Blockheads, roundheads, pointy heads: Intellectual disability and the brain before modern medicine

Abstract

Recent work on the conceptual history of intellectual disability has pointed to a discontinuity in the seventeenth century, identifying the concept as essentially modern in a more radical sense than mental illness or physical disability. However, Galenist accounts of intellectual impairment were clearly connected (via anatomy) to neurology, which could be taken as prima facie evidence that Galenism shares with modern medicine one of its basic explanatory approaches to intellectual disability. Close textual examination does not bear out this counter-claim, at least as far as the conceptual apparatus itself is concerned. However, it does reveal a degree of continuity in the medical mind-set as discourses of monstrosity were transposed from the domain of anatomy to that of post-Cartesian psychology.

Essentialist theory of ‘hybrids’: From animal kinds to ethnic categories and race

“…Perceiving monstrosity always has an ambivalent touch to it: it inspires fear and aversion, but also curiosity and interest. Traditionally, freak births were called monstrous, as were mental (Goodey, 2005) and physical disabilities (Livneh, 1980). Nowadays, the terms ‘monster’ and ‘monstrosity’ have fallen into disrepute and only a few instances can be found in public discourse, fiction and mass media.…”

‘This cold night will turn us all to fools and madmen’: Feste, Lear’s Fool and the border between ‘idiocy’ and mental illness

“…The compression made the spirits excessively dry and led them to burning up, causing intellectual flaws like attention deficit, incapacity of conceiving difficult things (requiring more spirits than can be produced), and 'long and drawn out thoughts'. 13 While the adjective 'dry' may be taken also as a synonym of 'dull', Feste quickly rejoins it to its basic meaning as lacking water when he proposes to 'give the dry fool drink, then is / the fool not dry' (1.5.41-2). The irony of this proposed solution to mend folly was apparent to Shakespeare's audience, in that a natural fool, by medical as well as by legal definition, could not improve.…”

“…While Galen deemed that such an individual could not exist, because part of his brain would have been missing, 29 Vesalius and his followers reported some cases of the type, like a Venetian deformed 'mindless' child who suffered from an excess of catarrh and apoplexy. 30 Lear's folly morphs into madness as he is hit by trauma. The 'heart-struck injuries' (3.2.8) caused by his daughters generate a series of symptoms: temper loss, 'hysterica passio' (2.2.232), weeping, ranting, delirium, delusions, physical suffering, thirst for revenge, self-pity and hate, compulsive obsession with his daughters' ingratitude, hysterical desire to strip off his clothes, and violence.…”

Level of knowing issues and approach to persons with intellectual disabilities

“…Pojam intelektualne teškoće učestalije je u uporabi od pojma mentalna retardacija. Tijekom zadnjih 200 godina upotrebljavali su se pojmovi poput idiotizam, slaboumnost, mentalni nedostatak, mentalne teškoće i mentalna ispodprosječnost [1,2,3,4,5,6]. Postoji pet značajnih čimbenika koje je potrebito uzeti u razmatranje pri razmatranju navedenog pojma [7].…”

“…Analizom rezultata aritmetičkih sredina skupine A, na frekvencije odgovora "uopće se ne slažem" s aritmetičkom sredinom 21,5%, "ne slažem se"-aritmetička sredina 1.4%, "niti se slažem, niti se ne slažem" -aritmetička sredina 3,9%, "slažem se"-aritmetička sredina 3,1%, "vrlo se slažem"-aritmetička sredina 10,1%, te frekvencijom odgovora skupine B na odgovor "uopće se ne slažem" s aritmetičkom sredinom 13,7%, "ne slažem se"-aritmetička sredina 9,1%, "niti se slažem, niti se ne slažem" -aritmetička sredina 8,6%, "slažem se"-aritmetička sredina 3,1%, "vrlo se slažem" ima aritmetičku sredinu 3,7%, dolazimo do zaključka da je razlika u stupnju znanja značajna. Odgovori skupine B su u prosjeku za polovicu nižih vrijednosti od odgovora skupine A. Pretpostavka je da je razlika između stupnja znanja me-dicinskih sestara u Centru "NADA" i medicinskih sestara u zdravstvenim ustanovama prema osobama s intelektualnim teškoćama značajna; 5] Analizom odgovora na svaku pojedinu tvrdnju te njihovom komparacijom, ispitanici skupine A i skupine B daju istovjetne odgovore na tvrdnje 2, 4 i 5, dok se odgovorima na ostale tvrdnje [1,3,6,7,8,9,10]…”