An Analysis of One Hundred Cases Studied in Connection with the Municipal Criminal Courts of Boston

V. V. Anderson
1914 Boston Medical and Surgical Journal  
Medical Officer, Municipal Criminal Courts. Op the many wonderful strides of modern civilization none are more striking than the reduction of disease aud mortality. The elimination of those terrible pestilences, small-pox, yellow fever, bubonic plague, malaria, etc., that once depopulated great districts has proven one of the greatest blessings that science has ever contributed to mankind ; making habitable desolate and pestilence-ridden districts and saving millions of human lives; making
more » ... lives; making possible such feats of undertaking as the Panama Canal, more a lesson to the world in the prevention of disease than in engineering skill, for the French failed not because of their poor engineering ability but because of the terrible death rate from yellow fever, malaria, etc. So high was the rate of death, that one, it has been said, could walk across the Isthmus on dead bodies. With the discovery of the causes of yellow fever, malaria, bubonic plague, etc., by our laboratory investigators, and the utilization of this knowledge by the medical profession in the eradication of these diseases, the Isthmus of Panama is practically a health resort, its death rate being lower than some of our American cities. Compare the extraordinary death rate in our Civil and Spanish-American wars due to typhoid, many thousands in each succumbing, with the almost total absence of typhoid among the Japanese in the Russo-Japanese war. A feat of prevention; a memorial to preventive medicine. So in our fight against the diseases of childhood, the diseases of middle life, and in the great battle against the White Plague, the key note of all our progress is prevention. Now in her social problems, Society has similar methods to pursue. Crime must be looked at in the light of natural phenomena, and an effort made to discover the underlying causative factors that are responsible for its production. This is not to be done by hasty generalizations, not by the guesswork of untrained observers, but by patient and persistent study at the hands of those trained in methods of scientific research. Dogmatic assertions have been made that poverty, social inequality, alcoholism, or what not, was at the basis of crime. The, burden has been laid on a faulty environment, and efforts have been made to eradicate it by improving social conditions. The expected decrease, however, has not come about. It still remains one of the most serious problems that Society has to face. One state alone, last year, spent thirtyfive million dollars in handling the crime problem. Almost universally now are earnest students attributing this failure to the fact that in our search for the causes of crime we have overlooked the most important factor in the whole situation, the criminal himself. We have sought for external conditions associated with crime, and passed by its real source. We have overlooked the real springs of human conduct, the impelling forces within the individual that drive him to commit a criminal act, and have directed our attention on the act itself together with the environment within which the criminal lives. As might have been predicted, the treatment administered under such conditions, being simply plain guessing, based on nothing more than intuition,-without an adequate diagnosis of the criminal himself, of what he really is and really needs,-has very often missed the mark. Now if we are to make any progress in the handling of the crime problem, if we are to get at the very roots of crime, we must adapt the particular treatment to each individual offender as he needs it. This is not a matter of guesswork, but depends upon the constitution of the offender; it depends upon a knowledge of the psvehopathical makeup of the individual himself. In the practice of medicine if we should treat a man with typhoid for tuberculosis, our ignorance might be the cause of his death. In these modern days we demand a careful examination and diagnosis before we begin the treatment of a disease. We want to know just what is the matter with our patient, else our ignorance is liable to result in disastrous consequences. The same thing is true in the treatment of the criminal, except that the Court's failures are followed by recidivism rather than the death of the patient. If our Courts are in sympathy with the spirit of progress, if they desire to improve the present court procedure and reduce perceptibly the apparently increasing criminal army, they have it within their power to utilize the same scientific methods for careful examination and diagnosis, as well as prognosis, before they undertake to say what kind of treatment shall be meted out to an offender. The need of such a rational procedure I am sure requires no unnecessary urging, for it must be self evident how different should be the disposition of the case of a mental defective from that of an individual capable of profiting well by experience; or in what a different light are we to view the misconduct of an epileptic from
doi:10.1056/nejm191408271710903 fatcat:gfrloik2qrd4rdhpwdnsnnbj5e