Pre-Owned Mental Retardation in America: A Historical Reader (Paperback) 0814782485 9780814782484

From The New England Journal of Medicine This is a highly readable and well-edited historical anthology, a wide-ranging collection that deals with mental retardation over two centuries. The focus is on the views and actions of society. The book deserves perusal by anyone interested in mental retardation. The editors consider the history of retardation in the context of general history. There are only two sections that deal with medicine: one concerns a history of the recognition of "Mongolism" by John Langdon Down, the racial detour that accompanied that recognition, and the eventual delineation of trisomy 21 as the cause; the other is a treatise on the pathology of mental retardation by Dr. William Fish, of the Albany Medical College, which he wrote in 1879. The treatise is welcome fare for a physician reader. Discussed are consanguine marriages, abnormalities of the "minute structure of the brain," microcephaly, epilepsy, and cretinism in Switzerland (". . . the precise element or elements producing it have not as yet been determined"), hydrocephaly, trauma, and paralysis. Equally clear is Dr. Fish's prescription: "The necessity for training schools and asylums for the reception of the idiotic and imbecile is now unquestioned. . . . [It is] the duty of society to provide for these `feeble ones.' . . . An idiot child in the family of a laboring man is a burden weighing heavily upon him, and may indirectly be the means of rendering the whole family dependent on the state for support." This rather straightforward approach contrasts with the complexity of the history of mental retardation in American society, which "is reflective . . . of the larger course of events in American society." The full sweep of that history is outlined -- from retarded persons functioning as integral parts of their families in the Colonial and early rural United States to the almshouses of the late 18th and early 19th centuries, where the poor, infirm, "insane," and "idiotic" were conflated in conditions of indescribable depravity. Later came the specialization of institutions for epileptics and the retarded. The pressures of urbanization and industrialization, the needs of immigrant families, and the application of scientific concepts to the definition of retardation (e.g., the advent of intelligence tests and the familiar categorization of the retarded as "idiots," "imbeciles," and "morons") led to the heyday of institutionalization. Between 1870 and 1880, there was a fivefold increase in the number of "feeble-minded" people. Social forces and scientific interest led to intense focus on and very convoluted thinking about the retarded. The 19th-century view of "degeneracy" (roughly synonymous with "bad heredity") led theorists to conceive of social problems such as insanity, poverty, intemperance, and criminality -- as well as idiocy -- as interchangeable. This view was expounded in The Jukes: A Study in Crime, Pauperism, Disease, and Heredity (Richard Dugdale, 1875), a study of a rural clan that "over seven generations produced 1,200 bastards, beggars, murderers, prostitutes, thieves and syphilitics." The second equally influential study was The Kallikak Family: A Study in the Heredity of Feeble-Mindedness (Henry Goddard, 1912). Inspired by the new mendelism, the study traced back six generations of the family of a young institutionalized woman and found "an appalling amount of defectiveness." Yet there was also information about "a good family of the same name." It emerged, of course, that the forebear met "a feeble-minded girl by whom he became the father of a feeble-minded son." Subsequently the father "married a respectable girl of good family," by whom he produced children with "a marked tendency toward professional careers," who had "married into the best families . . . signers of the Declaration of Independence . . . etc." Goddard invented the pseudonym Kallikak by combining a Greek root meaning "beauty" (kallos) with one meaning "bad" (kako