For sheer readability, Simon Jarrett has few peers in the burgeoning field popularly known as the Medical Humanities. This partly derives from a crucial task Those They Called Idiots sets itself. Each of the three parts of this monograph carefully contextualizes the shifting proliferation of terms foisted upon the mentally disabled (and the mentally ill with whom they are often equated). At the same time, Jarrett explicitly inducts his readers, be they professional or lay, practitioners or theorists, into the shift in current Anglophone attitudes towards the mentally disabled. It is a shift he identifies since the 1994 North American volume Inventing the Feeble Mind by James Trent and the 1996 British anthology From Idiocy to Mental Deficiency edited by Anne Digby and David Wright (15-16).   

This critique will basically undertake three overlapping tasks. We shall firstly sample the introductory means by which readers are drawn into past prevailing attitudes and assumptions that insidiously infiltrate the present. Next, we shall explore key features of Jarrett’s actual historical practice particularly when dealing with Joseph Banks and John Langdon Down. Thereafter, we shall briefly conclude by questioning the nature of Those They Called Idiots. 

I

Jarrett immediately introduces his readers to one of his first male patients. Admitted in 1924 at the age of six, the patient’s file described him as “a bat-eared cretin” (7). Having entered the world as “a bat-eared cretin,” why, asks Jarrett, was he “never allowed to be anything else” (8)?

So begins a series of questions with which Jarrett has wrestled since the ‘eighties whilst working with people whom he initially knew as people “with mental handicaps, then people with learning disabilities/difficulties, then as the intellectually disabled, and who, at other times, had been known as mentally subnormal, defectives, morons, cretins, feeble-minded, mentally retarded, idiots” amongst many other labels (8). Five questions immediately ensue:

Why did the name keep changing? Who were these people? Who decided that they were these people? Why, if not ill, were they managed and treated by doctors? Had they always lived in asylums…? (8)

Then, as Jarrett begins to elaborate these questions, his monograph’s five key themes are also enunciated. First of all, “the army of professionals” employed nowadays to work with the mentally disabled largely regard them as lacking a history as if they were “an unchanging, universal phenomenon over time” (8). All that apparently needed altering were therefore faulty methods of treatment and inadequate public policies of previous generations. Secondly, given frequent changes in how the mentally disabled were described or categorized, what did such changes signify?  Alternatively expressed, does the use of different descriptions signify different kinds of mentally disabled people or does it signify different generations’ views of “what, and who, merits exclusion on the grounds of mental capacity” (9)? Thirdly, evidence culled from the era before the 1792-1815 World War suggests that those described as “idiots and imbeciles lived as integrated members of [their] communities” (10). Although they were “members of families, of neighbourly and employment networks” within a predominantly agrarian realm, they were sometimes seen as “strange” and often as “amusing,” albeit vulnerable to being “bullied” and “abused” (10). Yet, Jarrett claims, “they were accepted…and were seen as naturally belonging, their differences absorbed into the everyday lives of communities” (10). In short, Jarrett frames the social evolution of British society in paired concepts associated with Ferdinand Tönnies’ influential 1877 Gemeinschaft und Gesellschaft hypothesis; their contrast pithily captured by Jarrett’s assertion “Communities adapted to people rather than people having to adapt to them” (10). 

The fourth and fifth themes mark a radical shift in attitudes towards and treatment of the mentally disabled. The fourth theme focuses upon what brought about “the great incarceration” (11) in nineteenth-century Britain of the mentally disabled in the aftermath of war. In a phrase echoing the “great confinement” emerging in the mid-seventeenth century throughout western Europe as depicted by Michel Foucault’s provocative treatise Folie et Déraison (1961[2006], pp. 44-77), Jarrett assigns the banishment of the mentally disabled amongst others to the intersection of at least three factors: firstly, “Enlightenment thought—the mania for classification and diagnosis, the construction of a set of mental attributes that constituted ‘human'”; secondly, “the rise of a centralizing and bureaucratic state” which was accompanied by “new notions of citizenship”; and, thirdly, “a newly…empowered medical profession” (11). The conjunction of such factors meant that “the idiot and the imbecile lost their toehold in society and slipped quietly into institutional oblivion” (11). Jarrett’s fifth major theme pursues the shift from banishment to extermination last century. Here, Jarrett unflinchingly explores

the bizarre entanglement of ideas of idiocy and imbecility with ideas of race and intelligence, a process that began with global exploration in the eighteenth century and ended in the scientific racism of the mid-nineteenth century, and the highly radicalized eugenic science of degeneration after Darwin. Idiocy moved… to a much darker idea of existential racial threat and danger. (17)

II

Without doubting Jarrett’s rhetorical strengths, what else does Those They Called Idiots reveal about his actual historical practice as he focuses upon Britain and its seaborne empire (occasionally supplemented by events, trends, and writers in western Europe and North America)? His carefully organized text demarcates its scope where mental disability is “not a stable historical concept” (16). Hence its manifestations “as part of everyday society” (16) opens the need for sources to reflect common attitudes, interactions, and perceptions of successive generations, be they drawn from civil and criminal court reports, the circulating slang, jokes, and gossip of the day, artistic portrayals and caricatures, popular fiction and theatre, published and private travelogues and diaries, sermons and letters. As we shall shortly see, these sources are not simply passing illustrations or shunted into endnotes, but are skilfully interwoven as a means of propelling the five key themes listed above.

Before Jarrett’s interwoven narrative, we find theorized distinctions aimed at clarifying the goal of his monograph. The most crucial distinction encountered anticipates the very question of what he means by mental disability (“idiocy”) and whether it differs from mental illness (“lunacy”). Disability is taken to being “born with some lack of mental faculties” (12), resulting in ricocheting difficulties of understanding, learning, and independence. Although these difficulties need not preclude development, mental disability, ranging from severe to mild, is an incurable “lifelong condition” (13). Mental illness, by contrast, tends to be acquired during a person’s lifetime. For all its variability, ranging “from depression and anxiety…to schizophrenia and psychosis,” such illnesses need not preclude the potential for individuals so afflicted “to recover” (13). The conflation of disability and illness often occurs because they are both perceived as “mental afflictions of some sort” (13). Indeed, although cases of, say, catatonia and dementia can have effects similar to affective, cognitive and/or physiological disabilities, the onset of either case basically represents “a change in a person’s mental faculties” (14). Furthermore, the mildly disabled (previously labelled the “feeble-minded,” “imbecilic,” or “moronic”) were gradually defined more narrowly as “those born with a lack of intellectual capacity,” that is, neither “fully ‘idiotic'” nor obviously “‘normal'” (14). 

After distinguishing the above gradation of disabilities, Jarrett concedes that derangement of the genius and the psychopath alike has attracted far more historical attention than has “idiocy” in earlier accounts of “the history of the medical profession and its heroic role in rescuing idiots from the cruel outside world, or protecting society from them through the asylum system” (15). This leaves Jarrett free to pursue the historical challenge posed by Roy Porter when reviewing the 1996 Digby & Wright anthology for the 8th May 1997 issue of London Review of Books. Idiots, suggests Porter, might well function as “the definitive Other: the living dead whose minds are irrecoverable and unfathomable” (1997, p. 23). Yet, he continues, historians can 

set about determining how idiotism was framed and named in the past—who was judged to be innocent and who impaired, and on what grounds? How were such defectives explained? Above all, how were they managed? (1997, p. 23)

In pursuing Porter’s challenge, Jarrett extends the task facing him as one which ultimately implicates our conception of what it is to be human.

Now, turning to Jarrett’s technique of narrativized interweaving throughout the nine chapters of Those They Called Idiots, consider how the following two instances undertake increasingly abstract functions, the first centred upon personal networks and the second upon social institutions. The third chapter introduces us to the naturalist Joseph Banks—but strangely not his unacknowledged collaborator Daniel Carlssen Solander, one of the designated “apostles” of the author of the pre-eminent revised taxonomy Systema Naturae (1758), Carl Linnaeus. Both men joined James Cook’s first 1768/1771 scientific voyage commissioned by the British Admiralty to the Pacific. The voyage’s other purpose was to search for evidence of terra Australis. Jarrett forecasts the initial response by Banks in April 1770 to the indigenous Gweagal: “Who were these people, recognizably human in physical form but culturally deeply alien to these European visitors? … Could it be…these strange people represented whole races of mentally undeveloped humans?” (89) Perhaps, adds Jarrett, these naked, seemingly unresponsive “‘savages’…were like the indifferent, lethargic, barely communicative ‘idiots’ they had encountered at home” (89-90). 

The point of the resemblance between “savage” and “idiot” turns upon the connection between Banks and Gilbert White, whose study published twenty years later of natural phenomena and people “including Gypsies and idiots” of provincial England was markedly influenced by not only Linneas but also Banks himself (93-94). Both were “part of the elite late eighteenth-century network of gentleman natural scientists and natural philosophers who eagerly shared and exchanged observations, findings and classifications” (92-93). Banks’ life and work serves to demonstrate the potency of “densely interconnected intellectual” networks (93).  Indeed, these networks were equally present in the sheer popularity of travel narratives whose readership included explorers, travellers, and scientists and which became “an essential intellectual tool…creating new shared assumptions” as again seen in the case of Banks and his many connections (104).

The closing of Chapters Four and Six and intermittently elsewhere bring Dr John Langdon Down into focus, less in terms of personal connections and more of legal, professional, and clinical institutions.  At first, readers encounter Down reminiscing in his first 1887 Lettsomian lecture—published in his last major work Mental Affections of Childhood and Youth—about his early realisation that “bodily formation” stemmed from the “intra-uterine life” of “idiots” (1887, p. 28). His paper, demonstrating the “corroborative proof” of “defective mental power” and its “congenital origin,” appeared “too late” (1887, p. 29; paper reprinted 1887, pp. 154-166) for the adjudication of the highly sensationalized contemporaneous 1862 trial involving the wealthy, eccentric, imbecilic William Windham’s attempt to dissolve his precipitous marriage to the exploitative, promiscuous Agnes Willoughby.  We next encounter Jarrett’s account of Down’s membership between 1864 and 1869 in the rapidly expanding Anthropological Society (207ff.). It stimulated his research and writing about cranial capacity and hierarchical assessment of human development amongst different types of non-Europeans and idiocy as exemplified by his 1867 paper (reprinted 1887, pp. 210-217) on a systematic “classification of the feeble-minded,” especially what he termed the “Mongolian type of idiocy” (pp. 212 & 214).  Ironically, his description of the latter is nowadays known as Down’s syndrome, albeit one removed from its “incorrectly attributed … racial origin” (212). 

Finally, Jarrett turns to Down’s appointment in 1858 to the publicly-funded Earlswood in southern England, specifically built three years earlier to house idiots in fifteen-bed dormitories. By the time he resigned a decade later and founded the upper-class private asylum, Normansfield Training Institute for Imbeciles, Earlswood had 455 patients. By that time, too, the “ascendency” of medicine “to identify, control and treat” the mentally disabled was paramount (241). Down himself described Earlswood as containing “every variety of imbecile mind”:

just as in the outer world there is a graduated series from the most commonplace intellects, —who are “the hewers of wood and drawers of water,” [Joshua 9.21]—up to giant minds that…impress…the age in which they live; so is there amongst an imbecile population a gradual shading in an inverse direction—from youth who might, if he had property [like William Windham], become the subject of inquiry…to one who, with every means of communication with the external world, except feeling, closed, vegetates in impenetrable mist. (1862/1887, pp. 155-156)

Indeed, Down continues, considering those whom Earlswood “shelters”:

one is able to set some…into natural groups, by simple reference to their physical state, and to predicate from that state what will be their probable future mental improvement. (1862/1887, p. 156)

Jarrett unhesitatingly sees Earlswood as the very “microcosm of the colonial system” (213). Given Earlswood’s endorsement by British royalty and its publicity during Down’s tenure, Jarrett adds, its “daily playing of the military band,” its 

well-formed lines of idiot pupils marching through the towns and countryside plugged into the deep national feelings about empire, Britain’s place in the world, military power, race and humanity… This was not an isolated, cut-off asylum… (214-215)

III

In summary, Jarrett ties his readers to specific times and places, persons and practices whilst retrospectively probing, through their oral, pictorial, and written modes of communication, the wider range of people’s attitudes towards and understanding of those deemed mentally disabled. Such understanding, for all its variability and transformations, is never made the exclusive preserve of an individual or group. Yet, when interpreting changes in wider understanding, Jarrett sees them as the result of intellectual revolutions; sometimes generalized (the “Enlightenment”), sometimes theorized (evolutionary psychology, eugenics), sometimes personified (Charles Darwin, Adolf Hitler). Further, is Jarrett’s portrayal of Down as “ambitious” (207) or his failure to acknowledge it in Banks trivial? Or does it threaten to make scientific enquiry randomly contingent, as dependent upon its practitioners’ desire to curry favour with their ruling socio-political echelon—a murderous dependency during the Nazi era’s Rassenhygiene (277ff.)? Again, by emphasizing how British law had developed by the eighteenth century and its subsequent interaction with medicine, why is far less attention given to the development of psychology over the same period? Should Jarrett’s readers be introduced to debates about, say, the enduring impact upon psychology of René Descartes’ Meditationes de Prima Philosophia (1641)? Descartes reconfigures the classical conception of persons by identifying the psyche as the source of thought or reason, re-assigning other functions or capacities as bodily or physical. Little wonder this unquestioned duality permeates not only selected quotations from Down alone, but also throughout a volume more sociologically than psychologically attuned.

R.A. Goodrich is affiliated with the A.R.C. Centre for the History of Emotions (University of Melbourne) and the A.D.I. Philosophy & History of Ideas Research Group (Deakin University), co-edited the online refereed arts journal Double Dialogues since 2002, and co-ordinates with Maryrose Hall a longitudinal project investigating linguistic, cognitive, and behavioural development of higher-functioning children within the autistic spectrum and related disorders.