Mongolian idiocy

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The obsolete medical terms Mongolian idiocy and Mongolism referred to a specific type of mental deficiency, associated with the genetic disorder now known as Down syndrome. The obsolete term for a person with this syndrome was called a Mongolian idiot.

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In the 21st century, those terms are no longer used as medical terminology, deemed an unacceptable, offensive and misleading description of those with Down syndrome. [1] The terminology change was brought about both by scientific and medical experts, [2] as well as people of Asian ancestry, [2] including those from Mongolia. [3]

The stand-alone term "idiot" itself has a similar history of meaning and connotation change. [4]

"Idiot" as a former technical term

While the term "idiot" is, in the present day, not used in a medical, legal or psychiatric context, instead meaning a stupid or foolish person, the term previously held meaning as a technical term used in both legal and psychiatric contexts for some type of profound intellectual disability, wherein the disabled person's mental age was considered to be two years or less. Along with terms like "moron", "imbecile", and "cretin", "idiot" has become an archaic description of dismissed mental capacity in legal, medical and psychiatric terms.

History

John Langdon Down first characterized what is now known as Down syndrome as a distinguishable form of mental disability in 1862, and in a more widely published report in 1866. [5] [6] [7] Due to his perception that these children shared facial similarities with the populations that German physician Johann Friedrich Blumenbach described as the "Mongolian race", Down used the term "mongoloid" in his characterisation of these patients. [8] [2]

The term continued its usage into the 20th century. A study published in 1908 by W. Bertram Hill was titled Mongolism and its Pathology. [9] The term "mongolism" was used by English psychiatrist and geneticist Lionel Penrose as late as 1961.

F. G. Crookshank published a pseudoscientific book in 1924 named The Mongol in our Midst which suggested that the syndrome was due to genetic traits literally inherited from Mongoloid races.

Rock band Devo released a song titled "Mongoloid" in 1977, describing a man with Down syndrome.

Deprecation and depreciation of the term

In 1961, genetic experts wrote a joint letter to the medical journal The Lancet which read:

It has long been recognised that the terms Mongolian Idiocy, Mongolism, Mongoloid, etc. as applied to a specific type of mental deficiency have misleading connotations. The importance of this anomaly among Europeans and their descendants is not related to the segregation of genes derived from Asians; its appearance among members of Asian populations suggests such ambiguous designations as 'Mongol Mongoloid'; increasing participation of Chinese and Japanese in investigation of the condition imposes on them the use of an embarrassing term. We urge, therefore, that the expressions which imply a racial aspect of the condition be no longer used. Some of the undersigned are inclined to replace the term Mongolism by such designations as 'Langdon Down Anomaly', or 'Down's Syndrome or Anomaly', or 'Congenital Acromicria'. Several of us believe that this is an appropriate time to introduce the term 'Trisomy 21 Anomaly', which would include cases of simple Trisomy as well as translocations. It is hoped that agreement on a specific phrase will soon crystallise once the term 'Mongolism' has been abandoned. [2] [10] [3] [1]

In 1965, WHO resolved to abandon the term at the request of the Mongolian People's Republic. [3] Despite decades of inaction to change the term and resistance to abandoning it, the term thereafter began to fade from use, in favor of its replacement, Down's syndrome, Down syndrome and Trisomy 21 disorder.

However, the term "Mongolian idiocy" was reported as continuing in use at least 15 years after the WHO's decision to abandon it; in his book The Panda's Thumb , published in 1980, paleontologist Stephen Jay Gould reported that the term "mongolism" was still commonly used in the United States, despite being "defamatory" and "wrong on all counts". [11]

Related Research Articles

<span class="mw-page-title-main">Down syndrome</span> Genetic disorder

Down syndrome or Down's syndrome, also known as trisomy 21, is a genetic disorder caused by the presence of all or part of a third copy of chromosome 21. It is usually associated with developmental delays, mild to moderate intellectual disability, and characteristic physical features.

<span class="mw-page-title-main">Idiot</span> Person of low intelligence

An idiot, in modern use, is a stupid or foolish person.

Mongolism may refer to:

The term imbecile was once used by psychiatrists to denote a category of people with moderate to severe intellectual disability, as well as a type of criminal. The word arises from the Latin word imbecillus, meaning weak, or weak-minded. It originally referred to people of the second order in a former and discarded classification of intellectual disability, with a mental age of three to seven years and an IQ of 25–50, above "idiot" and below "moron". In the obsolete medical classification, these people were said to have "moderate mental retardation" or "moderate mental subnormality" with IQ of 35–49, as they are usually capable of some degree of communication, guarding themselves against danger and performing simple mechanical tasks under supervision.

<span class="mw-page-title-main">Patau syndrome</span> Chromosomal disorder in which there are three copies of chromosome 13

Patau syndrome is a syndrome caused by a chromosomal abnormality, in which some or all of the cells of the body contain extra genetic material from chromosome 13. The extra genetic material disrupts normal development, causing multiple and complex organ defects.

<span class="mw-page-title-main">Trisomy 18</span> Chromosomal disorder in which there are three copies of chromosome 18

Trisomy 18, also known as Edwards syndrome, is a genetic disorder caused by the presence of a third copy of all or part of chromosome 18. Many parts of the body are affected. Babies are often born small and have heart defects. Other features include a small head, small jaw, clenched fists with overlapping fingers, and severe intellectual disability.

The term feeble-minded was used from the late 19th century in Europe, the United States and Australasia for disorders later referred to as illnesses or deficiencies of the mind.

<span class="mw-page-title-main">Brushfield spots</span> Spots in the iris of the human eye

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<span class="mw-page-title-main">John Langdon Down</span> British physician who described Down syndrome (1828–1896)

John Langdon Haydon Down was a British physician best known for his description of the genetic condition now known as Down syndrome, which he originally classified in 1862. He is also noted for his work in social medicine and as a pioneer in the care of mentally disabled patients.

A chromosomal abnormality, chromosomal anomaly, chromosomal aberration, chromosomal mutation, or chromosomal disorder is a missing, extra, or irregular portion of chromosomal DNA. These can occur in the form of numerical abnormalities, where there is an atypical number of chromosomes, or as structural abnormalities, where one or more individual chromosomes are altered. Chromosome mutation was formerly used in a strict sense to mean a change in a chromosomal segment, involving more than one gene. Chromosome anomalies usually occur when there is an error in cell division following meiosis or mitosis. Chromosome abnormalities may be detected or confirmed by comparing an individual's karyotype, or full set of chromosomes, to a typical karyotype for the species via genetic testing.

<span class="mw-page-title-main">Cat eye syndrome</span> Genetic partial duplication of chromosome 22

Cat-eye syndrome (CES) or Schmid–Fraccaro syndrome is a rare condition caused by an abnormal extra chromosome, i.e. a small supernumerary marker chromosome. This chromosome consists of the entire short arm and a small section of the long arm of chromosome 22. In consequence, individuals with the cat-eye syndrome have three (trisomic) or four (tetrasomic) copies of the genetic material contained in the abnormal chromosome instead of the normal two copies. The prognosis for patients with CES varies depending on the severity of the condition and their associated signs and symptoms, especially when heart or kidney abnormalities are seen.

<span class="mw-page-title-main">Trisomy 22</span> Medical condition

Trisomy 22 is a chromosomal disorder in which three copies of chromosome 22 are present rather than two. It is a frequent cause of spontaneous abortion during the first trimester of pregnancy. Progression to the second trimester and live birth are rare. This disorder is found in individuals with an extra copy or a variation of chromosome 22 in some or all cells of their bodies.

Mongoloid is an obsolete racial grouping of various peoples indigenous to large parts of Asia, the Americas, and some regions in Europe and Oceania. The term is derived from a now-disproven theory of biological race. In the past, other terms such as "Mongolian race", "yellow", "Asiatic" and "Oriental" have been used as synonyms.

Moron is a term once used in psychology and psychiatry to denote mild intellectual disability. The term was closely tied with the American eugenics movement. Once the term became popularized, it fell out of use by the psychological community, as it was used more commonly as an insult than as a psychological term. It is similar to imbecile and idiot.

The Mongol in Our Midst: A Study of Man and His Three Faces is the title of the pseudo-scientific book written by British physician Francis Graham Crookshank and published in 1924.

Rex Brinkworth MBE was the founder of the UK Down's Syndrome Association. He was a pioneer of early treatment for babies with Down syndrome through stimulation and diet. He collaborated on this with Jerome Lejeune, the French geneticist who discovered that Down syndrome is caused by an extra chromosome 21. He was also a campaigner for integrated mainstream education for children with Down syndrome, and against the use of term 'mongolism' to refer to the syndrome. By coincidence, later he and his wife themselves had a child with Down syndrome.

In typical usage, retard is a pejorative term either for someone with an actual mental disability, or for someone who is considered stupid, slow to understand, or ineffective in some way as a comparison to stereotypical traits perceived in those with mental disabilities. The adjective retarded is used in the same way, for something very foolish or stupid. The word is sometimes censored and referred to as the euphemistic "r‑word" or "r‑slur".

<span class="mw-page-title-main">Kate Brousseau</span> American professor and researcher on mental hygiene

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<span class="mw-page-title-main">Tetrasomy X</span> Chromosomal disorder with 4 X chromosomes

Tetrasomy X, also known as 48,XXXX, is a chromosomal disorder in which a female has four, rather than two, copies of the X chromosome. It is associated with intellectual disability of varying severity, characteristic "coarse" facial features, heart defects, and skeletal anomalies such as increased height, clinodactyly, and radioulnar synostosis. Tetrasomy X is a rare condition, with few medically recognized cases; it is estimated to occur in approximately 1 in 50,000 females.

<span class="mw-page-title-main">Trisomy X</span> Chromosome disorder in women

Trisomy X, also known as triple X syndrome and characterized by the karyotype 47,XXX, is a chromosome disorder in which a female has an extra copy of the X chromosome. It is relatively common and occurs in 1 in 1,000 females, but is rarely diagnosed; fewer than 10% of those with the condition know they have it.

References

  1. 1 2 Rodríguez-Hernández, M. Luisa; Montoya, Eladio (2011-07-30). "Fifty years of evolution of the term Down syndrome". Lancet. 378 (9789): 402. doi:10.1016/S0140-6736(11)61212-9. ISSN   1474-547X. PMID   21803206. S2CID   8541289.
  2. 1 2 3 4 Ward, O Conor (1999). "John Langdon Down: The Man and the Message". Down Syndrome Research and Practice. 6 (1): 19–24. doi: 10.3104/perspectives.94 . ISSN   0968-7912. PMID   10890244.
  3. 1 2 3 Howard-Jones, Norman (1979). "On the diagnostic term "Down's disease"". Medical History. 23 (1): 102–04. doi:10.1017/s0025727300051048. PMC   1082401 . PMID   153994.
  4. ↑ "The Clinical History of 'Moron,' 'Idiot,' and 'Imbecile'". merriam-webster.com.
  5. ↑ Hickey, Fran; Hickey, Erin; Summar, Karen L. (2012). "Medical Update for Children With Down Syndrome for the Pediatrician and Family Practitioner". Advances in Pediatrics. 59 (1): 137–157. doi:10.1016/j.yapd.2012.04.006. ISSN   0065-3101. PMID   22789577.
  6. ↑ Down, JLH (1866). "Observations on an ethnic classification of idiots". Clinical Lecture Reports, London Hospital. 3: 259–62. Retrieved 2006-07-14.
  7. ↑ O Conor, Ward (1998). John Langdon Down, 1828-1896: A Caring Pioneer. Royal Society of Medicine Press. ISBN   978-1853153747.
  8. ↑ Howard Reisner (2013). Essentials of Rubin's Pathology. Lippincott Williams & Wilkins. pp. 129–131. ISBN   978-1-4511-8132-6.
  9. ↑ Sir William Osler (1909). The Quarterly Journal of Medicine. Oxford University Press. p. 49.
  10. ↑ Allen, G. Benda C.J. et al (1961). Lancet corr. 1, 775.
  11. ↑ Gould, Stephen Jay (1980-01-01). The panda's thumb : more reflections in natural history . Norton. pp.  168. ISBN   9780393013801. OCLC   781219337.
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