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BOOK REVIEW

How Psychiatry Sought Asylum From the Insanity of Eugenics

Ludy T. Benjamin, Jr.

Keeping America Sane: Psychiatry and Eugenics in the United States and Canada, 1880-1940. Ian Robert Dowbiggin. 245 pp. Cornell University Press, 1997. $37.50.

A historical marker hangs today on the London home that Francis Galton occupied for more than 50 years until his death in 1911. "Explorer, Statistician, Founder of Eugenics." Although Galton coined the term "eugenics" in 1883, the essence of the concept was described in the opening paragraph of his most important book, Hereditary Genius, published in 1869: it would be "quite practicable to produce a highly-gifted race of men by judicious marriages during several consecutive generations." Galton's selective-breeding designs defined his eugenics program. But others who followed pursued a difference approach, one that advocated involuntary sterilization and restrictive laws for marriage and immigration, a program often labeled "negative eugenics." Focusing first on the mentally ill and mentally handicapped, negative eugenics expanded to embrace notions of racial inferiority.

There is a mythology that has grown up around the concept of eugenics that is a part of many histories, present and past. Too often the treatments of eugenics are incomplete, simplistic and misinformed. One would hope that those authors will read Ian Dowbiggin's history of eugenics in the United States and Canada so that they might correct or enrich their own accounts. In this archive-based history, Dowbiggin, a historian of psychiatry, focuses on the role that psychiatry played in the eugenics movement. The author seeks to understand why psychiatrists endorsed eugenics, what eugenics programs they advocated, why they lost faith in eugenics and what role they played in the eventual passage of eugenics laws. These and other questions are answered in this very readable account.

The story of psychiatry's involvement in eugenics is told principally through the lives and work of two important figures: George Adler Blumer and Charles Kirk Clarke, both born in 1857. They were superintendents at what were among North America's most influential mental asylums. Blumer spent his career at the Utica State Hospital in New York and the Butler Hospital for the Insane in Providence, Rhode Island. Clarke administered the mental hospitals in Kingston and Toronto before accepting a government mental-health post. They were highly visible and influential, both in psychiatry and government, and they used their clout to campaign for programs that would reduce the incidence of mental illness, provide for better care for those who were institutionalized and advance the psychiatric profession's influence in making medical and political decisions.

Both Blumer and Clarke were early proponents of eugenics, emphasizing the importance of restrictive laws that would limit the immigration and marriage of the "mentally defective." To them, such laws seemed necessary to stem the explosive growth of state and provincial mental asylums where foreign-born patients made up more than 50 percent of the hospital population. Further, the growth of hereditarian views in science supported eugenic proposals; psychiatry's desire for greater respectability in the medical profession made eugenic "science" attractive.

The bloom would soon be off the eugenic rose, however. By 1905 Blumer and Clarke had abandoned the movement, and many of the other leading psychiatrists would follow suit by the end of World War I, when it was clear that eugenic measures were not having the desired effects.

Nevertheless, eugenics did not die when psychiatry withdrew its support; the movement had a life of its own pursued by what Dowbiggin has labeled "restrictionists," people whose views called particularly for immigration legislation with a decidedly open racial agenda. There is no denying that psychiatry's early support had provided a perceived scientific respectability for eugenics. Building on that base, the restrictionists were able to pursue their agenda in a 1920s North America that had grown increasingly xenophobic.

There are several subplots in this story. One is the turn-of-the-century transformation of psychiatry as a profession, marking the end of psychiatry as asylum medicine and management and its beginning as a modern medical specialty with stronger ties to science and a passion for prevention. The context of this metamorphosis in psychiatry helps to explain changing attitudes toward eugenics.

This book offers readers two histories woven into one story: the eugenics movement in North America and the 20th century transformation of psychiatry. This book is not without errors (for example, Henry HerbertGoddard was a psychologist, not a psychiatrist), but mistakes are rare in this well-researched account. The history of eugenics is redefined in this outstanding book that draws on a rich analysis of behavior, medicine, politics and culture.


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