FOOTNOTES:

TotalNumberCongenitallyDeafPerCentRatio perMillion ofPopulation188033,87812,15535.6242189040,56216,86641.2269190037,42612,60933.7166

From this it appears that congenital deafness is decreasing both in relation to all deafness, and to the general population.

For further statistics, we may revert to our tables under adventitious deafness. In the tables relating to periods of successive recent years we find in respect to three schools, the New York and Western Pennsylvania institutions and the Maryland School, with certain fluctuations, no great change on the whole, though the last named school shows still a very high proportion. In two schools, the Michigan and Wisconsin, rather an increase is observed. In the Pennsylvania Institution, which covers a period of seventy years, there is a decrease from over 50 per cent to less than 40.

A better test perhaps lies in the comparison of the proportions found for congenital deafness in the tables relating to periods widely separated in time. In these an increase is seen in the single case of the Ohio School; while a decrease is apparent in three, namely, the American and Iowa schools and the New York Institution. These decreases in percentages are respectivelyfrom 44.8 and 50.1 to 35.2; from 37.2 to 26.9; and from 42.9 to 38.0.[60]

From the evidence that we have, then, taken together, it seems reasonable to conclude that congenital deafness is, though slowly, becoming less in the course of the years.

Most of what has been said in this chapter with respect to the elimination or prevention of deafness may be summed up as follows:

1. There are two kinds of deafness—adventitious and congenital. Of the total number of cases adventitious deafness comprises nearly two-thirds, and congenital deafness a little over one-third.

2. Nearly all adventitious deafness is caused by some disease of infancy or childhood attacking the middle or internal ear, a large part being of infectious character. The two chief diseases causing such deafness are scarlet fever and meningitis, with a less amount from brain fever, typhoidfever, measles, catarrh, diphtheria, whooping cough, etc.

3. A considerable part of this deafness is preventable under enlightened action. Medical science is principally in control of the situation, but there is also much that can be done in general measures for the protection of the health. In attacking the problem, the most immediate practical program lies in the arrest of those diseases, especially infantile and infectious diseases, that cause deafness.

4. Our evidence is incomplete to determine definitely whether adventitious deafness is increasing or decreasing relatively among the population; but it is hardly other than likely that it is decreasing. Although certain diseases producing deafness fail to show any extensive signs of abatement, there are other diseases from which there can be little doubt that deafness is decreasing.

5. In the outlook there is, on the whole, promise, both in respect to the treatment of deafness itself and of the diseases that lead to deafness, though it cannot be said in any sense that any large or general relief is at present in sight.

6. Of congenital deafness nearly half occurs in families often without any positively known strain to indicate a predisposition to deafness. Though concerning this deafness little in the present state of our knowledge can be predicated,it is likely that with measures to secure a race sound in all particulars there will be a reduction to a greater or less extent of such deafness.

7. Consanguineous marriages do not take place, so far as deafness as an effect is concerned, to any great extent; though where they do the consequences are very marked. Their relation to deafness consists apparently for the greatest part in the fact that the chances of its transmission are thereby intensified, there being also a very strong connection with the question of deaf relatives in general.

8. There are a certain number of families in society deeply tainted with deafness, in evidence both lineally and collaterally, and this deafness may be transmitted from parent to offspring.

9. Children of deaf parents are far more likely to be deaf than children of hearing parents.

10. The great majority of the children of deaf parents, however, are able to hear, the proportion of those who are not being small.

11. The likelihood of deaf offspring is not necessarily greater when both parents are deaf than when one is deaf and the other hearing.

12. The liability to deaf offspring depends in the greatest degree upon the presence or absence in the parents, deaf or hearing, of deaf relatives, and, to a less extent, upon whether or not the existing deafness is congenital—being especiallygreat under a combination of these two conditions.

13. Action in respect to marriages of the deaf likely to result in deaf offspring seems for the present rather to be limited to moral forces.

14. Congenital deafness appears, from all the evidence, to be decreasing relatively among the population, though probably only at a very slow rate.

15. Finally, with respect to our original inquiry, it is to be said that there are no indications that deafness will disappear from the human race within any time which we can measure; and hence that the deaf are to be in society not only for a season, but for a period apparently as yet indefinite. Nevertheless the situation is not without encouragement. From the data in our possession regarding deafness as a whole, it seems certain that deafness is not on the increase relatively among the population. From our knowledge concerning adventitious deafness, the probabilities are that, if anything, it is decreasing; while the evidence as to congenital deafness is that it is decreasing. It is likely, then, that deafness in general is tending to decrease; and we are thus justified in believing that the number of the deaf will in time become less.

FOOTNOTES:[15]Moreover, later censuses are probably taken more thoroughly than former, with a consequent discovery of a larger number of the deaf; while at the same time greater care is employed in preparing the later censuses, with the more rigorous elimination of doubtful cases, all in some measure, however, tending to even up the differences. On the difficulty of making comparisons of the censuses of the deaf, see Special Reports, pp. 66-69;Annals, li., 1906, p. 487.[16]Ibid.[17]Deafness has also been divided into three classes: adventitious deafness, congenital or hereditary deafness, and infantile or sporadic congenital deafness, the last class including many cases where there are other antecedent defects, mental or physical, or where the deafness occurred shortly after birth with the exact cause not definitely determined. See Proceedings of International Otological Congress, ix., 1913, p. 49;Volta Review, xiv., 1912, p. 348; xv., 1913, p. 209.[18]Of the cases usually ascribed to accidents, as falls, blows and the like, the probabilities are that a large part are really to be attributed to some other cause. Deafness is not often likely to result from such occurrences.[19]See Proceedings of International Otological Congress, ix., 1913, p. 49;Volta Review, xiv., 1912, p. 348.[20]Special Reports, pp. 110, 122, 124. See alsoAnnals, xxxiii., 1888, p. 199; lii., 1907, p. 168. In the table are given only the specified causes that represent at least 0.7 per cent of the total amount of deafness. In respect to external ear trouble, impacted cerumen is usually found to result from water in the ear, or wax in the ear. Other diseases of the middle ear of suppurative character are diphtheria, pneumonia, erysipelas, smallpox, tonsilitis, teething, bronchitis, and consumption. Other non-suppurative diseases of the middle ear are whooping cough, scrofula, exposure and cold, disease of the throat, thickening of eardrum, croup, etc. Of the internal ear, other causes affecting the labyrinth are malformation, noise and concussion, mumps, and syphilis; affecting the nerve, paralysis, convulsions, sunstroke, congestion of brain, and disease of nervous system; and affecting brain center, hydrocephalus and epilepsy. Among unclassified causes are also adduced neuralgia, childbirth, accident, medicine, heat, rheumatism, head-ache, fright or shock, overwork, lightning, diarrhea, chicken-pox, operation, and other causes.[21]Proceedings of National Conference of Charities and Corrections, 1906, p. 250; Ceremonies of Laying of Corner Stone of Rhode Island School, 1907, p. 27.[22]There are no general or organized movements on foot for the prevention of deafness as there are for the prevention of blindness. This is perhaps chiefly because there are believed to be nothing like so many preventable cases of the one as of the other, so much of blindness being due to diseases that might have been avoided without great difficulty, and to accidents and other injuries to the eye.[23]It has been estimated that three-fourths of deafness from primary ear diseases, and one-half from infectious diseases, is preventable. See Proceedings of International Otological Congress,loc. cit.;Volta Review, xiv., 1912, pp. 251, 348.[24]Proceedings, 1903, p. 1036.[25]Volta Review, xv., 1913, p. 136. See alsoibid., v., 1903, p. 415;Outlook, civ., 1913, p. 997.[26]SeeMedical and Surgical Monitor, vii., 1904, p. 47;New York Medical Journal, lxxxiii., 1906, p. 816;Annals, lv., 1910, p. 192;Volta Review, xiii., 1911, p. 332.[27]The possibilities, for instance, in the use of antitoxins and vaccines in certain diseases are just beginning to be known, and some results as affect deafness may be expected from such operations.[28]In 1909 a special committee in regard to the prevention of deafness was created by the Otological Section of the American Medical Association, and in 1910 both by the American Laryngological, Rhinological and Otological Society and by the American Otological Society. SeeLaryngoscope, xx., 1910, pp. 596-665;Volta Review, xii., 1910, pp. 267, 545.[29]Laws, 1906, ch. 502.[30]On the possibilities of the prevention of adventitious deafness, see Dr. J. K. Love, "Deaf-Mutism", 1896; Archives of Otology, xxiv., 1895, p. 50;Journal of American Medical Association, liii., 1909, p. 89;New York Medical Journal, l., 1889, p. 205; lxxxix., 1909, p. 1007; xcv., 1912, p. 1189;New York State Journal of Medicine, xii., 1912, p. 690ff.;Maryland Medical Journal, lv., 1912, p. 33;Pediatrics, xxiv., 1912, p. 335;Popular Science Monthly, xlii., 1892, p. 211; "Progress in Amelioration of Certain Forms of Deafness and Impaired Hearing," Proceedings of American Association to Promote the Teaching of Speech to the Deaf, iv., 1894;Annals, xxxiv., 1889, p. 199; lvi., 1911, p. 211; lviii., 1913, p. 131;Volta Review, xii., 1910, p. 143; xv., 1913, p. 303; New YorkTimes, April 6, 1913; Public School Health Bulletin, Eyes and Ears, by Superintendent of Public Instruction of North Carolina, 1910.[31]Census Reports, 1880. Report on Defective, Dependent and Delinquent Classes of the Population of the United States, 1888, p. 402ff.; Census Reports, 1890. Report on Insane, Feeble-minded, Deaf and Dumb and Blind, 1895, pp. 108ff., 648; Special Reports, 1906, p. 122.[32]Ibid.[33]Probably with the "fevers" the proportion would be larger.[34]Less than 0.7 per cent.[35]Probably included with certain of the suppurative diseases.[36]Not a large number of schools, it is greatly to be regretted, give, regularly and over an extended period of time, such information in statistical form and upon the same basis from year to year.[37]Total attendance.[38]These tables are based upon statistics given in the reports of the schools, and given inAnnals, vi., 1854, p. 237; xv., 1870, p. 113; xvii., 1872, p. 167.[39]One case reported.[40]Letters of inquiry as to whether or not "total" deafness appeared to be decreasing were sent by the writer to the professors of diseases of the ear of the medical schools of Johns Hopkins University, University of Pennsylvania, Columbia University, Cornell University, Harvard University, University of Chicago, Northwestern University, University of Michigan, and the Jefferson Medical College of Philadelphia. The opinion of four of these is that such deafness is clearly decreasing; of three that little or no decrease is apparent; while by two no opinion can be vouched yet. The greatest encouragement is found in respect to treatment for middle ear affections and infections from fevers. By Dr. S. MacCuen Smith, of the Jefferson Medical College, it is believed that there is a decrease, "largely due to the fact that not only the general medical profession, but the public at large, are recognizing the importance of having the minor aural lesions promptly and properly cared for. This being the case, it is no longer possible for children in the public schools to continue their studies when suffering from diseased tonsils and enlarged adenoid vegetations. From this cause alone, many cases of impairment of hearing which usually occur later in life will be prevented in the future". By Dr. E. A. Crockett, of Harvard University, it is believed that, although there is a larger amount of deafness from measles, there is less, not only from scarlet fever, but also from chronic suppurations, from adenoid and throat troubles in general, and even from meningitis, owing to the use of serums. Regarding his own observations, within a period of twenty-five years "the number of extremely deaf persons and deaf-mutes has very materially diminished".[41]Hereditary deafness is sometimes of a kind that manifests itself some years after birth, often with certain relatives similarly affected. This is especially true of catarrhal and middle ear affections, though their results may more often be partial rather than total deafness.[42]In a part of such deafness, and also in a portion of that occurring shortly after birth, the cause is said to be syphilis. See Proceedings of International Otological Congress, ix., 1913, p. 49;Volta Review, xiv., 1912, p. 348; xv., 1913, p. 209.[43]Special Reports, pp. 125, 236. There were 3,341 who failed to answer, and if all had made reply, our percentage would probably be higher yet.[44]P. 108.[45]In the Louisiana School 10 per cent of the pupils are said to have parents who were blood relatives; in the Illinois, 5 per cent; and in the Kansas, from 5 to 5.5 per cent. Report of Louisiana School, 1906, p. 17. See also Transactions of American Medical Association, xi., 1858, pp. 321-425; Proceedings of Conference of Principals, iii., 1876, p. 204;Annals, xxii., 1877, p. 242.[46]On this subject, see Francis Galton. "Natural Inheritance", 1889, p. 132ff. See also G. B. L. Arner, "Consanguineous Marriages", 1908, p. 65ff.; C. B. Davenport, "Heredity in Relation to Eugenics", 1911, p. 124ff.[47]Special Reports, pp. 128, 235, andpassim.[48]These proportions are further indicated in the succeeding section.[49]Special Reports, p. 135ff.[50]Report, 1908, p. 31.[51]Out of 107 children born to former pupils of the Minnesota School up to 1892, 2, or 1.9 per cent, were deaf. Report, 1892, p. 39. Out of 811 children born to former pupils of the American School up to 1891, 105, or 12.9 per cent, were deaf. Report, 1891, p. 20.[52]The study had been originally planned by Dr. F. H. Wines for theInternational Record of Charities and Corrections. See issue for October, 1888. The work was published by the Volta Bureau. For a discussion of the results, seeAssociation Review, ii., 1900, p. 178; Publications of American Statistical Association, vi., 1899, p. 353;Biometrika(London), iv., 1904-5, p. 465. See also charts in current numbers ofVolta Review.[53]From the total number of marriages, 974 were deducted, being cases concerning the offspring of which no information could be obtained, and also 434 cases where there were no offspring.[54]From p. 134. It has also been computed by Dr. Fay from his data that of 5,455 married deaf persons, 300, or 5.5 per cent, have deaf offspring.Annals, lii., 1907, p. 253.[55]The proportions for the general population are hardly over 0.3 per cent and 0.05 per cent respectively.[56]The proportion of the married deaf who are married to deaf partners is found by Dr. Fay to be 72.5 per cent, and of those married to hearing partners, 20 per cent, there being no information for the remaining 7.5 per cent. The census returns, however, give the respective proportions as 51.3 per cent and 48.7 per cent.[57]See Proceedings of National Conference of Charities and Corrections, 1879, p. 214; A. G. Bell, "The Formation of a Deaf Variety of the Human Race", Memoirs, 1883, ii., part 4, p. 177; Proceedings of Conference of Principals, i., 1868, p. 91; v., 1884, p. 205; A. G. Bell, "Marriage, an Address to the Deaf", 1898; Evidence before the Royal Commission on the Deaf, etc., 1892, ii., pp. 74-129;Annals, xxix., 1884, pp. 32, 72; xxx., 1885, p. 155; xxxiii., 1888, pp. 37, 206;Popular Science Monthly, xvii., 1885, p. 15;Science, Aug., 1890, to March, 1891 (xvi., xvii.);Arena, xii., 1895, p. 130;Association Review, x., 1908, p. 166;Volta Review, xiv., 1912, p. 184; Proceedings of Reunion of Alumni of Wisconsin School for the Deaf, vi., 1891, p. 46; National Association of the Deaf, iv., 1893, p. 112; ix., 1910, p. 69; Report of Board of Charities of New York, 1911, i., p. 150.[58]No statutory action seems ever to have been taken in the matter. In Connecticut, however, in 1895 when a law (Laws, ch. 325) was enacted forbidding the marriage of the feeble-minded and epileptic, a provision respecting the congenitally deaf and blind came near being included.Annals, xl., 1895, p. 310.[59]Census Reports, 1880. Report on Defective, Dependent and Delinquent Classes of the Population of the United States, 1888, p. 402ff.; Census Reports, 1890. Report on Insane, Feeble-minded, Deaf and Dumb and Blind, 1895, pp. 108ff., 684; Special Reports, 1906, p. 122. The ages of the deaf were reported less fully in 1880 than in 1890, and less fully in 1890 than in 1900; and if we take the numbers of those whose ages were reported in these three censuses, we have the following table, showing the proportion of the congenitally deaf.THE CONGENITALLY DEAF ACCORDING TO NUMBERS IN WHICH AGE WAS REPORTEDNumberWhose AgeWas ReportedCongenitallyDeafPerCent188022,47312,15554.7189037,20416,86645.8190035,47912,60935.3If we assume that the proportion of the congenitally deaf to all the deaf in each census was the same that it was among the cases in which the age of the occurrence of deafness was reported, we have this table to show the number of the congenitally deaf and the ratio of the deaf among the population.THE CONGENITALLY DEAF ACCORDING TO NUMBERS ASSUMEDAssumedNumber ofCongenitallyDeafRatio PerMillion ofPopulation188018,531369189018,375293190013,286175These tables are taken fromAnnals, li., 1906, p. 487.[60]In the three schools where an increase in congenital deafness appears to be found, namely, those of Michigan, Wisconsin and Ohio, a partial explanation probably lies in the fact that in these states a number of day schools have been created of late years, which are not likely to draw congenitally deaf pupils to the extent that the institutions do, thus leaving a larger proportion for the latter. See also E. A. Fay,op. cit., p. 125.

[15]Moreover, later censuses are probably taken more thoroughly than former, with a consequent discovery of a larger number of the deaf; while at the same time greater care is employed in preparing the later censuses, with the more rigorous elimination of doubtful cases, all in some measure, however, tending to even up the differences. On the difficulty of making comparisons of the censuses of the deaf, see Special Reports, pp. 66-69;Annals, li., 1906, p. 487.

[16]Ibid.

[17]Deafness has also been divided into three classes: adventitious deafness, congenital or hereditary deafness, and infantile or sporadic congenital deafness, the last class including many cases where there are other antecedent defects, mental or physical, or where the deafness occurred shortly after birth with the exact cause not definitely determined. See Proceedings of International Otological Congress, ix., 1913, p. 49;Volta Review, xiv., 1912, p. 348; xv., 1913, p. 209.

[18]Of the cases usually ascribed to accidents, as falls, blows and the like, the probabilities are that a large part are really to be attributed to some other cause. Deafness is not often likely to result from such occurrences.

[19]See Proceedings of International Otological Congress, ix., 1913, p. 49;Volta Review, xiv., 1912, p. 348.

[20]Special Reports, pp. 110, 122, 124. See alsoAnnals, xxxiii., 1888, p. 199; lii., 1907, p. 168. In the table are given only the specified causes that represent at least 0.7 per cent of the total amount of deafness. In respect to external ear trouble, impacted cerumen is usually found to result from water in the ear, or wax in the ear. Other diseases of the middle ear of suppurative character are diphtheria, pneumonia, erysipelas, smallpox, tonsilitis, teething, bronchitis, and consumption. Other non-suppurative diseases of the middle ear are whooping cough, scrofula, exposure and cold, disease of the throat, thickening of eardrum, croup, etc. Of the internal ear, other causes affecting the labyrinth are malformation, noise and concussion, mumps, and syphilis; affecting the nerve, paralysis, convulsions, sunstroke, congestion of brain, and disease of nervous system; and affecting brain center, hydrocephalus and epilepsy. Among unclassified causes are also adduced neuralgia, childbirth, accident, medicine, heat, rheumatism, head-ache, fright or shock, overwork, lightning, diarrhea, chicken-pox, operation, and other causes.

[21]Proceedings of National Conference of Charities and Corrections, 1906, p. 250; Ceremonies of Laying of Corner Stone of Rhode Island School, 1907, p. 27.

[22]There are no general or organized movements on foot for the prevention of deafness as there are for the prevention of blindness. This is perhaps chiefly because there are believed to be nothing like so many preventable cases of the one as of the other, so much of blindness being due to diseases that might have been avoided without great difficulty, and to accidents and other injuries to the eye.

[23]It has been estimated that three-fourths of deafness from primary ear diseases, and one-half from infectious diseases, is preventable. See Proceedings of International Otological Congress,loc. cit.;Volta Review, xiv., 1912, pp. 251, 348.

[24]Proceedings, 1903, p. 1036.

[25]Volta Review, xv., 1913, p. 136. See alsoibid., v., 1903, p. 415;Outlook, civ., 1913, p. 997.

[26]SeeMedical and Surgical Monitor, vii., 1904, p. 47;New York Medical Journal, lxxxiii., 1906, p. 816;Annals, lv., 1910, p. 192;Volta Review, xiii., 1911, p. 332.

[27]The possibilities, for instance, in the use of antitoxins and vaccines in certain diseases are just beginning to be known, and some results as affect deafness may be expected from such operations.

[28]In 1909 a special committee in regard to the prevention of deafness was created by the Otological Section of the American Medical Association, and in 1910 both by the American Laryngological, Rhinological and Otological Society and by the American Otological Society. SeeLaryngoscope, xx., 1910, pp. 596-665;Volta Review, xii., 1910, pp. 267, 545.

[29]Laws, 1906, ch. 502.

[30]On the possibilities of the prevention of adventitious deafness, see Dr. J. K. Love, "Deaf-Mutism", 1896; Archives of Otology, xxiv., 1895, p. 50;Journal of American Medical Association, liii., 1909, p. 89;New York Medical Journal, l., 1889, p. 205; lxxxix., 1909, p. 1007; xcv., 1912, p. 1189;New York State Journal of Medicine, xii., 1912, p. 690ff.;Maryland Medical Journal, lv., 1912, p. 33;Pediatrics, xxiv., 1912, p. 335;Popular Science Monthly, xlii., 1892, p. 211; "Progress in Amelioration of Certain Forms of Deafness and Impaired Hearing," Proceedings of American Association to Promote the Teaching of Speech to the Deaf, iv., 1894;Annals, xxxiv., 1889, p. 199; lvi., 1911, p. 211; lviii., 1913, p. 131;Volta Review, xii., 1910, p. 143; xv., 1913, p. 303; New YorkTimes, April 6, 1913; Public School Health Bulletin, Eyes and Ears, by Superintendent of Public Instruction of North Carolina, 1910.

[31]Census Reports, 1880. Report on Defective, Dependent and Delinquent Classes of the Population of the United States, 1888, p. 402ff.; Census Reports, 1890. Report on Insane, Feeble-minded, Deaf and Dumb and Blind, 1895, pp. 108ff., 648; Special Reports, 1906, p. 122.

[32]Ibid.

[33]Probably with the "fevers" the proportion would be larger.

[34]Less than 0.7 per cent.

[35]Probably included with certain of the suppurative diseases.

[36]Not a large number of schools, it is greatly to be regretted, give, regularly and over an extended period of time, such information in statistical form and upon the same basis from year to year.

[37]Total attendance.

[38]These tables are based upon statistics given in the reports of the schools, and given inAnnals, vi., 1854, p. 237; xv., 1870, p. 113; xvii., 1872, p. 167.

[39]One case reported.

[40]Letters of inquiry as to whether or not "total" deafness appeared to be decreasing were sent by the writer to the professors of diseases of the ear of the medical schools of Johns Hopkins University, University of Pennsylvania, Columbia University, Cornell University, Harvard University, University of Chicago, Northwestern University, University of Michigan, and the Jefferson Medical College of Philadelphia. The opinion of four of these is that such deafness is clearly decreasing; of three that little or no decrease is apparent; while by two no opinion can be vouched yet. The greatest encouragement is found in respect to treatment for middle ear affections and infections from fevers. By Dr. S. MacCuen Smith, of the Jefferson Medical College, it is believed that there is a decrease, "largely due to the fact that not only the general medical profession, but the public at large, are recognizing the importance of having the minor aural lesions promptly and properly cared for. This being the case, it is no longer possible for children in the public schools to continue their studies when suffering from diseased tonsils and enlarged adenoid vegetations. From this cause alone, many cases of impairment of hearing which usually occur later in life will be prevented in the future". By Dr. E. A. Crockett, of Harvard University, it is believed that, although there is a larger amount of deafness from measles, there is less, not only from scarlet fever, but also from chronic suppurations, from adenoid and throat troubles in general, and even from meningitis, owing to the use of serums. Regarding his own observations, within a period of twenty-five years "the number of extremely deaf persons and deaf-mutes has very materially diminished".

[41]Hereditary deafness is sometimes of a kind that manifests itself some years after birth, often with certain relatives similarly affected. This is especially true of catarrhal and middle ear affections, though their results may more often be partial rather than total deafness.

[42]In a part of such deafness, and also in a portion of that occurring shortly after birth, the cause is said to be syphilis. See Proceedings of International Otological Congress, ix., 1913, p. 49;Volta Review, xiv., 1912, p. 348; xv., 1913, p. 209.

[43]Special Reports, pp. 125, 236. There were 3,341 who failed to answer, and if all had made reply, our percentage would probably be higher yet.

[44]P. 108.

[45]In the Louisiana School 10 per cent of the pupils are said to have parents who were blood relatives; in the Illinois, 5 per cent; and in the Kansas, from 5 to 5.5 per cent. Report of Louisiana School, 1906, p. 17. See also Transactions of American Medical Association, xi., 1858, pp. 321-425; Proceedings of Conference of Principals, iii., 1876, p. 204;Annals, xxii., 1877, p. 242.

[46]On this subject, see Francis Galton. "Natural Inheritance", 1889, p. 132ff. See also G. B. L. Arner, "Consanguineous Marriages", 1908, p. 65ff.; C. B. Davenport, "Heredity in Relation to Eugenics", 1911, p. 124ff.

[47]Special Reports, pp. 128, 235, andpassim.

[48]These proportions are further indicated in the succeeding section.

[49]Special Reports, p. 135ff.

[50]Report, 1908, p. 31.

[51]Out of 107 children born to former pupils of the Minnesota School up to 1892, 2, or 1.9 per cent, were deaf. Report, 1892, p. 39. Out of 811 children born to former pupils of the American School up to 1891, 105, or 12.9 per cent, were deaf. Report, 1891, p. 20.

[52]The study had been originally planned by Dr. F. H. Wines for theInternational Record of Charities and Corrections. See issue for October, 1888. The work was published by the Volta Bureau. For a discussion of the results, seeAssociation Review, ii., 1900, p. 178; Publications of American Statistical Association, vi., 1899, p. 353;Biometrika(London), iv., 1904-5, p. 465. See also charts in current numbers ofVolta Review.

[53]From the total number of marriages, 974 were deducted, being cases concerning the offspring of which no information could be obtained, and also 434 cases where there were no offspring.

[54]From p. 134. It has also been computed by Dr. Fay from his data that of 5,455 married deaf persons, 300, or 5.5 per cent, have deaf offspring.Annals, lii., 1907, p. 253.

[55]The proportions for the general population are hardly over 0.3 per cent and 0.05 per cent respectively.

[56]The proportion of the married deaf who are married to deaf partners is found by Dr. Fay to be 72.5 per cent, and of those married to hearing partners, 20 per cent, there being no information for the remaining 7.5 per cent. The census returns, however, give the respective proportions as 51.3 per cent and 48.7 per cent.

[57]See Proceedings of National Conference of Charities and Corrections, 1879, p. 214; A. G. Bell, "The Formation of a Deaf Variety of the Human Race", Memoirs, 1883, ii., part 4, p. 177; Proceedings of Conference of Principals, i., 1868, p. 91; v., 1884, p. 205; A. G. Bell, "Marriage, an Address to the Deaf", 1898; Evidence before the Royal Commission on the Deaf, etc., 1892, ii., pp. 74-129;Annals, xxix., 1884, pp. 32, 72; xxx., 1885, p. 155; xxxiii., 1888, pp. 37, 206;Popular Science Monthly, xvii., 1885, p. 15;Science, Aug., 1890, to March, 1891 (xvi., xvii.);Arena, xii., 1895, p. 130;Association Review, x., 1908, p. 166;Volta Review, xiv., 1912, p. 184; Proceedings of Reunion of Alumni of Wisconsin School for the Deaf, vi., 1891, p. 46; National Association of the Deaf, iv., 1893, p. 112; ix., 1910, p. 69; Report of Board of Charities of New York, 1911, i., p. 150.

[58]No statutory action seems ever to have been taken in the matter. In Connecticut, however, in 1895 when a law (Laws, ch. 325) was enacted forbidding the marriage of the feeble-minded and epileptic, a provision respecting the congenitally deaf and blind came near being included.Annals, xl., 1895, p. 310.

[59]Census Reports, 1880. Report on Defective, Dependent and Delinquent Classes of the Population of the United States, 1888, p. 402ff.; Census Reports, 1890. Report on Insane, Feeble-minded, Deaf and Dumb and Blind, 1895, pp. 108ff., 684; Special Reports, 1906, p. 122. The ages of the deaf were reported less fully in 1880 than in 1890, and less fully in 1890 than in 1900; and if we take the numbers of those whose ages were reported in these three censuses, we have the following table, showing the proportion of the congenitally deaf.THE CONGENITALLY DEAF ACCORDING TO NUMBERS IN WHICH AGE WAS REPORTEDNumberWhose AgeWas ReportedCongenitallyDeafPerCent188022,47312,15554.7189037,20416,86645.8190035,47912,60935.3If we assume that the proportion of the congenitally deaf to all the deaf in each census was the same that it was among the cases in which the age of the occurrence of deafness was reported, we have this table to show the number of the congenitally deaf and the ratio of the deaf among the population.THE CONGENITALLY DEAF ACCORDING TO NUMBERS ASSUMEDAssumedNumber ofCongenitallyDeafRatio PerMillion ofPopulation188018,531369189018,375293190013,286175These tables are taken fromAnnals, li., 1906, p. 487.

THE CONGENITALLY DEAF ACCORDING TO NUMBERS IN WHICH AGE WAS REPORTED

NumberWhose AgeWas ReportedCongenitallyDeafPerCent188022,47312,15554.7189037,20416,86645.8190035,47912,60935.3

If we assume that the proportion of the congenitally deaf to all the deaf in each census was the same that it was among the cases in which the age of the occurrence of deafness was reported, we have this table to show the number of the congenitally deaf and the ratio of the deaf among the population.

THE CONGENITALLY DEAF ACCORDING TO NUMBERS ASSUMED

AssumedNumber ofCongenitallyDeafRatio PerMillion ofPopulation188018,531369189018,375293190013,286175

These tables are taken fromAnnals, li., 1906, p. 487.

[60]In the three schools where an increase in congenital deafness appears to be found, namely, those of Michigan, Wisconsin and Ohio, a partial explanation probably lies in the fact that in these states a number of day schools have been created of late years, which are not likely to draw congenitally deaf pupils to the extent that the institutions do, thus leaving a larger proportion for the latter. See also E. A. Fay,op. cit., p. 125.

Afterexamination of the question of how long the deaf are to be an element of the population, our discussion turns to their position at present as an actual part of society. The first relation to be considered is that of the state to them.

The state acts on men through the law, and in the law is represented not only its authority, but its attitude as well towards the problems that confront society, including the treatment of the various elements of its population. In this chapter it is our purpose by a study of the law in respect to the deaf to discover the attitude of the state towards them and the treatment which it has accorded them.

Generally in ancient and even in more modern days the deaf, especially the congenitally deaf without education, have been held in the eyes of the law more or less as though they were an abnormal element in the state, at times being regarded as though they were of defective minds,and now and then being considered practically as idiots. Though there was usually meditated no unduly harsh treatment of the deaf, they were for the most part deemed incapable of performing the full duties of citizenship, certain of the rights that belonged to their fellowmen were denied to them, and they were held in considerable degree in what amounted to legal bondage. It was only in the course of time in most countries that the law came to look upon the deaf differently, to regard them more as normal persons, and to grant them in greater measure the rights of other men.[61]

In America the attention of the law has been directed to the deaf both by legislation relating to them, and by court decisions affecting them. In addition, in the constitutions of a number of states, as we shall see, provision is made for institutions for the education of the deaf; and in one state, Mississippi,[62]a provision is foundexempting the deaf from the payment of a poll tax. The law cannot be said to have concerned itself extensively with the deaf, but the light in which they have been viewed has been indicated fairly clearly. Judicialdictaand opinions have been of less frequency and importance than legislation, and have rather dealt with the mental capacity of the deaf in certain legal relations and proceedings, as in their responsibility for crimes, the making of wills, the appointment of interpreters, etc. Legislation itself has not often been engaged in providing for the deaf as a special class, beyond maintaining schools for the education of the young. Where this legislation has taken place, it may be said to be of three kinds. First, the deaf have been regarded as mentally deficient or incapable of certain civic acts, and discriminatory laws have been enacted. Next, the deaf have been thought to need special consideration or protection on the part of the state, and laws have been passed for the appointment of guardians or otherwise for their security or benefit. The third class of legislation is where the state bases its action upon the supposed weakness of the deaf, their "physical disability," as it is frequently termed, and here we have a series of what may be called negative benefactions, designed to make less hard the way of the deaf. Such special provision hasconsisted chiefly in the remission of taxes in certain instances or of some other form of more or less direct assistance.

Legislation which may be termed discriminatory in respect to the deaf has really been of but slight extent.[63]In Georgia we find an enactment of 1840,[64]in which the deaf were to be regardedpro tantoas idiots, so far as concerned the managing of their estates, though this was in fact intended for their protection. In New Mexico a law has been enacted, forbidding those deaf by birth from making wills, unless their intention is declared in writing;[65]and in Louisiana a deaf man is incapable of acting as a witness to a testament.[66]In several states, as New York and Massachusetts, there have been enactments in regard to deaf-mute immigrants together with other classes who might be likely to become apublic charge, with the exaction of bond as security.[67]In Georgia[68]there is an enactment in reference to various itinerant concerns which might leave deaf persons, as well as others, in the state as public charges.[69]

Legislation of the second class, where the deaf are thought to require particular consideration or protection, has likewise been infrequent. The first instance is an enactment of Massachusetts in 1776,[70]relating to the appointment, on certain occasions, of guardians for the deaf, especially those deaf "from their nativity," together with other persons—which is probably the earliest statutory reference to the deaf in America. A later example is an enactment in Georgia in 1818,[71]and still in force, providing for the appointment of guardians, on somewhat the sameorder as that which we have indicated, for deaf and dumb persons incapable of managing their estates. In New Jersey in 1838[72]a law was enacted, forbidding deaf persons under seventeen years of age to be bound out as apprentices. In Ohio a statute also of 1838[73]provided for guardians for the deaf, and several modern statutes are somewhat of this nature. In Maine the deaf cannot be sent to the reform school.[74]In Arkansas[75]and Missouri[76]it is provided that the court may appoint guardians for deaf persons from fourteen to twenty-one years of age in case of the death of a parent. Of somewhat different character, but still for the protection of the deaf, is the enactment in several states, as Wisconsin[77]and Virginia,[78]where injury or abuse of the deaf is made a matter of special attention in the law.

Examples of legislation designed to be of material aid to the deaf are rather more common,the chief of which, as we have noted, is the exemption from the payment of some personal or property tax.[79]Thus in Missouri we find a statute of 1843[80]allowing a deaf man to be exempt from the poll tax and the tax on property up to $300. Indiana in 1848[81]exempted its deaf and blind citizens from a poll tax and a property tax up to $500. Mississippi[82]exempted these classes from the road duty in 1878, and two years later from the poll tax as well, this exemption being incorporated in the state constitution, as we have seen. Tennessee[83]in 1895 also exempted from the poll tax the deaf, the blind and those incapable of labor. In Pennsylvania legislation seems to have gone the furthest in its desire to be of material help to the deaf, for here we find the deaf with the blind exempted from the penalties which usually apply to tramps.[84]Such are instances of this form of legislation, but similar legislation has been enacted in other states.

Very rare are instances where the state makes special provision for the care of, or extends special poor relief to, any of its deaf population.The chief example seems to be the action of some of the New England states with their so-called "missions for the deaf." These are associations, composed in great part of the deaf and engaged in various forms of mission work, and to them state funds are granted to aid the aged, infirm and helpless deaf. By this plan Maine is said to have been without a deaf-mute pauper in ten years. The amounts allowed, however, for this purpose are not large, being $200 a year in Maine and $150 in New Hampshire.[85]In Ohio the counties are allowed to contract with private homes for the maintenance of the aged and infirm deaf—there being but one such in the state, that supported by the deaf themselves—and the state board of charities is given power to remove deaf persons thereto from the county infirmaries.[86]

Instances are likewise rare where the state makes a distinct appropriation of money for the benefit of the deaf other than for schools. We have one instance in New York where the state for a certain number of years allowed a small sum to the publishers of a paper for the benefit of poor deaf-mutes.[87]

As a last species of legislation in aid of the deaf, we have a single enactment of quite different character from that which we have hitherto found, and of later appearance. This is the law enacted in Minnesota in 1913,[88]which provides for a division for the deaf in the state bureau of labor. Its duties are to

Collect statistics of the deaf, ascertain what trades or occupations are most suitable for them and best adapted to promote their interests, ... use [its] best efforts to aid them in securing such employment as they may be best fitted to engage in, keep a census and obtain facts, information and statistics as to their condition in life with a view to the betterment of their lot, and endeavor to obtain statistics and information of the conditions of labor and employment and education in other states with a view to promoting the general welfare of the deaf in this state.

Such legislation may prove highly beneficial to the deaf, not only in rendering very desirable aid to them, but also in offering means of learning very important facts as to their condition.

The opinions of the courts of law in regard to the deaf have, as we have noted, rather revolved upon the mental capacity of the deaf in certainproceedings, and upon their competence in certain legal relations. These judicial expressions have in the main referred to four relations of the deaf in the law: 1. in their responsibility for crime; 2. in acting as witnesses; 3. in requiring guardians; and 4. in the making of wills and contracts generally.

As to the responsibility of the deaf man for his misdeeds, there has been in times past more or less presumption against it, especially if he were born deaf and were without education; but to-day he is quite generally held fully answerable for his crimes and misdemeanors, and his deafness cannot mitigate his punishment.[89]As a witness, the deaf man under proper circumstances is now allowed to appear without hindrance before virtually any court.[90]As to special guardians, these will be accorded the deaf when there appears sufficient need, though there is less of this than formerly.[91]With respect to the testamentary capacity of the deaf, we find that in times past the deaf were often said to be more or less incapable of making wills, though this presumptioncould always be overcome. Naturally their wills were subjected to considerable scrutiny for the purpose of preventing fraud; but if written and apparently genuine, they could usually stand. To-day the deaf are practically everywhere held to be quite capable in this respect, and probably nowhere would a will be set aside for reason of the deafness of the testator alone. Likewise the deaf are now generally held capable of entering into all contractual relations.[92]

In most of the statutes and decisions to which we have referred there appears a distinct trend towards treating the deaf quite as normal persons, and the tendency may be considered to be general to-day to hold them very much as other citizens. The greater part of all the special legislation has ceased of late years, and it is seldomnow that a particular enactment is placed upon the statute books. Where such does occur, it arises chiefly where some peculiar protection of the deaf has been felt to be needed. Discriminatory legislation has practically disappeared, as has also beneficial legislation of the old sort, the only kind likely to be enacted in the future being along the new lines pointed out.

In judicial proceedings likewise particular usage in respect to the deaf has almost entirely passed away, and the deaf to-day receive little distinctive treatment. Practically the sole special consideration now accorded them is in the procurement of interpreters for proper occasions. On the whole, then, the present attitude of the law may be said to be to regard the deaf more and more fully as citizens, to allow them all the rights and duties of such, and to consider them in little need of particular aid or attention.[93]

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