412Section IV.F. W. Mott.
The above table shows the proportion of males to females; the latter
are much more numerous; it will be observed that owing to a lower death-
rate of the femades, they tend to accumulate. This is no doubt due to
the fact that general paralytic males are three times as numerous as
females, whereas other non-fatal forms of insanity are much commoner in
females. It will be observed that of the 3,042 relatives who are at present
or have been in the London Asylums 1,533 still remain resident, a little
more than half. I shall have occasion later to refer at length to some
important deductions made from the age incidence of the first attack of
insanity in these insane relatives. Nature and Nurture.
No child is born insane, though it may be born feeble-minded either
from actual organic disease or inborn germinal cerebral deficiency. The
former being an acquired character is not heritable, a fact of very con
siderable importance in diagnosis and segregation with the view of pre
vention of transmission of feeble-mindedness.
We should endeavour to study every case of nervous or mental disease
as a biological problem, ascertaining as far as possible what the individual
was born with, ancestral inheritance (Nature); what happened during
development after conception (congenital); finally what happened at or
after birth (nurture). The collection of statistics and pedigrees merely
relating to the question of certifiable insanity or epileptic fits is quite
inadequate for scientific purposes, as the neuropathic predisposition mani
fests itself in many ways; and it is necessary to seek the first stages and
less obvious conditions of degeneration in a stock. Morel, who studied
this question more than fifty years ago, pointed out that nervous irritable
weakness, the neurotic temperament, neurasthenic predisposition, may be
the first evidence of degeneration of a stock. The inborn morbid neurotic
temperament may be manifested in a variety of ways by the behaviour
and conduct observed in various members of the stock. The signs of
degeneracy which may be exhibited are self centred narrow-mindedness in
religious beliefs, fanaticism, mysticism, spiritism, an unwholesome con
tempt for traditional custom, social usages, and morality, a vain spirit of
spurious art and culture, a false self-loving vanity in the pursuit of a
sentimental altruism, or by eccentricities of all kinds; such signs of
degeneracy are often combined with talent and even genius, especially of
the constructive imaginative order; but the brilliant intellectual qualities
of a degenerate are invariably associated with either a lack of moral sense
or of sound judgment and highest control. Time, chance, circumstances,
and opportunities play an especially important part in moulding and
determining the career of a neurotic stock; circumstances and environ
ment may favour one member and he rises on the tide of fortune to an
eminent position, whereas another, unfortunate or less fortunate, but with
