INSANITY AND ALCOHOLISM.
_Nerve Derangements--Insanity._
We saw in the preceding chapter that during quite recent years the
dangers of early life have been greatly lessened because of our
increased knowledge of infantile hygiene, and from the fact that the
infective diseases, which are always most dangerous to the young,
have been greatly abated. We saw, however, at the same time, that
the constitutional weaknesses of humanity are by no means lessened,
and that there are strong grounds for believing that during the
last thirty years the race has observably degenerated, a result to
be anticipated from the withdrawal of selective influences during
childhood and early life. Amongst these constitutional weaknesses
we may specially notice defects in the respiratory, circulatory,
nervous and other systems, as being of interest and importance,
and their observation worthy of our close attention. In this
little treatise it is impossible however to do more than shortly
to allude to hereditary defects in the nervous system associated
with incapacity, a tendency to insanity, or to excesses in the use
of alcohol. The subject is not only one of popular interest, but
it can be understood by those who are not technically instructed.
Just as no two men agree in the possession of equally sound mucous
membranes or lung tissues, so we may have decided variations in the
brain tissues. Together with unsound brain tissue we have symptoms
which we call mental derangement, and of these we have an infinite
variety, starting from the mentally too excitable, or too inert, and
passing on to those who are more obviously diseased and useless, and
finally to those who are dangerous to society at large. Now, these
brain affections are markedly hereditary--proverbially so indeed.
It is true that an overplus of work, or anxiety, or depressing
surroundings, may produce insanity or other nervous conditions in
one who under better surroundings would undoubtedly escape. These
are, no doubt, true exciting factors, but they act with alarming
ease in the case of certain types, while in others their action
is relatively inoperative. This type, an organic variation, is
transmitted, it is not destroyed. As Dr. Bastian says: “It is now a
well-established fact that persons who are endowed with a neurotic
habit of body very frequently transmit a similar tendency to their
children. It is not a tendency to any particular nervous disease,
but a vulnerability of the nervous system as a whole, which is
transmitted, so that under the influence of even a comparatively
slight strain the weakness may manifest itself in one or other of
several ways.” Speaking of the suicidal tendency, Dr. Maudsley
remarks: “It is, indeed, striking and startling to observe how
strong the suicidal bent is apt to be in those who have inherited
it, and how seemingly trivial a cause will stir it into action.
Persons affected by it will sometimes put an end to themselves on
the occasion of a petty contrariety, or when they are a little out
of sorts, and with almost as little concern as if they were taking
only a slight journey.” In half his cases Dr. Maudsley traced an
inherited fault of organisation. And again, speaking of the many
ways in which a neurotic taint may manifest itself, he says: “In
families where there is a strong predisposition to insanity, one
member will sometimes suffer from one form of nervous disease, and
another from another form: one perhaps has epilepsy, another is
afflicted with a severe neuralgia, or with hysteria, a third may
commit suicide, a fourth become maniacal or melancholic, and it
might even happen sometimes that a fifth evinced remarkable artistic
talents.”
It is generally supposed by the members of the medical profession
that insanity is on the increase, and this is in accordance with
the fact that deaths from several diseases of the nervous system
are on the increase too. This supposition has, however, been hotly
disputed, and may be left in other hands for final settlement,
for it must be remembered that our statistics date back but a few
years, a day as it were in history, and we must not presume to be
able to settle offhand every problem that arises.
_The Importance of preventing its Transmission._
For our present purpose the hereditary nature of the neurotic
temperament is the important point that we have to consider, for
its hereditary nature places it in the category of affections,
which ought to be eliminated by selective means, instead of being
provided for merely by the personal treatment of those who suffer
from it. It is true that by the selection suggested the world might
lose the occasional genius which is found here and there in families
with a strong taint of insanity, but on the other hand it must be
remembered that by far the greater number of distinguished men and
women have been derived from vigorous and mentally sound parentage;
for the association which we make between genius and insanity is
due not so much to its common occurrence as to the possibility of
the co-existence at all in the same family circle of these two
things that at first sight must appear so strangely opposed to each
other.
With a certain amount of sacrifice, humanity by selection might free
itself from those types who are a drag upon the resources of the
community, and who suffer themselves, certainly in the melancholic
cases, to a degree which it is impossible for an ordinary individual
to experience.
_Marriages of Insane Persons._
While there has so far been no organised effort to bring about
this selection, for we have not yet turned our attention with
sufficient interest to the race as a whole, yet there is a popular
and widespread feeling against the marriage of those with a distinct
family history of insanity. This feeling has had in the past an
undoubtedly selective influence, and has in some measure diminished
the number of marriages with neurotic families; and the strengthening
of this feeling in the future is the only thing we have to look
to, as matters stand, as a means whereby the race may free itself
from an inherent weakness of a most distressing kind.
_Alcoholism a Habit, and Alcoholism a Sign of Mental Instability._
Not unfrequently we hear of the hereditary tendency to alcoholism,
and it is generally understood that a specific tendency to drink
alcohol is transmitted. To me it appears that the facts at our
disposal seem rather to warrant the conclusion that most of those
cases which are supposed to be examples of transmission, are really
due to the permanence of intemperate habits in the same family or
district perhaps for generations, and that in these cases the children
drink from the force of imitation. In other cases I would rather
infer that unbalanced vicious temperaments are transmitted, but that
as to the way in which these will manifest themselves it depends
much upon the circumstances and surroundings of the individual, who
may become a drinker, an opium eater, or a profligate, or perhaps
a combination of all three.
_Drink is a Selective Agency._
Among the lower classes at the present day there are, no doubt,
whole families who generation after generation have had a bad
name for drunkenness; but it would appear that in these cases the
drunkenness is but one manifestation of the same careless or vicious
temperament, which shows itself also in idleness and crime. Among
the middle and upper classes a generation or two ago families of
hard drinkers were often known. In these cases, as one may learn
nowhere better than from Barrington’s “Sketches of Irish Life,” the
drinking was a part of a general devil-may-care temperament, or was
even in many cases associated with a pride in the accomplishment
itself. At the present day, when drunkenness is looked down upon
as disgraceful by the better and more educated classes, excessive
drinking has vastly diminished. It is fair, therefore, to conclude
that, while what we may term unbalanced temperaments and instincts
of self-indulgence are inherited, the actual way in which these
instincts will manifest themselves depends upon the surrounding
conditions which may happen to prevail. Such unbalanced persons
would under certain surroundings of training and education fall a
prey to drink, as when they are associated with drunken parents
or friends; under other surroundings they may be guilty of crime
or debauchery and tend in any case to avoid the quiet, orderly
routine of citizenship. While, therefore, we can hardly say that
the tendency to drink is hereditary, yet we may affirm that certain
type variations, running, no doubt, in families, are especially
liable to drink and other forms of vice. It follows, too, that drink
may be looked upon as a selective agency--one constantly thinning
the ranks of those who are weak enough by nature to give way to
it, and leaving unharmed those with healthy tastes and sound moral
constitutions.
_Parents who drink from Habit may have Debilitated Offspring._
In a former chapter we have suggested that the alcohol circulating
in the parental veins may affect the germinal cells, not in such
a manner as to make those cells develop into individuals with a
tendency to drink, but rather with the result that debilitated
offspring are often thereby produced. It is quite conceivable that
this latter effect may be brought about, although our study of the
infective diseases has indicated to what lengths the whole system
may be affected without the production of any permanent change in
the germ cells; but it is, I think, greatly over-stating the case
to adduce examples such as one brought forward by Galton, in which
we are told of a man who had begotten children of the ordinary type
becoming a drunkard, and afterwards having imbecile children. This
seems to me to be very questionable evidence indeed. We can seldom
ground any general rule on the basis of a few isolated cases, and
just as one may support almost any argument by means of a text of
Scripture, so one might bring forward isolated cases to support almost
any view of heredity. Amongst the some forty million instances of
transmission to be seen at the present day in the British Islands
and the many thousands of imbeciles and drunken parents, one hardly
wonders at what may after all be only a coincidence. That this is
a coincidence, and that the production of the imbecile children
had no necessary connection with the drunken habits of the parent
will seem to us very probable when we reflect that in the Scottish
Lowlands, large English towns, and in parts of Germany, habitual
heavy drinking is exceedingly common; therefore, did such startling
cases of transmission occur, they would occur frequently, and be
matter of common observation and comment. While refusing to accept
this case in evidence, it is still probable on general grounds
that the offspring of habitual drunkards suffer hereditarily, but
definite evidence on this score appears still to be wanting.
_Preventive Measures._
This leads us to the question as to whether or not legislation
with a view to prevent the sale of alcohol would further or retard
race progress. Experiments of this kind have been, and are being
tried--notably in Scandinavia and the United States; and there
are those who strongly advocate preventive legislation in our own
country.
But has this enforced diminution of one particular form of vice
given us any guarantee as to immunity from the other forms into
which the habitual drunkard may develop? That preventive measures
have diminished drunkenness cannot for a moment be denied, but this
diminution is certainly not more notable than the corresponding
change in the habits of the English upper classes brought about
entirely by the force of conscience and habit. Granted that preventive
measures will improve the individual, we have to ask ourselves the
question, how will they improve the race?
_Drink among Australian Convicts._
Dilke informs us[19] that the convict element may now be disregarded
in Australian society. In the case of some their crime was an
accident, and criminal tendencies would not be transmitted to the
children they left behind them. On the other hand, the genuine
criminal and also the drunken ne’er-do-well left no children. Drink
and vice among the “assigned servants” class of convicts, and an
absence of all facilities for marriage worked them off the face
of the earth, and those who had not been killed before the gold
discovery generally drank themselves to death upon the diggings.
We have here a very clear case in which alcohol acted as a most
beneficial selecting influence. Had there been prohibiting laws,
preventing the sale of alcohol, the innately depraved would have
left behind them descendants imbued with the paternal instincts.
_Drink and Prevention in America._
In the United States there is and has been a strong feeling against
the liquor traffic, not only on the part of those who hold that
drinking is in itself wrong, and leads to crime and misery, but
on political grounds as well. The Americans drink, not at meals
as we do, but at the drinking-saloons and bars, and the habit of
“treating” to liquor is universal. These drinking-saloons are,
too, the cause of much of the political corruption deplored by the
better class of Americans; there are many reasons, therefore, for
the introduction of local option, or even prohibition, and in many
of the states stringent anti-liquor laws are consequently enforced.
Inasmuch as these laws have been in operation for some years, we
can study their effect on those who have been subjected to them.
We are told[20] that in Maine a Prohibitionary Law was enforced
in 1851, lapsed for two years (1856 and 1857), but has continued
since that time up to the present date. We have, therefore, an
experiment in liquor prohibition lasting for forty years. In
Maine, the manufacture and sale of alcohol in any form is illegal,
and punished by imprisonment and fine. The law is enforced, and we
are told[21] regarding its operation that, “by tending to drive
the traffic into by-ways and disreputable ‘dives,’ by removing the
visible temptation offered by open bars and saloons, by making it
relatively if not absolutely difficult to obtain drink, and by
throwing a general atmosphere of subterfuge and disrepute about the
trade, it has been a material agent in suppressing a demand which is
not only regarded by many as morally wrong and physically ruinous,
but is rendered by the operation of the law disreputable. These
tendencies, receiving support from the general voice and sentiment
of the women, have so influenced manners that, whatever share in
the result ought to be assigned to the effect of prohibition, it
is a fact that the demand for liquor, or the desire for it, either
in large quantities or small, proceeds only from a limited section
of the population.” If now we turn to the statistics of crime,
pauperism, and insanity, we shall find a result which may appear a
startling one to many. The statistics of the Insane Hospital show
a great and progressive increase of patients, from 75 in 1850–51
to 685 in 1891–92. In regard to in-door paupers, the ratio is
slightly lower than that of the neighbouring states:--
1880. 1890.
Maine--ratio of paupers per million of population 2319 1756
Other states, non-prohibitive 2339 1790
In regard to out-door paupers, the census attaches to Maine a number
very considerably in excess of the average. As regards prison
population, Maine has a low but decidedly increasing ratio, which
comes out especially clearly in the case of the juvenile offenders
in reform schools:--
1880. 1890.
Maine--ratio per million of population in reform schools 176 256
Average in other nine North-Eastern states 469 425
In Kansas, another state in which prohibition prevails, dating from
1881, the United States census tells us that there were more prisoners
in its penitentiary and county gaols in proportion to its population
in 1890 than there were in 1880, and that of all the neighbouring
states Kansas had in 1890 absolutely the largest ratio of prisoners
to population. In Iowa, the third state in which prohibition has
been most effectually carried out, we are told[22] that “in one
small town prohibition was so effectually enforced that, when the
bishop of the diocese visited it, an intended celebration of the
Sacrament had to be abandoned because no wine could be obtained.
In this town we are also told that opium dens are formed as the
alleged result of prohibition, and my informant, whose testimony
was unimpeachable, was told by a physician practising there that
the use of opium in the place was a positive curse; he had twenty
or thirty cases on his hands of persons suffering from the habit,
both men and women.”
_Public Habit and Conscience the best Preventive._
One may often draw false deductions from statistical evidence through
ignorance of facts, which qualify and give quite another colour to
the figures quoted, but the above data suggest that any lasting
prohibition, other than the dictates of a man’s own conscience and
sense of self-respect, may do more harm than good; for when not
upheld as a fashion, excessive drinking can only be looked upon as a
symptom of a debilitated or depraved nature, which, without access
to drink, would show itself depraved in other ways, and which, if
artificially kept sober and assisted thereby to live, will tend to
perpetuate itself and widen the circle of its depravity.
May it not be said that a clear case is to be made out for the
introduction of preventive measures in districts where drunkenness
has become a matter of universal habit or fashion, where, therefore,
the selective action of alcohol--from the fact that almost all take
it--is reduced to a minimum, and where, from its general consumption
in injurious quantity, the debility possibly transmitted may be
considered as reaching towards a maximum? In this case preventive
measures, introduced perhaps for a few years only, would be
instrumental in getting the people into more reasonable habits of
living, and might enable those who possessed the necessary tastes
to cultivate such pastimes and recreations as mould keep them free
from falling victims to a vice, to which they had previously given
way rather from force of imitation than from any strong _personal_
predilection. On the other hand, from our point of view, that of
racial progress, the case for preventive interference is not so
clear when introduced into a district where the population have in
the mass learnt to lead sober lives, where drunkenness is looked
upon as a vice, and where only those naturally without self-respect
and proper self-control fall victims to drink; the artificial
interference prevents the operation of a selective influence which
eliminates from society many of its most undesirable elements.
Under these conditions excessive drinking is but the symptom of
something which lies deeper, namely, an organic defect, a poor
and vicious type, and its prevention cures the symptom, while the
disease remains and perpetuates itself to the hapless children of
the future.
_The Power of the Community over the Individual._
It might appear to the superficial reader that I am advancing
arguments which would give a moral sanction to the broadcast
scattering of the germs of phthisis and enteric fever, and to the
leaving of unlimited whisky as a stumbling block at the doorsteps
of one’s weaker neighbours. This is far from being the case. While
it is undoubtedly true that the germs of phthisis have from time
immemorial been freeing humanity from an unhealthy variation to
which we are subject, and while alcohol has on the whole been
ridding us of the vicious and uproarious since our forefathers
first drank mead from the teats of the she-goat Heidhrun, yet it
does not follow that any individual or set of individuals have a
right to take upon themselves the responsibility of retaining and
meting out such selective treatment.
Were there, indeed, no other means of improving the race and
eliminating its at present inherent faults, it might be different,
and, perhaps, one could hardly say that society might not take upon
itself the responsibility of the actual outrooting of these faults by
drastic measures; but other ways are open to it. At present society
claims the right to exterminate the murderer, and a few decades
back the life of the thief was also taken. But while these lives
were taken by a custom which is the survival of retribution, and in
which the State takes the place of the injured person or family,
there is a growing feeling that such a motive is not of the best
or highest, and that the only excuse for the disposal of the life
or person of the individual is that of the seeking of the general
well-being of the State. When we consider the enormous sacrifice
in modern times of what were at one period thought to be personal
rights (such as the right of every man to ill-treat and neglect his
wife or children, or to live in whatever insanitary house or room he
pleases, or to work as long as he wishes, etc. etc.), we can hardly
draw, even in imagination, a line beyond which the State may not,
at some future time, see its way to make claim upon the individual.
It is, however, very improbable that the advanced politicians of
any century will ever call for a general battue upon the inveterate
drunkards or consumptives, nor is there any likelihood of the work
of preventive medicine abating for one single instant, even for the
sake of the race. The love of the individual is antecedent, both in
the history of humanity and in the life history of each individual,
to any regard for the race, and the latter is but an extension of
the former feeling. While, therefore, there are certain and sure
means of improving the race by simple and unheroic measures, no one
would for a moment dream of depriving the individual of all that
modern medicine and civilisation can do for him.
_The Necessity for replacing One Selective Agency by Another._
The microbes and other selective agencies have been improving
the race, or at any rate have in the past been preventing its
deterioration, but it by no means follows that this action is to
be permitted to them in the future. We have studied them and have
followed out their life histories; we know on what they thrive, and
also that which is injurious to them; we can exterminate them; and
human affection, that emotion beyond all others that we have to
trust to for race perfection, demands complete control over “their
reckless inroads.” But if the selecting microbe is to disappear, we
have to replace it by something else. If the individuals of to-day
are to have the advantage of better surface drainage, and an absence
of their microscopic foes, the children of the future must not be
the sufferers; and we must replace the selective influence of the
microbe by the selective action of man’s forethought, which shall
provide that these children shall alone be produced by healthy
parents. We need have no fear of the removal of the selective
influences that at present surround us, provided a selection is still
carried on; but if we remove selective influences without replacing
them by others, then racial decay is certainly and inevitably upon
us. At the present time people with strong strains of insanity or
phthisis marry freely. The dangers are to a certain extent realised,
but these are generally overcome by the power either of personal
attraction or dowry. A man may be summoned for neglecting to send
his son to school, but at present there is no strong public feeling
against the knowingly begetting a son who all his life may suffer
from weak lungs or brain, and hence obvious disease is no bar in
the marriage market.
_How it is that the Production of Children by Diseased Parents is
tolerated._
We cannot wonder at this state of things when we recall the fact
that in less advanced times than the present a rapidly recruited
population was often the determining cause of a nation’s continued
existence. The depopulation produced by war and zymotic disease was
often so dreadful that nations with great fertility alone survived;
and thus it came about that all minor questions were sunk in the
one great necessity, namely, that of keeping the population large
enough to resist extinction or to effect foreign conquest.
Added to this, most of the sickly diseased offspring died in infancy
as a result of improper feeding or want of care, and there was no
such thing as the existence of a large section of the community
evincing an increase of hereditary weakness. Under these conditions
the parents of large families added so much the more to the strength
and power of the community, and the production of children came to
be regarded as a virtue. This view of the question very naturally
survives, and is probably the reason why at the present day marriage
with a diseased person is not viewed as a sin against the children
that are to be produced, and against the community at large.
_The Necessity for producing Posterity out of our Best Types._
But the end towards which we have to aim is the production in
each generation of children from the best and healthiest of the
population alone, for it is surely only reasonable that we should
as a community pay the same care and attention to our own race
propagation that a gardener does to his roses or chrysanthemums,
or a dog-fancier to his hounds or terriers, or a cattledealer to
his southdowns or shorthorns. That there is no means of improving
our race so efficaciously as by selection we may be certain, and
that there is no other way is highly probable; our interest in the
subject, and the value we place upon changes the effects of which
we shall never live to see, will determine whether we are prepared
to adapt our ideas and modes of action to the lines that reason and
the knowledge of the times have clearly pointed out as the only
ones which it is expedient to follow.
I have so far only indicated in most general terms the aim which in
my opinion we should have in view. We have in the two succeeding
chapters to consider several problems somewhat similar to those
which we have already discussed, and then it will be more easy to
obtain a general view of the whole question. We may then consider
what steps it may be advisable to take with a view to bringing
about satisfactory selection of the population, remembering always
that in such a matter nothing can be accomplished which has not the
sanction and approval of the mass of the community. The education
and conviction of the masses must precede legislation, so that we
shall have to consider what is expedient, from a practical point
of view, for us to do at the present time, and we shall leave
speculation as to possible future action to those who have greater
gifts of foresight, and who believe in the possibility of predicting
the future action of such a complex machine as an empire of men
and women.
FOOTNOTES
[19] “Problems of Greater Britain,” vol. i., chap. ii.
[20] “Liquor Legislation in the United States and Canada.” Rathbone
and Fanshawe.
[21] _Op. cit._, p. 104.
[22] _Op. cit._, p. 170.