DEGENERACY OF MENTALITY AND MORALITY
In the mental and moral degeneracies there is a complete transition from
the durencephalic monster through the microcephalus, the idiot, the
imbecile, and the feeble-minded to the mentally normal individual. Between
the feeble-minded and the normal individual occurs a group whose general
characteristics is, as was pointed out by Magnan, a disharmony and lack of
equilibrium, not only between the intellectual operations, properly
so-called on the one hand, and the emotions and propensities on the other,
but even between the intellectual faculties themselves. A degenerate may
be a scientist, an able lawyer, a great artist, a poet, a mathematician, a
politician, a skilled administrator, and present from a moral standpoint
profound defects, strange peculiarities and surprising lapses of conduct.
As the moral element--the emotions and propensities--is the base of
determination, it follows that these brilliant faculties are at the
service of a bad cause, of the instincts and appetites which, thanks to
the defects of the will, lead to very extravagant or very dangerous acts.
In other cases the opposite occurs. Degenerates of irreproachable
character show strange defects in their intellect. They often have a
feeble memory in certain directions. Sometimes they cannot understand
figures, or music, or drawing. In a word, an otherwise normal individual's
intelligence is lacking as regards certain faculties. The centres of
perception are unequally impressionable, unequally apt to gather together
impressions, only certain impressions are registered and leave durable
images; certain relations, certain associations between different centres,
are perverted or even entirely destroyed.
The mental stigmata of degeneracy, therefore, may be divided into those
involving the moral elements (in which case there is no very striking
intellectual disorder) and those involving the intellectual elements, in
which the conditions may be divided into states where intellectual
disorder alternates with periods of complete lucidity or with neuroses
(periodical insanity, neuroticism, hysteria, and epilepsy), and states in
which the intellectual disorder is a permanent quantity (paranoia,
one-sided genius, imbecility, and idiocy). Great as is the apparent gap
between idiocy and one-sided genius, on the one hand, and between idiocy
and crime, on the other, this gap is, as already stated, filled by
numerous closely interlinked forms, dependent on the proportionate removal
of checks (which the race has acquired during evolution) on the explosive
expressions of egotism and mentality. The removal of these checks is
dependent on the removal or weakening of the power of associating tracts,
to which reference has been made in connection with the degenerate brain.
The idiot, capable only of purely vegetative functions, who would perish
were food not placed far back in his mouth, is one step lower than the
normal infant, who is essentially, as has been remarked, an egotistic
parasite. On slightly increased development this idiot, with the powers of
a rather low animal, gains food and satisfies its instincts. These
instincts at this stage may manifest themselves in the explosive manner
characteristic of the undomesticated and non-social animals. With these
instincts may appear others which man has long lost; thus an idiot girl
(who was delivered of an infant when alone) gnawed through the umbilical
cord in the manner of animals, thus effecting separation and preventing
haemorrhage. At still a higher stage the imbecile may manifest destructive
instincts, may steal without the signs of remorse displayed by a housebred
dog, or may kill without recognising the results of killing. The intellect
may be comparatively developed in certain imbeciles in comparison with the
ethical defects. For lack of proper associating fibres, the imbecile may
be unable to acquire those higher associations constituting the secondary
ego, in the most elevated sense. To this class ultimately belong the
instinctive homicides, torturers, sexual criminals and thieves, so
frequently found among the juvenile offspring of degenerate stock. In them
the primary ego is strong, and the restraints of the secondary ego, which
perceives the rights of others, weakened or completely absent. This class
forms the germ of the congenital criminal whom no discipline can tame, and
who is incapable of being taught the dangers of his procedures under the
law of the land. Between this class and the paranoiac there is at once a
curious likeness and distinction. The lack of proper associating powers
prevents the moral imbecile from recognising any rights of others. The
same lack in the paranoiac prevents him from recognising the force and
rights of other people in opinion. The moral imbecile has lost the
greatest acquirement of the race in evolution, that acquirement which
fully recognises the secondary ego in accordance with the sublime precept,
"Do unto others as ye would that they should do unto you."
For practical purposes the division of criminals given by Tyndall is
sufficient. Crime is essentially an anti-social factor, and violations of
law can be regarded as crimes only in proportion as they are anti-social.
The essential character of crime is its parasitic nature. Parasites, in a
general way, may be divided into those which live on their host, without
any tendency to injure his well-being (like the dermodex in the skin
follicules); those which live more or less at his expense, but do not tend
to destroy him; and, finally, those which are destructive of the
well-being of man and lack proper recognition of individual rights which
constitutes the essential foundation of society. The first type is
impurely represented by the idiots, imbeciles, lunatics, paupers by
deprivation, blind, crippled, senile, insane, and deaf mutes. Society,
either indirectly or directly, has been the source of the parasitic state
of many of these, and hence, as also in the case of law-made criminals,
such parasitism really takes nothing from society. The second class is
represented by prostitutes, sexual degenerates, paupers, and inebriates.
Some of these, however, could be put into the third class, among those
moral lunatics and criminals who fail to recognise that individual rights
constitute social order. Prostitutes, paupers, and inebriates have this in
common, that crime in them has taken the line of least resistance. The
great ethical defect in the prostitute is not lack of checks on explosive
sexual propensities so much as the use of these last as a method of living
by her wits. In essence prostitution is the expression of the criminal
tendency manifested by the confidence operator. The researches of
sociologists like Chaplain Merrick,[252] of the Millbank Prison, London,
show that at least one-half of the prostitutes leave their homes
voluntarily to take up a "life of pleasure." Pauline Tarnowsky[253] finds
that in Russia prostitution is crime in women taking the line of least
resistance. The prostitutes, like the other criminals, are divisible into
criminals on occasion (vice, monetary reasons, &c.), accidental criminals,
law-made criminals, weak-willed criminals, and insane criminals. The
proportion of the law-made and accidental criminals among the prostitutes
is much less than among other criminals, as Merrick has shown. Seduction
stands very low in the list of causes. The proportion of the occasional
criminal type is very large. Pauline Tarnowsky concludes from her
researches, which my own tend to verify, that the prostitute, as a rule,
is a degenerate being, the subject of an arrest of development, tainted
with a morbid heredity, and presenting stigmata of physical and mental
degeneracy fully in consonance with her imperfect evolution. C. Andronico,
of Messina, Italy, arrived some time previously[254] at the same
conclusions as those of Tarnowsky. Tarnowsky found that 44-1/3 per cent.
of the prostitutes had skull deformities, 42-2/8 face deformities, 42 ear
deformities, and 54 teeth deformities. Andronico found among 230
prostitutes the following anomalies: Flat nose, 20; handle-shaped ear,
35; vicious implantation of teeth, 10; convergent strabismus, 2; facial
asymmetry, 4; prognathism, 7; receding forehead, 35. Grimaldi, in a study
of 26 prostitutes, had similar results to those of Tarnowsky. Lombroso, in
an examination of 50 prostitutes, found exaggerated jaws, 27 times;
plagiocephaly, 23 times; nasal asymmetry, 8 times; exaggerated zygomae, 40
times. Tarnowsky found that in 150 prostitutes, taken at random from those
answering to the necessary conditions (uniformity of race, ability to give
their family history and years of residence in licensed houses), there
were present signs of physical degeneracy in 87. Among the abnormalities
were oxycephaly, platycephaly, stenocephaly, plagiocephaly, and heads with
marked depression either at the bregma or the lambda. The majority had a
marked development of the external occipital protuberance; in an equal
number of virtuous women it was present but four times. These and other
anomalies were thus distributed among the 150 prostitutes: Malformation of
the head (oxycephaly, plagiocephaly, &c.), noticed in 62; development of
the occipital protruberance, 62; very receding foreheads, 18;
hydrocephalic, 15; various anomalies of the face (prognathism, asymmetry),
64; ogival palatine vault, 38; congenital division of palate, 14; vicious
implantation of teeth, 62; Hutchinson's and Parrot's teeth, 19; absence of
lateral incisors, 10; Morel ears, 16; defective ears (detached from head,
deformed, &c.), 47; anomalies of the extremities, 8.
In my researches in the same class, with the assistance of Harriet C. B.
Alexander and J. G. Kiernan, the subjects chosen were those committed to
the Chicago House of Correction. They are the least intelligent of
Chicago's professional prostitutes. The number examined was 30. As regards
the race they included 13 Celtic-Irish, 5 Irish-American, 3 Scandinavian,
1 German, 1 German-American, 2 American, 1 English-American, 1
Latin-Swiss, 2 Negro.
It should here be remembered that the "fine" system of Chicago places only
the "obtuse" class in the Bridewell. One was seventeen years old, two
eighteen years, one nineteen years, five between twenty and twenty-five
years, three between twenty-five and thirty, six between thirty and
thirty-five, five between thirty-five and forty-five, one was forty-six
years old, two were fifty-five, three sixty-one, and one sixty-five. There
were eighteen blondes, ten brunettes, and two negroes. Four were
demonstrably insane and one was an epileptic.
In sixteen cases the zygomatic processes were unequal and very prominent.
There were fourteen other asymmetries of the face. Three heads were
Mongoloid (one Irish-Celt, one Swiss, and one Scandinavian). There are
Mongoloid race types in the regions where all three come from. Sixteen
were epignathic and eleven prognathic. In one there was arrested
development of the lower jaw, and in four arrested development of the face
bones. The nose was abnormal in six. There were sixteen brachycephalic and
thirteen mesaticephalic skulls. There were no dolichocephalic skulls.
There were three with oxycephalic skulls, of whom one was a Celt, one a
German, and one a Scandinavian. There were eighteen dome-type skulls, of
whom seven were Irish-Celts, five Celtic-American, one English
Anglo-Saxon, one American Anglo-Saxon, and one German-American. There were
four tectocephalic skulls, of whom one was an Irish-Celt, one an
Anglo-Saxon American, and one a Scandinavian. There were three
platycephalic skulls, of whom two were Celts and one a Scandinavian. There
was a plagiocephalic German and a stenocephalic Celt. One skull had a
protuberance at the bregma. Twelve occiputs were flattened, and in four of
these there was no tubercle; eighteen had an enormously developed
occipital protuberance. The percentage of deformities of the jaws was
large. Twenty-nine had defective ears. Normal ears were present only in a
member of a family which had furnished one mother and two sisters to the
institution.
The direct hereditary history of prostitutes is excellently illustrated in
Marie Duplessis, idealised by Alexandre Dumas in _La Dame aux Camelias_.
Her paternal grandmother, who was half prostitute, half beggar, gave birth
to a son by a country priest. This son was a country Don Juan, a peddler
by trade. The maternal great-grandmother was a nymphomaniac, whose son
married a woman of loose morals, by whom a daughter was born. This
daughter married a peddler, and their child was Marie. She had the
confidence-operator tendencies of many of her class. She died childless,
early in life, from consumption.[255] With their ancestry, habits,
perverse instincts, prostitutes cannot be cured or reformed by the
enforcement of municipal ordinances. Though those of criminal and
congenital type be taken from their surroundings and placed where they can
earn an honest livelihood, they soon go back, voluntarily, to their old
mode of life.
An allied class, belonging to a still blacker phase of biology, are the
sexual perverts. The congenital form associated with the stigmata of
degeneracy, as already shown, is an expression of the defective line
whence the victim has sprung. The congenital types are, like the similar
types of the prostitute, victims of inherited defects. The sexual pervert
may be divided into precisely the same classes as other criminals. The
congenital type often links degenerate lunatics, epileptics, &c., with a
born criminal class.
Between the criminal and the insane is a debatable line occupied by moral
imbeciles, reasoning maniacs, &c. There are many insane persons in whom
the principal deviation from the normal consists in disorder of the moral
faculties. In most closer inspection generally reveals signs of
degeneracy. The seeming immorality is the striking factor of the case and
superficially the mind otherwise appears clear and rational by contrast.
As Krafft-Ebing has shown in these cases, the most striking features are
moral insensibility, lack of moral judgment and ethical ideas, the place
of which is usurped by a narrow sense of loss or profit, logically
apprehended only. Such persons may mechanically know the laws of morality,
but if such laws enter their conscience these persons do not experience by
any real appreciation, still less regard, for them. These laws to them are
cold, lifeless statements. The morally defective know not how to draw from
them motive for omission or commission. To this "moral colour-blindness"
the whole moral and governmental order appears as a mere hindrance to
egotistic ambition and feeling, which necessarily leads to negation of
the rights of others and to violation of the same.
These defective individuals are without interest for aught good or
beautiful, albeit capable of a sentimentality which is shallow cant. Such
persons are repellent by their lack of love for children or relatives, and
of all social inclinations, and by cold-hearted indifference to the weal
or woe of those nearest to them. They are without other than egotistic
care for questions of social life or sensibility to either the respect or
the scorn of others, without control of conscience and without sense or
remorse for evil. Morality they do not understand. Law is nothing more
than police regulation. The greatest crimes are regarded as mere
transgressions of some arbitrary order. If such persons come in conflict
with individuals, then, hatred, envy, and revenge take the place of
coldness and negation, and their brutality and indifference to others know
no bounds.
These ethically defective persons, when incapable of holding a place in
society, are often converted into candidates for the workhouse or the
insane hospital, one or the other of which places they reach after they
have been, as children, the terror of parents and teachers, through their
untruthfulness, laziness, and general meanness, and in youth the shame of
the family and the torment of the community and the officers of the law,
by thefts, vagabondage, profligacy, and excesses. Finally, they are the
despair of the insane hospital, the "incorrigibles" of the prisons, and
(Krafft-Ebing might have added) the veritable burdens of the poor-house.
If intellectual insanity or crime do not claim them, pauperism or
criminality is likely to be their destiny. The moral imbecile may,
however, keep within the law, and as in the instance of the "Napoleon of
Finance," cited elsewhere from Kiernan, may achieve business success. His
descendants often, however, evince degeneracy in an aggravated form. Many
of the supposed reformers of various alleged social evils are often of
this class. Their morbid egotism takes the direction of cant and
sentimentality, so common at certain states in evolution, as points of
least resistance. Like Guiteau, the assassin of President Garfield, they
aim at doing a "big thing for humanity and myself," the humanity being
concentrated in "my" ideas. The moral lunatic needs but a slight twist
intellectually to become the paranoiac in whom there is, as Spitzka has
pointed out,[256] a permanent undercurrent of perverted mental action
peculiar to the individual, running like an unbroken thread through his
whole mental life, obscured, it may be, for these patients are often able
to correct and conceal their insane symptoms, but it nevertheless exists,
and only requires friction to bring it to the surface. The general
intellectual status of these patients, though rarely of a very high order,
is moderately fair, and often the mental powers are sufficient to keep the
delusion under check for practical purposes of life. While many are what
is termed crochety, irritable, and depressed, yet the sole symptoms of the
typical cases of this disorder consist of the fixed delusions. Since the
subject matter of the delusion is of such a character that these patients
consider themselves either the victim of a plot or as unjustly deprived of
certain rights and position, or as narrowly observed by others, delusions
of persecution are added to the fixed ideas, and the patient becomes sad,
thoughtful, or depressed in consequence. The patient is depressed
logically, as far as his train of idea is concerned and his sadness and
thoughtfulness have causes, which he can explain, and which are intimately
allied with that peculiar, faulty grouping of ideas which constitutes the
rendezvous, as it were, of all the mental conceptions of the patient. Nay,
the process may be reversed, and the patient, beginning with a
hypochondriac or hysteric state, imagines himself watched with no
favourable eye. Because he is watched and made the subject of audible
comments (hallucinatory or delusional), he concludes that he must be a
person of some importance. Some great political movement takes place; he
throws himself into it, either in a fixed character that he has already
constructed for himself, or with the vague idea that he is an influential
personage. He seeks interviews, holds actual conversation with the big men
of the day, accepts the common courtesy shown him by those in office as a
tribute to his value, is rejected, however, and then judges himself to be
the victim of jealousy or of rival cabals, makes intemperate and querulous
complaints to higher officials, perhaps makes violent attacks upon them,
and being incarcerated in jail or asylum, looks upon this as the end of a
long series of persecutions which have broken the power of a skilled
diplomatist, a capable military commander, a prince of the blood, an agent
of a camarilla, a paramour of some exalted personage, or finally the
Messiah Himself. All through this train of ideas there runs a chain of
logic and inference in which there is no gap. If the inferences of the
patient were based on correctly observed facts and properly correlated
with his actual surroundings, his conclusions would be perfectly correct.
For years and years many such patients exhibit a single delusive idea as
the only prominent symptom. There is hereditary taint in most of these
subjects, who are strange in disposition from infancy. As children they
frequently shun society and indulge in day-dreams. Their bodily growth is
normal, but even trifling disease takes on a cerebral tinge. They may show
talent in special directions, but their intelligence rarely passes out of
the puerile stage. They often brood over a feminine ideal, a girl who has
never encouraged them, and whom they persecute with absurd plans of
marriage.
Connecting the paranoiac with the moral imbecile are the so-called
"reasoning maniacs." Here the intellectual power is less than either that
of the moral imbecile or of the paranoiac, twisted though the intellect of
the latter be. Loquacious or unusually taciturn, heedless or morbidly
cautious, dreamers, wearisome to all brought in contact with them,
capricious and unmitigated liars, their qualities are often, in a certain
manner, brilliant, but are entirely without solidity or depth. Sharpness
and cunning are not often wanting, especially for little things and
insignificant intrigues. Ever armed with a lively imagination and quick
comprehension, they readily appropriate the ideas of others, developing or
transforming them and giving them the stamp of their own individuality.
But the creative force is not there, and they rarely possess enough mental
vigour to get their own living. Passing without the slightest transition
from one extreme to the other, they felicitate themselves to-day on an
event which they sneered at the night before. In the course of a single
second they change their opinions of persons and things, novelty
captivates and wearies them almost in the same instant. They sell for
insignificant sums things they have just bought, in order to buy others
which, in their turn, will be subjected to like treatment; and, strange to
say, before possessing these objects, they covet them with a degree of
ardour only equalled by the eagerness they exhibit to get rid of them as
soon as they become their own. To see, to desire, and to become
indifferent are three stages which follow each other with astonishing
rapidity.
The intense egotism of these persons makes them, as W. A. Hammond remarks,
utterly regardless of the feelings and rights of others. Everybody and
everything must give way to them. Their comfort and convenience are to be
secured though every one else is made uncomfortable or unhappy; and
sometimes they display positive cruelty in their treatment of persons who
come in contact with them. This tendency is especially seen in their
relations with the lower animals.
Another manifestation of their intense egotism is their entire lack of
appreciation of kindness done them or benefits of which they have been the
recipients. They look upon these as so many rights to which they are
justly entitled, and which in the bestowal are more serviceable to the
giver than to the receiver. They are hence ungrateful and abusive to those
who have served them, insolent, arrogant, and shamelessly hardened in
their conduct toward them. At the same time, if advantages are yet to be
gained, they are sycophantic to nauseousness in their deportment towards
those from whom the favours are to come.
The egotism of these people is unmarked by the least trace of modesty in
obtruding themselves and their assumed good qualities upon the public at
every opportunity. They boast of their genius, their righteousness, their
goodness of heart, their high sense of honour, their learning and other
qualities and acquirements, and this, when they are perfectly aware that
they are commonplace, irreligious, cruel, and vindictive, utterly devoid
of every chivalrous feeling, and saturated with ignorance. They know that
in their ratings they are attempting to impose upon those whom they
address and will even subsequently brag of their success.
It is no uncommon thing for the reasoning maniac, still influenced by his
supreme egotism and desire for notoriety, to attempt the part of reformer.
Generally he selects a practice or custom in which there really is no
abuse. His energy and the logical manner in which he presents his views,
based as they often are on cases and statistics, impose on many people,
who eagerly adopt him as a genuine overthrower of a vicious or degrading
measure. Even when his hypocrisy and falsehood are exposed he continues
his attempts at imposition, and when the strong arm of the law is laid
upon him, he prates of the ingratitude of those he has been endeavouring
to assist, and of the distinctiveness and purity of his own motives.
Closely akin to that instability of inter-association resulting in loss of
proper checks on action in the types just described, is the sentimentalism
which often covers real hardness, but which charms and allures the mass.
This has essentially the same psychological basis as the suspicional
tendencies and pessimism with which it is so often associated. Suspicional
tendencies arise from states of anxiety resultant on instability of
association, dependent on lack of associating fibres. Pessimism (so
frequently present in the otherwise healthy degenerate) is often, as
Magalhaes has shown, nervous instability with alternations of irritability
and prostration. The subject is supersensitive; impressions call forth
intense and prolonged reactions followed by exhaustion. The state is
characterised by a general hyperaesthesia, which naturally results in an
excess of suffering. From instability and hyperaesthesia results discord
between the feelings themselves, between the feelings and the
intelligence, between the feelings, the ideas and volitions. Discord
between the feelings shows itself in a great variety of paradoxes,
contradictions, and inconsistencies. To the pessimist possession of a
desired object does not atone for former privation. Pain or unsatisfied
desire is replaced by the pain of _ennui_. With inability to enjoy what he
has are coupled extravagant expectations regarding that which he does not
have. He is extremely susceptible both to kindness and to contempt. He
passes suddenly from violent irritability to languor, from self-confidence
and vanity to extreme self abasement. His intense sensitiveness results in
intellectual disorders. For this involves a great vivacity of the
intuitive imagination, which favours the setting up of extravagant ideals,
lacking in solid representative elements. Hence a gap opens between his
ideal and the actual. He can never realise the ideal he pursues and so his
feelings are of a sombre hue. From this excessive realism results a state
of doubt, a certain distrust of all this rational objective knowledge. It
assumes another form in extreme subjectivism. The pessimist is haunted by
images of the tiniest religious scruples, suspicions, fears, and
anxieties, resulting in alienation from friends, seclusion, misanthropy.
The pessimist is further characterised by an incapacity for prolonged
attention, a refractory attention and a feeble will. These result in
inaction, quietism, reverie, self-abnegation, abolition of the
personality, annihilation of the will, amounting sometimes even to poetic
or religious ecstasy. Pessimism is frequently associated with a morbid
fear of death. The tramp is one phase of the degenerate in whom the
restless wandering tendencies of the neurasthenic and paranoiac are added
to the parasitic tendencies of the pauper, and the suspicional egotism of
the "reasoning maniac."
The one-sided genius is a link between the neurotic, the epileptic, the
paranoiac, the hysteric, and the imbecile. Cases crop up in which all
these elements are so mingled as to create a puzzle where they shall be
placed. In some cases, in accordance with the general law that physiologic
atrophy is accompanied by hypertrophy in other directions, the
intellectual powers other than along certain lines may be remarkably
deficient. Moreover, the intellectual power due to healthy atavism is
increased by the degeneracy in certain directions. Without going into the
question, raised by Lombroso,[257] as to genius being an epileptoid
neurosis, sufficient evidence exists to show that ill-balanced genius
often coexists with defects in a large number of directions. The
coexistence of genius with imbecility and even idiocy has been well
illustrated by Langdon Down, who cites numerous instances thereof.[258]
Defect in genius, whether of the imbecile stamp or otherwise, accompanied
by deficiency, is not expressed in the genius, but in its deficient
accompaniment. Even the mental instability of the highest type of
defective genius is closely akin to that of the neurotic.
The hysterics, as has been shown by Des Champs,[259] are neurotic women in
whom an aggravated sensibility exists. Neurotic women are divisible into
three categories according to the predominance of one of three
centres--cerebral, genital, and neuropathic. These types may be pure or
intermixed. The general characteristics are an absolute want of
equilibrium in sensibility and will power. There exists mobility of humour
in direct relation with facile impressionability to external influences or
to internal states. The nerves vibrate to all sentiments coming from
within or without, and all are registered without proper relation. One
fact chased by another is forgotten. Another produces a momentary
hyperexcitation, which takes place of the truth, whence it is that
falsehood is instinctive, but the patient protests her good faith if
accused of the same. This lack of equilibrium leads to a decided
modification of the mental faculties. Intellectual activity is over
excited, but in diverse degrees and variable ways, according to the
particular tendencies adopted. Absorbed by a preoccupation or controlled
by an idea, they become indifferent to all else. Their ideas are abundant,
and they rapidly pass from the idea to the act. Their vivid imagination,
coupled with a bright intelligence, gives them a seducing aspect, but
their judgment is singularly limited, attenuated, or false. They judge
from a non-personal standpoint excellently. They are quick at discovering
the faults of even their own relatives, but faults rightly attributed to
themselves are repudiated. Their memory is capricious. They forget their
faults and their acts under impulse, albeit these may be consciously done.
The cerebral type is led by the intelligence. She has little or no
coquetry; what coquetry there may be is the result of intention and
temporary. There is an ethical sense, frankness and nobility in her ideas,
disinterestedness and tact in her acts, and she is capable of friendship.
Her tastes carry her to male pursuit, in which she succeeds. She becomes
often what is called a "superior woman," and too often what is called an
"incomprehensible woman." She has but little guile. To the sensual type
voluptuousness is the aim of life and the centre of her acts and thoughts.
She is well endowed with guile and extremely diplomatic. She is full of
finesse, but not very delicate. Her lack of scruple often spoils her tact.
She is ruseful, dissimulating, and unconsciously mendacious. She despises
friendship and needs watching. If circumstances permit she loses all
delicacy, reserve and modesty. She is destitute of scruples. Her crimes
are coolly remorseless. The neuropathic type is one to which the
grasshopper is a burden. Her nerves are always on edge. She is a heroic
invalid who displays the air of a martyr about trivialities.
The character of the neurotic, as Kiernan remarks, recalls the observation
of Milne-Edwards concerning the monkey character. Levity is one of its
salient features, and its mobility is extreme. One can get it to shift in
an instant from one mood or train of ideas to another. It is now plunged
into black melancholy and in a moment may be vastly amused at some object
presented to its attention.
Neuroticism in man differs in no respect from that in woman except that
anaesthesia, paralysis of emotional origin, and conscious convulsions are
less common. The male neurotic could be subdivided precisely as Des Champs
has the hysteric. Neurotics are often long-lived, peculiarly resistant to
certain acute and fatal disease, and are frequently retentive of their
youthful appearance, which is to a certain extent an evidence of their
resistance to the wear and tear of life and advancing old age, and due to
emotional anaesthesia. Recognition of the neurotic tendency often induces
the individual to take better care of himself. The youthful appearance may
be due largely to arrest of facial development at an early age, the face
thus retaining the child character throughout life. Considering,
therefore, this class of neurotics, which does not include those afflicted
with the more serious nervous disorders such as epilepsy, they may be
looked upon as the victims of evolutionary processes that are constantly
going on in the race and under civilised conditions.
Neurotics are not met with to any extent among barbarous races, but are
numerous in civilised communities, where the weak are preserved from early
death and then subjected to the struggle for existence. Neurotics are
individuals naturally imperfect in some directions, but by the law of
economy of growth they are often superior in others. Their disordered
nervous functions and hyperaesthesia are not, necessarily, indicative of
inferiority of general organisation compared to their ancestry. They may
simply imply a more rapid advance in some one direction in the development
of the nervous system than can be kept up with by the remainder. These
defects may in some cases be the advance guards in the progress of the
development of the race.
As the nervous system controls nutrition in all departments of the
organism, anomalies occur with erratic nervous functions in such
individuals. In these neurotics are often found defective development
involving the bony and other structures. They have fine and delicate
features, small jaws and defective teeth. These are the results of general
systemic modifications connected with the neurotic state. The arthritic
diathesis occurs also; it is one of the underlying conditions of many
neurotic manifestations, often responsible for acquired bony deformities,
not infrequently involving the jaws to some extent.
Neurotic degenerate symptoms from a mental standpoint are noticeable long
before deformities of the osseous system are developed. They show
themselves in mental weakness, extreme stupidity, and precocity. Under the
first class the child is obstinate, quarrelsome, malignant, even immorally
inclined, and is often spoken of as being wicked or vicious. Harriet C. B.
Alexander[260] says the ruling instinct in the child of three or four is
self-gratification. It destroys what it dislikes. Among the earliest
manifestations of morbid mental activity in childhood are hallucinations,
which depend on already registered perceptions.
In many instances even moral agencies produce sudden explosions of mental
disorders. The inherited tendencies of childhood predispose to these
attacks. As Clouston has shown, neuroses and psychoses not requiring
hospital treatment are by no means uncommon in the too sensitive child
with hereditary taint. Children of this class have crying fits and
miserable periods on slight or no provocation. As Clouston has also shown,
precocity, over-sensitiveness, unhealthy strictness in morals and religion
for a child, or too vivid imagination, want of courage, thinness and
craving for animal food, are common characters. These children are
over-sensitive, over-imaginative, are too fearful to be physiologic, and
tend, as a general thing, to be unhealthily religious, precociously
intellectual, and at first hyperaesthetically conscientious.
The other class of children, as a rule, are very handsome babies and
children. The brightness is noted by parents at a very early age, and they
extol their many clever qualities and sayings. The tendency is for the
parents to cultivate these precocious qualities and believe it to be the
proper thing to encourage them; while in early life this class may possess
the peculiarities of the other class and also show those of degeneracy.
These children are the best scholars in the schoolroom and learn their
lessons with apparently little or no study. They are usually thin, frail
children, and very nervous. Very little food is taken and much of that is
not assimilated. Especially is this true of the lime salts, which form
bone and tooth structure. These lime salts are excreted through the
kidneys and salivary glands. This is easily demonstrated by an examination
of urine, mouth, and teeth. Large collections of tartar are always found
in these cases. Children of both classes are sure to show stigmata of
degeneracy. This period of degeneracy commences at the sixth year, or at
about the time the first period of brain development ceases. The bulk of
the brain has obtained its growth. In some the child commences to improve
mentally very fast. In others mental development is slow. In still others
it ceases altogether. From the time the second set of teeth begins to
develop until the twelfth year, neuroses of development and stigmata of
degeneracy are stamped upon the head, face, nose, jaws and teeth, and
later any of the conditions mentioned under the heads of nutritive
degeneracy and local perversion tendencies may appear.
Closely akin to these states are expressions of degeneracy manifesting
themselves with some approach to regularity in periods, as in epilepsy and
the periodical insanities. The periodical insanities may be simply
emotional states of exaltation (as in mania), of extreme depression (as in
melancholia), of stupor, or of mental confusion. They may show themselves
in periodical acts, as in dipsomania. This condition differs from the
condition called inebriety in the fact that it is a periodical expression
of degeneracy whose form has been accidently determined, but which would
exist even were its form changed. The differences are excellently outlined
by Dana,[261] who divides intemperate drinkers into four classes:
Periodical inebriates or dipsomaniacs, pseudo-inebriates, common drunkards
and victims of delirium inebriosum. The disease in the first class is a
periodical insanity. In the pseudo-inebriates the desire for drink is
only one of many manifestations of a weakened constitution or inherently
unstable nervous system. The third type are those which approximate the
occasional criminals. Another periodical insanity is kleptomania, in which
insane stealing occurs at intervals of greater or lesser regularity.
Nymphomania or satyrasis is a periodical insanity in which there is an
insane impulse for sexual intercourse. Pyromania is a periodical tendency
to commit arson. All of these periodical conditions may occur alone or in
combination with other degeneracies.
Closely related to the periodical insanities are the epileptic states
which play so large a part in many of the phenomena presented by the
degenerates. In the epileptic the mental rather than the gross nervous
expression merits attention. From what has already been said about
epilepsy, it and the periodical insanities are in no small degree the
effect of mal-development of the fore brain as compared with the centres
of organic life. The great convulsive centre is, according to
Spitzka,[262] the reticular grey matter of the brain isthmus, particularly
of the pons and medulla. All characteristic features of the full epileptic
onset can be produced in animals deprived of the related cerebral cortex.
It needs but a slight puncture with a thin needle to produce typical
convulsions in the rabbit, and some of the convulsive movements reported
by Nothnagel have not only shown the true epileptic character but also
that peculiar automatism noted in aberrant attacks. It is in this segment
of the nervous system that all the great nerve strands conveying motor
impulses, both of a voluntary and automatic and some of a reflex
character, are found united in a relatively small area, and just here a
relatively slight irritation might produce functional disturbances
involving the entire bodily periphery.
The experiments of physiologists have shown that if a sensory irritation
of a given spinal nucleus be kept up, after having produced a reflex
movement in the same segment, any reaction beyond the plain of that
segment is not in the next or succeeding planes but in the medulla
oblongata. The motor reaction then manifests itself in laughing, crying,
or deglutitory spasms, and, if the irritation be of the severest kind,
epileptic or tetanic spasms in addition. Now the occurrence of laughing,
crying, or deglutitory spasms could be easily understood if the molecular
oscillation induced by the irritation were to travel along the associating
tracts from the given spinal segment to the nuclei of the medulla
oblongata. For in the medulla are found the nerve nuclei which preside
over the facial, laryngeal and pharyngeal muscles. It is not easy at first
to understand how tetanus and epilepsy, that is, spasms consisting in
movements whose direct projection is not in the medulla oblongata but in
the cord, can be produced by irritation of the former.
There are scattered groups of nerve cells in the medulla oblongata which
have either no demonstrable connection with the nerve nuclei, or are
positively known to be connected with the longitudinal associating
strands. These cells hence can safely be regarded as representing a
presiding centre over the entire spinal system. No spinal centre exerts
any influence even remotely as pronounced as that of the entire cord.
This applies to man and other mammals. That the elaboration of the
medullary centre was as gradual a process as that of other higher
differentiations is illustrated by the case of the frog, whose medulla has
acquired the faculty of reproducing general spasms while the spinal cord
itself retains this property also; hence here the predominance of the
medulla is not so marked as in mammals.
The reticular ganglion of the oblongata is not in the adult a part of the
central tubular grey matter, but has, through originally developing from
it in the embryo, become ultimately isolated from its mother bed. It
constitutes a second ganglionic category, and the association fibres
bringing it in functional union with the spinal grey (first category) in
lower animals and shown to have assumed the position of projection fibres
in the higher, constitute a second projection tract; both together are a
second projection system. The scattered grey matter of the medulla has
great importance. Anatomically it is (though its cells be scattered
diffusely as a rule) a large ganglion with numerous multipolar cells of
all sizes, many of them gigantic, sometimes exceeding the so-called motor
cells (which they simulate in shape) of the lumbar enlargement in size.
Scattered in the "reticular substance" of the medulla from the upper end
of the fourth ventricle to the pyramidal decussation, they merit the
collective designation of reticular ganglia.
The cells of the reticular formation are known to be connected with the
nerve nuclei, on the one hand, and with longitudinal fasciculi, which,
since they run into the cord, terminate either in the grey matter or the
nerve roots directly, for nerve fibres do not terminate with, as it were,
blind ends. Now in the mammalian brain the reticular ganglion lies
scattered among fibres which come from the higher centres, and the
interpellation might be made whether, after all, the reticular ganglion be
not a mere intercalar station for fibres derived from a higher source.
Originally the ganglion was an independent station. In reptiles this body
of cells is too considerable to account for a termination in them of the
few cerebral fibres possessed by these animals. And, on the other hand,
the vertical strands are notably increased in their passage through the
field of the medulla oblongata.
The medulla oblongata with its reticular ganglion seems to be the great
rhythmic centre. In fish the movements of the operculum and mouth, in
sharks those of the spiraculum, in perenni-branchiate amphibians the
branchial tree, in the infant the suctorial muscles, in all vertebrates
the movements of deglutition, of the heart and respiratory muscles, all
movements presenting a more or less regular rhythm, are under the control
of the medulla oblongata. The early differentiation of this part of the
cerebro-spinal axis is related to the manifestations of rhythmic movements
in the embryo and their predominant importance in lower animals. The
possibility should not be excluded that a rhythmic movement may be spinal,
nay even controlled by peripheral ganglia (heart of embryo). A higher
development, however, implies the concentration of rhythmic innervations
at some point where that anatomical association may be effected which is
the expression of the mutual influence these movements exercise among
themselves.
Two sets of phenomena must be borne in mind in studying the physiological
pathology of the epileptic attack. First, the condition of the epileptic
in the interval. Second, the explosion itself. Too much attention is paid
to the last, too little attention to the first. The constitutional
epileptic is characterised by a general deficiency of tone associated with
exaggerated reaction and irritability. Thus the pupils are at once widely
dilated and unusually mobile. The muscular system, though generally
relaxed, manifests exaggerated reflex excitability. The mental state is
characterised at once by great indifference and undue irascibility. In the
same way the vascular system is depressed in tone in the interval with
rapid marked changes under excitation. The state of the nervous system as
a whole Spitzka forcibly compares to that of an elastic band which, being
on the stretch continually, is apt to rebound violently when one end is
let go. Under normal circumstances the band is less stretched and hence
not as liable to fly so far when the check is removed.
An irritation which, in health, produces restlessness of the muscular
system, accelerated respiration and pulsation and various mental phenomena
within the normal limits, in the epileptic results in more intense
phenomena in the same direction. The nervous irritability of the epileptic
manifests itself in one direction especially. An important vaso-motor
centre for the brain vessels exists, possibly diffused through an area
somewhere between the thalamus and subthalamic region above the pyramidal
decussation below. The irritability of this centre results in sudden
arterial spasm in the carotid distribution (so characteristic a feature of
the fit onset); simultaneously with the contraction of the vessel the
pupil undergoes an initial contraction, and relaxation instantly results
in both cases. The sudden interference with the brain circulation produces
unconsciousness, and destroys the checking influence of the higher centres
on the reflexes in a manner analogous to any shock affecting the nerve
centres. In the meantime, while there has been a sudden deprivation of
arterial blood and a sinking of intracranial pressure so far as the great
cerebral masses are concerned, there has been as sudden an influx of blood
to the unaffected district of the vertebral arteries whose irrigation
territory is now the seat of an arterial hyperaemia. The result of this is
that the great convulsion centre, the medulla, being over-nourished,
functional excess, that is, convulsion, occurs unchecked by the cerebral
hemispheres, which are disabled by their nutritive shock. The
unconsciousness and coma of epilepsy more resemble shock than they do
cerebral anaemia or syncope. The impeded return circulation of venous blood
now comes into play. The contraction of the neck muscles explains this
obstruction and especially the accumulation of venous blood in the
cerebral capillaries of the medulla.
True epilepsy presents an enormous number of sub-groups, exhibiting every
variety of deviation from the ideal convulsive form, and the existence of
these forms tends to demonstrate the views just expressed. In ordinary
petit mal the initial arterial spasm has but to be confined to the surface
of the hemispheres, leaving the thalamus ganglia undisturbed, and it can
readily be understood how the momentary unconsciousness or abolition of
cortical function can occur without the patient falling, his automatic
ganglia still carrying on their functions. At the same time with the
lesser spasm there would be a less extensive sinking of intracranial
pressure with less consecutive collateral hyperaemia of the lower centres
and therefore no convulsion.
In certain cases the arterial spasm fails to affect the entire cortical
surface simultaneously; some one trunk may be more pervious, and as afflux
of blood may occur in its special field where certain impressions and
motor innervations are stored, the result will then be that the function
of the relatively well-nourished territory will be exalted. If it be a
visual perception territory, sights, colours or luminous spectra will be
seen; if it be an olfactory territory, odours will be smelt; if a tactile
centre, crawling, tingling and cold sensation are felt; if a speech
centre, cries, phrases, and songs may be observed. This explains the
manifold epileptic aura, which is simply an isolated, exaggerated, and
limited cortical function. The recurrence of the aura is readily
explicable on the ground of the well-known physiological law that any
nervous process, morbid or normal, having run through certain paths, those
paths will be the paths of least resistance for that process to follow in
the future.
These conditions will be greatly exaggerated in proportion to the
deficiencies in the associating tracts and will often, in turn, pervert
these. The sexo-religious and other mental states of epilepsy often
closely mimic normal mentation and serve to disguise the intense depth of
degeneracy which epilepsy implies.
In their explosive, unchecked character the morbid restlessness of the
neurotic, hysteric, and criminal depend upon like brain disorder to that
of the epileptic, except that consciousness is not involved, and with
conscious acts are intermingled those preceding from the lower automatic
processes described. Consciousness, however, is sometimes lost in part,
whence frequently the defects so often noticed in the thoughts of the
degenerates.
The two following cases which have come to my notice illustrate the
obliteration of the function of limited areas of the brain. A young lady,
aged 22, of refinement and highly accomplished, was engaged to be married.
One evening her _fiance_ called; she failed to recognise him and he
remained ever after a stranger to her. In every other respect her mind was
seemingly normal. She died of tuberculosis. In another case a young lady,
an expert stenographer, while riding her wheel, fell striking her head
against a stone. She remained unconscious for some days, and was quite ill
for three or four months. After her recovery she was much surprised to
find that she knew nothing about her former employment, although her brain
was perfectly normal in other respects.