Mongolian idiocy

The obsolete medical terms Mongolian idiocy, Mongolism, and Mongoloid 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 Mongolian idiot.

In the 21st century, these terms are no longer used as medical terminology, deemed an unacceptable, offensive and misleading description of those with Down's 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has become an archaic description in legal, medical and psychiatric contexts, becoming instead an offensive term deemed outdated and discriminatory towards those it was once used to describe.

The term was gradually replaced with "profound mental retardation", which has since experienced euphemistic evolution and been gradually replaced with other terms.[4]

History

John Langdon Down first characterized the syndrome that now bears his name 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 children with Down's syndrome shared facial similarities with the populations that Johann Friedrich Blumenbach described as the "Mongolian race", Down used the term "mongoloid" in his characterisation of those with Down's syndrome.[8][2]

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

Racial pseudoscience

The incorrect connotations of the term were popularized by F. G. Crookshank in his pseudoscientific book The Mongol in our Midst first published in 1924.

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 two decades 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]

References

1. Rodríguez-Hernández, M. Luisa; Montoya, Eladio (2011-07-30). "Fifty years of evolution of the term Down's syndrome". Lancet. 378 (9789): 402. doi:10.1016/S0140-6736(11)61212-9. ISSN 1474-547X. PMID 21803206. S2CID 8541289.
2. 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. 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. 1941-2002., Gould, Stephen Jay (1980-01-01). The panda's thumb : more reflections in natural history. Norton. pp. 168. ISBN 9780393013801. OCLC 781219337.CS1 maint: numeric names: authors list (link)