I have for some time, writes Dr. Down, had my attention directed to the possibility of making a classification of the feeble-minded, by arranging them around various ethnic standards - in other words, framing a natural system to supplement the information to be derived by an inquiry into the history of the case.
I have been able to find among the large number of idiots and imbeciles which come under my observations, both at Earlswood and the out-patient department of the hospital, that a considerate portion can be fairly referred to one of the great divisions of the human family other than the class from which they have sprung. Of course, there are numerous representations of the great Caucasian family, Several well-marked examples of the Ethiopian variety have come under my notice, presenting the characteristic malar bones, the prominent eyes, the puffy lips, and retreating chin. The woolly hair has also been present, although not always black, nor has the skin acquired pigmentary deposit. They have been specimens of white negroes, although of European descent.
Some arrange themselves around the Malay variety, and present in their soft, black, curling hair, their prominent upper Jaws and capacious mouth, types of the family which people the South Sea Islands. Nor have there been wanting the analogues of the people who, with shortened foreheads, prominent cheeks, deep-set eyes, and slightly apish nose, originally inhabited the American Continent.
The great Mongolian family has numerous representatives, and it is to this division I wish, in this paper, to call special attention. A very large number of congenital idiots are typical Mongols. So marked in this, that when placed side by side, it is difficult to believe that the specimens compared are not children of the same parents.
The number of idiots who arrange themselves around the Mongolian type is so great, and they present such a close resemblance to one another in mental power, that I shall describe an idiot member of this racial division, selected from the large number that have fallen under my observation:
The hair is not black, as in the real Mongol, but a brownish colour, straight and scanty. The face is flat and broad, and destitute of prominence. The cheeks are roundish, and extended laterally. The eyes are obliquely placed, and the internal canthi more than normally distant from one another. The palpebral fissure is very narrow. The forehead is wrinkled transversely, from the constant assistance which the levatores pebrarum derive from the occipito-frontalis muscle in the opening of the eyes. The lips are large and thick, with transverse fissures. The tongue is long, thick and is much roughened. The nose is small. The skin has a slight dirty-yellowish tinge, and is deficient in elasticity, giving the appearance of being too large of the body.
The boy's aspect is such, that is difficult to realise that he is the child of Europeans; but so frequently are these characters presented, that there can be no doubt that these ethnic features are the result of degeneration. The Mongolian type of idiocy occurs in more than 10 per cent of the cases which are presented to me. They are always congenital idiots, and never result from accidents after uterine life. They are, for the most part, instances of degeneracy arising from tuberculosis in the parents. They are cases which very much repay judicious treatment. They require highly azotized food, with a considerable amount of oleaginous material. They have considerable power of imitation, even bordering on being mimics. They are humorous, and a lively sense of the ridiculous often colour their mimicry. This faculty of imitation may be cultivated to a very great extent, and a practical direction given to the results obtained. They are usually able to speak; the speech is thick and indistinct, but may be improved very greatly by a well-directed scheme of tongue gymnastics. The coordinating faculty is abnormal, but not so defective that it cannot be greatly strengthened. By systematic training, considerable manipulative power may be obtained.
The circulation is feeble; and whatever advance is made intellectually in the summer, some amount of retrogression may be expected in the winter. The mental and physical capabilities are, in fact, directly as the temperature.
The improvement which training effects in them is greatly in excess of what would be predicated if one did know the characteristics of the type. The life expectancy, however, is far below the average, and the tendency is to the tuberculosis which I believe to be the hereditary origin of the degeneracy.
Apart from the practical bearing of this attempt at the ethnic classification, considerable philosophical interests attaches to it. The tendency in the present day is to reject the opinion that the various races are merely varieties of the human family having, a common origin, and to insist that climatic or other influences are sufficient to account for the different types of man. Here, however, we have examples of retrogression, or at all events, of departure from one type and the assumption of the characteristics of another.
If these great racial divisions are fixed and definite, how comes it that disease is able to break down the barrier, and to stimulate so closely the features of another division? I cannot but think that the observations which I have recorded are indications that the difference in the races are not specific, but variable. These examples of the result of degeneracy among the mankind appear to me to furnish some argument in favour of the unity of the human species.
Down's essay originally appeared in England in 1866. It is generally credited as the earliest clinical description of what he called "mongoloid idiocy," as a condition separate and distinct from cretinism. The version reprinted here is actually itself a reprint of that original essay,which appeared in The Journal of Mental Science in 1867, and was reprinted in Mental Retardation in February 1995. Down elaborated his views at much greater length in a later book entitled Mental Affections of Children and Youth (1887). The racially based terms 'mongoloid' and 'mongolism' that Down coined continued to be widely used well into the 1980s.
Down, J. L. H. (1887). Mental affections of children and youth. London: Churchill.
Gould, S. J. (1980). The panda's thumb: More reflections in natural history. New York: Norton.
Scheerenberger, R. C. (1983). A history of mental retardation. Baltimore: Brookes.