In 1965, the World Health Organization (WHO) yielded to pressure and renamed “Mongolian idiocy” as “Down’s syndrome”. Yet variations of the outdated term persisted colloquially for decades.
Mongolian idiocy was coined in the 1860s by John Langdon Down when he was Earlswood Asylum medical superintendent. The term, like its creator, was a product of ideas that were debunked decades before the WHO dropped the term.
Like many superintendents in the mid 19th century’s rapidly expanding asylum sector, Down focused on making his specialism scientific, observing, measuring and classifying the humans in his charge. This was – ostensibly – to help him manage and “train” them according to their needs.
Divisions of humans
Down’s classification used a widely accepted 18th century division of humanity into five “great races”, including American/Aztec, Ethiopian, Malay and Mongolian. This became a hierarchical ladder, with Caucasians at the top.
He drew on this in his 1866 paper Observations on the Ethnic Classification of Idiots, claiming to observe the features of the other four ethnicities in his (white) patient population. Most prevalent was the “great Mongolian family”.
Down described patients as “typical Mongols”, finding the similarity so striking compared to ethnic Mongolians that it was “difficult to believe that [they] are not children of the same parents”.
Down bolstered his rather superficial observation by referencing contemporary scientific theories. Chief of these were evolution and “recapitulation”.
Recapitulation theory argued that “higher animals” go through evolutionary steps while in an embryonic state: the human embryo acquires then loses attributes of fish, reptiles and “lower mammals” before emerging as a fully formed child.
Occasionally “arrests of development” occur, where the process gets stuck and children are born with “throwback” features from an earlier evolutionary phase.
Down adapted this theory, arguing his patients experienced arrests of mental development so they were born with the characteristics, both mental and physical, of those from a race lower down the evolutionary ladder.
The widespread term Mongol was used in ‘every hospital and asylum’ for ‘imbeciles of the kind Down first distinguished with precision’
For his time, Down was comparatively liberal on race. Arguments raged between those who believed mankind had one common ancestor (monogenism) and those who argued different races descended from separate ancestors (polygenism), the latter position often used to justify slavery.
By claiming humans could revert to “less evolved” races, Down at least supported the common-origin theory of humankind “in favour of the unity of the human species”.
His son, Reginald Langdon Down, and Francis Graham Cookshank (the physician who popularised the term Mongolian idiocy among a lay audience) were less liberal. They believed evolutionary regression went further back – to primates.
This belief, rather unfashionable by the time Crookshank revived it in his 1924 book The Mongol in Our Midst, held that humankind was descended from chimpanzees, gorillas and orang-utans. As Crookshank put it, there is “something more than Mongolism to be seen. There is the suggestion of the ape”.
The Mongol in Our Midst was widely derided by the scientific community, but found favour with the public and was expanded to over 500 pages by its third edition.
Although the racial theories behind the term were disdained even before geneticists found the cause of Down syndrome in the 1950s, the term Mongolian idiocy and its offshoots persisted.
Crookshank had observed the widespread use of the term Mongol in “every hospital and asylum” for “imbeciles of the kind Down first distinguished with precision”.
It seems this is what kept such an offensive term in circulation for so long. While Down had described what would come to be known as Down syndrome, his terminology sustained a longevity it never deserved.
Further reading
Crookshank FG. The Mongol in Our Midst. Kegan Paul, Trench, Trübner and Co; 1924
Down JLH. Observations on an ethnic classification of idiots. London Hospital Reports. 1866; 3: 259-262
