Feeble-Minded in Our Midst: Institutions for the Mentally Retarded in the South, 1900-1940

By Kevin W. Young

The problem of how to treat the mentally handicapped attracted much attention from American reformers in the first half of the twentieth century. In this book, Steven Noll traces the history and development of institutions for the 'feeble-minded' in the South between 1900 and 1940. He examines the influences of gender, race, and class in the institutionalization process and relates policies in the South to those in the North and Midwest, regions that had established similar institutions much earlier. At the center of the story is the debate between the humanitarians, who advocated institutionalization as a way of protecting and ministering to the mentally deficient, and public policy adherents, who were primarily interested in controlling and isolating perceived deviants. According to Noll, these conflicting ideologies meant that most southern institutions were founded without a clear mission or an understanding of their relationship to southern society at large. Noll creates a vivid portrait of life and work within institutions throughout the South and the impact of institutionalization on patients and their families. He also examines the composition of the population labeled feeble-minded and demonstrates a relationship between demographic variables and institutional placement, including their effect on the determination of a patient's degree of disability.

Originally published in 1995.

A UNC Press Enduring Edition -- UNC Press Enduring Editions use the latest in digital technology to make available again books from our distinguished backlist that were previously out of print. These editions are published unaltered from the original, and are presented in affordable paperback formats, bringing readers both historical and cultural value.

• Language: English
• Publisher: The University of North Carolina Press
• Release date: Jun 15, 2018
• ISBN: 9781469647708

Kevin W. Young

Kevin W. Young teaches at Appalachian State University.

Book preview

FEEBLE-MINDED IN OUR MIDST

STEVEN NOLL

Feeble-Minded in Our Midst

Institutions for the

Mentally Retarded in the

South, 1900—1940

The University of North Carolina Press

Chapel Hill and London

© 1995 The University of North Carolina Press

All rights reserved

Manufactured in the United States of America

The paper in this book meets the guidelines for permanence and durability of the Committee on Production Guidelines for Book Longevity of the Council on Library Resources.

Library of Congress Cataloging-in-Publication Data

Noll, Steven.

Feeble-minded in our midst: institutions for the mentally retarded in the South, 1900–1940 / Steven Noll.

   p. cm.

Includes bibliographical references and index.

ISBN 0-8078-2220-5 (cloth : alk. paper).

ISBN 0-8078-4531-0 (pbk. : alk. paper)

   1. Mentally handicapped—Institutional care—Southern States—History. 2. Mentally handicapped—Government policy—Southern States. 1. Title.

99 98 97 96 95     5 4 3 2 1

Portions of Chapter 5 appeared in a somewhat different form in Southern Strategies for Handling the Black Feeble-Minded: From Social Control to Profound Indifference, Journal of Policy History 3 (Spring 1991): 130–51.

Other portions of the manuscript have appeared in a different form as parts of the following articles: Care and Control of the Feeble-Minded: Florida Farm Colony, 1920–1945, Florida Historical Quarterly 69 (July 1990): 57–80; ‘A Far Greater Menace’: Feeble-Minded Females in the South, 1900–1940, in Hidden Histories of Women in the New South, edited by Virginia Bernhard, Betty Brandon, Elizabeth Fox-Genovese, Theda Perdue, and Elizabeth Turner, 31–51 (Columbia: University of Missouri Press, 1994); and Patient Records as Historical Stories: The Case of Caswell Training School, Bulletin of the History of Medicine 68 (Fall 1994): 411–28.

THIS BOOK WAS DIGITALLY PRINTED.

To Dorothy and Fred Noll,

and Tillie Braun

CONTENTS

Acknowledgments

Introduction

Chapter 1. From Neglect to Control: The Opening of Institutions in the South

Chapter 2. The Establishment of a National Profession: Mental Retardation, 1900–1940

Chapter 3. Southern Institutions in a Wider World

Chapter 4. The Promise of Sterilization

Chapter 5. Under a Double Burden: Feeble-Minded Blacks in the South

Chapter 6. The Multiple Functions of Southern Institutions

Chapter 7. Internal Dynamics: Demographics and Mental Levels in Southern Institutions

Chapter 8. Internal Dynamics: Staffing and Schooling in Southern Institutions

Conclusion

Notes

Bibliography

Index

A section of illustrations follows page 80.

TABLES

I.1. Comparison of Descriptive Terminology, 1930 and 1994

1.1. Institutions for the Feeble-Minded in the South

2.1. Median IQ Scores of Southern Males, 1917 Army Alpha Test

2.2. Commitment Procedures of Southern States

2.3. Numbers of Mental Defectives Institutionalized, by Region, 1937

2.4. Numbers of Mental Defectives Institutionalized in Southern States, 1937

7.1. Patients in State Institutions for Mental Defectives, 1923, 1940 (average per 100, 000 persons)

7.2. Average Length of Residence in Caswell Training School, by Sex, 1914–1939

8.1. Monthly Pay of Superintendents, Teachers, and Attendants, Florida Farm Colony, 1921–1935

8.2. Places of Employment for Patients at Caswell Training School, 1935

8.3. Schools in Southern Institutions, 1938–1940

ACKNOWLEDGMENTS

In the six years this work has consumed my life, I have accumulated more debts than I care to imagine. I can never repay them; all I can do is acknowledge them with heartfelt thanks and hope I have not left anyone out. The financial help provided by the University of Florida Department of History was essential, for without it, this project could not even have been started, much less completed. I would also like to thank the Rockefeller Archive Center, Pocantico Hills, New York, and the North Caroliniana Society of Chapel Hill, North Carolina, for their travel to collection grants, which enabled me to conduct much of my research.

The supervising committee that oversaw this work in its initial form as a dissertation provided me with guidance, support, and help at every step of the process. Special thanks to Kermit Hall, my chairman, for his faith in my abilities and his knack for discovering the truly meaningful in my work. He always found time for my harried questions, even in the middle of an incredibly busy schedule. The other committee members—Robert Hatch, Michael Radelet, Bertram Wyatt-Brown, and Robert Zieger—all provided valuable intellectual advice and guidance. Michael Radelet also proved that good teaching, good research, and social activism are not mutually exclusive variables. My colleagues at the University of Florida (some of whom have moved on to other places in the interim)—Jeff Adler, David Chalmers, Tom Gallant, Susan Kent, Anne Jones, Chris Morris, and Samuel Proctor—gave me valuable help, some of it unsolicited, much of it unheeded, all of it appreciated.

Through the writing of this book I have discovered the meaning of the community of scholars. Many individuals with little stake in my work took the time to read the manuscript and offer encouragement and suggestions. Thanks to Cheryll Cody, Ellen Dwyer, Gerald Grob, John Hughes, Michael Sokal, Nicole Rafter, and Todd Savitt for their efforts.

Researching can be a difficult and lonely process. The help of archivists, librarians, and staff people made my life significantly easier. The librarians at the University of Florida, particularly Gary Cornwell in Government Documents, Lenny Rhine at the Health Center Library, and the staff of the P. K. Yonge Library of Florida History, saved me literally thousands of steps in running around campus. The staffs at the National Library of Medicine, University of Florida Health Center Library Annex in Jacksonville, the Rockefeller Archive Center, the Florida State Archives, the Georgia State Archives, the North Carolina State Archives, the South Carolina State Archives and Library, the Virginia State Archives and Library, the Jones Memorial Library in Lynchburg, Virginia, the South Caroliniana Collection and the medical library of the University of South Carolina, the Southern Historical Collection and the North Carolina Collection at the Wilson Library, University of North Carolina, Chapel Hill, the Alderman Library of the University of Virginia, the Social Welfare History Archives at the University of Minnesota, the General Federation of Women’s Clubs Archives in Washington D.C., and the Florida Baptist Historical Collection at Stetson University all provided advice and comfort to a weary, and often grouchy, researcher. Special thanks to Mary Barnes and Gene Williams of the Old Records Center of the North Carolina State Archives, Conley Edwards of the Virginia State Archives, David Klaassen of the Social Welfare History Archives, and Earl Joiner of Stetson University for their personal attention. I would also like to thank Reed and Angie Bohne, Reggie Clark, Tom and Alison Duncan, Sue Lang, Don and Lane Neisen, Miriam Reiser, Al and Betsy Sharrett, and Bettye and Joe Harris for opening their homes and their refrigerators and providing a touch of home while I was on the road.

For this work, much research had to be conducted in nonresearch facilities, on the grounds of functioning institutions for mentally handicapped individuals. This could not have been possible without the help of staff who opened their archives and files to me. Special thanks to former superintendent Max Jackson and his secretary, Agnes Stanford, of the Tacachale Community (formerly Sunland Center) in Gainesville, Florida, for their encouragement of my work and their help in allowing me access to the vault files there. Similarly, the director of Caswell Center, Jim Woodall, and his assistants, Joanne Richiutti and Becky Brown, showed me the meaning of southern hospitality on my two trips to Kinston, North Carolina. Thanks also to Helen Hester, staff librarian at the Central Virginia Training Center, Lynchburg, Virginia, and the staff at Whitten Center, Clinton, South Carolina.

Other debts incurred in the writing of this book have little to do with the actual production of it. Perhaps they are more important, however. Words cannot express the sincere appreciation of the help supplied by Jane Landers and Rosemarijn Hofte. Their support, both intellectual and emotional, has been incalculable. Their friendship helped me handle the rough times. Their historical work also stands as an example of the kind of work I aspire to. The students, staff, faculty, and administration of Sidney Lanier School have helped pull me through the doldrums of a work that never seemed to end. They continue to show me that my work has relevance and importance today. Lenny, Helene, Moe, and Jamie Rhine have once again made me see what was truly important in my life. Thanks also to Abner Doubleday and James Naismith, without whose games this work would never have been finished—or would have been finished long ago.

Finally to my family, my thanks are incalculable. To my parents, Dorothy and Fred Noll, your support of my intellectual endeavors, your pride in my meager accomplishments, and your amazing courage in the face of adversity have given me strength and hope. That neither of you lived to see the completion of this project does not diminish your involvement but only saddens me that you could not share my sense of fulfillment in finishing. To my wife, Beverly, my son, Jody, and my daughter, Amanda, you have given me financial and emotional support, laughter, love, friendship, broken arms, and dirty diapers. Without your help, this work would never have been completed. Maybe now I can become a better husband and father. Finally, to Joel Jaskolski, you may not be able to read this, but you know why.

FEEBLE-MINDED IN OUR MIDST

INTRODUCTION

In 1923, Superintendent C. Banks McNairy, of North Carolina’s Caswell Training School, addressed the annual meeting of the American Association for the Study of Feeble-Mindedness. Just one year after he served as the first southern president of that organization, he warned, Our problem is far more difficult… [because the] organization [of institutions] in the South is another problem that must be approached from far more different angles than in other parts of the country. McNairy concluded in his speech, We [in the South] have not been studying or handling this problem nearly as long as other parts of the country have.¹

The problem of caring for and controlling America’s feeble-minded population proved especially vexing for reformers in the forty-year period from 1900 to 1940. A1914 editorial in the influential social welfare journal Survey concluded: Among the social tasks that confront state governments today, none is more pressing than the care of the feeble-minded.… [I]t is because they, at least as much as any other class, complicate and involve every social problem, and because, they, more than any other class, tend to increase on our hands.² Although a national concern, feeble-mindedness and its concomitant complexities proved especially troublesome in the South. Beset by endemic poverty and mired in a caste-based system of racial separation, southern states truly faced a feeble-minded situation of far more different angles. Yet the responses of southern reformers, administrators, and bureaucrats did not address the particular southern situation. Instead, bolstered by northern philanthropy and example, southerners generally followed tried-and-true northern responses to problems caused by feeble-minded individuals. These responses, based on an institutional model, proved relatively ineffective in providing solutions to the societal dilemmas posed by the feeble-minded. The following work examines southern care for the feeble-minded, focusing on institutions for the mentally retarded in the South from 1900 to 1940.

The problems of nomenclature and terminology clouded the issue of what actually constituted mental retardation during the first four decades of the twentieth century. Before World War II, the term retardation, now professionally defined as significantly sub-average general intelligence, was used infrequently.³ During that time period, researchers and professionals invoked a myriad of terms to identify people as intellectually below average. They sometimes used these labels with assumed scientific accuracy and at other times bandied them about with little precision. They used the term feeble minded to refer to the entire class of people who today would be categorized as mentally handicapped (the names of many institutions even contained the feeble-minded label in their title—for example, Kentucky’s institution was officially known as the Feeble-Minded Institute). This term began to fall into disfavor in the late 1920s when professionals replaced it with mental defective, though feeble-minded continued as a synonym into the 1940s.⁴ Leaders in the field also utilized mentally deficient to identify those classified as intellectually subnormal (in 1934 the American Association for the Study of Feeble-Mindedness, the organization founded in 1876 to conduct research in the field of mental retardation, changed its name to the American Association on Mental Deficiency).⁵ Professional people and laymen used all three of these labels—feeble-minded, mentally defective, and mentally deficient—interchangeably, with little concern for accurate description.

Leaders in the retardation field also broke down the category of feeblemindedness into definitional subcategories, which often obfuscated as much as they illuminated. Today, intelligence testing scores provide three specific groupings under the broad heading of mental retardation. Those people classified as educably mentally handicapped or educably mentally retarded receive IQ scores ranging from 55 to 70. The trainable mentally handicapped category falls below the educable one, with IQ scores ranging from 25 to 55. The lowest grouping, the profoundly mentally handicapped, score below 25 on their IQ tests. A similar three-tiered arrangement existed from the mid-1910s onward, but its use was not as standardized and formalized as that of the system in use today (see table I.1). In this earlier system, three categories—moron, imbecile, and idiot—composed the general grouping of feeble-minded individuals. These scientifically acceptable descriptive labels persisted long after they had been adopted as part of the derisive slang vocabulary.⁶ Although these categories differentiated between levels of retardation, the distinctions between the levels remained blurred, especially between the moron class and the borderline normal. Borderline individuals scored between 70 and 85 on standardized intelligence tests, and experts disagreed over their level of true retardation. Poorly standardized IQ tests exacerbated the inexactness of identification. Reflecting middle-class value systems, early intelligence tests notoriously underscored those groups that did not share middle-class patterns of thought and behavior. The lower classes, minority groups, and immigrants constituted significant percentages of those classified as mentally defective on the basis of these tests.

The disputes over the definition of mental retardation mirrored broader sociological concerns about the nature and origin of deviant behavior generally. Labeling theory provides one explanation for the display of deviant behavior by individuals. According to sociologist Howard Becker, Deviance is not a quality that lies in behavior itself, but in the interaction between a person who commits an act and those who respond to it.⁷ Under this definition, individuals are determined [as retarded, or otherwise deviant] by the judgement of others, not by their innate characteristics.⁸ This societally based model of retardation can be used to explain the ever increasing numbers of feeble-minded people identified in the first forty years of the twentieth century.

Table I.1. Comparison of Descriptive Terminology, 1930 and 1994

Mental retardation poses a specific problem to the adherents of labeling theory, however. Labeling theorists assert that secondary deviance, deviance ascribed by societal reaction, is paramount in the assigning of a deviant role. Sociologist Bernard Farber has written, The history of mental retardation as deviance represents an attempt to integrate a variety of social problems … [and] to explain a connection between retardation and poverty, alcoholism, crime, and other forms of deviance. Yet, for many retarded people, particularly in the severe and profound ranges, deviance is primary—the significant physical and mental defects are innate and are not caused by societal reaction. To Farber, these people are not deviant but incompetent. He suggests, Incompetence refers to the inability of a few to attain the level of conduct necessary for the continuation of an existing social organization.⁹ This differentiation is extremely important, since it provides a framework for understanding the conflicting rationales for the care and treatment of varying people labeled as mentally handicapped. Society can ignore, pity, or help those viewed as incompetent. Conversely, it can punish or isolate those seen as deviant.

Although the work of Farber and other sociologists of mental retardation such as Jane Mercer has placed retardation research squarely in a social context, their work has no empirical historical component. This book examines the process of identifying and institutionalizing feeble-minded individuals in the South in the first forty years of the twentieth century in the light of Farber’s dichotomy of deviancy versus incompetency. Southern states, in ways similar to their northern counterparts, often institutionalized morons because of their seeming inability to meet the norms of society. Those people who lacked desirable social characteristics and engaged in behavior deemed deviant ran the risk of being labeled as mentally defective morons. Because institutions, both northern and southern, dealt directly with morons, they served the controversial function of protecting society from these individuals labeled deviant.

Southern states found the institutional solution for their mentally retarded populations rather late. Many northern and midwestern states opened separate institutions for their feeble-minded populations in the nineteenth century, guided by, in the words of historians Peter Tyor and Leland Bell, humanitarianism and reformist faith in the perfectability of man.¹⁰ Southern states developed separate institutional facilities for the care and treatment of feebleminded individuals by the early 1920s, influenced by a different intellectual climate: the scientific reform impulse and the concerns about the plight of society of the Progressive Era.

The opening of southern institutions coincided with a nationwide increase in the numbers of institutionalized feeble-minded individuals nationwide. In 1904, 17.3 feeble-minded persons per 100,000 of the general population had been institutionalized. By 1923, this figure had climbed to 46.7.¹¹ These numbers were not simply a manifestation of the better medical and scientific detection and reporting methods that leaders in the field developed during this time period. Nor did they solely signify an increasing societal awareness of the problems of the feeble-minded, as many Progressive Era reformers believed. Finally, the numerical increase did not represent merely a blatant attempt to segregate and control a portion of the population labeled as deviant and therefore threatening. On the contrary, between 1900 and 1940, the generation of progressive reformers and their successors incorporated elements of all three aspects to forge solutions to the problems associated with feeblemindedness. This complex interplay between scientific ideas and public policy implementation, between humanitarian impulses and the need for social control, forced southern institutional leaders to develop facilities without a clear understanding of their function or their relationship to the larger society.

Progressive attempts at reform and social engineering gave special emphasis to the effects of deviant populations on society. Social reformers often blamed societal ills on those classes least able to conform to mainstream values and expectations. The social workers, physicians, and philanthropists who pressed for institutions for the feeble-minded, and the legislators and governors who supported them, considered protection for society from retarded people, and not the reverse, as their major priority. A1921 Georgia Department of Public Welfare Report put the matter into clear perspective. What shall it profit Georgia if we stop the loss from the boll weevil and fail to stamp out the germs of dependency and delinquency that eat the heart out of the human family itself?¹² This concern made the relationship between outside pressures and inside responsibilities especially difficult for the superintendents charged with operating the newly opened institutions.

Nowhere was the tension greater than in decisions about which people to admit. Although judges and social workers often tended to label and initiate institutionalization of morons on the basis of their deviant behavior, these officials identified idiots through their appearance and inability to function in society. Usually physically handicapped, idiots appeared obviously different, and even laymen could appreciate their need for assistance. The personal incompetence of idiots, not their societal role, dictated admission to institutions nationwide. The perception of idiots as individually unable to fit into society, according to Farber, represented an attempt to isolate retardation from other social problems.¹³ The idiot population of southern institutions seemingly presented more of a medical than a social problem.

The tension inherent in identifying and institutionalizing retarded people based both on social deviancy and on personal incompetency fostered conflict over the functions of southern institutions. Whereas protection of the feeble-minded provided the major rationale for committing low-level idiots, protection of society from the feeble-minded remained the reason for admitting higher-level morons.¹⁴ For the moron population, judges and other committing officials viewed their retardation as deviance from the norm rather than individualized incompetence. This deviance, wrote Farber, implies a social problem, a threat to established social relationships; it suggests that a proportion of the population is using inappropriate means or goals.¹⁵ Once an individual was labeled as deviant and retarded, labeling theory predicted that he or she would fulfill the expectations of that role. Many high-level morons fit this sociological model of deviant behavior. Since they were unable to conform to societal expectations, their deviant behavior allowed community officials to label them as mentally defective and commit them to institutions for the feeble-minded. Conversely, lower-level idiots appeared to be no threat to the established social order. Judges committed them to institutions to ensure their own protection and to provide relief for their overburdened families. Caught between these two mutually exclusive missions of protection for and from society, southern institutions struggled to fulfill both. In the first decades of their existence, these institutions muddled along, neither training retarded individuals for a more productive life nor protecting society from the supposed menace of the feeble-minded.

Although Farber’s sociological dichotomy of deviancy versus incompetency provides a clear theoretical focus for this work, the historical notion of social control appears more problematic. The concept of social control has provided historians with the agenda for numerous books, articles, papers, and conference sessions; yet there is no precise resolution of how and when to use the term. The idea of social control has become so elastic that it lacks clear explanatory power. It can be used to explain almost any historical phenomenon.

Many historians of the 1970s and 1980s developed a new framework for examining the American past, one that emphasized the notion of social control. Often set in Marxist terms, this history viewed the American landscape as one of conflict, oppression, and control by dominant groups. These radical historians called into question the liberal humanitarian values of assumedly benign American social welfare institutions. Authors used the methodologies of this new social history to investigate many social welfare agencies and organizations. Juvenile justice systems, public education, welfare, and the institutionalization of those labeled as mentally ill all received sustained attention.¹⁶ In 1983, historian Walter Trattner explained their analytical framework, organized loosely around the social control model. Trattner wrote:

Historians of social welfare challenged the idealistic and moralistic interpretations of welfare programs and the reasons for their implementation. Humanitarian and reformist rhetoric aside, progressive ideas did not shape social policy, the critics argued. Rather, the changes and reforms that occurred were designed by the upper classes to manipulate and coopt those below them; control of the poor by shaping their opinions and world view, by buying them off with short- or long-term but inadequate benefits, and when necessary, by using repressive force, has enabled the elite to prevent the serious disruption of society, preserve the capitalist economy, and maintain its social and economic advantage.¹⁷

Much good historical work concerning social welfare institutions came out of the loosely organized social control framework. Monographs provided a healthy corrective to the previous Whiggish institutional histories that viewed the growth of services for the deviant and dependent as inherently positive and uplifting. But the new works did little to advance the argument past the catchwords of control and subordination. The widespread attempt to label reform movements as social control efforts, wrote John Mayer in 1983, … while occasionally serving the purpose of polemics, often does little to help understand historical developments over time.¹⁸

Whereas the social control theorists viewed social services generally as instruments of oppression, other historians have examined these institutions and found them well-intentioned yet still seriously flawed. The work of Gerald Grob stands out in this regard. In 1983 Grob noted, Many [mental] hospitals had serious defects and shortcomings … the quality of care left much to be desired … yet these shortcomings were not limited to mental hospitals; they simply mirrored the imperfections and limitations of most human institutions.¹⁹

Historians, however, have largely ignored the societal concern about feeblemindedness that so worried educators, physicians, and social work professionals in the first forty years of the twentieth century. Analysts have also ignored the institutional solutions forged by successive generations of reformers during this era. In spite of the advances made by the new social history, the study of mental retardation and the institutions designed to house mentally retarded individuals, particularly in the South, remained generally unexplored. What few historical works were written, usually by nonhistorians, stressed the humanitarian nature of care for the retarded and the progressive pattern of improving that care.²⁰

In 1984, Peter Tyor and Leland Bell published their Caring for the Retarded in America: A History. Based on Tyor’s previous articles and dissertation, this work promised to bring the historical study of retarded people into the debate over social welfare policy.²¹ It did not fulfill that promise, however; the book failed to tie retardation to broader themes in American history. Furthermore, it treated the care of retarded individuals as if this care were geographically consistent. Ignoring the differing social, economic, demographic, and political conditions of the South, Tyor and Bell assumed that southern institutions treated patients in a similar fashion to their more well-documented northern counterparts.²² Yet southerners concerned with the treatment of the mentally retarded certainly recognized the regional differences even if later historians did not.

The disputes over the historical interpretations of social welfare institutions have been many and heated but not very illuminating. All sides agree, however, that the debate must move past a continued discussion of the merits of social control. This work does that by examining the important question of why, at a particular period of time, ten southern states suddenly discovered the problem of the feeble-minded and attempted to alleviate it with an institutional solution. Accepting that those people interested in institutionalizing feeble-minded individuals acted from a variety of motivations (from genuine concern to an attempt to control a loosely defined deviant population), I place humanitarianism and social control as two poles of a continuum rather than as divergent Manichaean worldviews. This work also presupposes an inherently dialectical relationship between the state and its citizens. Social control analysis, on the other hand, assumes the invisibility of individual actors. For social control adherents, the state and its pervasive influence hold center stage. The state certainly victimized many individuals institutionalized as feeble-minded, but these people and their families also helped to shape the dimensions of their commitment. Families and communities played major roles in the process of institutionalization, often for mundane and personal reasons.²³

The social control model may turn erstwhile reformers into villains, but it places the institution squarely in a social context. Sociologists Stanley Cohen and Andrew Scull commented in 1983: What became recognized is that matters of crime, deviancy, delinquency, illness, and madness don’t just every now and then touch on wider issues of politics, economics, and power. They are intimately related and, indeed, these very categories are politically defined.²⁴ The move to institutionalize feeble-minded people in the South in the first decades of the twentieth century took place in the political arena. It formed part of an attempt to grapple with the vast economic and demographic changes that swept across the South during this period. This work owes a debt to the social control theorists, whose work encouraged me to look at retardation and the public response to it in a broadly defined political context.

Other scholars, particularly Ellen Dwyer and Nancy Tomes, have examined institutions from an internal, rather than an external, perspective.²⁵ This case study approach highlights the interaction between staff and patients and deemphasizes the larger issues raised by the social control theorists. These authors provide the reader with a sense of the daily life of an institution, the mundane programming that affects the lives of patients and staff alike. Done well, this type of analysis provides insight into the implementation of public policy at its most basic point and returns human agency to a social control argument that, at its most extreme, regards individual action as either malevolent or inconsequential in the face of impersonal economic and social trends.

"We need to know far more about the internal and external factors that governed the evolution of psychiatry and mental hospitals," wrote Gerald Grob in 1977.²⁶ The following work heeds Grob’s precept by examining institutions for the mentally retarded from both the inside and the outside and reveals a program in search of a true purpose. Southern institutions grew rapidly in the 1910s and 1920s in response to a problem neither rigidly defined nor scientifically delineated. Beset by political pressures and monetary constraints, institutional superintendents also struggled to control diverse populations of individuals labeled as feeble-minded. The implications of racial, class, and gender decisions in labeling and institutionalization necessarily provide insight into the nature of southern society in the first four decades of the twentieth century. Emphasizing these categories of analysis allows much more than a portrait of feeble-minded institutions in ten southern states. The southern treatment of people labeled as feeble-minded illuminates broad issues relating to both national social welfare policy and southern society.²⁷

Although southern institutions retained a somewhat separate identity from those in other regions, national social welfare organizations played an important role in their growth and development. Funding and support from northern philanthropies proved especially crucial to the timing and development of these institutions. Money and personnel from the National Committee for Mental Hygiene (funded by the Rockefeller Foundation) and the Russell Sage Foundation provided the groundwork and rationale for the opening of many of the South’s institutions for the feeble-minded. The entrance of the United States into World War I proved crucial for this relationship at a time when northern influence and southern social welfare policy coincided. The widespread use of the newly developed individualized intelligence tests on World War I military recruits revealed an astounding number of feeble-minded people among the thousands tested. The results proved