PAPERS AND DISCUSSION ON THE CARE OF THE FEEBLE-MINDED, SIXTEENTH ANNUAL CONF'ERENCE OF CORREC- TIONS AND CHARITIES, SAN FRANCISCO, 1889. HENRY M. DECHERT, Esq., Mr. Chas. A. Murdock, Rev. Fred. H. Wines, Rt. Rev. Bishop Gillespie, Rev. J. B. Silcox, Rev. H. H. Hart, Dr. Whitvvell. Mrs. C. W. BROWN, W. W. Johnson, Dr. A. G. Byers, Mrs. Isabel C. Barrows, Rev. Dr. H. Stebbins, Mrs. Sarah B. Cooper, REPRINTED AND DISTRIBUTED BY THE DIRECTORS OF PENNSYL- VANIA TRAINING SCHOOL FOR FEEBLE-MINDED CHILDREN, ELWYN, PA. CARE OF IDIOTIC AND FEEBLE-MINDED CHILDREN. HENRY M. DECHERT, ESQ., OF PIIIRADELPHIA. Unfortunately, these children are classed together in popular language as “idiots”; and many persons in their ignorance turn away from any consideration of them and from any organ- ized efforts for their relief. The census of 1880 reported a total idiotic population of 76,895. The term “idiot” is repulsive, especially to the ears of loving parents; and we conclude that many children whom experts would pronounce to be “feeble- minded” were not returned by their families. This Conference should take measures to obtain, through the census of 1890, a proper classification of the defective classes. Scientific men have divided these children into four classes; but, for the pur- pose of individual and State relief, it would be sufficient to have returns under two heads,—namely “Idiots” and “Feeble- minded Children.” The scientific division may be stated as follows, namely:— 1. Idiocy. (a) Excitable, (b) Apathetic. 2. Idio-imbecility. 3. Imbecility. (a) Lowest grade. (b) Middle grade. (c) High grade. 4. Moral imbecility. These children, of one or another of these kinds, are to be found in every State and almost every community. What should we do with them ? What can be done with them ? The answer to the first question will be given according to our knowledge and sense of duty. Some heartless or ignorant man or woman may reply that it is a necessary evil which may be allowed to take care of itself, that these children are suffering the penalty for the offences of fathers and mothers against the laws of religion or of health. But census reports show that the evil multiplies, and that neglect does not extirpate it. Expe- rience shows that a large proportion of our criminals, inebriates, and prostitutes are congenital imbeciles; and yet, in a very 2 large degree, these children are allowed to grow up unrestrained and without any attempt to improve them. The small number within asylums and training-schools, as compared with the grand total, supports this assertion. The State suffers the pen- alty of this neglect in an increase of pauperism and vice; and, finally, at a greatly increased cost, it is compelled to take charge of adult idiots in hospitals and almshouses, and of imbecile crimi- nals in jails and penitentiaries,—often during the remainder of their natural lives. Certainly, if anything can be done to prevent these mischiev- ous results, the sternest moralist and cold-hearted or ignorant formalist must agree with us that we should do everything pos- sible to protect individuals and society from the injuries coming to them by these unfortunate children. Who can doubt the ex- istence of an increasing injury to society where it permits such children to grow up without restraint and improvement into manhood and womanhood? In early childhood, they may be sheltered by fond parents and kind friends; but they outlive parents and guardians, and after a few years become the prey of the vicious, or themselves become the teachers of vice and crime. They had hands, but they were not taught to use them; passions, but they were not taught to restrain them; mental faculties, more or less impaired, which by neglect became more obscure, thus making them servants of their passions and vic- tims of the depraved. Can we do anything to prevent these evils, but especially can we do anything which will improve these mentally defective children ? The answer is two-fold. Actual separation from the other members of the family and of the community alone will prevent these evils. When present in the family circle and sheltered by parents, either rich or poor, they are frequently a menace to the peace and happiness of parents, brothers, sisters, and neighbors. This “skeleton in the house’’ is present in the poor man’s house to make life a burden, his only escape being to send the child to the poor-house. The history of such children in many of the poor-houses is a record of shame for the States in which imbeciles are allowed to live in common with worthless tramps and abandoned women. It is true that the imbecile children of well-to-do parents are protected against such evils, either at home or in private retreats; but our proposition is that every family is entitled to this kind of protection, and that the State must have its own defence. Separation must be secured by opening training-schools for feeble-minded children. We do not mean asylums or places for separate or individual treatment. Let us be guided by experi- ence in charitable work of this kind. Select a tract of land five or ten miles from any city or town, and erect upon it buildings at a moderate cost. Let them also be of moderate size, and in every way adapted to the work before you. A cottage dormi- tory for thirty children is better than one intended for one hun- dred children. Provide a common dining-room and kitchen. You will need a laundry, sewing-room, workshops, and school- rooms, and large spaces for gardens. Spend more money in pre- paring the garden soil and in under drainage to it from the buildings than in external adornment. We will imagine that you started your school for feeble- minded children with one hundred of these unfortunate crea- tures, and that the institution has reached its second year. You have a competent superintendent and well-educated women teachers, a gardener and a cobbler, a tailor or a mechanic,—as you may prefer one or the other kind of work for boys. You have a laundry woman, a cook, and a sewing woman for the girls. Your institution will furnish the answer to the whole question, and moreover it is largely self-supporting. The asso- ciation of these children in their play and work, and in the school-rooms, is perfectly safe when enjoyed under proper re- straints. It excites the latent mental faculties and restrains all the brutal or dangerous passions. A visit to your school will show us boys and girls learning the contents of school books which belong to the primary or sec- ondary schools; girls doing much of the cooking, sewing and washing; boys doing the farm and garden work, and perhaps the cobbling or carpentering and painting; perhaps, also, some of the boys are glad to help the girls in the kitchen or in the tailoring work. Individual charity and county or State aid must, of course, be called in to help the work. After a few years, you will be ready to discharge some of the children; and the girls may return home to help in the house-work, and the boys to support themselves as farm laborers, or in some useful way. An experience of twenty-five years in our school at Elwyn, 4 Delaware County, Penna., now containing 759 children (under the able superintendence of Isaac N. Kerlin, M. D.), shows that 35 per cent, of the discharged children are improved to that de- gree.* Of course others must remain in the institution for many years or for life; but many of these contribute something to their own support by work in the house or upon the farm. By keeping them, they, their families, and the community gen- erally, are alike benefited. If, after a lapse of ten years, we should take up the indi- vidual histories of these hundred feeble-minded boys and girls in the training-school, and of another hundred coming to man- hood and womanhood outside of its bettering and protecting in- fluence, that research would give complete, answers to the two questions propounded by this paper, namely: first, that by placing feeble-minded children in training-schools we can pro- tect them, their families, and the State; seco?id, that these chil- dren, by association and instruction, can be improved and made self-supporting and happy, and, in a fair percentage of cases, safe and useful members of society. PUBLIC AID FOR THE FEEBLE-MINDED. MRS. GEORGE BROWN, OF BARRE, MASS. In ail assemblage like this Conference, it must be an axio- matic proposition that the State should educate all its depen- dent children. It is not charity: it is simply providing for those of its own household, as when it furnishes schools for the well-endowed. I can see no reason why the means for such ed- ucation should not be appropriated from the general school fund, without lobbying or begging. The question, then, is, In what * Mr. Dechert probably draws this statement from the following para- graph: “The experience of the past thirty years proves that, of those who are received and trained in institutions, ten to twenty per cent, are so im- proved as to be able to enter life as bread winners ; that from thirty to forty per cent, are returned to their families so improved as to be self- helpful, or at least much less burdensome to their people; and, further, and of greater importance, that one-half the whole number will need cus- odial care so long as they live." i. n. k. 5 respects must this provision for the feeble-minded differ from that given to others ? When the first tentative experiments to elevate the feeble- minded in this country were made in the year 1848, the primary idea of both Dr. Howe and Dr. Wilbur was the same; i.e., to educate like others, so far as possible. The thousands of pupils since trained in the thirteen State institutions and numerous pri- vate schools through the country testify, without question, that a goodly number can be thus educated. It has also been proved that the feeble-minded pupil cannot be classed with the well- endowed, as the former must be helped more, be individually instructed. His steps are slow, and the rapid pace of his nor- mal brother paralyzes all effort; while associated with those of his own plane, his mental eye brightens, and he takes courage. Therefore, special schools with special appliances must be fur- nished, as for the deaf and blind. How large a number should be gathered in one place, and how long the period of school life should last are relative matters, as the progress of the pupil and local surroundings differ. In determining these points, it would be wise to study the varied experiences of training-schools in this country, as given in their published reports, and also to note European methods. Within a few years, schools for exceptionally backward child- ren called “ auxiliary,” have been established in Germany, with satisfactory results. Into these departments have been gathered all pupils unable to make equal progress with their companions in the national schools. The German Minister of Education thinks these auxiliary classes should be instituted in every town numbering twenty thousand inhabitants. From their ex- perience, they also judge that one instructor can efficiently teach only twenty pupils, and should himself be a person of su- perior ability. Norway gives to its intellectually weak chil- dren similar instruction, compulsory, as for normal children, and paid for out of the general fund. The Norwegian pupils comprise four divisions,—those able after two or three years’ special instruction to enter the ordinary schools; those who by continuing can be brought to confirmation; those sent to special imbecile institutions; and the uneducable, who are returned to their homes. But the wide difference between this class and all others is the fact that, for the majority, State care must be given throughout 6 their life-time; since, however far some may progress in ability to care for themselves, the many remain little children, weak in will, weak in moral power, without homes, and must be de- livered from temptation. This after-care must be very similar to that which the harmless insane require,—simple dwellings, plain food, intelligent classification, with continuous supervision, are the necessities. The sexes must live apart, but with land contiguous to their homes. The girls equally with the boys should cultivate the gardens, raising therefrom table supplies. Classifying the in- mates with a due proportion of the ablest and most helpless, the former, under direction, can do the work for the latter, thus minifying the expense. When the village almshouse is properly managed, it should care for the few harmless insane and feeble-minded that legally come within its jurisdiction. I know this proposition is heret- ical in the eyes of philanthropists generally; but there is no ne- cessity for conducting an almshouse upon unchristian principles that does not equally pertain to an insane asylum, or an institu- tion for the feeble-minded. All will acknowledge that this life-care must be made as eco- nomical as is consistent with the comfort of these unfortunates; and the tax-payer who grumbles at the burden must be taught that such care as has been described is less expensive than the neglect which multiplies the number of helpless persons and swells the calendar of crimes. For the satisfaction of the tax- payer, it may also be stated that in this class the average dura- tion of life is somewhat less than for the well-endowed. No ex- periment has yet been made in this country whereby the lowest cost of support for such a class can be accurately computed. The New York State Custodial Asylmm for Feeble-minded Women, in its report for 1888, gives the weekly cost as $2.43 for each of its 200 inmates. This estimate is below that of some of the county almshouses. To each of these adult asylums of the fu- ture trained graduates of the schools should be assigned as helpers. 7 DISCUSSION ON THE CARE OF THE FEEBEE-MINDED. Mr. Murdock, of California.—When Paul in his letter to the Thessalonians besought the church to “ comfort the feeble-mind- ed,” he uttered a charge that in its fullest sense the world is just beginning to heed. Blackstone defines an idiot as ‘1 one that hath had no under- standing from his nativity, and therefore is by law presumed never likely to attain any.” But it happens that many things “presumed by law” are not, as a matter of fact, true; and, with the progress of man’s love for man, and the patient investi- gation and effort that have sprung from it, it has been found that “ understanding ” may be attained in many cases formerly thought hopeless. From our standpoint of to-day two things seem wonderful: first, that it remained for this century to be- gin systematic effort to develop defective minds ; and, second, that this effort has reached in forty years such grand proportions and found so general an acceptance in the public mind. We Californians are proud of our material achievements, and look admiringly on this city that in the days of ’49 was not even a dream; but about the same time that the discovery of gold drew from the four quarters of the world the people who found- ed our State, there began in the State of Massachusetts an ex- periment whose results we must acknowledge of greater sig- nificance, if, with the olden prophet, we believe that God ‘ ‘ will make a man more precious than fine gold, even a man than the golden wedge of Ophir.” In April, 1846, the Massachusetts legislature appointed a Board of Commissioners to inquire into the condition of the idiots of the Commonwealth. Dr. Samuel G. Howe, that lofty leader and patient worker, was made the chairman. In May of 1848, an act was passed in accordance with the recommendation of the Commissioners, providing for an experimental school ; and in October ten idiotic youths, mostly from the almshouses, were gathered in one wing of the Institution of the Blind at South Boston, and placed under the care of Dr. Howe, who had agreed to conduct the school without charge. This, I believe, was the first school for feeble-minded, although in July of the same year Dr. H. B. Wilbur, of Barre, received into his family a single pupil. New York and Pennsylvania followed in 1851, and others soon 8 after. At present, fifteen States have asylums for iodiots and feeble-minded, supported by legislative appropriations. In July, 1883, a meeting of some of our citizens, which had been brought about by a few devoted women, determined that an institution for the care and training of feeble-minded child- ren should be established. An association was soon afterward formed, funds were collected, and in May, 1884, the Home was formally opened at Vallejo. The legislature in the following winter adopted the movement, making an appropriation of $25,- 000 for a site, and $20,000 for two years’ maintenance. A Board of Five Trustees was appointed by the governor. The census of 1880 gave the number of imbecile children in the State at over 500 ; and it is probable that 700 is a low esti- mate of those who at the present time should be under our care. The legislature has been generous in its appropriations, and at the last session provided $170,000 for a new site and buildings, $15,000 for furniture, $15,000 to secure water and drainage, and $81,000 for two years’ maintenance,—in all, $281,000. For four months the trustees have been examining sites,— about 130 were offered,—and last night reached a decision. By the bill we were limited to 30 per cent, of our appropriation ($51,000) for the site, which should not consist of less than 300 acres. The tract of land selected lies in the beautiful valley of Sonoma. It cost less than the sum mentioned, and embraces over 1,600 acres. It is watered by three living streams, two of which rise on the place and give us 100,000 gallons of water daily, at an elevation of 150 feet above the building site. There are over 50,000 fruit-trees on the place, besides acres of vines and hundreds of acres of pasturage. Two railroads pass through the land, and will give us stations on it. The climate is perfect, the situation picturesque, the location central; and, altogether, the trustees are jubilant, and feel that the millennium is at hand. There seems no reason why our Home should not be the equal of any institution in the land. We shall not be satisfied with any lessor glory. The extent of our domain will render isolation and classifi- cation easy. We propose having for the proper custodial care of low-grade cases a separate building, supplied with its own kitchen, baths, treatment wards and dormitories, but contiguous to the main building. For that sadly afflicted class, the epilep- 9 tics, for whom our superintendent has especial sympathy, we likewise propose a separate building. For the high-grade cases of adult males, our farm will offer abundant employment in the dairy, wood-chopping, fruit culti- vation, etc.; and the same class of girls can add to their pres- ent household duties such healthful out-door work as grape- picking, light gardening, fruit-packing, etc. We firmly believe that, if the legislators of any State not yet provided with a home for the feeble-minded could see with their own eyes what has been accomplished, they would not fail to provide at once a similar home. It is no matter of sentiment: such treatment of defective children is counselled by expedience, invited by economy, and demanded by justice. The name of our institution clearly states the two-fold objects of the modern idea,—“the care and the training.” The pio- neers in the work, Wilbur and Howe, began with the training : their aim was to educate. Their experiment was successful ; but, with the best efforts of to-day, barely a third of the child- ren trained are susceptible of being so improved as to become self-supporting, safe members of the community. What shall be done with the other two-thirds ? When training has done its all, what next ? What are the rights and privileges of this defective class, and what is the policy or duty of the State ? Humane sentiments will accord these unfortunates the privilege of support,—the strong will bear the weak ; but they will not accord them the right of unrestricted liberty. It is against the interest of society that this class shall be allowed to bring into being children who shall be like afflicted, or who from congeni- tal causes shall swell the alarming numbers of our insane, our criminals, and our paupers. Not alone from self-interest has society a right to stop this source, but in the prevention of the human misery that these children shall themselves suffer. And hence comes the care to complement the training. The custo- dial class proper is large : the expense to the State of caring for it would be great ; but economy and philanthropy combine in dictating that policy. Could we present what those of special experience and ob- servation know to be facts as to the number of criminals, pau- pers, and especially insane, whose parents were mentally defec- tive or morally irresponsible, there would be common consent, not only that we ought, but that we must, by the custodial care of these pitiable beings, prevent their propagation. Wise efforts at reform of every nature are directed more and more to the source of the stream,—to prevention through the removal of causes ; and, surely, here is a source that can be controlled. In the treatment of this class, we shall be wise when we unite mercy with justice,—care for them tenderly, add what light we may to their darkened lives, but hold them firm- ly from doing the ill they know not of. Mr. Johnson, of Indiana.—If that delightful location of six- teen hundred acres had been chosen by the trustees of the Cali- fornia School for Feeble-minded after this Conference, what a piece of glory it would be for us ! We should have said, “ That is the result of the Conference.” But it was chosen while we were here, so we will claim it only as a thing we like to hear of and see. There are some points that have been made that I should like to question. One is the percentage of boys and girls made fit for outside life. One institution claims 35 per cent. If that institution returns to ordinary life 35 percent., it certainly is very chary in receiving low-grade cases. In Indiana, we do not hope to return 10 per cent. ; but we do not refuse any cases. We believe the lowest-grade cases need the teuderest care. I think 10 or 15 per cent, would be the outside estimate of those safe to send out. But to train to self-support is a very different thing. We hope to train 65 or 75 per cent, to support them- selves within the institution. In our Indiana institution, we have 270 children. They each wear out, on the average, two pairs of shoes a year. They make in the shoe-shop all the new ones and repair all the old ones. We have only one practical shoe- maker,—no other help in the shop except the imbecile boys. When we bought shoes, they cost considerably more, and did not last half so long. Some of the boys who work at this trade were quite stupid when they came to us. The boys also do their own tailoring and make their own shirts, while the girls do all of their own sewing. In the laundry, the boys do the washing and the girls do the ironing. What we need now is to adopt the principle of custodial care. L,et it be understood that every imbecile is there for life, unless he or she shall be competent to go out as an ordinary free citizen. This is of great importance. I do not believe there is any work so statesmanlike, humane, 10 11 and Christian as the care of the feeble-minded of the State. We find training the mind through the hand, what is commonly called manual training, more successful than through the eye and ear only. The ordinary work of the school-room—reading, writing, and arithmetic—gets on slowly. Bach day the child- ren learn a little, but the next day they seem to have forgotten most of it. It is touching to see girls in their teens struggling in the primary grade. The garden affords work for the boys. We have one epileptic boy who was very violent and hard to manage. He was put into the garden detail, and showed a great liking for his work. He now works hard all day, and so gets rid of his superfluous energy ; and his spasms are less fre- quent and less painful than formerly. We do not separate the epileptics from the others. The lowest grades, what we call custodial cases, are by themselves : the rest are all together, ex- cept as the sexes are kept apart. The feeble-minded are very affectionate creatures. They soon remember any one who has been kind to them ; and nowhere does a little kindness go such a long way. They are made happy by a pleasant word or a pat on the cheek ; and they clus- ter around one, eager for the touch or the smile. Even the low- est grades soon lose their repulsiveness, as one becomes familiar with them. We have a few who are bright, and many who are very sweet and nice. Still, they have weak wills and feeble minds. They would be unsafe in the outer world. They must be kept quietly, safely, away from the world, living like the angels in heaven, neither marrying nor given in marriage. Mr. Murdock asked Mr. Wines to take part in the discussion. Mr. Wines, of Illinois.—In the census of Great Britain (and of some other countries), no distinction is made between the insane and idiotic. They are all classed together as insane persons. Whether this is because those who organized the cen- sus did not appreciate the difference between a lunatic and an idiot, or because the difference is so difficult to recognize, I do not know. I suppose that, if I should take to a large poorhouse the average superintendent of an insane hospital, and show him the inmates of the institution, it would be impossible for him to say which of the imbeciles whom he would see there were sim- ply demented insane persons, and which of them were, in fact, idiots. But I think that, if I should take the superintendent of an institution for idiots to the same almshouse, and show him the same population, he would pick out with reasonable certainty all those who were true idiots, and separate them from the others. This is because, as an Irishman might say, an idiot, to those who know the class, is not so much like an insane person as an insane person is like an idiot. But, to one unfamiliar with the distinc- tions between them, they are so nearly alike that any census which may be made either of insane persons or of idiots must contain a large percentage of error in classification. In the last census, we undertook to classify them, and we arrived at some proximate degree of precision ; but it was, after all, only an approximation. The distinction between an insane person and an idiot is this : the insane person is one who has come to mental maturity, and then, from disease of the brain, has lost to a greater or less ex- tent his mental capacity. The idiot is one who never did arrive at the full development of his mental powers, by reason of some impression made on him, either prior to birth or after birth, be- fore arriving at the age of puberty.* A great many of these children are no doubt prenatal idiots, more, perhaps, than we suspect. Many of them lose their minds in consequence of the acute diseases of childhood, or from accidents which arrest the development of their nervous and mental organizations. The number of idiots is greater than any one unfamiliar with the subject would imagine. I sometimes think that there must be many of them as of the insane. Idiots are often hidden from sight in the homes where they live,—their family and friends are ashamed of them,—and a great many idiotic children are not recognized by their parents as such. Some years ago, a lady called on me, and brought with her a little girl seven years old. While I talked with the lady, I drew the child to me, took her on my lap, and observed that she had a very remarkable tongue, with a deep longitudinal furrow down the centre. The lady saw that I noticed it, and said, “That is a seven months’ child.” “Ah!” I said. I looked at her a little longer, and then asked her mother, with 12 *Some physicians would confine the term “idiot” to persons born with weak intellects. But Griesinger says, “ By the term ‘ idiocy ’ we are to understand those conditions in which a state of mental weakness has ex- isted from birth, or from early infancy.” some hesitation, “Why don’t you send her to Jacksonville?” “ What is in Jacksonville ? ” “ There is a school where feeble- minded children are tenderly cared for by an excellent superin- tendent. ’ ’ The mother flared up : “ You call that a feeble-mind- ed child ! That is the smartest child you ever saw in your life ! Get down out of that man’s lap, pet! He dosen’t like you ! ” What constitutes a feeble-minded child I do not know. We know a true idiot You have no idea, perhaps, of the physical degradation of the true idiot. I have in my mind now a man, possibly forty years old, who has never outgrown the state of infancy. Everything that has to be done for a baby has to be done for him, even to feeding him with a spoon and amusing him with a rattle. I have seen a full-grown woman, in the yard of a county almshouse, creeping on all-fours, just like a baby, and playing with straws, as a little child would play. Nothing that can be done for her will ever change her. You mothers, who have brought up babies, can hardly realize the physical care that, in some exceptional cases, has to be bestowed on these unfortunate creatures. Mr. Johnson speaks of their affection,— yes ; but it is the affection of a baby. Some never walk ; some never speak, and can never be taught to speak ; they cannot at- tend to their own physical wants, but will have to be cared for like babies, even if they live to old age. Idiots are not all alike. There are as many varieties of char- acter and habit among them as among the members of this Con- ference. You find them all along the line, from the low type of which I have spoken up to a condition of simple feeble-min- dedness. The rule about admitting a blind child to an institu- tion for the blind is that he shall not be able to see to read, or that he can distinguish letters by sight only with great difficulty. Similarly, we admit to our schools for idiots children who are so backward that they are incapable of being taught in an ordi- nary school with other children, even though they may not be true idiots. Some people, however, have a very exaggerated notion of idiots and feeble-minded children. They suppose them all to be wholly incompetent. I have heard superintendents of hospi- tals for the insane argue learnedly that an idiot could not be in- sane, because insanity is a disease of the brain, and idiots have no brains. I never saw an idiot who did not have a brain, such as it was : it may have been very small and very imperfectly 13 organized. Some of these idiots are exceptionally talented in certain directions, as Blind Tom was in music, or as others are in drawing or in some branch of mechanical industry. Many of them are capable of being made useful to a large extent, even though they may be unable to talk. I have seen idiots who were useful on a farm, for instance, who could not speak a word. Is not a mule valuable on a farm? Yet he cannot talk. I do not agree with what has been suggested, rather than said, in one of the papers just read,—that any large number can be made useful without oversight and direction. They are useful under direction, just as a horse is. But you cannot make a horse use- ful except under direction. You cannot get out of an idiot what is not in him; and all expectation that you are going to make men and women even of ordinary intelligence out of idiots, by any system of training which you may adopt, is a vain anti- cipation. You may correct bad habits, you may develop and improve them ; but they must remain under control, in order to be of any real service to the world, and very many of them will be of no service whatever in any direction, but simply a burden to be carried by those who love them. While it is important to maintain training-schools for persons of this class, yet the longer you observe the work, and the more you know about it, the more you will feel that these institutions must, to a large extent, be custodial in their character, especi- ally for girls. The idiot girl is exposed as no other girl is exposed in the world. She has not sense enough to protect herself from the perils to which women are subjected. I sup- pose the majority of our criminals in the penitentiaries are more or less imbecile. Certainly, the great majority of that class of women who excite the pity of men and the scorn (for the most part) of their own sex are to a large degree imbecile. If they were not so, they would not be what they are. We must make up our minds to take these children, to train them as far as possible, and to hold them as long as possible. This form of charity is the purest charity in which the State can engage, be- cause the persons to whom it is extended are the most in need of it, and because there is not the least prospect of any pecuni- ary return from it. There isnoreason why imbecile children and imbecile women should not be cared for by the State as much as the demented insane. There is the same reason for such care in both cases. 14 I am extremely glad to hear what California has done already in this direction. With that immense number of acres, she ought to be able to develop a system of care surpassing that of any other State in the Union. On twelve hundred acres of land you can not only establish different buildings, but different groups of buildings,—separate colonies for different classes,— remote from each other. I shall look with great interest and expectation to the results of the work done in this State by an exceptionally intelligent and enthusiastic Board of Trustees. Mr. Woodworth.—You make use of several terms,—idiots, feeble-minded, insane, demented insane. How many classes do you include under those terms? Mr. Wines.—I do not know whether I can make it clear. A person who becomes insane, whether the form of insanity be mania or melancholia,—in other words, whether it manifests it- self in mental exaltation or in mental depression,—tends to be- come demented whenever the disease, if the patient does not recover, has run its full course. The final result of insanity is dementia. I have seen a row of such demented persons sitting on a bench in the ward of an insane hospital, who did not have sense enough to take their medicine. It had to be poured into their mouths. That is extreme dementia. Idiocy is a con- dition resembling and approaching that ; but it originates early in life, whereas dementia is the result of disease later in life. Both of these conditions are included under the general term ‘ ‘ imbecility. ’ ’ Feeble-mindedness is a form of idiocy approach- ing the ordinary state of children. The feeble-minded child is not a true idiot perhaps, but very backward and dull of in- tellect. You would do a wonderful work, for yourselves and for your State, if you would only become familiar with the various classes of imbeciles and of feeble-minded by personal observa- tion. Go and visit your insane asylums, your idiot schools, your prisons, your pauper institutions, and learn to know these people when you see them, as you learn to know the various plants and flowers in your gardens and in the fields. A Delegate.—You say that the asylums should hold them as long as possible. Does any State forcibly detain them through life? Mr. Wines.—There is no need for forcibly detaining them. Delegate.—Wouldn’t they go away of their own accord ? 16 Mr. Winks.—The great mass of them would not. They are happy where they are. Girls ought to be so kept. I do not agree that, because there are seven hundred idiotic children in California, you must have an institution capable of taking care of seven hundred, since many of them can be kept at home, and ought to be kept there. Mrs. Barrows.—May I ask Mr. Wines what is to be done with moral imbeciles ? Mr. Wines.—That is a hard question. Many of these moral imbeciles are sent to penitentiaries. President GiKKESPiE.—What dismissal is there from the Jacksonville School for the Feeble-minded ? Mr. Winks.—That school has now been removed to Lincoln. There is no formal dismissal, except that the friends are notified that the children cannot be kept any longer. President GiLKESPiE.—No age is fixed? Mr. Wines.—Not at all. The legislature at its last session made an appropriation for a custodial building for idiotic girls. We shall take about one hundred, and keep them probably for life. Our intention is to add to that from time to time, and to take these girls from the poorhouses and off the streets. Many of them are the children of feeble-minded mothers. President GiKKESPiE.—What proportion do you send away as fit to be returned, who can as well be kept at home? Mr. Wines.—I doubt whether many can be kept at home equal- ly well. We send them back, because they are pushed out of the asylum by the demand for the admission of new cases. They are usually very troublesome and burdensome in their own homes. Mrs. Sperry.—Where there is no school for imbeciles, would you send a feeble-minded child to an insane asylum or to a poor- house ? I have in mind a little child who ran after her sister with a butcher-knife, a child who is certainly imbecile. Mr. Wines.—If you had a good almshouse, I should rather put her there. The laws forbid insane asylums to receive idiots, as a rule. Within a year or two, a complaint was made to me that a certain idiot girl was being outrageously abused in one of the counties of Illinois, and I was urged to investigate the case. I found that she was no girl at all, but a woman forty or fifty years old. She was a wee bit of a creature, almost a dwarf, having never attained her physical growth. Her hair was partly gray. She could not speak a word ; and she looked more like an ani- mal than a human being. She was at home with her father and mother, who were very poor, living in a humble cottage in front of a railroad, where trains passed every hour. She had a constant desire to run away. The erratic tendency in her was uncommonly strong. The moment she was released, she would go, and often she would run for miles and miles before she could be overtaken. Her parents had invented a peculiar way of re- straining her. The story that I heard was that she was drained ; but she was not. They had stretched a long wire from the door of the room which she occupied to the trunk of a tree at some distance from the house, and made it fast at each end. Then they had taken a long leather strap, attached to a ring at one end, so that it would slip back and forward on this wire, and the other end they had fastened about her throat, but loosely, so as not to hurt her, any more than a collar would hurt a dog. She could go up and down the yard as far as the wire and this strap would let her, and could go in and out of her room at her own pleasure. She had two short clubs which she used as playthings and with which she could defend herself against attack. I knew that nothing could be done for her. Her mother loved her with alove thatknew no bounds. For, ofall the children of any mother, those who are feeblest awaken the deepest, tenderest affection. She took care of this creature as no attendant could have been hired to do it. The unfortunate woman was not suffering at all. She was a mere animal, well cared for as an animal; and I conclu- ded to let her alone. When I was in the army, I had charge of the refugees who fled or were brought by our troops from North-west Arkansas into South-west Missouri. On one occasion, when I had an un- usual number to provide for, some one came to me and said that among the new arrivals was a “ snake-girl.” What a “ snake- girl” might be, I could not imagine. I was gravely informed that she had the body of a woman, which terminated in a point like the tail of a snake. This story seemed to me incredible, the offspring of a superstitious fancy. I went to one of our army surgeons, and asked him, as he was a physician, to inves- tigate the case, and let me know what was really the matter with the girl. He did so, and reported that, where her limbs joined her body, they were no larger than my wrist, that they were 18 drawn up so that her knees touched her breast and her heels her thighs, and that, instead of feet, she had only rudiments of feet, which tapered off to points, with no resemblance to ordinary feet and no indication of toes. This was why the ignorant called her a ‘ ‘ snake-girl. ’ ’ She was about twenty-one or twenty-two years old. She had never been dressed, for she could not be. She was put into a loose sacque, without arms, merely a bag with a draw-string around the neck, but it covered her, so that she was not exposed to observation. She could not sit up ; could not turn over; had never in any way helped herself with her hands ; and had never uttered an articulate sound. When she wanted anything, she gave an unearthly grunt; and, when her wants were supplied, she grunted again. I said to the mother, who had a large family of children,—not less than a dozen,— as she sat under a tree, without even a tent to shelter her from the sun or rain, with no food, no occupation, no friends : ‘ ‘ This girl must be a great trouble to you. I do not know, but I think perhaps I could get some benevolent people in St. Louis to pro- vide for her in an institution, so as to relieve you of her.” She glared, at me with the eyes almost of a fury. “ Give up that child ! give up that child ! I will give up every other child I have before I would give up that child ! ” That is the mother’s heart. And I thought of that passage in Scripture : ‘ ‘ Though a mother may forget her sucking child, that she should not have compassion on the son of her womb, yet will I not forget thee ” ; and in that hour I got a new sense of the love of God for his children, which I have never lost, and which has often comfort- ed me in my own deepest sorrows. Mr. Johnson.—Among our poorliouses there is hardly one that has not one or more feeble-minded but able-bodied men, and they are generally about the best bauds on the farm. There is hardly a poorhouse where there are not two or more feeble- minded women, with from one to four illegitimate children each. I think that is about as strong a proof of the need of custodial care for feeble-minded girls as we could find. Dr. Stebbins, California.—It is manifest that among the themes which have challenged our humane sentiments, no theme has taken a deeper hold on the Conference than this. That is a suggestive fact. The concluding words of Mr. Wines, touch- ing the revelation of maternal love as the eternal symbol of the love of God, must have touched us all. And we may say, in- deed, that that human heart has been bereft which has never had such illustrations of human affections leading us upward to that almighty and encircling love of God that holds us all. I do not think I shall be charged with extravagance when I say that the subject we are talking about is not surpassed in its importance by any theme that comes before us. We are talking about idiots. What is an idiot ? Sorrowful and pitiful as it is to speak of such a creature, an idiot, my friends, is one of the most distinguished signals of the dignity, the greatness, and the destiny of our human nature. Idiots are possible only in the human race, in the human family. The theme is so large, it offers such a field for philosophic speculation and humane sentiment, that I cannot avoid giving some of the moral and spiritual aspects of it. No scientific demonstration has de- termined the minimum of human faculties. Where is the human creature that walks upright or that lies helpless, like the “snake-girl” under the tree in Missouri, of whom we can say that humanity is there extinguished? We know that the maximum of humanity is very great. It is easy to find illus- trations, culminating in the divine manifestation in Jesus Christ; but who will say on the downward scale where it stops ? or where, quenched in sense or mired in the clay of the body, the divine spark becomes extinct ? No : never will science make the dis- covery, do I apprehend. Then there is something else in regard to this condition, this imbecility, feebleness of mind, idiocy: it is individuality carried to its last extremity. The idiotes is the one cut off, isolated, by himself, unable to communicate with others. That is the idiot. But there are some things in regard to this condition which raise the question of our destiny. Did ever the unhappy mother of an idiot believe that her imbecile son or daughter was merely a brute ? I cannot conceive it. I have never known such a phenomenon in my life. There are some things in the New Testament—I am not going to be theo- logic—that suggest that our immortality is an attainment, that it is not an endowment. We sometimes look into human faces, that are not idiotic faces either, and we say, Is there anything there that can sustain itself and rise above the mighty floods and waters of death ? It is not the idiotic countenance only that suggests that. There is a countenance of deviltry, of hell, and self-will that also awakens that question in our mind and heart. And now concerning this charity. I was much touched by what Mr. Wines said of the purity of this charity, the simpli- city, the sweetness, and the love of it. We talk learnedly about the worthy and the unworthy, the fortunate and the unfortu- nate; but when we understand the whole thing, if ever we do understand it, as the infinite understands it, we shall know what it means when we say that the only true charity is to the unworthy and the hopelessly unfortunate, the children of sin, of ignorance, and misery. And now another lesson. You will pardon me for saying that I have myself taken philosophic satisfaction in talking with these people. In my early studies I had a glimpse in the morn- ing dawn that made me think I should give up the profession to which I was dedicated. I had an ambition to be a great physician and an aspiration to be the superintendent of an asylum for the insane or for the feeble-minded. The of human nature, its character, its temptations, its weaknesses, its divine manifestations, and its final destiny, were of deepest in- terest to me. Pardon this personal allusion ; but it illustrates what may not be alien to your own thoughts and feelings. Then, too, let us not be deceived in talking about the feeble-minded : we are all feeble-minded. That remarkable man, Thoreau, who had a touch of genius, thought he would lead a life of loneli- ness on the shore of Walden Pond. But he was visited by all classes of men: paupers from Concord, philosophers from Bos- ton, and all sorts of people came to hear his unique experience. And he relates this : Among my visitors there was one unhappy creature from the poorhouse at Concord. He was accustomed to walk out across the fields on a sunny morning, and sit down with me on a log by the lake-shore ; and there we talked together. Once he turned to me and said, “ I know what ails me : I am feeble-minded.” Thoreau said, of all the men that visited him, philosophers, Christians, statesmen, that pauper was the only man who knew what ailed him. I wish to express my sense of gratitude for this occasion. I thank you for your benignant presence here, for I read in your faces profound sympathy and deep tenderness combined with wisdom. And may I interpolate a word in behalf of California ? We see here a remarkable instance of the sporadic appearance of one of the best things in the midst of some of the worst. We have in California an institution for the class of imbeciles of 20 21 whom we have been speaking, with opportunities and facilities unsurpassed in any State in the Union. This is a remarkable social fact, that out of such crude conditions should have sprung so promising an institution. Dr. Byers, of Ohio.—The institution in Ohio is one of the oldest and perhaps one of the best educational institutions for feeble-minded children. They do not take idiots. They do not seem to comprehend that it is the more needy, the more humble, the more dependent, the more unworthy, that need most the help which the charitable can bestow. Dr. Whitweer.—One point has been referred to before this Conference, of which I might say a word,—the tendency toward sterility of the criminal class. The first effect on the man or woman who falls into the crimnal class, their morals being de- based, might be toward fertility. But we find from numerous and unquestioned instances, where this tendency has been fol- lowed through two, three, or four generations, that it is toward mental debasement and idiocy, and, as a result, sterility. Rev. J. B. Silcox, of Oakland, thought that the State should take imbecile girls and forcibly detain them. They should be protected at once, and not wait for three or four generations to pass, even if the tendency then was toward sterility. If a man is insane, the State by force takes him under charge and deprives him of his liberty. If he has committed a criminal offense, the State by force takes him under charge and keeps him from com- mitting crime. Surely, the harm done by the imbecile in many ways, and more especially by repeating the evil by propagation, would warrant the State in keeping him as it would an insane person or crimnal. Such a method is not only good statesman- ship, but it is wise and Christian humanity. Mrs. Sarah B. Cooper, of California, said that she wanted to emphasize the value of the State School for Imbeciles. She re- lated the case of a woman who came to her in distress, because, though she had a large family to support, she was tied down with an idiot child. On bringing the case before the Institution for Feeble-minded, the child was at once accepted. The pe- culiar form of feeble-mindedness manifested by the child at home was malicious mischief and cruelty. It has now been brought into ways of kindness, and is quite docile ; while the mother, freed from this burden, is able to care for the rest of her family, and her gratitude knows no measure. A DELEGATE said he would like to ask Mr. Wines his opinion as to the possibility of training imbecile children to become self- supporting. Mr. Wines.—A large number of imbecile children, from re- spectable families, are returned, when discharged from the insti- tution, to their parents. The intense sympathy which parents feel for their defective offspring is to a certain extent a disquali- fication for taking proper care of them. They are apt to be too indulgent. They do not correct their faults. They do not bring them under control. And many parents, especially those who are not otherwise ignorant, do not know how they ought to be treated. They cannot train them for useful avocations about the house. But, when the child has been sent to the institution and brought under control, and its most outrageous habits have been corrected, and it has been taught to do certain things which its family did not suppose it could do, it may be returned to the family, and made a comparatively harmless and agreeable inmate. As to the placing out of children who have no proper homes to which to go, there is a small percentage of those who are trained in these schools who can be made good farm-hands and house ser- vants of lower grade, provided they get into the right hands after they leave the institution. If they get into the wrong hands, nothing can be made of them. I do not think a large per- centage can be made self-supporting. Dr. Stebbins.—I understand you to mean by the term “self- supporting ’ ’ able to go out and be their own guides. Mr. Wines.—No: I mean that they can earn by their labor, under direction, as much as it costs to maintain them. A few can do that; but they must always be directed. A great many can never do that, though they may contribute something to- ward their own support. Mr. Hart, of Minnesota.—We have had some experience in regard to this matter of training. We established ten years ago a training school for feeble-minded children. The idea seemed to be prevalent that a large proportion, especially of selected children, might be brought to a point where they could be self- supporting. That has run ten years; and we find, instead of their going out and being able to care for themselves, we are brought to the point of making them permanent charges, and we have opened a custodial department especially for the care of older girls. Our observation in the poorliouses is that these 22 feeble-minded girls grow up to be the great curse of the com- munity. Many of them become mothers ; and their children are almost always feeble-minded. It is absolutely essential that such girls should be the subjects of permanent guardianship. Not only do they become the mothers of children like themselves, but they become the source of great corruption, especially to the growing boys of the communities where they are. I am more and more convinced that it is the duty of the State to take custo- dial charge of the adult imbecile as of the chronic insane. The difference between the adult imbecile and the chronic insane, so far as practical purposes are concerned, is the difference between tweedledee and tweedledum. They need essentially the same care, and I believe that the public must provide for it. I would not advise any State to establish a school in the hope that it can reclaim any considerable number so that they can take care of themselves. That has been the experience of Pennsylvania, Ohio, Massachusetts, and of other States. From our own school we used to send the children home every summer. The num- ber sent home has steadily diminished, until this year probably not fifteen per cent, went home; and the number will grow less and less. That indicates the tendency to the accumulation of children who are to become a permanent care to the state. Dr. Stebbins.—Is Minnesota moving in the direction of taking permanent control of them ? Mr. Hart.—Yes : we occupy this year for the first time a building for the older girls, and have purchased a large farm, with the expectation that it will be utilized for the boys. Dr. Stebbins.—The economical aspect of this question is comparatively new, isn’t it? Mr. Hart.—I think no one knew what it was coming to. I think it would, however, be unfortunate to lose sight of the humanitarian aspect of this question. There is no more benefi- cent thing for the community and for parents than institutions for imbeciles. There have been many cases where mothers were practically exiled from the community because they could not go out for shame at having such a child. There is one thing that might be suggested in the way of education, especially for boys : a department might be opened to train boys for an oc- cupation in which they might shine, to serve as jurors! In Chicago, within a few days they have had great difficulty in ob- taining a jury. If the Illinois School for Feeble-minded would 23 establish a department .of this kind, they might train tip a class who could be taught not to read the papers, to sit straight, look wise, and to write guilty without spelling it “ gilty”! Dr. Stebbins.—Do not for a moment misunderstand me. I would not sink the humane in the economic aspect; but since the custodial care must become permanent, and whatever useful faculty is developed must be under direction, is not the indus- trial side one of the most striking features ? It seems to me that such custodial institutions furnish a remarkable instance of the union of economic policy and of humane sentiment. Dr. Byers.—The institution in Ohio for the feeble-minded, as I said, is an educational institution ; but we have had to keep girls, because it was unsafe to let them return to the poorliouse. Dr. Doren, the superintendent, has made the proposition to the legislature of Ohio that, if it will furnish the land, he will cul- tivate it with the labor of the boys, and will produce enough to support the institution and supply with fresh vegetables all the year all the public institutions of the State. That is an answer to those who want to know the economic phase of the question. Mr. Johnson.—This system not only makes these people al- most self-supporting, but think of the immense saving in the next generation ! That is the strongest economic argument. Each hundred dollars that we spend now will save a thousand in the next generation. 24 advp;rtisement. So valuable seemed the papers of Mr. Henry M. Dechert, and Mrs. C. W. Brown, and so practical the discussion participated in by some of the most distinguished men in the country which followed, that the Directors of the Penna. Training School for Feeble-minded Children ordered the publication of 2500 copies, to be freely distributed among those desiring information on the important question of State provision for the feeble-minded. This pamphlet, with others bearing on the same subject, will be sent to any who apply to ISAAC N. RERUN, M. D., Elwyn, Pa.