June 13, 1913] 



SCIENCE 



901 



stuttering or lisping, special pedagogy or 

 psyeho-elinical methods of testing. An 

 alienist accordingly is not to be considered 

 a specialist on the mentally exceptional 

 child in the schools unless indeed he has 

 supplemented his general medical and 

 psychiatric education with a technical 

 study of the psychological and educational 

 aspects of the problem. The alienist of 

 the future will certainly have to secure a 

 different preparation from that now fur- 

 nished in the medical schools, if he is to 

 enter the field of pedagogic child study. 



Before me lies the report of the depart- 

 ment of medical inspection of a large 

 school system. Six hundred retarded chil- 

 dren were examined in this department, 

 which is in charge of an alienist, who, as I 

 am told, is an expert on the questions of 

 adult insanity, but who has no specialized 

 preparation in the psychology and peda- 

 gogy of the mentally defective child. Of 

 these children 49.7 per cent, are recorded 

 as feeble-minded. Applying this figure to 

 the 6,000,000 retardates of the public 

 schools of the country, we get a total feeble- 

 minded school population of 3,000,000. 

 This figure, it need scarcely be said, is 

 monstrously absurd. It is fully ten times 

 too large. Feeble-mindedness and back- 

 wardness in children, it must be said, are 

 distinct problems from mental alienation, 

 and require for their satisfactory handling 

 a specialist on mentally deviating children. 

 A high grade feeble-minded child can not 

 be identified merely by some rule-of -thumb 

 system of intelligence tests. Feeble-mind- 

 edness involves more than a given degree 

 of intelligence retardation. At the same 

 time, lest I be misunderstood, it should be 

 specially stated that psychiatry and clin- 

 ical psychology will be mutually helped by 

 a closer union. Clinical psychology has 

 many important facts and a valuable ex- 

 perimental technique to offer to psycho- 



pathology, and psyehopathology in turn is 

 able to contribute facts of great value, and 

 more particularly an effective clinical 

 method of examination, to clinical psychol- 

 ogy. As the idiogenic conception of the 

 causation of various psychoses wins greater 

 recognition, clinical psychology will be- 

 come more and more indispensable to the 

 psychiatrist. It is certain that the effi- 

 ciency of the clinical psychologist will be 

 greatly increased by a study of mental 

 alienation — not a study of texts on psy- 

 chiatry, but a first-hand study in institu- 

 tional residence of individual cases. Any 

 one intending to do psycho-clinical work 

 with mentally deficient children certainly 

 should spend a year or two in residence at 

 institutions for feeble-minded, epileptic 

 and alienated children. The clinical psy- 

 chologist should be prepared to recognize 

 cases of incipient mental disorder, so that 

 he will be enabled to select these cases and 

 refer them to a psychiatric specialist for 

 further examination. 



2. Clinical psychology is not neurology. 

 There are important neurological aspects 

 involved in the study of mentally excep- 

 tional children. Mental arrest can be 

 largely expressed in terms of neurological 

 arrest, and a clinical psychologist should 

 have a first-hand knowledge of nerve signs 

 and a practical acquaintance with the 

 methods of neurological diagnosis. His 

 knowledge of neurology should be suffi- 

 cient to enable him to pick out suspected 

 nervous cases and refer them for expert 

 examination by a neurologist. However, 

 it must be emphasized that neurology 

 touches only one side — though an ex- 

 tremely important side — of the problem of 

 exceptional mentality. 



3. Clinical psychology is not synony- 

 mous with general medicine. The average 

 medical practitioner certainly knows far 

 less about the facts of mental variation in 



