TESTS FOR MENTAL DEFECTS 



How the Public Health Service Prevents Contamination of Our Racial Stock by- 

 Turning Back Feeble-Minded Immigrants —General Characteristics Noted 

 and Progressive Series of Tests Applied to Determine Exact Mentality. 



Howard A. Knox, 

 Assistant Surgeon, United States Public Health Service, Ellis Island, X. )'. 



BEFORE one enters upon a search 

 for a thing he must know defi- 

 nitely what he is seeking, else 

 the object of his quest may pass 

 him unnoticed. This is even more true 

 with regard to the various grades of 

 mental cnfceblemcnt than in the case 

 of any physical infirmity because there 

 still exists considerable chaos in the 

 minds of many as to just w^hat consti- 

 tutes mental deficiency. 



Some have attempted to formulate 

 a social definition and hold that anyone, 

 not actually insane, who is unable to 

 reside harmoniously in the environment 

 to which he is accustomed, and in com- 

 pliance with its laws and customs, is 

 defective mentally. This definition, 

 while it includes many defectives, leaves 

 f)Ut nearly all the potential ones and the 

 majority of the higher ones that are not 

 criminally inclined. Its application 

 would necessitate turning all defectives 

 loose in the world to see whether they 

 can keep out of pubHc institutions. 

 This is exactly what some of the doctors 

 and lawyers representing some of the 

 immigrants would hke to have done in 

 the case of feeble-minded aliens who are 

 detained at immigration stations. For- 

 tunately the laws are such that feeble- 

 minded aliens may be certified and de- 

 ported before they have had an o])por- 

 tunity to contaminate the blood of the 

 nation or to commit anv crime. 



The United States ' Public Health 

 Service has worked laboriousl\' and in- 

 tensively to determine the standards of 

 knowledge of the various races. The 

 standard and definitions of feeble- 

 mindedness are based on what a given 

 subject can do, his i)rcvious environ- 

 ment, education and the stress under 



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which he may be laboring being taken 

 into account. In short, the tests are 

 functional tests of the brain used in 

 much the same way as functional tests 

 are used to determine the amount and 

 quality of work which the kidne\-s, for 

 example, are capable of doing. The 

 most successful test in use for the detec- 

 tion and classification of deficiency in 

 educated children, namely the Simon- 

 Binet Scale, is based on the same 

 principle, that is, to learn exactly by 

 experiment w^hat normals can do with 

 ease and to use the result of this work 

 as a scale for weeding out defectix'cs. 



RECOGNIZING THE DEFECTIVES. 



The public in the past has only 

 recognized as defective those ijersons 

 who are lacking in the intellectual 

 sphere, in other words those who are 

 stu])id, dull and foolish. The emotional, 

 volitional and criminal defectives have 

 received scant attention. Vet, it is the 

 latter, perhaps, who are the greatest 

 menace. They are able to sujjport 

 themselves yet they are also able to 

 re])roduce the real old fashioned idiot 

 and imbecile which the state must care 

 for. 



Now this ])eing true, how ma\- these 

 potential inferiors be recognized' In 

 the first i^lace those who are themselves 

 not markedly defecti\'e. but who are 

 capable of transmitting weakminded- 

 ness to their progeny, usualh' possess 

 facial ])eculiarities,temi)eramental queer- 

 ness or both. For in.stance, as in the 

 case of the frontisijiecc, the mother may 

 IKissess many of the facial signs of a 

 Mongolian defective and \'et ha\-e no 

 recognizal)le mental imixiinnenl. With 

 a health v husband wlio had a clean 



