THE TREATMENT OF FEEBLE-MINDED CHILDREN THE feeble-minded, as defined by the Royal College of Physicians, are persons who may be capable of earning a living under favourable circumstances, but are incapable from mental defect existing from birth, or from an early age, (a) of competing on equal terms with their normal fellows; (b) of managing themselves and their affairs with ordinary prudence.' They are not to be confounded with imbeciles and idiots, though they may easily sink into the ranks of these. We can all recall examples : the 'innocent' of the village, the child who is growing up not quite all there,' the gentle, foolish girl who is not quite like other people.' The following points have also been emphasised: that a really feeble-minded child will always remain feebleminded; that feeble-mindedness is hereditary. From results collected by the Royal Commission on the care and control of the feeble-minded, which issued its report in 1908, it is estimated that there were in England and Wales in the previous year 149,628 mentally defective persons, other than certified lunatics; and of these, 66,509 were urgently in need of institutional care. Harmless in themselves, such persons become a source of weakness to the country, a danger to which we are only becoming fully alive as it threatens to grow almost unmanageable. The mentally deficient are peculiarly sensitive to sexual influences; evidence collected affords ample proof of their rather abnormal fertility and of the almost invariable degeneracy of their offspring. In one case, the descendants of a feeble-minded woman have been traced, showing a line of forty-eight persons, every one of whom is of deficient intellect or has alcoholic tendencies. In one workhouse sixteen feeble-minded women gave birth to 116 children. A woman was recently brought to a Home who had had eighteen children, sixteen of whom had died; the remaining two were imbecile. Another defective woman is instanced as having one apparently normal child, one who is a violent epileptic and two who are criminals-another manifestation of the same disease. The normal child and one criminal have no children. One son has five, all criminal like himself; the epileptic acounts for four imbecile and three criminal children; and such examples could be multiplied ad nauseam. In one gaol alone, moreover, 600 mental defectives passed through in a year. Seventeen cases had at least forty convictions each, while three had 102 and another 94, yet not one of these could be classed as detainable. The Royal Commission gives such figures as the following: From 45,000 to 50,000 of the school-children of the country, from one-fourth to one-fifth of all the inmates in workhouses, one-tenth of the prisoners, about one-half of the girls in Rescue Homes, one-tenth of the tramps all over the country, and two-thirds of the inmates of Homes for Inebriates, are mentally defective. During four years the Society for the Prevention of Cruelty to Children dealt with 1113 cases in which either the parents or the children were of weak intellect. Present conditions involve untold suffering to these unhappy beings. The greater number are quite unable to earn a living, and drag on a miserable existence, involved in poverty and disease, the butt and sport of the town or village, often ill-treated and punished, starved and beaten, for faults which are beyond their own control. Their criminality is generally owing to their having no strength of will to resist temptation; their idleness may be ascribed to inability to work steadily without skilled supervision. Yet practically no classified provision, no provision at all on any adequate scale, is made by the State for this large body of dependent persons. Feeble-minded children who commit lawless actions cannot be sent to any ordinary Industrial School as soon as their mental condition is discovered the school refuses to keep them. The deficient child offender coming from a poor home is sent back to that home, to knock about the streets, to fall further into crime, to be the cat's-paw of every sharp and unscrupulous companion he may come across, and often to undergo long terms of imprisonment as the only way magistrates can devise for dealing with him. Dr. Tredgold, in a paper read at the Manchester Poor Law Conference, says: Those who are fortunate enough to have means are kept by their relatives. For those who are not so fortunate the State does not provide any definite system of care. It makes no effort to supply the favourable conditions under which these people might earn a living. It simply looks on, furnishes neither protection nor control, and allows them to prey upon it. It is no matter for surprise to find that in a very short time the youth or the young woman is in the prison or the Rescue Home. But there is no power to detain them in these institutions-they are very soon at large again, and the process goes on indefinitely. During their whole lives they are bandied from pillar to post, and it is no exaggeration to say that the existence of many of them is a continuous round of prison, workhouse, Rescue Home, and street. The girls are in and out of the Maternity Wards year after year, without anyone having power to detain them, and it is not uncommon to find working-men taking half-witted girls to wife. Mental deficiency, in short, stands high among the causes of destitution and crime. It has been a repeated subject of legislation, and the principle, as a principle, will hardly be questioned, that a state of things exists which calls upon the State to subordinate individual liberty to national interests, and to exercise the function of parent and guardian towards those who have no one to take them in charge. There was a time when the ducking-stool was the only remedy which suggested itself for the half-witted woman, and when the 'softy' and the 'innocent' shared in the treatment meted out to the insane. By degrees other ideas have established themselves, and now the main principle laid down in dealing with this class is that their circumstances shall be in every case improved. The causes that have chiefly contributed to make them what they are lay a heavy responsibility upon England. We look back to the past, down a long vista of generations of workers, in our agricultural districts, in our mining country, in our manufacturing towns, enfeebled by unwholesome surroundings and crippled by grinding conditions. In all her catalogue of achievement,' says Mr. George Peel in a recent book, 'England has neglected her own breed of men.' Her wage-earners in the last century were unable for many years, even with the most careful management, to procure the necessaries of healthy life. Their offspring grew up under-nourished, poorly clothed, degenerate in physique; they had families prone to early deterioration, and the extreme point was reached in those members who fell below the normal in mental capacity. The fact that their numbers are rising and that they are becoming a grave and progressive danger to the country has, in all its urgent significance, been taken to heart at last. The Prime Minister, speaking on the 20th of November, said that the care and control of the feeble-minded was occupying the serious attention of himself and his colleagues, and he earnestly hoped it would be possible to deal with it at an early date. Since then we learn that Mr. McKenna intends to bring in a Bill this session for dealing with the situation, and it seems the moment for examining the present position and for considering various proposals. We are bound not only to keep the feeble-minded alive, but we are bound to do our best for them If, as seems scarcely to be doubted, it will be judged fair in the future to deprive them of liberty, we must see that they are made happy, and it is a task that will entail lifelong care, for it is urged even more strongly by those who have the fullest knowledge of them, that, whenever possible, detention should begin from early years, when they are easily restrained and do not feel the loss of freedom. we have said, these defective members of society usually belong to a poor class, and are apt to be the outcome of generations of want, vice, and alcoholism; numbers of them are illegitimate, and even when they have families who are kindly disposed towards them, they are a dead-weight upon these relatives, who are totally unable to provide the proper care and control needed for training them, and who are hampered and economically hindered by their presence. As children, their effect upon other children in a small home where all live at close quarters cannot but be a bad one, and those parents who are fondest of their deficient children are often anxious and harassed at the thought of their future, and express their misgivings in such words as 'Who will care for them when I am gone?' On the other hand, when such children are trained and taught a trade in an institution, it is not at all uncommon for the parents to take them home as soon as they become profitable, and sometimes even to overwork them, disregarding the almost universal experience that their work only remains really effective when carried out under the supervision to which they have grown accustomed. Girls who are admitted to maternity wards are often determined to go out. Kindly officials may plead, lady visitors may offer every argument that can induce towards honest and respectable living; but they have just sense enough to know they can go if they like, and, if they are at work, they are capable of arguing that they can work outside and have the money they earn for themselves. The destitute feeble-minded of any age come under the jurisdiction of the Poor Law authorities, who are compelled to provide accommodation for them; but even if these had the power to detain them personally, it does not follow that the workhouse is the proper place for them. It cannot provide the sort of training they require, and their services are utilised as children's nurses, or in other ways for which they are wholly unfit. More especially is the workhouse the wrong place for the children. In the evidence given before the Royal Commission it was stated that feeble-minded children were often placed among the imbeciles and that there was no place where they could be trained. One witness said: A recent visit paid to workhouses showed imbeciles, idiots, and slightly feeble-minded living in wards together; all ages from fourteen to ninety. Hardly any attempt was made to teach or occupy the children; the accommodation was cheerless, and the life idle and dreary. Six of the children had formerly been in special schools. Five of them had greatly deteriorated, VOL. LXXI-No. 423 3 N probably through lack of training and association with imbeciles. A girl of fourteen, who had made considerable progress at the special school, was associated with a roomful of low-type imbecile women. In fact, one of the gravest charges brought by the Royal Commission was the want of classification in the workhouses by Boards of Guardians. Yet the Guardians have not been indifferent in many cases the problem has been constantly before the Boards, and of late years some of these have made efforts to use the power they possess to combine, in order to provide special institutions. Conferences have been held at many centres, where the need for some such experiment has been almost unanimously admitted, where one member after another has deplored the waste of money and pains, on account of the children being allowed at sixteen to return to normal life, and where the establishment of additional special institutions and colonies, which should provide continuous care and treatment from childhood onwards, has been advocated. Oldham Board has a special school in which small classes and qualified teachers are obligatory, and in which great stress is laid on the teaching of manual occupations. Out of seventy-seven children who have attended for periods varying from six months to ten years, four have been removed as normal and forty are working, or making themselves of use at home; but here, again, the children, after sixteen, are subject to no organised control, and deteriorate when removed from the influence of the school. Yorkshire has just come to the determination to establish a Village Community, in which children under the age of thirteen can be received, chosen from the high-grade imbecile and the feeble-minded, who can be trained to lead a simple country life, working in house, farm, and garden, and earning at least a part of their living. It is hoped that they will become so accustomed to their surroundings and so fond of their life that when the age-limit is reached there will be no desire to leave. Boards have combined with good effect in the Manchester and Birmingham districts, and important conferences have been held all over England, when Homes of Industry and Farm Colonies have been advocated. A suggestion which has found considerable favour is that one workhouse should be set apart in each district for the reception of all classes of the mentally deficient, but, pending proposed legislation, there has on the whole been little positive action taken. By the Elementary Education Act of 1899, local authorities are empowered to provide special schools for the children in their district who are unfit for work in the normal elementary schools of the country. This Act is, unfortunately, permissive, not compulsory, and, owing principally to the cost involved, few districts |