HV
UC-NRLF
553
Reprinted from "PROBLEMS IN EUGENICS/' being
Papers communicated to the First International Eugenics
Congress, London, igi2.
HEREDITY AND EUGENICS
IN
RELATION TO INSANITY,
BY DR. F. W. MOTT, F.R.S.
Pathologist to the London County Asylums.
Physician to Charing Cross Hospital.
PRICE SIXPENCE.
EUGENICS EDUCATION SOCIETY,
6, YORK BUILDINGS, ADELPHI, LONDON, w.c.
Reprinted from "PROBLEMS IN EUGENICS/' being
Papers communicated to the First International Eugenics
Congress , London, 19/2.
HEREDITY AND EUGENICS
IN
RELATION TO INSANITY,
BY DR. F. W. MOTT, F.R.S.
Pathologist to the London County Asylums.
Physician to Charing Cross Hospital.
EUGENICS EDUCATION SOCIETY,
6, YORK BUILDINGS, ADELPHI, LONDON, w.c.
HEREDITY AND EUGENICS IN RELATION
TO INSANITY.
DR. F. W. MOTT, F.R.S.,
Pathologist to the London County Asylums.
Physician to Charing Cross Hospital.
Allow me to thank the Eugenics Society for doing me the honour of
asking me to fill the place of so distinguished a physician as Sir Wm. Osier,
the Regius Professor of Medicine at Oxford. The subject of Heredity and
Eugenics in relation to Insanity is one which I, as Pathologist to the
London County Asylums, have been studying in a practical manner for
many years, and the more deeply I consider the question the more I find
there is to be done before we shall be safe in drawing ultimate conclusions
regarding certain practical questions dealing with the prevention of insanity.
The subject of Heredity in its broad aspect is one of national importance
and interest, as it affects many social and legislative questions. The interest
taken by the general public in the question of heredity is a sign of social
progress. People are beginning to recognise the truth of Professor Arthur.
Thomson's dictum: '^The present is the child of the past ; _our_ start in
life is no haphazard affair, but is vigorously determined by our parentage
and ancestry ; all kinds of inborn characteristics may be transmitted from
generation to generation."
All the modern doctrines of Human Heredity were foreshadowed by the
ancient philosopher Lucretius, who, in de serum nature?, says: "Some-
times, too, the children may spring up like the grandfathers, and often re-
semble the forms of their grandfather's fathers, because the parents often
keep concealed in their bodies many first beginnings mixed in many ways,
which, first proceeding from the original stock, one father hands down to
the next father, and then proceeding from them Venus produces
forms after a manifold chance, and repeats not only the features but the
voice and hair of forefathers, and the female sex equally springs from the
father's and males go forth equally from the mother's body, since these
distinctions no more proceed from the fixed seed of one or other parent,
than our face and bodies and limbs. Again we perceive that the mind is
begotten along with the body and grows up together with it, and grows old
along with it."
301558 ,
Sir Francis Galton. the founder of Eugenics, and to whom the nation
/ owes so much, established the Law of Ancestral Inheritance. According
/ to this law each germ, male or female, contains on an average representative
/ particles or germinal determinants derived from the two ancestral stocks in
I definite proportions. Thus one quarter comes from each parent, one-sixteenth
| from each grand-parent, and one-sixty-fourth from each great grand-parent.
Thus an inheritance is not merely dual, it is multiple. Galton himself
recognised, however, that this law only applied to masses of people and not
to individual cases, for he says : " Though one half of each child may
be said to be derived from either parent, yet he may receive a heritage from
a distant progenitor that neither of his parents possessed as personal char-
acteristics." Again, speaking of Particulate Inheritance, he remarks; " All
living beings are individuals in one aspect, composite in another. We seem
to inherit bit by bit this element from one progenitor, that from another,
in the process of transmission by inheritance elements derived from the
same ancestor are apt to appear in large groups, just as if they had clung
together in the pre-embryonic stage, as perhaps they did." They form
what is well expressed by the word traits — traits of feature and character,
that is to say, continuous features, not isolated points. The offspring of
parents possess a mosaic of inheritance bearing usually a more or less
similarity, yet the mosaics of character, whether bodily or mental, are
not in any way identical, except in the case of identical twins. Now,
there is a reason for this. Identical twins are the result of fertilization of
one ovum containing two germs of identical substance, and this leads me
to refer to Galton's remarkable inquiry into the History of Twins in con-
nection with Nature and Nurture. He found that similar twins living in a
different environment nevertheless remained similar in temperament and
character, while dissimilar twins brought up and living in the same environ-
ment remained dissimilar ; these dissimilar twins, however, were the product
of two separate ova with dissimilar germs. This shows that every germ has
a specific energy of its own, as manifested by a different potential
inheritance.
Galton also made a statistical inquiry into good and bad tempers, and
as a result of this inquiry he says : "It now becomes clear enough and
may be taken for granted that the tempers of progenitors do not readily
blend in the offspring, but that some of the children take mainly after one
of them, some after another, but with a few threads, as it were, of
various ancestral tempers woven in, which occasionally manifest themselves.
If no other influences intervened, the tempers in the children of the same
family would on this account be almost as varied as those of their ancestors.
To recapitulate briefly, one set of influences tends to mix good and bad
tempers in a family at haphazard ; another tends to assimilate them, or
that they shall all be good or all be' bad ; a third set tends to divide each
family into contracted portions. These facts, ascertained by Galton, are
of great interest in connexion with the inheritance of the predisposition to
nervous and mental diseases, a predisposition which is termed the neuro
pathic taint. Gallon's law of filial regression again seems to explain
many facts regarding the inheritance of feeble-mindedness as well as ability.
In respect to the latter, Galton showed that only a few out of many children
would be likely to differ from mediocrity as their mid parent, and still
fewer would differ as widely as the more exceptional of the two parents.
The more bountifully the parent is gifted by nature, the more rare will be
his good fortune if he begets a son as richly endowed as himself, and still
more so if he begets a son who is endowed yet more largely. But the law
is even-handed, it levies an equal succession tax on the succession of badness
as of goodness. If it discourages the extravagant hopes of a gifted parent
that his children will inherit all his powers, it no less discountenances
extravagant fears that they will inherit all his weaknesses and tendencies to
disease." This tendency to revert to the normal average of the race is
tEus a great factor in heredity. Amphimixis, or the blending of the in-
heritances of two individuals, is claimed by Weismann as the great factor
in the production of variation and evolution, but when a functional and
structural dynamic equilibrium has been established in all the organs and
tissues of the body for a species and race, amphimixis would act in an
opposite manner in tending to prevent the perpetuation of variation, patho-
logical or otherwise. Change of type comes about through inheritance of
modification, and many abnormalities and defects, arising we know not why,
are transmitted through successive generations, and apparently are not
swamped out by dilution unless they interfere with self-preservation or with
marriage selection and propagation. I may cite the following as examples :
Polydactylism, six fingers and six toes ; brachydactylism, short fingers, lobster
claw hand, white tufts of hair, various eye and skin diseases. A remark-
able example of an hereditary visual defect is congenital stationary night
blindness which has continued through nine generations, affecting 135
members out of close on 2,000 descendants (Nettleship and Cunier).
Colour blindness, and the tendency to bleed (haemophilia) are curious affections
limited to the male sex but transmitted by the females. Then we have
those tendencies to disease affecting stocks, e.g., tuberculosis, rheumatism,
diabetes, gout, and nervous and mental diseases, or neuropathic tendency.
In the case of tuberculosis and rheumatism the tendency is shown by a weak-
ness in defence against specific and ubiquitous microganisms. In gout
and diabetes there is a tendency in the stock to disease arising from
a disturbance of the bio-chemical equilibrium of the blood in relation
to the functions of the organs and tissues of the body and nutrition.
The neuropathic diathesis may also be due to an inherent tendency
to a disturbance of the bio-chemical equilibrium of the blood and the
nervous system occurs, especially in the brain, or the potential energy stored is
nervous and mental diseases, a predisposition which is termed the neuro-
unstable, consequently there is an inherent failure to control its conversion
into active energy as in epilepsy and other paroxysmal nervous states.
The discovery of Mendelism has opened up a new and vast field of investi-
gation, and although so far Mendelian analysis is as yet imperfectly developed
in respect to human inheritance, yet as Bateson says : " Organisms may be
regarded as composed to a great extent of separate factors, by virtue of
which they possess their various characters or attributes. These factors
are detachable, and may be recombined in various ways. It thus becomes
possible to institute a factorial analysis of an individual." How far such
analysis can be carried we do not yet know, but we have the certainty that
it extends far, and ample indications in supposing that we should probably
be right in supposing that it covers most of the features, whether of mind or
body, which distinguish the various members of a mixed population like that
of which we, form a part. From such a representation we pass to the
obvious conclusion .that an individual parent is unable to pass on to off-
spring a factor which he or she does not possess. Since thqse individuals
only which are possessed of the factors can pass them on to their offspring,
so the offspring of those that are destitute of those elements do not acquire
them in subsequent generations, but continue to perpetuate the type which
exists by reason of the deficiency. It should be explicitly stated, however,
that in .the case of the ordinary attributes of normal men we have as yet
unimpeachable evidence of the manifestation of this system of descent for
one set of characters only, namely, the colour of the eyes. Moreover,
if the evidence as to normal characteristics of man is defective — which in
view of the extreme difficulty of applying accurate research to normal
humanity is scarcely surprising — there is in respect of numerous human
abnormalities abundant evidence that a factorial system of descent is
followed." (Bateson: Biological Fact and the Structure of Society.)
This may be, as Bateson claims, true for certain well defined abnormali-
ties, e.g., polydactylism, brachydactylism, xeroderma pigmentosa, or
for night blindness, but as applied to the inheritance of a diathesis or
tendency, e.g., the neuropathic, Mendelian proportions are not shown as a
rule, although there is evidence of segregation of the factor underlying the
diathesis or tendency.
With this brief introduction to my subject, allow me to consider the
problem of Heredity and Eugenics in relation to insanity. Let me first
define my terms : Heredity has been defined by Thomson as*" the genetic
relation between successive generations, and inheritance includes all that the
organism is or has tQ^start with in vktii£^£HtS~""rieTe~ditary relation; r>
Heredity is a relation in successive generations which is sustained by^X
more or less visible material— basis, the germinal substance. i.Eugenics_is
the science of racial improvement by the application of ihe laws p*
heredity, viz., by encouraging the survival and the propagation of the
fittest in all classes of society, and by seeking to cut off the lines of
7
inheritance of the unfit in all classes of society. rHowever, we do not
know en^gh^abput human genetics to predict always the fittest and Ae
(imfittest. Some of the greatest men the world has seen have sprung
from the most humble and unknown stocks. Eugenics, therefore,
should aim at giving every individual that is worth preserving in every
class a chance of survival. A living wage, enough to ensure a sanitary
dwelling and a sufficiency of nourishing food for parents and family, should
be possible for every labourer and artisan. For if the rich and the intel-
lectuals will in a progressive manner restrict their birth-rate, natural selec-
tion is deprived of its rights among these classes, and Eugenists can have no
sympathy with such but rather with the masses of the people. The wealth
of the nation depends upon labour, and labour demands a'sufficiencv. to live
and propagate under far more favourable conditions than now exist in our
great cities, where the poorer the people and the more uncertain their wages
the higher is the rent demanded for the miserable tenements in which they
have to bring up a family. It is a fact, as Professor Karl Pearson keeps
urging, that at the present time in Great Britain restriction of families is
occurring in one-half or two-thirds of the people, including nearly all the
best, while children are being freely born to the feeble-minded, the
criminal, the pauper, the thriftless casual labourer, and other denizens, of
the one-roomed tenemen'ts of our great cities. The alien Jew and Irish
Roman Catholic have large families as their religion prohibits restriction,
perhaps unfairly in the case of the Irish, for the poorest classes of the
population in some of our large cities are largely of Irish extraction. Profes-
sor Pearson keeps warning us that 25% of our population, made up mainly
of the above-mentioned poor types, is producing 50% of our children, and
if this goes on must lead to degeneracy. If the better classes will not
propagate they must pay for the propagation of the poorer classes, and
natural selection, aided by human effort, must encourage the propagation
of the fit and the cutting off the lines of inheritance of the unfit.
Yv In considering the subject of Heredity and Eugenics in relation to
insanity, we have to ask ourselves what constitutes insanity at the present
time. It is often extremely difficult to draw the line between sanity and
insanity. jTt~mayr~nTTW'eveT, be asserted that a/person is insane who, on
this terminated the stock on that side. That there was latent
insanity was shown by the result of the marriage and the fact that a sister
became insane. A., however, married into a healthy, virile stock; she
became insane at 38, although living many years after she never recovered,
the exciting cause was the death of a son by suicide (S.) at 18. There were
two daughters who became mothers of families, the eldest son of one
suffered with a marked epilepsy, but no other evidence of neuropathy was
shown in this generation. The taint seems to have disappeared, inasmuch
as there are healthy, grown-up members of the fourth generation.
Fig. 6. — A pedigree illustrating marriage of first cousins. A genius
was the product who married a healthy woman, and the family consisted of
an eldest son, committed suicide (S) ; a second son, epileptic (E) ; a daughter,
healthy, unmarried; and a fourth son a genius. This man was a genius,
Fig. 6
but had an extremely well-balanced mind ; all his five children are healthy
in spite of collateral insanity.
Fig- 7- — A family of drunken and insane people. The figures with
half black circles are insane; the same with the cross indicates drink and
insanity; the circles with only a cross indicate excessive drinking. The
two stocks show a marked difference; one side the maternal is practically
free from any taint ; almost every member of the paternal stock is unsound.
20
Fig. 7
The degeneracy commenced with aNdrunken woman whose sisterjjied,
age 53, in Colney Hatch Asylum, where she had been 20 years; she had
a congenital imbecile daughter in Leavesden.
The result of mating a sound individual with a drunken woman with
insane predisposition is shown in the members of the family born : a son
tto tears
21
healthy, then two sons who were insane at the ages of 36 and 27, then a
healthy son, then another son who also was insane at 27, finally five children
who died in early life, probably through the neglect of a drunken mother,
indicated by small, shaded, circular figures. One member of this drunken
and insane family married into a healthy, sound stock. Seven children
were the fruit of this marriage; of these, two sons and a daughter were
normal and three were insane, two of them having become insane at the age
of 13. The clear circle with a black centre indicates bodily disease.
I used to give this pedigree as an instance of drink causing insanity,
but after the establishment of the card system of relatives I found the notes
of the sister of the drunken grandmother ; she was an inmate of Colney
Hatch for 20 years. It sometimes happens that the one is taken and the
other left, and it would have been a benefit to society if the drunken pro-
genitor of this degenerate stock had been taken.
Fig. 8. — The ending of a degenerate stock is illustrated in this pedigree.
A very distinguished man had a dissolute daughter, drunken and immoral
(figure with a cross) ; she had a daughter who behaved in a similar manner,
was married twice, then became insane; by her first husband she had two
children born dead.
Fig. 9. — A pedigree showing pauperism, fecundity, insanity, and infant
mortality. Shaded circles indicate infants dying in early life.
CM?
Fig. 9
22
Fig. 10. — A pedigree showing pauperism, insanity (black half circles),
and blindness in four generations (Lidbetter.)
6
Fig. 10
Figs, n, 12, and 13.— Three pedigrees to illustrate " antedating "; the
onset of insanity in the offspring is shown to occur at a much earlier age than
in the parents. These pedigrees also illustrate extreme cases of hereditary
transmission of the neuropathic taint; as a rule not more than one insane
*
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42
Fig. ii
Fig. 12
Fig- 13
offspring of an insane parent occurs in four or five. The occurrence of in-
sanity in all the children is probably due to the fact that there is a
double insane inheritance in all these instances, although it is only shown
in one completely, and one partially.
Fig. 14. Two total abstainers, but born of drunken parents (circles
with cross and with direct and collateral insanity in stocks (black figures),
give birth to eight children, the first two are healthy and grown up, the
second with numerous children ; then come two children (shaded circles)
dying in early life, followed by a son and two daughters (black figures)
all suffering from dementia of adolescence, and lastly a healthy daughter
with children. What we want to know is this : have all the unsound elements
been segregated out? This can only be ascertained by following up the
children of the sound or apparently sound members.
9
66666^
Fig. 14
Importance of Ancestral Inheritance. ^
Everybody knows the value of coming from a good stock or a bad stockt
and in judging whether an individual who is insane should marry and pro-
pagate or not it is absolutely necessary as the study of a large number of
pedigrees shows that we should consider (i) the nature of the insanity, and
(2) what was the cause. Certain forms of insanity are much more likely
to be transmitted than others either in the same form or still more fre-
quently in some other form indicative of the neuropathic taint. The card
system of relatives which I shall refer to in detail, investigated for me by
Dr. Edgar Schuster showed that /epilepsy, recurrent insanity, and delu-
sional insanity are especially liable to be transmitted in the same form, but
general paralysis, which is now recognised as an organic brain disease due
to syphilis, -is not due to heredity, knd the cases consequently do not figure
largely in these relative cases.
In considering the question of marriage and - propagation a study of
these relatives and pedigrees convinces me of the importance of looking
back into the stocks and ascertaining whether there are many lines of
defective heredity, and whether with some lines of defective heredity there
are lines of sterling worth, for often enough with insanity and epilepsy we
find great talent, even genius and members of civic worth. The very fact
that a person would come and consult the physician as to whether he should
marry or not is a sign of civic worth and high moral character, and in giving
advice we should be guided by a consideration of the stock into which he
or she proposes to marry. <4jf there is a neuropathic tendency in that stock,
marriage into it should be discountenanced, for I shall show you that the
chances of insane offspring arising are much greater, y Let me illustrate my
remarks by two pedigrees, one is that of a man of genius and remarkable
mental stability with a bad collateral heredity (Fig. 6), the other is that in
which pauperism, tuberculosis, and blindness in successive generations occur.
24
(Fig. 10.) It would have been a national calamity had the former not been
allowed to propagate j to cut off the lines of propagation in the latter would
have been a national benefit. The popular expression, " He comes from a
good stock or a bad stock," then, is the result of experience and quite
scientific according to the laws of ancestral inheritance, yet now and then
even from an apparently unknown or even bad stock a great man arises.
Are we to say that^because a parent is insane that therefore the children
must necessarily be insane or useless to the race? God forbid ! The
parents of some of the most eminent men became insane and genius with
insanity frequently occurs in the same stock indicative of a variation from
the normal average. V.
The great point in any scientific investigation is not to try and prove some-
thing, and to avoid any propagandist tendency ; thus the question of alcohol
and insanity is an illustration in point. The Council of Fifty in Massachu-
setts investigated the number of patients admitted to asylums in which there
was an alcoholic history ; it was then suggested that they might investigate the
number of total abstainers, it was found that they were as numerous.
The scientific way to approach this question is to carefuly investigate the
pedigrees of patients admitted, selected not because they show a large number
of members of the ancestral stocks as being degenerate or insane, but selected
because a complete family history can be obtained for three generations.
This has been most successfully done by Dr. Hill Wilson White,
formerly at the Manor Asylum. The pedigrees he has obtained show con-
clusively that we must judge the right of a patient to propagate who has
had an attack of insanity by a full consideration of his pedigree. Certain
pedigrees which I have are of interest in relation to the question of alcohol ;
they are numerically insufficient to draw any conclusions, all we can say is
they are indicative of a devitalisation of the germ when chronic poisoning
occurs in successive generations. (Figs. 7, 14.)
Statistics Relating to 3,118 Relatives.
They show the following facts : —
1. In the insane offspring of insane parents, daughters are much more
numerous than sons.
2. Amongst insane members of the same family (brothers and sisters)
sisters are more numerous than brothers.
This may be correlated with the fact that more women are in asylums
than men. There are several reasons for this : general paralysis, which
is a fatal disease, is three times more frequent in men than in women ; the
recoveries in women do not bear the same proportion as in men. Now,
why should women be more liable to become insane than men ? I will briefly
summarize the causes which, in my opinion, are operative : —
i. The physiological emergencies connected with reproduction, i.e.* the
25
menstrual periods, child-bearing, and the cessation of the period of repro-
duction, the climacterium.
I would also add as an important and perhaps the only cause in many
instances the enforced suppression by modern social conditions of the repro-
ductive functions and the maternal instincts in women of an emotional
temperament and mental instability.
Anticipation or Antedating.
Dr. Maudsley has observed that Nature tends to mend or end a de-
generate stock/C Now, how could Nature best end or mend a degenerate
stock? Obviously by segregating in a relatively few germs all the unsound
elements, leaving the others as it were free. The accompanying figure 15
helps to explain this theory.
Assuming the intensity of inheritance is constant for each chromosome or
other unit of germ-plasm, but to vary with the number of the germinal
units tainted, we have as a result of the mating of these two tainted stocks
all degrees of manifestation of ancestral characters from perfect normality
to the most profound disease. /CThe more numerous the tainted germinal
units the greater will be the chance of the disease appearing in the offspring.^
On the other hand, the oftener reduction, with its possible random arrange-
ment, has occurred — i.e., the greater the number of generations — the less
will be the chance of any particular character finding a place in the inheri-
tance (Nettleship).
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This tendency of certain diseases to occur at an earlier age in the off-
spring of diseased parents was termed by Darwin " antedating " or
"anticipation," and I have found, as the above statistics show, that
there is a singular tendency in the insane offspring of insane
parents for the insanity to occur at an earlier age and in a more intense
form, either as congenital imbecility or the primary dementia of adolescence,
an incurable disease; not that all the cases are of this nature, but a large
proportion of them. First let me call attention to certain facts regarding
the age at first attack in 508 pairs of parents and offspring. Some of the
parents had more than one insane offspring; there were only 464 parents.
You will observe that 47*8% of the 500 offspring had their first attack
at or before the age of 25 years, and as you see in the curves of parents
and offspring the liability to the child of an insane parent becoming insane
tends rapidly to fall. (Figs. 16 and 17.) Now, besides the fact that this shows
Nature's method of eliminating unsound elements of a stock, it has another
important bearing, for it shows that after 25 there is a greatly decreasing
liability of the offspring of insane parents" to become insane, and therefore
in the question of advising marriage of the offspring of an insane parent
is of great importance. Sir Geo. Savage recently said that this statistical
proof entirely accorded with his own experiences, and that if an individual
who had an hereditary history had passed 25 and never previously shown
any signs he would probably be free, and he would recommend marriage.
Another important fact was elicited, viz., that in 58 8% of the 508 off-
spring of insane parents the first attack in the offspring occurred at an age
20 or more years earlier than in the parent. Similar tables and curves
(Figs. 1 8 and 19) compiled from 193 pairs of uncles or aunts and nephews
and nieces show the same fact but not to so marked a degree.
As a leading article in a recent number of the British Medical
Journal refers to this question of anticipation tending to the ending or
mending of a degenerate stock being used as an argument against measures
being taken to prevent the propagation of the unfit, I particularly desire
to impress upon my audience the fact that I have always laid great stress
upon the necessity of segregating congenital imbeciles now that Nature, by
man's aid, does not kill them off as formerly. Moreover, it is highly desir-
able to follow up those members of the family who are sane, and par-
ticularly those who are discharged as cured, in order to see whether Nature
has really mended that degenerate stock.
Recurrent Insanity and Propagation.
One of the great arguments advanced for sterilization has been that
recurrent cases of insanity breed lunatics between their respective dates of
admissions to asylums. I have no doubt this is the case, but before Parlia-
ment would consider such a procedure it would require the strongest and
3°
soundest evidence that life segregation or sterilization would appreciably
diminish the numbers of the insane.
I have endeavoured to ascertain some facts relating to this question.
The inference that can be drawn is that about one-fifth of the recurrent
cases or approximately one-twentieth of the female admissions have children
after their first attack of insanity and of 31 such cases examined, 73
children were born after the first attack of insanity in the parent. A
number of these were cases of puerperal insanity. I am unable to give
exact figures as to the fate of these children, but a good proportion of them
died in infancy, and the majority of them would be too young to decide
which might become insane.
Recurrent insanity and epilepsy, with which it is closely allied, in relation
to hereditary transmission, is one of the most important problems requiring
scientific investigation by complete family histories and construction of
pedigrees, and I can conceive no more important work on the relation of
heredity to insanity than the following up, systematically, the history of
children born in the sane intervals of cases admitted to the asylum and
subsequently discharged.
From the statistics of relatives a computation has been made of the pro-
portion of offspring who were born after the the first attack of insanity in
the parent; it was found that 46 offspring out of 581 were born after the
first attack of insanity in the parent, i.e., 7 '9%. That is to say, in the
case of 529 insane parents, the birth of only one-twelfth of their 590 off-
spring would have been prevented by sterilization or life segregation of the
parent after the first attack of insanity. These figures refer to the offspring
which become insane, but there are a large number of offspring who do not
become insane, and these would be cut off if life segregation or sterilization
were adopted.
Single and Dual Neuropathic Inheritance.
Every pedigree is a study in itself and occupies a whole book if sys-
tematically carried out as regards inheritance of characters, and the classi-
fication of the same is a matter of considerable difficulty. We have not
enough systematic pedigrees yet to form precise data and conclusions upon,
but perhaps I may be permitted to refer to indications from the examination
of pedigrees of three generations which I have obtained myself and com-
bined with those obtained by Dr. Wilson White and Dr. Daniel. I will
divide them into two groups : —
Group i. Those with a double pathological inheritance, that is, both
ancestral stocks show insanity, feeble-mindedness, drunkenness, epilepsy,
suicide, or nervous disease of various kinds, direct or collateral, within two
generations. In these 18 families there were 116 children born alive, and
100 reached adolescence, and among them were 39 insane, suicides, or
sufferers with nervous disease, and 61 apparently normal. Thus 39% of
the offspring reaching adult age were affected. But these are probably
selected pedigrees, and are not numerous enough to draw definite conclusions
from.
Group 2, in which there was an insane inheritance on one side only.
Ninety families were examined. Of 384 children born alive 40 died in
early life; there were 33 insane, suicide, or nervous disease, and 311 normal.
Thus 9-6% of the offspring reaching adult age were affected.
The conclusion which possibly might be drawn is that a_ghil«j horn r>f a
dual neuropathic inheritance^ stands on an average a chance of being insane
four H™^ a^-great aVjySere only one stock is infected. This, however,
applies to the mass and not the individual.
It might be argued that there are a certain number of imbeciles who
could be allowed all social privileges excepting reproduction ; this would
be on the ground that they could pick up a living, and sterilization would in
no way interfere with their doing this. The objections are: The cry of
one law for the rich and another for the poor ; and the legalisation of an
operation that is fraught with many hidden social dangers. I often think
that a number of people who are crying out about the monetary burden of
supporting the unfit are themselves not doing their duty to the race. Many
have no children or they restrict the births ; moreover, one does not find the
numbers in a family increase with the income. When hereditary health as
shown by longevity, fertility, and mental stability in a stock is regarded as
a greater asset for happiness in the family and the nation than hereditary
wealth, then will be the time for the rich and comparatively prosperous to.
suggest the desirability of sterilization of the insane 'pauper. For no one
supposes that it would be carried out in all classes..
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