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Thursday, September 1, 2005
Subject: FAS: From 1977 to
2006
Time: 12:38:21 PM EDT
Author: psoba
1977. The Merck Manual: Thirteenth
Edition. Fetal Alcohol Syndrome is not mentioned in this
edition.
Minimal Brain Dysfunction is now
under the heading, Learning Disorders and "More common labels include
brain injury, brain damage, minimal brain damage, hyperkinesis, perceptual
deficits and dyslexia."
Under
treatments:
"... to keep the child in his regular
classroom and to schedule some periods with a teacher who is trained to
provide special help-technics which succeed in improving poor
performance..."
The use of stimulants to improve
attention is again mentioned.
Under Personality
Disorders, only the Hysterical (*histronic) Personality, Psychopathic
(*Sociopathic or Antisocial) Personality and the Inadequate Personality
are still included. The quotes beside psychopathic personality are
the Merck's quotes. This indicates that for many in the medical
field, the sociopathic/antisocial/psychopathic diagnoses are
interchangeable. The etiology of the two conditions are identical to
those descriptions in the Twelfth Manual
(1972).
The National Institute of Alcohol
Abuse and Alcoholism (NIAAA) issues the statement that 6 or more drinks
per day incurred the risk that a woman could produce a child with birth
defects.
1978. Third Special Report to Congress on Alcohol and
Health: Fetal Alcohol Syndrome. published by the Department of
Health and Human Services and the National Institute of Alcohol Abuse and
Alcoholism (NIAAA). This was the first time FAS became an integral
part of this specially commissioned report to the U.S.
Congress. Each report adds information to the previous report
on alcohol and other related topics. Therefore, information
presented in these reports to Congress seldom repeat each other except for
the introductions. Contents cover etiology, symptoms, physical
signs, physical damage to organs, psychological aspects, economic costs
and current research. Extensive bibliography accompanies each
section.
1979. By this year, over 600 cases of FAS had been reported
worldwide. Dr. Ernest Abel in Fetal Alcohol Syndrome and Fetal
Alcohol Effects. (New York: Plenum Press.) reported
that incidences of FAS were in articles from Australia, Belgium, Brazil,
Canada, Chile, Czechoslovakia, France, Germany, Hungary, Ireland, Italy,
Reunion, South Africa, Spain, Sweden, Switzerland, and the U.S.
1980. Research Society on Alcoholism (RSOA) issues three criteria
for a diagnosis of FAS. "A pattern of characteristic facial
features, pre-postnatal deficit in height and weight, and central nervous
system damage."
1981. Fourth Special Report to Congress on Alcohol and
Health: Fetal Alcohol Syndrome published by the Department of
Health and Human Services and the NIAAA. Pages 59-111.
The Surgeon General of the United States issues a
health advisory recommending that pregnant women or women considering
getting pregnant abstain from using alcohol because of possible harm to
the unborn child.
1982. The Merck Manual: Fourteenth
Edition. Nine years after the first international paper on the
etiology of Fetal Alcohol Syndrome was published, FAS finally appears in
the Merck Manual. Under Section 16: Pediatrics and Genetics, Chapter
189: the Newborn, Metabolic
Conditions:
"...The most serious consequence is
mental retardation..."
Under Section 23: Clinical
Pharmacology, Chapter 274: Drug Toxicity, Drugs in
Pregnancy: "...borderline mental deficiency..." No other
serious behavioral problems are discussed.
Under Section 12: Psychiatric Disorders,
Chapter 142: Personality Disorders are described for the first time in the
nomenclature of the Diagnostic and Statistical Manual of Medical Disorders
(DSM-III).
The diagnostic section, the following has
been added to coping mechanisms (5) Turning against one's self
allows aggression towards others to be expressed indirectly and
ineffectively through passivity. It includes failures and illnesses
that affect others more than one's self, and silly, provocative
clowning. The mechanism underlies most sadomasochistic
relationships.
The Hysterical (*histronic) and
Antisocial Personalities (*psychopathic, sociopathic) (*quotes are from
the Merck Manual) are the only two that remain under personality
disorders.
" The Histronic (Hysterical) Personality
is described in various terms such as "
egocentric...attention
seeking...theatrical behavior...emotional immaturity...childish, emotional
response...lively manner...rarely deeply involved emotionally...insatiable
need for affection...easily repress or forget unpleasant or discreditable
experiences...responsiblity for misfortunes and failures is usually
ascribed to others."
" The Antisocial Personality
"(previously used designation: psychopathic,
sociopathic)
characteristically act out their conflicts and flout normal rules of
social order. ...impulsive, irresponsible, amoral, unable to forego
immediate gratification. They cannot form affectionate relationships with
others, but their charm and plausability may be highly developed and
skillfully used for their own ends. They tolerate frustration
poorly, and opposition is likely to to elicit hostility, aggression, or
serious violence. Failure and punishment rarely modify their
behavior or improve their judgment and foresight."
Suggested therapies or treatments, "Although these mechanisms may not
be breached by reason or interpretation, they respond to improved
interpersonal relationships and to supportive but forceful confrontation
in prolonged psychotherapy or peer encounters."
1983. Fifth Special Report to Congress on Alcohol and
Health: Fetal Alcohol Syndrome published by the Department of
Health and Human Services and the NIAAA. Pages 68-82.
1984. Fetal Alcohol Syndrome and Fetal Alcohol
Effects. by Dr. Ernest Abel. One of the first textbooks to
overview the mechanisms and laboratory research on the effects of alcohol
upon laboratory animals and selected cases.
1985. A Poison Stronger than Love. by Anastasia
Shkilnyk. A book that tells the story of FAS in an American Indian
(Ojibway) community. New Haven: Yale University Press.
1987. The Merck Manual: Fifteenth
Edition. Fetal Alcohol Syndrome is comprised of one paragraph on
page 1887. "The most serious consequence is severe mental
retardation." There is no mention of other behavioral
problems.
Under Section 12, Psychiatric Disorders, Chapter
137, Personality Disorders the diagnosis section and the Histronic
(*Hysterical) and Antisocial (*Psychopathic, Sociopathic) Disorders
section are copies of the Fourteenth Manual (1982) manual entries.
(*quotes are from the Merck Manual.)
Under Section 15: Gynecological and Obstetrical
Care, Chapter 176: Normal Pregnancy, Labor and Delivery, Prenatal
Care, the Merck states, "Recent studies indicate that...a daily
intake of (less than) 2 ounces of wine probably would not cause
fetal abnormalities."
Sixth Special Report to
Congress on Alcohol and Health: Fetal Alcohol Syndrome published
by the Department of Health and Human Services and NIAAA. Pages
79-96.
1988. High Risk: Children Without a Conscience by
Dr. Ken Magid and Carole McKelvey. A highly popular book at the
time. It deals almost exclusively with psychopathic (antisocial)
personalities. The problems therein are ascribed to working mothers,
day care, teenage pregnancy, divorce, tv violence, schools, lack of
religion, too much money, too little money, lack of bonding/trust,
adoption and foster care...everything except prenatal alcohol
exposure. The introduction was written by Congresswoman Patricia
Schroeder. The topics brought up in this book are still being
discussed as reasons for children's behavioral problems.
1989. The Broken Cord by Michael Dorris. The
first nationally distributed book on FAS and its effects on a
family. Dr. Dorris cited 165 articles and books and three videos on
the dangers of drinking during pregnancy.
U.S. law calls for the mandatory labeling of
all containers of alcohol sold in the United States.
1990. Seventh Special Report to Congress on Alcohol and
Health: Fetal Alcohol Syndrome published by the Department of
Health and Human Services and the NIAAA. Pages 138-161.
1992. The Merck Manual: Sixteenth
Edition. Fetal Alcohol Syndrome is mentioned
on
Page 1860 with no mention of the behavioral
problems of FAS.
Pages 1880-1881, "...severe
behavioral effects..." "...varying degrees of mental retardation, and
abnormal neurobehavioral development." "FAS is the leading known
cause of mental retardation..."
Page 2009 with no
mention of behavioral problems
Page 2109, "...and
MR."
Page 1860, does state "In one study, an
increased frequency of abnormalities was not found until 45 ml of alcohol
(equivalent to 3 drinksper day) was exceeded."
[The Surgeon General of the United States issued his warning against
drinking during pregnancy in 1981.]
Personality
Disorders are derived from the Diagnostic and Statistical Manual of
Mental Disorders - Revised edition (DSM III-R) and include the Histronic
(*Hysterical) Personality and the Antisocial (*Psychopathic, Sociopathic)
Personality. (*quotes are from the Merck
Manual)
Under treatment, the following has been
changed and added:
"The physician's job is to
contain the patient's externalization through setting limits,
confrontation, and avoiding his own tendency to become
overinvolved--first to rescue and then condemn. ... Over the long
term, the anxiety and and depression...are rarely abolished by
pharmacotherapy...(exceptions are associated depression and compulsive
disorders).
"Patients must be confronted with the
way their behavior affects other people. Frequently, limits on
behavior need to be set and reality issues dealt with. ...the family
should be involved, since group pressure seems to be effective.
Group and family treatment, group living situations, therapeutic social
clubs, self help groups, milieu hospital therapy--all can be valuable in
treatment. ...It is also important that those who undertaken
treatment be aware of the difficulties and avoid the disappointment,
annoyance , and moral judgments that tend to creep
in."
Finally, "Life expectancy is diminished
but among those surviving, there is some tendency to stabilization after
age 40."
1993. Eighth Special Report to
Congress on Alcohol and Health: Fetal Alcohol Syndrome published
by the Department of Health and Human Services and the NIAAA. Pages
202-232.
1995. Fetal Alcohol
Syndrome: Diagnosis, Epidemiology, Prevention and
Treatment. edited by Kathleen Stratton, et al. This
Institute of Medicine textbook was the American effort to consolidate the
research and practical knowledge that was available up to that time and to
provide a uniform basis for diagnosis.
1995-2004.
The Merck Manual: Seventeenth Edition is online at http://www.merck.com/.
Fetal Alcohol
Syndrome is found in this volume. The behavioral aspects of FAS are
as follows: Section 21, Chapter 286,
"..with mental retardation and behavioral
disturbances..."
Section 18, Chapter 250,
"...varying degrees of mental retardation and abnormal neurobehavioral
development."
Personality Disorders are in Section
15: Psychiatric Disorders Chapter 191: Personality Disorders.
The excerpts quoted are taken from the Diagnostic and Statistical Manual
of Mental Disorders, Fourth Edition (DSM-IV), under Cluster B:
dramatic/erratic.
Antisocial Disorder (*previously
called psychopathic or sociopathic) is essentially the same as the
previous entries from prior Merck editions.
There
are additional comments on the environment. "Antisocial personality
disorder is often associated with alcoholism, drug addiction, infidelity,
promiscuity, failure in one's occupation, frequent relocation, and
imprisonment. ...more men have this personality disorder than women,
and more women have borderline personality; these two disorders have much
in common. In the families to patients with both personality
patterns, the prevalence of antisocial relatives, substance abuse,
divorces and childhood abuse is high. Often the patient's parents
have a poor relationship, and the patient was severely emotionally
deprived in his formative years. Life expectancy is decreased but
among survivors, the disorder tends to diminish or stabilize with
age."
Histronic (*hysterical) Personality is also
essential the same as in previous editions of the Merck. There are
no comments on therapies or treatment for this
disorder
(*quotes are from the Merck
Manual)
1996. Alcohol, Pregnancy and the Developing Child.
edited by Dr. Hans-Ludwig Spohr and Dr. Hans-Christoph Steinhausen.
The European effort to consolidate the research and knowledge about FAS
that was available up to that time. Spohr and Steinhausen also
reported that papers on the occurrences of FAS had appeared in Germany in
1976, Sweden in 1979 and Japan in 1981.
1997. Fetal Alcohol Syndrome: A Guide for Families
and Communities, by Dr. Ann Streissguth, premier researcher on
the behavior of children with FAS. Streissguth gives a partial list
of countries reporting cases of FAS, France, Germany, Iceland, South
Africa, and Canada.
Ninth Special Report to Congress on Alcohol and Health:
Fetal Alcohol Syndrome. published by the Department of Health and
Human Services and the NIAAA. Pages 192-246.
2000. Tenth Special Report to Congress on Alcohol and
Health: Fetal Alcohol Syndrome published by the Department of
Health and Human Services and the NIAAA. Pages 282-338.
2001. Craig Lesley writes Storm Riders, a
fictionalized account of his adopted son who has FAS. Picodor
Pubishers.
2004. Damaged Angels by Bonnie Buxton. The
second internationally distributed book on FASD and its effects on a
Canadian family. It was first published in Canada and soon to be
published in the United States in May of 2005.
Fetal Alcohol Syndrome: Guidelines for Referral and
Diagnosis. Published by the National Center on Birth Defects and
Developmental Disabilities, Centers for Disease Control and Prevention,
Department of Health and Human Services. The latest update on
diagnostic criteria.
2005. Stout, Martha. The Sociopath Next
Door. In an interview on NBC Saturday Today Show, she states,
"Most sociopaths are not violent." "They are often have a failure to
plan." "They can be charming."
Russell, Elizabeth. Alcohol and
Pregnancy: A Mother's Responsible Disturbance.
(2005) Burleigh, Australia: Zeus Publications. One of
the only non-fiction books written by an Australian birth mother about her
struggles to advocate for her two sons. Discusses legal issues and
residential alternatives.
2006: The Merck Manual: Eighteenth
Edition. Will not be online until August of 2006. Two
paragraphs are devoted to Fetal Alcohol Syndrome.
Section
18: Gynecology and Obstetrics, mentions "...increased risk of
spontaneous abortion... fetal growth restriction...facial and
cariovascular defects and neurologic dysfunction." "It is a leading
cause of mental retardation and can cause neonatal death due to failure to
thrive."
Section 19: Pediatrics, mentions, "...a
constellation of physical and cognitive abnormalities." "After
birth, cognitive deficits become more apparent." "The most serious
manifestation is severe mental retardation..." "...lesser degrees of
alcohol use cause less severe manifestations..."
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Tuesday, August 2, 2005
Subject: FAS: From 1956 to
1973
Time: 2:29:30 PM EDT
Author: psoba
1956. The Merck Manual: Ninth
Edition. The Neuropsychiatric section is almost always seeped in
Freudian Theory and uses the "id, ego and superego" as well as other
Freudian terms for different types of psychoses.
This is the first time that Personality Disorders
has its own chapter. Personality Disorders are "...characterized by
developmental defects or pathologic trends in personality structure, with
minimal subjective anxiety and distress. ...these disorders are
manifested by lifelong behavior patterns, rather than by mental or
emotional symptoms."
Under Personality Pattern
Disturbances, "Prolonged therapy may improve functioning ... but rarely
accomplishes basic change in their inherent
structures."
The Inadequate Personality is defined
as "In response to intellectual, emotional, social and physical
demands, these individuals show inadaptability, ineptness, poor
judgment, lack of physical and emotional stamina, and social
incompatibility."
Under Sociopathic
Personality Disturbances, "Individuals...are ill primarily in terms of
conformity with the prevailing cultural milieu, as well as in terms of
personal discomfort and relations with others. Sociopathic reactions
are often symptomatic of severe neurosis or or result from organic brain
injury or disease." (The sociopathic personality and the antisocial
personality are combined in later editions of the
Merck.)
The Antisocial Personality is described
as: "...individuals who are always in trouble, profiting from
neither from experience nor punishment, and maintaining no real loyalties
to any person, group or code. They are callous and hedonistic,
showing marked emotional insecurity. They lack judgment and a sense
of responsibility but can rationalize their behavior so that it appears
reasonable and justified. The term includes cases previously
classified as 'constitutional
psychopathic state' and 'psychopathic
personality'."
There are no suggestions for
treatment or therapy.
1957. Jacqueline Rouquette in "Influence de l'intoxication
alcoolique parentale sur le development physique et psychique des jeunnes
enfants." (Influence of intoxicated parents on the physical and
psychological development of their young children.) These, Paris.
Streissguth (in Fetal Alcohol Syndrome: A Guide for Families and
Communities) says of her work: "...a medical thesis from Paris
described 100 foundling home children born to alcoholic mothers and
fathers who had malformations very similar to those now recognized as
constituting FAS. She concluded that maternal alcoholism, in
particular, posed very grave dangers for the developing fetus and
child."
From Steissguth's Fetal Alcohol Syndrome: A
Guide for Families and Communities, reports that D.
Papara-Nicholson and I.R. Telford administered alcohol to pregnant guinea
pigs and observed the resultant offspring had problems with low
birthweight, poor locomotion, incoordination , feeding and sucking.
Streissguth notes that this may have been the first report of the
neurobehavioral effects of prenatal alcohol.
1960. Many physicians who graduated this year are
nearing retirement in 2005.
1961-1966. The Merck Manual: Tenth and Eleventh
Editions. These editions are nearly identical to the Ninth
Edition. The theories of Sigmund Freud are quoted. Almost the
same wording occurs in all three editions.
Again,
Personality Disorders are deemed to be "lifelong problems rather than
mental or emotional symptoms."
In the Tenth Edition
under Neuropsychiatric, Personality Disorders, Sociopathic Personality
Disorders, Antisocial Reaction and in the Eleventh Edition, Section
16: Neuropsychiatric, Chapter 2; Personality Trait
Disturbances, Psychopathic Personality Disturbances, Antisocial
Reaction, "This term refers to individuals who are always in
trouble, profiting neither from experience nor from punishment, and
maintaining no real loyalties to any person, group, or code.
Frequently they are callous and hedonistic, showing marked emotional
immaturity. They lack judgment and a sense of responsibility but can
rationalize their behavior so that it appears reasonable and
justified."
Note that the term changes from
Sociopathic Personality Disorders to Psychopathic Personality Disturbances
from the Tenth to the Eleventh edition.
The
Inadequate Personality in also mentioned in both editions. The
definition is the same, "In response to the intellectual, emotional and
physical demands, these individuals show inadaptability, ineptness, poor
judgment, lack of physical and emotional stamina, irresponsibility and
social incompatibility."
There are no recommended
therapies.
The 10th Edition starts to include a
section on Organic Brain Damage but that is almost exclusively of
traumatic origin.
1966. Coffey, T.G. "Beer Street: Gin Lane Some Views
of 18th Century Drinking." Quarterly Journal Alcohol
Studies.
Fuchs, A.R. "The Inhibitory Effect of Ethanol on the Release of
Oxytocin During the Parturition of the Rabbit." Journal of
Endrocrinology.
1968: Dr. Paul Lemoin publishes "Les infants de parents
alcooliques; anomolies observees a propos de 127 cas." Ouest.
Med. This was not published internationally and received relatively
little notice.
1970. The National Institute of Alcohol Abuse and
Alcoholism (NIAAA) is formed.
1972. Cantwell, D.P. "Psychiatric Illnesses in the Families
of Hyperactive Children." Achives of Genral
Psychiatry.
The Merck Manual: Twelfth Edition. This edition is
notable for finally dropping the Freudian theories that were predominate
in the prior editions that covered nearly 25 years of psychiatry. It
also includes a pediatric section for the first time.
This is an excerpt from the 1972 edition of the
Merck Manual.
Under Section 18: Psychiatric Disorders, Numbers
3. Mental Subnormality and 4. Disorders of Childhood:
Number 3. "Mental Subnormality (Mental
Deficiency, Mental Retardation, Feeblemindedness)" "Etiology
(includes)...(3) Birth trauma or physical agent (6) Unknown
prenatal influence (Alcohol is not mentioned as a possible cause in either
case.)
Number 4. "Minimal Brain Dysfunction
(also known as) Minimal Brain Damage (and) Hyperkinetic Impulse
Disorder." "This syndrome has received much attention over the past
decade and is being diagnosed with increased frequency"
[* Minimal Brain Dysfunction is cited in the 1978
Third Special Report to Congress on Alcohol and Health as possibly being
part of the FAS spectrum of physical and behavioral
disorders.]
Under symptoms and
signs:
"...characterized by inappropriate activity,
either hyperkinesis or listlessness and withdrawal."
"Activity is impulsive and occasionally destructive or
aggressive."
"Emotional lability, low stress
tolerance and intellectual deficits..."
"The child's
attention span is short and he is hyperresponsive to environmental
stimuli, as if there were no selective filtering out of less meaningful
stimuli."
"Intellectual deficits...may include
difficulty with arithmetic, slowness in learning to read and write, and
deficits in abstract concept formation."
"...coordination difficulties, perceptual motor difficulties, and a delay
or failure in developing (right-or
left-handedness)."
"...various signs of psychiatric
disability, possibly the result of 'innate' high anxiety or an impaired
ability to handle stresses."
"These children are
often developmentally slow and require more and longer lasting support
than normal children."
Under
diagnosis:
"The neurologic examination may show a
variety of 'soft' neurologic signs such as clumsiness, impairment in rapid
successive movements , mild choreo-athetosis, mixed laterality of with
right-left confusion, finger agnosia and evidence of dyslexia or
dyspraxia."
"The EEG may be useful in detecting a
seizure disorder or cerebral dysrhythmias."
"Psychological testing ...should include standard intelligence tests and
perceptual-function test to document the visual perceptual difficulties,
problems with spatial organization and distractable
behavior..."
Under prognosis:
"The syndrome appears to be self limited, since many of the
characteristics fade during early adolescence. Though the
hyperkinesis and behavioral order usually subside, some of the
learning or emotional difficulties continue and the child is often
left with school problems,
continued high levels of anxiety and low
self esteem."
Under treatment:
Amphetamines are mentioned as a way to increase attention
span.
"Special education, geared to the child's
individual needs, is necessary, especially for
children...regarded as
poorly motivated or retarded..."
"Raising these
children in a supportive atmosphere requires education inunderstanding by
most parents."
"It is important that parents and
school both provide the child with sensory experiences that are more
clearly defined and of controlled intensity."
The edition
prior to this one, the Eleventh Edition, published in 1966 does not
mention minimal brain dysfunction. The edition following this, the
Thirteenth Edition, published in 1977, lumps minimal brain dysfunction
under learning disorders and Fetal Alcohol Syndrome is not mentioned even
though the international paper on FAS appeared in 1973.
Under Section 18: Psychiatric
Disorders: Disorders of Psychogenic Origin,
Personality
Disorders are discussed as being "...relatively fixed and
inflexible... Individuals may show patterns of repetitive,
maladaptive and...self defeating patterns of behavior, inadequate handling
of impulses, or restricted and inappropriate feelings. ...limited
variety of responses to stress. ...tends to show little anxiety or
mental or emotional symptoms. ...low self esteem, paucity or
relative superficiality of intimate relationships, difficulty in
sustaining interests, low frustration tolerance, difficulty in postponing
gratification and inability to learn from experience. (It is
recommended) ...that early interpersonal relationships are important to
establishing modes of defense and their rigidity."
Number 8: Antisocial Personality .."formerly
referred to as 'sociopathic'" still remains the same.
Other Personality Disorders that have been added in
this edition are:
Number 4: Explosive
Personality: "...characterized by sudden tantrum-like outbursts of
rage or verbal or physical aggressiveness. Despite guilty and
regretful feelings, these individuals are unable to control their
outbursts. They are easily excited by environmental
frustrations. Recently, questions have been raised as to whether
underlying minor organic brain changes predispose to this
explosiveness."
Number 6: Hysterical
(*histronic) (*quote is from the Merck Manual) Personality:
"...characterized by dramatic and attention-seeking behavior,
excitability, emotional instability and over-reactivity,
self-centeredness, and a provocativeness or sexualization ofnon-sexual
relationships often with sexual frigidity or fears. Though
superficially self assured, such people have major doubts as to their
identity and goals. Their difficulty in expressing genuine feelings
further intimate relationships. Such relationships are
affected by the individual's need for affection."
(In the 15th edition of the Merck Manual under
Antisocial Personalities, it states "In our culture, men are more
often labeled as antisocial and women as histronic personalities but the
two patterns have much in common.")
Number 7:
Asthenic Personality: "...characterized by lack of enthusiasm, low
energy and capability, difficulty in developing a broad sense of enjoyment
and pleasure, and a poor response to even small physical or emotional
stresses."
Number 10: Inadequate
Personality: "...describes individuals whose response to any form of
stress seems ineffectual. Their behavior shows poor judgment,
ineptness, lack of energy, poor long-range planning, and poor
performance. Incentive is lacking, especially to achieve culturally
desired levels. These people are marginally involved in social
relationships, tend to drift and take non-demanding jobs. There is
no evidence for physical or mental
defects."
The "Nervous" section found in
previous manuals has been changed to "Neurological Disorders" and
covers most diseases of the brain and spinal cord. Reactions to
exposure to toxins are limited to the adult experience.
Ulleland, Christy. "The Offspring of Alcoholic
Mothers." (1972) Annals of New York Academy of
Sciences. 1972.
1973. Fetal
Alcohol Syndrome was first presented in an internationally recognized
study published by a team of researchers at the University of
Washington (Dr. Christy Ulleland, Dr. Kenneth Jones, Dr. David
Smith, and Dr. Ann Streissguth). Written by psoba . Link to this entry | Blog
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Sunday, July 3, 2005
Subject: FAS: From
1941-1950
Time: 4:32:16 PM EDT
Author: psoba
1941, 1964, 1982. The Mask of Sanity by
Hervey Cleckley. This book is considered to be such a classic, I
have found citations from three editions published that have covered five
decades. Dr. Cleckley based much of this book on the male patients
at the Veteran's Administration Hospital in Augusta, Georgia, one of the
largest in the country at the time of his writing. He estimated that
well over 40% of the patients in the Augusta, Georgia VA's psychiatric
ward fitted the description that he classified as "semantic dementia",
Cleckley describes this as "...a mind or personality so damaged that
experiences as a whole cannot be grasped or utilized in its significance
or meaning." Cleckley goes on to say, "...in semantic dementia,
the purposiveness, the significance of all life striving and of all
subjective experience are affected without obvious damage to the outer
appearance of the personality." "...the persistent maladaptation at the
personality level, the inevitable purposelessness of behavior, suggested
at times not a lack of purpose so much as a negative purpose. The
person despite all his opportunities, his intelligence and his plain
lessons of experience, seem to go out of his way to woo misfortune."
The families of the patients in Cleckley's book are described as "...sound
if not superior stock." even though each of the patients described were
alcoholic by nature and abused it constantly throughout their
lives.
Cleckley's Section XXII: Clinical
Profile of the patient with semantic dementia is revealing:
"He is usually a very attractive person
superficially and makes a strong positive impression when one first meets.
him."
"He is free from...any marked
...psychoneurosis."
"...he has no sense of
responsibility whatsoever to others."
"...appears to
have a total disregard for truth..."
"...much of his
trouble is his own fault."
"...he cheats and lies
without any apparent compunction."
"...he continues
to show the most execrable judgment about attaining...his own
ends."
"...His inability to learn or profit by
experience no matter how chastening his experience may
be."
"...distinguished by
egocentricity."
"...shows no more real evidence of
object love."
"His absolute indifference to the
hardships, financial, social, emotional, physical, and others, that
he brings upon those for whom he professes love..."
"But mature, wholehearted anger, true or constant indignation, honest,
solid grief, sustaining pride, deep joy, despair are never found within
this scale."
"...he does not show anything that
could be called woe or despair or serious sorrow."
"The emotional poverty, the complete lack of stronger or tragic
feeling..."
"...lacks the insight to a degree seldom
if ever found in other mental disorders."
"He has
absolutely no capacity to see himself as others see
him."
"...he has no ability to know how others feel
when they see him or to feel anything comparable himself about the
situation."
"...blaming his troubles on others with
the flimsiest of pretexts but with elaborate and and subtle
rationalization."
"...to have little or no ability
to feel the significance of his situation, to experience the real emotions
of regret or shame, or determination to improve."
"...clever statements have been purely verbal, even his expressions
without underlying content; an excellent mimicry of
insight."
"...apparently a total lack of insight as
a real and moving experience."
"...uses all the
words that would be used by one who understands and who could define all
the words, but who is still blind to the meaning."
"The psychopath shows little of the ordinary responsiveness to special
consideration or
kindness."
"Alcoholic
indulgence is very frequently prominent in the psychopath's life
story."
"...an independent and pre-existing
personality maladjustment is primarily causal."
"...their almost total lack of self imposed
restraint."
"...a striking inability to follow any
sort of life plan consistently whether it be regarded as good or
evil."
"...seems to go out of his way to make a
failure of life."
"...he cuts short by some
incomprehensible and untempting piece of folly or buffoonery, any activity
in which he is succeeding, no matter whether it is crime or honest
endeavor."
"...that some unconscious purpose to fail
has been active, some unrecognized drive at social and spiritual
self-destruction."
"He shows no real insight into
his condition. There is a persistent tendency to project the source
of his troubles to the environment. We see a striking lack of normal
and appropriate emotional response, a general flattening or
hollowness in affect, such as marked impairment of ordinary judgment
that he fails repeatedly to adapt himself in the social group. His
record furthermore reveals not one but a series of follies and disasters
involving himself and others and brought about for no discernible
purpose. We may, therefore, say that he is psychotic, incompetent,
and incapable of carrying on the usual activities of life without constant
supervision."
Cleckley goes on to
state:
"...it is a different type of psychosis from
all those now recognized, and one which differs more widely in its general
features from any of those than they differ from one
another."
"The first and most striking difference
is...in other psychoses, one finds...a more or less obvious alteration of
reasoning processes or of some other demonstrable personality
feature. In the psychopath, one...is confronted by with a convincing
mask of sanity. All the outward features of this mask are intact;
nor can it be displaced or penetrated by questions directed toward
deeper personality levels. ...The thought processes retain their
normal aspect even if
psychiatrically dissected. One finds...a
solid and substantial structural image of the sane and
rational
mind."
"...one usually finds verbal and facial
expression, tones of voice and all the other signs we have come to regard
as implying conviction and emotion and the normal experiencing of life as
we know it ...and we assume it to be in others. Only very
slowly, and ...by intuitive judgment,
does the conviction come upon us
that, despite these intact rational processes and their
consistent
application in all directions, we are dealing here not with a complete man
at all but
with what might be thought of as a subtlely constructed
reflex machine which can mimic the
human personality
perfectly."
On treatment, Chapter
25:
"The present writer humbly confesses he has
found all true examples of semantic dementia to be very little influenced
by therapeutic efforts."
".....makes it necessary to
place him on wards where patients are closely confined and
supervised..."
"An old physician...suggested
that they be carefully gathered from all over the earth, placed on some
large habitable island with all the equipment and supplies needed to
establish
themselves, and then forgotten by the rest of
humanity."
On occurrence, Chapter
25:
"In this writer's opinion approximately as many
beds as those now occupied by all other
psychotic patients in the
nation would scarcely be an exaggerated estimate.
1942. Butler, F.O. " The Defective
Delinquent." American Journal of Mental
Deficiency.
Chesler, A., LaBelle, G.C. and Himwich, H.E. "The Relative
Effects of Toxic Doses of Alcohol on Fetal, Newborn and Adult Rats."
Quarterly Journal Studies in Alcohol.
******************************************************************************
1942. Howard W. Haggard and E.M. Jellinek received a grant from the
Rockefeller Foundation to conduct a study that refuted the research that
indicated that maternal drinking adversely affected the unborn
child. (from Philip Pauly. "How Did the Effects of Alcohol on
Reproduction Become Scientifically Uninteresting in the Early Twentieth
Century." Journal of the History of
Biology.)
E.M. Jellinek became famous for his
work, The Disease Concept of Alcoholism, New Haven: College
and University Press, published in 1960. It was the first work that
suggested that alcoholism was a disease rather than a matter of personal
choice or a flaw of character.
******************************************************************************
1944. Crime and the Human Mind by Dr. David Abrahamsen of the
Department of Psychiatry, Columbia University. Morningside
Heights: Columbia University Press. Dr. Abrahamsen writes in Chapter
VI: The Psychology of the Individual Offender: Classification
of the psychopathic
offender.
"...we have discussed
criminals with neurotic characters, including in this group, those persons
who are known...as psychopathic personalities. Since this term has
been in use for over a hundred years...it is probably impossible to
dispense with it..."
"...one is inclined to designate as
psychopathic personalities all those persons who do not fit into...other
groups."
"...the term psychopathic personality has
been used to mean a certain person who because of deviations and
inadequacies in his personality and in his mental make up is neither
mentally defective nor psychotic, but has a defect, especially regarding
his character or emotions."
"We...will define a
psychopath as an abnormal personality who suffers because his aberrant
character or one who because of his abnormalities disturbs
society."
"A psychopath may...show less valuable
qualities."
"...we find among offenders persons with
a superior intelligence who are endowed with a capacity to accomplish
criminal acts which are not only...well done but also
eccentric."
"...most of them should be classified in
the near neurotic or in the neurotic character
group."
"...usually self centered, aggressive and
emotionally unstable."
"...superior
attitude...showed little inclination to be
corrected."
"There has been an inclination to
include practically all chronic criminals in this group and even to
restrict it to the antisocial."
"The psychopath
cannot express love."
"...earliest
childhood...caused trouble by truancy, petty stealing or some other
antisocial activity."
"D.K. Henderson has given this
definition: The term psychopathic state is the name given to those
individuals who conform to a certain intellectual standard, sometimes
high, sometimes approaching the realm of defect...who have...exhibited
disorders of conduct of an antisocial or social nature...which have proved
difficult to influence by methods of social, penal or mental care and
treatment and for whom we have no adequate provision of a preventative or
curative nature."
"It is usually found that the age
distribution varies from about fifteen to thirty-five or forty, the peak
age being about twenty."
"...the psychological
development extends over a longer period of time (than the normal
person)."
"..his instability begins in childhood,
reaches a peak in young adulthood and then drops down in the late twenties
and early thirties."
"Partridge wants to change
the term psychopath to sociopath..."
In Chapter
X, Treatment and Research, Abrahamsen goes onto say about the
Neurotic Character: "The offenders with neurotic characters
represent the most difficult problem to the psychiatrist and prison
authorities."
"Punishment is without success, except
that incarceration protects society..."
"...one may
consider the possibility of whether a training program...might be
considered. This could only be accomplished by keeping them under a
continued disciplined regime in a friendly way."
"...treat them firmly but at the same time, let them know they are not
rejected."
1947.
Developmental Diagnosis: Normal and Abnormal Child
Development by Drs. Arnold Gisell and Catherine Amatruda. Dr. Gisell
was a professor in the Clinic of Child Development at the the Yale School
of Medicine. Under the chapter, Amentia of High Grade, Section 4 is
titled "Inferior Endowment" and contains the following
statements:
"...those individuals who without being
definitely defective are nevertheless well below average with respect to
developmental status..."
"...border on amentia
without being certifiably feebleminded."
"...a
highly diversified category...distinguished (by) three types: (1)
borderline dull (2) borderline unstable (3) borderline
defective."
"Borderline dull denotes a mild degree
of retardation and a general reduction of performance particularly in the
fields of language and adaptive behavior."
"Borderline unstable denotes a similar inferiority combined with
impulsivity, highly changeable and other atypical emotional
reactions."
"Borderline defective.
...The behavior is relatively well organized and balanced. In quality and
caliber it is defective but not sufficiently so as to warrant a diagnosis
of frank amentia."
Gisell warns, "The foregoing distinctions must
rest on clinical impressions rather than on precise objective
criteria. They are useful as descriptive diagnoses." He goes on to
elaborate on borderlineunstable: "A borderline unstable child
displays unsteadiness and exaggeration in his emotional reactions and
atypical deviations in one or more fields of behavior.
...Discrepancies and disparities become apparent when his maturity is
separately evaluated for the several fields of behavior."
Gisell
goes on to describe four cases:
"...over active,
over afraid of men, not interested in toys...touches objects in a gingerly
manner..."
"...rapport between himself and the
examiner was shallow and variable."
"...perservative
and stereotyped manner..."
"..described as
'stubborn, backward, slow, very jealous, craves an unusual amount of
attention'..."
"Screams at about 5 o'clock and
refuses to eat supper; moans in bed; wakes at night with weird cries;
clings to bottle; refuses cup."
"...rocked back and
forth incessantly..."
"...failure to carry out
differential commands..."
"..her amiable personality
cast a spell which tended to conceal her fundamental
limitations..."
"The somewhat inferior quality of
her intelligence and judgment make it necessary to provide good
supervision and training throughout adolescence. If she is
adequately protected, there is an excellent prospect of her making a
satisfactory social and vocational adjustment in adult life."
(Gisell, however, does not follow this case into
adulthood.)
Section 5 is titled "Pseudo-Symptomatic
Retardation" and contains the following
observations:
"There is a type of retardation which
is falsely ascribed to such causative factors (unfavorable institutional
or home environments), but which in reality a true
amentia..."
"He does some thing so
well."
"He understands so
much."
"It is though he were thwarted and as though
something were holding him back."
"He has an
excellent disposition."
"He has more abilities than
he likes to use."
"He seems
unhappy."
"...there are residues of behavior which
resemble the normal so much..."
"...the child may
show extreme fixations on one toy, or on one
pastime..."
"There may be an excessive amount of
rocking or mouthing, ofjargoning, of chewing, clicking, respiratory and
other mannerisms."
"...heedlessness to sound
or oblivious to persons..."
"...frequently
found in association with hyperactivity."
"...the activity and the bizarre exaggeration are frequently associated
with an attractive
countenance and a far-away, wistful expression
which builds up an impression of dormant or
obscured
normality."
"Parents go to heroic lengths to
re-educate the child and remove the obstructions which they believe
are retarding or deflecting the child's
development."
"...the parents of these children do a
lot of 'shopping around'. They try one expedient or one program
after another."
"But the retardation is...organic
and symptomatic."
"...the mental deficiency may be
of either high or low grade."
"..heedlessness to the
spoken word and the failure to talk."
"...slow weight gains."
"Any progress he makes will
be exceedingly slow."
"School, in the ordinary
sense, will be quite beyond him."
Gisell and
Amatruda also noted that "The parents are encouraged to believe that the
child will find himself in time." But they advise, "If you can bring
yourself to shaping your child's need to her needs...your own distress
will be reduced. If there is a remote chance that a change will
occur, you will be increasing that chance more by these means than by
constantly sustained efforts to teach her beyond her capacity to
learn.". Advice often promoted by today's experts in FAS
education.
1950-1972. The 26 page study, "The Effects of
Drinking on Offspring: A Historical Survey of American and British
Literature." by Rebecca Warner and Henry l. Rosett. (1975) in
The Journal of Studies on Alcohol. cites 14 articles written
in this period that warn of the danger of drinking during pregnancy.
Copies of these articles are not included in this study. I may
include them at a later date if I can obtain them.
1950. The Merck Manual: Eighth
Edition. The first six editions of the Merck Manual, starting in
1899, were pharmaceutical references which listed medicinal remedies for
specific conditions. Starting with the Sixth Edition in 1934, the
Merck Company started to include diagnostic indications but did not
include pediatric, psychiatric or psychological sections. Therefore,
I have not included the editions prior to 1950.
The Eighth Edition was the first to contain a
section on Neuropsychiatric and Psychosomatic conditions, none of which
are recognizable as descriptive of FASD behavior.
In
modern times, the Merck Manual is considered to be the "medical handbook"
for medical and ancillary medical personnel. It is used as a reference,
diagnostic and therapeutic guide.
Written by psoba . Link to this entry | Blog
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Wednesday, June 1, 2005
Subject: FAS from
1926-1938
Time: 3:53:53 PM EDT
Author: psoba
1926. In 1926, a professor of psychology at
Harvard College, Dr. William McDougall, discussed the issues of cause in
his book, An Outline of Abnormal Psychology published by
Metheun and Company, London. In his introduction, Dr. McDougall
states, "The whole field of of abnormal psychology falls into two
corresponding divisions, concerned, respectively, with the organic and
functional disorders." He goes on to say, "Owing to the immense
difficulties of research in the organic division... The functional
division is, at the present time, much more profitable for the student of
human nature." His book therefore deals mainly with the functional
division of abnormal psychology.
What, then,
is the organic division? The organic division of psychology believes
there is a physical cause for behavior. This would include
changes in the brain due to the environment or genetics, such as
lead/mercury poisoning, and alcohol consumption during pregnancy or the
inherent damage might be found in the genes. Modern psychology's
tools for finding "organic" causes have only begun with the advent of
functional MRIs, gene studies and increasingly sensitive tests for
chemical imbalances and absences.
The functional
division of abnormal psychology believes "...there is something besides
that permits the nervous to take refuge just in disease, while there are
other means of evading difficulties." In other words, the brain is
normal but events and situations cause it to revert to unhealthy
techniques for coping. The implication for treatment is the
recognition of the impropriety of the behavior and then the modification
of that behavior.
******************************************************************************
1927. Feldman, W.M. "Alcohol in
Ancient Jewish Literature." British Journal of
Inebriety.
1931. Dr. Franz Alexander and Hugo
Staub in Germany wrote The Criminal, The Judge and the
Public. which described the neurotic
criminal.
"Not infrequently, he rejects
the crime unconsciously and this rejection is brought to light through
irrational self injury, which serves the purpose of self punishment."
"...the transgressions are acompulsive nature."
"Kleptomania, hydromania, compulsive lying
and betrayal, belong to this type of crime."
"...unable to give a very definite account as to why he committed a given
crime."
"(Freud described) 'individuals who
break as a result of success.'"
"...irrational behavior, which is motivated by unconscious causes..."
"...totally lacks insight into his illness."
"...tendency to self injury..."
"...suffers from a neurosis without symptoms..."
"...impossible to classify him in accordance with
existing diagnostic tables."
"These individuals
have a very dramatic fate: they are driven through life by a demonic
impulse..."
"...they always succeed in being
punished quite unjustly (unjustly a least from their subjective point of
view)..."
"...the punishment with which he is
threatened cannot intimidate him and therefore deter him from his
behavior, because...he feels the need of punishment and therefore welcomes
the severity of the law; quite often he even actively seeks punishment..."
"To punish such individuals is psychologically
meaningless and sociologically harmful."
Alexander states that
these people are very curable. However, he does not state if the
"cure" was observed over a long term period nor if the patients were ever
re-examined. As many FAS families can attest, it is common for their
children to convince therapists that they can understand their behaviors
and can also change them accordingly but return to their previous behavior
within a short time span.
[Franz Alexander's work is also
discussed in Karl Menninger's work, Man Against Himself, published in
1938.]
G.P. Fretz in Alcohol and the Other Germ Poisons. The Hague,
the Netherlands: Martinus Nijhoff. Quote from Streissguth's
Fetal Alcohol Syndrome: A Guide for Families and
Communities: "The germ injurious effect of alcohol is accepted
by most authors, doubted by some, and denied by a few."
1932. Durham, F.M. and Woods, H.M.
Alcohol and Inheritance: An Experimental Study.
(Medical Research Council, Special Report Series No. 168)
London: H.M. State Office.
******************************************************************************
1932: Charles R. Stockard on "The Effects of Alcohol in Development
and Heredity." Alcohol and Man. Ed. H. Emerson.
New York: MacMillan. At this time, Stockard had changed
his 1910-1914 stance on maternal consumption of alcohol and instead
declared that there was no connection between maternal drinking and harm
to the fetus. It is believed part of this stemmed from the criticism
of his experimental animal subjects whose purebred genetic backgrounds
were believed to be prone to natural degeneration.
******************************************************************************
1938. Man Against Himself by Karl
Menninger. Dr. Karl Menninger was a psychiatric icon in the Midwest,
most importantly known for his Menninger's Clinic, formerly located in
Topeka, Kansas. His Man Against Himself was written in the
hope of applying an intellectual methodology toward solving some of the
more unusual problems in psychiatry. Menninger discusses several
types of self destructive behavior including suicide, hypochondria, self
mutilation, sexual dysfunctions, and alcoholism. However, he also
describes a type of anti-social personality which he calls the Neurotic
Character.
In Chapter Four of the Antisocial
Personality, Section A of the book that deals with alcohol and
addiction, Menninger describes the "Neurotic Character" as "...(a)
form of chronic self destruction, disguised aggressive behavior, is quite
similar to alcoholism except that the individual ruins himself in
inexpedient conduct ..."
Menninger goes on to
describe this person more completely:
"...not a
single injurious act but a certain consistent addiction...to
'bad'...behavior."
"...always successful in
failing"
"In older psychiatric categories these
patients were called psychopathic personalities and by this term, they are
still known by the majority of psychiatrists."
"..on
account of their provocativeness, aggressiveness, and inexplicable bad
judgment..."
"...driven by their consciences to
bring about a punishment which a more normal person would
avoid."
Menninger goes on to describe a case that
had been previously researched by Franz Alexander, a German contemporary,
who, Menninger felt, was the most thorough expert on the neurotic
character:
"...son of wealthy and aristocratic
Boston parents who were the chief victims..."
"By
the age of seven he had already done considerable petty stealing...and
spending it on candy."
"He was expelled (from
school) repeatedly."
"He began sexual activities at
a very early age..."
"...when admitted to a second
preparatory school defied the authorities and his parents by refusing to
study....this was not on account of any intellectual defect was clearly
shown by subsequent psychometric tests which indicated his intelligence to
be definitely superior."
"He admitted with engaging
candor that he did not know why he persistently got himself into so much
trouble..."
Menninger attributes the young man's
behavior to an early parental preference for the sister over the baby
brother (Alexander's patient). It is to be noted however, that his
mother was an extreme disciplinarian and was given to dressing him in
girls clothing and allowing his hair to grow long and curly. Such
revelations however, failed to curb the young boy's tendencies and he
continued to commit petty crimes into adulthood.
"All of his drinking, stealing, forging, raping, car smashing, fighting,
and so on failed to achieve for him any substantial
gain."
"He was constantly in trouble, actually
unhappy."
"...how he deliberately arranged to punish
himself, he would vigorously deny that he had even so much as a sense of
guilt..."
Another case of Franz Alexander's was cited by
Menninger in which the child was also from a well to do family and was
also "compelled" to steal although, "He stated frankly that something he
did not know what, drove him to steal and that his behavior was a puzzle
to himself." After a series of stays in correctional facilities, he
distinguished himself by a heroic act in a prison catastrophe and was
granted a pardon....only to "...(run) away and soon was implicated in a
series of thefts and burglaries in another state." A psychiatrist
who examined him at a later date said he did not have normal criminal
impulses but "..committed criminal acts because of an inner
compulsion."
A subsection to Section A of the
Neurotic Character is titled "Passive Neurotic Aggression". In this
section Menninger describes individuals who fail at nearly every
opportunity in life. Given large amounts of money and property by
relatives and friends, these people nevertheless tend to lose the money
and/or property due to bad judgment calls and inadequately thought out
decisions. In the end, "...he has the mad satisfaction of many a
wild, impulsive fling...a throwing away of life for momentary
satisfactions."
Menninger never did ascribe the
cause of these personality problems to maternal drinking.
[Note: personality disorders are included in
the Axis II section of the DSM.] Written by psoba . Link to this entry | Blog
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Wednesday, May 4, 2005
Subject: FAS from 1900 to
1925
Time: 3:05:39 PM EDT
Author: psoba
1900-1949. A 26 page study, "The Effects of Drinking on
Offspring: An Historical Survey of American and British Literature."
by Rebecca Warner and Henry L. Rosett. (1975) The Journal of
Studies on Alcohol. cites 33 articles written in this time period
that warn against the dangers of drinking while pregnant. Copies of
these articles are not included in this study. I may include them at
a later date if I can obtain them.
1900. "Passage de l'alcohol ingere de la mere
su foetus et passage de l'alcohol dans le lait, en particular chez la
femme." Obstetriq. by M. Nicloux. 5.
97-132. In Streissguth's Fetal Alcohol Syndrome: A Guide
for Families and Communities, she says he
"...documented in dogs, sheep and humans that alcohol consumed by a mother
passed through to her milk and then on to her suckling offspring."
From a journal article, "Alcohol and the
Antenatal Child Welfare" by Dr. J.W. Ballantyne in The British Journal
of Inebriety, on the research of M. Nicloux, "Nicloux...found
alcohol in the cord, the placenta, and the blood of the child... He
found, too, that alcohol passes into the milk..."
1901. Bezzola, D.A. (1901) "A
Statistical Investigation into the Role of Alcohol in the Origin of Innate
Imbecility." Quarterly Journal of Inebriety.
Paul Ladrague wrote "Acoolisme et Enfants."
These pour le doctorat en Medicine. (Alcoholism and
Infants. Doctoral Dissertation.) Paris: Universite de
Paris, Faculte de Medicine. (Paris, University of Paris, Faculty of
Medicine.) According to Dr. Ann Streissguth in Fetal Alcohol
Syndrome: A Guide for Families and
Communities, (he) "...reported from personal observation that
alcoholic mothers had a high proportion of spontaneous abortions, weak and
poorly developed infants, early infant demise and epilepsy, idiocy among
their children. He also presented 10 cases in which infants who were
breast-fed by mothers or wet nurses who were alcoholic exhibited diarrhea,
vomiting, extreme agitation and convulsions."
1903. Hodge, C.F., "The Influence of Alcohol
on Growth and Development." In Atwater, W.O. et al.,
eds. Physiological Aspects of the Liquor
Problem. Boston: Houghton, Mifflin.
1905. "A Study of the Effects of Alcohol on
School Children." Quarterly Journal of Inebriety. by
T.A. McNicholl. I have this citation but have been unable to
locate the original article.
1907. Aiken, J.M. "Brain and Nerve
Degeneration." Journal of Inebriety.
1909. From a lecture by U.S. Congressman
Richmond Pearson Hobson as reported in Drugs in America: A
Documentary History. Edited by David. F. Musto.
(2002) New York: New York University Press. "Dr.
Laitinen of the University of Helsingfors reports in the Proceedings of
the International Congress on Alcoholism. 'These investigation
uncover the degenerating effect of even the most temperate drinking by
parents upon their children, showing the general use of 'light wine' or
'light beer' must in time bring about the disintegration of any family,
and the decline and downfall of any nation.'"
1910-1914. Three papers by Charles R. Stockard
of Cornell University:
1910: "Influence of Alcohol and other
Anaesthetics On Embryonic Development." American Journal of
Anatomy. 10. 369-392.
1913: "Alcoholic
Injuries to Germ Cells." American Naturalist.
1914:
"Alcoholic Injuries to Germ Cells." Journal of
Heredity.
A quote from Dr. William
Healy, page 263 of The Individual Delinquent (1918), reads,
"A fine example of controlled experiment is that by Stockard, who has most
cautiously studied the effect of alcohol on the germ cells of
animals. He finds that the degeneracy caused by alcohol may be
passed on by degenerate offspring." The majority of subjects in
Healy's book were entire families affected by
alcoholism.
Stockard's experiments were considered
to be among the most influential of his time. However, he did cause
his experimental subjects to inhale the alcohol fumes rather than ingest
the liquid and his subjects were often purebred dogs whose genetic
dispositions were often questionable.
1910-1911: Keynes, J.M. "Influence of
Parental Alcoholism." Journal of the Royal Stat.
Society.
1910. Hoppe, H. "Procreation
During Intoxication." (Translated and abridged by Brown, K.O.)
Journal of Inbriety. 32. 105-110.
K. Pearson and E.M. Elderton. A First
Study of the Influence of Parental Alcoholism. (2nd ed.)
London: University of London. Quote from Dr. Ann Streissguth in
Fetal Alcohol Syndrome: A Guide for Families and
Communities, "...after studying several hundred children
in Edinburgh, Scotland, that short stature was associated only with
maternal, not paternal, alcoholism."
Ribakoff, F. Ye. "Heredity and
Alcoholism: Statistical Investigation Based on 2,000
Cases." Journal of Nevropathology i Psikhiatry.
Korsakova, Mask.
Sazhin, I.V. (1910) "Alcohol and
Heredity". Russk. Vratch.
1912. Abstract of A. Gordon's article,
"Parental Alcoholism in Mental Deficiency of Children." in the Journal
of the American Medical Association. Gordon's study
involved 298 cases of mental deficiency. He states that he only
reported on the living members of the family. He also noted that
several children died at a very tender age or very early. The
survivors "presented mental and physical stigmata of degeneracy.
Therefore, one must logically conclude that the effect of alcoholism on
the offspring is most disastrous."
1913. Davenport, C.B. "Alcoholism in a
Rural Community of Defectives." Journal of
Inebriety.
The Kallikak Family: A Study in the
Heredity of Feeble-Mindedness by Henry Herbert Goddard, published in
1913. This book originally started out as a study of
feeblemindedness. In 1995, a group of researchers, lead by Robert J.
Karp, re-examined Goddard's study and came to the conclusion that Goddard
had actually been studying a family comprised of several adults with Fetal
Alcohol Syndrome. Goddard had originally believed the father, Martin
Kallikak was the carrier of the "feeblemind" gene. However, his
marriage to a "normal' woman produced a majority of "normal" children
while his illicit affair with a "feebleminded" woman produced a majority
of children and grandchildren with physical and behavioral characteristics
that Karp ascribes to FAS.
Photos of members of the
family also show the facial features associated with full FAS.
(Photos
may be found at http://psychclassics.asu.edu/Goddard/)
1914. Excerpt from Drugs in America:
A Documentary History. Edited by David. F. Musto.
(2002) New York: New York University
Press. Testimony of U.S. Congressman Richmond Pearson Hobson in
the debate over Prohibition. "...it blights the offspring; it
attacks the tender tissues associated with reproduction in both male and
female; it affects the tender system of the embryo in the prenatal
period. For both parents to be simply moderate drinkers, to drink
but once a day beer or wine will quadruple the chance of miscarriage for
the mother, increasing 400 per cent the suffering and danger of maternity,
will increase nearly 100 per cent the number of children who die in the
first year of infancy. The children of a drinking person die off at
a rate of from four to fives times as many as those of abstaining
parents. Do not talk of prohibition invading the rights of
individuals--liquor blights the rights of our citizens before they are
born."
Cole, L.J. and Davis, C.L. "The Effect of
Alcohol on the Male Germ Cells, Studied by Means of Double Matings."
Science.
1916. Dr. J.W. Ballantyne in the Journal of
the American Medical Association, "Alcohol and the Development
of the Fetus." "Alcohol is a danger to antenatal health and a menace
to to antenatal life at every one of the stages of that existence and
through each of the progenitors."
Gordon, A. "The Influence of Alcohol on the
Progeniture." Int. Med. Journal.
1917. Ballantyne, J.W. "Alcohol and
Antenatal Child Welfare." British Journal of Inebriety.
Dr. Ballantyne makes another educated argument for not drinking during
pregnancy. But what makes this journal article interesting is the
bibliography. Dr. Ballantyne has collected journal articles on
alcohol and pregnancy from all over Europe. There are 38 references
from France, 31 from Germany, 10 from Italy, 4 from Switzerland, 3 from
Austria, 2 from Finland, the Netherlands, and Spain and 1 each from
Russia, Sweden, and Yugoslavia.
1918. The Individual Delinquent by
William Healy, MD, published in 1918. Dr. Healy was a meticulous
researcher who was the director of the Psychopathic Institute, Juvenile
Court of Chicago and an associate professor of Mental and Nervous Diseases
of the Chicago Policlinic. His massive work of over 800 pages
documents his study of young people who consistently got themselves into
trouble during the last part of the 1800s and the first part of the
1900s.
Of particular interest is this Section
152, titled Alcoholism During Pregnancy. "Difficulty that there is
in understanding the bad effect of alcohol upon germ cells is not
paralleled by its obviously easy influence upon the growing fetus.
Alcohol circulates with great ease through such membranes as separate the
mother's blood from the embryonic circulation, and thus the growing brain
cells are bathed in it in proportion as the mother takes it into her
person. So the drinking mother stands a very good chance, by all
accounts, of bringing forth children with defective or unstable nervous
systems. We know the relation, in turn, of these abnormalities to
human inefficiency and to criminalism.
"Proofs of
the above as a cause are, very naturally, vitiated by the fact that a
later defective environment practically always is also a factor.
Indeed, in cases where we heard of the mother's alcoholism during
pregnancy, we found there was so much else that might account for the
child's bad conduct that we have been obliged to refrain from ever
including this as a main factor. As in the case of probable
alcoholic deterioration of germ cells (vide Section 194) proofs of actual
deterioration will have to come through direct physiological rather than
through social and psychological
studies."
Section 194, parts b and c: (b)
Alcohol and Procreation. The effect which the parent, being under
the influence of alcohol at the time of procreation, may possibly have on
the offspring stands on the border line between defective heredity and
defective environmental conditions. The time is probably not yet
ripe for a definite statement upon this subject, but certainly one may
assert the probably correctness of the view of those who hold that an
undue amount of alcohol in the circulation of either parent at the time of
procreation may be the cause of degeneracy of the offspring.
(c) Antenatal Conditions. We have
already sufficiently discussed this point in Section 152. There
cannot be the slightest doubt that the ingestion of alcohol by the
pregnant mother may have a very deleterious effect upon the nervous system
of the unborn child.
Some of the characteristics
Healy tested for were memory, ability to give testimony (attention to
detail), attention, motor coordination, associative process, perception of
form and color relationships, learning ability, ability to profit from
experience, language ability, arithmetical ability, mental representation
and analysis, foresight and planfulness, visual perception and analysis,
judgment and discrimination, suggestibility, will power, apperception
(recognition of the relationship of parts to parts and then to other more
generalized things), moral discrimination, and ability to follow
instructions.
Some interesting chapters in Healy's
book:
Chapter VII: Influence of Pictures especially Moving
Pictures
Chapter XVII: Defects in Special Mental
Abilities...language deficits...defect in arithmetical
abilities...defect in judgment and foresight...defect in self
control.
Chapter XXIII: Abnormal Social Suggestibility
Chapter
XXV: Pathological Lying and Accusation
Chapter XXVI: Love
of Excitement and Adventure
Chapter XXVII:
Kelptomania...Pyromania...Suicide...Vagabondage
Healy did not propose any form of treatment or therapy, rather he simply
asked for the recognition of the various factors that comprised the
behavior of the "delinquent" child.
[It is
interesting to note that a later researcher, Dr. Hervey Cleckley in 1941,
felt there was no connection between the patients he was observing and the
subjects of Healy's text.]
Glueck, B.A. "A Study of 608 Admissions to
Sing Sing Prison." Mental Hygiene. .
1920-1933. The Volstead Act / Eighteenth
Amendment / Prohibition. A paper by Philip Pauly, (1996) "How Did
the Effects of Alcohol on Reproduction Become ScientificallyUninteresting
in the Early Twentieth Century?" Journal of the History of
Biology, says that one factor was the illegalization of
alcohol made unnecessary to study the effects of alcohol
consumption. Other readings I have done indicate that women in the
work force after World War I and questions about research methodologies
also influenced the decline in research.
******************************************************************************
1923-1930. The Hanson Papers. Between 1923 and 1930, Frank B.
Hanson wrote a number of scientifically influential papers that took a
neutral approach in regard to maternal drinking causing problems in
the unborn child. This, in effect, made further research into the
problem of maternal drinking, a scientific dead-end. (from Philip
Pauly, "How did the Effects of Alcohol on Reproduction Become
Scientifically Uninteresting in the Early Twentieth Century."
Journal of the History of Biology.
******************************************************************************
1925. George, M.D. (Reprinted in 1965) London Life in the
Eighteenth Century. New York: Capricorn.
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Tuesday, April 12, 2005
Subject: FAS in the
1800s
Time: 10:04:15 AM EDT
Author: psoba
1800s There is a 26 page article, "The Effects
of Drinking on Offspring: An Historical Survey of American and
British Literature" by Rebecca Warner and Henry L. Rosett (1975) in The
Journal of Alcohol Studies which cites 19 articles written in this
time period that warn against the use of alcohol when pregnant. The
complete articles are not presently included in this study but I have
included the citations in the year they were written.
1812. Formation of the Massachusetts' Society
for the Suppression of Intemperance.
Rush, B. An Inquiry into the Effects of
Ardent Spiritis upon the Human Body and Mind: with an Account of the
Means of Preventing, and the Remedies for Curing Them.
Boston: Manning and Loring.
1813. Trotter, T. An Essay, Medical,
Philosophical, and Chemical on Drunkenness and Its Effects on the Human
Body. Boston: Bradford and Read.
1826. Formation of the American Temperance
Society
1827. Beecher, L. Six Sermons on the
Nature, Occasions, Signs, Evils and Remedy of Intemperance.
Boston: Crocker and Brewster.
1831. Gooch, R. (Skinner, G., ed)
A Pratical Compedium of Midwifery. London: Longman, Rees,
Orme, Brown and Green.
1837. Ryan,
M. The Philosphy of Marriage in Its Social, Moral and Physical
Relationships. London: John Churchill.
1841-1842. Beaumont, T. "Remarks Made in
Opposition to the Views of Dr. Clutterbuck." Lancet.
1847. Edwards, J. The Temperance
Manual. New York: American Tract Society.
1848. Forbes, J. The Physiological
Effects of Alcoholic Drinks. Boston: Massachuetts
Temperance Society.
Howe, Samuel G.,
Report Made to the Legislature of Massachuetts on Idiocy.
Boston: Coolidge and Wiley. Although couched in the language
of the times, Howe does indicate the concern that alcohol consumption by
parents, with particular mention of the mother, affects the minds and
physical outcomes of the children.
1857. Stevens,
J.P. "Some of the Effects of Alcohol upon the Physical Constitution
of Man." Sth. Medical Surgical Journal. As of this
date, I have been unable to locate a copy of this citation.
1872. Bessey, W.E. "On the Use of
Alcoholic Stimulants by Nursing Mothers." Canadian Medical
Record. As of this time, I have been unable to locate a
copy of this citation.
1873. Beginning of the Women's Crusade which
later became the Women's Christian Temperance Union.
1876. Dr. John Haddon in "On Temperance in
Women with Special Reference to Its Effects on the Reproductive
System." British Medical Journal, wrote, "On her family the
effects of intemperance are strongly marked. Children born at the full
time (of her intemperance) are generally weak and puny, and likely to fall
at an early age victims to disease. ...it is possible that a large
proportion of our excessive infant mortality may be due to the
malnutrition of the embryo, caused by the use of alcohol." Dr.
Haddon goes on to say, "...however much it may please the palate and raise
our spirits, (wine) is hurtful in health and in disease, requires the
utmost discrimination in its use."
1876-1897. Criminal Man by Cesare
Lombroso, published in five editions from 1876 to 1897. This book
was one of the first to ever attempt to classify criminals by inherited
physical features rather than condemning the criminal for purposeful acts
against society. Lombroso felt that criminals, in general, had
certain physical characteristics that indicated that criminality is an
inherent trait rather than assumed from the environment. (From
Born to Crime: Cesare Lombroso and the Origins of Biological
Criminology by Mary Gibson. 2002.)
Some of the
physical features were: small heads, protruding cheekbones*, flat
noses, large ears, deformed skulls, greater height and weight*, protruding
jaws, lack of muscular strength, and little sensitivity to pain. In
particular, Lombroso was interested in the size of the head.
(*Note: characteristics not normally found in people with full
FAS.)
Lombroso also refers to behavioral
characteristics such as the lack of remorse, inability to control their
passions, laziness and ineptness at crime because of the repetitiveness of
their behavior. (Note: Repetitiveness might be
interpreted as the inability to learn from one's
mistake.)
Lombroso also had a theory of degeneration
which "explain physical and psychological malformations that had resulted
from fetal disease rather than inherited weakness....Their development
blocked in the womb, babies could thus be 'born' with predisposition to
crime..."
Others from his school of thought also noted that these
people had evidently been unable to transition from childhood to
adulthood, had hands like apes (simian crease?) and noted that many were
descended from alcoholics. Lombroso also had a category which he
called The Morally Insane. The Morally Insane, he stated, were
"people who looked normal but were unable to distinguish between good and
evil behavior." They were identical to other criminals because of
"...their compulsion to harm others and their lack of remorse." These
people also exhibited a lack of physical
sensitivity. [Note: Lombroso's work fell into disrepute
as his observations were used to justify racial profiling and may have
been included as a part of the propaganda that produced the German Aryan
race "theory". However, many people in the modern justice system and
in social work still call some children "FLK" or "funny looking kid"; a
remnant of the Lombroso studies on physical characteristics.]
1877. Fournier., E.H. Annual
Oration. Transcript of Medical Association
Alabama. As of this date, I have been unable to obtain a copy of
this citation.
1879. Long, J.F. "Use and Abuse of
Alcohol." Transcript of Medical Society of North
Carolina. As of this date, I have been unable to locate a
copy of this citation.
1880. Prohibition Party was
started.
1883. McDaniel, W.H.
"The Effect of Alcohol Upon the Foetus Through the Blood of the
Mother." Maryland Medical Journal.
1890. Dr. T. D. Crothers' article in the
Journal of the American Medical Association, "Alcoholic Heredity in
Diseases of Children". Crothers notes of two children whose
parents were alcoholics, "...both invalids, and had been under constant
medical care from infancy, the general diagnosis being scrofula (a skin
disease), and general anaemia; both were of pale and delicate appearance,
extremely excitable and nervous. They had continuous irritation of
the stomach...were very passionated at the slightest opposition to their
wishes, and after a period of rage would be greatly exhausted and have a
distinct fever for a day or more."
Their
family physician found that "...both had suffered from rubeola and
scarlatina (scarlet fever), and were supposed to never have fully
recovered. Bronchitis, enteritis, gastritis, neuritis, and various heart
diseases were constantly threatening." A new physician recognized
the alcoholic heredity of these cases and ordered "...(their) diet
restricted and enforced exercise...and frequent
bathing."
Crothers goes on to state, "No fact is
more firmly established than that alcoholic ancestors will transmit to
their children a defective brain and nerve power. The form and shape
of this defect and its manifestations will vary
greatly.
"In many cases, it might not be prominent
until after the higher peripheral brain has reached a certain development,
especially in the growth of the emotional and inhibitory centers. In
others this defect is seen in infancy, in an abnormal hyperaesthesia of
the senses, and nutrient disturbances. Some children manifest
irritation at all sounds, and all changes of light and surroundings by
continuous crying; the skin of the alimentary canal is also very
sensitive, and various skin disorders and nutrient troubles follow.
Low powers of vitality and slow irregular growth are common. This
condition may continue for years, then gradually disappear, and only
re-appear at puberty..."
Crothers notes of some
other children of alcoholics, "...noted...by their precocious development
of brain and nerve force. They exhibit powers of brain receptivity
and instability that is called genius, which gives way early to some
disease or form of nerve degeneration from various causes." He goes
to note, "...their extreme sensitiveness or obtuseness to sensory
impressions, and low powers of vitality and
recuperation..."
Other symptoms that are noted are,
"...extremes of activity, particularly where there is a tendency to the
sudden liberation of nerve energies, as in violent passion (grief or joy)
or work, play or study, which is followed by extreme prostration.
The child is said to be sullen, morose, or melancholy, then suddenly
manifests the other extremes, indicating a great instability of brain
cells and functional control. (The child's) life seems to be
threatened with fevers, prostrations, and inanitions (state of being
empty), accompanied by mental irritations and wandering neuralgias...they
always point to a degree of nerve and brain degeneration or retarded
development, and defective co-ordination..."
Crothers states, "From these facts it will be obvious that the diseases of
children of alcoholic parentage are far more complex, and require greater
care." Interestingly, he recommends the following care:
"1. No form of alcohols are safe... 2. The diet should
not include meats of any kind...the diet should always be non-stimulating
and farinaceous (rich in starch), and should be carried out with military
regularity. 3. ...avoid brain and nerve stimulation...
4. ...(guard) against every possible extreme, both in the
surroundings and physical conditions."
1893. "The Effect of Alcoholic Intoxication
Upon the Human Brain and Its Relation to the Theories of Heredity and
Evolution." Quarterly Journal of Inebriety. By A.H.
Forel. I have not be able to find a copy of this article
but in an anonymous editorial in a 1910 Journal of the American Medical
Association, Volume 54. 617., the writer states. "...Forel in
particular, having contended that alcoholism injures the germinative
cells; he supported this view with statistics from asylums for the insane
and epileptic, and gave to the alteration in the germinative cells the
title of 'blastophtorie'."
1895. Anti-Saloon League was formed.
1895. Dr. Lloyd Andriezen at the Neurological
Society of London as reported in Journal of the American Medical
Association, "Alcoholism and Its Relation to Heredity."
Dr. Andriezen states, "...that the more frequent results of
alcoholic parentage showing its expression in the offspring, viz; (1)
imbecility and weak-mindedness; (2) infantile convulsions and
meningitis; (3) a large proportion of still births; and (4) brutal
degradation and incapacity in the children, with tics and impulses,
including hereditary drink-craving. ...The inebriate as a
result of his habits transmitted to the offspringa damaged or diseased
germ (ovum and spermatozoon), and even the most healthy married couple
could from temporary intoxication do the same and beget a child which
might exhibit one or another of the abnormalities above mentioned."
1898. Ballantyne, J.W. "The Pathology of
Ante-Natal Life." Glasgow Medical Journal.
1899. From the notes of a discussion in the
Journal of the American Medical Association, "Alcoholism and
Its Relation to Heredity." Dr. Seymour Turke "...insisted on the
fact that inebriety in the parents resulted in damage to all the tissues
of the body--some more than others--and must affect the ovum or the foetus
according to the period when the drinking
began."
Dr. Fletcher Beach
"...emphasized the fact that imbecility and even idiocy resulted in the
children from parental intemperance...The effect of alcohol reaching the
ovum and germ elements by the circulation could not for a moment be
doubted..."
The (unnamed) President of the
section "...summed up the discussion, referring to the special fact of
some form of nervous or mental instability being transmitted to the
children of alcoholic subjects and stated that the evidence of facts in
this direction in the field of mental disease was overwhelming."
"A Note on the Influence of Maternal Inebriety on
the Offspring." Journal of Mental Science. (1899) by W.C.
Sullivan and Stewart Scholar. Both Sullivan and Scholar were
medical officers in British prisons. This study was conducted in the
women's prison in Liverpool.
The main point of this
study was to determine the number of fetal and early childhood deaths of
children born to women who drink. As can be expected, the death rate
climbs in a direct relation to the birth order of the child. First
born children seem to be less affected, but as the birth order increases,
so does the probability of death or epilepsy (an older term for
convulsions which may or may not be caused by
epilepsy).
The website of Davidson College,
N.C. <http://www.bio.davidson.edu/kabemd/
seminar/studfold/ Fall/Embryo/ethanol/ EthanolontheBrain.html> has this
quote from Sullivan and Scholar, "Maternal inebriety is a condition
peculiarly unfavourable to the vitality and to the normal development of
offspring. Its gravity in this respect is considerably greater than
that of paternal alcoholism. There is a tendency to still births and
abortions, and a high rate of epilepsy in the surviving children. This
influence of alcohol is in part due to a direct toxic action on the
embryo."
The University of Duisburg Essen's German
site, <http://www.uni-essen.de/~ibp010/
alkemb/FASinfo/depubrig. htm> quotes Sullivan and Scholar as having
written, "...that pregnancies of these women resulted in stillbirths and
infant death, 2 1/2 times more often than those of their sober female
relatives." Also, "...that infants born to alcoholic mothers had a
starved, shriveled and imperfect look."
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Wednesday, March 2, 2005
Subject: FAS in the
1700s
Time: 1:12:16 AM EST
Author: psoba
1700s From a 26 page study, "The Effects of Drinking on
Offspring: An Historical Survey of American and British
Literature." by Rebecca Warner and Henry l. Rosett. (1975)
The Journal of Studies on Alcohol. lists 4 articles written
in this time period that refer to the dangers of drinking while
pregnant. The complete articles are not presently included in this
study but I have included the citations in the year they were
written.
1725. from a chapter,
"British Physicians on the Dangers of Alcohol: Petition to the House
of Commons." in Drugs in America: A Documentary History by
David F. Musto. (2002). In 1725, London physicians petitioned the
British House of Commons to solve the unbridled consumption of distilled
spirits using as one of their arguments that distilled alcohol affected
the parents who were "...too often the cause of weak feeble and
distempered children, who must be, instead, of an advantage and strength,
a charge to their country."
Sedgewick, J. (1725) A New Treatise on Liquors, wherein the
Use and Abuse of Wine, Malt-Drinks, Water etc. are Particularly Consider'd
in Many Diseases, Constitutions and Ages; with the Proper Manner of Using
Them, hot, Cold, either as Physick, Diet or Both. London:
Charles Rivington.
1730. From Drugs in America: A
Documentary History edited by David F. Musto (2002), excerpts from an
essay by Stephen Hales, an Anglican priest and an early researcher on the
effects of alcohol. Please note that Hale was referring to distilled
spirits. Like many of his time, he believed that brewed alcohol
contained no such dangers; many people today still believe
this.
"Nay, the unhappy influence of these liquors
reaches much farther than to the destruction of those who indulge in the
use of them, even to their posterity, to the children that are yet
unborn. Of this we have we have too frequent instances, where the
unhappy mothers habituate themselves to these distilled liquors, whose
children, when first born, are often either of a diminutive, pigmy size,
or look withered and old, as if they had numbered many years, when they
have not, as yet, alas! attained to the evening of the first day.
How many more instances are there of children, who tho' born with good
constitutions have unhappily sucked in the deadly spirituous poison with
their nurses' milk."
Hales goes on to express his
opinion. "Whence it is evident that in proportion as the contagion
spreads father and farther among mankind, so must the breed of human
species be proportionately more and more depraved, and will
accordingly degenerate more and more from the manly and robust
constitution of preceding generations."
1751. Fielding, H. An Enquiry into the
Causes of the Late Increase in Robbers, etc. with Some Proposals for
Remedying this Growing Evil. London: A.Millar.
William Hogarth prints a lithograph called "Gine Lane". Modern
researchers say the baby in the picture has features resembling a child
with full Fetal Alcohol Syndrome.
1759. Morris, C. A Colletion of
the Yearly Bills of Mortality from 1657 to 1758 Inclusive. To which
are Subjoined...III. Observations on the past growth and present
State of the City of London; reprinted from the edition printed at
London. London: A. Millar.
1781. Foster, E. The Principles and Practices of
Midwifery. London: R. Baldwin.
1785. Dr. Benjamin Rush (one of the signers of
the Declaration of Independence and described as the first psychiatrist in
America) in Inquiry into the Effects of Ardent Spirit Upon the
Human Body, writing about alcoholics and their effect on their
children. He writes in part "...their children, filthy, and half
clad, without manners, principles and morals!" From Drugs in
America: A Documentary History edited by David. F. Musto.
(2002) New York: New York University Press.
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Sunday, February 13, 2005
Subject: FAS in the
1600s
Time: 11:08:12 AM EST
Author: psoba
1450. Gutenberg Press invented. Books
printed after this period were expensive and rare. Because of the
exclusivity of education to the upper classes, the majority of the
population during the 15th and 16th centuries could neither read nor
write.
1621. Ibid from A. Lynn Martin. Martin
mentions the work of Burton's Anatomy of Melancholia (1621),
in which he talks of ancient Greek scholars and the topic of drinking
during sexual activities and the outcome of the children. Burton's
work is also cited in Warner and Rosett (ibid).
1627. Sir Francis Bacon in Sylva
Sylbarum (p.665) writes, "...if the mother eat onions or beans, or
such vaporous food; or drink wine or strong drink immoderately; or fast
too much;...it endangereth the child to become lunatic, or of imperfect
memory..." From Ernest Abel's Fetal Alcohol Syndrome and Fetal
Alcohol Effects (1884).
1638. Another writer in Martin's article in
Food and Foodways, Richard Young in his The Drunkard's
Character (1638) writes, "...many of our children are half killed
before they are born with distempered drink."
Note: Martin also found three references by 17th Century
writers who blamed the drinking of the fathers for the behaviors of their
offspring.
At the end of her journal piece, Martin
asks, "What became of of those born with fetal alcohol syndrome or fetal
alcohol effects who survived? Did the world we have lost contain
many people who were hyperactive with poor attention spans, who behaved in
an impulsive and uninhibited manner, and who had low
intelligence?"
(Note: An FAS family from
Canada has surmised that many of these children were probably placed in a
religious setting. The strict rules and unwavering schedules would
have been perfect for adults dealing with the problematic life of
FASD.)
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Tuesday, January 25, 2005
Subject: FAS in
Antiquity
Time: 3:34:41 PM EST
Author: psoba
Significance of Study
For many years, it has been assumed that Fetal
Alcohol Syndrome is a "new" malady. Although the etiology of the
disorder was first mentioned in 1968 paper by Dr. Paul Lemoine, it does
not mean that the symptoms were not recognized years if not centuries
before. Although not each citation is a study in the earlier
centuries, it is evident that these observations detected a connection
between drinking alcohol and the unsuccessful outcomes for the resultant
offspring by several observers. As scientific procedures were
applied in the 20th Century, notes and case studies seem to more clearly
reflect an obvious pattern of behavior that might indicate that these
modern researchers were observing children with prenatal alcohol
exposure. And if they wrote about these children/adults and included
chapters on them, then there must have been enough cases appearing on a
regular basis that they felt the behaviors and their observations were
more than an errant anomaly.
There has often been a
question as to the frequency of occurrence of FASD. Many researchers
ask, "If maternal alcohol consumption is such a problem, why did we not
hear about it before 1968? Modern estimates have ranged from 9.7 per
10,000 births to almost 1 per 100. The lower estimates do not
reflect the occurrence of the non-physical forms of FAS [also called Fetal
Alcohol Effects (FAE), partial FAS (pFAS), Prenatal Effects of Alcohol
(PEA), Alcohol Related Birth Defects (ARBD) and Alcohol Related
Neurodevelopmental Disorders (ARND)...all of which are now grouped under
the term Fetal Alcohol Spectrum Disorders (FASD)], where only the brain is
affected. FAE, pFAS, PEA, ARBD, ARND or FASD without the physical
signs is thought to occur 3-5 times more often than the full FAS which has
both physical and behavioral manifestations. Studies are
seldom done on conditions that rarely occur. Therefore, the existent
studies and records of conditions that closely resemble FASD but not
properly named could mean that un-named FASD cases existed in enough
numbers to be observed and scientifically recorded as far back as the 16th
Century.
There are some important caveats to
this study. The researchers of this period were limited by the
number of patients they could see and the limitation of correspondence and
publications available during their lifetimes. Note that the
Gutenburg Press was first developed in 1450. Prior to that time,
books were copied by hand and there was not any widespread use because of
the prohibitive cost and educational exclusivity. Also, books
printed for a few centuries after the invention of the movable press are
considered to be rare and difficult to obtain until the general population
gained the ability to read and write and generated a greater interest in
printed books and articles.
The
words and phrases used in these studies are in the language of the
period. The labels and descriptive phrases do not necessarily have
the same connotations then as they do now. And the different
combinations of the words often carry a much different
meaning. For example, having a neurosis is very different from
having a neurotic character...the latter considered to be less definitive,
more of a lifelong problem and less likely to have a program of treatment
than an episodic condition that might be
remedied.
It is also important to note that
each of the researchers appears to have recognized a particular facet of
FASD without recognizing there are other behaviors that may be attributed
to the same cause. This is due to the nature of FASD which follows a
wide spectrum of physical and behavioral
characteristics.
Finally, contrary to popular
opinion, there are, in all probability, several hundred articles and books
that have dealt with unrecognized FASD over the centuries. I am
constantly finding new ones. If I have left some out, it was because
I have not yet found them. This present set of information probably
represents only 20% of my current file.
Items offset
by a *** boundary are those articles that are considered to be pivotal in
refuting the research that indicated that maternal drinking caused
physical and mental problems in the offspring. I included them because
they give an idea of when the researchers started to deny the connection
between maternal drinking and fetal damage.
Editions of the Merck Manual for physicians and
medical personnel (1950-2005) have been added in order to demonstrate what
is being taught in psychiatry and psychology classes. This includes
description of the conditions and the treatments and/or recommended
therapies.
Notations on the printings of the Special
Reports to Congress on Alcohol and Health (1978-2000) were added because
of the extensive amount of current research that was presented in each
report and because the bibliographies indicate the large number of
researchers presently in the field. It also marks the entrance of
the federal government into the recognition of Fetal Alcohol Syndrome and
Fetal Alcohol Spectrum Disorders.
Other notations on
various landmark decisions, laws or studies on FAS were included to
compare the action of the government and of the medical community.
Biblical References. Exodus, 20:5:
"...visiting the iniquity of the fathers upon the children unto the third
and fourth generation..." (Fathers, in this case, may be thought of
as parents in general.)
Judges, 13:3-5: "...you shall conceive and
bear a son...take no wine or strong drink and to eat nothing unclean...for
this boy is to be consecrated to God from the womb." (Said to
Samson's mother and not to the Jewish community in general.)
814-146 B.C. Carthage (city-state) in
Northeast Africa. From "The Effects of Drinking on Offspring"
by Rebecca Warner and Henry L. Rosett in Journal of Studies on
Alcohol, (1975. Warner and Rosett mention that the ancient
civilization of Carthage (814-146 B.C.) forbid the use of alcohol for
newlyweds. Cited from Robert Burton's Anatomy of Melancholia
(1621). This information has also been variously cited J.P.
Frank in System einer vollstandingen medicinischen Polizei (1784) and by
Haggard and Jellinek in Alcohol Explored (1944).
725-371 B.C. Sparta (city-state) in
Greece. From "The Effects of Drinking on Offspring" by
Rebecca Warner and Henry L. Rosett in Journal of Studies on
Alcohol, (1975. Warner and Rosett mention that the ancient
civilization of Sparta (725-371 B.C.) forbid the use of alcohol for newly
weds. This is cited from Robert Burton's work, Anatomy of
Melancholia (1621).
Plutarche's Life of Lycurgus, on Sparta, "In
order to the the good education of their youth, he went so far back as to
take into consideration their veryconception and birth by regulating the
marriages." From an article in the British Medical Journal by
Dr. John Haddon (1876). [Plutarche also suggested that pregnant
women exercise.]
500 B.C. Buddhism's Five Precepts warn against
strong drink. From East Asia: The Great Tradition by
Edwin Reischauer. (1958) Harvard: Harvard University
Press.
427-347 B.C. Plato's Laws. From
"The Effects of Drinking on Offspring" by Rebecca Warner and Henry L.
Rosett in Journal of Studies on Alcohol, (1975). 1397, Robert
Burton's Anatomy of Melancholia (1621) noted that Plato (427-347
B.C.) recommended that newly married couples forgo alcohol..."...that the
child that is begotten may be sprung from the loins of sober
parents." The last quote is from Ernest Abel in Fetal Alcohol
Syndrome and Fetal Alcohol Effects (1984).
322 B.C. Aristole's Problemata.
From a journal study by A. Lynn Martin. (2003) "Fetal Alcohol
Syndrome in Europe, 1300-1700: A Review of Data on Alcohol
Consumption and a Hypothesis". Food and Foodways. Martin
mentions the work of Robert Burton's Anatomy of Melancholia (1621),
in which he talks of ancient Greek authorities (Aristole in
Problemata in 322, B.C.) who stated, " Foolish, drunken or
hair-brained women, for the most part bring forth children like unto
themselves, morose and languid."
120 A.D. Plutarche in Symposiacs. From "The
Effects of Drinking on Offspring" by Rebecca Warner and Henry L. Rosett in
Journal of Studies on Alcohol, (1975), Burton in
Anatomy of Melancholia (1621) is also said to have quoted Plutarch
(120 A.D.), "..one drunkard begets another..."
130-180 A.D. Aulus Gellius
(Roman). From "The Effects of Drinking on Offspring" by
Rebecca Warner and Henry L. Rosett in Journal of Studies on
Alcohol, (1975), Robert Burton reported Gellius (130-180
A.D.), a Roman diarist, is cited as saying, "...if a drunken man get
a child, it will never likely have a good brain."
200-500 A.D. Babylonian Talmud, Kehuboth, 32b, warns, "One
who drinks intoxicating liquor will have ungainly children." From
Michael Dorris' The Broken Cord (1989).
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