DR. John Langdon Haydon Down (1828 to 1896) was a brilliant medical student from a distinguished family.1 It therefore came as a surprise to his colleagues when he decided to devote his career to the study and care of the mentally retarded. Langdon Down became the first superintendent of the Earlswood Asylum for Idiots in Surrey, England, from 1858 until 1868, and then established his own private home at Normansfield in Teddington with the aid of his two sons, both physicians.
Among his many patients, Down discovered a group that exhibited a characteristic syndrome.2,3 Certain of the features of the syndrome, such as prominent epicanthal folds, suggested a mongolian appearance to Down, and led him to advance an explanation. Apparently influenced by Charles Darwin's ideas of evolution, Down proposed an ethnic classification of mental retardation that viewed the so-called mongolian idiocy as a reversion to an earlier