The Shifting Borderlands of Disability

Although it would seem a straightforward matter to recognise or define the idea of 'disability', it has changed continuously over the centuries. People seen as disabled - by society or by themselves - have varied significantly over time. The implications of being disabled have also changed over the years and will undoubtedly continue to do so.

Currently, several types of disability have almost disappeared from our society, or can be treated as a disease or illness to reduce their disabling consequences. Leprosy, for example, is no longer commonplace in English society. Polio caused widespread disability in England for much of the 20th century, but has now been eradicated by vaccination. Opthalmia, which caused the blindness that affected Edward Rushton (founder of the first English Blind School in Liverpool in 1791), is now treatable. However, while some disabilities or disabling conditions have disappeared, other new ones have emerged. Autism, for example, only surfaced after the Second World War.

Sometimes political and social attitudes shape what is seen as a disability - in the first half of the 20th century the idea of the 'moral imbecile' was invented. Some disabled activists argue that disability is just a political idea anyway - in their opinion, the problem is society's attitude towards people who are considered different. The shifting borderlands of disability can be a complicated matter.

Leprosy - a disappearing disability

Today leprosy is not considered a disabling condition. Known as Hansen's Disease, it is still prevalent in some parts of the world, but is no longer highly infectious when treated. With treatment, its disabling consequences can be avoided and patients do not need to be isolated.

When leprosy reached its peak in medieval England, it was society's single most disabling condition. It resulted in the first big institutional response to disability - more than 300 'leper houses' or 'lazar houses' were built across the country.

At the end of the 14th century, for no apparent reason, leprosy declined. One theory is that it was supplanted by the plague. The leper houses were no longer needed - some fell into disuse, while others were remodelled. St John's Hospital in Canterbury, for example, became an almshouse. However, leper houses had laid the foundations for later institutional responses to disability such as the almshouses, the madhouse, the workhouse and the asylum.

Possibly the best example of the diverse history of disability is the 12th century Leper Hospital of St Mary Magdalene in Sprowston, near Norwich. Built for male lepers, it became a home for 'poor, aged and sick men' after leprosy receded. Today, the same building is used for employment and personal development activities by people with learning disabilities.

The building was intended for people with leprosy, but they are no longer a disabled group in our society. In the medieval period, the people with learning disabilities who now use the building would not have been seen as a disabled group needing special provision. They would simply have lived and worked in their families and communities. Each age has its own idea of disability.

Autism - a newly identified disability

The condition of autism was identified towards the end of the Second World War by a psychiatrist and a psychologist working independently of each other - the American Leo Kanner (1894-1981) and the Austrian Hans Asperger (1906-1980) (after whom Asperger's syndrome was named).

The relatively recent identification of this disorder raises interesting questions for historians of disability. Has autism always been with us, or is it a recent phenomenon? There are of course no historic buildings associated with autism, given that it had never been a named disability.

But some historians and psychiatrists have looked for evidence of autism in the past. In 1799, for example, a 5-year-old boy at the Bethlem hospital was described in a case study. He never engaged with other children or became attached to them, but played in an absorbed, isolated way with toy soldiers. Is this the first formally recorded clinical case of autism in England?

Others have examined the life and work of some famous historical figures and speculated that they may have been autistic:

• The great scientist Sir Isaac Newton (1642-1727) was described as having a rigorously logical mind, an inability to form intimate friendships, and numerous eccentric behaviours.
• John Howard (c1726-1790), the great 18th century penal reformer, travelled 60,000 miles over 17 years visiting prisons in Britain and Europe, meticulously recording and reporting everything he saw. His solitary lifestyle, his intense focus on one special interest and his extreme obsession with punctuality have led some to believe that he may have had Asperger's syndrome.
• Lewis Carroll (1832-1898) (the pen name of the Reverend Charles Lutwidge Dodgson) the author of Alice's Adventures in Wonderland (1865) was known to have had difficulty with social interaction, narrow obsessive interests, odd speech and 'compulsive orderliness'.

However, using modern criteria to diagnose historical figures can only result in guesswork. What we do know is that when Newton, Howard and Carroll were alive, they were probably just seen as eccentric rather than as having any sort of disability or condition. They were simply valued for their extraordinary talents.

The idea of moral deficiency - a socially created disability

The Mental Deficiency Act of 1913 invented a whole new category of disabled person - the 'moral imbecile'. At this time, supporters of eugenics were arguing that 'defective' members of the population would cause a general deterioration of the racial stock unless they were kept strictly controlled and segregated, and sterilised if possible.

They were not only referring to people who had an intellectual or physical disability, but also to those who represented a 'moral threat' to society. These were only to be found, the eugenicists believed, in the 'lower orders' of society and could include habitual petty criminals, alcoholics, prostitutes and unmarried mothers.

The meaning of 'moral imbecile' was never made entirely clear, even when it was changed to 'moral defective' in 1927. It was widely understood to mean someone who appeared not to know the difference between right and wrong. It also included people whose behaviour did not seem to conform to the moral values of mainstream society. As a result, many people with no sort of intellectual disability found themselves living in the new network of mental deficiency colonies that grew up around the country. Many lived there until they died, or only emerged in their old age.

The category of 'moral defective' survived until 1959. Disability in this case was nothing to do with the shape of a person's body or their intellectual capacity. It was about how someone thought and behaved. Once more the boundaries had shifted. They will move again. 'Disability' is not a fixed idea - it changes over time and place.

Watch the BSL video on the shifting borderlands of disability