Dr. John Langdon Down: The "Down" in Down Syndrome
Dr. John Langdon Down:
The "Down" in Down Syndrome
John Langdon Down was a remarkable man, known for his fine perception, inquiring mind, and open heart. His observations paved the way for a new branch of medicine and science. He was also a man of deep and abiding faith, which was foundational for his life's work to help others.
Born 18 November 1828 in an upstairs room above his father's grocery shop in the working class village of Torpoint, Cornwall, on the southwest coast of England, John grew up helping his family in the shop, the youngest of six children. His neighbors were all artisans who worked in the naval base in Devonport, just east of Plymouth, where John went to school until the age of fourteen. His father and mother, Thomas Joseph Almond Down and Hannah Haydon were devout followers of Christ, having served as original subscribers to the Congregationalist Church in Torpoint and descended from four generations of ministers.
At age eighteen, after working for four years in his father's shop, John had an encounter he would never forget. His family was taking a stroll in the fields around Devon one day, when the clouds lowered and it began to rain. They took shelter in a nearby farmhouse, where a young girl served them tea. Her appearance, quiet demeanor, and impaired learning ability impacted John. He wondered if her condition resulted from a disease, and if there were any help for her. She was the first of hundreds of persons John would later observe who were affected with what is today called "Down Syndrome," or "Trisomy 21." Upon his father's death in 1853, he pursued his passion, motivated by his love of Christ, to minister to the "least of these." John promptly enrolled at the Medical School of the London Hospital.
While a student, John lived at his sister's home with her husband Phillip Crellin, and there he met Philip's sister Mary, whom he later married in 1860. She was also a devout believer. John studied hard, earning a gold medal in medicine, surgery and obstetrics, and the summa cum laude award as the best student of his graduating class of 1858. He was invited to join the prestigious Royal College of Surgeons and became an astute scientist and medical doctor. Soon the Peers directing the "Royal Earlswood Asylum for Idiots," its official name, paid him a visit.
The dictionary for this period used the word "idiot" to describe those persons whose intellect matched that of a normal two-year-old, and the term "imbecile" for those whose intellect was similar to a seven-year-old child. Today it is unthinkable to use either term for people, but in those days they were inoffensive medical terms. Earlswood was the largest center in England, housing 400 children and adults with intellectual and developmental disabilities, but was in serious trouble. The "Lunacy Commission," which had been tasked to judge the welfare of the mentally ill since the Lunacy Act of 1845, had just submitted its report and was outraged. The Commission had found horrific conditions at Earlswood, including dehumanizing punishments, unsanitary conditions, neglect, overcrowding, many tuberculosis cases and other life-threatening illnesses, and a high mortality rate. The Commission determined to "clean house" and created a new Chief Physician position. The recently graduated John Down was decidedly the best candidate. He was brilliant, a strong organizer, sociable, inquiring, and was able to inspire others. Another factor that played an important role was the strong Christian conviction that under-girded his approach. He showed a deep empathy and concern for those in his care, recognizing their inherent dignity.
John immediately improved the policies of the Asylum in every aspect. He replaced the Board, hired new staff, and made hygiene and good food the top priorities. He insisted that all the residents of the institute ate with a knife and fork. He prohibited all punishments. Good behavior was rewarded and bad behavior was condoned as much as possible. To keep the inhabitants busy in useful and pleasant ways, John and Mary organized stimulating activities, including piano, hobby, craft-making, diction, and basic life skills lessons, and elementary education classes. Attention focused on improving the quality of life for the mentally disabled at all levels. Within a year, Earlswood became an exemplary residential institution. An article celebrating its success appeared in the medical journal The Lancet, making Earlswood and Dr. John Down famous.
In addition to improving the physical and psycho-social conditions, John also engaged in scientific research. In this era, too little was known about the causes of mental challenges. Johann Blumenbach had published a book in Germany theorizing that there were five races of humans, based upon comparative anatomical classifications and skull measurements. After reading it, John wondered if similar measurements could help to categorize his Earlswood guests. To keep things clear and facilitate classification, he took photographs of each one of them in 1865 (when photography was still in its infancy), inviting them to pose in their nicest gown or suit, and in a flattering posture. More than 200 of these valuable photographs have remained, comprising the largest collection of clinical photography from the Victorian era.
John published his results in 1866, finding similarities in his group of individuals to the published skull and facial measurements of citizens of Mongolia. At the time, he assigned his patients with the Blumenbach term, "Mongolian," but later abandoned that ethnic theory. He was the first, however, to describe his patients' physical characteristics, behavior and skull measurements, and to advise a regimen of care, diet, and residential schooling to help them achieve their full potential. He both modeled and called for an attitudinal change - an embracing of all human beings made in God's image.
John resigned his post in 1868 and purchased a spacious, beautiful, white house in Kings Road, Hampton Wick, about forty miles southwest of London. He and Mary opened this home for the care of mentally disabled children. The parents agreed to have their children educated so they would be able to become functioning members of society. A lawyer friend, Norman Wilkerson, offered John a mortgage loan, and in gratitude, John named the house Normansfield. It became an immediate success. The majestic mansion was equipped according to the highest standard of that time, both in comfort and hygiene. Soon, new living spaces and schoolrooms were added, and a farm with stables, piggeries, and a vegetable garden, were constructed. He employed and trained a diverse team of expert care-givers, who would now be classified as play, occupational, and speech therapists, special education teachers, and dieticians, although none of these groups had as yet emerged as distinct professions.
Despite the prevailing view of physicians of his era, who thought residents of a "lunatic asylum" were unable to learn, John proved them to be utterly wrong. John and Mary taught them to ride horses, clean the stables, grow vegetables and fruit, collect eggs, and milk the cows. In the workshops, various crafts were taught, like weaving and making puppets for plays. Here Down observed that when children with a similar talent are put in the same group, their learning improves, and that shopping is very useful in social training programs. Further, so as not to lose sight of the artistic component, a small theater was added to the building complex where plays were performed, and choir practice for Sunday services and concerts were held. The Normansfield family increased from nineteen residents in 1868, to 106 in 1876, to 160 in 1896.
In 1896, John Langdon Down died unexpectedly at the age of sixty-seven. All of England mourned his passing. Aside from his contribution to medicine, he was a visionary in accepting the advancement of women in medicine, law, and the church. Two sons, Reginald and Percival, also became physicians and directed Normansfield, as did one of his grandsons, named after his grandfather. Interestingly, ten years following John's death, a son with Down Syndrome was born to Reginald and his wife, Jane. He lived a full life at Normansfield and died at the age of sixty-five.
In the western world, the term “Mongolism” remained an accepted term until 1960. In 1961, a group of world-renowned genetic scientists wrote an open letter to the medical journal The Lancet, requesting a name change for this medical condition. Two years before, in 1959, French geneticist Jérôme Lejeune had discovered that the medical phenomenon was actually due to the presence of an extra copy of the 21st chromosome. In addition, this condition had no association with normal Asian genes, and any correlation between the geographic region of Mongolia and an extra chromosome 21 was also non-existent. The term seemed racist and was rightly considered offensive. Therefore, the authors of the letter insisted that the term "Mongolism" be completely banned as a obsolete term. The medical and scientific communities agreed, as would have John Langdon Down.
One of the signatories of the letter approached Down’s grandson, who at that time was the third generation medical director of Normansfield. The family gave permission for their name to be used to indicate what grandfather John had described so outstandingly. The World Health Organization then confirmed the "Down Syndrome" name in 1965. Normansfield continued to house and care for people with disabilities until 1997. As of 2025, the old Normansfield Center houses the UK national office of the Down Syndrome Association and the Langdon Down Museum of Learning Disabilities, and still continues its excellent work today.
This month, we celebrate Christians who stride into the "messy marketplaces" of our globe. As they roll up their sleeves for hard work and embody their strong biblical convictions, they become a source of hope for those who are forgotten or discarded by the world. John and Mary Langdon Down were points of grace, who taught their own culture, and ours, how best to value human life. The Downs had this verse painted on the theater wall at Normansfield: “Blessing and honor and glory and power be to Him that sitteth upon the throne” (Revelation 5:13b). Today we honor Down's God and His humble servants, who simply loved people.
-Karen O'Dell Bullock
Born 18 November 1828 in an upstairs room above his father's grocery shop in the working class village of Torpoint, Cornwall, on the southwest coast of England, John grew up helping his family in the shop, the youngest of six children. His neighbors were all artisans who worked in the naval base in Devonport, just east of Plymouth, where John went to school until the age of fourteen. His father and mother, Thomas Joseph Almond Down and Hannah Haydon were devout followers of Christ, having served as original subscribers to the Congregationalist Church in Torpoint and descended from four generations of ministers.
At age eighteen, after working for four years in his father's shop, John had an encounter he would never forget. His family was taking a stroll in the fields around Devon one day, when the clouds lowered and it began to rain. They took shelter in a nearby farmhouse, where a young girl served them tea. Her appearance, quiet demeanor, and impaired learning ability impacted John. He wondered if her condition resulted from a disease, and if there were any help for her. She was the first of hundreds of persons John would later observe who were affected with what is today called "Down Syndrome," or "Trisomy 21." Upon his father's death in 1853, he pursued his passion, motivated by his love of Christ, to minister to the "least of these." John promptly enrolled at the Medical School of the London Hospital.
While a student, John lived at his sister's home with her husband Phillip Crellin, and there he met Philip's sister Mary, whom he later married in 1860. She was also a devout believer. John studied hard, earning a gold medal in medicine, surgery and obstetrics, and the summa cum laude award as the best student of his graduating class of 1858. He was invited to join the prestigious Royal College of Surgeons and became an astute scientist and medical doctor. Soon the Peers directing the "Royal Earlswood Asylum for Idiots," its official name, paid him a visit.
The dictionary for this period used the word "idiot" to describe those persons whose intellect matched that of a normal two-year-old, and the term "imbecile" for those whose intellect was similar to a seven-year-old child. Today it is unthinkable to use either term for people, but in those days they were inoffensive medical terms. Earlswood was the largest center in England, housing 400 children and adults with intellectual and developmental disabilities, but was in serious trouble. The "Lunacy Commission," which had been tasked to judge the welfare of the mentally ill since the Lunacy Act of 1845, had just submitted its report and was outraged. The Commission had found horrific conditions at Earlswood, including dehumanizing punishments, unsanitary conditions, neglect, overcrowding, many tuberculosis cases and other life-threatening illnesses, and a high mortality rate. The Commission determined to "clean house" and created a new Chief Physician position. The recently graduated John Down was decidedly the best candidate. He was brilliant, a strong organizer, sociable, inquiring, and was able to inspire others. Another factor that played an important role was the strong Christian conviction that under-girded his approach. He showed a deep empathy and concern for those in his care, recognizing their inherent dignity.
John immediately improved the policies of the Asylum in every aspect. He replaced the Board, hired new staff, and made hygiene and good food the top priorities. He insisted that all the residents of the institute ate with a knife and fork. He prohibited all punishments. Good behavior was rewarded and bad behavior was condoned as much as possible. To keep the inhabitants busy in useful and pleasant ways, John and Mary organized stimulating activities, including piano, hobby, craft-making, diction, and basic life skills lessons, and elementary education classes. Attention focused on improving the quality of life for the mentally disabled at all levels. Within a year, Earlswood became an exemplary residential institution. An article celebrating its success appeared in the medical journal The Lancet, making Earlswood and Dr. John Down famous.
In addition to improving the physical and psycho-social conditions, John also engaged in scientific research. In this era, too little was known about the causes of mental challenges. Johann Blumenbach had published a book in Germany theorizing that there were five races of humans, based upon comparative anatomical classifications and skull measurements. After reading it, John wondered if similar measurements could help to categorize his Earlswood guests. To keep things clear and facilitate classification, he took photographs of each one of them in 1865 (when photography was still in its infancy), inviting them to pose in their nicest gown or suit, and in a flattering posture. More than 200 of these valuable photographs have remained, comprising the largest collection of clinical photography from the Victorian era.
John published his results in 1866, finding similarities in his group of individuals to the published skull and facial measurements of citizens of Mongolia. At the time, he assigned his patients with the Blumenbach term, "Mongolian," but later abandoned that ethnic theory. He was the first, however, to describe his patients' physical characteristics, behavior and skull measurements, and to advise a regimen of care, diet, and residential schooling to help them achieve their full potential. He both modeled and called for an attitudinal change - an embracing of all human beings made in God's image.
John resigned his post in 1868 and purchased a spacious, beautiful, white house in Kings Road, Hampton Wick, about forty miles southwest of London. He and Mary opened this home for the care of mentally disabled children. The parents agreed to have their children educated so they would be able to become functioning members of society. A lawyer friend, Norman Wilkerson, offered John a mortgage loan, and in gratitude, John named the house Normansfield. It became an immediate success. The majestic mansion was equipped according to the highest standard of that time, both in comfort and hygiene. Soon, new living spaces and schoolrooms were added, and a farm with stables, piggeries, and a vegetable garden, were constructed. He employed and trained a diverse team of expert care-givers, who would now be classified as play, occupational, and speech therapists, special education teachers, and dieticians, although none of these groups had as yet emerged as distinct professions.
Despite the prevailing view of physicians of his era, who thought residents of a "lunatic asylum" were unable to learn, John proved them to be utterly wrong. John and Mary taught them to ride horses, clean the stables, grow vegetables and fruit, collect eggs, and milk the cows. In the workshops, various crafts were taught, like weaving and making puppets for plays. Here Down observed that when children with a similar talent are put in the same group, their learning improves, and that shopping is very useful in social training programs. Further, so as not to lose sight of the artistic component, a small theater was added to the building complex where plays were performed, and choir practice for Sunday services and concerts were held. The Normansfield family increased from nineteen residents in 1868, to 106 in 1876, to 160 in 1896.
In 1896, John Langdon Down died unexpectedly at the age of sixty-seven. All of England mourned his passing. Aside from his contribution to medicine, he was a visionary in accepting the advancement of women in medicine, law, and the church. Two sons, Reginald and Percival, also became physicians and directed Normansfield, as did one of his grandsons, named after his grandfather. Interestingly, ten years following John's death, a son with Down Syndrome was born to Reginald and his wife, Jane. He lived a full life at Normansfield and died at the age of sixty-five.
In the western world, the term “Mongolism” remained an accepted term until 1960. In 1961, a group of world-renowned genetic scientists wrote an open letter to the medical journal The Lancet, requesting a name change for this medical condition. Two years before, in 1959, French geneticist Jérôme Lejeune had discovered that the medical phenomenon was actually due to the presence of an extra copy of the 21st chromosome. In addition, this condition had no association with normal Asian genes, and any correlation between the geographic region of Mongolia and an extra chromosome 21 was also non-existent. The term seemed racist and was rightly considered offensive. Therefore, the authors of the letter insisted that the term "Mongolism" be completely banned as a obsolete term. The medical and scientific communities agreed, as would have John Langdon Down.
One of the signatories of the letter approached Down’s grandson, who at that time was the third generation medical director of Normansfield. The family gave permission for their name to be used to indicate what grandfather John had described so outstandingly. The World Health Organization then confirmed the "Down Syndrome" name in 1965. Normansfield continued to house and care for people with disabilities until 1997. As of 2025, the old Normansfield Center houses the UK national office of the Down Syndrome Association and the Langdon Down Museum of Learning Disabilities, and still continues its excellent work today.
This month, we celebrate Christians who stride into the "messy marketplaces" of our globe. As they roll up their sleeves for hard work and embody their strong biblical convictions, they become a source of hope for those who are forgotten or discarded by the world. John and Mary Langdon Down were points of grace, who taught their own culture, and ours, how best to value human life. The Downs had this verse painted on the theater wall at Normansfield: “Blessing and honor and glory and power be to Him that sitteth upon the throne” (Revelation 5:13b). Today we honor Down's God and His humble servants, who simply loved people.
-Karen O'Dell Bullock
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