ciation" by Doctor Tom A. Williams, of Washington. Their study is illuminating. Here are a few selections:

One of these, a girl aged 8 (Case 49), was kept from school; a simple analysis lasting half an hour revealed that the child had become overscrupulous from injudicious teaching of physiology. The condition was rectified, she was sent back to school, and is now perfectly well.

The ardent affection of another little girl (Case 50) was mistakingly repulsed by the parents, which led to a melancholia. After eight hours' analysis she was cured in two weeks and restored to the class of normal children.

A boy of 14 (Case 51) had developed since 3 a jealousy of a little brother which caused such shame that he devoted half his time to penances, the meaning of which was unknown to his relatives. An hour's analysis and four re-educative sittings sufficed to transform his character and turn him toward useful activities.

All these were cases of poor adaptation, which was supposed to be due to inherent nervousness, more or less hopeless. Yet they were merely the result of faulty handling and required only a proper comprehension of their psychological constitution. All were the children of people of superior attainments and conscience.

From the author's own practice numerous cases of children1 might be added that were saved by removal from their environment into a sane and natural educational atmosphere, with much fresh air, light, and sleep, simple, nourishing food, regular exercises, manual and occupational work and a modicum of "school lessons" presented in a manner to stimulate the child's interest and to distract him from his morbid, self-centred moods.

1 Figure 33 represents a free-hand drawing, illustrating a story, by a psychopathic boy of 14 (K. B., Case 52). The work shows very good conception, skill and action, considering the boy had had no training. This talent was utilized as a point of vantage in redeeming the child.

Self-centredness and lack of spontaneity are among the most obvious symptoms in a psychopathic constitution. Much of positive suggestion toward higher social and mental ideals and ambitions, and toward genuine selfrealization is needed.1

The Educational Clinic.-The only practical way of detecting psychopathic conditions in children is through organized co-operation of school and home. The family physician should be a careful adviser, and the school physician a ready and determined diagnostician. Observations in an educational clinic, such as ought to be connected with every school system, in conjunction with medical inspection, and which will be described in the second part of this book, should be supplemented by a careful detailed study of the child of this type by an experienced psychiatrist at a psychopathic clinic.

1 Doctor Louis E. Bisch, in a recent article, calls attention to the fact that Charles Lamb (Case 53) suffered from an attack of insanity in his early life, and this is what he wrote to Coleridge: "At some future time I will amuse you with an account . . . of the strange turns my frenzy took. I look back upon it at times with a gloomy kind of envy, for while it lasted I had many, many hours of pure happiness. Dream not, Coleridge, of having tasted all the grandeur and wildness of fancy till you have gone mad. All now seems to me vapid, or comparatively so."

CHAPTER IX

THE FEEBLE-MINDED GROUP

Vagueness of Definition.-Feeble-mindedness has been studied widely of late, so widely, indeed, that its study has overshadowed consideration of other mental difficulties to an enormous degree, much to the detriment of scientific accuracy and progress. The most remarkable feature of this study, however, is that it has not yet led to any clear-cut definition of what feeble-mindedness is. And this is curious if we remember that normality, too, has never before been clearly defined, except by negative terms. These facts show beyond the shadow of a doubt that the field of this study is yet very backward in cultivation, and that we are still dealing with practically unrelated facts. We must wait until, after the passing of generations, we have gathered a sufficient store of really scientific data, data of exact observation, from which to draw conclusions which are tenable. All deductions as yet made are tentative only, some very ambiguous, even fallacious; and many of them are based upon opinions, not on absolutely established facts. Professor C. B. Davenport, of Cold Spring Harbor, speaks of the "vague class of the 'feeble-minded'—the incapable." Miss E. E. Farrell, in her discussion of the Goddard report on ungraded classes in New York, says: "We do not know what is meant by a feebleminded child." Terman, in his review of the Meumann tests, writes: "It would seem that our concepts of feeblemindedness still rest largely upon tradition. In their

characterization of different grades of mental defects psychologists are still prone to fall back upon the crude descriptions found in the earlier medical literature. In short, the psychology of mental deficiency needs to be entirely revised."

Doctor H. H. Goddard, in his recent book, "The Criminal Imbecile," contributes these statements to the definition of an "imbecile":

There are various ways of designating this type of individual. Imbecility, as used in law in this country, may be defined as "the state of mental defect existing from birth or from an early age, due to incomplete cerebral development, in consequence of which the person affected is unable to perform his duties as a member of society." The high-grade imbecile . . . feeble-minded, as he is called in England, or the moron, as we are coming to call him in the United States, is one who is "capable of earning a living under favorable circumstances, but is incapable from mental defect, existing from birth or from an early age, (a) of competing on equal terms with his normal fellows, or (b) of managing himself or his affairs with ordinary prudence." These definitions were formulated by the Royal College of Physicians in England, and accepted by the Royal Commission on the Care and Control of the Feeble-Minded.

These definitions tally in a measure with the author's own contention, as stated in various places in this book, except that "competition on equal terms with his normal fellows" is a somewhat ambiguous term. These "equal terms" bear further scrutiny.

But it is interesting to note in Doctor Goddard's statement that he practically abandons the grouping of the feeble-minded in three distinct groups, as has been customary for some time in this country, viz.: the groups of the idiots, imbeciles, and morons. He combines the two latter classes in one and ascribes to them a "mental

age" of from three to twelve years. The high-grade imbecile, according to this modification of terminology, is the moron, another example of variation in the use of terms.

Amentia vs. Dementia.-Feeble-mindedness has often been confused with psychopathic conditions. A good presentation of the difference between feeble-mindedness (amentia) and normality, on the one hand, and psychopathic states (dementia), on the other, is contained in A. F. Tredgold's work on "Mental Deficiency." He says, in part:

The essence of mental defect is that it is incurable, and by no "special" education, however elaborate, can a case of amentia be raised to the normal standard. Some defect must always remain, and upon this fact all authorities agree.

It is not, however, to be assumed that amentia is merely a subtraction in varying degree from the normal. Although the contrary might be thought, nevertheless the two conditions do not merge into one another, and between the lowest normal and the highest ament a great and impassable gulf is fixed. While the former is heavy, stolid, and uniformly dull-witted, he has yet sufficient common sense to look after his interests and hold his own in that environment in which Nature has placed him. The mildest ament, on the other hand, may show no apparent dulness; he may even be bright and vivacious, and in some of his abilities be immeasurably superior to the clodhopper. But the other faculties of his mind are not present in like proportion. Instead of harmonious working there is discord, and in possession of that essential to independent existence-common sense— he is lacking, and the want can never be supplied.

Mental defect occurring subsequently to mental development may be compared to a state of bankruptcy, and is more fittingly described as dementia (de, down, from; mens, mind); while the person whose mind has never attained normal development may be looked upon as never having had a bank account, and this state is designed amentia (a, without; mens, mind). In both of these, of course, there is literally mental deficiency.