NORA L, BLUE g MOS. • 1 BABY CmiB The mother was overworked and worried previous to the birth of Nora. Whether there was a sufficient disturbance to be the reasonable cause of the condition cannot be determined. The neuropathic ancestry seems more likely to be the fundamental cause, with the mother's condition accessory. CASE 221. HARVEY L. 27 years old. Mentality 3. Has been here II years. American born, of German parents. Has had measles, whoop- ing-cough and chicken-pox. Harvey is probably a case of mental defect compHcated by mental disease. He is insane at times, but at other times is quiet, obedient, cheerful, very forgetful ; does not do very much work and needs careful supervision. He is a tall, well-built boy, rather good-looking. The family history shows, without doubt, a morbid condition 340 FEEBLE-MINDEDNESS CHART 221 I MELAN- altho it can hardly be said to be hereditary feeble-mindedness. A younger brother is indeed feeble-minded, but he is also epileptic, and his mental I — I TvJ weakness may be a result of the epilepsy. The father and mother and their sibs are all nor- I I mal so far as is known. The father, however, had locomotor- ataxia and, what "^'^'' there may have been in the grandparents, we have been unable to determine. An aunt of the mother died at forty, of melancholia. [n][n][n][n][3[n]--pH^(n)(n) *- LOCOHOTOR f N N k CHART 222 O-r-O D-rO M I A ^TO (N)!N][Nl[N]lNl(N)(N)[l][il 7 MORE CinU)REN nELAN CHOUA AT 21 ONVUL- d. 11 d. 40 \JV VJV ^^1 CONVUL^^ IONS ACCIDENT ^^-^ V.^ glONS ^ ® m CASE 222. THEODORA Q. 34 years old. Mentality 3. Has been here 20 years. Began to walk at the age of two, had a fall at the same age. She was just beginning to talk, upon admission at the age of fourteen, later improved somewhat in speech and learned to count to twenty. CASE 219, FAY B., AGE 17. MENTALLY 3. CASE 222, THEODORA Q., AGE 34. MENTALLY 3. CASE 226, NATHALIE E., AGE 30. MENTALLY 2. NEUROPATHIC ANCESTRY. MENT.'U.ITY 3 341 She is a quiet inoffensive woman, assists with the dormitory work and takes care of the more helpless children ; is quiet, obedient, good-tempered. There is nothing to account for Theodora's condition, except the neuropathic condition of the mother's family. We have no record of how severe was the fall and we only know that the father had periodic drinking spells. The family came from Germany and there is no record of them farther back. CHART 223 O D i) S □ h tl[NH=fH^[N] [N]|tl6 <«• HEHIPLECIA |n1 [n](n) (^(n)[n] J 6® (N) CLARENCE X. CASE 223. CLARENCE X. 18 years old. Mentality 3. Has been here 4 years. American born, of American parents. Had spasms at one month, measles at three years, whooping-cough at three years; has had pneumonia. Assigned cause, " acute attack of indigestion at the age of one month." Clarence is a very low grade boy, and so far, it has not been possible to train him to any great extent. He has learned to string beads, can separate black and white ; has learned to dress and undress himself; grows rough as he grows older; cannot understand a command ; is silent. The family history would indicate that this is a case of neuro- pathic ancestry. We have discovered no other feeble-minded individuals but there is considerable physical trouble. The father was a partial invahd from a stroke of hemiplegia. Clar- ence's older sister was defective and died at the age of three. This is a case where the marriage of cousins was apparently 342 FEEBLE-MINDEDNESS disastrous; as a matter of fact the blood itself was bad, and the bringing together of the two strains from the same family doubled the potency, and brought out the defect. CASE 224. THOMAS D. 18 years old. Mentality 2. Has been here 7 years. American born, of American parents. Had convulsions in the third year, whooping-cough at six years. Supposed cause, " premature birth, mother thrown from car." Thomas was a weak, sickly baby, with much emaciation ; did not begin to walk until seven years old, began to talk at six. This is a very low grade case, practically untrainable. Nothing has been discovered to adequately CHART 224 ^ account for Thomas's condition. Q O o 6ei-t~7-[5 O-tO 5 / "QUpif CANCEl I r ERRATIC T I ■■" "7" ®®® EI k CASE 233. BESSIE X. 15 years old. Mentality 2. Has been here 8 years. American born, of American parents. Had a fall at the age of three ; had whooping-cough at one year ; paralysis at three ; mumps and chicken-pox at two. Condition is said to be congenital. NEUROPATHIC ANCESTRY. MENTALITY i 349 Bessie is a low grade child and entirely helpless. The family history in this case is an unusually difficult one to understand ; there seems to be no hereditary feeble-mindedness, but the epi- lepsy is probably hereditary and there is also some insanity. If we attempt to account for Bessie's condition, we conclude that it is a summing up of various morbid tendencies, which have appeared at various times, in several generations. That there is some hereditary taint in this family, there can hardly be a doubt. Bessie has a cousin who is epileptic, and a number of more distant relatives, who are insane or epileptic. Others have been pronounced ''queer and pecuhar." CHART 234 D >^(A)[i] iS*^ (§11 (N) (N) GUSSIE q. 2 k Gussie is an interesting little fellow, much under size, as would be expected from the fact that he is a cretin. He is apparently a deaf mute; has made some little progress in ACCIDENTS BEFORE BIRTH. CRETIN 363 364 FEEBLE-MINDEDNESS kindergarten, is particularly adept at free hand cutting; can also tear out the figures, as can be seen from the accompanying reproductions. He is learning to talk a Httle and has learned to make a bed. The family history is thoroly good and the members are in- telligent with no mental defect am^ong them. The father died of apoplexy after a pecuUar illness ; one physician considers it a case or form of general paralysis due to a latent rather than an acquired condition. Unfortunately the history farther back is too imperfect to confirm this. CHART 247 N ^ (SH— [n] (n) (fe (n) (n) (n) [n] D— r-(^^ I I POTTER IN 2k [1^ (n) (n) [n] [n] [n] [n] |nI[nJ [nUn) (n) [}] ^^ iT FRJED( k CASE 247. FRED C. 24 years old. Mentality 2. Has been here 16 years. American born; father American, mother Scotch. Has had chorea and diphtheria. Fred was a sickly babe, weighed only three pounds at birth. He is low grade and untrainable. He can carry a tune, however, and sings to himself most of the time. This is another one of the unsettled cases, where the mother's family is entirely good and normal, but, unfortunately, of the father's family we know practically nothing except that he was alcoholic ; his whereabouts are entirely unknown. The mother's explanation of the condition is, that during the third month of pregnancy, she attended a sick child who finally ACCIDENTS BEFORE BIRTH. MENTALITY i 365 died in a convulsion. Soon after Fred was born the mother noticed contortions similar to those of the child that died. Fred's father was a potter and lead poisoning has been sug- gested. But there is no evidence that lead poisoning in the father could affect the offspring. A Wassermann test on Fred gave a positive reaction. CHART 248 m — ^ ^—^ ^^ BABY BYRS. IRENE N. nONCOUAN CASE 251. IRENE N. 16 years old. Mentality 5. Has been here 4 years. American born, of American parents. Had whooping-cough at the age of seven, measles at nine ; had gastro-enteritis at the age of ten days, which is supposed by the family to be the cause of her mental condition. Irene belongs to the Mongohan type and has probably reached the hmit of her mental development. She is somewhat train- able, can make beds, and do a Httle table work, sews and weaves a httle and seems to be improving somewhat. Can count to ten and knows colors. As usual in the case of Mongohan children we find no other 368 FEEBLE-MINDEDNESS defect in the family, and we have been able to learn in this case that many, at least, were normal. The Mongolian type is congenital but not hereditary. CHART 252 fc ^ J— ^ I \ I I I ■(E) m- 48a vns. 0[Nk^lN| [n]- N "^ mimAHB iKi&LAjio cannot be said, however, that the alcohoHsm of the parents caused the defect but rather that the alcohol that they adminis- tered to Dottie in 4LKED 1 T7YRS. J infancy has produced the result in her, and the same result in an older sister. The important question arising in this case is whether, without the alcohol and under hygienic conditions, the defects can be overcome. Time alone can tell. CASE 269. CLARA I. 20 years old. Mentality 3. Has been here 5 years. Born in Russia, of Russian parents. Had measles at the age of three years. Supposed cause of the condition, '' a fall on the head." Clara is the second IT71 /r\ ^"^^^ '"^n /-\ born in a family of ten. "— ' ^-^ I— I ><^ 'pj^g family are Russian Jews who have been in this country several years. No others are defective, two died in infancy, several are very bright. The father and mother are apparently (n)[n](n)[n] — i-H^ (n) (n) (n) '\ \k ^ [N]-(t)(N) b (n) [N] [N] [£] 384 FEEBLE-MINDEDNESS normal, as are the other relatives. No evidence of unusually severe physical defect or disease can be found. Clara is fairly low grade and deaf. No reason is given for the condition, except the fall received when eight weeks old. The child is very sUghtly trainable, able to do some errands about the house and simple housework. CASE 270. JENNIE K. 9 years old. Mentality 3. Has been here 3 years. American born, mother colored. Had measles at the age of four. Jennie is an attractive Kttle colored girl. She came here when she was five years and nine months old. At that time she could do nothing; was just beginning to walk and could not talk. She had been discovered under very peculiar conditions, which indicate NH-r-(N) that she had been very seriously maltreated. One theory is that the TO^ [nI [Nl [n] [n] '^''^^^' ^^^^^ ^^^ because she was ^ ^^ — so nearly white ; at least she had L V been for a long time neglected, and ^ >v probably drugged and brutally :sdDWii!« treated to prevent her from being I discovered and recognized. When JENNIE K. *=* finally discovered and brought to the Training School she was in the condition as above indicated. During the three years here, she has made great improvement. Not knowing at the time of her arrival anything about her his- tory that would give us any clue as to her mental condition, we were much in doubt as to whether she was distinctly feeble- minded or only backward by deprivation. Her rapid improve- ment during the first months led us to hope that if her con- dition were due to her treatment, she had been rescued early enough to save her. At the present time, altho she has de- veloped remarkably, it is probable, that if she was not naturally feeble-minded, the treatment she received has made her so 'crep- ACCIDENT AFTER BIRTH. MENTALITY 3 385 arably, and while she has perhaps not yet reached the limit of her mental development, it is more than doubtful if she will ever recover entirely. She will probably remain a feeble-minded child, altho possibly of high grade. What httle we have been able to learn of the family history would not indicate that this is a case of hereditary feeble-minded- ness. The mother is not normal herself but certainly belongs to a normal colored family, rather above average inteUigence. The mother is said to be the black sheep of the family and her behavior may be pure wickedness rather than defect. Of the father no one knows anything. In all probabihty he was a white man, judging by the color of the child. The mother has other illegitimate children ; the first one died in infancy and was colored, the one younger than Jennie is a little boy who is also colored, the very youngest, a Httle girl, is prob- ably of a white father. CASE 271. MATTIE S. lo years old. Mentality 3. Has been here 2 years. Born in Russia, of Russian parents. Had whooping-cough at nine months, sore ears at seven years, measles at one year. This is a very interesting httle Hebrew child, very pretty, but of low grade ; does very Httle in the kindergarten ; plays and dances with the other children in the cottage; seems happy. She has had frequent screaming spells, late at night or early in the morning ; had been in kindergarten years before she CHART 271 two came here. She has what seem like insane spells ; has pulled out two teeth and pulled out her ear- rings while in one of them; beats her head; digs herself with her 2C nsj^ ■® N NK/j^(N)CN)rN: N Nl N)(N CASE 274. HARVEY D. 16 years old. Mentality i. Has been here 9 years. American born, of American parents. Had convulsions between the ages of one and four years. 388 FEEBLE-MINDEDNESS This is the ninth child in a family of eleven. It is a thoroly respectable family. All members, that have been found, are entirely normal. Our boy had a brother and two sisters that died young but the rest were normal. The only thing to ac- count for our boy's condition is the con\nilsions which came on at the age of one year. He gradually retrograded from that time and has never recovered. He is of the lowest type, perfectly helpless and untrainable. Does nothing at all, has violent spells, pounds his head, screams and cries ; runs away. CHART 275 BOUND. <5^1-T-^(n)[n| |Nh NEVER TALKED (SWn& (§® k LUELLAX. CASE 282. LUELLA X. 17 years old. Mentality 4. Has been here 8 years. American born, of Russian parents. Had epilepsy at five years, chorea, measles, brain fever at nine months. Brain fever is the assigned cause of the condition. Luella speaks Russian but never talks unless it is necessary ; cannot do an errand, Kkes music, is dangerous with fire; has 396 FEEBLE-MINDEDNESS learned to sew on a button without help; helps with the smaller children; is very noisy; lately has learned to darn stockings. Luella is a very attractive looking child, would never be sus- pected of being defective ; has a smihng, pretty face. She had brain fever when nine months old. It was evidently a severe attack as ice bags were kept on her head for three months. She was then bhnd for two years and did not talk until she was six. This would be considered sufficient to account for her condition, but the father's defect points to heredity. She is the second born in a family of six. This is a Russian family, and it is very difficult to judge of the mentahty of the various people, especially the elders. Of the children, there is not much doubt. The remaining five are normal. The mother seems to be a normal woman and, as far as is known, her family are normal. The father is feeble-minded. There seems a high probabiHty that this is a case of hereditary feeble-mindedness, yet since we know the meningitis could account for Luella's condition and we do not know that the father's condition was not also due to accident, we have credited this to meningitis. n-T-O CHART 283 O-rO • BEFORE nARRiAce ^ e Tn CASE 283. ULYSSES C. 18 years old. Mentality 3. Has been here 10 years. American born, of American parents. Had spinal meningitis followed by paralysis at the age of nine months ; has had spasms. Was an instrumental delivery. MENINGITIS. MENTALITY 397 Ulysses is a very low grade boy, says a few words but can hardly be said to talk ; acts insane at times, is a little incKned toward echolalia ; talks to himself as tho he were another person, and strikes himself because he is disobedient. The father is reported as being probably s^-phihtic. A younger brother of Ulysses is normal. The maternal grandfather is said to have died at forty of blood-poisoning. Beyond this we have been unable to get any satisfactory data. It is clearly a menin- gitis case. CASE 284. FRED K. 11 years old. Mentality 3. Has been here 3 years. American born, of American parents. Has had brain fever which is supposed to be the cause of his defect ; also had spasms when two weeks old, and eczema. This is a very low grade imbecile who has not changed, except physically, since his admission. Apparently he is at a decided standstill ; cannot dress nor undress himself, understands a com- mand but does not recognize color or form ; is very disobedient and naughty, kicks and strikes ; has rather regular features and would be a good-looking boy if there were any mind to shine out thru his eyes ; he looks dazed and stupid. Fred's is a very interesting case when we come to the family history ; (see Chart 255, page 370), not only because he is a cousin of the Mongohan in Case 255 but because on the father's side there is an interesting condition. The father himself, altho prob- ably normal, is nevertheless exceedingly dull. His father and mother were rather low grade people, the father being alcohohc and syphilitic, which disease the mother also contracted. The family physician considers that there is sufficient defect on the father's side alone to account for the children's condition ; besides being alcoholic the grandfather was promiscuous in his habits, as would indeed be indicated by the venereal disease. Fred's younger brother is also considered defective by many, but according to the Binet test he did not at the time examined FEEBLE-MINDEDNESS show defect ; it is entirely possible that it may appear later and an effort will be made to examine him. In view of all of the facts, including the brain fever, which probably means cerebral meningitis, it is not quite safe to con- sider this a case of hereditary defect. Such a thing is of course possible but not provable from our data. Fred gives a positive Wassermann reaction. For later report, see page 3 1 . CHART 285 ii](J5(J)66d [ti6[N](^(§[N](§j^ Q E] la CASE 285. DANIEL X. 45 years old. Mentality 3. Has been here 21 years. American born, of American parents. Had measles, whooping- cough, brain fever at the age of two, pneumonia, cholera infantum at two. The cholera infantum and congestion of the brain are supposed to be the cause of his condition. When admitted at the age of twenty-four Daniel's speech was imperfect ; he could do errands and liked to draw animals and boats most of the time. He has never been very trainable, learned to sweep and dust a Httle, and to do some other simple housework. The family has the appearance of being a normal one. It is highly probable that the meningitis is the cause of the condition. CASE 286. SYLVANUS C. 19 years old. Mentality 2. Has been here 9 years. American born, of American parents. Has had epileptic convulsions and meningitis. Instrumental delivery. MENINGITIS. MENTALITY 2 399 Sylvanus is a low grade case of the very excitable type. He is very active and quarrelsome, is said to take advantage of any one who shows fear of him. The family is thoroly respectable and seems clear of any- thing that could account for either the physical or mental con- dition. This seems to be a perfectly clear case of mental defect result- ing from meningitis and scarlet fever. There is no hereditary CHART 286 [a^[a[N]M (S»(N)(N)n^ Nl ^-'mos.hos. a «»■ hobhos. a hos. poor david n. ^ a k this is a case of acquired defect, the meningitis or some of the other early troubles undoubtedly being the cause. A cousin on the father's side is indeed feeble-minded, but this is also a case of meningitis. CASE 290. HENRY U. 16 years old. Mentality 2. Has been here 2 years. American born, of American parents. Instruments were used at birth. Child had measles at the age of four; probably had cerebro- spinal meningitis at two and a half. This is a low grade child concern- ing whose case little satisfaction can be gathered. He commenced to talk at two years but lost his speech at four. Had chills and fever when two and a half years, which might have been meningitis as he had slight convulsions. From three to eight years he had nervous ex- citabiHty. CHART 290 Q-rO k MENINGITIS. MENTALITY i 403 In the Training School he has accompHshed nothing, hkes to play with blocks and look at books but is not improving, is not even a clean child. The family history is too meager to give us anything satisfac- tory as to the cause. CHART 291 Qt^ D ■Q m-r<5 5Q5i-r(SS5a^55 *■ APOpIaCY *I "PECULIAR" in.cL » LN-ClLCa. [N]d(j(N)[Nl(N)!Nl-r-®^ ® [SSS OEUCATE SIBtreV B.^*^ CASE 291. SIDNEY M. 12 years old. Mentality i. Has been here 3 years. Sidney is a low grade case with practically no intelligence. He cannot care for himself, walks with much effort altho he seems to be improving a httle in that direction. The family chart shows an array of normal people and we learn that Sidney was a victim of cerebral meningitis at the age of fourteen months, also had spasms ; had measles at the age of eight years. The meningitis is without doubt the cause of the condition. CASE 292. NATHAN S. 15 years old. Mentality i. Has been here 7 years. American born, of Austrian parents. He had measles at two years and brain disease from a fall at thirteen months, which is supposed to be the cause of the condition. This is a very difficult family about which to get accurate data. All the members seem normal but they are all foreigners 404 FEEBLE-MINDEDNESS and of rather low intelligence, altho seemingly not low enough to be called feeble-minded. There is much intermarriage. The parents were second cousins and the grandparents were also CHART 292 [^(n)[^(n)[n][nH^ IJ(n)(n) (N)|i(N)[N](N)(N)(N) [nI[n](n)(n)(n)[n][!] related. Our boy is of the lowest grade, does not talk, does not play, cannot dress nor undress himself ; is sober, silent, cranky, restless, slow and destructive. It seems probable that this is a meningitis case. He gives a positive reaction in the Wassermann test. NO CAUSE FOUND. MENTALITY 8 405 NO ASSIGNABLE CAUSE The following 8 cases, Nos. 293 to 300, compose the No Cause Group. In spite of the fact that our records are very complete, there is nothing in the history of these cases that would usually be accepted as an adequate cause. CHART 293 D o D "BEAJtT TRODBLE" O 'UVER TKOUBLT* (55hS1-T-<§ S [n] (^[n] [n1 (n) »*• I m ^ (n)(n) n □ ST. vrru L ^m DANCE MK^nnvnnso N XM rn I'n [n1(n)(n)^[n] (n) CASE 293. MOSES W. 24 years old. Mentality 8. Has been here 7 years. American born of American parents. Had diphtheria at the age of two, measles at twelve, scarlet fever at eleven, whooping-cough at ten and convulsions at thirteen. Assigned cause of the condition, " the worry of the mother." Moses is a moron, but not of the highest grade ; has a somewhat dull look, his mind works very slowly, he does not seem interested, is rather indolent ; has learned about the usual amount of the three R's; writes a very bad letter in penmanship, spelling and expression. His chief work is of the coarser, heavier sort, housework, shoe- shop, laundry and the like. He is a cheerful boy, quiet and obedient, truthful and honest, somewhat sensitive, very affec- tionate ; is very faithful and tries hard to do whatever he can do. The following is a sample of one of his letters and a program that he made up for Morning Assembly at the Training School— 4o6 FEEBLE-MINDEDNESS Vineland, NJ. June 15, 1910 Dear mother I hope you are well How did you in joy your anual meetin last week I hope you in joyed it very much we had a nice time to day I got some flowers to day I hope you are all well at hom hope to here from you soon your Loving son NO CAUSE FOUND. MENTALITY 2 40? One would need to know about the Assembly to understand his program. He seems to have ten numbers but as a matter of fact the figures only designate the Hnes and have no connection with his subjects. Moses' family history raises some questions that are unan- swerable. The general appearance of it would seem to indicate good stock, indeed they are thoroly respectable and good people. A paternal uncle, however, was a defective of very low grade. He never learned to talk but was harmless and lived alone with his mother. If we were to count this as indicative of hereditary taint we must conclude that the taint is decidedly recessive since it very seldom appears. To prove this would re- quire much more data than we have from earHer generations. The probabiHty is much greater that this uncle was also a case of accidental defect and that here we are dealing not with heredity, but with the coincidence of two accidental cases of mental defec- tiveness in the same family. CASE 294. GEORGE C. 32 years old. Mentality 2. Has been here 24 years. American born; father German, mother American. Had spasms at two years, measles and whooping-cough. George is another case belonging to the group of unsolved problems. The family is normal and intelligent; and nothing is known to account for George's con- ^^^^^ ^ dition. Q_l^ [nH-® The maternal grandfather died of "* -. -32 a. paralysis at the age of fifty- two; this is the only thing that approaches brain [n] [n] |^ trouble of any kind so far as we can *■ "^ "" learn. . —^ — . George is of low grade, does not talk, r\-^ — \n\ H (n) [n] cannot even unbutton his clothing; is "^j!^^ dangerous with fire ; will eat garbage ; I is bad tempered. Since admission he N N o ® m d.70 ® (n)(n)|n] mi (n)[n](n) k LOUIS B. CASE 297. LOUIS B. 10 years old. Mentality i. Has been here 3 years. American born, of American parents. Had whooping-cough at five months. Condition is said to be congenital. 4IO FEEBLE-MINDEDNESS This child is of a highly respectable family, all the members being normal. The paternal grandfather died of paralysis at seventy-five. His wife's father was alcoholic. The maternal grandmother died of apoplexy at sixty-four. There is no theory to account for our child's condition. He is low grade, does not talk, and appears not to hear. He makes a queer sucking noise with his tongue. Is undersized ; is very nervous. There are some indications that he may be of the cretinoid t5^e. CHART m ^ kind of work that he likes to do, very well indeed, hr ^-^ can run the electric sewing machine and the button- hole machine. /'^fal He is quiet, rather sober but obedient, and ap- ^-^ parently perfectly contented with his life and work. I He is a good Institution helper. He is a Children's Home case and nothing is known about his family, except that he had an older sister. The father is dead and the mother was unable to take care of her children. CASE 314. FRANK H. 19 years old. Mentality 8. Has been here 4 years. American born, of American parents. Instruments were used at birth. Had whooping-cough at six years, measles at twelve years. Assigned cause, " masturbation." This case is an interesting one because Frank came on the assumption that he was feeble-minded, but he has proved to be insane. It well illustrates the difficulty that sometimes is met with in deciding between the two. We of course knew very quickly that there was insanity present 424 FEEBLE-MINDEDNESS but, on the basis of the information, we thot at first it was insanity grafted on to primary feeble-mindedness. His abiUty in drawing, specimens of w^hich are reproduced opposite, was taken to illustrate one of those remarkable cases usually classified under the head of idiot savant. In other words, we thot that he had a special gift in this one direction, being feeble-minded in all other ways. After a careful study of his previous history and his family [55 CHART 314 O NORnAL I 1 1 FAMILY. _ O (3"®-rM-r-® ® "i"^ 2NDWIFE Z 13 14 No Cause 8 46 5.7 8 31 3 3 I Unclassified 27 118 4-3 26 34 I 19 10 28 Totals 327 1776 5-4 585 401 39 275 225 251 In the foregoing Table is given the average children per mating. If we wish, however, to get an idea of the fecundity of these groups of women we must make some corrections. Many of these women have had more than one mate (legal or other- wise) ; a few have been deserted or died early. Making these corrections we get the following : DISEASES AND CONDITIONS 473 Group No. Mothers No. Children Average Hereditary Probably Hereditary . . Neuropathic Accident No Cause Unclassified 139 27 36 50 8 27 992 i68 204 258 46 118 7-1 6.2 5-6 5-1 5-7 4.3 Totals 287 1786 6.2 In addition to the mentaKty, whether normal or feeble-minded, record has been kept of certain diseases and conditions supposed to be more or less associated with feeble-mindedness in a causal relation . These are the following : I. Alcohol (A) ; 2. Tuberculosis (T) ; 3. Sexual immoraHty (Sx.) ; 4. Paralysis (Par.) ; 5. Insanity (I) ; 6. Epilepsy (E) ; 7. Neurotic condition (Neu.) ; 8. Syphilis (Sy) ; 9. Criminahty (C) ; 10. Deafness (D) ; 11. Blindness (B) ; 12. Migraine (M) ; 13. Goitre (G) ; i4> ^Vag rancv (W). Records have been kept besides of Inmates of other Institutions, and Illegitimate children. Table VI shows the distribution of these conditions in the fundamental groups. The corresponding percentages will be found with each topic as it is taken up. Table VI Group A ; T Sx. Par. I E Neu. Sy c D B M G w In Inst. Illeg. Ch. H. 272 187 258 58 54 56 22 35 37 23 28 4 3 4 119 259 P.H. 29 59 8 19 20 5 23 3 5 5 I 2 3 12 12 Neu. 33 36 17 46 32 13 15 4 3 II 3 7 I I 16 3 Ace. 29 39 5 22 4 4 II 3 6 2 2 2 4 N.C. 2! 3 6 I C I Unci. 10 20 5 3 9 4 I 8 I Totals 375 344 293 154 119 79 75 46 45 45 34 13 8 7 157 279 These sixteen conditions will now be considered in the Hght of our data. 474 FEEBLE-MINDEDNESS ALCOHOLISM This chapter does not enter into a full discussion of the question of alcohol but merely presents our data so that the reader may see for himself what they show on this question. Tables VII, VIII, IX, X show the facts as we have been able to work them out. We have not included any cases that are complicated by the presence of Sy, I, Par., and E. As already shown in a previous chapter on the analysis and classification of the cases we have no family charts upon which there is conclu- sive evidence that the condition of the child in question was due to alcohol. There are a few charts in which there is much alco- holism in the family and one is led to ask — Did not the alcohol cause the feeble-mindedness in these cases ? But when we look closer we find that it is impossible to draw that conclusion logi- cally, because not enough is known about the other conditions of the family. In many cases it is not known but that the alco- holic father or mother may have been also feeble-minded. In the entire group of charts where hereditary feeble-mindedness prevails, it is of course not possible to draw any conclusion in regard to alcohol since the feeble-mindedness of the ancestors is the all sufficient cause of the feeble-mindedness of the child. We must look for any arguments to be found in the Neuropathic Ancestry or the Accident Group. Alcoholism at the Time of Conception. Many people be- lieve that the condition of the father or the mother in reference to alcohol at the time of conception is significant. Such per- sons are, as a rule, ignorant of the principles of modern biology and their opinion is based upon an incomplete understanding of the processes by which a new organism is formed. One of the best demonstrated facts in biology is that the germ cell is most carefully protected from all injurious influences, it lives what someone has termed a "charmed existence." That any amount of alcohol which a father had taken immediately pre- ALCOHOLISM AT CONCEPTION 475 vious to the conception of a child could so permeate the system as to reach the germ cell and so affect it that the result would be shown in the offspring is well nigh inconceivable from a bio- logical standpoint. Dr. Stockard has indeed shown that, if the eggs of fish are placed in a solution of alcohol within a short time after fertiHzation, monstrosities result. But no one, so far as the writer knows, has shown that the spermatozoa of any animal, placed in an alcoholic solution and then allowed to fertihze the ova, transmit any pecu- liarity whatever to the offspring. Ireland makes the statement that in the villages in Scotland where the whole population gets drunk at New Year, or at the time of the return of the fishermen, "No one has noticed that there is an excess of defectives born nine months after this time"; this argument has never been answered. It has been asserted that in somewhat similar conditions in Switzerland there are more defectives ; but in this case other factors have not been eliminated. Therefore Ireland's argument stands. He says, page 21 : "The children of drunken parents in many cases have an unhealthy nervous system, they are weak, unsteady and ex- citable,and often have a diseased craving for spirituous Hquors, but in my opinion idiocy is not the ordinary legacy which drunk- ards leave to their children." Tredgold says, page 19, after quoting Dr. Ireland's state- ment above referred to, " I have histories of idiots conceived under such circumstances, but so I have of normal children, and my opinion is, that while this may be a cause in some cases, the number of instances in this country at any rate is exceedingly small." So far as our field workers have been able to get any information it would tend to confirm the above view. The Children of the Habitual Drunkard. Passing from the question of alcohoHsm at the time of conception to the general question of alcoholism as a cause of mental defect, we will first examine the parents of our own children. 476 FEEBLE-MINDEDNESS The following Table shows the condition of the parents of our children in regard to alcohol, paralysis, epilepsy, insanity and syphilis, and the percentage of their children that were normal, feeble minded, etc. Table VII SHOWING THE CONDITION OF PARENTS OF OUR CHILDREN IN REGARD TO ALCOHOL, ETC. Hereditary Group — 164 Cases Condition of Parents No. OF Matings Total Children Condition of Children %F %N % ? % d. inf. % Mis. Un. NonA . . . A . . . Par., E, I, or Sy 78 57 29 449 365 164 3V 40.2 48.7 9.5 6.3 9-7 4.0 3-0 1.7 16.0 22.5 17.0 14.2 16.I 7-3 16.9 II.8 15.2 Totals 164 978 41.2 8.3 3.2 18.6 13-8 14.7 Probably Hereditary Group — 34 Cases NonA . . . A . . . Par., E, I, or Sy 16 7 II 81 29 51 28.3 30-7 29.4 22.2 3-4 15.7 3-9 1.2 3-4 13.7 30.8 24.1 9.8 17-3 37.9 27.4 Totals 34 161 29.1 16.7 1.2 5-5 22.9 24.2 Neuropathic Group — 37 Cases NonA . . . A . . . Par., E, I, or Sy 17 7 13 72 52 77 26.3 17-3 19.4 40.2 42.2 3I-I 2.5 9.8 13-4 19.4 9.8 11.6 13.8 5-7 iS-5 Totals 37 201 21.3 37-3 0.9 14.4 13-4 12.4 Accident Group — 57 Cases NonA . . . A . . . Par., E, I, or Sy 41 9 7 191 51 30 21.4 19.6 23-3 58.1 52.9 46.6 I.O II-5 7.8 23.3 3.6 9.8 4.1 9.8 Totals 57 272 21.3 55.8 0.6 12. 1 4-7 5.1 ALCOHOLIC PARENTS Table VII — Continued 477 SHOWING THE CONDITION OF PARENTS OF OUR CHILDREN IN REGARD TO ALCOHOL, ETC. No Cause Group — 8 Cases Condition of Parents No. OF Matings Total Children Condition of Children %F %N %? % d. inf. %Mis. Un. NonA . . . A . . . 8 o 46 17.4 67.4 6.5 6.5 2.1 Totals NonA . . . A . . . Par., E, I, or Sy i6o 8o . 6o 839 497 322 31.8 35-2 36.3 27.6 14.6 19.2 2.3 2.2 2.1 12.5 18.9 17.7 12.6 16.4 8.3 12.9 12.4 16.I Grand Totals 300 1658 33-7 22.1 ^■?> 15-4 12.7 134 Explanation of Table VII. — The first Kne reads as follows : In the Hereditary Group 78 of our children had parents who were not alcohoHc. These parents had 449 children (including ^^our chiW). Of these children 39.1% were feeble-minded; 9.5 % were normal, etc. It will be noted that in the totals the percentage of feeble- minded steadily decreases as we go thru the groups, from 41.2 in Hereditary to 29.1, 21.3 and 21.3 while the percentage of normal goes up from 8.3 in Hereditary to 16.7, 37.3 and 55.8. The percentage of feeble-minded is slightly greater in the alcohoHc group than in the non-alcohoHc, in the Hereditary and Probably H. groups, but in the other two groups it is less. There seems to be no conclusion to be drawn from the data in this form, as regards the effect of alcohol. Of our 310^ children comprising this study, 80 have parents 1 Omitting the unclassified there are 300 matings; ten of these have two chil- dren each in the Training School. 478 FEEBLE-MINDEDNESS one or both of whom are alcoholic. In i8 cases or 5.5 % the mother was alcoholic, and in 10 cases father and mother both were alcohohc. Of the 1 8 cases all but one are in the Hereditary Group. That one, Case 268, has been placed in the Accident Group (causes acting after birth) since the child herself was fed on alcohol from infancy and was known to have been often drunk. Altho we cannot be sure that there was not hereditary feeble-minded- ness here, yet the probabiHties seem to be against it, and one has a strong feehng that without the alcohol the child would have been normal. There is not, therefore, a single case among our children in which it can be said that the alcohoHsm of the mother was clearly the cause of the feeble-mindedness of the child. These 18 cases are Nos. i, 4, 8, 44, 46, 53, 57, 62, 73, 74, 87, 95, 124, 125, 151, 156, 191, 268. The question naturally arises as to the mentahty of these cases, whether or not the alcohol in the mother, if it has not pro- duced feeble-mindedness, may still be credited with having pro- duced a lower grade of feeble-mindedness than would otherwise have occurred. While this study gives no positive answer to this, yet it reveals the following: of the 18 under discussion 5 are of the moron grade, 1 1 of the imbecile, 2 of the idiots. This is approximately the usual distribution of a group of cases, with a Httle preponderance in favor of the higher grade. From this there is no evidence that the alcohol has even lowered the grade of the child. Two of these cases are among the highest grade children in the Institution. If alcohol in the mother, where it conceivably might affect the fetus thru the mother's nutrition, does not produce feeble-minded- ness or does not lower the grade of the children, it would not seem likely that the father's alcohoUsm, which can only affect the offspring thru his germ cells, could produce feeble-mindedness. The reader will note that this conclusion is not that alcohoHsm of the mother does not cause feeble-mindedness in the child, but simply that the fact is not proved from our data. ALCOHOLIC FATHERS 479 There remain 62 of our children whose fathers are alcoholic ; 47 of these are in the Hereditary Group; 7 are in the Neuro- pathic; 8 are in the Accident. Table VII shows that in the Non-hereditary Groups these A parents have a smaller percent- age of feeble-minded children than the Non-A parents in the same groups. In both the number of alcohoHcs is small. In no case is the alcohoHsm of the parent given, by parent or physician, as the cause of the child's condition. In every case there is a cause given that is more generally accepted than the alcohol. It is, of course, possible that the alcohoKsm of the fathers may have rendered the children more susceptible to the conditions in some of the cases. For example in the Accident Group, one case is that of a hydrocephahc boy (No. 278), one is a meningitis case (No. 281), two are MongoHan imbeciles (Nos. 250, 260), one is a case of ''medicine" administered to produce abortion (No. 239), another is a case of supposed lead poisoning (No. 247), another is typhoid fever (No. 266) and another spastic paralysis (No. 272). We are therefore compelled to admit that so far as our own children are concerned we cannot prove that alcohol caused their feeble-mindedness in the Non-hereditary Groups any more than in the Hereditary. That alcohol causes deaths and miscarriages is nowhere more convincingly shown than in Table VII. Referring as it does to our own children — the present generation — the statistics of deaths in infancy and miscarriages are very rehable. A study of these figures shows a considerably higher percentage wherever the number of ma tings is great enough to give a fair average. This is corroborated so far as the difference between alcohohc and non-alcoholic is concerned, by the figures of Table IX, which covers all matings. We turn now from our own children and their parents to a con- sideration of all the persons on all the charts, in relation to alcohol. A count of all the charts gives us the following : 48o FEEBLE-MINDEDNESS Table VIII Of 6868 Persons in Hereditary Group 272 or 3.96% are Alcoholic Of II 15 Persons in Probably H. Group 29 or 2.60% are Alcoholic Of 1 21 2 Persons in Neuropathic Group S3 or 2.72% are Alcoholic Of 1913 Persons in Accident Group 29 or 1.51% are Alcoholic Of 281 Persons in No Cause Group 2 or 0.10% are Alcoholic Of 1 1389 Persons in all Groups 365 or 3.20% are Alcoholic '' Alcoholic" thruout this study means drunkard. Table VIII shows us the number of each group that are alco- hoHc and the per cent that this is of the total group. Refer- ring to the figures we see that a larger percentage of the Heredi- tary Group are alcohohc than is found in any other group, and larger than the average of all the groups. Practically 4 % (3.96 % ) of all persons Hsted in the Hereditary Group are alco- hohc, while of the 281 persons in the group where we can find no cause for the condition of feeble-mindedness, only .1 of i % are alcoholic. This of course agrees exactly with what we would expect. If there is no influence producing alcoholism in one group more than another these 365 cases should be found in the different groups in the proportion of the whole number of persons in those groups or 60.3 : 9.7 : 10.6 : 16.7 : 2.4. (See Table III for the H., P. H., Neu., Ace. and N. C. Groups respectively.) For example, if all of the alcohoHcs were proportionately divided among the groups we should expect 220 in the Heredi- tary Group. There are really 272, that is, there are 52 more persons in this group than an even distribution would warrant, which means that there is some influence in the situation producing more alcohohcs in this group than in the others. What that something is, is the lack of control characteristic of those persons that belong to famiHes where there is hereditary feeble-mindedness. The following table shows what would be expected compared with what we actually find. ALCOHOLIC AND NON-ALCOHOLIC PARENTS 481 Group Expectation Actual Too Many Too Few Hereditary Probably Hereditary . . Neuropathic Accident No Cause 220 36 39 61 9 272 29 33 29 2 52 7 6 32 7 A decided relation between Alcoholism and Hereditary Feeble- mindedness ! Is it a causal relation ? If so, which is cause and which is effect ? Table IX COMPARING THE FAMILIES OF ALCOHOLIC AND NON-ALCOHOLIC PARENTS OF THE SAME MENTAL CONDITION Hereditary Cases Condi riON ENTS No. OF Matings Total Children Per Mating Condition of Chh.dren OF Par %F %N %d. inf. % Mis. %Un. F — F {NonA 1 A 90 36 445 216 4.9 6.0 66.7 59-2 0.7 0.9 14.4 14.8 3-5 6.9 14.6 18.5 N— F jNonA 1 A 45 5 204 16 4-5 3-2 31.8 56.2 21.5 18.7 8.7 18.7 9-7 0.0 27.8 6.2 F— N /NonA 1 A 31 12 142 78 4-5 6.5 23.0 26.9 39-4 29.4 14.7 21.7 4.2 7.6 18.3 I4.I Un— F jNonA 1 A 142 53 561 337 3-9 6.3 35-4 3I-I 9.9 5.6 I3-I 21.6 6.9 11.8 35-2 29.6 F— Un {NonA i A 59 14 237 65 4.0 4-6 50.6 50.7 10.5 3-0 7-1 15-3 2.1 4.6 29.5 26.1 N— N NonA A 92 4 433 19 4-7 4-7 6.6 5-2 60.4 21.0 8.5 15-7 3.6 42.1 21. 1 15-7 Un— N (NonA I A 146 19 488 117 3-3 6.0 6.9 14.5 55.9 28.2 7-7 23-9 1.2 2.5 28.0 30.7 N— Un (NonA I A 87 4 316 20 3-6 5-0 4.1 19.9 70.5 29.9 5-3 14.9 2.5 0.0 17.4 34-9 Un— Un [NonA i A 328 54 1446 279 4.4 5-1 20.4 25.8 23.0 12.8 7-9 16.8 3-1 6.4 45-2 38.7 Totals [NonA i A 1020 201 4272 1147 4.1 5-7 25-4 33-^ 29.7 II. I 9.2 18.8 3-7 8.1 31.6 28.0 2 I 482 FEEBLE-MINDEDNESS Table IX — Continued COMPARING THE FAMILIES OF ALCOHOLIC AND NON-ALCOHOLIC PARENTS OF THE SAME MENTAL CONDITION Neuropathic Cases CONDIl ION ENTS No. OF Matings Total Children Per Mating Condition of Children OF Par %F %N %d.inf. % Mis. %Un. N— N [NonA I A 21 4 IIO 32 5-2 8.0 9.0 9.3 49.0 56.2 13-6 3-1 6.3 31.2 21.8 0.0 Un— N (NonA i A 44 6 127 30 2.9 5-0 3-9 20.0 68.5 43-3 3-9 20.0 6.2 3-3 17.3 13-3 N— Un [NonA I A 26 76 2 2.9 2.0 2.6 0.0 89.4 lOO.O 0.0 0.0 0.0 0.0 7.8 0.0 Un— Un [NonA i A 32 2 122 9 3.8 4-5 1.6 0.0 59-8 II. I 2.4 0.0 4.9 0.0 3I-I 88.9 Totals NonA i A 123 13 435 73 3-5 5.6 4-3 12.3 64.8 46.5 5-2 9-5 4.8 15.0 20.6 16.4 Accident Cases N-N jN°"^ 130 3 614 17 4-7 5-7 6.1 17.6 72.9 70.5 9.7 5.8 2.2 0.0 8.7 5.8 Un-N 1^°"^ A 80 8 302 32 3-7 4.0 1.9 15.6 83.7 56.2 3-9 9-3 5-9 12.4 4-3 6.2 ^T TT [NonA N-Un 1 ^ 66 206 3-1 0.4 87.8 2.9 0.4 8.7 Un-Unj'^""^ 44 3 177 17 4.0 5-7 2.2 II. 7 48.0 64.7 12.9 0.0 0.6 5-8 36.1 17.6 F— N ■ [NonA i A I 6 6.0 16.6 83.3 Totals P''"-^ A 321 14 1305 66 4.1 4-7 3.8 I5-I 74-3 62.1 7-7 6.0 2.6 7-5 11.4 9.0 ALCOHOLIC AND NON-ALCOHOLIC PARENTS Table IX — Continued 483 COMPARING THE FAMILIES OF ALCOHOLIC AND NON-ALCOHOLIC PARENTS OF THE SAME MENTAL CONDITION No Cause Condition No. OF Matings Total Children Per Mating Condition of Children OF Parents %F %N %d.inf. % Mis. %Un. N-N j^^^^ 20 2 102 7 51 3-5 7.8 0.0 S3.3 85.7 6.8 14.2 2.9 0.0 0.9 0.0 Un— N [NonA i A 12 36 3-0 0.0 944 2.7 0.0 2.7 N — Un [NonA [ A II 26 2-3 0.0 lOO.O 0.0 0.0 0.0 TT TT [NonA Un— Un . 7 I 28 I 4.0 I.O 3.5 0.0 82.1 lOO.O 0.0 0.0 0.0 0.0 14.2 0.0 ^ , , [NonA Totals . 50 3 192 8 3-8 2.7 4.6 0.0 86.4 87.5 4.1 12.5 1.5 0.0 3-1 0.0 Totals Hered. . NonA A 1020^ 201 4272 1147 4.1 5-7 254 33-8 29.7 II. I 9.2 18.8 3-7 8.1 31-6 28.0 Neu. . NonA A 123 13 435 73 3-5 5.6 4-3 12.3 64.8 46.5 5-2 9-5 4.8 15.0 20.6 16.4 Ace. . NonA A 321 14 1305 66 4.1 4-7 3-S I5-I 74-3 62.1 7-7 6.0 2.6 7-5 11.4 9.0 N.C. . NonA i A 50 3 192 8 3-8 2.7 4.6 0.0 86.4 87-5 4.1 12.5 1-5 0.0 3-1 0.0 Unclass. [NonA i A 92 9 400 22 4-3 2.5 5-0 27.2 53-5 27.2 8.0 18.1 2.7 0.0 30.7 27.2 Grand Totals [NonA i A 1606 240 6604 1316 4.1 5-5 17.9 3^-3 43-9 16.4 8.5 17.6 3.5 8.2 26.0 26.2 ^In Hereditary Group i mating resulting in 18 children is omitted, because of suspected Sy. 484 FEEBLE-MINDEDNESS In Table IX we have our fundamental groups. In each of these we have subdivided the cases by matings. These subdivisions are on the basis of the mental condition of parents. For example, (F — F) means father feeble-minded, mother feeble-minded; (N — F) means father normal, mother feeble-minded. Each of these groups is again subdi\'ided into those matings where one or both of the parents were alcohoHc and those where neither was alcohoHc. From this Table we find some interesting facts. If alcohoUsm cannot be proved to directly produce feeble-mindedness may it be that it at least has some influence in that direction ? Taking the first Kne in Table IX we have the following figures : Both parents are feeble-minded ; of the non-alcohoHc group there were 90 matings resulting in 445 offspring, which is an average of 4.9 children per mating. Of these 445 children, 66.7 % were feeble-minded ; .7 of i % were normal ; 14.4 % died in in- fancy; 3.5% resulted in miscarriages; 14.6% are undetermined. With these figures we can compare the corresponding figures for the group of the same kind of matings, that is, father and mother both feeble-minded but one or the other alcoholic. Here we have only 36 matings resulting in 216 children, that is 6 per mating, an average of one child more than in the non-alcoholic group. From a study of the matings it will be seen that there are more children per mating in the alcoholic families ; there are only two exceptions and in both of these the number of matings in the alcoholic group was very small. We may make it therefore as a generalization that in alcoholic families the average number of children is about one more than in the non-alcoholic families. Looking at the condition of the children we find that there are nearly as many feeble-minded in the alcoholic as in the non- alcoholic group. That is, we have 59.2 in the alcoholics whereas there were 66.7 in the non-alcoholics. The number that died in infancy is practically the same in both. The number of mis- carriages is, however, practically doubled in the alcoholic group. The undetermined are only a few more in the alcoholic group. ALCOHOLIC AND NON-ALCOHOLIC PARENTS 485 In the same way the reader can compare the alcohoHc group with the non-alcohoHc group for each kind of mating. Unfortu- nately the number of matings for the alcohoHc group is usually Feeble-minded 10% 20 Normal 30 40 50 Died Mentality Undetermined 60 60 80 90 100 Non A TOTAL Diagram showing the relative proportion of children who were defective, normal, died in infancy (including miscarriage), and undetermined, in families that were Alcoholic as compared with the same in famihes that were Non- alcoholic. Based on the totals of Table IX. small and in several instances too small to be really valuable. This should be borne in mind in making the comparisons. In several instances it will be seen that the number of feeble- minded children is considerably larger in the alcohoHc group than in the non-alcohoHc. Corresponding to this we find that as a 486 FEEBLE-MINDEDNESS rule the number of normal children in the alcoholic group is less than in the non-alcohoHc. Taking from Table IX the (N — N) matings in each of the fun- damental groups we find that out of 276 matings where both parents are known to be normal there are only 13 cases where there is alcohoHsm in one or both of the parents. It is inter- esting to note that in these cases the children are as a rule not all feeble-minded. Assuming that alcohol causes feeble-mindedness, how shall we account for a family where the father or mother is alcohohc, having two to five children only one of whom is feeble-minded ? If the defective one was the last born it might be argued that the poison of the alcohol was cumulative, but he is not always the last born. Perhaps it may be said that the father reformed after the feeble-minded child was born. This is not the case. Wherever the parent has reformed in his habits that fact has been noted and such expressions as "once alcohohc" or "alcoholic early in hfe" are found on our charts. The following shows the condition of the children in the 13 cases where both parents were normal mentally and one or the other alcoholic. Chart Number of Children Condition of Children F N d. inf. Mis. Un. 9 14 73 i6i 201 211 213 233 260 278 281 299 299 2 9 6 2 13 2 II 6 4 8 5 5 5 I I I I 2 2 6 6 6 2 7 3 5 4 3 I I I 8 6 I 3 3 I Totals ! 78 7 43 6 18 4 ALCOHOLISM AND NON-VIABILITY 487 As an argument for alcohol there is nothing here. There are 126 matings in the Hereditary Group (Table IX, page 481), where both parents were feeble-minded. The chil- dren of these matings are of course practically all feeble- minded, but that is because their parents are feeble-minded and not because their parents were alcohohc. In 36 of these matings one or both mates were alcohoUc. These are 28.5 % of all the matings in this group. Our 13 (N ■ — N) matings were only 4.7 % of their group. Therefore the proportion of alcoholics in the (F — F) matings is more than six times as great as in the (N — N) matings. Table IX, however, is not so valuable for this comparison as the next one. Its main value is to show how the children are classified, how many are N, F, etc. and especially to show the high death rate — the non-viability especially of the offspring of alcoholic parents. Both the deaths in infancy and the mis- carriages are as a rule much higher in the alcohoUc than in the non-alcohohc group. The effect of alcohol in producing non- viable offspring is shown in the final totals which give 8.5 % of deaths in infancy among the non-alcohoKc families while it is 17.6 % among the alcohohc. Likewise the number of miscarriages including still births is 3.5 % among the non-alcohoHc but 8.2 % among the alcohohc. This agrees with other studies in this connection. For example, Professor Taaz Laitinen, M.D., reporting at the Twelfth Inter- national Congress on AlcohoHsm gives the percentage of mis- carriages among total abstainers 1.07%, moderate drinkers 5.26%, drinkers 7.11%. These percentages are based on a study of 3600 for the first group, 6600 for the second group and 9600 for the third group. Our groups probably correspond roughly, the non-alcohoHcs to his abstainers and moderates, our alcohohc to his drinkers. Since ours are all drunkards we get a little higher percentage. 488 FEEBLE-MINDEDNESS Table X PER CENT DISTRIBUTION OF FEEBLE-MINDED ANT) NORMAL CHILDREN IN ALCOHOLIC AND NON-ALCOHOLIC FAMILIES Hereditary Group Condition of Parents Kn nv Total Chix- M ATTvr^ DREN OF KNOWN Matings Mentality %F %N ^ 1 Non A ^ . • 1 A 90 300 36 130 99.0 98.4 I.O 1.6 N_F . . j^^^^ 45 i 109 5 ' 59-6 75-0 40.3 25.0 F — N . . Non A A 31 j 89 12 44 37.0 j 62.9 47-7 i 52.2 Un. — F . [Non A i A 142 250 S3 124 79.6 20.4 84.6 1 15.3 F-Un. .j^^^^ 59 145 14 : 35 82.7 1 17.2 94-2 5-7 N — N . . ■ [Non A i A 92 4 289 5 lO.O 20.0 89.9 80.0 Un.-N .jNonA 146 19 307 50 II.O 34.0 88.9 66.0 N-Un. JNonA A 37 4 236 10 5-5 40.0 94-5 60.0 Un.-Un. . (^'""A [ A 328 54 630 106 46.9 66.0 53.0 33-9 Totals . . jN^^^ 1020 201 2355 516 46.1 75-1 53.8 24.8 Neuropathk N — N . . fNon A i A 21 4 64 I 21 I 15-6 14.2 • 84.3 85.7 Un.-N . Non A i A 44 6 92 19 5-4 31-5 94.5 68.4 N — Un. . [Non A i A 26 I 70 2 2.9 0.0 97.1 lOO.O Un. — Un. . [Non A [ A 32 2 75 2.7 0.0 97-3 lOO.O Totals . . Non A A 123 13 301 1 43 ! 6.3 20.9 93.6 79.0 ALCOHOL VERSUS NO ALCOHOL Table X — Continued 489 PER CENT DISTRIBUTION OF FEEBLE-MINDED AND NORMAL CHILDREN IN ALCOHOLIC AND NON-ALCOHOLIC FAMILIES Accident Co>fDiTiON OF Parents No. OF Matings Total Chil- dren OF Known Mentality %F %N N-N . . JNonA A 130 3 4S6 15 7.8 20.0 92.1 80.0 Un. — N . Non A i A 80 8 258 23 2.3 21.7 97.6 78.2 N — Un. . [Non A i A 66 181 0.5 99.4 Un.-Un. . j^^^^ 44 3 89 13 4.4 15-3 95-5 84.6 F-N . . j^^^^ I 6 16.6 83-3 Totals . . jNonA 321 14 1020 SI 4.9 19.6 95-0 80.3 No Cause N — N . . [Non A i A 20 2 91 6 8.7 0.0 91.2 1 00.0 Un. — N . [Non A I A 12 34 0.0 100. N — Un. . [Non A i A II 26 lOO.O Un.-Un. . [Non A [ A 7 I 24 I 7.0 0.0 92.9 lOO.O Totals . . Non A i A 50 3 175 7 5-1 0.0 94.8 100. 490 FEEBLE-MINDEDNESS \ Table X — Continued PER CENT DISTRIBUTION OF FEEBLE-MINDED AND NORMAL CHILDREN IN ALCOHOLIC AND NON-ALCOHOLIC FAMILIES Totals Condition of Parents No. of Matings Total Chil- dren OF Known Mentality %F %N Hereditary. | ^""^ ^ I020 20I 2355 516 46.1 75-1 53.8 24.8 Neuropathic!^""'^ 123 13 301 43 6.3 20.9 93.6 79.0 A • J ^ [ Non A Accident . . . 321 14 1020 51 4.9 19.6 95-0 80.3 No Cause . [Non A i A 50 3 175 7 5-1 0.0 94-8 lOO.O Grand | Non A Totals . . 1 A 1514 231 3851 617 30.2 65-9 69.7 34-0 Table X hardly needs discussion. It speaks for itself. We have here considered only the offspring who lived and whose mentality has been determined. In practically every case the percentage of feeble-minded is markedly greater in the alcoholic group than in t-j ie non -alcohohc — sometimes as much as 35 %more. — • It looks evident that alcohol almost doubles the number of feeble-minded children in a family. But are we sure alcohol is a cause and not merely a symptom ? May it not be that alcohol has been a tag by which we have got into our groups more pronounced types of feeble-mindedness, who therefore have a larger proportion of defective children ? It may be thot by some, readers that we are resisting the evi- dence, but the logically minded will see the danger of fallacy. Suppose one were to divide by careful medical examination a large group of people into the tuberculous and the normal (non- ALCOHOL A CAUSE OR A SYMPTOM 491 tuberculous) — as we have divided ours into feeble-minded and normal. After the division we decide to examine our data for facts on the race problem as we decided above to use our data to study the alcohol problem. We find twice as many negroes in our tuberculous group as in the normal group. Can we logically conclude that a dark skin causes tuberculosis, or that anything about or in the negro constitution causes it ? Of course this is absurd. But we see the absurdity here easier than in the problem of alcohol and feeble-mindedness, because we know the cause of tuberculosis and we know the negro is pecul- iarly susceptible to the tubercle bacillus. Case 236 is somewhat interesting for study in this con- nection. Our child is feeble-minded supposedly because of the mistreatment of the mother during pregnancy and the fever from which both mother and child suffered at the time the child was born. Neither the father nor mother was alcohohc. The mother, however, later married a man who was alcohoHc, a drunken brute. By him she had a daughter and in spite of the drunkenness and the brutahty of the father this child is normal. It is such instances as these that must give us pause before we conclude that alcohoHsm is a cause of feeble-mindedness. There is great danger of being illogical in our thinking in this regard. We forget that a causal relation once estabhshed, the effect must always follow when the cause is present and the conditions the same. On the whole then we are forced to decide that, altho in this group the percentages are very high for the feeble-minded children of alcohoHc parents, and at first glance it appears that alcohol has greatly increased the number of feeble-minded, yet the argument is not complete. It must not be forgotten also that we are dealing with only one side of the question, that is, the side of feeble-minded children with their parents. In considering the question of whether alcohol causes feebl e-mind edness we ous^ht to consider the cases of normal children with alcoholic parents in otherwise normal 492 FEEBLE-MINDEDNESS families. While we have at hand no statistics on this subject every one knows that there are many such cases. Indeed one must admit the argument that if alcohol did cause feeble- mindedness, the number of the f eeble-m inded would be enor- mously greater than it now is. Even to-day there are cases of severely alcohohc parents with famihes of children none of whom are feeble-minded ; and if we go back two or three genera- tions, when it was much more common for intelligent people to get intoxicated than it is to-day, we see how unlikely it is that alcoholism could be a serious cause of feeble-mindedness, else a large proportion of the population would be defective. Since the definition of alcohohc as used in our work is practi- cally synonymous with drunkard, the argument is heightened. If it cannot be shown that drunken parents more certainly have feeble-minded children, it is hardly worth while to discuss the cases of the moderate drinkers or even the habitual drinkers who never drank to intoxication. Everything seems to indicate that alcoholism itself is only a symptom, that it for the most part occurs-in families where there is some form of neurotic taint, especially feeble-mindedness. The percentage of our alcoholics that are also feeble-minded is very great. Indeed one may say without fear of dispute that more people are alcohohc because they are feeble-minded than vice versa. PARENTS — PARALYTIC, EPILEPTIC, INSANE, OR SYPHILITIC In the foregoing discussion of alcohol the cases of alcoholism and non-alcoholism have been uncomplicated by any other serious conditions. In the following Table we present those cases where the parents have one or more of the above con- ditions which may also be complicated by alcohol. We have for example, alcohol and paralysis in the same family, sometimes in the same parent ; in other cases we have alcohol PARENTS PARALYTIC, EPILEPTIC 493 and epilepsy ; other combinations are presented for comparison as also the cases of paralysis, insanity, epilepsy, etc. alone. A study of these figures must give one serious doubt as to the causal effect of these conditions in producing feeble-mindedness. If we take the Hereditary Group where wq know we are deahng with a defective stock and we might expect that these conditions would greatly increase the proportion of feeble-minded we find strange figures. For example, where the parents are both alcoholic and paralytic there are, out of 22 children, no feeble- minded ones. Where there is epilepsy, alcohol and syphilis, there are equal numbers of feeble-minded and normal, a condi- tion of things which we have learned to expect in any family where one parent is normal and the other defective — as in this case. In the Neuropathic Group we find that parents who were both alcoholic and paralytic have not as large a proportion of feeble- minded children as another group of parents who are only paralytic. Insanity alone gives us 2.2 % feeble-minded ; epilepsy alone gives 20 % feeble-minded ; but insanity and epilepsy give us no feeble-minded. The Accident Group appears no different. SyphiHs gives 20 % feeble-minded ; alcohol and syphilis only 12%. The number of matings and children is of course small in many of these combinations. They are probably too small to prove anything one way or the other, but it seems altogether unhkely that, if these conditions were potent causes of feeble-mindedness, it should not show in a table hke this even tho the numbers are small. The figures are presented only as showing one more failure in an attempt to discover some causal connection between these conditions and feeble-mindedness. It is of course known that there are in the general population quantities of matings where one or the other of the parents has syphilis or is alcoholic and there are no feeble-minded children. But in a stock already tainted with feeble-mindedness we might 494 FEEBLE-MINDEDNESS expect to find a greater percentage of feeble-mindedness, thus showing the influence of these conditions. That we do not find it must have at least a Uttle significance. Table XI f PARENTS — PARALYTIC, EPILEPTIC, INSANE, OR SYPHILITIC Hereditary Group Condition OF No. OF Matings Total Children Condition of Children Parents %F %N % d. inf. % Mis. %Un. Par. . . A. Par. . I. Par. . I. . . A. I. . E. I. . E. . . A. E. . A. E. Sy. Sy. . . A. Sy. . 35 4 3 26 9 2 19 7 I lO 7 209 22 23 50 7 III 35 5 40 42 27.2 0.0 34-7 16.6 45-9 28.5 37.8 20.0 40.0 42.4 42.8 45-5 0.0 18.6 0.0 28.5 10.8 8.5 40.0 4.9 9-5 II.O 18.I 4.3 lO.O 5-9 14.2 14.4 8.5 0.0 27.7 21.4 3'^ 4-5 0.0 1-3 1.9 14.2 6.3 8.5 0.0 lO.O 19.0 42.5 31-8 60.8 S3-3 45-9 14.2 30.7 54-2 20.0 14.9 7.2 Totals 123 694 28.8 14.2 12.3 4.8 39-6 Neuropathic Group Par. A. Par. I. Par. I. . A. I. E. I. E. . A. E. Sy. . 28 3 2 7 4 I I I 3 163 22 4 45 33 5 5 3 16 296 4.9 4.6 0.0 2.2 6.0 0.0 20.0 12.4 42.9 22.7 0.0 42.2 42.4 80.0 20.0 66.6 6.3 17.2 9.0 0.0 22.2 9.0 0.0 40.0 0.0 31-3 3-6 0.0 50.0 0.0 0.0 0.0 0.0 0.0 43-8 31.2 63.6 50.0 42.4 20.0 20.0 0.0 . 6.3 Totals 50 5-4 39.1 16.8 5-0 33.4 TUBERCULOSIS Table XI — Continued 495 PARENTS — PARALYTIC, EPILEPTIC, INSANE, OR SYPHILITIC Accident Group Condition of No. OF Matings Total Children Condition of Children Parents %F %N % d. inf. % Mis. %Un. Par. . . . A. Par. . . . I Sy A. Sy. . . . i8 2 3 I 2 86 i6 5 8 4-7 6.6 0.0 20.0 12.4 63-9 86.6 62.4 20.0 74-9 8.1 0.0 12.4 40.0 0.0 3-4 0.0 0.0 20.0 0.0 19.7 6.6 24.9 0.0 12.4 Totals . . 26 130 5-3 65.3 8.4 3.0 17.6 No Cause Par Sy 6 I 29 2 3-4 0.0 58.6 lOO.O 3-4 0.0 0.0 0.0 34-4 0.0 Totals . . 7 31 3-2 61.2 3-2 0.0 32.2 Unclassified Group Par I A. I. ... 3 I I 18 7 3 28 0.0 0.0 33-3 44.4 28.5 0.0 II. 2 42.9 0.0 0.0 0.0 0.0 44.4 28.5 66.6 Totals . . 5 ■ 3.5 35.8 17.8 0.0 42.8 Grand Totals 211 1179 19.0 27.9 12.9 4.4 35-5 TUBERCULOSIS Records have been kept on the assumption that tuberculo- sis might produce a poison in the parents which would prevent their bringing offspring to full and normal development. There are on these charts 324 cases of tuberculosis. The cases are scattered thru all of the four groups and an inspec- tion of the various charts will show that their location is only such as would be accounted for by contagion. There- 496 FEEBLE-MINDEDNESS fore, this presents no argument that tuberculosis has causal relation to feeble-mindedness. Some of these famihes show numerous cases of tuberculosis, probably due to the low social order of these people, their unclean- liness and failure' to take proper precautions against the disease. Doubtless our reported cases cover not much more than the most clearly defined cases of tuberculosis of the lungs, whereas the usual statistics count all forms. Even so, we can allow for much error in this direction and still have left a low per cent of tuber- culosis, for only 2.8 % of all persons charted are marked tuber- culous, while in the general population the proportion is from 10% to 15%. This agrees with the view that feeble-minded stock may be primitive and possessed of much animal strength and possibly some immunity to disease. For the number of cases and percentages see Tables, pages 531. 532. If there is no influence producing tuberculosis in one group more than another these 324 cases should be found in the different groups in the proportion of the whole number of persons in those groups or 60.3 : 9.7 : 10.6 : 16.7 : 2.4 ; for the Hereditary, Probably Hereditary, Neuropathic, Accident and No Cause respectively. The following table shows what would be expected compared with what we actually find. Group Expectation Actual Too Many Too Few Hereditary 195 187 8 Probably Hereditary . . 32 59 27 Neuropathic .... 35 36 I Accident 54 39 IS No Cause 8 3 5 Here is much tuberculosis in the Probably Hereditary group, but a study of the charts will show that this is largely accidental. Ten of these cases occur on one chart (No. 181). SEXUAL IMMORALITY 497 SEXUALLY IMMORAL (SX) Sexual immorality as here used means notorious cases — cases where there is external evidence in the form of illegitimate children, notorious prostitutes, or men equally notorious in their violation of the moral code. The figures strike one as low and undoubtedly they are much below the facts. However, it is well to remember that with a large proportion of the people among whom this practice prevails the moral code is so unknown or unrecognized that there is very little shame connected with this matter, so that it is less difficult to get the facts than it would be in any similar investigation in better society. This is emphasized by the fact that 170 of these people were feeble-minded while only 15 were normal, the re- mainder being undetermined. On the other hand there is a great deal of evidence that feeble- minded people are not nearly so promiscuous in their sexual re- lations as we might at first expect. There is every evidence that a great many of them Hve together in wedlock and true to each other. There a^e^also many unmarried among them who hve a hfe of continence and chastity. While it is a somewhat difficult matter to prove, the writer has come to the conviction after years of study of the problem that the sexual instinct in these people is under-developed rather than over-developed. This is not generally recognized and it is true that it often appears otherwise, butjafhat appears to be an over-development of the instinct, in many cases at least, proves upon examination to be simply an excess due to lack of^ ontrol. Instinct itself is not stronger but the power of control being re- moved it manifests itself more strongly than with normal people. One-third of our charts show sexually immoral individuals but only 2.5%_iQf^the total number of individuals charted are sexually immoral (Sx) according to our information.. An inspection of the Table shows that the Hereditary Group 498 FEEBLE-MINDEDNESS gives a percentage for immorality both in charts and in indi- viduals over three times as great as any other group, showing that the lack of control has led a larger proportion of these people into this error. It can be plainly seen how feeble-mindedness contributes to our sexual problems. Table XII SHOWING FREQUENCY AND DISTRIBUTION OF SX ON OUR CHARTS 288 Persons on 96 Charts are marked Sx. They are divided as follows : Mentality Hereditary 79 Charts Probably H 5 Charts Neu. 8 Charts Accident 4 Charts Total 96 Charts XT 1 [ Men Normal ,,, Women Feeble-minded [^^^^^^ Undetermined I ,^'^" ^ [ Women 6 3 40 129 31 49 2 2 I 2 I I II 5 I I 3 9 6 40 130 45 58 Totals 258 8 17 5 288 Total feeble-minded 170 — Normal 15 — Undetermined 103. Total Men 94 — Total Women 194. Of 164 Charts in Hereditary Group 79 Charts or 48.2% show Sx Of 34 Charts in Probably H. Group 5 Charts or 14.7% show Sx Of 37 Charts in Neuropathic Group 8 Charts or 21.6% show Sx Of 57 Charts in Accident Group 4 Charts or 7.0% show Sx Of 8 Charts in No Cause Group o Chart shows Sx Of 300 Charts 96 Charts or 32.0% show Sx Of 6868 Persons in Hereditary Group 258 or 3.75% are marked Sx Of 1115 Persons in Probably H. Group 8 or 0.71% are marked Sx Of 1212 Persons in Neuropathic Group 17 or 1.40% are marked Sx Of 1913 Persons in Accident Group 5 or 0.26% are marked Sx Of 281 Persons in No Cause Group o are marked Sx Of 1 1 389 Persons in all Groups 288 or 2.52% are marked Sx ILLEGITIMACY 499 The following table shows what would be expected compared with what we actually find. Group Expectation ^ Actual Too Many- Too Few Hereditary .... Probably Hereditary . Neuropathic . . . Accident No Cause .... 174 28 31 48 7 258 8 17 5 84 20 14 43 7 Sex immorality is closely associated with hereditary feeble- mindedness. ILLEGITIMATE CHILDREN Closely connected with the subject of sexual immorahty is the one of illegitimacy. Our records show 278 illegitimate children of whom 259 or 93 % are in the pure Hereditary Group, 12 are in Probably Hered- itary, 3 in Neuropathic and 4 in the Accident Group. There is nothing new in these facts, they are simply confirma- tory of what we have found in other Hues. The following table shows what would be expected compared with what we actually find. Group Expectation > Hereditary . . . Probably Hereditary Neuropathic . . Accident .... No Cause . . . 168 27 29 47 7 Actual 259 12 3 4 o Too Many Too Few 91 15 26 43 7 It is plain to be seen that there is a decided relation between illegitimacy and hereditary feeble-mindedness. 1 See page 480 under Table VIII. 500 FEEBLE-MINDEDNESS PARALYSIS A neuropathic condition of some of the ancestors or relatives which has been designated by our informant and on our charts by the words paralysis, apoplexy, stroke or some simi- lar term is noticeably frequent. The question arises — is this a symptom or a cause of f eeble-mindedness ? The following Table gives a summary of what information we have as to the relation of paralysis to feeble-mindedness in these cases. Table XIII SHOWING FACTS ABOUT PARALYSIS AS IT APPEARS ON OUR CHARTS Of 300 charts a total of 99 gr 33 % show paralysis, divided as follows : Hereditary Group 1 Line of Descent WITH OUR Child Paralysis appears on Charts i Number of Cases Numbered ON Each Chart Direct Line and Sibs^ CoUaterali 29 8 4 4 80 4 4 161 3 3 3, 56, 70, 72, 104, III, 132, 134, 148 2 14 4 12, 18, 19, 22, 24, 26, 28, 35,44,46,53,58,59,78, 85, 86, 87, loi, 102, 130, I 24 I 146, 150, 154, 159, 163 Total, 37 charts, 22.5 7o of entire Hereditary Group of 164 charts. Probably Hereditary Group 183, 195, 198 181, 185, 197 172, 178, 184, 190 1 *' Direct line" in these tables includes sibs of parents, grandparents, etc., i.e. all persons who have the same blood. " Collaterals " include only those in whose blood is another strain brought in by marriage. PARALYSIS 501 Table XIII — Continued SHOWING FACTS ABOUT PARALYSIS AS IT APPEARS ON OUR CHARTS Total, 10 charts, 29.4 % of the entire group of Probably Hereditary (34 charts). Total Hereditary (Certain and Probable), 47 charts or 23.7% of the 198 charts in these two Hereditary Groups. By individuals, 77 or 0.96 % of all persons in these groups. Neuropathic Group Paralysis appears on Charts Number of Cases ON Each Chart Line of Descent with our Child Numbered Direct Line and Sibs^ Collateral i 199 5 4 I 205, 218, 231 3 9 200, 211, 212, 213, 215, 225, 227 1 2 13 I 201, 202, 203, 204, 207, 1 208, 210, 214, 216, 217, 220, 221, 223, 224, 228, I 17 I 229, 230, 232 Total, 29 charts, 78.3 % of the entire Neuropathic Group of 37 charts. Accident Group 291 3 3 279, 281 2 4 237, 238, 246, 247, 252, 257, 258, 262, 263, 265, I 15 280, 285, 288, 289, 290 1 Total, 18 charts or 31.5 % of the entire Accident Group of 57 charts. No Cause Group 297 293, 294, 295, 296 Total, 5 charts or 62.5 % of the entire No Cause Group of 8 charts. 1 Idem. 502 FEEBLE-MINDEDNESS Summary Hered. Prob. H. Nexjr. Ace. N. C. Total 0. Charts . . 37 10 29 18 5 99 No. Individuals Men Women Dir. 23 26 Col. 5 4 Dir. 13 6 Col. Dir. 26 17 Col. 2 I Dir. 12 10 Col. Dir. 3 3 84 M 67 w Total Persons 49 9 19 43 3 22 6 151 Of 6868 Persons in Hereditary Group Of 1 1 15 Persons in Probably H. Group (Of 7983 Persons in H. & Prob. H. Of 1 212 Persons in Neuropathic Group Of 1 91 3 Persons in Accident Group Of 281 Persons in No Cause Group 58 or 0.84% show Paralysis^ 19 or 1.74% show Paralysis 77 or 0.96% show Paralysis) 46 or 3.82% show Paralysis 22 or 1.15% show Paralysis 6 or 0.31% show Paralysis Of 11,389 Persons in all Groups 151 or 1,32% show Paralysis The following table shows what would be expected com- pared with what we actually find. Group Expectation i Actual Too Many Too Few Hereditary Probably Hereditary . . Neuropathic .... Accident No Cause 91 15 16 25 4 58 19 46 22 6 4 30 2 33 3 The predominance here is in the Neuropathic Group. We note first that the percentage of neuropathic charts show- ing paralysis, 78%, is greater than is that of any other group. This is to be expected since there have been placed in this group all cases that, showing no probabiHty of hereditary feeble-minded- ^ " Paralysis " includes hemiplegia, apoplexy, stroke, etc. 2 See page 480, under Table VIII. PARALYSIS 503 ness, have among other neuropathic conditions this one of paral- ysis. The proportion is however quite large in the other groups, being 22% of the hereditary, 29% of the probably hereditary and 31% of the accident. It would seem to be significant that a very large number of these cases are in direct line ^ with the case studied, that is to say, it is paralysis of one of the parents, one of the grandparents, or their sibs. Perhaps the strongest evidence for the causal relation of paraly- sis is found in the No Cause Group where there are five charts with six paralytic individuals and so far as can be determined nothing else to account for the condition of the feeble-minded person. It is true that the paralysis in these cases is in the grandparents while the parents were normal and reasonably healthy. It does not seem impossible however that the paralysis may be a symptom of a neural condition which is inherent, and which under certain conditions shows itself as feeble-mindedness. It must be understood that while it is probable that the cases that we have are properly described as paralysis, we are by no means sure that we have all of the cases. An illustration may be taken from the cases of ''heart failure" or ''heart trouble." There are many of those on our charts but they have not been included in this group, altho undoubtedly what is called "heart failure" is sometimes a paralysis, hemiplegia or stroke of apo- plexy. Unsatisfactory and incomplete as the data are we perhaps shall not get anything more definite until we have a more complete equipment and are able to follow the hving cases into the coming generations and have examinations made by medical experts. If for example the people on our charts who are now Hving could be carefully examined and later their children and grandchildren we would have a mass of data that would be accurate and on which it would be possible to base definite conclusions. Such a plan is entirely feasible. 1 See note, p. 500. 504 FEEBLE-MINDEDNESS INSANITY AND FEEBLE-MINDEDNESS The distinction between insanity and feeble-mindedness is theoretically an easy one to make. Neurologically, insanity re- sults from a brain that is diseased while in the case of feeble- mindedness the brain has never attained normal develop- ment. A dwarf never grows to normal stature but a man of normal stature may be reduced to the height of the dwarf by an accident which cuts six inches from his legs or by disease which shortens him at the hip-joint, or which curves his spine so that he can no longer stand up straight. A feeble-minded person is a person with a dwarf brain, not necessarily in size it is true, but in function ; while an insane person is one with a diseased brain. Functionally the two con- ditions may approach each other so nearly that, to the inex- perienced at least, they are difficult to distinguish. For the layman, the easiest way to distinguish between these is by means of the early history of the individual. A child who has had in the past better intelKgence than he now possesses is probably suffering from disease of the brain, since simple arrest of development would not account for the previous superior intelUgence. Case 314 is a good illustration of this. The psychiatrist seldom has any difficulty in distinguishing between the two; he usually finds either an anatomical lesion showing disease of the brain, or well-known mental symptoms characteristic of insanity, which are distinctly different from those of arrested development. The Binet-Simon Measuring Scale of IntelKgence differen- tiates, fairly accurately, insanity from feeble-mindedness. Epi- lepsy, it is true, gives apparently much the same result as insanity, and it is sometimes difficult to say by this method whether it is the one or the other, but they are distinguished in either case from distinct feeble-mindedness. A child suffering from simple arrest of development goes to a certain point in the scale then INSANITY 505 stops rather abruptly, whereas a person with a diseased brain will answer a part of the questions in a number of different years, missing some questions in all of these years, showing that disease has affected some of these mental processes while not affecting others. This " scattering," as it is called, has been proved to be characteristic of epilepsy and of insanity. Here at Vineland were collected some few years ago all of the cases that showed *' scattering" by the Binet test. Out of the twenty that were thus recorded four had gone to an insane asy- lum within a year, even tho at the time the test was made there was no suspicion of insanity about them. These were of course cases of feeble-mindedness plus insanity. The brain that has been arrested in its development thus causing feeble-mindedness may later become diseased, and so we have insanity in a feeble- minded person. These cases of insane feeble-minded are some- times difficult to recognize, but usually they show sooner or later such positive signs of insanity that all doubt is removed. The need for autopsies and histological examinations in all such cases is evident. The pecuh'arities of insanity in the feeble-minded is a chapter in the story of feeble-mindedness which is not yet written. The real theme of the present section is not the question of the insane feeble-minded, but the question of the relation of insanity in the family to feeble-mindedness in the same family, not in the same individual. Previous to the present investigation we at Vineland shared the common idea that insanity and feeble-mindedness were largely interchangeable in the same families ; that is to say, there was a neuropathic taint which sometimes manifested itself as insanity and in other individuals as feeble-mindedness. We were accord- ingly prepared to find our charts heavily sprinkled with insane individuals. Great has been our surprise therefore to find the number of insane persons so much smaller than was anticipated. Inspection of the charts themselves does not convince one that \ 5o6 FEEBLE- MINDEDNESS insanity in the ancestry has any very potent influence toward causing feeble-mindedness. It undoubtedly may be a symptom of nervous derangement which will occasionally give rise to feeble-mindedness. Table XIV SHOWING INSANITY AS IT APPEARS ON OUR CHARTS Of 300 charts 62 or 20.6% show Insanity, divided as follows: Hereditary Group Insane Persons appear on Charts Numbered Number of Cases ON Each Chart Direct Line and Sibs Collateral 29 4 97 56 11, 32, 61, loi, 154 12, 16, 19, 21, 34, 35, 43, 50,52, 58, 71,72,82, 91, no, 119, 126, 132, 145, 151, 156, 159, 160, 161 7 6 4 3 2 I 5 5 4 9 20 2 I (S 3 I 4 Total charts 2>2> or 20.1 % of the Hereditary Group of 164 charts. Total individuals 54 or 0.78 % of all persons on charts of Hereditary Group. Probably Hereditary Group 183 6 4 2 170 3 2 I 165, 177, 184 2 3 3 179, 180, 186, 192, 196 I 4 I Total charts 10 or 29.4 % of the entire Group of Probably H. (34 charts). Total individuals 20 or 1.79 % of all persons on charts of Probably Hereditary Group. Total Hereditary (Certain and Probable) 43 charts or 21.7 % of the 198 charts of these two groups. By individuals 74 or 0.92 % of all persons in these groups. INSANITY 507 Table XIV — Continued SHOWING INSANITY AS IT APPEARS ON OUR CHARTS Neuropathic Group Insane Persons appear on Charts Numbered Number of Cases ON Each Chart Direct Line and Sibs Collateral 200 7 6 I 225, 228 4 7 I 233 3 3 220, 222, 235 2 6 205, 207, 209, 210, 227,1 229, 231, 234 J I 8 Total Charts 15 or 40.5 % of the entire Group of 37 Neuropathic Charts. Total individuals 32 or 2.64 % of all persons on charts of Neuropathic Group. Accident Group 240, 253, 259, 288 Total Charts 4 or 7 % of the entire Accident Group of 57 charts. Total individuals 4 or 0.20 % of all persons on charts of Accident Group. Summary Hereditary Probably H. Neuropathic Accident No. of Charts 33 10 15 4 No. Individuals Men Women Dir. 23 20 CoL 4 7 Dir. 3 10 CoL 3 4 Dir. 13 14 CoL 3 2 Dir. 2 2 CoL Total Persons 43 II 13 7 27 5 4 Total Men 51. Total Women 59. Total Insane no. In direct line with our cases 87, in collateral line 23. Of 6868 Persons in Hereditary Group 54 or 0.78% are Insane Of 1 1 15 Persons in Probably H. Group 20 or 1.79% are Insane Of 121 2 Persons in Neuropathic Group 32 or 2.64% are Insane Of 1 913 Persons in Accident Group 4 or 0.20% are Insane Of 281 Persons in No Cause Group o are Insane Of 11,389 Persons in all Groups xio or 0.96% are Insane 5o8 FEEBLE-MINDEDNESS The following table shows what would be expected compared with what we actually find. Group Expectation i Actual Too Many Too Few Hereditary . . 66 54 12 Probably H. . . II 20 9 Neuropathic . . 12 32 20 Accident . . . i8 4 14 No Cause . . . 3 o 3 The Insanity is clearly in the Neuropathic group, not among the Heredi- tary Feeble-minded. Not only is there no close relationship between insanity and feeble-mindedness, but the conviction has grown since the begin- ning of our study of the problem, that these two types of abnor- mal mentality belong at opposite ends of the physical scale. It is an old and cherished thot that feelDle-mindedness is a kind of reversion to a more primitive type of the human race. The idea of reversion in this sense is no longer held, since the Men- dehan law has come in to give us a clearer and more satisfactory explanation. Once the hereditary character of feeble-minded- ness is recognized one can hardly keep from thinking of a feeble- minded person as belonging to a strain that has not yet developed to the higher levels of intelHgence. In other words, we come back again to the view of a more primitive form of humanity, a vigorous animal organism of low intellect but strong physique — the wild man of to-day. The striking thing is that this viev; is remarkably borne out in many phases of the physical nature of this group. One cannot study the moron without discovering that he is not only largely free from the marks of degenera- tion, frequently possessing a comely face, but he also has many of the physical characteristics of a more primitive stock. ^ See page 480, under Table VIH, INSANITY VS. MENTAL DEFECTIVENESS 509 A dentist assures me that the finest set of teeth he has ever seen is in the mouth of one of our morons. It is true that our study of the Height and Weight of the Feeble-minded (see Journal of Nervous and Mental Diseases, April, 191 2, Vol. 39, pages 217-236) shows the average moron to be no taller nor heavier than the average normal, and moreover they seem to have stopped growing two or three years earUer than the normal person. It must be remembered however that these figures are the average of all morons and include those that are defective by disease, accident and neuropathic ancestry, and it is quite possible that if we had the statistics on the pure hereditary morons we might find that they even exceed the stature of the average normal person. They at least equal it. They also have strength. This does not show in statistical studies where the dynamometer is used because such measure- ments involve will power and intelHgence. The dynamometer itself is a measure of intelligence among these defectives. They are unable to exert their strength in obedience to the command, "squeeze this as hard as possible." But wherever an exercise of strength is called forth by a natural situation and their action is impulsive or instinctive one discovers at once how great is the strength. The writer was one of six persons required to hold one of these boys in the chair while the dentist looked at his teeth. That same boy could not squeeze a kilogram on the dynamometer in spite of all efforts to induce him to do it. An examination of the inmates of any Institution will show among the cases of hereditary feeble-mindedness a large number of tall, broad-shouldered, heavy, thick-set individuals with great strength. There is an incoordination of their movements and a certain coarseness of features which do not make them attrac- tive, but which in many ways suggest the savage. The fact that many of these defectives become vicious and dangerous when mistreated possibly points in the same direction. 5 lo FEEBLE-MINDEDNESS Sometimes these hereditary cases when of a low type swallow anything that comes within their reach that is small enough to. be swallowed, — sticks, stones, leather and the Hke. But rarely do these things disturb their health, which again would seem to indicate a primitive digestive system. Wounds seem to heal many times where in normal people they would give much trouble. There is apparently more or less resistance to certain diseases. Theije is a dullness to pain. These with other facts have given the impression that we are deaHng with a primitive, crude, coarse form of the human organism; not a '' reversion" but a primitive strain that has remained much as in the savage condition. On the other hand it is maintained by psychiatrists that many if not all forms of insanity come upon individuals who have what we may term a more elaborately developed organ- ism, a nervous system that is highly developed, that is high strung, and that requires only a sHght shock to throw it over into an abnormal condition. If this view of the two conditions is correct, it would throw much Hght upon many things in connection with them. It is true that an unusually high percentage of feeble-minded persons become insane, but whether these persons are predominantly in the Hereditary Group and of the moron grade, it is difficult to say ; possibly it would be found that they do not interfere with the argument. At least the above view seems worth consideration. GENIUS AND FEEBLE-MINDEDNESS Much confusion exists in the popular mind in regard to the relation of feeble-mindedness to genius. It is quite commonly supposed that it is but a step from the one to the other, and that the presence of an idiot in the family may mean that there is a genius at the other end. So strong is this beUef that some object to all methods of Hmiting the propagation of the feeble-minded, fearing to deprive the world of geniuses. It is probable that GENIUS 511 this view is based upon the misunderstanding of the difference between feeble-mindedness and insanity. There is no question that it often is a simple step from insanity to genius ; indeed, there are many cases of genius that would pass with any psychi- atrist as true insanities. Apparently the decision as to whether a man is called insane or a genius depends upon whether his special form of aberration proves to be useful or dangerous. I beHeve that in cases of hereditary feeble-mindedness we are dealing with a mentahty upon which it is absolutely impossible to graft any kind of genius ; that there is no connection between feeble-mindedness and genius. It is significant that in our 300 family histories totahng 11,389 individuals not a single genius has been found. These figures certainly can be taken at their face value because it is evident that had there been a genius in any of these families all of the other members would have called our attention to it. In the case of the neuropathic ancestry and accidental cases the situation might be different from the hereditary. In the neu- ropathic especially it might seem that we were deaUng with the kind of nervous system which might give rise to those pecuKar ec- centricities which sometimes spell genius. It is perhaps signifi- cant that even in this group we have discovered no geniuses. It may indicate what some students are inclined to claim, that there is no case of feeble-mindedness unless there is an hereditary taint, the only exception to this being the cases of actual traumatism. Not only are there no geniuses, but the fact cannot be too strongly emphasized that even the people who are considered normal (and so charted) in the families of the Hereditary Group are not as a rule people of average intelligence, but in almost all cases are of a low grade of intelHgence and often low type socially. So far as the eugenic problerrTis concerned therefore, there is no argument against eugenical measures for fear of cutting off possible geniuses by preventing procreation in families where hereditary feeble-mindedness exists. 512 FEEBLE-MINDEDNESS FEEBLE-MINDEDNESS AND EPILEPSY The relation of feeble-mindedness to epilepsy is one which has never been cleared up. Epilepsy is a generic term under which are grouped a number of different kinds of epilepsy. It is possible that some of these are intimately connected with feeble-mindedness either as cause or eft'ect, and it is also possible that others of the epilepsies have no connection whatever with feeble-mindedness. While the great majority of the epileptics in our Institutions are feeble- minded, this is because they do not come to the Institutions until there is such a degree of mental deficiency that they are unable to take care of themselves. On the other hand there is a con- siderable percentage of epileptics who have only occasional seizures, and at other times are perfectly normal and able to carry on business or manage their own affairs. There is the psychic epilepsy or psychical epileptic equivalents. We have made no attempt to collect data in this unsettled field. The relations here we leave to the students of epilepsy. We confine ourselves to those cases where the motor manifestations are sufficientl}^^«rarked to render a diagnosis reasonably sure. There is considerable association between epilepsy of the easily recognizable kind and feeble-mindedness. As to any causal relation between the two conditions, it seems evident that it is possible to make two groups. There are those cases that are primarily epileptic and in which the epilepsy acts to cause a deterioration of mentality so that we have eventually an in- dividual whom it is hard to distinguish from the true feeble- minded person. And then there are others who are primarily feeble-minded — perhaps belonging to the Hereditary Group, perhaps to the Non-hereditary — who acquire epilepsy. In these cases the epileptic attacks often have Httle or no apparent effect upon the mentahty of the person. They remain, for many years at least, at the same intellectual level that they have mani- fested since the arrest showed itself. EPILEPSY 513 It is possible to divide epileptics into these two groups with considerable accuracy by means of the Binet Scale. The person who is feeble-minded primarily and epileptic secondarily re- sponds to the Binet questions as does the purely feeble-minded person. That is to say, he answers them up to a certain point and then stops more or less abruptly, showing that at a certain level his mental development has stopped. He can do every- thing up to that level, nothing beyond. The other, group shows the scattering which was spoken of under the head of insanity (page 505). This indicates that such a person has been at one time of higher intelligence than at the time of examination. The epilepsy has interfered with the mental functioning along certain Hnes more than along others, with the result that some questions in the higher levels are answered while some of those in the lower levels are missed. Sometimes it happens, for ex- ample, that an epileptic will answer all the questions in age nine or ten while failing on some or all in age six or seven. That there is any relation between epilepsy and feeble-minded- ness in a hereditary way, that is to say that an epileptic person is more apt to have feeble-minded children or vice versa, our data give Httle evidence beyond, the fact that epilepsy seems often to indicate a neuropathic condition, and that in such famihes feeble- mindedness may appear. We have found seventy-nine cases of epilepsy. It must be borne in mind that we have been making no study of epilepsy. Our field workers were in no wise qualified to determine epilepsy in any of its more psychic phases, and our records are of such individuals as have been diagnosed by the local physician oi- have so many and such characteristic features that it is apparent to the layman that they suffer from this malady. The somewhat larger percentage of the cases in the neuro- pathic group is perhaps insignificant, since the presence of epi- lepsy in some members of the family has been one of the criteria determining this group. The small number in the accident group as compared with the hereditary is distinctly significant. 2L 514 FEEBLE-MINDEDNESS These cases of epilepsy will be found on the following charts : Hereditary Charts — Nos. 8, 9, ii, 12, 13, 15, 17, 20, 21, 29, 30, 37, 39, 45, 47, 52, 56, 70, 71, 75, 80, 81, ^2, 85, 107, 109, 114, 118, 141, 144, 151, 152, 158, 161 Probably Hereditary Charts — Nos. 172, 177, 186, 189, 190 Neuropathic Charts — Nos. 200, 203, 206, 208, 215, 220, 221, 225, 233 Accident Charts — Nos. 237, 252, 260, 289 No Cause Chart — No. 298 Table XV Of 6868 Persons in Hereditary Group 56 or 0.81% are Epileptic ^ Of 1 115 Persons in Probably H. Group 5 or 0.44% are Epileptic Of 1 212 Persons in Neuropathic Group 13 or 1.07% are Epileptic Of 1 9 13 Persons in Accident Group 4 or 0.20% are Epileptic Of 281 Persons in No Cause Group i or 0.03% are Epileptic Of 11,389 Persons in all Groups 79 or ojSQ ^are E pileptic The following table shows what would be expected com- pared with what we actually find. Group Expectation 1 Actual Too Many Too Few Hereditary .... Probably H. . . . Neuropathic . . . Accident .... No Cause .... 48 8 8 2 56 .5 13 4 I 8 5 3 9 I Epilepsy is seen to predominate shghtly in the Hereditary and Neuropathic Groups. - — CRIMINALITY AND FEEBLE-MINDEDNESS Every feeble-minded person is a potential criminal. This is necessarily true since the feeble-minded lacks one or the other of the factors essential to a moral life — an understanding of right and wrong, and the power of control. If he does not know right and wrong, does not really appreciate this question, then of course he is as likely to do the wrong thing as the right. Even ^ See page 480, under Table VIII. CRIMINALITY 5^5 if he is of sufficient intelligence and has had the necessary train- ing so that he does know, since he lacks the power of control he is unable to resist his natural impulses. _ Whether the feeble-minded person actually becomes a crim-N inal depends upon two factors, his temperament and his environ- / ment If he is of a quiet, phlegmatic temperament with thoroly weakened impulses he may never be impelled to do anything seriously wrong. In this case when he cannot earn a living he will starve to death unless philanthropic people provide for him. On the other hand, if he is a nervous, excitable, impulsive person he is almost sure to turn in the direction of^giiminaUty. For- tunately for the welfare of society the feeble-minded person as a rule lacks energy. But whatever his temperament, m a bad environment he may still become a criminal, the phlegmatic temperament becoming simply the dupe of more intelligent crim- inals while the excitable, nervous, impulsive feeble-minded person may escape criminaUty if his necessities are provided for, and his impulses and energies are turned in a wholesome direction. It is not easy to decide beforehand which of these conditions is fulfilled in any particular group. In the data that we are studying, criminality seems at firsUiahUobe surprisingly small. This is partly explained by the fact that our cases mclude only those who have been under arrest. Thirty-two charts with a total of forty-five individuals show criminaUty. That is, crim- inality appears on lo % of the charts, but only *ne^hii:d.i»t*-% of the individuals are criminaUstic. It is perhaps significant that the greater proportion ol these are intheHereditary Group. Thirty of the charts in the Hereditary Groups, or 15.1 %, have criminals on them ; in the Neuropathic Group two charts or 5.4 % ; in the Accidents none. The criminal individuals ar^a5^% of the persons in the Hereditary Groups; 0.24% of those m the Neuropathic Group and none of the accidents. Of the 45 cnm- inals 41 are men, 4 are women, while 24 are known to be feeble- minded, I is normal and 20 unknown. 5i6 FEEBLE-MINDEDNESS It is probable that in these cases two factors account for the small proportion of criminals. These people are very largely from rural districts, and their temptations perhaps have not been so great. But more significant is the fact that in such communi- ties minor kinds of crime are not taken account of, so that they do not get marked "criminal" because they were never arrested. In the city cases our data are always much less complete. There are individuals of whom we have learned enough to determine their mentality while not being able to follow their careers. They have left home or have been lost sight of and may be to-day in prison without their friends and relatives knowing anything about it. Undoubtedly there are cases that escape in this way, but on the whole it seems probable that the fact of a criminal life would be one that we would be likely to discover if it existed. Such facts are hard to conceal. There are nine criminahstic individuals on the charts that do not belong to the family, that is to say, they have married in, and they are only significant as showing the kind of company these people keep. Table XM. showing criminality as it appears on our charts Of 300 charts a total of 32 or 10.6 % show criminality, divided as follows : Hereditary Group Criminalistic Persons appear ON Charts Numbered Number of Cases ON Each Chart Direct Line and Sibsi Collateral i 29 5 2 3 7, 64, 15 3 4 S 2, 3, 4, 5, 16, 21,31,37,48,1 57, 62, 65, 72, 79, 84, 90, III, 116, 119, 124, 131, I 18 5 156, 159 J See note, p. 500. CRIMINALITY 517 Table XVI — Continued SHOWING CRIMINALITY AS IT APPEARS ON OUR CHARTS Total charts 27 or 16.4 % of Hereditary Group of 164 charts. Total individuals 37 or 0.53 % of all persons on charts of Hereditary Group. Probably Hereditary Group Criminalistic Persons appear ON Charts Numbered Number of Cases ON Each Chart Direct Line and Sibs^ Collateral 1 176 171, 186 3 I 3 2 Total charts 3 or 8.8% of the entire group of Probably Hereditary — 34 charts. Total individuals 5 or 0.44 % of all persons on charts of Probably Hered- itary Group. Total Hereditary (certain and probable) 30 charts or 15.1 % of the 19S charts of these two groups. By individuals 42 or 0.52 % of all persons in these groups. Neuropathic Group 206 I I 217 2 2 Total charts 2 or 5.4% of the entire group of 37 Neuropathic charts. Total individuals 3 or 0.25 % of all persons on charts of Neuropathic Group. Accident Group — No Cases Summary Hereditary Probably H. Neuropathic Accident No. charts . . . 27 3 2 No. Individuals Men .... Women . . . Dir. 22 2 Col. 12 I Dir. Col. 4 I Dir. Col. Dir. Co'. Total persons . . 24 13 5 3 1 See note, p. 500. 5i8 FEEBLE-MINDEDNESS Total Men, 41. Total Women, 4. Total Criminal, 45. In direct line with our cases, 27 — in collateral Unes, 18. Nine criminals (not included in above) have married into these families — 7 men, 2 women. Eight of these are in the Hereditary Group, one in the Neuropathic. Of 6868 Persons in Hereditary Group 37 or 0.53% are Criminalistic Of 1 115 Persons in Probably H. Group 5 or 0.44% are Crimmalistic Of 1 212 Persons in Neuropathic Group 3 or 0.24% are Criminalistic Of 1 9 13 Persons in Accident Group o are Criminalistic Of 281 Persons in No Cause Group o are Criminalistic Of 11,389 Persons in all Groups 45 or 0.39% are Criminalistic The following table shows what would be expected compared with what we actually find. Groxip Expectation 1 Actual Too Many Too Few Hereditary .... Probably H. . . . Neuropathic . . . Accident .... No Cause .... 27 4 5 8 I 37 5 3 10 I 2 8 I The strong preponderance in the Hereditary Group is signifi- cant. SYPHILIS None of the diseases supposed to be potent causes of feeble- mindedness is so difficult of investigation, so enigmatical, as syphilis. Not only in the popular mind but in the professional thot it is given a prominent place, yet of all the causes there is per- haps none for which there is less evidence. This does not neces- sarily mean that it is not a cause, but simply that it is not proved. The terrible nature of the disease ; the serious results that it is known to produce, such as miscarriage, deaths in infancy, general paralysis of the insane ; the fact that it is one of the two diseases that can be transmitted from the mother to the child, because the germs can pass thru the chorion cells ; the fact of its close SYPHILIS 519 association with sexual immorality ; all tend to render it in the minds of most people a horror of which anything can be beHeved. Under these conditions it is but natural to expect that it might be a cause of feeble-mindedness. The fact that its presence is so generally concealed tempts us to argue that if we knew more about it we should find it standing in causal relation ; and this secrecy makes it impossible to arrive at the truth. We have had no better success in getting at the true history than have other investigators. We have recorded only 46 cases found on 27 charts. That the number should be much greater than this there is no doubt. It is well understood by the medical profession that a mat- ing, which shows first a number of miscarriages followed by deaths in infancy, and finally Hving offspring, is a picture that means syphiHs in one or both of the parents almost without question. A survey of the charts with this in mind will show at once that in a large number of cases syphiHs might be suspected even where not so marked. A glance at the Table of distribution of the syphiUtic cases will show that there is little evidence that syphilis is a cause of feeble-mindedness. The cases are very largely in the Hereditary Group. Table XVII SHOWING THE DISTRIBUTION OF SYPHILIS (sy) ON OUR CHARTS Sy appears on 27 charts or 9.0 % of all the charts, divided as follows: Hereditary Probably H. Neur. Ace. No Cause No. of Charts . . 17 3 4 2 I Men Women .... Dir. 7 6 Col. 8 14 Dir. 2 Col. I Dir. 3 Col. I Dir. 2 I Col. Dir. I Col. Totals .... 13 22 2 I 3 I 3 I Total 46. Total Men 24. Total Women 22. 520 FEEBLE-MINDEDNESS Of 164 Charts in Hereditary Group 17 or 10.36% show Syphilis (Sy) Of 34 Charts in Probably H. Group 3 or 8.82% show Syphilis Of 37 Charts in Neuropathic Group 4 or 10.81% show Syphilis Of 57 Charts in Accident Group 2 or 3.50% show Syphilis Of 8 Charts in No Cause Group i or 12.5% shows Syphilis Of 300 Charts 27 or 8.6 % show Syphilis Of 6868 Persons in Hereditary Group 35 or o.^^a^are Syphilitic (Sy) Of 1115 Persons in Probably H. Group 3 or 0.26% are Syphilitic Of 1 21 2 Persons in Neuropathic Group 4 or 0.33% are Syphilitic Of 1913 Persons in Accident Group 3 or 0.15% are Syphilitic Of 281 Persons in No Cause Group i or 0.35% are Syphilitic Of 11,389 Persons on all Charts 46 or 0.40% are Syphilitic The following table shows what would be expected, if there were a uniform distribution, compared with what we actually find. Group Expectation 1 Actual Too Many Too Few Hereditary .... 28 35 7 Probably H. . . . 4 3 I Neuropathic . . . 5 4 I Accident .... 8 3 5 No Cause .... I I The Wassermann test is now being applied to our children and under the most perfectly controlled conditions. Twenty-nine of the children involved in this study have been tested ; 20 of these gave a positive reaction. Some of these cases were selected because of suspected syphilis ; in 5 we had a pre- vious history of syphiUs in the family. In one case both paternal grandparents were affected ; in the second it was both parents and a brother ; in the third it was a relative of the mother ; in the fourth it was the father ; and in the fifth the father's brother. This leaves 1 5 cases where we get a positive Wassermann but with no history of syphilis. Of these 29 children only one has evi- dently had an infection. ^ See page 480, under Table VIII. BLINDNESS AND DEAFNESS 521 There are 9 cases with history of syphilis which gave negative Wassermann reaction. In all but two the syphihs was in the father ; in one of these two it was in both father and mother ; in the other case it was in the paternal aunt. The 20 positive Wassermanns are distributed as follows: 9 are in the Hereditary Group, 3 in the Neuropathic, 3 in the Meningitis, 2 are Mongolians, 2 Accidents, and i Unclassified. It is thus seen that these cases are all attributed to other causes than syphilis. To the extent that these others are acceptable causes there is no need of calling in syphilis to account for the mental defect nor is there any argument therefor. While these figures are few and any argument based on them is incomplete, yet one cannot help having the feeling that if syphilis is a cause of feeble-minded ness, it certainly is not a very potent one. One is also led to question it from consideration of such cases as the following : In Case 284, Fred K. shows a positive Wassermann. His father and five sibs were normal and are children of a syphilitic father and a syphilitic mother. This is a striking instance of those cases where syphilis does not produce feeble-mindedness, and it suggests a line of evidence which every physician can dupHcate ; that is, parents one o r both syphilitic, children normal. In conclusion, our charts bear abundant evidence of the well- known fact that s}^hilis pr oduces miscarriage and early death, and the data indicate that if it ever produces feeble-mindedness it does so only under most favorable conditions. What those conditions are cannot be shown until we have much more careful studies. BLINDNESS AND DEAFNESS Blindness and deafness appear in 34 and 45 individuals respec- tively. Our records do not always show whether or not the cases are congenital. We have endeavored to omit the cases where 522 FEEBLE-MINDEDNESS the condition was due to accident but it has not always been possible to determine even that. The fact that the blindness is nearly all in the hereditary cases is significant. The deafness on the other hand appears relatively larger in the neuropathic than in any other group. Blindness Of 6868 Persons in Hereditary Group 28 or 0.40% are Blind Of 1 1 15 Persons in Probably H. Group i or 0.08% are Blind Of 1 21 2 Persons in Neuropathic Group 3 or 0.24% are Blind Of 1913 Persons in Accident Group 2 or 0.10% are Blind Of 281 Persons in No Cause Group o are Blind Of 11,389 Persons in all Groups 34 or 0.29% are Blind The following table shows what would be expected compared with what we actually find. Group Expectation ^ Actual Too Many Too Few Hereditary .... Probably H. . . . Neuropathic . . . Accident .... No Cause .... 20 3 4 6 I 28 I 3 2 8 2 I 4 I Deafness Of 6868 Persons in Hereditary Group 23 or 0.33 % are Deaf Of II 1 5 Persons in Probably H. Group 5 or 0.44% are Deaf Of 1 21 2 Persons in Neuropathic Group 11 or 0.90% are Deaf Of 1913 Persons in Accident Group 6 or 0.31% are Deaf Of 281 Persons in No Cause Group o are Deaf Of 11,389 Persons in all Groups 45 or 0.39% are De^ai— ""^ The following table shows what would be expected compared with what we actually find. 1 See page 480, under Table VHI. CONSANGUINITY 523 Group Expectation i Actual Too Many Too Few Hereditary .... Probably H. . . . Neuropathic . . , Accident .... No Cause .... 27 . 4 5 8 I 23 5 II 6 I 6 4 2 I CONSANGUINITY There is a common belief that f eeble-mindedness is caused by consanguinity of the parents, — that if cousins marry some of the children will be feeble-minded. There are 30 cases of cousin- marriages among our 2058 matings. Of these 20 are in the Heredi- tary Group. There is no argument from these since the children are feeble-minded by heredity. Inspection of the charts does not show that there are more defectives where the parents are related than where they are not related^ These cases are on Charts 22, 29, 30, 40, 46, 59, 70, 74, 80, 120, 123, 124, 134, 142, 143, 154, 159 and 164. Case 187 is in the Probably Hereditary Group. It is interest- ing because the father is probably feeble-minded and his wife being his second cousin may have carried the same defect, yet from this mating there are three normal children and no de- fectives. \„.^ Case 252 has been discussed in the chapter on the Mongolian defective. In this case the normal parents have two defective children out of three. These parents were more than cousins^ as will be seen from a study of the chart. Since there was defect in the family it may very well have been so doubled up that it reappeared in these children. Of all the cases on our charts this is the strongest in favor of the influence of consanguinity, and yet it is not conclusive. 1 See page 480, under Table Vm. 5 24 FEEBLE-MINDEDNESS In Case 237 the maternal grandparents of our child were third cousins ; this is so distant that it is not worth discussing. Case 276: the parents of our child were cousins; Gertie's defectiveness is explained by an injury, so it is not necessary to call in the theory of consanguinity. In Case 292 the parents were second cousins. The child Nathan was a meningitic case which satisfactorily explains his condition. Case 223 is at first sight a strong one ; the parents were normal but cousins ; two children are defective. The father was hemi- plegic. Unfortunately we are without proof because the grand- parents are undetermined. They may have been feeble-minded, in which case these defective children would be accounted for. These cases confirm the view now generally held by physicians and students of the problem that there is nothing in consan- guinity per se; but_giyen a tainted family the mating of two members of the same family increases the liability of the defect appearing. It may be very well maintained that since very few families are free from defect of one form or another, physical or mental, the ban against cousin-marriage is on the whole wise. The evil of this form of statement however is twofold. First, there are cases, whether they be many or few, w^here there is no taint in the family and consequently no objection what- ever to the marriage of cousins. Second, the form of statement would imply that there is no objection to any mating where they are not relatives. This is the greater error of the two, for it is just as dangerous for a person of tainted familyto mate with a person of another tainted family as it would be to mate with his own cousin. In both cases we are increasing the liaJpiHty that the taint will reappear. It might be added that many persons are wont to argue this matter from an analogy of animal breeding. The fallacy of attempting to use such analogy is evident when we consider that the effect of consanguinity, or inbreeding as it is called, is very different with different kinds of animals. With TWINS 525 some species inbreeding is the rule, and produces no deleterious results. If we are going to reason by analogy it is just as logical to draw our analogy from this species of animal as from one where inbreeding does lead to bad results. TWINS Fifty-one of our charts record the birth of twins. There seems to be nothing especially worthy of discussion in connection with this matter save in Cases 84, 134, 144, 185. (See also 157.) In these four cases we ha ve_the^ interesting condition of one of the twins being normal, the other feeble-minded. The special interest in these cases comes from the bearing they have upon a popular idea as to the relation between the similarity of twins and their mode of genesis. There is a theory that twins who closely resemble each other, sometimes called ''identical twins," come from a single fertilized ovum which in the course of development divides and develops into the two individuals, whereas, twins that do not closely resemble each other are the result of two fertilized ova. Attractive as this explanation is at first sight, Thorndike has shown in his Monograph on "The Measurement of Twins," that while the development of twins from a single fertilized ovum is not impossible, yet it is not at all a necessary explanation, nor is it a very probable one. His study would seem to show that twins are the result of two fertilized ova, with the possi- biHty of some exceptions. It is unfortunate that our data are incomplete in regard to the majority of our cases, nevertheless the four where the data are complete are all in agreement and constitute another strong argument for true heredity. On any theory of environment, pre-natal or post-natal, it would be difficult to account for cases of twins with one normal and the other defective. On the heredity theory however the case is simple. Se^iar as heredity is concerned, the fact that these individuals "were of different 5 26 FEEBLE-MINDEDNESS mentality is no more difficult to explain if they were born at the same time than if they were born separately. We have two ova, fertilized by the different spermatozoa, each of them subject to whatever possibiKties the conditions of the chromosomes warrant. In the one case a ''defective" sperma- tozoon has fertilized a " defective " ovum with the resulting defective offspring. In the other case, a normal spermatozoon has fertihzed a normal ovum, or else one of the germ cells has been normal and the other '' defective," in either case resulting in a normal offspring. The fact that from the time of fertilization the two embryos have the same environment until the birth of the children con- stitutes what must be considered an almost ideal test of the theory of heredity and environment. If we add to this, the argument that twins usually have the same environment thru childhood, we still further emphasize the point. NEUROTIC, MIGRAINE, ETC. The remaining conditions have not proved of great significance in this study. They are therefore passed by with brief mention. The distribution of the cases will be found in Tables XIX-XXI, pages 531. 532- Neurotic. Seventy-one individuals have been marked neu- rotic. Little importance is attached to the figures in this case as the term is too general and the conditions included under it are too varied to have scientific value as a group. Migraine. Migraine or periodic sick headache is a disease that indicates a disturbed nervous system and may have some relation to mental defect. We have found however only 13 cases. Here again it must be said that our diagnoses have not always been those of physi- cians and consequently we are not Hkely to have discovered nearly all of the cases. The greatest number of them (7 of the 13) occur IN OTHER INSTITUTIONS 527 in the Neuropathic Group as we would expect. Th^i^re 4 in the Hereditary Group and 2 in the Probably Hereditary. Goitre. We have found among our families 8 cases of goitre ; 6 o{Jhese are in the Hereditary Group, i in the Neuropathic and I in the Unclassified Group. Altho the number is small it is per- haps not without some significance that 6 out of the 8 cases be- long in the Hereditary Group. Wanderer. The classification ''Wanderer" is also one thot to be significant but we have found only 7 cases, 4 of which are in the Hereditary Group. The small number of cases under these last four headings would give us the impression that they in reality have Kttle to do with feeble-mindedness. And when we note further the large percentage that fall in the group of hereditary feeble-mindedness, it is only logical to conclude that the individuals were feeble- minded by heredity and that these other conditions had little or nothing to do with it. Whatever may be ultimately determined as to the actual part that any of these conditions plays in caus- ing feeble-mindedness, it is at least clear that we should in no case rely upon any one of these supposed causes, without looking further and deeper into the family and individual history to dis- cover if there be a more fundamental cause. One gets the im- pression from these cases that all the foregoing conditions are merely symptoms of an underlying defect. IN OTHER INSTITUTIONS On 76 of the charts there are 149 persons recorded who are inmates of other Institutions than the Training School. Be- sides institutions for the feeble-minded this includes jails, ahns- houses, insane hospitals and reformatories. Many of those in the jails and almshouses are there either because their condition has not been recognized, or because there has been no other place for them. Of these 149 individuals, 67 have been found feeble- minded. This number with our own cases makes 377, or 19.6 % 528 FEEBLE-MINDEDNESS J of all the feeble-minded individuals on our charts, who are or have been in Institutions, and maintained very largely at pubHc expense. Table XVIII PERSONS IN INSTITUTIONS OTHER THAN THE TRAINING SCHOOL MOSTLY AT PUBLIC EXPENSE Seventy-six Charts, 25.3 % of all charts, show individuals in other Insti- tutions than the Training School. There are 149 persons divided as follows : Hereditary Probably H. Neuropathic Accident No. of Charts 59 7 8 2 Men Women Dir. 40 32 Col. 21 26 Dir. 4 4 Col. 3 I Dir. 5 7 Col. 3 I Dir. I I Col. Totals 72 47 8 4 12 4 2 Of 6868 Persons in Hereditary Group 119 or 1.73% were in other Insts. Of II 1 5 Persons in Probably H. Group 12 or 1.07% were in other Insts. Of 1212 Persons in Neuropathic Group 16 or 1.32% were in other Insts. Of 1913 Persons in Accident Group 2 or 0.10% were in other Insts. Of 281 Persons in No Cause Group o were in other Insts. Of 11,389 Persons in all Groups [49 or 1.3 1 So were in other Insts. Mentality Hereditary Probably H. Neuropathic Accident Feeble-minded {^L^"^ \ Women Undetermined ^-, Women 29 33 32 25 3 2 4 3 8 8 I Totals 119 12 16 2 Feeble-minded 67 ; undetermined 82. Of 1918 Feeble-minded Persons on the 300 charts 377 or 19.6% were in Institutions, including Vineland. SUMMARY TABLES 529 In the three following tables will be found a summary of the preceding figures arranged for easy comparison. Table XIX relates to Charts. It shows the number of charts and the distribution of the total number in each of our five fun- damental groups. It shows also the number of charts in each group that have persons marked AlcohoKc, Tuberculous, etc., and the percentage these are of all the charts in the funda- mental groups, e.g. 164 or 54.6 % of the total number of charts are in the Hereditary Group, 98 or 59.8 % of the Hereditary charts have Alcohol on them, 42.6 % have Tuberculosis, 48.2 % have Sx, etc. Table XIX SHOWING NUMBER OF CH.IRTS HAVING ALCOHOL, TUBERCULOSIS, ETC. AND THEIR DISTRIBUTION IN THE FUND.UIENTAL GROLTS Funda- mental Total Charts % Alcoholic Tuberculous Sx Paralytic Insane Groups No. 0/ 70 No. % No. % No. % No. % Total Hered. P. H. Neu. Ace. N. C. 300 164 34 37 57 8 100 54.6 II-3 12.3 19.0 2.6 152 98 15 18 20 I 50.6 59-8 44.4 48.6 35-0 12.5 143 70 20 17 22 2 47.8 42.6 58.8 45-9 38.5 25.0 96 79 5 8 4 32.0 48.2 14.8 21,6 7.0 0.0 99 37 10 29 18 5 33-0 22.6 29.4 78.3 31-5 62.5 62 33 10 15 4 20.6 20.1 29.4 40-5 7.0 0.0 Epileptic Neurotics Sy Criminal- istic Deaf Total 300 TOO 53 17.6 44 14.6 27 9.0 32 10.6 3S 12.6 Hered. 164 54.6 33 20.1 15 9.1 17 10.4 27 16.5 17 10.4 P. H. 34 II-3 5 14.8 9 26.4 3 8.9 3 8.9. 5 14.8 Neu. 37 12.3 9 24-3 12 32.4 4 10.9 2 5-4 10 27.0 Ace. 57 19.0 5 8.8 8 14.0 2 3-5 0.0 6 10.5 N. C. 8 2.6 I 12.5 0.0 I 12.5 0.0 0.0 530 FEEBLE-MINDEDNESS Table XIX — Continued SHOWING NO. OF CHARTS HAVING ALCOHOL, TUBERCULOSIS, ETC. AND THEIR DISTRIBUTION IN THE FUNDAMENTAL GROUPS Funda- mental Groups Total Charts % Blind Migraine Goitre Wanderers In Other Institutions Total 300 100 19 6.3 10 ^•3, 6 2.0 6 2.0 76 25-3 Hered. 164 54.6 13 7-9 4 2.4 2 1.2 3 1.8 59 35-9 P. H. 34 II-3 I 2.9 I 2.9 3 8.8 0.0 7 20.6 Neu. 37 12.3 3 8.1 4 10.8 I 2.7 I 2.7 8 21.6 Ace. 57 19.0 2 3-5 0.0 0.0 2 3.5 2 3-5 N. C. 8 2.6 0.0 0.0 0.0 0.0 0.0 Table XX relates to Persons. It shows the distribution of all persons charted in the five fundamental groups, and the distribution of those who are Alcohohc, Tuberculous, etc. ; e.g. 60.3 % of all persons charted are on charts in the Heredi- tary Group ; 74.5 % of all the alcoholics are in this group, which is 14.2 % more alcoholics than there should be on the basis of a uniform distribution. In like manner it can be seen that the Hereditary Group has 2.6 % too few Tuberculous, 29.2 % too many Sx's, etc. SUMMARY TABLES 531 « )J <: H ;z; w a ro ^ r^ 10 CO -^ d^ (N d M ^ 04 CM M 1 ++ 1 1 ii 10 t--. M -^ -^ d\ M d VO CN + 1 + T-i J5 2 c 5f2 Tt M Tj- q c^ M ^o d 00 t-. CO q dod d M d P4 S-2 Q 10 ■rj- 00 r^ "N d CO ^ M i-< + I + M w g < (N !>. CO -"^ CO d\ CO M CN I 1 ++ 1 m 00 CO '^ - •^ !>. CO rO ^ f^ M CO M 1 ++ 1 1 ^ii M (N ^ q dv 06 d^ CO d 00 CO ^j q q c^ c^ Tf d < < i d > 00 00 -i VO C^ .2 c cs ^ "^ C> 1>- "^ l-O «N + i 1 1 1 Q 00 00 -^ c^ vd M d . q\ r-- q cjN c^ ^ M d CO On CO 00 q (N (N 00 00 q^ 4 M M 00 H -f 1 1 1 1 1^ 0\ rf r^ '^ ! ++ 1 1 1 iig 10 C> 1^ '^ !>. ON i>- d CN M q q !> vO t^ -^ 6 6^ 6 <) f^ VO MM CO 1> VO t^ -^ 6 6^ 6 ^6 f^ \0 MM 5 S 1 W d U ^ ffi fi; ;z: < ;zi 1 W d d ^ 532 FEEBLE-MINDEDNESS O < < X 2 o W o w o w fin W W H w o o 1 H < w H o H i :z: (5 M \0 OO M (N OS Q M u^vo CO M (N tJ- + 111 1 o < < 0*3 <3 (N ro ^ M O - J>- "N M (MM 1 ++ 1 I 1 OS 1 ++ 1 ^ < < ^3 CO CO 1 ++ 1 + to 1 § . CO 00 CO - i 5 oo t^ M ro lo 1 ++ 1 1 1 OS U M n 00 + + 1 1 1 s ^1 OO lO CO ro !>. 10 CO CO ^ s «'! u-> fs U-) rt OO c^ ^o t^ lo M r^ rf to CO M s 1 < 5 + 1 1 1 1 in + 111 PQ •< •^1 0 00 (N « < C CHAPTER VI MENDEI.^S'-tAW-eF INHERITANCE Th3 classical experiments of the Austrian monk, Gregor Mendel, are becoming familiar to all who follow, with even a passing interest, the development of modern science. Mendel was struck by the remarkable colors that were ob- tained by cross fertilization in plants. He found upon looking into the matter that no one had carried on experiments to such an extent and in such a way " as to make it possible to determine the number of different forms under which the offspring of hy- brids appear, or to arrange these forms with certainty accord- ing to their separate generations, or definitely to ascertain their statistical relations." After eight years experimenting he was able to present his results and formulate a law, — a law which has done more to energize scientific study of inheritance and to arouse popular interest in this branch of science than anything that has ever been devised. It is a veritable Arabian Nights story how this wizard of Brlinn planted in his garden two kinds of peas, one of which was tall and the other dwarf ; how he cut out the stamens and trans- ferred the pollen from one variety to the pistils of the other ; and how when his plants matured he gathered the fruit, planted it again, only to find that all of these plants were tall, none were dwarf ; how he allowed these to grow by themselves and be fertilized naturally, raising the fruit and planting it the second year, with the result that thruout his whole garden there were three tails to every dwarf. Three to one, — what magic ! Fijst generation all tall; second generation tall and dwarf in the 533 534 FEEBLE-MINDEDNESS ratio of three to one ; always three to one. Precisely the same thing happened if he used, instead of tall and dwarf peas, a va- riety which had a green pod and another a yellow pod ; or whether he chose his two kinds because the one had rounded peas and the other wrinkled. This was not all ; he found that if he planted the peas from his dwarf plants he got all dwarfs, and he might plant them year after year, they were always dwarf, never tall. With the tall peas this was not true. The tall peas all looked alike, but when planted, one- third of them always produced tall peas, no matter how many years they were replanted. But the other two-thirds always yielded tall and dwarf in the ratio of three to one. The same three to one ! Mendel called the peculiarity in which his two plants differed the ''unit character"; for example, the tallness or the color of the seed. He called the character which appeared in the first generation as the result of his cross fertilization the dominant, the one that did not appear until the second generation he called recessive — on the ground that it was there in the first genera- tion but did not appear. It had receded, as it were, into the background, only to reappear in the next generation. This work of Mendel's was pubHshed in 1866 and was then lost for thirty-four years and re-discovered in 1900. What is the explanation of this strange mixture of mathematics and biology, this three to one ratio in the growing of peas? In Mendel's day there was no explanation. Biology had not caught up with this problem. Mendel died before biological science had reached the point of development where it could explain his marvelous discovery. The Explanation. While some details are still obscure we can follow the general plan. Consider the spermatozoon and ovum in animals. It was found that if these "germ cells" pre- vious to being placed under the microscope were put in some kind of stain, certain bodies appeared in the cells because MENDEL'S LAW 535 they had absorbed some of the stain or coloring matter. Nothing was known of the function or the purpose of these bodies, but because they became colored under this treatment they were called color bodies, or in the Greek, chromosomes. It was found that there was practically always the same number of these bodies in the germ cells of the same species of plant or animal. They were thus not accidentally colored bodies but bodies of some significance. Furthermore it was discovered that there is a process of maturing or ripening in these cells before they are ready to unite with the cell of the opposite sex for the formation of a new individual. In this ripening the number of these chromosomes is reduced one-half. This process is too complicated to be described here, but the student should refer to biology and master this point as it is essential to an understanding of the mechanism of in- heritance. (See Bibliography, E. B. Wilson ; also Davenport, Heredity in Relation to Eugenics, p. 15.) It is thus seen that in the new indi\ddual formed by the union of these two mature cells there will be the regular number of chromosomes, half of which have come from each parent. It was soon concluded that these chromosomes were to be con- sidered the bearers of heredity. It is now doubtful whether they are the sole bearers, but for the present purpose of making clear our problem we shall consider only the chromosomes. We are now getting at the mechanism of the transmission of traits from parents to children. The offspring may inherit the same trait from both father and mother or he may inherit from one alone. In the latter case only half of his chromosomes carry the trait, while in the former all of them carry it. For reasons which we cannot explain here the biologist con- ceives that each chromosome has within it what are called deter- miners, that is, certain particles, molecules or elements which contain within themselves the potential organ which they rep- resent, or some quality or characteristic of the organ such as 536 FEEBLE-MINDEDNESS the color of the eye or of the hair. If the individual has brown eyes it is because his chromosomes carried determiners for brown eyes. If he has long arms it is because his chromosomes, some of them at least, carried determiners for long arm bones. If we stop here we should conclude that we inherit half from our fathers and half from our mothers ; but there is a further step. It would be equally true that our father inherited his twenty- four chromosomes twelve from his father and twelve from his mother. But we must not forget that each germ cell in maturing divides into two, each part carrying twelve germ cells. The ques- tion now is — how does it divide ? Do twelve father cells and twelve mother cells go into each of the respective parts, or is it eleven father one mother, or ten father and two mother, or any of the other possible combinations ? So far as we now know this division is purely accidental, and as likely to be one combination as another. We thus see that while A inherited twelve chromo- somes from his father, these in turn came from the grandparents and because of the division, A may have ten chromosomes from his paternal grandfather and two from his paternal grandmother, or any other combination. So far as those traits are concerned, which an individual has inherited from both parents, it of course makes no difference how the division takes place. Every mature germ cell will carry that trait, but if a trait has been inherited from only one parent, of course it is a vital matter whether a germ cell containing that trait or one that does not contain it unites with the germ cell of the opposite sex. Suppose, for example, that Mendel plants noth- ing but tall peas, then no matter how the chromosomes divide every chromosome will contain the determiner for tallness. On the other hand, what Mendel actually did was to place the pollen of a tall pea on the pistil of the dwarf pea (or vice versa). These two cells then unite and a new germ cell is formed. This germ cell carries only one determiner for tallness — not two. When those germ cells divide, half of the resulting mature cells will MENDEL'S LAW 537 carry the determiner for tallness and half will lack it. Now sup- pose a pistillate plant of this character, only half of whose ovules carry chromosomes with determiners for tallness, is fertilized by pollen grains from a plant only half of whose chromosomes carry the determiners for tallness. There are four possibilities. A pollen grain with a determiner for tallness may unite with an ovule having a determiner for tallness ; the resulting plant will have two determiners for tallness or will be what we call duplex. Second, a pollen grain with a determiner for tallness may unite with an ovule without the determiner for tallness ; the resulting plant will have only one determiner for tallness. It will be tall but simplex. Third, a pollen grain without the determiner for tallness may unite w^ith an ovule with a determiner for tallness ; there will therefore, be only one determiner in the resulting plant but the plant will be tall and simplex. Fourth, a pollen grain without the determiner for tallness may unite with an ovule without the determiner for tallness ; the resulting plant will have no determiner for tallness and will therefore be a dwarf. Thus we have the explanation of what Mendel found. His dwarf peas that always produced dwarfs, that is, "bred true," had no determiners for tallness. The others always had at least one determiner for tallness and therefore were all tall, but one- third of these had two determiners and therefore, when combined with others of the same kind, must always produce tall peas with two determiners ; while two-thirds of the tall peas had only one determiner for tallness so when they combined they repeated the story that we have just told — of three to one. Any individual plant or animal that has inherited a trait from both parents is said to be duplex in respect to that trait, whereas if it has inherited it from only one side it is simplex; and if the trait is entirely absent it is nulliplcx. We are now ready for the application of Mendel's law to our problem. The law has already been proved to apply to many human traits; for example, color of hair, color of eyes, color- 538 FEEBLE-MINDEDNESS blindness, night-blindness, haemophilia, brachydactylism. It also seems probable that it applies to the inheritance of certain insanities and some of the epilepsies, as has been worked out by Rosanoff for the insanities, and Davenport and Weeks for epilepsy. Does it apply to feeble-mindedness ? CHAPTER Vn IS FEEBLE-MINDEDNESS A UNIT CHARACTER? In attempting to apply the Mendelian formula to the inherit- ance of feeble-mindedness our first question would be : is feeble- mindedness a unit character, and if so, is it dominant or is it recessive, due to the presence of a determiner that arrests devel- opment or to the absence of a determiner that makes for nor- mahty ? That feeble-mindedness is hereditary is abundantly demon- strated from the case histories presented. Feeble-mindedness is most naturally considered as a lack of intelligence ; from this standpoint we would expect that intelhgence is dominant, but it is hard for psychologists to think of intelligence as a unit. Intelligence results from numerous but undetermined factors. One may be intelligent along some lines and unintelligent along others, and it matters not how much we divide the mind up, so to speak, we may say from one standpoint that we never reach the unit. The will, which is popularly spoken of as tho it were an entity in itself, is for the psychologist simply the sum of various processes, with the result that a person may have strong will-power along some lines and very weak along others. The same is true of the judgment, which is so markedly deficient in the feeble-minded. At this point, one asks again — is judgment or will-power inherited? No more than tuberculosis or blacksmithing or soldiering. What is inherited is a constitution that is particularly Uable to be attacked by tubercular bacilli, a good skeleton and musculature which make a man capable of swinging a large 539 540 FEEBLE-MINDEDNESS hammer and working in iron, or lastly a physique that meets the requirements of a soldier; in other words the capacity for any one of these. In the same way we must look not for judg- ment and will-power, but for the capacity for the development of judgment and will-power. These he, in the last analysis, in the brain and the brain cells. To take the simplest possible illustration ; in order to have will-power one must have good sense organs for receiving im- pressions, for example sight and hearing, with good communica- tion between their corresponding brain areas. The physical basis for this communication is supposed to be along what is called association fibers. Let us for the sake of clearness attempt to work out a possible hypothesis, making such assumptions as are not forbidden by any known facts. In accordance with present day views of heredi- tary transmission of characters, we naturally assume that there is a vast number of determiners in the* human chromosome. There must, for example, be a determiner for the size of every particular organ, tissue and structure, to what fineness or par- ticularity no one can of course guess ; but everything that is handed down from father to son must be handed down by means of a determiner in the chromosome. How minute those char- acters are can be appreciated by recalHng what is already known. Pigmentation has been thoroly studied so that the color of the hair and of the eyes is known not only to be transmitted defi- nitely but strictly in accordance with the MendeHan law. Un- doubtedly the size of the hair or its fineness, possibly its length are also determined. Carrying this thot over into the brain, we have every right to believe that there is a determiner for perhaps thousands of different groups of brain cells ; further, for the size of the cell body, the size of the neurite and dendrite, also for the chemical composition of the cell body, of the neurite and den- drite and for the medullary sheath. Let us now consider some well-known facts. Here is a person A POSSIBLE HYPOTHESIS 541 who can see a piano perfectly well. He recognizes it, knows what it is, can repeat the word piano, appreciates the music of the piano, knows what is meant when he hears the word piano, all of which facts show that both his eyes and his ears, and his motor speech centers, are intact and normal. But if you take him into a room and he sees the piano, while he recognizes it and knows what it is, he is unable to say the word piano. In such cases we say the man is suffering from a disease which we call aphasia which we explain by saying that there is a break in the association fibers that connect the sight center with the motor speech center or with the auditory center. This actually happens in life, and as we have said, is a disease. For the sake of our illustration assume that this is hereditary, and that this individual lacks the association fibers between sight and motor speech centers, not because they have been diseased and broken up but because they never developed, because the determiner for the proper development of those cells was lacking from this man's chromosomes. Now suppose a child with this inheritance comes before us; what kind of pecuHar mentality will he exhibit ? It will of course be the inabihty to associate things seen, with sounds, with names, or with the abihty to pronounce the names. If it is the latter, the condition is quickly discovered and we call it aphasia. But suppose it is the former, that is to say, the association between the visual image and the auditory image. I desire to send this boy on an errand, I say to him — ''You know what a piano is ? " "Yes." The child hears and understands what I say because his auditory center is intact. My words sound to him sensible and reasonable. But he had no visual image of a piano, conse- quently when I say ''Show me the piano in this room," he does not understand, not because he does not see the piano, but be- cause he does not associate what he sees with the spoken word, piano. I therefore say the boy is stupid. After repeated ex- periences of this kind I conclude that he is feeble-minded, and 542 FEEBLE-MINDEDNESS such a child undoubtedly would be feeble-minded but of a pe- cuHar type. In similar manner, let us suppose there is a girl whose associa- tion fibers between the auditory center and the motor centers are not developed, so that the child hears what is said, under- stands perfectly well, but has no power of innervating the motor muscles and acting upon what is said. This is the child that does not act, or does not do what she is told. We cannot induce her to obey a command. Such a child is feeble-minded but again of a peculiar type. Now let us assume that in both of these cases these conditions are recessive, due to the absence of the determiner for normal association fibers in these two fields. We know from our study of the Mendelian law that if a person hav- ing either one of the above mentioned defects marries a normal person, in the first generation all the children will be normal but simplex, half their chromosomes will lack the determiner for normaHty along this line. If one of the second generation marries a person of Kke inheritance, the offspring will be in the ratio of 3 normal (i duplex, 2 simplex) to i defective. Now suppose a person having both these defects — i.e. he lacks the visual auditory and the auditory motor fibers — marries; if he marries a normal person, in the first generation of course all will be normal, but now let us take the second generation mating. A person who has inherited normal association fibers in each of these fines from only one parent marries a person of like inherit- ance, what will be the result? Let us represent the presence of the association fibers in the first instance by X and the absence by Y ; in the second assumed case the presence will be indicated by A and the absence by B. Now we want to know the result if a person, only half of whose chromosomes carry determiners for sight-hearing association marries a person of the same con- dition, and at the same time each of these individuals has only half his chromosomes carrying determiners for the hearing- action association fibers. That is to say, each person is simplex TWO UNIT CHARACTERS 543 in each of these unit characters. Taking each one separately we have a person who is represented by XY marrying a person whose condition is also shown by XY ; the result of this is, of course, our famiHar formula : XX + 2 XY + YY ; in a similar manner for the second condition the individuals are AB and AB with a result that we have AA + 2 AB + BB. Now all of the possibilities are enumerated when we combine each of the first terms with each one of the second. The following are the terms that we get : AAXX + 2 AAXY + AAYY + 2 ABXX + 4 ABXY + 2 ABYY + BBXX + 2 BBXY + BBYY Now let us see what we have. Remembering that wherever there are two A's or two X's we have that character duplex. Two Y's or two B's mean a complete absence of the character. While an A or an X means that the character is present but with only one determiner instead of two. In other words, taking our results as they stand, AAXX means a thoroly nor- mal individual. Next there will be two people AAXY, that is, with the A character present and duplex and the X charac- ter simplex. Next, an AAYY gives us the A character pres- ent, and the X character absent entirely. Next we have two individuals with the XX that is duplex, and AB simplex, in that character. Then we have four individuals that are sim- plex for each character. Then two that are simplex for the A character and nulliplex for the X character. Next comes one that is nulliplex for the A and duplex for the X ; then two that are simplex for X and nulliplex A, and lastly, a BBYY which means an individual entirely lacking in both qualities. We thus have nine different kinds of individuals resulting. One of those kinds is represented by four individuals, four others by two each, and each of the others by one person. If now we collect all those that to the outward appearance will be the same, we have the following : 544 FEEBLE-MINDEDNESS First, there are nine individuals all possessing both A and X, therefore manifesting the presence of both characters. Only one is duplex in both ; in the others either A or X is simplex. Next, we have three individuals in whom the X character is entirely lacking but the A character present. In one it is present as a duplex, in the other two as a simplex — the AAYY and the 2 ABYY. In the next group are three individuals in whom the A charac- ter is lacking entirely, but the X character is either duplex or simplex ; these are the BBXX and 2 BBXY. Lastly, one individual represented by BBYY is lacking in both A and X. In tabular form this gives : Normal Defective in the X Trait Defecttve in the a Defective in Tr.\it I Both Traits 1 AAXX duplex 2 AAXY simplex X 2 ABXX simplex A 4 ABXY simplex 2 ABYY (l) I AAYY (2) (i) simplex A nuUiplex X (2) duplex A nuUiplex X 2 BBXY (i) I BBXX (2) (i) nuUiplex A simplex X (2) nuUiplex A duplex X I BBYY nuUiplex both 9 3 3 Here we see we have three different kinds of feeble-minded people so far as their outward appearance is concerned. All those in any one group are alike having or lacking the same characters. To sum up : if two people marry under the conditions that we have assumed and 16 children are born, there would be g normal children; there would be j that lacked the X character^ 3 that lacked the A character, and i that lacked both. In other words there would be one group of normals and three groups of feeble-minded, showing three different grades or kinds of feeble- mindedness. When it came to the eugenics question and the marrying of these people there is only one out of the sixteen that is absolutely normal, the others are all defective in their THE NEGATIVE ARGUMENT 545 germ plasms and are capable of transmitting defect if they mate with persons Hke themselves. But the point that we are emphasizing here is that if two people marry, each of whom has only half the chromosomes carry- ing the determiners for two mental traits, the result would be that out of 16 children 9 would be normal, altho 8 of them capable of transmitting the defect, and the other 7 would show three different kinds of feeble-mindedness. If there are three characters instead of two in which the mating parties are each simplex, the result would be that out of 64 off- spring 27 would he normal, altho only i of these would be a duplex normal, all the others being capable of transmitting one or two of the defects, the remaining j/ would represent 7 different kinds of defectives. If there were four determiners involved, the numbers would run up into the thousands. By way of clarifying this somewhat difficult situation we quote an identical case from Castle (W. E. Castle — Heredity, Appletons, 191 1) to whom the reader is referred for a further explanation of this point. "In each of the cases thus far considered a single unit-character is con- cerned. Crosses in such cases involve no necessary change in the race, but only the continuance within it of two sharply alternative conditions. But the result is quite different when parents are crossed which differ simul- taneously in two or more independent unit-characters. Crossing them becomes an active agency for the production of new varieties. " In discussing the crosses now to be described it will be convenient to refer to the various generations in more precise terms, as Bateson has done. The generation of the animals originally crossed will be called the parental gen- eration (P) ; the subsequent generations will be called filial generations, viz., the first filial generation (Fi), second filial (F2), and so on. " When guinea-pigs are crossed of pure races which differ simultaneously in two unit-characters, the Fi offspring are all alike, but the Fo offspring are of four sorts. Thus, when a smooth dark animal is crossed with a rough white one the Fj offspring are all rough and dark, manifesting the two dom- inant unit-characters, — dark coat derived from one parent, rough coat 2 N 546 FEEBLE-MINDEDNESS derived from the other. But the F2 offspring are of four sorts, viz. ; (i) smooth and dark, like one grandparent, (2) rough and white, like the other grandparent, (3) rough and dark, like the Fi generation, and (4) smooth and white, a new variety. It will be seen that the pigmentation of the coat has no relation to its smoothness. The dark animals are either rough or smooth, and so are the white ones. Pigmentation of the coat is evidently a unit- character independent of hair-direction, and as new combinations of these two units the cross has produced two new varieties, — the rough dark and the smooth white. " Again, hair-length is a unit-character independent of hair-color. For if a short-haired dark animal be crossed with a long-haired albino, the Fi off- spring are all short-haired and dark ; but the F2 offspring are of four sorts, viz. (i) dark and short-haired, like one grandparent, (2) white and long- haired, like the other, (3) dark and long-haired, a new combination, and (4) white and short-haired, a second new combination. " Now the four sorts of individuals obtained from such a cross as this will not be equally numerous. ' ' The expected proportions of the four classes of F2 offspring are accordingly 9:3:3: I, a proportion which is closely approximated in actual experience. The Mendelian theory of independent unit-characters accounts for this result fully. No other hypothesis has as yet been suggested which can ac- count for it." Page jp. The Other Side From the point of view of feeble-mindedness the case looks different. Feeble-mindedness is clearly an arrest of development at some time previous to adolescence — a stopping of mental development along all lines. This arrest is not necessarily sudden. There is usually a slowing down covering several years. This is somewhat difficult to explain along the lines of the previous argument. It is not at all as tho the determiner for the development of some little group of cells had been left out, or as tho something intervened to prevent the development of some other group of cells, which would result in one mental pro- cess being stopped while the others went on. Whatever has hap- pened seems to have affected all the mental processes alike. That is, all that had not developed at the time the arrest took place, failed to develop afterwards. A UNIT CHARACTER 547 The fact would seem to be accounted for either by the presence of some determiner which showed itself at the proper time and stopped the further development of the brain, or by the absence of something which furthers development and which is normally present. From one aspect it seems that the condition is more as tho some poison, for instance, had suddenly been injected into the system which stopped the development of the brain uni- formly thruout. This comes from the fact that studies of the mentality of these children, at least so far as such studies have gone, seem to indicate that a child that is arrested mentally, say at nine years of age, is Hke a normal child of nine in everything except physical growth which does not seem to be affected, at least in the high grades.^ From this standpoint therefore it seems more in accordance with the facts to conceive that feeble-mindedness is a iinit^Qharacter,^aTi^jdAJie^ehher to the presence of something which acts as an inhibitor, or due to the absence of some stimulus which sends the normal brain on to further development. Of these two we may further suggest that the absence of a determiner that would make for normahty is biologically and phylogenetically the more easy to conceive. If this is true we might expect to find normal intelligence not only a unit character but dominant. Which of these views the better fits our facts we shall con- sider in the next chapter. 1 It is not strictly correct to say that a defective of mentality g (e.g.) is like a normal child of 9 years. For discussion see page 579. CHAPTER VIII IS THE INHERITANCE OF FEEBLE-MINDEDNESS IN ACCORDANCE WITH THE MENDELIAN LAW? In attempting to answer this question it will be best to de- termine what that law would lead us to expect, then to examine the data of the Hereditary Group to see how that expectation is fulfilled. The accompanying diagram, for which I am indebted to Mr. S. C. Kohs, shows graphically all of the possible condi- tions. In applying the Mendelian law to human heredity we meet a difficulty, which arises from the comparatively small number of human offspring in a family. When we say the mating of two simplexes gives i duplex, 2 simplex and i nulliplex, we can only mean that this proportion will be met if there are enough off- spring to give the law a chance to show itself. But our simplex man and woman may have only two children ; even if there are four they may be all simplex, w^hile if there were four more they might be two duplex and two nulliplex, thus carrying out the law. To overcome this difficulty it has been proposed to add to- gether all the offspring of similar matings. A hundred children from twenty matings are as good as tho they were from a single mating, provided the twenty matings are similar, i.e. all are cases where one parent is simplex and the other nulliplex, etc. Mendel himself used this method ; e.g. from 253 hybrids (mat- ings) he gets 7324 seeds; 5474 were roundish, 1850 were angular wrinkled. ''Therefrom the ratio 2.96 to i is deduced." Out of 1345 matings in the Hereditary Group we have been able to find 324 matings that could be used in this connection. 548 MENDELIAN INHERITANCE 549 1 THE MENDELIAN THEORY It must not be forgotten in all of this, that it is not only a question of taking care of these individuals, so that they themselves are less a menace to society directly, but it is a question of heredity. A large percentage of these people are not only obnoxious themselves but they are propagatmg their own weak-mindedness and continuing our social problems. Our present methods, besides being unjust and cruel and thot- less and careless, are doing nothing to prevent the continuance 572 FEEBLE-MIXDEDNESS of this species of humanity. It is hereditary feeble-mindedness that is at the basis of all these problems, and it is hereditary feeble-mindedness that we must attack and attack hard if we would solve them. Stanley Hall has said that one's feelings and impressions are often truer than one's logical reasoning. One cannot study a mass of data like the preceding without having certain large and general impressions, which, while not demonstrable by a logical array of premises with their conclusions, nevertheless have a certain consistency which tenders them helpful in any attempt that may be made to use the facts discovered for prac- tical purposes. The first of these we may designate as a general viewpoint of the problem of mental defectiveness — the conception of mental levels^ or levels of intelligence. IntelUgence as here used con- notes more than the psychological intellect, it is more the popular understanding of the term, which, when reduced to psychological expression, means all of the essential mental processes in such proportion as to render the possessor able to adapt himself to his environment. It thus includes not only the intellect but the sensibihties and the will, to use an older classification. Conscious adaptation to one's environment involves, on the one hand, a taking into account one's instincts, impulses, emo- tions, feelings ; on the other a perception of the situation in all those details to which adaptation must be made. It involves a calling up of past experiences which show the result of various lines of action involving association, judgment, reasoning ; it involves an attention to the situation and certain habits of action therewith connected. The amount of each one of these pro- cesses that may be involved, and the relative proportion of them all is determined by the environment itself. A highly complex situation may involve the highest degree of all of these processes, while a simple situation may involve only a part of them or all of them in a slight degree. We may thus have varying degrees LEVELS OF INTELLIGENCE 573 or levels of intelligence which can be measured by the degree of complexity of the environment to which the individual is capable of adapting himself. Such a conception ought not to be difficult to entertain since the evidences are at hand. All men have their limitations, some high, some low. Strictly speaking, a feeble-minded person is not one who lacks intelligence, but one who lacks a particular degree of intelhgence. That degree or level is fixed not arbi- trarily but by the social necessity. Intelligenc e is thus ^ dative. This again is a common enough idea ; we say of a man that he is fairly intelh'gent, or very intelHgent, or among the most intel- Hgent; or we go down the scale and say he is only moderately intelligent, or has very little intelligence, or that he is unintelli- gent, meaning of course, that his degree of intelligence is ab- normally low. / The degree of intelligence which marks the Hne between the f^ feeble-minded and the normal person has been defined as that degree below which the possessor cannot manage himself or his affairs with ordinary prudence. ' Now it is the environment which determines how he must manage himself and what affairs it is necessary for him to control. In consequence of this it happens that a man may be intelHgent in one environment and unintelligent in another. It is this point which Binet has illus- trated by saying "A French peasant may be normal in a rural community but feeble-minded in Paris." The peasant Hfe is simple; the environment requires Httle adjustment. In Paris, y it is different, all is compHcated and requires the highest functioning of certain mental powers in order to enable one to adapt himself. That fact should be borne in mind thruout this discussion. We have practically agreed to call all persons feeble-minded who do not arrive at an intelhgence higher than that of the twelve year old normal child. But it must be remembered that this is merely an average, a norm from which to measure and by 574 FEEBLE-MINDEDNESS which we can compare different individuals. It does not mean and must not be taken to mean, that the person of only ten year old intelHgence is incapable of functioning in any environment, any more than it means that the person of fourteen year old intelHgence is capable of functioning in every environment. We are already struggHng with the problem of the defective I delinquent, the individual whom we cannot call feeble-minded according to our present standard, and yet who has not intelli- gence enough to function in the environment in which he finds himself. Such a person very probably has fourteen or sixteen year intelhgence, and would function very well in any environ- ment which required no more than that amount. But he hap- pens to have been born or has got into an environment that requires a twenty year old intelligence and he therefore is defective. The same is true if we go below twelve years. While we say that the child of ten-year mentality is feeble-minded this does not mean, as has been said, that he cannot function in any environment. It does mean that as society is now constituted in most civilized countries, he cannot function in the ordinary group ; but he could function in a simpler one. Since he is in the minority and the majority has made the environment what it is, it would seem to be incumbent upon the majority to provide a special environment for this defective individual, with the expectation that in that special environment he would be normal — that is to say, he would be able to adapt himself and to func- tion satisfactorily. This expectation has been abundantly ful- filled wherever it has been tried. That there are mental levels is thus seen to be a tenable hypothesis and a possible key to the situation. We shall return to it later. The second of these impressions obtained from studying the / data relates to heredity. We have seen that feeble-mindedness is hereditary ; can we say that these grades or levels of intelli- LEVELS INHERITED 575 gence of which we have spoken are directly transmitted as is the color of the eyes or the hair or the stature of the body ? It is our conviction that, other things being equal, the children will have at maturity the same level of inteUi gence as their parents. This is not a new discovery altho our studies of feeble-minded- ness have made the whole matter clearer than perhaps it has previously been made. Furthermore, it must be remembered that in such matters we can only speak in general terms. The intellectual level is not transmitted from father to son with the same accuracy that blue eyes are transmitted. In the case of the intellectual level there are too many factors for us to be able to show a long series of precisely the same mentality. It is, however, perfectly demonstrable that in a general way this principle holds true. One has only to recall the Edwards family, the Adamses or the Lees, and scores of others to see what this means. A perusal of the biographical dictionary will show hundreds of families that have maintained the same high level of intelHgence thru many generations. Coming down in the scale from those who have had a national reputation we find that what we may call the average citizen in his community has maintained about the same level of intelH- gence as his father and grandfather who were also men of average intelligence. And it is only by way of completing the series that we find that among the mental defectives of the pure heredi- tary type the level is maintained. If the child is a moron it is probable that the father or the mother or both were morons and the grandparents also.^ Our families show this in many cases. The same holds for the high grade and the middle grade imbe- ciles. Defectives of lower grade than the middle imbecile sel- dom marry and so our series ceases. As explained in another place, the children of lower mentality than middle imbecile, who are of hereditary feeble-minded origin have their low grade of mentahty either as the result of added disease or because they are exceptions to the rule, and exceptions we cannot often explain. 576 FEEBLE-MINDEDNESS The fact of the transmission of the intellectual level becomes of tremendous significance in connection with the social problems. It is furthermore greatly compHcated by the biological principle that if the condition is due to disease or acquired in any other way it will not be transmitted. This shows once more the necessity for separating the two elements, the one of pure or in- herited feeble-mindedness from feeble-mindedness due to some extraneous cause. r-~^ A third point of view, or principle, that has come out of the jr study of these defective minds is of great importance for their training. This principle is somewhat difficult to state but may be put in this form : a person can never be trained to-do intelligently any task the doing of which requires intelHgence of a higher level than that to which he has attained. It is difficult to realize that fact when we consider only normal people. The view has been strongly impressed upon us all that any one can do whatever he wills to do, and we are unwilling to give up that belief, in spite of the fact that we see many persons attempting things that, as we say, are beyond them. We seem to be very unwilling to give up our prejudice that nothing is really beyond us. With the men- tally defective, however, this becomes easy to demonstrate. The histories of our children as recorded give scores of illustrations. They are in fact so many tests of the principle. Our teachers with a dehghtful optimism have tried over and over again to teach a child with the mentaHty of four to do things that can only be done by a child of the mentality of six or beyond. Before we understood as much about the defective mind as we now do, it was always expected that many of these children could learn to do much of the ordinary school work. Only a few years ago it was a proud boast of Institutions for the Feeble-minded that their school departments were exactly Hke the public schools. Every child that gave any promise what- ever, that is to say, who was of the middle imbecile grade or above, was sent to school and every effort was made to teach TRAINING LIMITED BY THE LEVEL 577 him everything that the school could teach. If the reader will turn back and read the sentences that refer to the accom- plishments of our children, taking them as they are arranged by mental age, he will discover that all those of any one age have had practically the same history. They have tried to do great things; the teachers have persisted in their efforts to teach all things to all children; gradually the higher things have been dropped and they finally settled down to those attainments which are commensurate with the mentaUty of the particular child. For example, those- who have a mentality of 10 or 11 are doing some of the finer and more compHcated work of the Institution, in the shops, in the household, on the farm or in the garden. Those who test 8 or 9 are doing the coarser work in the shops or on the farm or at the house. Those of mentality 10 or 1 1 have learned to read a Httle. Those of 8 or 9 perhaps got into the First or Second Reader but not farther. Those who test 6 or 7 have never succeeded in getting anywhere with the three R's and while they did some manual training and shop work in school, after leaving school they are not found in the shops but only on the farm and in the house, there doing the simplest kind of work. Altho every effort, born of a blind devotion to an ideal, has been made to make these children normal, or at least of relatively high grade, it has invariably failed and they have learned nothing that is beyond their mental age. This is of profound significance for the training of the defec- tives of the future, and is it of any less importance in the training of normal children ? The principle must be as true of normals as of defectives. It would seem clear therefore, that if we would train our normal children wisely without wasting their time or energy, or running the risk of discouraging any further effort on their part, we ought to discover : first, how much intelHgence is required for the various subjects that we present to them; and secondly, what level of inteUigence each person has reached so that we may know whether he is ready for the proposed 2 p 578 FEEBLE-MINDEDNESS subject. This is the next great step in the pedagogy of the future. We may now consider what bearing these principles would have upon the problems growing out of low intelligence. First we have illustrated the 'levels of intelligence" view by showing that different levels of intelligence can function in dif- ferent environments. Let us now apply this definitely to the problem of caring for these mental defectives. As we have said, it is clear that the people of higher intelH- gence must, in self-defense if for no other reason, care for those whose intelHgence is too low to enable them to care for them- selves. In accordance with the principle we are discussing, this can be done by providing a sufficiently simple environment. The amount of care and effort which the majority, the so- called intelligent people, must put forth in order to create an en- vironment in which these lower grades of intelligence can func- tion, varies inversely as that intelKgence. Beginning with the lowest idiot, the environment consists of a comfortable home with an attendant who prepares the food and feeds it to the child, and performs whatever other labor is necessary to make the child comfortable and happy and his presence at all tolerable to those who thus care for him. This we usually call custodial care. ~" Those who have the intelligence of a child from three to seven, technically called imbeciles, also require more or less custodial care, altho the higher division of them can largely take care of themselves so far as the immediate necessities are concerned. They cannot provide for the future, they cannot even meet the little emergencies which arise in connection with such occupa- tions as they may be trained to perform. They must, therefore, have constant oversight and must be given occupation which presents as few emergencies as possible. The lower half of this group will do Httle but sit around or walk about, pick up sticks, carry stones or the Hke ; but the upper group, those of mentality SIGNIFICANCE OF MENTAL AGE 579 from five to seven, may be trained to simple occupations which they can do over and over again, provided, as already said, there is some one having the oversight of them to step in whenever any emergency arises. Both of these, the idiot and the imbecile, therefore, require segregation, colonization, where the environ- ment has been simpHfied to the last degree. We come now to the moron, the child of from eight to twelve years of age mentally. We will get an approximate idea of the needs of this grade of intelligence if we recall the normal child of from 8 to 12, for it has been determined that these defectives are very like normal children of the corresponding age. Of course the similarity is not exact. His physical growth and especially his sex development react upon the defective to give him certain characteristics not found in the normal of the same mental age. His environment and experience have also made some changes in him, altho these changes are slight because being defective he does not take in the environment or profit by experience. It must not be forgotten also that the defec- tive child lacks energy. He is consequently not active, inquisi- tive, interested like the normal. His emotional reactions are less marked. In spite of all these differences, to say that he is like a normal child of the same mental age is to describe him much more accurately than can be done in any other way, and to regard him and treat him from that standpoint is the most useful and helpful as well as the safest procedure. Bearing these two facts in mind we can easily work out the program for this grade. Let us consider a mentality of 10 in order to have a specific case. A normal boy of 10 can learn to do a great many things and can do them well. There are many things also that the normal boy could learn to do that he could not himself do because of physical inabihty. That incapacity is not present with these defectives, because as we have said, physically they are Uke men and women. Therefore they have in that way greater 58o FEEBLE-MINDEDNESS capacity, that is a larger range of capacity, than the normal child of the same age. A normal child of ten does a great many tasks for which he has been trained. No one expects a normal child as a rule to set himself to work, to keep himself working, or to use good judgment in meeting the emergencies that arise in con- nection with his work. This is precisely the case with the de- fective of this grade. All this means that we must provide him with an environment in which there are few emergencies, in which the activities call for intelhgence of his level and may be carried on by habit. This may include much of the routine of farming, of housework, and many kinds of simple industrial occupations. These pursuits, however, require more or less of planning and there are inevitably more or less emergencies, which means that there must always be a person of higher intelligence who can be called upon at a moment's notice, who will make the plans from day to day. This at once suggests a farm colony and segregation so much discussed at the present time. In this connection the following industrial classification is of interest. This classification was made in the following manner : Every employee at the Vineland Training School was asked two questions about every child in the Institution, viz. : What does he do ? What can he do ? The answers were grouped and all those of the same mental age were put together. From the many answers in each mental age group an expression was sought that would describe the activities of the group. The children of the same mental age were often doing different things, and the grades sometimes overlapped. One does not expect a generalization to fit individual cases. On the whole however the classification has proved wonderfully accu- rate. While some children of five-year mentality {e.g.) are doing better and some worse the great majority are doing work that is covered by the expression, '' Only simplest tasks." WHAT DEFECTIVES CAN DO S8i Industrial Classification Mental Age Industrial Capacity Grade Under I year (^) Helpless, {b) Can walk, (c) With volun- tary regard Low I yr. Feeds self. Eats everything Middle Idiot 2 yrs. Eats discriminatingly (food from non-food) High 3 " No work. Plays a little Low 4 Tries to help 5 Only simplest tasks Middle Imbecile 6 " Tasks of short duration. Washes dishes High 7 Little errands in the house. Dusts 8 " Errands. Light work, flakes beds Low 9 " Heavier work. Scrubs. Mends. Lays bricks. Cares for bath-room lO '' Good institution helpers. Routine work Middle Moron II Fairly compUcated work with only occasional oversight High 12 " Uses machinery. Can care for animals. No supervision for routine work. Cannot plan One important correction must be mentioned, as it is a matter that bears upon the problem of the feeble-minded. We soon found when we attempted to group our cases that those chil- dren who were over 20 years of age chronologically were a dis- turbing factor in our plan. They could not be grouped with the others of the same mental age. Some study of the situa- tion showed that these older persons were doing tasks that seemingly required a higher mentality, but they were doing them not intelligently but automatically, that is after long train- 582 FEEBLE-MINDEDNESS ing and drill they had learned to go thru the motions in a more or less efficient manner. This well illustrates the way in which feeble-minded persons sometimes seem to have an intelligence beyond their mental age. The man who is 40 years of age, but of ten-year mentality has had 30 years in which to learn not only more ten-year accom- pHshments than any one normal boy of ten could acquire, but also he has had time to learn to do by habit and drill many things that he cannot possibly understand. In making the foregoing classification we threw out all cases who were over 20 years of age. Since we have begun to reahze the enormous number of de- fectives we are bewildered at the thot of segregating them all. There are between 300,000 and 400,000 feeble-minded persons in the United States. That would mean 1000 colonies of 300 each, or 300 colonies of 1000 each — from 2 to 30 institutions in each state according to the population. In view of such an enormous undertaking we naturally look about to see if anything else is possible. Under the present social conditions it is hard to think of any other treatment as being adequate to the situation. But when the mountain would not come to Mahomet, Mahomet went to the mountain. If we cannot remove the mental defective from society to a colony, we can at least colonize him where he is and possibly this may be made quite as satisfactory as the other plan. Indeed it requires only a Httle optimism to believe that it may be better than the other. One of the main reasons that the moron is so dangerous under present conditions is that he is not understood ; he is assumed to be normal, he is treated like a normal person and is expected to react like a normal person. There is no evidence to prove that the feeble-minded person taken in the beginning, understood and properly treated, be- comes vicious, bad or dangerous. On the contrary there is much to prove that he is not vicious ; he may be made so by mistreat- ment but he is not so naturally. A menace to society ? Yes MISTREATMENT 583 when mistreated, when not cared for, when allowed or compelled to bear the burdens of intelligent people. If a nine year old child is left alone in a house with fire and matches and he sets fire to the house, — who is to blame, the child or the people who left him in such a position ? In precisely the same way the feeble- minded in the world to-day are a menace to society, because we have not understood them, because we have placed them in an environment where they easily go wrong. But cared for and protected, as all wise parents care for their children, these chil- dren need be no more of a menace than other children are. Suppose, for the sake of making the matter clear, that every normal person recognized these defectives, that a moron as he grows up is recognized as a moron ; altho full size for a 20 year old boy, with a physique as healthy and comely as that of the average, all realize that he has a mind of 8 or 10. What will this changed attitude or condition mean ? In the first place it will mean that we will teach him in school only those things that a ten year old child can learn. This will leave him with a minimum of the three R's and a maximum of manual and industrial train- ing. Suppose he is ready to go to work ; he seeks employment ; he thinks he would like to run an elevator — Will any one employ him ? Does any one employ a ten year old boy to run an ele- vator? Why not? Not because he has not the strength, not because of the Child Labor Law, but because a ten year old boy is known not to have sufficient judgment to manage a machine where a shght error might be so serious. If it is asked how the employer is going to know that this likely-looking man of adult years and normal-looking physique has only the mentality of a 10 year old child, the answer is at hand. There must be a registration bureau where the grade of intelligence of all such persons is recorded. Until some other agency is estabHshed for this purpose the public schools must serve in this capacity. Under our compulsory education laws every child must attend school. Our school officers are already 584 FEEBLE-MINDEDNESS discovering that for their own efficiency they must determine the mentality of their dull children, and must provide for them such training as they are able to take. They will record the degree of efficiency in terms of mental capacity. But what will impel the employer to seek the information that he can obtain from this school system ? In many states the employers already have the strongest kind of motive to seek this information. This is in the Employers' Liability Law. Employers will be quick to learn that there are these defective persons and that the danger of employing them in complicated work is very great. A man who employs a mental defective to run an elevator will sooner or later be compelled to pay for injuries that result from such a boy's lack of judgment. He will then seek for the information that will protect him; and will act upon that information. Therefore, if our 20 year old boy sought the job of running an elevator but was known to have only ten-year intelKgence, he would not secure the job. He would however secure such a job as a ten year old boy could do. Besides getting employment that fitted his intelligence he would be treated as a 10 year old child, he would be guarded and protected from dangers of all kinds by all persons who had intelligence. With this protection born of an understanding of his condition he would get along very well; having been properly trained as a young boy he would probably be nearly if not quite self-supporting. If not quite self-supporting he would be a ward of the state and whatever he lacked of enough to support himself would be made up to him in the proper way. This could easily be arranged thru the Police Department or the Probation system, or the Department of Charities, and would be justified on the understanding that if this were not done the individual would become a pauper or a criminal and cost society vastly more because then his entire support would be at public expense. Thus the problem would be largely solved. RECOGNIZE THE MORON 585 In a goodly percentage of the cases he would live out his life pleasantly, happily, and be relatively useful. Our first problem then is to recognize the moron. By suitable mental examination they must be discovered, and discovered as early as possible. This is best done in pubhc schools. If a child is backward he must be carefully watched. If it is only a temporary matter or one due to physical causes which can be removed, he will eventually be normal. But if he is really men- tally defective it will soon show and as soon as it is determined his treatment must begin. It is then a matter of education, of training. We must learn what this mental defective can do, what kind of training is profitable to him. At present the in- dications are that comparatively few people who are mentally defective are ever able to learn to read, write and count, or in short to do the ordinary school work. It is even questionable whether those who are able to do this after an enormous effort ought to be compelled to make the effort ; whether their efforts cannot be better utilized in other directions which will make them more useful and happier. We are beginning to learn, not only how to recognize them, but how to determine what degree of mentahty they possess, or where in the scale of development their arrest has taken place. Careful studies of this problem will show us the kind of training that is adapted to each one. Trained along these fines from early childhood, kept from learning vicious ways and bad habits, they remain innocent children with much of the naivete and attractiveness of normal children. They are simply perpetual children. They may five to be sixty years of age and stifi remain the same childlike persons that they have been for fifty years. There are many things that they can be trained to do with sufficient proficiency to pay for their cost of maintenance. Here then, is perhaps the solution of this part of the problem — early recognition, careful determination of the degree of 586 FEEBLE-MINDEDNESS defect and careful training fitted to make them happy, useful, and self-supporting under direction. It will be seen that what we have said here is based upon the ^view that these mental defectives are cases of arrest of develop- ment and they are like normal children of the age at which their arrest takes place ; and that our safest guide in the treatment of these cases comes from a consideration of the wise treatment for the normal child of that age. That this is a correct view is becoming more and more evident every day. The more experi- ments and tests are made and the more we study the problem of the defective the more we discover and become convinced of this truth. The foregoing is not proposed for all mental defectives. It is offered as a possible help in view of the practical impossibility of segregating the large number of defectives that we are finding in every community. Suppose now we go back to the general question — what shall we do with people of low intelligence ? Colonize them, says one ; sterilize them, says another ; educate them, says a third. Each plan has its advocates and each has its difficulties. The first two seem to assume that the people of low intelligence are a different group and should be treated in a very special way ; that those of us who are pleased to style ourselves intelligent have the right to deprive these people of something that we enjoy. The third plan suggests that these people are our equals in some things and that they can be educated as we have been educated. It will be well to examine what facts we have before coming to a decision. Our facts at most are too few to warrant us in neg- lecting any. To begin with, no student of the problem will admit that these people constitute a different species of humanity. Some inteUigence is possessed by all unless possibly the very lowest. It is a question of degree and a question of the need that ~~^e individual has of intelligence, in other words of his environ- ^ ment. If an individual cannot adapt himself to his environment, COLONIZATION 587 can we not adapt the environment to him? ''This is what colonization does," says the advocate of this method. In theory this is true, in practice it is also often true, but not always. With certain high grades and under certain conditions there is an ele- ment of restraint, the colony becomes practically a prison ; only under the wisest management, by the most broad-minded policy can this element of restraint be kept out of the mind of the high grade defective. And it is doubtful if it ever can be kept entirely away from the highest grade. Suppose then we are content to colonize as many as can be made contented in the colony, what of the others? It is for these that sterilization is supposed by many to be the panacea. But sterilization seems only to apply to a narrow zone; many of these high grades are regarded as being on the border line, where it is of doubtful justice to take this action. Many other objections are urged. We may accept the verdict that the facts, particularly those that are set forth in this study, show that we must colonize as / many of the feeble-minded as we possibly can, that we must^'^ steriHze some and then we discover that we have only tithed the problem, we have not solved it. We still have left one expedient, that of educating them. ''But," says some one, "they cannot be educated, they have not mentahty enough to take an education."^ That depends upon our definition of education. The group that cannot be colonized and many of those indeed who will eventually be colonized, and the group where we are in doubt about the propriety of steriKzing can be trained to a rela- tively high degree in certain directions. But again, says some one, they will always be vicious and dangerous and a menace to society. There are, however, no facts to prove this. That may sound strange in view of what has already been said in this volume. But it must be remembered that we have studied people, who in addition to their feeble minds, have had a bad environment, have been misunderstood and mistreated. With a better comprehension of the nature of these persons, 588 FEEBLE-MINDEDNESS '^ with wiser methods of training in a suitable environment, the '' viciousness that we sometimes see will seldom, if ever, develop. Only one thing remains to be considered, their propagation. We have said that no feeble-minded person should marry or become a parent. From the standpoint of an ideal eugenics that cannot be denied. But the ideal and the practical are seldom the same. We must aim at the ideal but take what we can get. The feeble-minded will continue to become parents for many years to come. Let us face the fact and make the best of it. Does not our horror at the mating of the feeble-minded and the production of more feeble-minded offspring arise largely from our experiences with them up to the present time, and is this not complicated by the bad environment and mistreatment of w^hich we have spoken? When we have learned to recognize these people and learned how to treat them, how to train them, will not the situa- tion be entirely changed ? May it not be possible that we will find use for all these people of moderate intelKgence, and that the production of so many high grade feeble-minded is only the pro- duction of so many more people who are able and wilKng to do much of the drudgery of the world, which other people will not do. This is not to be understood as advocating such a procedure. The point is made merely by way of emphasizing the fact that when we shall have come to understand these people and to treat them in accordance with their mental condition, their low in- telligence, that a large part of our problem will have been solved and that many of the evils that we now complain of will not reappear. We have said that in spite of all of our efforts, after we have colonized all that we can, these people will become parents ; so f^r as we can see there is only one way to obviate it, that is by a very general practice of sterilization. If the process of vasectomy proves as satisfactory as its advocates believe, it may be that we shall ultimately be willing to sterilize all of these border- RfiSUMf: 589 line cases, and then, there will be no longer any objection to their marrying. Indeed it has already been proposed more than once, that when a feeble-minded person wishes to marry he shall be told that, if he is wiUing to submit to vasectomy, a marriage certificate will be granted and he may enter upon a career where he will be a husband but not a father. Such a procedure may have many objections and may be re- pugnant to many of us. Nevertheless, a broad-minded view of the problem, a willingness to consider all possible solutions, re- quires that this suggestion should be considered in the light of conditions as they will be when our fundamental requirements are achieved, namely, that the feeble-minded are recognized and their degree of mentahty and responsibility is understood and they are treated in the manner that they require. For the sake of clearness let us repeat some of the points of this Chapter. ^^^ First : the mere recognition that there is a problem of the " . feeble-minded will go a long way toward its solution. Second : a large part of the mental defectives who cannot be segregated may be reasonably and safely cared for in their homes, when we learn to recognize them for what they are, children in intelligence, tho men and women in body. Third : we must increase our efforts to segregate as many as possible, because for a long time to come there will be a larger number who need colonization, than we can possibly care for. Fourth : we must have sterilization wisely and carefully prac- ticed for the solution of many individual problems that are not reached by any other method. In conclusion, we believe that we have demonstrated that feeble-mindedness is sufficiently prevalent to arouse the interest and attract the attention of all thotful people who are interested in social welfare ; that it is mostly hereditary ; that it underlies all our social problems ; that because of these facts it is worthy the attention of our most thotful statesmen and social leaders ; 590 FEEBLE-MINDEDNESS that much of the time and money and energy now devoted to other things may be more wisely spent in investigating the problem of f eeble-mindedness ; and that since feeble-minded- ness is in all probability transmitted in accordance with the Mendelian Law of heredity, the way is open for eugenic procedure which shall mean much for the future welfare of the race. BIBLIOGRAPHY^ The following selected titles include those referred to in the text, and will serve to introduce the student to the hterature of the topics discussed. With a few important exceptions periodical literature has not been in- cluded, and only the most authoritative or important books. Fuller bibliographies will be found in Nos. i, 2, 4, 7, 17, 19, 24, 25, 30, 32. 1. Barr, Martin W. Mental Defectives; Their History, Treatment and Training. 1904. P. Blakiston's Son & Co., Phila. 2. Bateson, W. Mendel's Principles of Heredity. 1909. Cambridge University Press. 3. BiNET, A., and Simon, Th. Le developpement de T intelligence chez les enfants. L'Annee Psychol., 1908, Vol. 14, 1-94. 4. Castle, William E. Heredity in Relation to Evolution and Animal Breeding. Appleton & Company, 191 1. 5. CoNKLiN, E. G. Heredity and Environment in the Development of Men. Princeton University Press, 1914- 6. Danielson, Florence H., and Davenport, C. B. The Hill Folk. 1912. Eugenics Record Office, Cold Spring Harbor, N.Y. 7. Davenport, C. B. Heredity in Relation to Eugenics. 191 1. Henry Hoh & Co. 8. Davenport, C. B. The Origin and Control of IMental Defectiveness. Pop. Sci. Mon., Jan. 191 2, 87-90. 9. Davenport, C. B., and Weeks, D. F. A First Study of Inheritance in Epilepsy. ' Journal of Nerv. and Ment. Dis., Nov. 191 1, 641-670. 10. EsTABROOK, A. H., and Davenport, C. B. The Nam Family. 191 2. Eugenics Record Office, Cold Spring Harbor, N.Y. 11. GoDDARD, Henry H. The Binet-Simon Measuring Scale of InteUi- gence (Revised Edition) . 1911 . The Training School, Vineland, N.J. 12. GoDDARD, Henry H. Four Hundred Feeble-minded Children Classi- fied by the Binet Method. Jour. Psycho-Asthenics, Vol. XV, No. I, September, 1910. 13. GODDARD, Henry H. Two Thousand Normal Children Measured by the Binet Measuring Scale of Intelligence. Ped. Sem., \'ol. XVIII, pp. 232-259, June, 1911. 591 592 BIBLIOGRAPHY 14. GoDDARD, Henry H. The Kallikak Family. The Macmillan Com- pany, N. Y., 1912. 15,- Hue Y, Edmund B. Backward and Feeble-minded Children. Chnical Studies in the Psychology of Defectives, with a Syllabus for the Clinical Examination and Testing of Children. Warwick & York, Baltimore, 191 2. 16. Jelliffe and White. Modern Treatment of Nervous and Mental Diseases. 1913. Lea & Febiger, Phila. ^^17. Johnson, G. E. Contribution to the Psychology and Pedagogy of Feeble-minded Children. Ped. Sem., Vol. Ill, No. 2, 246-301. 18. Kellicott, Wm. E. The Social Direction of Human Evolution. New ^ York, D. Appleton & Co., 191 1, pp. 240. i9>Lapage, C. p. Feeble-mindedness in Children of School Age. 191 1. University of Manchester Press. 20. PuNNETT, R. C. Mendelism. 1911. The Macmillan Company, N. Y. 21. RosANOFF, A. J., and Orr, F. I. Study of Heredity in Insanity. Am. Jour. Insanity, October, 191 1. 22. Seguin, Edward. Idiocy; and its Treatment. 1907. Teachers Col- lege, Columbia University. 23. Sherlock, E. B. The Feeble-minded. 191 1. The Macmillan Com- pany. ^N^ 24. Shuttleworth, G. E., and Potts, W. A. Mentally Deficient Children. 1910. P. Blakiston's Son & Co., Phila. 25. Thomson, J. Arthur. Heredity. Putnam, 1908. 26. Thorndike, Edward L. The Measurement of Twins. Science Press, New York, 1905. 27. Town, Clara Harrison, Ph.D. A Method of Measuring the De- velopment of the Intelligence of Young Children by Alfred Binet and Th. Simon. (Trans.) Courier Co., Lincoln, 111., 1912. 28. Tredgold, a. F. Mental Deficiency (Amentia). 2d Edition, 1914. Balliere, Tindall and Cox, London. 29. Whipple, Guy Montrose. Manual of Mental and Physical Tests. Revised edition. 2 Vols. Warwick and York, Baltimore, 1914. 30. Wilson, E. B. The Cell in Development and Inheritance. N. Y., The Macmillan Company, 1900. 31. WiNSHiP, A. E. Jukes-Edwards ; A Study in Education and Heredity. R. L. Myers & Co., Harrisburg, Pa., 1900. 32. Walter, Herbert E. Genetics. An Introduction to the Study of Heredity. The Macmillan Company, 1913. u. ^t INDEX Accident Group, defined, 47. Accidental cases, defined, 438. Accidents before or at birth, 448-455. after birth, 455-460. Acquired character, non-transmissibility of, 559- Acromegaly, 429. Admission blanks, 23. Age of father, effect of, on mentality of children, 178. age of parents in Mongolian cases, 451-452. Alcohol, 281. in the father, 479. in the mother, cases, 476. doubles the number of feeble-minded children in a family, 490. and tuberculosis, remarkable case, 209. and weak will, 12. Alcoholic, means drunkard, 480. man reformed, instance, 13. Alcoholics, percentage feeble-minded, 12. Alcoholism, 10. at the time of conception, 474-475, as a cause discussed, 474-492. Almshouse case, 58, 245, 312. came from, 292. Gertie's mother in, 352. in Poland, 431. Almshouses, inmates mentally defective, 17. Ament, defined, 3-4. Animation at birth, deficient, 411. Arithmetic, samples of work in, 103-104. Arrest of development and Mendelism, 546. Ataxia, case of, 188, 197, 390. Autobiography of Case 5, 58. B Backward child, proved minded, 172, 183. Beri-beri, 375. Billikens' case, 382. 2Q to be feeble- Binet, Alfred, 19. quoted, 573. age of our children, 440. Binet-Simon Measuring Scale of Intelli- gence, 4, 48. differentiates insanity from feeble- mindedness, 504. Binet tests, typical answers, 51, 112, 141, 146, 154, 181, 193, 205, 213, 220, 233. seven on same case, 183. Biological problem, the, 20. Birth, difficult, 354, 356. Bite of spider, assigned cause, 268. "Black Dutch," 120. Blackwell's Island, 243, Blindness, 521-522. 8 cases on one chart, 160. 7 cases on one chart, 193. 2 cases on one chart, 86, 232. Blood poisoning, suffered from, 354. Blue baby, lead poisoning, 322, 365. Brachydactyhsm, 185, 238. Brain disease, indications of, 286. Bridgman, Dr. Olga, 8, 14. Bright's Disease in grandparent, 297, 339, 344, 409. Burt, Cyril, quoted, 556. Button, swallowed, cause of mental defect, 266. Cancer, in two generations, 302, 325, 329, 351- Carrier of defect, 292. Carson, Dr. J. C, 450. Castle, W. E., quoted, 545. Castle Garden, 234. Cataracts, 329. congenital, 328. double congenital, 372. hereditar>', 329. Cause, no assignable, 405. assigned, defined, 55. Causes, 435. accepted uncritically, 436. 593 594 INDEX Causes, illogical conclusions as to, 435, 449. rival, 447, assigned by parents or physicians, 436- 437- Cephalhematoma, 358. Cerebral tumor, 253. Chandelier, struck head against, 354. Charities, Department of, 584. Charity, objects of, 53. Chart, exceptionally large, 4 sections, 159- 161. 6 sections, 11 8-1 20. 10 sections, 128-131. 3 sections, 251, average number of persons per, 466. Charts, number of, in each group, 466. classification of, 47. field workers', 25. total individuals on, 466. Chicken-pox, case of, 348. Children of alcoholic parents, 474-492. illegitimate, 499. number of, per mating, 471. two from a family in the Training School, 51, 78, 82, 133, 196, 226, 227, 23s, 243, 280. Chromosomes, defined, 535. Classification, an industrial, 581. Cleft palate, 91, 304. Club-foot, case of, 322. Colonization, 566, 582, 587, 588. Colony, the, a prison, 587. Colored children in a white family, 550. Colored girl, an attractive little, 384. case of, 219. Conditions associated with feeble-minded- ness, 473, 532. Consanguinity, 523-525. list of charts showing, 523. remarkable case of, 368, Convulsions due to whipping, 382. Corner family, the, 40. Correspondence, clandestine, 56. Cretinism, case of, 361. Cretinoid type, case of, 410. Crime, the problem of, 6. Crimes of feeble-minded, g. Criminal, punishment of, 7. what is to be done with the, 569. Criminality, list of charts showing, 516. depends upon two factors, 515. and feeble-mindedness, 514-518. not hereditary, 8. Criminals, per cent defective, 7. Cripples, hereditary, 271. Data, incomplete, 21. manner of obtaining, 22. reliabihty of, 21. Davenport, Dr. C. B., 460, 538. Deaf, cases bom, 389. our children, 362, 421. Deafness, 521-523. 2 cases on one chart, 99, 245, 253, 278, 331, 388. Defect, not apparent until ages 7-10, 184. Defective delinquent, problem of the, 574. Defectives number of, in the United States, 582. recognized, 583. Delirium tremens, 335, 445. Deprivation, case backward by, 384. Determiners in the human chromosome, 540. Diagnosis, wrong, 32. Diagram showing the six possible matings, 549- showing effect of alcohol, 485. Diseases associated with feeble-mindedness, 473. Drawings, 79, 84, in. merry-go-roimd, 107. by a low imbecile, 316. by a cretin, 362. by a case of dementia praecox, 424. Drug fiend, 258. Drunkard, the children of the habitual, 475- what is to be done with, 570. Drunkenness, 10. Duplex, the term defined, 537. "Died in infancy" includes all under two years, 471. Dwarfness, cases of, 52, 205, 246, 387. Dynamometer, a measure of intelligence, 509. Echolalia, inclined to, 386, 397. Education, not mentality enough to take, 587. Emerick, Dr. E. J., 550. Employers' Liability Law, 584. Environment, effect of, 85, 89, 116, 554. Environment determines, 573. in relation to feeble-mindedness, 11. must be simplified for defectives, 578, 587. Epilepsy, and the Binet Test, 513. determining, 30. INDEX 595 Epilepsy, feeble-mindedness and, 512-514. list of charts showing, 514. Epileptic, Julius Caesar, 29. Napoleon, 29. our children, 168, 227, 248, 257, 267, 273, 27s, 276, 309, 314, 335, 350, 395, 401. St. Paul, 29. Eugenics, 558. case of non-eugenic matings, 204. Eye defect, 208, 321. "F?", meaning of, 22. Fall, severe, possible cause of defect, 401. Fecundity of feeble-minded women, 472. Feeble-minded, both parents, 561. vicious, a menace to society, 582. children in second marriage, none in first, 185, 209, 292. limits of, 573. children of feeble-minded parents, exceptions, 95, 116, 129, 145, 235. per cent of, in institutions, 528. defined, 3, 4. sex of, 467. Feeble-mindedness, diseases associated with. 473-532. and criminaUty, 8. and alcohol, 10. and white slavery, 13. not detected at first examination, 32. hereditary, at the basis of some prob- lems, 572. possible cases of sporadic, 215, 460-462. Feet, malformed, 223, 322. toes webbed, 238, 312. Field work, 24. Field workers, work of, tested, 30. qualifications of, 23-24. employing, 23. Field Worker's, sample report, 40-45. report, 293, 352. Fingers and toes, imperfect, shown in second marriage not in first, 185. Fishermen, return of the, 475. Fistula, recto-vaginal, 227. Friedreich's ataxia, case of, 337, 445. Fright, defect caused by, 312. Frightened by being held against a piece of ftir, 313. G Genius, 2. and feeble-mindedness, 510-511. and insanity, 511. Geography studied, 105, 427. Germ cell, the, 559. plasm, is it affected, 446. German, studied, 283. Goitre, 527. cases of, 100, 122, 305, 310, 329, 433. Griffiths, Miss Jane, 25. Grip, defect noticeable after the attack of, 297, 306. at foin: months, 305. Groups, fundamental. No. N, F, etc., in each. Table, 467. six fundamental, 47. H Habit, vs. weak will, 12. and intemperance, 12. Hack Tuke, quoted, 435. Hair-cut, frightened at the time of the first, 230. Hair long, born with, 361. Handwriting, sample of, 93, 107, 149, 151, 162, 406. Healy, Dr. William, 327. Heart trouble, three generations of, 314. hereditary, 320. Hereditary feeble-mindedness plus disease, 439. Hereditary Group, 438. defined, 47, 437. "Hexen Kuche," 293. Histor>' studied, 427. Horse, kicked by, 336. Hot weather, crazy from, 295. Head, large, three generations of, 36. Hydrocephalus, cases of, 300, 391, 394, 426. Idiots, defined, 3, 4. Idiot savant, 1 08, 42A. 4.6';^ Illegitimate children, 499. Imbecile, defined, 3, 4. Immigration officers passed, 74, 122, 201, 234, 238, 253, 259, 290, 375, 380, 431. 432. Inmioral family, remarkable, 215. Incapacity, 5. Incest, case of, 118, 158, 191, 214, 343. Incorrigible, 54, 239. Indian blood, 219. Industrial classification, 580. Infantile paralysis, case of, 379, 386. Information, sources of, 49. 596 INDEX Injured in utero, 337. Insane, not feeble-minded case, 423. Insane, drawings of, 423. sent to Hospital for, 155, 296, 419. Insanity, and feeble-mindedness, 504-510. and genius, 511. case of adolescent, 58. "Memoranda" by case of, 60-70. determining, 30. indicated by Binet Test, 154, 296, 505. list of charts showing, 506-507. manic-depressive, 4th attack, 433. shows symptoms of, 122, 165, 255, 286, 288, 307, 328, 339' 360, 385, 397- Instinct, maternal, utilized, 186. sexual, under-developed, 497. Institutions, in other, 527-528. reformatory, per cent defective in, 9. Instrumental delivery, cause of mental defect, 360. deliveries, no. of cases due to, 449. Instruments, use of, as cause of mental defect, 447. Intelligence beyond mental age, 582. difference in, of brother and sister, 81. general, 557. grades of, 2. levels of, 576. transmitted, 438. Intemperance, 10. Ireland quoted on alcohol, 475. J James, William, quoted, 557. Japan, born in, 375. Kallikak Family, Case gi related to the, 204. Kallikak, Deborah, 95. Family, quotation from, 28. Kite, Elizabeth S., 24. Laitinen, M. D., Professor Taaz, quoted, 487. Lameness, inherited, 143. Lazy boy, the, 17. Lead poisoning, 321, 365, 444. Letters of children, sample, 87, 132, 137, 141, 146, 152, 154, 286, 357. 377, 378, 392, 406, 422. from a mother, 71, 265. love, 57. of Wm. T., 79. about party, 319. to Santa Claus, sample, 73, 75, 80, 83, 93, 158. Letters used around the squares and circles, meaning of, 49. Levels of intelligence, 572. transmitted, 575. Liquid oozed from head, 333. Longevity, case of, 429. M Marasmus assigned as cause of mental defect, 410. Marriage of feeble-minded persons, 561. allowable, 588. Marriages under varying conditions, 561- 563. Masturbation assigned as cause of mental defect, 423. Matings, types of, used in study of Mendel- ism, 551. Measurement of twins, 525. Melancholia, inherited, 368. Mendelian law, and human heredity, 548- 557. and our results, 553-556. Mendelism, the explanation, 534. Mendel's Law, 533-538- recessive character of feeble-mindedness shown by charts 178, i8q, 204, 260, Meningitis, 457-460. cases, 390-404. morbidity of, 457. Mental age, defined, 48. of defectives and normals, 579. in relation to feeble-mindedness, 440- 443. intelligence beyond, 582. Mental levels, 572. Mental defectives, problem of caring for, 578-588. Mentality, determined, 27-30. Merry-go-round, plan for, 107. MicrocephaHc, 349, 421. Microphthalmic eyes, case of, 207. Migraine, 526. cases of, 246, 252, 269, 289, 300, 323, 340, 346, 349. Miscarriage caused by drugs, 271, 356, 360. Mongolian cases, 366-374. Group defined, 450. in collateral branch of defective family, 278. INDEX 597 Mongolian, type, congenital but not he- reditary, 368. type, other defectives in family, 371. type, revised chart, 31-32. Mongolians, distribution of ages of, 452. mentality of, 453. ages of parents of, 452. Moore, Miss Maude, 25. Moron, the, 579. defined, 4. recognized, 583-585- difficulty of determining, 30. Morons, heritability of, 443. percentage of, 6. Mother instinct aroused, 186. Music, sensitive to, case, 402. Musical ability, a family trait, in case, 168, 284. Mutes, six cases of, 86. our child, 289, 307, N *'N?", meaning of, 22. Ne'er-do-wells, 18. what is to be done with the, 570. Neuropathic ancestry, 47, 437, 443-448. cases, 318-350. Neurotic, 526. Newark daily paper quoted, 237. No Cause Group defined, 48. discovered, 460-462. Normal child of two feeble-minded parents, 95, 116, 129, 14s, 235. NuUiplex, the term defined, 537. Number work of BennieT. (facsimile), 149- 150. O Obesity, hereditary tendency to, 312. Offspring, effect of alcohol in producing non- viable, 487. Otitis media, given as cause, 334. Palate, no, 374. cleft, 91, 304. Pantomime, went thru tests in, 247. Paper cutting, 364. Paralysis, 500-503. charts showing, 500-501. sleeping, 313. Parents, normal but alcoholic, 486. Pauperism, 16. Paupers, what is to be done with, 569. Pedagogical problem, the, 20. Physicians, carelessness of, supposed cause of mental defect, 449. Piano, illustration, 541. Pineal gland, used, 428. valuable effect of, 382. Police Department, 584. Pott's disease, case of, 217. Premature births, that do not result in defective children, 450. 7 months, 332, 419. Prison report on Peter K., 173. Probability vs. certainty, 38. Probably Hereditary Group, defined, 47, 437. cases, 280-317. the group, 439-440, Probation system, 584. Problems, four, to be solved, 19. Program, for Morning Assembly, repro- duced, 405. Prostitutes, per cent feeble-minded, 14-15. what is to be done with the, 570. Prostitution, 13. keeper of house of, 130, 237. Psychological problem, the, 19. Public Schools must register defectives, 583-585. Punishment, idea of. 7. Pyromania, case of, treated, 324. Reformatories, per cent defective in, g. Reform School, a case in, 416. Registration bureau, 583. Related cases. Cases 43 and 97 ; Cases 30 and 707 ; 21 and 9 ; 13 and loi ; 64 and 140; 70 and 229 \ 145 and 112 ; 85 and 102 ; qi and Kallikak ; 175 and 86. Religious conversion and intemperance, 13. tendency, 216, 356, 424. Report, a sample, 41. from Children's Home Society, 163-164, of Massachusetts Vice Commission quoted, 15 (footnote). Responsibility, grades of, 2. limits of, 3. Reversion to type, feeble-mindedness as a, 508. Revised charts, Nos. i, 17, 97, 170, 177, 189, 2 so, 255, 264, 32-30- Revolution, soldier of American, remem- bered, 28. Rosanoff, Dr. A. J., 538. 598 INDEX "Scattering," in Binet Tests, explained, 505. indicates insanity, 154, 296. School attainments of children of various mental ages, 577. Self-supporting, moron, 584. Sex, instinct, 56. of feeble-minded, 467, under-developed, 497. Sexual immorality, in our cases, 497-499. Shop-girls, 14. Shuttleworth, Dr. G. E., 450. "Simplex," defined, 537. Sleeps, never, 434. Smallpox, 300. Smith, Florence Givens, report by, 40. Social problem, the, 19. Speech defect, case of, 113, 118, 382. hereditary, 91, 227. Speech training, loi. Spelling by Bennie T. (facsimile), 151. Spontaneous origin of feeble-mindedness, 460. possible cases of, 215, 461-462. State Hospital, case in, 155, 296, 419. State's Prison, served a term in, 327. Sterilization, 566, 587-588. Stigmata of degeneration, 171, 243. Stockard, Dr. C. R., quoted, 475. Strangulation, partial, 361. Suicide, some cases of, 55, 167, 308, 344, 350, 369 Survivors, total, in each group, 468. Swiss Lake Dwellers. 29. Symbols, explanation of, 48. Syphilis, 518-521. case of, latent thru three generations, 324- typical cases, 53, 216, 281, 335. Table I, Number in each group, 466. II, Number N, F, etc., in each group, 467. III, Total survivors in each group, 468. IV, Condition of children for each kind of mating, 469. V, Distribution of our children and their sibs, 472. VI, Distriburion of diseases and condi- tions, 473. VII, Alcohol, condition of parents of our children, 476. Table VIII, Number alcoholic, each group, 480. IX, Alcoholic and non-alcoholic parents, 481. X, Feeble-minded and normal children in alcoholic and non-alcoholic fami- lies, 488. XI, Parents, alcoholic, paralytic, epilep- tic, etc., 494. XII, Frequency and distribution of sex, 498. XIII, Paralysis, 500. XIV, Insanity, 506. XV, Epilepsy, 514. XVI, Criminality, 516. XVII, Syphilis, 5 1 9. XVIII, Persons in Institutions, 528. XIX, Alcohol, tuberculosis, etc., in the fundamental groups, 529. XX, .\lcohol, tuberculosis, etc., in the fundamental groups, 531. XXI, Summary of Tables, 532. Tempers, violent, 256. Tennis playing, Gussie's account of, 65, Thorndike, E. L., 525. "Ticks" explained, 565. Tooth extracted, diagrams drawn by de- fective child, 316. Tragic story of Gertie, 352. Training, kind of, must be learned, 585. purpose of, 586. Tredgold, quoted, 475. Truants, 18. per cent feeble-minded, 19. Tuberculosis, 495. Tumor on the brain, 434. Twins, 525-526. one normal, one feeble-minded, 197, 251, 260, 273, 304. Typhoid fever, cause of defect, 381. U Unclassified Group, defined, 48. discussed, 462-465. cases, 413-434. Undesirable, 421. Unit character defined, 534. is feeble-mindedness a, 539-547. Vagabond, a, 245. Vasectomy, 588. INDEX 599 Vasectomy and marriage, 589. Vice Commission Report (Mass.), iS- Viciousness will seldom develop, 588. W Walk, spells of inability to, 420. Wanderers, 527. cases of, 91, 210, 276, 336, 361, 367. Wassermann, Negative, Case Nos., 84, 91, i6s, 186, IQ3, 202, 215, 293. Positive, Case Nos., 700, 215, 234, 252, 253, 240, 263, 279, 347, 350, 364, 365, 3Q8, 399, 404, 430. Test applied to our children, 520-521. Webbed fingers and toes, 238, 312. Weeks, Dr. David F., 538. Whiskey, fed on, 382. White slave traffic, 13. Whooping-cough, 456. as a cause, 377. severe cases of, 309, 380, 395. Will, weakness of, and alcohol, 12. Woodwork, remarkable effect of, on Walter K., 170. Writings of a case of suspected dementia praecox, 60-70. Story by Bennie T. (facsimile), 149. Story of spiders, 135. Wundt, quoted, 557. 789 I'i ^ UNIVERSITY OF CALIFORNIA LIBRARY Los Angeles This book is DUE on the last date stamped below. J40V -iw "'"* Apr 2 iH>7qm JAN 2 las"^ Ikpr 16 -SE MAYS t964 J^ DEC 2 1S74 D'SCHARfiE-U RL May ^'i '5*^ M- 15 611 Form L9-100m-9,'52(A3105 „ taroio-uw. I MAY 71986 APR 2 91986 NOV 07 2003 )444 ) V liifilillil ■< RC -^23 G5U