288 The Eugenics Review
orientation of the usual kind, on "school knowledge" of the most elementary kind (Who was Bismarck? When is Christmas?), mathematical problems (simple interest on 300 marks at 3 per cent. for 3 years), general questions of an almost philosophical kind (Why do we have day and night? Why are houses built higher in towns than in the country? Why do children go to school?), difference (between "mistake" and "lie," between "Rechtsanwalt" and "Staatsanwalt"), composition of sentences (e.g. out of "soldier," "war," "fatherland"), the repetition of a story, the explanation of proverbs "general moral ideas" (Why does one learn? save money? What is truth?), memory and attention tests, and notes on the behaviour during the testing. It is no wonder that the German does not place much reliance on such tests, considered as tests of intelligence. The requirement on which most importance is laid for a diagnosis of mental defect is a persistent failure of the person concerned to maintain any sort of a position in life for himself and his family; if this is backed by an unsatisfactory school record - e.g. twice having to stay on in the same class instead of being promoted at the end of the year, or attendance at a special school ("Hilfsschule") - the diagnosis of mental defect may be made almost regardless of the results of the "intelligence test."
One of the special problems of mental deficiency is its ascertainment. Psychiatric cases are got hold of largely through the psychiatric clinics. A few mental defectives will be discovered in the same way, if they come into the clinics in a state of excitement, or complaining of the depressive or hypochodriacal symptoms not infrequent in defectives; but these must be few. The majority are discovered in other ways. In the country the local "Bezirksarzt" is supposed to, and generally does, know every single family that lives in his district. He is according able to put his hands on the local defectives, persistent low-grade misfits and failures at any time. In the towns the matter is more difficult, and the defectives are got hold of largely accidentally, as they come to doctors or hospitals for advice on entirely unrelated subjects - e.g. for appendicitis - or as they appear as candidates for financial or social assistance at the offices of charity organizations, church missions, public assistance offices, etc. With the development of the marriage-advice centers and related scientific and social institutions, there will be still further ways of ascertainment, until this should become in the end fairly complete.
Appeals Against Sterilization
Appeals from the order for sterilization come before a special court. In many cases there will have been a preliminary examination and report such as has been described. However, many other points have arisen than the question of diagnosis, and a number of appeals have been reported and discussed in a paper by Bostroem.
Bostroem, in his introduction, criticizes the haphazard practice of doctors in regard to notification. There is no point in worrying the authorities with 60-year-old alcoholics and 10-year-old idiots, when the really dangerous - in regard to propagation - are not being touched. The pressing cases are the physically healthy men and women from sixteen to forty, young schizophrenics and manic-depressives in remissions, young subjects of hereditary blindness and deafness, etc. It is important to make sure of the capacity for procreation. It must not happen in future that, after months of proceedings costing a lot of money, it appears that the case should never have been brought. Further, everyone is entitled to be heard in his own defence. If not capable of taking steps himself, he must be represented. The doctor must see to this. The following are some of the more interesting cases: 1. A man under guardianship for mental defect was held by the court to be a psychopath* and not sterilizable. The
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[footnote]*Both on German psychiatry and in the sterilization law there is a sharp distinction between the psychopathic and the psychotic. Only the following conditions render their subjects liable to sterilization: inborn hereditary defect, schizophrenia, circular (manic-depressive) insanity, hereditary epilepsy, hereditary