Frederick Bateman - The Idiot - His Place in Creation, and His Claims on Society

Idiocy may be a congenital infirmity, or may be developed in early infancy. In the first category, the cause must necessarily be traced to intra-uterine life, and must be sought for in the history of the parents; in the second class, the cause may sometimes depend upon parental defects, and sometimes is due to a cerebral affection occurring soon after birth, but even in this class of cases, hereditary predisposition must be considered as a powerful factor in the genesis of the disease. In fact, the development of idiocy, whether congenital or otherwise, is in most instances to be attributed to an hereditary morbid vice, and it is one of the most common and striking forms of the degeneration of the human species.

Hereditary tendencies have much to do with the development of physical defects and bodily ailments, and this result is especially apparent in diseases of the nervous system; and there can be no doubt that heredity is a potent factor in the production of idiocy. Dr. Ireland says, "idiocy is, of all mental derangements, the most frequently propagated by descent;" and the statistics of Ludwig Dahl, of Christiana, showed that fifty per cent. of idiots had insane relations, those of Dr. Fletcher Beach showed a history of hereditary predisposition in 76 per cent., whilst those of Moreau, of Tours, give a proportion as high as 90 per cent.

In thus expressing myself, I should be sorry that my remarks should be construed as intended to cast any imputation upon those who have unfortunately an idiot in their family; the cause of the evil may be in some remote progenitor, for the transmission of the infirmity is not always direct, and the neurotic tendency may skip a generation, or be traced even further back.

Intemperance. One of the most fruitful causes of idiocy is the abuse – mark, I do not say the proper use – of alcoholic stimulants, which tends to bring families into a low and feeble condition, which thus becomes a prolific cause of idiocy in their children. From a report on idiocy, by Dr. Howe and other Commissioners appointed by the Governor of Massachusetts to ascertain the causes of this calamity in that State, it is stated that "out of 359 idiots, the condition of whose progenitors was ascertained, 99 were the children of inveterate drunkards;" and the report goes on to say further, "that when the parents were not actually habitual drunkards, yet amongst the idiots of the lower class, not one quarter of the parents could be considered as temperate persons. From a table drawn up by the late Dr. Kerlin, an American physician, in which the causes of the infirmity are given in 100 cases of idiotic children, I observe that in 38 of the number, intemperance on the part of the parents is traced as an accessory, main, direct, or indirect cause.

At the annual meeting of the British Medical Association, held at Cambridge, Dr. Fletcher Beach read a paper on the Intemperance of Parents as a predisposing cause of idiocy in children. In 430 patients, he was enabled to trace a history of parental intemperance in 138 cases, or 31·6 per cent.; of this number, 72 were males and 66 females." 5 5 The question of the influence of alcoholic stimulants on the development of mental disease formed a prominent feature in the proceedings of this congress, and it is also a subject which is just now engaging the attention of pathologists in all parts of the world.

Other observers lay less stress upon parental intemperance as a cause of idiocy. Dr. Wilbur found that out of 365 cases in the State of Illinois, only eight cases were assigned to the abuse of drink in the parents; and Dr. Shuttleworth could trace this cause in only 16·38 per cent. of the cases observed by himself and by Dr. Fletcher Beach; 6 6 "Mentally-deficient Children, their treatment and training." By G.E. Shuttleworth, M.D. Page 36. the same writer, under the head of toxic idiocy, mentions the case of an idiot boy, who was said to have been brought up on porter instead of milk. It will therefore be seen that there exists a great difference of opinion about the influence of intemperance of the parent in the causation of idiocy; but although statistics may vary upon this point, there cannot be a doubt that the children of drunken parents inherit an unhealthy nervous system, which in many cases culminates in idiocy.

Idiocy is especially prevalent in Norway, and Ludwig Dahl, a Norwegian writer, says that to the abuse of brandy, especially in the fathers, but also in the mothers during pregnancy, may be assigned an important, perhaps the most important, influence in the production of the large number of idiots in that country.

In considering this question, we must bear in mind that intemperance is only a relative term; for in the early part of the century we read of our ancestors indulging in a bottle of port wine to each individual, without, it seems, incurring the charge of drunkenness. There cannot be a doubt, however, that the habitual use of alcohol, without being carried to the extent of actual intoxication, is calculated to cause a low and feeble condition of the body, and thus conduce to the production of idiocy in the offspring; for we may fairly assume that what too severely tries the nervous system in one generation will appear in their descendants. 7 7 Toussenel, a French writer, says "La plupart des idiots sont des enfants procréés dans l'ivresse bacchique. On sait que les enfants se ressentent généralement de l'influence passionelle qui a présidé à leur conception." At a discussion at the Obstetrical Society, Dr. Langdon Down is reported to have entertained similar views. Without, therefore, exaggerating the influence of alcohol on the genesis of idiocy, I think I shall not be deviating from the path of strict scientific accuracy, if I say that over indulgence in alcoholic beverages is calculated to produce a low state of vitality, and a degeneration of nerve tissue which may culminate in the development of idiocy in subsequent generations. 8 8 I would refer those who may wish to pursue the inquiry as to the baneful influence of alcohol on the human frame, to the celebrated Cantor Lectures on Alcohol, by my friend Sir B.W. Richardson, in which he introduces the physiological argument into the temperance cause, asserting that alcohol cannot be classified as a food; that degeneration of tissues is produced, that it neither supplies matter for construction nor production of heat, but, on the contrary, militates against both. Sir B.W. Richardson's latest views upon this subject are developed in the pages of the "Hospital" for February 1st and March 14th, of this present year. In France, M. Lunier, Inspector of Asylums, has shown that the departments in which the consumption of alcohol had increased most, were those in which there had been a corresponding increase of insanity, and this was shown most strikingly in regard to women, at the period when the natural wines of the country gave way to the consumption of spirits. In Sweden, Dr. Westfelt has lately made a communication to the Stockholm Medical Society, containing the statistics of alcoholic abuse and its results in Sweden. He calculates that at least from 7 to 12 or 13 per cent. among males, and from 1 to 2 per cent. among females, of all cases of acquired insanity, are due to the abuse of alcohol; and in reference to its influence on progeny and race, he shows that a steady diminution of the population was coincident with a period when drunkenness was at its greatest height.

Just now that the attention of the Legislature is being prominently called to the treatment of habitual drunkards, it cannot be too widely known that their innocent offspring are but too frequently the victims of the brutish excesses of their parents, who, a few years ago, were well described by the then Secretary of State for the Home Department, when receiving a deputation on the subject, as not quite criminals nor quite lunatics, although nearly approaching both classes in many cases. The above statistics fully corroborate the pertinency of Lord Cross's remarks.