MORAL IMBECILITY. 
TWO PAPERS READ BEFORE THE ASSOCIATION OF 
MEDICAL OFFICERS OF AMERICAN 
INSTITUTIONS FOR 
Idiotic and Feeble-Minded Persons. 
BY 
DR. ISAAC N. KERLIN, 
OF ELWYN, PA., 
AND 
HON. JOHN M. BROOMALE 
OF MEDIA, PA. 
LAKEVILLE, 1887. 
PRINTED BY J. B. LIPPINCOTT COMPANY, 
PHILADELPHIA. 
1889. MORAL IMBECILITY. 
By Dr. Isaac N. Kerlin, Elwyn, Pennsylvania. 
Read at the Lakeville Meeting, 1887. 
BY 
DR. ISAAC N. KERLIN, 
OF ELWYN, PA., 
AND 
HON. JOHN M. BROOMALE 
OF MEDIA, PA. 4 
KBRLIN—MORAL IMHKCILITY. 
tional insanity, I am fortified by the experience of thirty years with 
feeble-minded children, among whom it is not phenomenal to discover 
numerous illustrations of this radical malady. 
Moral insanity, emotional insanity, affective insanity, mania nine del trio, 
or reasoning mania, are a few of the various and in some respects inap- 
plicable terms which have been applied to a “ mental disorder in which 
there is a loss or absence of control over the lower propensities, or in which 
the moral sentiments rather than the intellectual powers arc confused, 
weakened, or perverted.” This definition by the distinguished alienist 
Dr. Hack Tuke refers to loss of control, the word “ loss ’ implying, there- 
fore, a change in the state of the individual which would constitute an 
insanity. At this point I will say that the condition known in after-life 
as moral insanity is most likely to present itself very early in life, yet may 
be temporarily suspended by the environment of the individual, or over- 
grown by the protrusion of the intellectual faculties and the business pre- 
occupation of the individual; the reappearance of the trouble only coinci- 
dent with shock, disaster, nervous break-down, etc, I think it will be 
found, upon a careful study of most of the typical cases of so-called 
moral insanity, that there had been an eccentric, unstable, eventful child- 
hood, with nervous disturbances such as epilepsy, chorea, uncontrollable 
paroxysms of anger, truancy, incorrigibility, intractable thieving, and the 
like; and hence the term “ moral imbecility” will better define the morbid 
state of the ndividual. 
That derangement or disorder of the moral part may be inbred and 
radical was first pointed out so long ago as when Dr. Kush wrote his early 
and remarkable work (“ Diseases of the Mind,” 1812), and it is strange 
that only a few American writers have distinctly followed. Hpitxka, in- 
deed, is singularly and exceptionally clear when writing as follows: “ It 
mav be advanced as a cardinal canon of psychiatry that in insanity the 
moral feelings are usually more or less dulled or perverted. The defi- 
ciency of the moral feelings may, however, be of a different kind; in 
certain cases it may be a necessary result of intellectual enfeeblement, it 
mav be due to an obtuse emotional condition, or it may be an original 
deficiency analogous to that lack of musical sense, or color-blindness, 
which may coexist with a fair faculty of language and good contour per- 
ception, just as that moral imbecility which authors call moral insanity 
may be found associated with fairly good logical powers in the abstract. 
An intense egotism is sometimes found to lie at the root of a constitutional 
inability of the individual to recognise any moral obligation to others. In 
such cases abstract moral conceptions may be inculcated by education. Hut 
the subject of this condition, while he may be able to guide bis conduct KERLIN—MORAL IMBECILITY. 
5 
by these, regards them as purely utilitarian conceptions. They never be- 
come as organically fixed as where they have been developed from that 
inborn tendency which is the common heritage of normal mankind.” 
In the last words of this paragraph from Spitzka is contained the 
doctrine, which I think permissible,—that the moral sense is a primary 
feeling, resulting from the long experience of the race, and that its percep- 
tions are of the same kind, engendered in the same way, and possessed of 
receptive and volitional centres, perhaps less localized, but common to large 
areas of the nervous system, exactly as obtains in the case of the special 
senses ; and as the ordinary perceptions are preceded by inward sensations 
transmitted from without, requiring for their integrity a healthy and im- 
pressible brain-centre, so the perceptions of the moral sense require an 
impressible and co-ordinating physical basis. (See Bannister, p. 652.) 
Hence, as there are persons in whom we discover a partial or entire 
absence of color perception, or of the musical-perception, and others who 
are partially or entirely destitute of the power of numbers, of distance, 
of direction, of analysis, of logic, or of any other special faculty,—nor 
can the absence be supplied by education,—so we have individuals who, 
from some inherent fault in, or some radical defect of, the receptive cen- 
tres, are destitute in part and sometimes wholly of the so-called moral 
sense, and no environment and no education will supply the deficiency. 
Who that has followed the history of bullet-wounds of the brain has not 
become familiar with the painful illustrations of the complete change in 
the moral character, resulting from the local injury: the strictly tem- 
perate man sinking into inebriety or alcoholism, or the virtuous man giving 
himself up to obscenity or sexual excess; changes attributable to dis- 
astrous lesion of the nerve-centres? Also, probably, to some of you 
have occurred cases of grave decadence in moral perception and self-con- 
trol coincident with the progress of a general disease, or associated with 
convalescence from some acute disorder. In all of these the condition 
interprets itself; but why are we less discerning in those of congenital 
standing? Why call such unfortunates “ incorrigible,” and, measuring 
their offences by their perception of right and wrong, fail to recognize 
an utter wanting of the power of self-control,—the real defect,—which 
in its relation to crime has been called by a distinguished observer “ the 
loss of the inhibitory power.” ? 
As long ago as 1842, Judge Edmonds, of New York, in simple language 
differentiating between the faculties themselves, described the condition 
we are trying to name as follows: He says, “ It must be borne in mind 
that the moral as well as the intellectual faculties may be so disordered by 
disease as to deprive the mind of its controlling power.” And since that 6 
KKRLIN—MORAL IMBECILITY. 
utterance, inoral insanity has had its recognition in the jurisprudence of 
the State of New York, and nearer and nearer are the courts and the har 
of that State approaching a safer judgment by inquiring into the nature 
of the criminal or civil acts involved in any question of insanity, rather 
than into the abstract knowledge of right and wrong of the individual 
under inquisition. 
But more embarrassing than the cases which corno to court are the hosts 
of uncanny people who never become certified lunatics, although the an- 
noyance of a community, the disturbers of domestic peace, and the skeleton 
of many a closet; if introduced to public notice it is through Borne unex- 
plainable and mortifying climax, as the elopement of an heiress with 
her father’s coachman, or the sudden abandonment of husband and chil- 
dren for a false paramour, or the slip in honesty and downright ruin of 
the reputable banker, his naturally enfeebled will yielding at last to its 
undue strain; or we may have the break-down in some form of startling 
tragedy, as a suicide with dramatic settings, or a murder with crimson 
accessories. 
Before these terrible climaxes the medical man could never have been 
able to supply the facts “ observed by himself” that would be sufficient 
for a medical certificate; but nearer and dearer observers have felt, 
and feared, and have lovingly covered over their anxieties from all the 
world. 
There are four classes of moral imbeciles, or, I should say, four classes 
of society largely consisting of moral imbeciles, to whom I would briefly 
call your attention,—(1) the alcoholic inebriate; (2) the tramp; (3) the 
prostitute; (4) the habitual criminal. There are other classes which 
might be enumerated, but they are beyond the reach of any immediate 
action either of law or of popular consideration. 
These four classes correspond in one characteristic defect; e.y., there is 
a radical lack of will-power to be other than they are, or to do* otherwise 
than they do. They all know the wrong of their living; if fairly ap- 
proached, they confess and regret their evil courses; they are generally 
ready to reform, and make promises that are self-deceptive and deceiving. 
In this psychical defect of instability, and conscious but helpless wrong- 
doing, they are almost uniformly alike. 
Secondly.—They are generally of bad heredity. The inebriate is not 
necessarily the outcome of inebriate stock, but back of him there is epi- 
lepsy, or insanity, or family scrofula, or aristocratic debility, or genius. 
The tramp and prostitute are not necessarily the children of tramps and 
prostitutes, but pauperism in some form is likely to have been in the 
blood, and, more likely still, the infection of syphilis or the poison of rum KERLIN—MORAL IMBECILITY. 
7 
may have cursed the loins that bore them. Carefully examined, I believe 
the history of the Juke family will be found repeated in thousands of the 
lives of these four classes of moral defectives. Of them all it is said that 
crime life is less likely to take its origin in heredity, and yet there is much 
to sustain an opposite view. 
Thirdly.—Examining these different individuals, we find that, if there 
be not original feeble intellect, there is a gradual weakening of the intel- 
lectual faculties in nearly all, and many of them, if carefully balanced, 
will be found of light weight in reason as well as in will-power. 
What I have said is confirmed, in the case of the inebriate, by those 
physicians who are so industriously and hopefully studying Alcoholism. 
In the case of the criminal, Mr. Z. Brockway, who has made a profound 
study at the Elmira Reformatory, defining the moral sense as shown in 
filial affections, sense of shame, or sense of personal loss, reports of 1463 
examinations : absolutely no moral sense, 1082 (or 73.9 per cent.) ; possibly 
some moral sense, 229 (or 15.7 per cent.) ; ordinary sensibility, 88 (or 6 
per cent.) ; specially sensitive, 64 (or 4.4 per cent.). Corresponding views 
with these of Brockway are boldly set forth by Dr. Paul in the reports 
of our Eastern Penitentiary. Mr. Howard Edwards, a philanthropist of 
Philadelphia, who has for many years devoted himself to the rescue of 
fallen women, writes me thus: “ I suppose I have studied this subject of 
prostitution as much as any person in Philadelphia. I agree with you 
that its cause is mainly mental and moral instability or imbecility, and 
not downright wantonness.” I have carefully examined and interrogated 
many tramps during the past few years, and am ready to aver that there 
is the same evidence—almost to a man—that the tramp is a low, cunning, 
lazy imbecile. 
The evidence of insanity occurring in the adult is determined by 
change in his previous habit of correct thinking and acting by unaccount- 
able perversity, suspicion towards former confidants, quarrelsomeness, mel- 
ancholia, etc., and, to aid a diagnosis, there may have been a starting-point 
for such change, as a severe illness, temporary mania, or a great reverse. 
In presumed cases of moral imbecility the evidence in childhood cannot 
be weighed, as in the adult, by contrasting conditions in the same indi- 
vidual, but must be established in a careful examination of unlikeness to 
normal and ordinary child-life, with allowance for neglect, abuse, and 
unfavorable environments. If the investigation concerns a carefully 
reared and guarded child, whose conduct is in violent contrast with the 
favorable circumstances of that rearing, a doubt is established as to its 
soundness which seldom needs more than the added fact of a neurotic 
heredity to make the case one of moral imbecility; proportionately diffi- 8 
KKRI.IN — MORAL IMBECILITT. 
cult is it to form a judgment if the child be of the “ slums,” in whom 
early contamination and abuse may have marred a normal development 
of the moral sense. To constitute a case of moral imbecility we must 
have badness without reason, violence without motive, deception without 
purpose, thieving without acquisitiveness, brutality inspired by a fiendish 
love for inflicting pain. There may be a clear apprehension of right 
and wrong, but an inability to choose the right because overborne by the 
seductiveness and sensationalism of the wrong; there is a perception that 
discovery is certain and that punishment will follow on the heels of 
offence, but the ingrained lowness and depravity bear its victim on to his 
fate, and under punishment he is stubbornly callous or extravagantly 
penitent, as best suits his dramatic instinct. Often we have to aid us 
some slight peripheral defect, indicating a central lack or early lesion,— 
the dragging of one limb, a shuffling or heedless gait, inconstant gaze, 
partial deafness, jerky pulse and irritable heart, habitually furred tongue, 
etc. We may find as aids to diagnosis, evidence of night-scares, fits, 
chorea, etc., in infancy, and farther back still a history of family insanity, 
alcoholism, or epilepsy. A keen analysis of ntellectual power will, I 
think, discover in most cases want of average power of attention, a signifi- 
cant feebleness of judgment and indecision of purpose in all matters of 
a rational character, not associated with the special and controlling im- 
pulse ; in the latter the attention and purpose are preternaturally fixed 
and directed. 
The moral sense being the latest and highest attribute of our rising 
humanity, it is the first and most to suffer from the law of reversion to 
lower type, when from any cause the progressive development of a family 
is broken in the birth of a defective child ; hence these moral monstrosi- 
ties are often found conceived and born in the best of families ; inheriting 
graces of body and precocious in accomplishments, there is an inherent 
failure or want of power to recognize the claims of others, which is the 
foundation of duty, truth, respect for property, prudence, discretion, and 
all the primary virtues of civilized society; in this declension consists the 
essence of moral insanity and imbecility. 
Coupled with this condition is a singular apathy to the consequence* of 
wrong-doing: the dock and prison excite no apprehension; the gallows 
has no terror; and death and eternity are faced with sensational stoicism ; 
indeed, it is a frequently-expressed doubt whether the impressions 
gained by this class from the punishable sequence* of crime, as published 
in our daily press, are not outweighed by excitation to crime-doing; for 
these people are egotists, who will play their role on any stage which ele- 
vates them into notice. THE HELPLESS CLASSES. 
By Hon. John M. Broomall, Media, Pennsylvania. 
Read at the Lakeville Meeting, 1887. 
It is now fully recognized that we are as we are very much by reason 
of our antecedents and surroundings. Heredity and associations, modified 
in their effects, to a greater or less extent, by the individual will, make 
us what we are. Over our antecedents we have no control, but we can 
to some extent escape the influence of our surroundings. That far our 
actions are our own, and that far and no farther our responsibility extends. 
Where is the dividing-line? Where does the effect of heredity cease? 
To go one step farther, our surroundings are not altogether within our 
control. We cannot choose the place nor the associations of our child- 
hood. Arrived at maturity we can change both, but in the early and 
tender years more or less of the effect of our surroundings is inextricably 
woven into our character to modify our whole future life. Who then shall 
draw the dividing-line between the two classes of actions : on the one hand, 
those resulting from our own wills alone; on the other, those resulting 
from antecedents and such surroundings as we could not escape ? There 
is of course a distinction between the misfortune which is the cause of the 
one class of actions and the guilty intention which is the cause of the 
other, but where is the dividing-line? An eminent English judge, after 
many years of constant administering of criminal law, was compelled to 
admit that in a large majority of the cases brought up for sentence he him- 
self would have committed the same acts if he had descended from the 
same stock and been subjected to the same surroundings in his early life. 
We all recognize the cruelty as well as the absurdity of punishing an 
act committed during insanity. This is for the plain reason that the per- 
son committing it could not restrain himself from it. Is it not equally 
absurd and cruel to punish an act resulting from the effect of heredity 
and childhood surroundings ? Take any given crime, and who shall say 
to what extent it resulted from causes beyond the control of the criminal ? 
Whatever that extent may be, just that far it is cruel and absurd to talk 
of punishment. Impossible as it is to ascertain that extent, no human 
tribunal should try it. Punishment, as a measure meted out to the crim- 
9 10 
BROOMALL—THE HELPLESS CLASSES. 
inal to pay him for what he has done, should have no place in any civil 
ized community nor under any proper government. 
The professed object of punishment is to prevent crime: first, by 
deterring the individual, and second, by settiug an example to others. 
This latter object is not very logical. We would not seriously think of 
punishing one man for a crime committed by another, and the propriety 
of punishing one man for a crime which another may commit is not very 
obvious. But, grant its propriety, centuries of experience have shown 
that the example of punishment, so far from deterring, really acts as an 
incentive to crime. Public hanging, public whipping, the pillory, have all 
been abandoned for the admitted reason that the example is pernicious, is 
degrading, that it really increases what it is designed to prevent. That 
object of punishment therefore has wholly failed, and the other one- 
deterring the individual—is little better. A boy—for these things com- 
mence in boyhood under the influence of bad associations and possibly 
with a hereditary taint—commits a crime, is detected, serves a few years 
of sentence, and is discharged. He is without means, he can get no em- 
ployment, nobody will trust him. He very soon discovers that he must 
steal or starve. His physical wants force the choice upon him. The 
earth has become so small of late, steam and electricity have so contracted 
it, and the newspapers have so lighted up every part of it, that it affords 
no hiding-place for the discharged convict. Let him change his name; 
let him leave the scene of his errors thousands of miles behind him ; let 
him commence a new career of honest industry: it is all of no avail. In 
a short time his reputation will find him out, and force upon him the choice 
between crime and starvation. 
We know what to do with the insane criminal. We restrain him of 
his liberty until the constituted authorities are satisfied that it is safe to 
set him free. I would treat the sane criminal in precisely the same man- 
ner. Why trouble the minds of ordinary jurymen with the intricate 
question of sanity? Why put it upon an ordinary criminal court to 
decide whether or not, and if so, to what extent, a vicious will, cultivated 
by the individual, caused him to commit the offence? I would discard 
all idea of punishment. I would abolish the word from our legal nomen- 
clature altogether. I would let the jury hear testimony of the doings 
of the accused and pass upon the single question whether or not it is safe 
to him and his neigh hors that he should be suffered to run at large. If 
this question should be decided against him, I would order his restraint, 
not for a fixed period, but indefinitely. I would change the prisons into 
reformatories such as New York has tried with marked success and such 
as Pennsylvania is now aJ>out trying. I would teach the inmate a trade BROOMALL—THE HELPLESS CLASSES. 
11 
or business, and encourage him to earn his living and to save something 
for his future use. Whenever the managers of the establishments become 
satisfied that it is safe to set him at liberty I would have them do so. 
They should not, however, turn him out, but suffer him to go and return 
at will for a time. They should find him employment outside, and gen- 
erally keep a kindly watch over him. If, with all this and without the 
necessity to resort to crime to avoid starvation, he should fall into evil 
ways again, and a jury should again find it not safe to trust him at large, 
I would renew the restraint with a much smaller chance of the authorities 
again trusting him with his freedom. After a few trials this might result 
in restraint for life, and why not? The lunatic with homicidal mania and 
without lucid intervals is restrained indefinitely, for life if necessary, and 
why should not the sane criminal, who has proved himself incorrigible, be 
treated the same way ? 
Remove the degradation of punishment as well as the example of it. 
Abolish the criminal coujts, those frightful schools of crime to the young. 
Save the discharged criminal from the necessity of returning to crime to 
avoid starvation, and the percentage of those who would prove themselves 
incorrigible would be very small. But suppose it should amount to one- 
fourth of the criminal classes, it would be cheaper, as well as more humane, 
to maintain that fourth for life in the reformatories than to suffer them to 
maintain themselves outside by depredations upon the community. One 
thing is very certain : the influence of heredity in keeping up the ranks, 
of criminals would gradually diminish as incorrigible criminals came to 
be restrained of their liberty for life. It is humane and it is right for us 
to say that the incorrigible criminal, the lunatic, and the imbecile shall 
not be represented in the coming generations. 
The helpless classes—lunatics, imbeciles, and criminals—all call for our 
sympathy as well as our care. They are all to a greater or less extent the 
victims of circumstances from which the more fortunate of humanity 
escape. There is no sharp dividing-line between these three. The ranks 
run into one another, and the individuals are readily interchangeable from 
one ratik to the others. There is a moral defect in all of them, often also 
a physical defect. Call it moral insanity, moral imbecility, or what we 
will, it runs throughout all the helpless classes, and is the main element 
in their helplessness. Being unable to govern themselves to the extent 
required by the public good, it is our duty to govern them, and that with- 
out unnecessary harshness or cruelty. 
The power of kindness in controlling and managing humanity is little 
understood even in our enlightened age. Christians manifest singularly 
little faith in their own religion. By their treatment of His system they 12 
HUOOMALL—THE HELPLESS CLASSES. 
characterize the Great Teacher of the law of love a* an enthusiast, an idle 
dreamer, But wherever the sublime precepts of that Teacher have been 
tried they have succeeded. The Indian, the lunatic, the imbecile, the 
public enemy, submits to the law of kindness. The wayward child obey* 
those who love it. Even wild beasts are subject to this law. The suc- 
cessful lion-tamer is the man who loves the lion, and his first lesson is to 
teach the pupil that he loves it. 
Before casting (’hristianity aside as a failure let us try it upon the 
criminal classes. They are the wayward children of society. Hate 
them, and they will hate us. Treat them cruelly, and they will retaliate. 
We have tried harshness and severity long enough, and have demonstrated 
their failure. Let us try the opposite course*. Show them that we re- 
strain them for their own good, and not because we enjoy seeing them 
suffer, and that we restrain them only as far as is necessary for their good 
and the safety of the community. I have an abiding faith in the law of 
kindness, and when it shall have shown itself by fair experiment to be 
applicable to the criminal classes. Christianity will have achieved its 
greatest triumph throughout all the centuries.