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defect or feeble-mindedness, the distinction being that feeblemindedness is an arrest of development whereas insanity is a degenerative process, the victim not simply stopping where he is but losing a part of the mentality that he once had. In the early years of childhood, it is practically impossible to differentiate between these two. The result is that we are apt to call everything feeblemindedness which occurs in the early years. And we have assigned as a cause of the feeble-mindedness whatever physical condition seems to be uppermost. For example, if we have a case of imbecility which also has hemiplegia, we classify it as a case of hemiplegic feeble-mindedness and assume, as a rule, that the cause which has resulted in the brain lesion producing the hemiplegia, has also caused the mental defect.
The thesis to be maintained in this paper is that this is not necessarily the case but rather that our whole problem will be simplified if we recognize some more heads of classification in this particular. To put the matter in another form, we may say that as the result of our study into the heredity of feeble-mindedness, we have come to the conclusion that the human family is divisible not only into the sane and insane, the healthy and diseased; but further, the sane and healthy group is subdivided possibly into many groups or strains; and that the mental capacity or possibilities varies widely in the different strains, but is fairly constant in each strain and is transmitted regularly, that is to say, so long as any given strain is kept pure, we will have the same mental capacity and possibilities generation after generation; that variations occur here as they do in the plant and lower animal world; that inbreeding and crossbreeding produce new combinations just as they do in plants or animals. To illustrate, we have only to call to mind almost any line of animal breeding. There is the genus horse, with various species, and within the species there are so-called strains. Every breeder knows that those strains will be transmitted and that they must be reckoned with in all attempts to breed horses for particular purposes or with particular characteristics. The same thing is true of dogs. No trainer would attempt to train a bull dog to retrieve or to point. Furthermore coming closer to our special problem, every trainer
knows that among the pointers, there are those that are easily and quickly trained to be high grade pointers; there are other strains that can never be trained to anything like the same efficiency. The same thing seems to be true of the human race.
There are strains that are capable of high mental development. These give us our geniuses or our brilliant leaders, or families with marked and valuable characteristics. Then there are strains with less capacity but still able to get along in the world and adapt themselves to their environment with fair success. These two groups are, of course, normal people. But when we go a step lower, we find a group of people whose capacity for development is so limited that they can never attain sufficient intelligence to get along in the world. Here we come to our group of feeble-minded and just as there are strains of varying degrees of intelligence which we call normal, so there are strains of varying degrees of defective intelligence, varying from those that are almost normal, almost able to take care of themselves, down to those who are so lacking in intelligence that they can do little more than procreate.
We are, for the time being, eliminating entirely all disease and abnormalities and fixing our attention upon what we call pure strains of feeble-mindedness. Furthermore, when this strain of pure feeble-mindedness is found uncomplicated as it often is, the mental condition is the chief peculiarity and the physical organism is oftentimes a remarkably perfect one, so that the strain is not recognized by any of its outward appearances, but only by those actions and movements which result from a less well-developed mentality. There can be found in institutions for the feeble-minded, persons of as fine physique and good health as can be found anywhere. This extends often even to details. For example: a dentist asserts that the finest set of teeth he has ever seen is in the mouth of an imbecile in an institution for feeble-minded.
Now it happens not unnaturally that these strains of defective mentality are liable to diseases of various kinds just as are socalled normal people. Whether the various diseases and accidents affect them in the same way as they affect people of normal intelligence, remains to be seen. It seems probable that in many cases the
effect is more serious and this accounts for the fact that the physical condition has in so many cases masked the hereditary factor and so our understanding of feeble-mindedness is usually much complicated by the presence of these diseased conditions. An illustration will make this clear.
Feeble-mindedness and epilepsy are often combined, constituting a complex that is very troublesome.
In the writer's opinion the problem would be much simplified by recognizing two groups : first those who belong to a strain of pure feeble-mindedness upon whom epilepsy has been grafted, and second a group of normal people suffering from epilepsy but in whom the epilepsy has produced an arrest of development and even set up a degenerative process. The clinical appearance of the two groups is much the same. The family history is needed to differentiate them.
Apparently also the Binet tests are useful on this line, those who are primarily feeble-minded testing in the same manner as other feeble-minded persons, that is to say, succeeding in the tests up to a certain definite point beyond which they cannot go, whereas those who are primarily normal but have deteriorated as a result of the epilepsy, show a scattering in their answers, that is to say, in some particulars, they show the intelligence of, for example, tenyear-old people while in others, they are only six, the degenerative processes set up by the epileptic attacks having destroyed certain mental processes and not others.
I shall not at this time go further into the question of the effects of the various diseases upon the different strains of mentality but shall content myself with showing you on the screen the portraits of
ises of pure feeble-mindedness together with charts, showing that it is hereditary.
Note: The author showed a number of slides of perfectly normal-looking people but whose mentality ranged from that of twoyear-old children up to that of ten-year-olds, although their physical age was in each case much greater. Each portrait was followed by a slide showing the hereditary character of the defect in several generations. One portrait with its accompanying family chart is here shown as an illustration.
Squares are males: circles females. F= feeble-minded; A= alcoholic; Sr=sexually immoral; T= tuberculous; B=blind; d inf=died in infancy; I=insane; small black circle= miscarriage; E = epileptic. Hand points to child in the institution for the feeble-minded. TRAINING SCHOOL FOR FEEBLE-MINDED CHILDREN,
VINELAND, N. J.
THE HEREDITY OF EPILEPSY ANALYZED BY THE
By DAVID FAIRCHILD WEEKS, M.D.
(Read April 19, 1912.)
Until recently it has been considered sufficient to determine the known number of epileptic ancestors or other relatives of a case of epilepsy, and then take this proportion as the index of heredity, with the natural result that the index increased as the study of the family was extended, resulting in a difference of from 20 to 75 per cent., as determined by different workers.
In our study of the inheritance of epilepsy at Skillman, we are endeavoring to analyze our data by the Mendelian method, which assumes that the inheritance of any character is not from the parents, grandparents, etc., but from the germ plasm out of which every fraternity and its parents and other relatives have arisen.
The relation of soma (body) and germ plasm is as follows:
1. If the body possesses a trait of the recessive to normality sort, it lacks the unit character upon which normal development depends, and it is prima facie evidence that the representative of that character is absent from its germ plasm, consequently such a person cannot transmit the character in question. The condition in the case when the determiner is absent may be called nulliplex.
2. If the body possesses a trait of the dominant to normality sort, it is evidence that the germ plasm has the corresponding determiner. But either one of two conditions is possible. (a) The determiner was derived from both parents, so that it is double in the germ plasm, and all the germ cells have the determiner; or else, (b) it came from one parent only, in which case it is single in the germ plasm, or simplex, and half of the germ cells have the determiner and half lack the determiner. A moment's consideration will show that three kinds of somatic