Mongolian idiocy

The obsolete medical terms Mongolian idiocy, Mongolism, Mongoloid, etc. were used to refer to a specific type of mental deficiency associated with the genetic disorder now more commonly referred to as Down syndrome. The obsolete term for a person with this syndrome was Mongolian idiot.

This article is about an outdated medical term for Down syndrome. For the modern country in east-central Asia, see Mongolia. For the empire which existed during the 13th and 14th centuries, see Mongol Empire.

In the 21st century, these terms are unacceptable, no longer in common use, and largely forgotten[1] because of their offensive and misleading implications about those with the disorder. 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 by itself

While the term idiot in modern use is not technical and simply means a stupid or foolish person, it was formerly a technical term in legal and psychiatric contexts for some kinds of profound intellectual disability where the mental age is two years or less.

The term was gradually replaced by the term profound mental retardation, which has itself since experienced euphemism evolution and been replaced by other terms.[4] Along with terms like moron, imbecile, and cretin, idiot is archaic in those technical uses and has become offensive in those contexts.

History of the term Mongolian idiocy

English physician John Langdon Down first characterized the syndrome that now bears his name as a separate 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 syndrome shared facial similarities with the populations that Johann Friedrich Blumenbach described as the "Mongolian race", Down used the term mongoloid.[8][2]

Mongolism and its Pathology was the title used by W. Bertram Hill for a published study in 1908.[9] The term mongolism was used by psychiatrist and geneticist Lionel Penrose as late as 1961.

Racial pseudoscience and the term

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

Professional rejection of the term

In 1961, a prestigious group of 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, the World Health Organization (WHO) resolved to abandon the term at the request of the Mongolian People's Republic.[3] Despite several decades of inaction and resistance, the term thereafter began to fade from use, in favor of the term such as Down's Syndrome, Down syndrome and Trisomy 21 disorder. However, as late as 1980, Stephen Jay Gould reported in the book The Panda's Thumb that the term "mongolism" still remained in common use in the United States, despite its being "defamatory" and "wrong on all counts".[11]

In the 21st century, these and all related obsolete medical terms for the syndrome are considered unacceptable in the English-speaking world, are no longer in common use, and have been largely forgotten.[1]

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.
  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.
  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.
  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. p. 168. ISBN 9780393013801. OCLC 781219337.
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