other, perhaps. They are at liberty to reproduce at will, and institutions like Glenwood go on caring for their offspring. What are we going to do with the moron? Superintendent Witte: This is a subject in which I have been profoundly interested for a very, very long time, and I was indeed very glad to hear Judge Cummings' excellent and suggestive paper. It is a gratifying and favorable sign that the intelligent layman who has the welfare of his fellowmen at heart, is beginning to take vital interest in matters which affect the welfare of the commonwealth so seriously. I agree with Mrs. Sickels about the moron. The people are beginning to talk and write much about the moron, and yet it is evident that so many have either a very hazy or altogether erroneous conception of the condition of the individual to whom the term is applied. The moron belongs to the highest type of feeblemindedness and to the ordinary observer presents no deviation either physically or mentally from a normal standard. You cannot discover him in the street car or as he sits at the table in the cafe, or even as a casual acquaintance in the neighborhood. His defective condition is only revealed by analysis of his conduct during a long period of time or through some overt act on his part. Conduct here as elsewhere is the gauge by which life is measured. It is found that the moron is an individual whose standard is below the normal in the more important higher traits, that he is not up to the normal average individual in the neighborhood. He is particularly lacking in judgment and self-control, and in ethical sense. He is an individual without guiding ideals, and drifts along lines of least resistance; and as Judge Cummings has properly said, his ideas of right and wrong are very hazy and have no influence on his conduct. With his course in life smooth and nothing to bring out his defect, it is difficult to recognize him. But the moron is dangerous aside from his defect in the sense of responsibility, in that he is capable to bequeath his own defect or some kindred deficiency of the nervous organization to his offspring. This inherited defectiveness in the offspring may not show as moronity, but of a graver type. It may be graver forms of feeblemindedness; insanity and various nervous disorders on a cor stitutional basis; here belongs chronic criminality and also the generally incompetent in your neighborhood. What is being done to remove this cankerous condition of our commonwealth? The state here and elsewhere has made large and generous provision to minimize conditions of this kind in our human family by erecting hospitals, asylums and reformatories for the segregation of those affected, from the public and to minimize conditions as they are today brought about to some extent. But as to relief of the future, not a thing is done. We are without any real actual effort to cut at the root of the evil, so that it may not appear later on, and the evil be lessened when these little ones playing about the house shall occupy the stage. The condition of those who reduce the average is almost always depending upon an inherited weakness. In other words they are degenerates not only morons and defectives but also of kindred disorder. Degeneracy includes graver forms of feeblemindedness the insane on a constitutional basis (two-thirds at least of all coming under the care and observation): the epileptics and other forms of nervous disorder; in fact many conditions that in society and to the state spell minus and not plus. Degeneracy is a constitutional infirmity inheritable and transmissible. In order to remedy it we must go much deeper and take drastic measures; but refusing marriage certificates to those affected would be of minor efficiency. Many of these people do not care about marriage certifi cates to legalize procreation. But in order to stop this trouble from going on, to lighten the white man's burden for the future, we must go and cut deep to the very root of evil. Now, how are we going to go about it and adopt drastic measures in the legislature? People need to be informed and must be educated, and in order to educate we must get away from general academic considerations. We must have something definite to go on and be able to point to the families affected and show the people just what is meant by it. Mention was made of the girl at Mitchellville whose family has cost the state $30,000. Who paid for it? You and I helped to pay for it. People in general do not know this fact. Knowledge of the conditions of families affected should be statewide. We should have absolutely definite facts and correct figures touching the defective part of our race to find where they are located and find out how much they are reducing the average of our commonwealth. When it comes to the mat ter of affecting the pocketbook, most people will listen, even if they will pay no attention to the common welfare otherwise. Something should be done with this exceptionally grave condition. It is recommended that research touching degeneracy should be an integral and organic part of the function of the psychopathic department of the State University Hospitai. There should be state agents to find out where the degenerates exist, including the moron, where he can be recognized. The same department should also act as an educational organization. Research first and then public education later. The campaign against degeneracy should be carried on as against the great White Plague, and as we are doing against the Black Plague. Degeneracy is much greater and more burdensome than the other evils. Something should be done, so that the future will have less burdens to impose than we are bearing. We can keep these defective people separate to some extent, and in a measure help' some in that way, but we do not get anything but a fraction of those affected and what is left is too great, and if not neutralized will continue to unfavorably leaven the mass. Judge Cummings: The central thought for the state to have is to seek to take these people out of circulation so as to prevent reproduction and I think the laws we have with a little amending will be adequate for the purpose. REST IN TUBERCULOSIS. Chairman Strief: The next paper on the program is "Rest in Tuberculosis" by H. V. Scarborough, M. D., Superintendent of the State Sanatorium, Oakdale, Iowa. The paper will be found on page 235. Superintendent Scarborough: The treatment of tuberculosis consists almost exclusively of three things-rest, fresh air and diet. The matter of ventilation and the matter of diet are reduced to such an extent by the average high class living in this state that the treatment by means of rest is practically the whole thing. Superintendent Kepford: I want to congratulate this conference on this very excellent paper which Doctor Searborough has presented. I regret that he felt impelled not to read all of it. I cannot add anything to what has already been said. The importance of rest in the treatment of tuberculosis has long been known. I think as the doctor said. it is the most important single phase in the treatment. Superintendent Stewart: I enjoyed Doctor Scarborough's paper very much and from the little experience I have had with tuberculosis, I can well realize the difficulties he experiences. One particular case I recall, and I referred the case to Doctor Scarborough. A patient had recently returned from a vacation and had in her possession a bottle of medicine, looking like an iron, quinine and strychnine mixture. She had had a tuberculin skin test made which was positive. She was informed that she had tuberculosis and was given this tonic to cure it. She was very tired and could not do her work. She was running an elevated temperature in the afternoon and had no appetite. She was still fleshy but anemic. This patient was gone over by Doctor Scarborough and she was informed I believe that in all probability she had a mild pleurisy, undoubtedly of tuberculous origin. She was advised that she could take rest every afternoon, which was possible, with proper food and fresh air. She took the food and the fresh air, but could not be induced to take the rest and she is not taking it. She is very much improved and has now assumed this euphoric condition which is recognized by all associated with tuberculous patients. This euphonia is only a little less marked than in general paralysis and is recognized as being a psychotic condition, and persists so far as I know, practically up until death. Chairman Strief: I will appoint as a program committee for the March 1923 conference, Doctor Stewart, Warden Hollowell, and Superintendent Von Krog. PROGRAM COMMITTEE REPORT. The program committee reported the following as the proram for the next conference to be held in December, 1922: 1. The Educational System of the Men's Reformatory, H. M. Stiles, Superintendent of Education, Men's Reformatory, Anamosa, Iowa. 2. Infection in Tuberculosis, C. G. Field, M. D., Oakdale, Iowa. 3. Paper, Lena A. Beach, M. D. Superintendent, 4. Paper, Ralph Reed, Secretary, Public Welfare Bureau, Des Moines, Iowa. 5. Paper, Don M. Griswold, Ph. G., State Epidemiologist, 6. Institution Accounting, R. R. Bovey, Accountant, Board of Control of State Institutions, Des Moines, Iowa. The conference adjourned sine die. |