History of Events Dealing With Mental Retardation

Guest lecture by Bruce Pacht, 2/22/96


Freely adapted from A History of Mental Retardation, R.C. Scheerenberger, Brookes Publishing Co. (Baltimore, 1983). No differentiation between his words and other's words quoted by him.

Very Early Evidence

Abortion, infanticide, celibacy and other means of limiting the population were held in ill repute. Kids could still be sold into slavery.

Greece and Rome

From Antiquity to the Enlightenment

"We have known others who are less foolish, who correctly attend to many tasks of life, who are able to perform certain skills, yet they show their dullness, in that they long to be praised, and at the same time they say and do foolish things.

"Some people have dullness from before birth. Such persons have deformed heads, or they spoke with a large and swollen tongue and at the same time with a humorous throat, or they were deformed in their general appearance."

Where did most people with mental retardation live? monasteries, hospitals, charitable facilities, prisons, almshouses, pesthouses, workhouses, warehouses, and other buildings most of which had lost their original usefulness.

ONE EXCEPTION: the family-care approach used by the citizens of Gheel, Belgium (still in effect). Gheel became a refuge and haven for "the mental afflicted" beginning in the seventh century; primary focus on family care.

19th cent. commentator: The patients were treated as members of the families in whose homes they had lived. They had their own bedrooms, ate meals with the family, and engaged in all family activities. Many were given responsibilities, such as babysitting and other family chores.

Many were employed in the town and on farms. They could use all the community facilities. Painting, drawing, and gardening were encouraged. A change of scence was viewed as beneficial, so picnics and other outings were organized.

This approach not adopted by other Euorpean countries until the late 19th cent., and in the US not until Charles Vaux during the 1930s.

1247 - Sheriff of London gave estate and land to the Bishop and Church of Bethlem for the purpose of building a hospital. Now believed to be the oldest providing continuous service in Europe, was converted to a mental asylum in 1377; first patients (both MI and MR) transferred from an old store house located much too close to the King's Palace. Bethlem soon earned the title "Bedlum". 1398 inventory: 4 pair of manacles, 11 chains of irons, 6 locks and keys, 2 stocks -- for 20 patients.

Dark cells were common and sexes mixed. Few staff and low quality. Tuke:

"Patients are ordered to be bled about the latter end of May, according to the weather; and after they have been bled, they take vomits, once a week for a certain number of weeks; after that we purge all thepatients."

Until 1770, Bethlem was one of London's favorite tourist spots. Sir Thomas More:

"For thou shalt in Bedlum see one laugh at the knocking of his own head against a post, and yet there is little pleasure therein."

1606 The Hotel Dieu ordered by King to tend all mentally ill and idiot people: The patients were herded together in rooms crowded with miserable beds in which they were put without distinction of disease; there were two, four, six, and even twelve people bedded together in various positions; one can easily imagine how sanitary this was!

Francis Bacon (1561-1626): knowledge about the world is acquired through sensory experience; discovery, investigation, and explanations of things could be accomplished only by controlled observation and experimentation. Recalls Roger Bacon (1214-1292) - philosophical teachings must be verified with the facts of experience and experimentation.

Rene Descartes (1596-1650): true understanding of the natural world would come through the proper application of mathematical principles and deductive reasoning.

Thomas Hobbes (1588-1679): purpose of philosophy is determined cause and effect relationships.

John Locke An Essay Concerning Human Understanding 1690 - at birth, the mind is a blank table; no one is born with innate ideas. All ideas come from experiences, either from sensation or reflection. Man is rational, and ahumane, enlightened social order is possible. Recognized difference:

"Herein seems to lie the difference between idiots and madmen, that madmen put wrong ideas together and reason from hem, but idiots make very few or no propositions and reason scarce at al."

Jean-Jacques Rousseau (1712-1778): Key notions: the natural child, self-direction, and the importance of sensory training and experiences:

In the North American British Colonies and Early United States

1660 - First Almshouse - Boston

1727 - First House of Corrections - All rogues, vagabonds, and idle persons going about in town or country begging, or common pipers, fiddlers, runaways, drunkards, wanton and lascivious perons, railers or brawlers, also persons under distraction and unfit to go at large, whose friends do not take care for their safe confinement,

1751 - First Hospital in Philadelphia separates a section for people with mental retardation and people with mental illness; by 1756, it's int he cellar, puts people on display for a slight fee . . .

1771 - First Workhouse - Philadelphia

1773 - Virginia - first hospital solely for "these miserable Objects who cannot help themselves"; 1769 law "to make provision for the support and maintenance of idiots, lunatics and other people of unsound mind:. Next one is 50 years later, 1824 in Lexington, KY

1773 - First Poorhouse

1787 - Benjamin Rush (1745-1813) signed Declaration of Independence, physician, describes Pennsylvania Hospital:

"Here were both men and women, between went and thirty in number. Some of them have beds, most of them clean straw. Some of them were extremely fierce and raving, nearly or quite naked; some singing and dancing; some in despair, some were dumb and would not open their mouths; others incessantly talking . . . Everything about them, notwithstanding the labor and trouble it must have required, was neat and clean."

1818 - American Asylum for the Deaf and Dumb - Hartford, CT, began to provide the first recognized residential service intended specifically for people with mental retardation in the US. After 1820, "all but the smallest of communities placed a greater reliance of the almshouse and its derivatives, as well as the mental hospital."

"Bidding out" - the pauper and the person with mental retardation were sold to someone who would provide cheaply their care and maintenance.

"Warning out" - informing a newcomer that the town would not be responsible for his misfortunes.

"Passing on" - loading people with mental retardation or mental illness into a cart, transporting them to another town, and leaving them there.

Alms houses intended for the poor became general holding pens for all sorts of children, aged and infirm adults, sick people, etc.