alcoholism, after the condition is well established, the patient has
little more freedom of will than a brute has. If he is accountable for
the habit, he is blamable for the crime that follows. If he is not
accountable, and it is often very difficult to prove that he is, he is
to be treated as a blamelessly insane man. In proper surroundings, and
with skilful direction, a child born with a tendency, or more exactly
a temptation, to dipsomania or other alcoholic neurosis can be saved,
but commonly the circumstances of such a child's life are the worst
imaginable. These children must never take alcohol, even as a
medicine, and they must not be pushed in school to nervous exhaustion.
A tendency to unchastity can "run in families," like a disposition
toward alcoholism, but the disgrace in yielding to this vicious bias
keeps many such unfortunates clean. It is to be regretted that public
opinion can not give the same aid in alcoholic predisposition.
A confirmed alcoholic should be prevented, if possible, from marriage,
because his sins will be visited upon his posterity. {112} The first
children of an alcoholic may be mentally sound, the younger children
are more or less mentally weak, the youngest are not uncommonly
imbeciles, or idiots, or under shock they grow insane. Fortunately
many of the children of alcoholics die at an early age, and the family
of a drunkard very seldom lasts beyond four generations. In the first
generation moral depravity and alcoholic excess are found; in the
second, chronic drunkenness and mania; in the third, melancholia,
hypochondria, impulsive and homicidal ideas; in the fourth, idiocy,
imbecility, and extinction of the family. The lower the social caste
of the drunkard, the greater the liability of meeting these blights.
Priests should take a deep interest in societies established for the
promotion of temperance, and the only temperance for most persons is
total abstinence. No man knows what latent tendency to alcoholism he
may have, especially in America, where great grandfathers are unknown
and the climate and life are trying on the nervous system. The
adulterated liquors sold everywhere at present make the danger greater
than it ever was. Whatever may be the truth as regards heredity, there
is no doubt concerning the strong influence of environment; therefore
get into the temperance societies the children of alcoholic parents,
of parents that are shiftless, hysterical, irritable. If a man has a
violent temper or if he is unchaste, get him and his children into the
society to check the downward drift. A bad temper is a neurotic taint,
and it commonly is a first step toward alcoholism. Do not forget to
warn the people against patent medicines that contain alcohol.
If you go over the list of the families in a parish, it is startling
to find how few there are without one or more "black sheep." The human
black sheep, in a good environment, is always physically imperfect,
and never so black as the gossips paint him. He may be a powerful
football player, but there is something wrong with his gray matter. He
is morally deaf, he was born so, and he is to be excused if he can not
always hear the still, small voice. This may sound like lax doctrine,
but it is true, nevertheless.
We must recognise that moral weakness is very often, {113} partly at
least, a physical defect, and there is no such state as "moral
insanity" where the intellect is normal. Now, I do not wish to be
quoted as holding that all moral depravity has a physical basis; most
of it is the unalloyed stuff; the Lombroso criminal is not a
scientific fact; but there is a moral condition very frequently met
with which is largely physical in origin. Given so many grains of
cocaine or morphine or so many ounces of alcohol, and you can make a
liar of a man once on the way toward sanctity. Given an attack of
hysteria in a holy nun, and she at once becomes a liar, an altogether
blameless liar, but no influence that does not remove the physical
cause will cure the lying.
The morally weak do not at present obtain enough religious
instruction. Their religion is more a matter of inheritance and habit
than of positive energy. It is "in the bones," sometimes in the fists,
rather than in the soul. They prefer the Sunday newspaper to the
Sunday sermon. The remedy here seems to be in making the Sunday school
solidly interesting and its teaching impressive.
Alcoholism in the parents, especially drunkenness at the moment of
conception, is one of the chief causes of idiocy in children. Fere, as
was said before, by injecting a few drops of alcohol beneath the shell
of hens' eggs, or by exposing the eggs to the vapour of alcohol, could
produce monsters almost invariably. In 1000 cases of idiocy at the
Bicetre, Bourneville found a history of alcoholism in 620, or 62 per
centum: in the fathers of 471, in the mothers of 84, in both parents
of 65; and in one-half of the remaining 38 per centum no history was
obtainable--probably most of these also had the alcoholic taint. The
administration of alcohol to infants, of gin and whiskey, of essences
of peppermint and anise, to relieve colic or induce sleep, and the
dosing with opiates like paregoric, are also well-established causes
of idiocy.
The idiot is practically dead, except for the trouble he gives in
caring for him; but another unfortunate, the imbecile, most commonly
the offspring of alcoholics, is often capable of great mischief. The
higher grades of imbeciles, those nearest the normal, are almost
invariably criminals. Not all criminals, of course, are imbeciles, but
a vast number of petty and brutal {114} criminals are imbeciles. We
keep these unfortunates most of their lives in jail, while we fine
their drunken fathers, the cause of the imbecility, "five dollars and
costs."
Imbecility has grades,--from marked lack of intellectual power, a
stage little beyond idiocy, up to the presence of a mind capable of
fair education,--but in all cases there is real defect, either of
intellect or of will. Sometimes, where the will is so weak that the
patient becomes a criminal in spite of all training, the intellect is
practically normal to the superficial observer.
The grades of imbecility can not be clearly marked off from one
another, but, roughly speaking, there are three. The lowest grade of
imbeciles understands simple commands, and has a slight manual
dexterity. They express themselves by signs and in monosyllables. They
can not concentrate attention upon anything, nor can they be taught to
read or write. Careful training can advance them so far that they may
do rough, menial work, and they are industrious when directed by a
present superior. They are inclined to masturbation. If they are not
teased, they are quiet; if annoyed, they may become dangerous.
Imbeciles of the middle grade can converse in a narrow vocabulary, and
they commonly stammer. They may be taught to read monosyllables; they
can not do even the simplest sum in addition, yet they show a certain
shrewdness. They are irritable and quarrelsome, inclined to lying and
stealing, and they have no sense of shame. They will not do any
regular work, but change from one occupation to another. They may have
sexual instincts and cause trouble on that account. They are slow to
understand, their memories are defective, and they are always very
vain. Their belly and what they shall wear are the chief things in
their lives. They are less criminal than the highest grade of
imbeciles.
The third class, the high-grade imbecile, is the most important,
because he is commonly a criminal. His intellect is below the average,
and his will is very flabby. He learns little at school, and what he
does learn is acquired slowly. He reads and writes badly and he may be
able to add simple {115} columns of numbers, but he can not multiply
or divide. Sometimes such an imbecile has a remarkable facility in
getting a speaking knowledge of two or three languages, and he may
learn a trade. There is a high-grade imbecile that is cunning and
shrewd, but he has no will, and he is a criminal. As imbeciles
approach the normal in intellect they recede from it in abnormality of
will.
Autopsies on imbeciles show an infantile development of the forebrain.
Imprisonment does no good in these cases. They are not taught anything
in prison, not even a trade, because the labour organisations and the
protected industries will not permit prison labour. They should be
confined so that they will not pervert youth and propagate their kind.
It is impossible to say how far a given imbecile is morally
accountable for what he does, but the accountability is not full in
the best cases. A neurasthenic, however, is not to be mistaken for an
imbecile. A neurasthenic person may have a tender conscience, an
imbecile has no conscience. In imbecility the fault is in the will,
rather than in the intellect, in the middle and highest grades. Many
women, especially, that are hopeless fools intellectually have strong
wills, but an imbecile never has a strong will except in the sense
that stubbornness is strength. Stubbornness is perverted strength.
_Morphine and Cocaine Intoxication_,--Morphine, an alkaloid of opium,
is used very extensively as an intoxicant. Since 1890 the importation
of opium into the United States has increased fourfold, although
physicians are now using less opium than they formerly did.
The insomnia, worry, moral distress, which bring on the alcoholic
habit in some persons, lead to morphinism in others. Some physicians,
by carelessly prescribing morphine for neuralgia, migraine,
dysmenorrhoea, or any pain, make their patients slaves of this drug.
The degenerative effects of morphine are not so great nor so rapid as
those of alcohol. It does not shorten life so much as alcohol does,
nor are the children of a person addicted to the use of the drug so
liable to idiocy and imbecility. The mind is enfeebled--slowly in some
cases, rapidly in others. The patient will resort to almost any means
to obtain the {116} drug, if he is deprived of it. Authorities hold
that he will lie without reason, merely for the perverse pleasure in
deceiving, that he is uncertain and treacherous, with a dull
conscience and morbid impulses. There are exceptions to this in cases
where the drug is easily obtained by the patients. Opium and morphine
diminish the sexual appetite in males, even to impotence. The bodily
changes are slow but profound.
When a user of morphine has been deprived of the drug for from ten to
fifteen hours, he becomes so weak he can not stand; he gets diarrhoea
with cramps; he sweats, trembles, and collapses. Later, mental
disturbance comes on. He grows delirious, sees insects and small
animals, as the delirium tremens patient does, and his suffering is
very great. It is extremely difficult, and commonly impossible, to
cure the morphine disease after it has been firmly established, and a
deliberate acceptance of the habit is evidently a grave vice. Where a
patient has become addicted to the use of the drug, through the fault
of a physician, or through ignorance, the treatment from the social
point of view of such a patient is commonly cruel.
Cocaine intoxication is much worse than morphinism. It is a new
excess, which was unknown before 1886. Many users of morphine can
carry on business, but the cocaine _habitue_ can not do so. He is
always extremely busy doing nothing. He writes long letters which are
never finished. He changes from work to work, and even his
conversation wanders. His bodily weight decreases rapidly, even
one-third of his whole weight may be lost within a few weeks. The skin
hangs in folds and is of a dirty yellow colour, the facial appearance
is that of extreme distress, and the muscles are feeble. Fainting,
irregular cardiac action, sweating, and insomnia are other symptoms.
Insanity is an occasional sequence, with hallucinations, especially of
hearing. Such a patient hears roaring noises and voices; his secret
thoughts are shouted out, he thinks, to crowds; loud screams, shrieks
of murder, and similar noises appall him. Again, he sees swarms of
flies, ants, roaches, which cover him and crawl into his mouth,
nostrils, {117} and ears. He feels bugs crawling under his skin, and
he has a multitude of similar interesting experiences.
Such patients grow homicidal. Like alcoholics, they are jealous and
suspicious of their wives, but, unlike the alcoholic, the cocaine user
is commonly reticent; he is not willing to talk of his troubles.
The prognosis is always bad, even in the best cases. This drug can be
withdrawn from a patient more rapidly than is possible in chronic
poisoning from morphine, but a relapse is to be expected.
In dipsomania, morphinomania, and other drug habits, and in the cases
of vicious and degenerate children, many encouragingly good results
have been reported from the use of hypnotism. Forel, Voisin, Ladame,
Tatzel, Hirt, Nielson, de Jong, Liebeault, Bernheim, van Eeden, van
Renterghem, Hamilton Osgood, Wetterstrand, Schrenck-Notzing,
Kraft-Ebbing, Francis Cruise, Lloyd Tuckey, Kingsbury, Woods, and
others have undoubtedly cured dipsomania by hypnosis.
Wetterstrand alone cured 37 of 51 cases of morphinism by hypnosis. One
of these patients had been using morphine for fourteen years and
morphine with cocaine for an additional four years. All his cases
except one were treated at home--they were not obliged to go to a
hospital or sanitarium.
As to vicious children: Liebeault in 1887 recorded 77 cases, 45 of
whom were boys and 32 girls. By hypnosis 56 of these were cured, 9
improved, 12 were not affected.
As to the so-called dangers of hypnotism in the hands of skilled
physicians, there are none. Forel said: "Liebeault, Bernheim,
Wetterstrand, van Eeden, de Jong, I myself, and the other followers of
the Nancy school, declare absolutely that, although we have seen many
thousands of hypnotised persons, we have never observed a single case
of mental or physical harm caused by hypnosis." Travelling mountebanks
that hypnotise in public can do harm, and they should be prevented
from so doing. On the continent of Europe only physicians are
permitted to use hypnosis.
For a bibliography of hypnosis as a curative agent, see _Allbutt's
System of Medicine_, vol. viii. p. 428 (The Macmillan Co.).
{118}
In Genicot's _Theologiae Moralis Institutiones_, vol. i. p. 162
(Louvain, 1902), is the following passage: "Videtur licitum ebrietatem
inducere ad morbum depellendum, si quando practicum est, ex gr. ad
typhum depellendum, vel ad coercendam vim veneni quod e serpentis
morsu haustum sit (Sabetti. N. 149). Similiter, per se licebit sensus
sopire ope ebrietatis ad magnos dolores levandos: nullum enim
discrimen morale videtur inter hoc medium et alia, ex gr.
chloroformium, quae adhiberi solent."
That is, Father Genicot permitted alcoholic intoxication to cure
typhus or typhoid (typhoid is called typhus abdominalis in Europe) and
snake bite, or to quiet great pain, as chloroform is used, in his
opinion. This doctrine would be correct morally if from a medical
point of view alcoholic intoxication cured typhus, typhoid, or snake
bite, but it does not. Alcoholic liquors are necessary in some stages
or forms of typhus and typhoid, and they must be administered
skilfully; but to induce alcoholic intoxication in any pathological
condition is always to add a grave poison to the disease already at
work. The very name of the condition is _intoxication_, poisoning. You
can end a toothache by removing a man's jaw, but the practice is not
to be encouraged.
In America, when a person is bitten by a rattlesnake or copperhead,
the first aid to the injured is commonly a pint of whiskey. You might
better rub milk on the patient's bootheels, because the milk is
harmless, but the pint of whiskey is anything but harmless; and one is
as good as the other as far as curing the snake bite is concerned.
Whiskey is popularly supposed to be a good medicine in all the ills of
humanity. It is a good medicine in certain cases and a very bad
medicine in others. A snake bite is a startling evil, and while far
from a physician the early settlers gave the patient the only medicine
they had, whiskey, and if a little is good a great deal is better. As
the "bite" of the North American snakes is frequently not fatal, some
early victims grew well in spite of the snake venom and the added
whiskey poisoning; therefore a pint of whiskey cured them, _post hoc
ergo propter hoc_. Thus the "cure" became fixed in the popular
ignorance, and some moral theologians, without investigating the {119}
matter, fixed it deeper. The venom of the East Indian cobra and of
other tropical and subtropical snakes would not be affected in the
slightest degree by all the whiskey in Kentucky. The only hope in such
cases, is in Calmette's antitoxin, administered within an hour or two
after the poisoning.
Snake venom paralyses the muscles of respiration, and the patient
ceases to breathe. A little whiskey may do good--whiskey pushed to
intoxication is very injurious. Artificial respiration, if needed, as
in a case of attempted resuscitation after partial drowning, with
skilful stimulation by a physician, and the use of an antitoxin, are
the main parts of the treatment in snake poisoning; but to pour a pint
of whiskey into the victim is cruel ignorance. Patients often come
into dispensaries showing bitten wounds which are stuffed with hair
from the dog that did the biting; whiskey causes a man to see snakes,
therefore use "hair from the dog that bit you." This may be good
homoeopathy, but it is not medicine.
The making a man drunk with alcohol "to remove great pain" is a
treatment not used by reputable physicians: there are many correct
medical methods of removing pain, but a big draught of whiskey is not
one of them. Even in a case where a physician can not be found, it is
usually questionable whether the effect of alcoholic intoxication
would not be worse than the irritation of the pain; and if it were
not, where is the line to be drawn? Some male and female old ladies
can work up "great pain" from a colic. The bigger and stronger a man
is, especially if he has never been ill before, the greater his
"agony" when he is having a tooth filled.
AUSTIN OMALLEY.
{120}
IX
HEREDITY, PHYSICAL DISEASE, AND MORAL WEAKNESS
Heredity is a very vexed question, with regard to which most varied
opinions are held even by those apparently justified in having
opinions, so that it is evident we are as yet only crossing the
threshold of definite knowledge and are not near anything like the
clear view that many people have imagined. The most striking proof of
this inchoateness of scientific knowledge of heredity is the fact that
within five years the work of a monk in Austria, done about forty
years ago, which has lain utterly unrecognised ever since, has come to
be accepted as the most striking bit of progress made--almost the only
real scientific knowledge with regard to heredity that was acquired
during the whole nineteenth century. Father Gregor Mendel's work
[Footnote 2] was done with regard to the pea plants in his monastery
garden, and it revolutionised all the supposedly scientific thinking
with regard to heredity that has been current in biology for half a
century.
[Footnote 2: _See American Ecclesiastical Review_, Jan. 1904; Walsh,
_A New Outlook in Heredity_. ]
This serves very well to show how far in advance of observed facts
theories of heredity have gone. There is undoubtedly a very
significant influence exerted over life and its functions by the
special powers that are transmitted by heredity. How far this
influence extends, however, and how much it may be said to rule
details of existence, of action and in human beings, that complex of
elements we call character, is entirely a matter of conjecture, and
the {121} belief in its extent, or limitation, depends absolutely on
the tendency of the individual mind to accept or discredit certain
theories in heredity which have had great vogue.
Until within a very few years it was considered a matter of common
experience and observation that under some circumstances, at least,
acquired characteristics were transmitted by heredity. That is to say,
it has been definitely asserted as probable, and by many even
intelligent people considered absolutely certain, that modifications
of a living being undergone during the course of its existence might
influence the progeny of that being in various but very definite ways.
It was not, of course, thought that if a man lost an arm and
subsequently begot a child, the child would be born without an arm,
but slighter modifications of the organism were somehow supposed to be
transmissible; and, on the other hand, modifications which affect
important organic structures of the body were somehow thought to have
a definite effect, by transmission, upon corresponding portions of the
progeny.
When this theory is stated thus baldly, very few people confess their
belief in it, yet how many there are who find ample justification for
such expressions as, "His father suffered from rheumatism and it is
not surprising then that he should have it"; "Her mother had heart
trouble and we've always been afraid she would suffer in the same
way." We are only just beginning to get beyond the period in which
consumption was thought to be directly and almost inevitably
inherited. With regard to mental ailments this was frankly conceded by
nearly every one. If the direct ancestry suffered from mental disease
of some kind, then it is not considered surprising that the immediate
descendants should be mentally affected in some way. Physicians are
quite as prone as those without medical training to make loose
statements of this kind.
Of course there is a reason for the confusion that exists in this
matter. Oliver Wendell Holmes once said that he could cure any patient
that came to him for treatment, if he but applied to him in time. For
proper success, however, he considered that many of his patients would
have had to come to him in the persons of their great grandfathers. As
{122} a matter of fact, many of the supposed hereditary influences
that are traced only to a father or a mother are family conditions
that have existed many generations, and that were probably originally
acquired, but the moment of whose acquisition cannot be definitely
determined. We know that the Hapsburg lip has been a distinguishing
feature, a persistently recurring peculiarity, in some of the members
of the Austrian ruling family in nearly every generation for seven
centuries. How much farther back than that it goes we have no way of
determining. It is a family affair, a characteristic which became a
matter of heredity perhaps ten centuries ago, but the mode of its
original acquisition is a mystery.
There is no really great scientist in biology at the present moment
who teaches the hereditary transmission of acquired characteristics.
Modifications of the organism that become matter for heredity have
existed for many generations and we cannot tell just how they began.
There is no doubt that there is some hereditary influence, for
insanity in the same family is likely to keep recurring in successive
generations. More than this, affections of certain less important
organs are evidently a common trait in certain family strains. There
is no doubt that in some families stomach affections are the rule in
successive generations. It is very hard to say, however, just when
such defective organisation became a family trait. The tendency to
nervous affections is undoubtedly a similar family affair. Certain
affections have been hereditary traits for many generations. An
excellent example of this is the so-called Huntingdon's chorea, which
several generations of American doctors, of the name of Huntingdon, by
following carefully the history of certain families on Long Island,
succeeded in tracing through four generations.