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 The Undesirable. 
 
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 READ BEFORE SEABOARD MEDICAL SOCIETY OF VIRGINIA 
 
 AND NORTH CAROLINA, DEC. 9, 1914, GOLDSBORO, 
 
 N. C, BY C. BANKS M'NAIRY, M. D., SUPT. 
 
 SCHOOL FOR FEEBLE MINDED, 
 
 KNSTON, N. C. 
 
 MR. PRESIDENT AND GENTLEMEN: 
 
 In bringing this subject to your notice, on this oc- 
 casion 1 hope, as I proceed, you will bear in mind, that 
 it is not my purpose to bring anything new before you 
 because I am quite sure you are all posted and well read 
 on all questions that look to the protection and better- 
 ment of humanity, both physically and mentally. 
 
 I hope only to call your special attention to the 
 one class of human beings, whose welfare, comfort, and 
 mental and physical needs have been overlooked, or for- 
 gotten, for years, by the forefathers of medicine, psy- 
 chology, and I might well say theology, in this mad rush, 
 as it were, to discover something new and the undesir- 
 able human beings, such as feeble-minded, imbeciles, 
 and idiots, had not until just recently, been given as 
 much thought or care, in many instances, as domestic 
 animals. 
 
 I think you gentlemen will readily agree with me 
 that there is nothing so undesirable in one's own family 
 as an imbecile, much less an idiot. 
 
 I know of nothing in tnis vale of tears, as we 
 sometimes speak of this life, that will bring to the moth- 
 er, the agonies, the shame, the remorse and pain, men- 
 tal and physical worry, as to have the constant care of 
 one of these low types of human animals. (I use the 
 word Animal advisedly, because many of them are really 
 lower in the scale of intellect and self preservation than 
 the lower type of animal. ) 
 
 <U 
 
28 
 
 I shall discuss this subject under three headings: 
 
 1st. Who Are the Feeble Minded, and How Many ? 
 
 2nd. What We Know of the Cause. 
 
 3rd. How We Hope to Reduce or Prevent? 
 
 A prominent American has said, the great trouble 
 with this problem of the feeble minded is that there are 
 so many of us. 
 
 I am quite sure you are all familiar, and can read- 
 ily recognize the idiot and low-grade imbecile. They 
 show it in their faces, they show it in their talk (if they 
 talk at all), and in many other ways. The condition is 
 manifest, but the real problem comes when we consider 
 the higher grade imbecile and the moron. These people 
 to the casual observer, are like the rest of us, but who, 
 if allowed to go on and attempt to take their places in 
 the world, are incapable. 
 
 A Moron is described as one who is capable of 
 earning a living under favorable circumstances, but is 
 incapable, from mental defects existing from birth or 
 from early age, of competing on equal terms with his 
 fellows, or of managing himself or his affairs with or- 
 dinary prudence. 
 
 It remains then, to discover some method of de- 
 tecting the quality of the mentality in these cases, and 
 thanks be to Prof. Binet, we now have a method of de- 
 termining the condition of any particular child, in rela- 
 tion to its mental standard. 
 
 The Binet-Simon measure scale of intelligence. 
 
 As to the number in the United States, in the 
 census report of 1890, one of the questions that was ask- 
 ed, was, ' 'Are there any idiots or imbeciles in your fam- 
 ily?" Result of this inquiry, that one in five hundred of 
 the population cames under this class. 
 
 It is a difficult matter to get just what the true 
 proportion is, as so many people naturally object to re- 
 porting any member of their family as idiotic or imbe- 
 
29 
 
 cile, unless they are very marked cases and the fact 
 cannot be concealed. 
 
 It has been concluded by those who are familiar 
 with the problem of feeble-mindedness that, at least, 
 one in three hundred was a safe estimate. And still 
 more recently and based upon a more careful study, 
 Goddard has said one in two hundred and fifty. Others 
 have dared to say one in two hundred of the population. 
 
 Goddard says, his study of the mentality of the 
 entire school system of one thousand children resulted 
 in finding two per cent of these children feeble-minded. 
 
 Dr. Terman tested a small system of eight hun- 
 dred children and found a little over three per cent of 
 the children were feeble-minded. 
 
 The number of feeble-minded, estimated in the 
 United States today, according to the best authority, is 
 about three hundred thousand. 
 
 I am not positive and have no correct statistics of 
 North Carolina, but am quite sure that a conservative 
 estimate will place them in the thousands. 
 
 Second. As to Cause. I realize fully that now I 
 am treading on disputed ground and no doubt that many 
 of you gentlemen will probably take issue with me as to 
 the cause, as I shall treat this division of my subject. 
 
 It is a fact, says Judge Olson of Chicago, that in- 
 sanity, feeble-mindedness and mental disease, are on 
 the increase. 
 
 He further says that during ten years' experience 
 as public prosecutor of the criminal courts of Cooke 
 County, the fact was constantly being imposed upon 
 him, that numbers of the criminal classes were defect- 
 ive to that extent— their defect was the cause of thei r 
 criminality. 
 
 These ranging from the idiot, who requires cus- 
 todial care, to the imbecile, who is quite harmless, up to 
 the highest type of feeble-minded, known as the moron, 
 or borderland cases. In which group is to be found the 
 
30 
 
 most dangerous individuals. And of the defects of the 
 race, none is attracting more attention, on the part of 
 the physicians, court officers, social workers, legislators, 
 than is feeble-mindedness today. 
 
 The moron, to the superficial view, is often con- 
 sidered normal, though perhaps somewhat dull and 
 backward. He is unable, however, to compete on equal 
 terms, with his fellows, and is unable to manage his own 
 affairs with ordinary prudence. The defect may be in- 
 born—germinal — and, therefore, the hereditary failure 
 of the higher structures of the brain to develop, or it 
 may be acquired, as for example, through an accident 
 or injury to the brain of the child in early life. The 
 failure of the development of the brain may be due to 
 injury of the child at birth by prolonged or difficult la- 
 bor. It may also be due to injuries inflicted by the mid- 
 wife or careless attending physician. 
 
 There is still another group, which includes all of 
 those cases due to arrest of growth of the brain from 
 such causes as maternal injury or diseases affecting the 
 developing embryo. These may be said to be congeni- 
 tal, as for example— that infectious disease— syphilis, 
 which is responsible for so much mental deficiency. 
 
 I think it is a generally conceded fact, by Alien- 
 ists, Neurologists, and Psychologists, that the cause of 
 two-thirds of the cases of feeble-mindedness is due to 
 heredity. 
 
 We may say the human family is composed of in- 
 dividuals of all grades of intelligence, from the lowest 
 to the highest, but the particular grade of intelligence 
 is characteristic of the family possessing it and is trans- 
 mitted. 
 
 If human mating always took place between per- 
 sons of the same level of intelligence, we should have 
 generation after generation of children of the same in- 
 telligence as their parents. We have only to look back 
 
31 
 
 in history a little to discover families of superior intelli- 
 gence, where the level has been maintained through 
 three, four, or perhaps, six generations; the Adams' and 
 Edwards' families, for instance, says Goddard. 
 
 It is important to realize that most of the mental 
 defects have existed from birth or early age, and path- 
 ological studies of neuropatic ■ constitutions, covering 
 several manifestations of abnormal, nervous systems, 
 such as insanity, epilepsy, and f eeble-mindedness prove, 
 beyond doubt, the fact that heredity is the first and 
 prime cause of mental deficiency. 
 
 The most evident fact in heredity transmission is 
 death, and the next is a tendency toward disease. 
 
 According to Neo-mendelian classification, if an 
 individual inherits a determiner, say for normality of 
 nervous structure from both parents, he is termed du- 
 plex for that character; if from but one parent, simplex; 
 and if from neither parent, mulliplex. 
 
 Because Gregor Mendel considered the peas of his 
 garden and how they grew, is built on the conception of 
 unit characters and their determiners. 
 
 Mendelism regards an individual as a Mosaic of 
 independently inheritable characters, whose appearance 
 depends on the way in which their respective determin- 
 ers are thrown together in the product of the union of 
 the germ cells, each bearing determiners. 
 
 The Kallikak family, as reported by Goddard. from 
 one member of which sprang four hundred and ninety- 
 six known descendents, all but two of whom were res- 
 pectable and useful citizens, and also through a clan- 
 descent mating with a feeble-minded girl, four hundred 
 andjeighty mediocre and subnormal individuals, one 
 hundred and forty-three of whom were distinctly fee- 
 ble minded. 
 
 Estabrook studied "The Nam Family" in the back 
 woods of New York, finding seven hundred and eighty- 
 
32 
 
 four individuals, of whom 19 were epileptics, 24 insane, 
 15 in orphan asylums, 3 in girls homes, 40 in state pris- 
 ons. Eighty-eight per cent of the females and ninety 
 per cent qf the males were alcoholics. Licentiousness 
 characterize 232 women and 199 men. 
 
 Florence Donaldson found, in two families of New 
 England, rural community, 737 persons dealt with; 136 
 feeble-minded; 10 epileptics; 24 showing criminal ten- 
 dencies; 8 prostitutes — alcoholism in a greater or lesser 
 degree characterized nearly all— 65 receive state aid and 
 37 are state wards. 
 
 In the Hucks family, reported by afield worker in 
 Massachusetts, 315 Hucks, including 121 others who 
 have married into the family and have been included in 
 the study, there have been 112 matings, producing 12 
 epileptics, 50 alcoholics, 52 sexually immoral, 56 proba- 
 bly sexually diseased, 48 feeble-minded, all morons. 
 
 "The Village of a Thousand Souls" is a middle- 
 western town observed by Gessell for the past 33 years. 
 Out of 220 families, feeble-mindedness was found in 37, 
 alcoholism in 36, insanity in 22, epilepsy in 3, and a 
 number of eccentrics scattered throughout the village. 
 
 The tribe of Ishmael was a tribe traced back by 
 McCulloch to 1790, comprising 30 family units, 62 indi- 
 viduals whose descendants in the six generations num- 
 bered 1,750 known, and 5,000 estimated, resembling 
 that of "The Jukes," a family studied by Dugdale in 
 1887 in which he reports 1,200 individuals— 280 were 
 professional paupers, 140 criminals, 60 habitual thieves, 
 50 prostitutes, a total of 2,300 years in the poor house, 
 7 murderers. He reports their cost to the state at a 
 million three hundred and eight thousand -dollars. 
 
 We cannot expect the development of a pure, 
 healthy, and noble race of women and men, when the 
 blood of the mother and father has inherited determin- 
 ers, that must produce their kind and has been poisoned 
 
33 
 
 by the contagion of vice and the effects of syphilis. 
 
 Can the vulture breed the eagle? Can the jackal 
 engender the lion? 
 
 The treatment of this problem, notwithstanding 
 the difficult sociological aspects, is relatively simDle. 
 
 Segregate, prohibit marriage, and sterilize. 
 
 All three measures within the limit of agencies 
 under social control. 
 
 We realize however, when it comes to selecting a 
 breeding class, we tackle the trinity of biology, psycho- 
 logy, and sociology, rolled into one problem of a formid- 
 able bulk. 
 
 The ancients regarded idiots, imbeciles, the 
 feeble-minded, and neurotics as God cursed, fit only for 
 reproach and persecution. 
 
 The Spartans made short work of them. 
 
 Early christians were compassionate and merciful. 
 
 In 1837, Sequin founded a school for idiots in 
 Paris and brought his gospel to America. 
 
 In 1842, Guggenbuhl studied and formed a colony 
 for Cretins in Switzerland. 
 
 In 1850, he was impeached and the institution 
 abolished. 
 
 Seagert established a school for imbeciles in Ber- 
 lin in 1845. 
 
 William Twinning and Miss White founded a pri- 
 vate school for defectives in Bath, England, in 1843. 
 
 In 1848, Park House, High Gate, was made the 
 home of 27 children, and two years later these with 23 
 more were removed to Essie Hall. 
 
 Since that time, the interests in these unfortunate 
 human beings have increased to national dimension, and 
 even yet twelve states of our union have no laws at all 
 upon the subjects of the marriage or divorce of the in- 
 sane, feeble-minded or epileptic. 
 
 Thirteen states have no home for the feeble- 
 
34 
 
 minded. 
 
 I don't think the question of segregation is any 
 longer debatable. All intelligent people agree that 
 something must be done to protect these unfortunate 
 beings, girls especially, must be protected during the 
 child-bearing period. 
 
 This is a Herculean task and is likely to become 
 burdensome. 
 
 It is conservatively estimated, that there are, in 
 the United States today, three-quarters of a million in- 
 sane and mental defectives at an annual cost of 110 
 millions, and yet one-quarter of this million is allowed 
 to propagate their species, which if we do not wage a 
 moral, political and physical campaign against, history 
 will, in the course of time, brand us a nation, once pow- 
 erful, bur. now degenerate. 
 
 I don't think any state has yet felt that it could 
 bear the increase taxation necessary to segregate all of 
 its defectives, and yet we arc constantly reminded that 
 they are on the increase. 
 
 To the thinking mind, something more radically 
 effective must be done. 
 
 I am fully aware that even in our profession, there 
 are those that believe that the communication of disease 
 in marriage is a matter between husband and wife and 
 that society has nothing whatever to do with it. 
 
 Society should be the foundation of life, and 
 strength to the state and nation. 
 
 Can the heart of a great State, as revealed in her 
 laws, be rotten and her children be pure, healthy and 
 virtuous? 
 
 When the mother, a leader in society, a woman of 
 of untold influence, spends a greater part of her time, 
 mentality and energy in what she terms innocent and 
 instructive amusement, in being the victor of a prize at 
 
35 
 
 a bridge party, that would equal in cost the heaviest 
 losing at a one dollar limit, poker game during a sitting 
 of four hours. In other words, she points to the gamb- 
 ling table and the deceitful smile of chance as a royal 
 road to caste, to wealth, to position in state and church. 
 
 "What shall it profit a woman if she gain the 
 whole world of academics of social distinction and lose 
 her own soul of motherhood?" 
 
 The laws of the state are defective, society is 
 rotten, when they do not consider man and his offspring 
 from the following standpoints: The development and 
 perfection, of the individual, physically, intellectually 
 and morally for time and eternity, as an individual, 
 with reference to his fellowmen and his relations to his 
 Creator in time and eternity, says Dr. King. 
 
 He says further that society owes it to God and 
 our nation to hand down to posterity a vigorous man- 
 hood and womanhood, and thereby wipe out the great 
 social evils, alcohol and syphillis, that are giving us a 
 heritage of moral and physical weaklings, to tax our 
 respective states for appropriations almost beyond en- 
 durance. 
 
 You ask, What the Remedy? Let every man's 
 standard of social morality be elevated, proclaim to the 
 world that the libertine cannot enter your home, ostra- 
 cize the social circles that entertain him, do not absolve 
 the male offender against immorality while condemning 
 to social infamy the femaie offender. And while the 
 tendency of the age is to magnify motherhood and mini- 
 mize fatherhood, magnify both. 
 
 I know the clergy and the educators stand in awe 
 at the thought of imparting to our young women and 
 young men, a knowledge of the hygiene of the repro- 
 ductive functions. 
 
 Social prophylaxis must be the pass word. 
 
 We must pass laws preventing marriage of 
 
36 
 
 feeble-minded, especially those who are such by heredi- 
 ty. 
 
 Twenty-three states and three territories have 
 what is so called Eugenic marriage laws, under which 
 marriage is denied being as follows: Insane 24, idiot or 
 imbecile 23, epileptic 9, feeble-minded 8, pauper 4, 
 drunkard 3, physically incapable 3, venereally diseased 
 3, and habitual criminal 1. 
 
 Along with marriage regulation marches the 
 sterilization of extreme cases of defectives, California, 
 Connecticut, Indiana, Iowa, Kansas, Michigan, Nevada, 
 New Jersey, New York and North Dakota have passed 
 laws permitting the operations of fallectomy and vasec- 
 tomy in accord with state regulations. 
 
 I fully realize, that we are likely to, and may 
 have already, called down the wrath and denunciation of 
 our theological brethren upon our views and eugenic 
 ideas, and the only argument I have to quote is Mr. 
 Hall's words, verbatim, which are as follows: 
 
 "The slogan of eugenics, a new religion, the 
 religion of this world, not of another, has caught the 
 imagination and won the applause of many who are 
 critical if not hostile to Christianity. But why call it a 
 new religion? Is not all of it simply a legitimate new 
 interpretation of our Christianity? Is it not all latent 
 in our Scriptures? Was anything more characteristic 
 of the ancient Hebrews of Old Testament davs than 
 their purity and to keep the purity of their blood, then 
 duties of parents to children and vice versa, and is 
 there any trait more peculiar to the Jews in our day 
 than that they excel all races save perhaps one in fecun- 
 dity? The very covenant of Jehovah with Abraham was 
 that if he kept God's law his seed should be as the stars 
 of heaven for multitude, as if that were indeed the 
 chief human felicity. This means, according to the 
 newest and highest psycho-genetic criticism simply that 
 Jehovah's laws are at bottom those of eugenics. 
 
37 
 
 The supreme criterion of virtue indeed is living 
 in every item for the interests of posterity. The world 
 is for the chosen, the best. It belongs to those who 
 come after us, who will be in number like the grains of 
 sand upon the shore. That their seed fail not is the 
 supreme blessing. 
 
 The entire Old Testament, from the myth ofEden 
 to the latest prophets needs a new eugenic exegesis, 
 while the dominant theme of the New Testament is 
 love, the strongest thing in the soul of man, centered 
 upon service and welfare of the race. 
 
 Love and serve God and man; that is the quintes- 
 sence of our religion. We only need to turn a little 
 larger portion of the love and seryice we have directed 
 toward God, who does not need it, to man who does, 
 and we have eugenics, for who serves mankind so much 
 as he who transmits the sacred torch of heredity, which 
 is the most precious of all wreaths and worths, un- 
 dimmed to later generations by bringing more and bet- 
 ter men and women into the world and rearing them to 
 the fullest possible maturity? 
 
 Read in this field and you will see only what has 
 so long lain concealed in Christianity standing forth 
 here revealed. The beatitudes are full of it. The meek 
 inherit the earth on the simple biological law that over- 
 individuation is at the expense of the genesis and be- 
 yond a certain point inversely as it . . . Christian- 
 ity has never said all it meant. It is not yet all reveal- 
 ed to man." 
 
 Ancient Greece gave us the heritage of an intel- 
 tectual, moral and political education. For the pure 
 life, the health of the body and soul, we point to Plato, 
 the Athenian, the pupil of Socrates, whose works re- 
 main to this day the great models of Athenian genius, 
 elegance and urbanity, and whose philosophy has been 
 the admiration of all ages. 
 
The scientific physician is entrusted with the 
 lives of his fellowmen; his life is spent in nearest com- 
 munion with the sick and dying, in sight of the very 
 gates of eternity. 
 
 From a sociobiological point of of view, he is the 
 most potent of all factors in emancipating from the I 
 
 social evil. 
 
 To the most 
 her most delicate 
 
 modest woman, without offending j 
 sensibilities, he can speak of sexual 
 life and its diseases, and how often he can forestall the! 
 shadow that has fallen over many a home and blighted 
 lives with wrecked nerves and tortured mentality. The 
 highest type of the physician today is the moralist as j 
 well as the hygienist. 
 
 Now gentlemen, let us strive the harder to en- 
 lighten the public and assist the legislature and the I 
 advocates of eugenics along such lines as tend to, or] 
 will relieve, or prevent the undesirable. 
 
 Then we shall be like the coral insect, helping to] 
 rear an edifice, which emerging from the vexed ocean 
 of conflicting credence, shall be first stable and secure 
 and at last cover itself with verdure, flowers and fruits! 
 and bloom beautiful in the face of heaven. 
 
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