Coming of Age in Samoa/Appendix 4
APPENDIX IV
THE MENTALLY DEFECTIVE AND THE MENTALLY DISEASED
Without any training in the diagnosis of the mentally diseased and without any apparatus for exact diagnosis of the mentally defective, I can simply record a number of amateur observations which may be of interest to the specialist interested in the possibilities of studying the pathology of primitive peoples. In the Manu'a Archipelago with a population of a little over two thousand people, I saw one case which would be classed as-idiocy, one imbecile, one boy of fourteen who appeared to be both feeble-minded and insane, one man of thirty who showed a well-systematised delusion of grandeur, and one sexual invert who approximated in a greater development of the breasts, mannerism and attitudes of women and a preference for women's activities, to the norm of the opposite sex. The idiot child was one of seven children; he had a younger brother who had walked for over a year, and the mother declared that there were two years between the children. His legs were shrunken and withered, he had an enormous belly and a large head set very low on his shoulders. He could neither walk nor talk, drooled continually, and had no command over his excretory functions. The imbecile girl lived on another island and I had no opportunity to observe her over any length of time. She was one or two years past puberty and was pregnant at the time that I saw her. She could talk and perform the simple tasks usually performed by children of five or six. She seemed to only half realise her condition and giggled foolishly or stared vacantly when it was mentioned. The fourteen-year-old boy was at the time when I saw him definitely demented, giving an external picture of catatonic dementia præcox. He took those attitudes which were urged upon him, at times, however, becoming violent and unmanageable. The relatives insisted that he had always been stupid but only recently become demented. For this I have only their word as I was only able to observe the boy during a few days. In no one of these three cases of definite mental deficiency was there any family history which threw any light upon the matter. Among the girls whom I studied in detail only one, Sala, discussed in Chapter X, was sufficiently inferior to the general norm of intelligence to approximate to a moron.
The man with the systematised delusion of grandeur was said to be about thirty years of age. Gaunt and emaciated, he looked much older. He believed that he was Tufele, the high chief of another island and the governor of the entire archipelago. The natives conspired against him to rob him of his rank and to exalt an. usurper in his stead. He was a member of the Tufele family but only very remotely so that his delusion bore no relation to reality as he would never have had any hope of succeeding to the title. The natives, he said, refused to give him food, mocked him, disallowed his claims, did their best to destroy him, while a few white people were wise enough to recognise his rank. (The natives instructed visitors to address him in the chief's language because he consented to dance, a weird pathetic version of the usual style, only when so opportuned.) He had no outbreaks of violence, was morose, recessive, only able to work at times and never able to do heavy work or to be trusted to carry through any complicated task. He was treated with universal gentleness and toleration by his relatives and neighbours.
From informants I obtained accounts of four cases on Tutuila which sounded like the manic stage of manic depressive insanity. All four of these individuals had been violently destructive, and uncontrollable for a period of time, but had later resumed what the natives considered normal functioning. An old woman who had died some ten years before was said to have compulsively complied with any command that was given her. There was one epileptic boy in Tau, a member of an otherwise normal family of eight children. He fell from a tree during a seizure and died from a fractured skull soon after I came to Manu'a. A little girl of about ten who was paralysed from the waist down was said to be suffering from an overdose of salvarsan and to have been normal until she was five or six years old.
Only two individuals, one a married woman of thirty or so, the other a girl of nineteen, discussed in Chapter X, showed a definite neurasthenic constitution. The married woman was barren and spent a great deal of time explaining her barrenness as need of an operation. The presence of an excellent surgeon at the Samoan hospital during the preceding two years had greatly enhanced the prestige of operations. On Tutuila, near the Naval Station, I encountered several middle-aged women obsessed with operations which they had undergone or were soon to undergo. Whether this vogue of modern surgery, by giving it special point, has added to the amount of apparent neurasthenia or not, it is impossible to say.
Of hysterical manifestations, I encountered only one, a girl of fourteen or fifteen with a bad tic in the right side of her face. I only saw her for a few minutes on a journey and was unable to make any investigations. I neither saw nor heard of any cases of hysterical blindness or deafness, nor or any anesthesias nor paralyses.
I saw no cases of cretinism. There were a few children who had been blind from birth. Blindness, due to the extremely violent methods used by the native practitioners in the treatment of "Samoan conjunctivitis," is common.
The pathology which is immediately apparent to any visitor in a Samoan village is mainly due to the diseased eyes, elephantiasis, and abscesses and sores of various sorts, but the stigmata of degeneration are almost entirely absent.
There was one albino, a girl of ten, with no albinism in the recorded family history, but as one parent, now dead, had come from another island, this was not at all conclusive data.