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"From all the points of the compass, steam and electricity cumulate men and ideas on this continent that will soon be, for good or evil, the new world; new for evil if the comers invade us, not by the sword, but their their low spirit of submission to Eastern or Western bonzes; new for good, if we are ready, with a powerful physiological system of education, to assimilate them, women, men, children, of all races and colors, to our unity and independence" (p.44).

In 1878, Seguin added: "...if ideas create architecture, architecture reacts upon its mother-idea, to develop, distort, even kill it (as it appears by the influence that the latter form of the insane asylum has exercised on the theory and practice of the treatment of insanity). Truly, the ideas, too soon cast in brick-form, shrink by compression; and the monument erected for their development becomes too often their empty sarcophagus" (p. 60).

Fifty years ago, Kirkbride (1916, p. 250) lamented, to little avail: "In studying the problems connected with the construction, organization and management of public institutions for defectives, I have had varying emotions....While I have seen much to thrill me and to make me proud of the devoted men and women who are giving their lives to the care of their less fortunate fellows, I have seen so much of the handicaps under which they suffer, resulting from mistakes in planning, construction and arrangement of the institutions in which they work, that my emotions have often been very mixed and sobering.

"Why, I have often asked myself, have the experiences, the failures and the successes of others not been of more use in preventing the needless repetition of costly mistakes? Local customs, politics, prejudice, lack of initiative, courage and vision, and a host of other factors are included in the answer."

The remarkable thing is that our experience has been shared by many countries that built large institutions in the last 100 years. It seems as if the very model, as we have known it, is unworkable.

If it is a universal fact that this model has failed, perhaps the institution built on it is not the solution to our problems. Perhaps the institution as we know it is unworkable and cannot be salvaged no matter how much money we spend.

In Greek mythology we encounter a somewhat overly friendly character by the name of Procustes. He wanted very much to be a good host to weary wayfarers, and when a traveler journeyed past his dwelling, Procrustes would insist that he stay the night with him. After some wining and dining, Procrustes would show his guest to his bed. Trouble was, there was only one bed, of one certain size, and Procrustes was a perfectionist. The bed just had to fit the guest. So if the guest was tall, Procrustes chopped off his legs until guest and bed were exactly of the same size. If the guest was too small, the host strapped him into a rack and lengthened him out a few inches. Obviously, by doing things his own way, Procrustes was prepared for all comers.

The moral of the parable: our institutions have been Procrustean. It did not matter who or what the retardate was, whether young or old; whether borderline or profoundly retarded; whether physically handicapped or physically sound; whether deaf or blind; whether rural or urban; whether from the local town or from 500 miles away; whether well-behaved or ill-behaved. We took them all, by the thousands, 5,000 and 6,000 in some institutions. We had all the answers in one place, using the same facilities, the same personnel, the same attitudes, and largely the same treatment.

And if our guest did not fit, we made him fit!

What we need to do is take an entirely fresh look at the needs of the retarded, and increase the goodness of fit between their needs and our programs. And we must face the possibility that we may need a new bed.

APPENDIX 1
Maintenance Costs of Residents in United States Public Institutions for the Mentally Retarded 1848-1966

Beginning in the section on "Protecting the Deviant From the Non-deviant," and elaborated in the section on "Failure of Preventive Segregation," certain hypotheses were elaborated regarding the relationship between institutional admission trends and institutional costs. To substantiate these hypotheses, I collated data on per capita maintenance costs of U.S. public institutions (or private institutions with a substantial proportion of publicly support residents) for the mentally retarded between 1848 and 1966. In compiling these data, only operating expenses were listed. Where it was impossible to separate capital expenditures and operating expenses, no entry was made.

The data were derived from articles and "reports from states" in the annual proceedings of the National Conference on Charities and Correction and its successor publication, from articles and reports in the various forerunners of the American Journal on Mental Deficiency, and from U.S. census and National Institute of Mental Health reports on institutions. In the U.S. censuses of 1850-1890, questions were asked aimed at the identification of retarded persons in the community. In 1880 and 1890, the Census Bureau reported data on residents in institutions for the retarded. Similar resident counts were published in 1906 and 1914, for the years 1903-1905 and 1909-1910 respectively. In 1919 reports on maintenance costs for the year 1915 were added to basic resident movement data. Similar data were published in 1926, 1931, 1932, 1934, 1935, 1936, 1937, 1938, 1939, 1941, 1943,and 1943 again, for years 1922, 1926-1927, 1928, 1929-1932, 1933, 1934, 1935, 136, 1937, 1938, 1939, and 1940 respectively. In most but not all cases, maintenance costs for retardates and epileptics were not sported separately, but since most epileptics appeared to be also retarded, this should have had little effect on overall trends.