Vermont Eugenics
Vermont Eugenics Survey Era Study of 62 'Normal' Kurn Hattin Boys
The New England Journal of Medicine November 29, 1934
VERMONT STATE MEDICAL SOCIETY
BY J. H. BLODGETT, M.D., AND W. I. MAYO, JR., B.S.
OBSERVATIONS ON CERTAIN PHASES OF THE HEALTH OF SIXTY-TWO NORMAL BOYS OVER A PERIOD OF A YEAR TOGETHER WITH A DESCRIPTION OF A METHOD OF ROUTINE PHYSICAL EXAMINATION
*Read before the Vermont State Medical Society at its Annual Meeting at Barre, October 5, 1933. Blodgett, J. H.—Chairman, Executive Committee and Attending Physician, New England Kurn Hattin Homes. Mayo, Jr., W. I.—Director of New England Kurn Hattin Homes.
The New England Kurn Hattin Homes of Westminster and Saxtons River, Vermont, admit children who are between the ages of seven and fourteen and who for various reasons have been deprived of a normal home. The trustees are required by the Articles of Association and by the terms of certain bequests to admit only children who are of normal mentality and who are in normal physical condition. They are not permitted to admit delinquents or to do correctional work.
The Healy test for children as administered at Kurn Hattin Homes for Children was originally designed by William Healy, a Harvard-trained psychiatrist and neurologist and, director of the Chicago Juvenile Psychopathic Institute (formed by Judge Harry Olson, who advised the Eugenics Survey of Vermont) designed for the mental classification of juveniles adjudicated in the courts of that city. Healy’s test detected juvenile ‘delinquents’ or ‘defective and aberrational individuals’ as he termed them. Though he worked for the court, Healy was not a champion of juvenile courts, on the contrary, he doubted their rehabilitative capacity. In 1913 Healy's test was used at Ellis Island to test Jewish, Italian, Russian and Hungarian immigrants for feeblemindedness. The test results were used in the justification for the 1924 Immigration Act, introduced by the Republican Senator from Vermont William P. Dillingham during the administration of Vermont native, President Calvin Coolidge, which limited the number of immigrants allowed entry into the United States from the countries in the Ellis Island study based on a national origins quota derived from the 1890 census. The U.S. War Department requested it for testing troops in 1917. In part, it was Healy’s test that led to the revelation of low intelligence scores of Vermont draftees during World War One. The resulting injury to Vermont’s miraculous sense of exceptionalism, perceived loss of the state’s ‘old pioneer stock’ and Vermonters endemic xenophobic / eugenics mindset, class consciousness and pathological fear of the ‘feebleminded’ were a major stimulus in the development of the Eugenics Survey of Vermont.
To determine eligibility for admission it is, therefore, necessary to secure a complete family history for the purpose of determining financial and social need, a physical examination backed by some family information to determine the normality of physical condition, and a mental examination to determine in some degree whether the child is of normal mentality.
During the time period of the Eugenics Survey of Vermont, Kurn Hattin Homes for Children participated in a 1935 Survey of Superior Germ Plasm and cooperated in providing data for this survey on superior genetic heredity. Eugenicist and American Genetics Association member, J.H. Kempton, also participated in the Superior Germ Plasm study. Kempton wrote in the Journal of Heredity, Plant, Animal Breeding and Eugenics, a review entitled, Sterilization of Ten Million Americans, of the book, A Case for Sterilization by Leon Whitney. Whitney (the book was personally requested by Adolf Hitler) advocated for the benefits of eugenical sterilization to the Eugenics Survey of Vermont, and Kurn Hattin director William Mayo, Chairman of the VCCL Committee on the Handicapped whose sole purpose, as stated by UVM Prof. Henry Perkins, was to ensure the enactment of eugenical sterilization law in Vermont. Kempton opines in the Journal:
“The real problem facing industrial civilizations is not human production but human reproduction. Everyone is agreed there are too many people supported by public charity and that many of these are incapable of living the abundant life even in good times. One of the suggestions as to how to eliminate this population of undesirables is to sterilize them, the premise being that they all arise from defective forbears and give birth to defective offspring. What every one wants to know is how many are to be sterilized and how it is proposed to choose them? Further, is the choice to be left to legislators and professors or is it to be voluntary? To the first of these questions the author supplies an explicit answer, namely: at least ten millions should be sterilized.”
There has to be some interpretation of the word normal. This is more difficult in dealing with the mental condition than with the physical. As a definition and guide to determining normal mentality the trustees of the Homes have turned to the experience of the State of Massachusetts where the Department of Mental Diseases and the Department of Education have cooperated in setting up regulations for determining children retarded in mental development. These regulations include ten fields of inquiry: the physical examination, the family history, personal and developmental history, school progress, examination in school work, practical knowledge and general information, social history and reactions, economic efficiency, moral reactions, and mental examinations.
In determining eligibility for admission of children, the Homes are increasingly having the help of social workers throughout New England. In Vermont this is particularly true. The Vermont Children’s Aid Society has for a consideration undertaken investigation where it could conveniently do so, and Kurn Hattin in turn for consideration has assisted in the training of children in their care. Sixty per cent of the children come from Vermont. Local physicians make the preliminary examinations and it is desired to express appreciation to the Medical Fraternity of Vermont and other New England states for this most valuable service.
The information needed for these determinations is collected on a Physical History Blank and a so-called Social History Blank. After the child arrives, a standard Binet test [Psychometric Test] is given which supplements the information given on the other blanks. The Binet test alone is never allowed to be the determining factor in arriving at a decision concerning a child’s mental development, but children as a rule are excluded who do not have an intelligence quotient of eighty or better. The policy of the trustees is that the Homes furnish a training program. This means that the children accepted must be able physically and mentally to profit by such a program. The Homes, however, attempt to correct minor physical defects which may occur after the children are accepted, such as adenoids and eye difficulties and, of course, dentistry. Each child is treated as an individual and records are kept of all activities. These include school work, hospitalization, clinic treatment, -- vocational training, and a personal record. A trial period of six months is given each child and during that period routine reports and studies are made by all workers with whom the child comes in contact. At the end of this period if it is felt that the expenditure of the necessary funds for a given child is not warranted, he or she is not retained.
Problematic assumptions were built into modern education systems in the decades around the turn of the 19th century and its application of mass schooling, psychometric testing, and modern examination. Mass schooling, psychometric testing and eugenics were all developed at a similar time during the 1800's. Eugenics helped establish the argument for psychometric testing and set in place some of its basic assumptions. Psychometrics in turn helped produce principles of examination and population control that guided the development of mass schooling and eugenical examination. Psychometric testing had a huge influence on the early development of statistical science and played a role to in political developments taken up not only by Nazis Germany but also by many states in the US including Vermont, which used its endemic eugenical culture and science to justify eugenic sterilization law targeting its most marginalized and vulnerable citizens who were judged by their own families, caregivers, neighbors, or doctors to be inferior in some way. It was and remains a hateful perspective on what is the inherent sanctity of human life... Kurn Hattin Homes Department of Psychometrics Mental Test
Menus are carefully planned to give a balanced diet. Weights and heights are recorded each six months but are taken monthly. The school program is flexible allowing each child to progress as rapidly as he is able. Seventh and eighth grade work is supplemented by shop or farm work. The homes have facilities for teaching printing, agriculture, carpentry, sewing, and household economics at the present time. Other vocational work is planned for when funds permit. No time is set for discharge but it has been found possible to plan for most of the children adequately by the time they are ready to leave the eighth grade. Some few are allowed to stay longer if necessary. Each child is given a complete physical examination before leaving.
A very strict rule sends all cases or suspected eases of illness directly and immediately to the infirmary for observation by a registered nurse who is always in attendance. A record of all infirmary attention, no matter how unimportant or trivial, is kept on a special admission blank. The nurse hospitalizes any cases which require the attention of the attending physician and calls him. A record of the physician’s diagnosis and treatment is kept on a special card, which later is made a part of the child’s permanent record.
Dental treatment is given at the dentist’s office where separate records are kept and later incorporated with the complete individual record and history. The material offered below is the result of a computation and study of the medical of sixty-two children of the Homes for one entire year. The Homes have an enrollment of ninety boys but many are accepted for a part of a year or are discharged before they complete a full year of residence.
Sixty-two was the largest number on which complete records could be obtained over the full period. Several studies were made of the records. The main purpose was to ascertain which diseases were most prevalent and the beginning of the period considered in this which times of the year one could expect the greatest amount of trouble.
The average age of the sixty-two boys considered was 12.43 years. The average weight at the beginning of the period considered in this paper was 86.98 pounds. This gave an average gain of 11.68 pounds.
The first chart depicts a study made regarding the relation of mentality to hospitalization. The question is often raised as to the relationship of physical make-up to intelligence. Most of the studies along this dealt with the lower levels of intelligence as a matter of interest and not because it proves anything in particular, the chart below was compiled. With the number of boys considered there is some evidence that might lead one to feel that those of higher intelligence were more often ill. In any case further study with larger numbers would be interesting. This would be true of all the studies.
This Chart two shows the complete hospitalization picture pertaining to the sixty-two individuals under consideration. The bars represent the number of individuals affected by the various diagnosed diseases. All of the diagnoses were made by a doctor. One individual may have had several diseases. Colds and coughs head the list, followed by measles. There was one case of scarlet fever and three of whooping cough.
Chart three shows the same picture as chart two except that the bars represent hospital days instead of numbers of cases. The order remains about the same except that the contagious diseases have required more time because of long quarantine periods.
Chart four shows the clinic treatments given the sixty-two boys over a yearly period. The bars represent ‘number of treatments regardless of the individuals considered. Diagnoses were made by the nurse in most eases. Some of the clinic cases were later hospitalized so that there is some duplication with chart two.
In order to study the seasonal distribution of colds and sore throats charts five and prepared. It may be interesting to six were note that in the particular year under consideration (1932) clinic treatments of colds and sore throats were in larger number in December, while hospitalization cases were most prevalent in March. The lightest months for both hospital and clinic cases were June, July and August.
A description of the method of routine physical examination used at the Homes follows: Beginning at the top of the head the} scalp is usually found negative. The frontal, ethmoidal, and maxillary sinuses are next examined. Serious involvement of these parts in children of the age under consideration is rare. Nasal polypi is almost never found.
As middle ear trouble has been very |common among children admitted, careful attention is given this portion of the head and any|signs of infection there are noted and carefully followed up. The attending physician has equipped himself to do special work in the field of eye, ear, nose and throat, as in the midst of epidemics these fields often become involved and daily work is required.
When a child is found to have 20/30 in each eye he is allowed to try regular work but the teacher is requested to watch him carefully. If the vision is under 20/30 the routine test as outlined at the Massachusetts Eye and Ear Infirmary, with refraction under Homatropin, is carried out. Necessary glasses are supplied.
Teeth are given early care. New admissions are sent to the dentist as fast as appointments can be made. Serrated edges of the teeth suggest struma possibly from lues or tuberculosis. There seems to be some difference of. opinion among dentists as to what are considered Hutchinson teeth. It is the opinion of the writer that it is better to depend upon the particular shape in making this determination rather than on the nutritional condition.
A routine Wassermann [antigen reaction derived from monkey tissue extracts in the diagnosis of syphilis] is not done. Because of the small size of the vessels of the child and because he is sometimes frightened and disturbed by his new surroundings it has seemed inadvisable to cover this ground. An experience of thirty years has not given occasion to regret this seeming neglect. If there has been any suspicion of a possibility of lues it has always been possible to get the cooperation of Boston agencies in having laboratory investigation made there.
Tonsils and adenoids are studied carefully. In deciding whether to operate many factors are considered. The most important are cervical and other glands, mouth breathing, type of arch in the roof of the mouth, physical and mental activity, chest, size of joints, and symptoms of rheumatic pains. It is felt that too many tonsils are removed. Yet this year when ten children were examined who had had their tonsils removed and six were examined who had not, the ten were found to be in strikingly better physical condition than the six.
Tonsillectomies are performed at the Rockingham Hospital with after-care in the Kurn Hattin Infirmary. The operation as performed at the Children’s Hospital in Boston is the technic used. The principal features of this operation are sitting position, continuous ether and suction, with dissection and snare. Each assistant is trained for his post and the operators and assistants are trained to work together. It is thought that free clinics, unfamiliar operation teams, and lack of adequate after-care, especially rest in bed, are a menace to children.
In completing the examination of the head it is thought well to bear in mind the possible connection between thyroid disease and an infected nose and throat. There may also be infection of the apices of the lungs from the same sources.
The chest like the middle ear is always a source of anxiety in epidemics, although at the Homes comparatively few cases of congestion in proportion to the total develop pneumonia. In all colds it is the practice to prescribe routine cleansing of the nose and throat. With definite pneumonia it has not been felt that the serums could be afforded but Lilly’s Pneumococcus Antigens have been found of the greatest assistance. Pneumonia complicating whooping cough and Fisher’s Rule as to prognosis in pneumonia were the subject of an interesting study recently. Dr. C. Lynnwood Chaffee, now of Jeffersonville, Vt., assisted and made observations which are here presented in chart form.
These studies would seem to show that while the relation of blood pressure in adults to pulse rate is of real prognostic value in pneumonia, in children it is not of value unless the child’s normal pressure can be determined. A case of tuberculosis is rarely discovered. If one does appear it is sent to the Preventorium and Sanatorium immediately.
For convalescence from chest cases a kind friend has given funds for two sun porches, capable of housing ten patients. These porches are heated and can thus be used summer and winter. It is hoped that we may soon have glass which permits the transmission of the violet ray, if only for a small corner.
In diseases of the heart, while records of functional murmurs are not available in these studies, it is believed that about twenty-five per cent of the cases in measles, pneumonia, scarlet fever and influenza develop such murmurs. These all call for rest in bed until the normal function of the heart is restored. The prophylaxis of serious heart disease and the prevention of the spread of contagious diseases add greatly to the number of days spent in the infirmary. It is believed that such hospitalization is one of the best services undertaken. The heart clinics of Philadelphia, New York, Boston, and the Mayos hold that much of the cardiac disease of later life is caused by lack of proper care of the heart during these acute infections.
Preventive medicine is being attempted and in this connection toxin-antitoxin for prevention of diphtheria is given. The State Board of Health does not advise the Dick work in its present state of development. For several years immunization against pneumonia and the common cold has been done. This was successful for the first six years, then the treatment seemed to break down, and it was decided to omit it. A healthy body with all organs functioning is the aim at graduation time.
In examining abdomens, hernias or appendicitis cases are rarely found. Constipation and ‘‘intestinal grippe’’ infections are frequent. Constipation has been corrected with a glass of water after each meal. Cases of enuresis [bed wetting] are not admitted. It is believed that this indicates a weakness of the central nervous system so much so as to amount to a defect.
University of Vermont (UVM President Guy Bailey was also president of Kurn Hattin Homes) Zoology Professor, Henry Perkins, head of the Eugenics Survey of Vermont, requested in an official ESV correspondence to Kurn Hattin Homes director W.I. Mayo, Jr., the records of all Kurn Hattin children. In a 1926 proposal - Suggestions for Schedule for Eugenics Survey of Vermont - Perkins writes: Medical History - Habits might include nail biting; thumb sucking; nervous twitching; throat spasms. Enuresis might be subdivided. - Daily, Nocturnal, Both.
A State Eugenics and Social Welfare Bulletin published in 1916 expounds on the same eugenical perspective of enuresis put forward by Kurn Hattin Homes as justification for their discriminatory admission practices: The occurrence of bed-wetting among institutional feeble-minded is partly explained at least by their low mentality. The higher rate for incontinence of urine among the feeble-minded may be accounted for by the fact that they are more defective. However, institutional children are not normal, at least 50 per cent. of them being recognized as mentally defective or nervously subnormal. In each of the cases where there is feeble-mindedness in the immediate ancestry there are also neurotic tendencies, and from this we may judge that the feeble-mindedness may also mean a condition of feeble-nervedness.
Enuresis is, as a rule, considered pathological and as being frequently associated with other perversions, such as masturbation, and is more common among boys. The presence of peculiar acts, and unnatural habits point strongly to a possible mental cause. The author is of the opinion that at least 90 per cent. of the cases of enuresis occurring in youth are due to 'self-abuse.' This habit he believes is to be expected of the inmates of orphan asylums and other institutions owing to seclusion, intimate association, and lack of diversion, in bodies and minds weakened by ancestral immorality.
The general appearance of the child is noted, particularly as it may relate to his mentality. The Massachusetts bulletin previously referred to states, ‘‘A bright-looking, alert, active, well-formed, attentive boy is rarely found to be mentally defective.’’ We believe this to be true. This completes the work of examination. The data are recorded and placed on file. Immediately before discharge the child is given another medical examination in order that the management of the Homes may be sure that all correctable defects have been given attention.
In a 1926 research project on “Rural Subnormalcy” the director of the Eugenics Survey of Vermont (funded by Kurn Hattin Trustee Emily Proctor Eggleston), UVM Professor Henry Perkins, proposed “to make a study of school children to learn the extent of mental and physical defect and the relation of these to the school grade, behavior, race, social and economic status of the family, language spoken in the home, and to the mentality of the parent.” Perkins proposed administering psychometric tests to thousands of Vermont children, then individually testing those with an IQ below 75. This same group was to be given physical and dental exams and studied as to “environmental and home conditions, race admixture, mentality, and antisocial behavior of parents, fraternity and so forth.” Kurn Hattin Homes for Children / UVM President Guy Bailey made the official grant application, which received $84,000. The organization created to carry out the 3 year comprehensive survey of rural Vermont was christened the Vermont Commission on Country Life.
The resulting Commission on Country Life, chaired by Vermont Governor and Kurn Hattin Homes Vice President John Weeks, immediately generated tremendous interest among progressive era Vermonters. Three hundred zealous citizens, were organized into 30 committees and subcommittees, whose task ultimately, was to suggest answers to the burning question of fear driven Vermonters during the 1920’s: “What is happening to the old Vermont stock?” The Committee on the Handicapped was the only committee of the 30 to serve both the VCCL and the ESV. Chaired by Kurn Hattin Homes for Children Director, William Mayo, The Handicapped Committee was, as stated by Perkins, for the purpose of ensuring the enactment of eugenical sterilization legislation. Kurn Hattin director W.I. Mayo and his ‘Handicapped’ committee were successful to their ends in 1931 when Act 174 “An Act for Human Betterment by Voluntary Sterilization” was signed into law.
The following Comprehensive Survey of Rural Vermont (VCCL) records of Kurn Hattin children, in cooperation with the Vermont Children’s Aid Society, Red Cross, Vermont Department of Public Welfare and the Sheldon Poor Farm, clearly reveal Kurn Hattin’s intent, role and participation in the Vermont Commission on Country Life, its Committee on the Human Factor – Committee on the Handicapped and the Eugenics Survey of Vermont.
Blodgett, J. H. Ph.D., M.D. University of Vermont College of Medicine 1897. Formerly: Vice-President of the Vermont State Medical Society. Now: Chairman, Executive Committee and Attending Physician, New England Kurn Hattin Homes. Address: Bellows Falls, Vermont. Associated with him is:
Mayo, W. I, Jr. B.S. Formerly: President of Vermont Conference of Social Work. Now: Director of New England Kurn Hattin Homes for Children. Chairman, Committee on Handicapped, Subcommittee of the Committee on the Human Factor for the Vermont Commission on Country Life and Eugenics Survey of Vermont. Address: Westminster, Vermont.