effects of alcohol, and still not be called an intemperate man. By pretty careful inquiry as to the number of idiots of the lowest class, whose parents were known to be temperate persons, it is found that not one quarter can be so considered."1 Dr. Maudsley says: "I think, too, there is no reasonable question of the ill effects of marriages of consanguinity, that their tendency is to produce degeneracy of the race and idiocy is the extremest form of such degeneracy." But while it is of importance to note the effect of foredone vice as a cause of disease, it is also incumbent upon us to note that prior to birth idiocy is not unfrequently produced by fright, care, anxiety, ill health, or accident to the mother, and that after birth injuries to the head, convulsions from teething, eruptive fevers, whooping-cough, defective nourishment, and other conditions of unhealth, will have the effect of producing idiocy. 267. Features of Idiocy.-Idiots of the lowest type have simply a physical existence, and even that is modified by bodily infirmity, and often by anæsthesia, which would lead to death unless they were very closely watched. In a higher form of idiocy, or a mental condition more nearly approaching to ordinary intelligence, the patients have sensations of heat and cold, hunger and thirst. But it is somewhat difficult to form classes of idiots by reason of the attribute of intelligence possessed by them in a greater or less degree. They almost always agree in these things: they have misshapen heads, large gaping mouths, and their other features are not unfrequently ill-formed and distorted. As for expression! Expression is only thought become external to itself in the flesh, and therefore idiots' faces are marked by an utter want of all expression, and there is little or no power of speech. Some of them, however, utter cries in which ingenuity has found close resemblance to the sounds made by inferior animals. Their limbs and trunks are imperfectly developed, their complexion is generally sallow and unhealthy. Very often one Second Report of the Legislature of Massachusetts, by the Commissioners appointed to inquire into the condition of Idiots within the Commonwealth. By S. G. Howe. Boston: 1848. 2 Body and Mind. London: 1870. P. 44. See a very interesting paper by Dr. Arthur Mitchel, (Commissioner in Lunacy, Scotland.) on Blood Relationship in Marriage considered in its influence upon the Offspring. Edinburgh Medical Journal, 1865. or more of the senses is defective, sometimes one of them is entirely wanting. Only in the rarest cases is the head of full size and well formed. They usually die before the age of thirty. In idiots it is usual to say that the power of will is entirely deficient; but we shall see more clearly, in considering the legal relations of idiots, what is meant by this phrase. They are sometime governed by impulses, and at the age of puberty manifest the sexual passion in ways as offensive as the ordinary normal indication of what Goethe calls "the presentment of sweet wants" is beautiful. They are exceedingly irritable, and subject to the most violent fits of passion, and have none of that exquisite sympathy which prevents them from injuring the feelings of another. Imitation influences them not a little, as it does monkeys. It is a power which is always strong in the weak." 268. Cretinism: its Features.-In Switzerland idiocy is often accompanied by one special kind of bodily deformity. The thyroid gland becomes enlarged, and this enlargement is known as goitre or bronchocele. But besides this deformity there are others. The stature is generally dwarfed; the belly protuberant; the legs small; the arch of the palate high and narrow; the mouth, from which the saliva is suffered to escape, large and 48 misshapen; the teeth irregular; the voice harsh and high pitched; the eyes squinting; the gait feeble and unsteady; the sexual power weak, or altogether absent. Persons afflicted by this disease are in Switzerland and Savoy called cretins, and in France cagots. It is ascribed to local peculiarities, and is said to prevail mostly in valleys lying among hills, although it has been argued that it only occurs. where the people are living upon or drinking the waters which flow over a calcareous formation. The best opinion seems to be that this mental deficiency, coëxisting with this physical defect, is developed some time after the birth of the child. In some cases it is complicated by spinal distortion, in some by hydrocephalus. There is a division of cretins into three classes, but for all the purposes that such a work as this is Esquirol, "Maladies Mentales," vol. ii. p. 284. * See Principles of Medical Psychology, by Feuchterslaben. intended to subserve, enough has been said concerning this very curious variety of idiocy. 69. Imbecility is, as we have already seen, only a less degree of idiocy. Yet it is well to remember, in relation to this form of mental defect, that it is actually the result of disease. It may be modified to a certain extent by education, but it is not a condition analogous to that which would result simply from an absence of all culture or education. One characteristic of a healthy mind is that, it will educate itself. However small its opportunities of culture may be, it will secure the means of mental sustenance-of mental growth. But imbecility is not to be confounded with a mental weakness which results from the stunting due to lack of opportunities. It is a condition of actual disease which precludes the assimilation of facts, and consequently prevents education. This fact has been overlooked by many who have written about this disease. It is to be understood, then, that imbecility is an insanity in the same way that mania is, with very different symptoms it is true, but still due to actual disease. 270. Sir John Nicholl's Description of Imbecility.-Sir John Nicholl has given an admirable description of the characteristic symptoms of imbecility, in the case of Ingram v. Wyatt,' which is worthy of attention. He says: "When imbecility is original, or, as medical authorities say, conate, the memory is often perfect, especially of trifling and simple circumstances, though the other mental powers remain infantine, or, as the same authorities suppose and express it, 'the brain has more developed itself.' In such an individual the understanding has made little progress with years-it has not matured and ripened in the [65]usual manner; yet even in such individuals, unless the imbecility be extreme, some improvement will have taken place, some progress in knowledge beyond mere infancy will have been made, by the help of memory, imitation, and habit. Such an individual will acquire many ideas, will recollect facts and circumstances, and places, and hacknied quotations from 1 Haggard's Eccl. Rep. 384. books; will conduct himself in an orderly manner; will make a few rational remarks on familiar and trite subjects; may retain self-dominion, and spend his own little income in providing for his wants as a boy spends his pocket money, and yet may labour under great infirmity of mind, and be very liable to fraud and imposition. The principal marked features of imbecility are the same which belong to childhood, of course varying in degree in different individuals-frivolous. pursuits, fondness for and stress upon trifles, inertness of mind, paucity of ideas, shyness, timidity, submission to control, acquiescence under influence, and the like. Hence these infantine qualities have acquired for this species of deficiency of understanding the name of 'childishness.' The effect is, that where imbecility exists at all, and in proportion to its degree, it becomes necessary, especially in a case exposed to other adverse presumptions, to ascertain its extent with some accuracy; to see how far the individual was liable to be controlled by influence, to submit to ascendancy, to acquiesce from inertness and confidence in those acts upon the validity of which the court has to decide." 2 71. Imbecility distinguished from Idiocy.—50) Imbecility is unsoundness of mind occurring in early childhood. Idiocy, we have seen, is congenital. Many writers have endeavored to distingush idiots from imbeciles by other means. Georget regards the use of speech as a distinguishing characteristic of the imbecile, and the ordinary impression that the imbecile has more mind than the idiot seems to have been adopted by scientific observers as a good means of differentiating these classes. So much may a few months or years of sanity, when a child has just come into the world, do for the mind of the half-ripened man. Others have thought that they were founding a distinction upon another and better principle when they thought that imbeciles were to be regarded as different from idiots in that they had a capacity for instruction. But Georget's distinction is precisely similar, for the fact that an imbecile has speech indicates the past fact of the capacity for instruction. Many men amuse themselves by dressing propositions in different words, as children do by attiring dolls in different dresses. 272. Question of Distinction between Imbecility and Idiocy considered.-But the truth is that no real distinction exists between the two, although for convenience they may be kept apart by means of the two designations. The probability is that imbecility like idiocy is congenital, but that the defect not being so marked in the former as in the latter, being a defect less in degree although the same in kind, that it is not at once observed; and that it is only when the progress of the child in mental stature is seen to be slower than it is in the case of a simply stupid child, that the imbecility is suspected, and the date of its inception is fixed as that of the observation instead of that of the birth. This is as if we assert that the planet Uranus began to be on the 13th March, 1781, when Sir William Herschel observed it for the first time. Besides it is well to be aware that this distinction is entirely arbitrary, as in many cases it is impossible to distinguish a minor degree of idiocy from a major degree of imbecility. 273. Degree of Imbecility: How it may be Ascertained. Just as some people differ from others in the amount of their capacity, in their mental power, so do imbeciles, and so nearly do some imbeciles approach in intelligence the more stupid of the sane that it is sometimes almost impossible to say whether the individual should be classed with idiots or fools. The degree of defect is likely to be accu rately indicated by the number of words they are capable of using. Indeed, we may judge of the power of ordinary sane men by simply numbering the words they habitually use. must be habitual use and not such a use as might be prepared for by means of a cram with reference to this census. The fact that Shakespeare has used 15,000 words, that Milton has used 8000, and that many ordinary day laborers are incapable of using more than 300, throws some light upon this suggestion, and when we go lower in the scale we find it still better illustrated, for many imbeciles can only use one word. It 274. Classes of Imbecility.-One class of imbeciles, then, are incapable of acquiring or retaining knowledge: they are unable to understand or appreciate any of the laws of the BR. INS.-10 |