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The Classifications Of Idiocy

Creator: H.B. Wilbur (author)
Date: 1877
Publication: Proceedings of the Association of Medical Officers of American Institutions for Idiotic and Feeble-minded Persons
Publisher: J.B. Lippincott Company, Philadelphia
Source: Available at selected libraries

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I use the plural term classifications for two reasons. First, because idiocy, like any other general term, is susceptible of a variety of classifications; and, secondly, for the reason that I shall have occasion to speak of several modes of classification that have been suggested by others, before suggesting some inquiries as to the possibility of establishing a new one to meet certain needs that we all must feel.

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Idiocy, or amentia of the older writers, may first be distinguished from dementia. The former applies to a default of mental faculties that is congenital, or manifests itself at an early age. The latter is an impairment or total loss of mental powers that have been once possessed. This occurs at a later period of life, and is always the result of diseased action of the nervous system.

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The essential feature of both conditions is the absence or imperfection of normal mental faculties, without reference to the physical defect or default, or the pathological condition underlying or associated with them.

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The difference or distinction between the two conditions is not one of age alone, but in other respects is a manifest one to those of us who have been accustomed to see and compare the two classes. The difference in manifestation is the result of the fact that, in the one case, the want of intelligence occurs in individuals who are undeveloped in every way, having only the germs of human faculties. There is, at the same time, an insusceptibility to development through agencies operating from without. There is an absence of normal instincts and intuitions going out for natural aliment and exercise, and the natural avenues of growth-stimulating influences from without are closed. In the other case, to one in possession of all the human faculties there comes a change, gradually or suddenly, that weakens or destroys them, -- loosens the hold upon mental acquisitions, and undermines that mental constitution which has been built up upon the combined elements of observation, reason, mental discipline, and habit.

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A single illustration from the range of physical education will explain my meaning. A certain degree of intelligence, of desire and volition, is necessary for an idiot child to learn to walk, where the organs of locomotion are perfect. But a much less amount of intelligence in the downward progress of dementia may leave the demented person capable of walking properly; for in the latter case a habit of the system and a facility of co-ordination of the locomotive organs make a moderate expenditure of mental impulse suffice for that particular work. The same may be said of other simple attainments, physical or mental.

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Having made this prime distinction between dementia and idiocy, and remanded the former term to its proper place, namely, as a stage of insanity, and usually succeeding to certain other forms of that disease, as mania and melancholia, we may now turn our attention to distinctions or classes in the case of idiocy.

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And, first, of the popular idea and classification of idiots. This we, as medical officers of institutions for the care and training of idiots, have various means of learning that I need not stop to specify. The people generally understand the fact that the range of idiocy is a wide one. Thus, at one end of the scale is seen almost the entire absence of manifestations of sensibility, of intelligence and will. At the other end of the series are to be found cases where, to a casual observation, the question may arise whether any default in these particulars exists at all.

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A similar observation might be made of the cases of dementia.

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The term idiot, then, however originally used, has acquired a popular meaning. From my experience, I may say that it is thus used in a generic sense, covering the whole range referred to. On the other hand, it is also used in a specific sense, and is then applied to the lower grades of idiocy, for the reason that in the formation of our ideas the type of any genus is usually made up of its most marked characteristics. There is a mental image formed of an individual thoroughly stamped with the peculiar features of the class. Applying this to the class before us, it is often said of an individual that he is, or is not, a complete idiot.

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To those at the upper end of the scale, the term is commonly applied of imbecile, or weak-minded. In this country and Great Britain these two classes are recognized in this way. To the latter, also, are frequently applied the terms simple, foolish, innocent, etc.

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Of course, in the popular mind, the line between these two classes is not well defined; but that is unavoidable, from the insensible gradation in the mental features of the individuals composing the whole category. This does not vitiate the merit of the classification. It meets the purpose of the popular need. The fact is recognized that there are degrees of idiocy; and contenting themselves with making two classes depending upon that distinction, people generally use the above-named terms to express their recognition of the fact.

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