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CHAPTER XII.
THE FEEBLE-MINDED, EPILEPTIC, AND INEBRIATE.

The term "feeble-minded" is now used to cover all grades of idiocy and imbecility, from the child that is merely dull and incapable of profiting by the ordinary school, to the gelatinous mass that simply eats and lives. If it is difficult to give an exact definition of insanity, it is manifestly even. more difficult to give an exact definition of feeble-mindedness. Dr. Ireland, in accordance with English usage, defines idiocy separately as: --

"A mental deficiency or extreme stupidity, depending upon malnutrition or disease of the nervous centres, occurring either before birth or before the evolution of the mental faculties in childhood."

Dr. Martin W. Barr, of Elwyn, Pennsylvania, gives a more comprehensive definition: --

"Feeble-mindedness, including idiocy and imbecility, is defect,. either mental or moral, or both, usually associated with certain physical stigmata or degeneration. Although incurable, its lesser forms may be susceptible of amelioration or modification, just in proportion as they have been superinduced by causes congenital or accidental."

The class to which the technical term "feeble-mindedness". is applied may be expected to increase as specialists improve their acquaintance with the different symptoms. For this reason, as in the case of the insane, the census figures bearing upon the subject indicate a rate of increase out of all proportion, probably, to any actual increase of the condition of feeble-mindedness in the population.

In 1880 the enumeration, although not complete, was more nearly so than in the two later ones; at that time there were 836 reported. 76,895 feeble-minded, persons -- a proportion of 153.3 persons per 100,000 of the population. In 1890, the number was 95,609, or 152.7 per 100,000 of population; but as this census was not supplemented by reports from physicians as the previous one had been, it undoubtedly falls far short of the total number. In 1903 the census law called for an enumeration of those in institutions only, which makes the figures not comparable with those of 1880 and 1890. Of those enumerated in 1890, only 5254 were in special institutions, and 2469 in asylums for the insane, the number in almshouses being unknown. In 1903 the feeble-minded in institutions numbered only 14,347, and there were in almshouses 16,551 "supposedly" feeble-minded. Competent authorities place the number of those needing institutional treatment at the present time at 150,000. (155)

It is apparent that provision for the institutional care of the feeble-minded is much less adequate than for the other defective classes. In 1890 there were twenty public and four private institutions. Table LXV. shows the numbers and distribution of institutions and inmates in 1904.

In New York, New Jersey, and Pennsylvania there are two or more institutions; in the North Central division every State has a public institution; in the South Atlantic and South Central divisions there are altogether only six institutions; while in twenty-four States there are none at all. In these latter States the feeble-minded are in almshouses, insane asylums, or chiefly in homes, receiving neither custodial care nor industrial training. Only a few of the forty-two institutions are custodial, the greater number being for feeble-minded children, and none of the public institutions can provide for all the applicants.

Of the 16,946 inmates of these institutions, 53.8 per cent were males, 46.2 per cent females; 75 per cent were between five and twenty years of age; nearly one-third were found to be epileptic, blind, deaf-mute, paralytic, crippled, maimed, or deformed, for the feeble-minded and epileptic, who are in need of institutional care quite as much as the insane, provision has only just begun and is likely to be inadequate for many years to come.

TABLE LXV.
FEEBLE-MINDED IN INSTUTIONS, 1904
Special Census Report, p.208.