September 17, 1908] 



NA rURE 



481 



tion the great mass of evidence which was tendered 

 to us in reference to the conditions and antecedents of 

 mental defect, especially in the very large class of 

 cases in which the evil dated from birth or from early 

 life." The great majority of the witnesses who spoke 

 specially on this question (among whom were Sir T. 

 Clifford AUbutt, Sir E. Ray Laiikester, Dr. Archdall 

 Keid, and Dr. Bevan Lewis) regarded fceble-minded- 

 ness (where not accidental) as a germinal variation, 

 a reversion to a more primitive type of brain, and a 

 condition which is necessarily inherited. The trend of 

 the evidence of these witnesses was distinctly opposed 

 to the notion that causes such as faulty nutrition, 

 wasting diseases, or alcoholism are of importance in 

 the production of feeble-mindedness. Considerable 

 evidence of a contrary kind was offered, but neither the 

 authority of the witnesses nor the data upon which 

 they relied was sufficient to shake what is at present 

 the accepted teaching of biology. As might have been 

 expected, an attempt was made by certain witnesses 

 to put forward the opinion that the existence of mental 

 defect in a community might be checked either by 

 surgical or other artificial measures, or by placing 

 obstacles"5n the way of the marriage of persons ascer- 

 tained to be mentally defective. The commissioners 

 repudiate these suggestions, but they nevertheless 

 somewhat hesitatingly come to the conclusion upon 

 the evidence submitted (vol. viii., p. 185), " (2) that 

 especiallv in view of the evidence concerning fertility, 

 the prevention of mentally defective persons from 

 becoming parents would tend largely to diminish the 

 number of such persons in the population." This is an 

 opinion on which there is much room both for doubt and 

 discussion. Many of the feeble-minded are the children 

 of parents of average physical and mental health ; a 

 still larger number are children of neurotic parents, 

 who are, however, of such mental integrity that no 

 State would venture to prohibit their unions. The 

 number of the feeble-minded who are descendants of 

 obviously imbecile parents, while probably not incon- 

 siderable, does not by any means form such a propor- 

 tion of the class that the prevention of their existence 

 would " largely " diminish the number. If mental 

 unsoundness were a foreign strain introduced into a 

 community, then it might possibly be extirpated in 

 one of the several ways suggested ; but as it is a 

 germinal variation which, so long as individuals are 

 not at a dead-level of mental endowment, must always 

 arise anew, it is useless to propose means, adaptable to 

 civilised societies, for checking its production. The 

 alleged fertility of the feeble-minded referred to in 

 the above quotation is contrary to general experience, 

 which has hitherto rather pointed to an increasing 

 sterility in direct ratio to the degree of the existing 

 mental degeneracy. The existence of a special degree 

 of fecunditv on the part of the parents of the feeble- 

 minded would require much fuller and more accurate 

 statistical proof than has been produced by the pro- 

 moters of the statement. The generally accepted view 

 is that the more pronounced the feeble-mindedness 

 the less fertile is the individual, and conversely, that 

 the less feeble-minded the individual the more fertile 

 he is likely to be. But feeble-mindedness is a term 

 including a variety of mental conditions ; on the one 

 hand it embraces the absolute idiot, and on the 

 other merges insensibly into the average mental level 

 of the community. The attempt to prevent the union 

 of the higher grades of the feeble-minded, who are 

 also the most fertile, would thus be manifestly futile. 

 The commissioners are, however, on safer ground 

 when they suggest that some prevention in this respect 

 is likely to be effected from the seclusion of the 

 numbers of the feeble-minded with which their far- 

 reaching recommendations propose to deal, for they 

 say {loc. cit.) " (3) that the evidence strongly supports 



NO. 2029, VOL. 78] 



measures, which on other grounds are of pressing 

 importance, for placing mentally defective persons, 

 men and women, who are living at large and uncon- 

 trolled, in institutions where they will be employed 

 and detained; and in this, and in other ways, kept 

 under effectual supervision so long as may be neces- 

 sary." 



At p. 193 (vol. viii.) of the report a tabulated 

 estimate of mentally defective persons (excluding cer- 

 tified lunatics) in England and Wales is given. From 

 it may be seen that out of 149,628 such persons 66,509, 

 or 44'4 per cent, of the whole, are practically un- 

 provided for. The following abstract from the table 

 is of interest : — 



" Needing 



32,405,864' 



149,628 



66,509 



These figures amply justify the grave statement in 

 the introduction to the report (p. 9), " there are 

 numbers of mentally defective persons whose training 

 is neglected, over whom no sufficient control is exer- 

 cised, and whose wayward and irresponsible lives are 

 productive of crime and misery, of much injury and 

 mischief to themselves and to others, and of much 

 continuous expenditure wasteful to the community and 

 to individual families." 



It is evident that the crux of the situation lies in 

 the education and after care of feeble-minded children, 

 75 per cent, of whom are not only neglected in youth, 

 but are more or less lost sight of in adult life. As 

 means towards remedying these defects the recom- 

 mendations of the commissioners appear sufficiently 

 comprehensive. County councils or burgh county 

 councils, as the case may be, are to be under statutory 

 obligation to provide for the manual, industrial, or 

 other training of mentally defective children who are 

 not otherwise properly provided for; specially qualified 

 medical officers of these bodies are to examine and 

 report upon all such children, and, in case of doubt 

 as to whether a child is mentally defective or merely 

 "backward," the child may be placed upon a special 

 probationary list and retained for such a period as 

 may be considered necessary in a special class, school, 

 institution or home for the mentally defective. 

 Further, in the case of feeble-minded persons under 

 twenty-one years of age who are not receiving suitable 

 training, or are being cruelly treated or otherwise neg- 

 lected, the local authority may, on the recommendation 

 of their medical olficer, assume all the rights of a 

 parent or guardian until the child ceases to be a 

 minor, subject to an appeal by the parents or guardians 

 to a court of law. In the case of a person of feeble 

 mind more than twenty-one years who is not suitably 

 provided for, the local authority may, if it considers it 

 necessary, present a petition as next friend of the 

 mentallv defective person with a view to his detention, 

 control, or proper care. 



Such, in brief, are the means suggested for the 

 selection, registration, education, care, and, where 

 necessary, the permanent control of the feeble-minded. 

 Were these recommendations to become law there is 

 good ground for believing that in course of time much 

 social sordidness, petty delinquency, and domestic 

 misery would be checked at its source. Under existing 

 administrative conditions it is well known to be 

 1 General population oth r than certified lunatics, &C. 



