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cept when the hereditary element is present, for cases have been observed that would prevent such a conclusion, though they are not exactly of the kind that the ordinary views of this subject would lead us to expect. It would seem as if a blow on the head, a sunstroke, a habit of drunkenness, a violent fever, were abundantly able, each of them, to cause insanity, without the aid of any innate tendencies. Yet it is a well-observed fact that in a large proportion of the cases thus ostensibly produced there is also present the hereditary predisposition. In fact, we find that the number of the cases attributed by practical writers to some special exciting cause has been steadily diminishing, while the number of those set down in the ordinary tables as hereditary or of unknown origin has been as steadily increasing. The meaning of this fact cannot be misunderstood; for, inasmuch as mental diseases do not spring out of the ground, we can scarcely resist the conclusion that most of these cases in which the cause is unknown have an hereditary origin. Moreau thinks that not less than nine cases of insanity out of ten may be fairly attributed to hereditary conditions; and we are inclined to believe that this estimate, large as it is, will be found to be hardly large enough. Still, the agency of exciting causes in producing insanity is too potent to be despised. Where the predisposition exists, they serve to foster and quicken it into activity, while without their influence it might have remained in a latent state. If a person strongly disposed to mental disease sustains a domestic affliction, or plunges into a course of religious excitement, or becomes absorbed in the mysteries of spiritualism, and then becomes insane, the true explanation of the fact is, not that any of these things caused his insanity, but that they helped to develop into fatal activity a morbid germ which otherwise would have always remained a germ. It is to be supposed that the germ itself had been created in a previous generation by the action of such causes in quickening the vital activity of the cerebral organism, and permanently establishing a state of superexcitation. And thus it is that great social movements, though implying an excessive strain of the mental powers, exert a pernicious influence on the brain, less by depriving the actors of their reason than by establishing
a morbid tendency which develops into insanity in a subsequent generation. This view of the subject might be strengthened, perhaps, by a searching examination of the operation of these so-called exciting causes,-an examination which would show, either that they are rather the effect than the cause, or that they are accidental,- having no necessary connection with the disease, or that they cannot be supposed, upon any acknowledged laws of pathological action, to possess the efficiency attributed to them. Such an investigation our limits forbid, for we have yet to unfold some important points more directly connected with the present inquiry. We have said that it is the tendency to insanity, the primordial germ, not the full-grown disease, which is transmitted from one generation to another. Let us now see what becomes of it after it is transmitted.
No one of the many manifestations of such morbid tendencies is more clearly or generally recognized than that which passes under the name of insanity. But it is not to be forgotten for the fact is one of great practical importance — that up to the very outbreak of actual disease the patient may have presented no indication whatever of mental disorder or imperfection, but, on the contrary, may have been uniformly quiet, self-possessed, and well balanced. The morbid condition may be manifested in some convulsive affection, such as hysteria, chorea, epilepsy, or some paroxysmal loss of proper consciousness, such as catalepsy or somnambulism. It can hardly be necessary, even if our limits would permit, to indicate all the manifestations of this unsoundness; but there are some not generally regarded as of an hereditary character, which, therefore, claim a more particular attention.
Among these the most common consists of those minor degrees of mental disturbance that pass under the name of eccentricity. Strange, queer, unreasonable as eccentric people often are, even surpassing the insane in their deviations from the line of recognized proprieties, nobody calls them insane. Many of them become unequivocally insane, and it is always difficult to determine the exact period when the transition was completely effected. The difficulty is not lessened by the prevalent disposition to scout at the idea of eccentricity being anything more than singularity, — a mere token of strong indi
viduality, signifying nothing abnormal. The truth is that, in common with affections more decidedly morbid, it can often be traced to an hereditary taint. Of course when it passes into insanity all doubt on this point is removed. This transition is made by such insensible gradations as to defeat every attempt to make an absolute distinction between the states, though there are many physicians and jurists who flatter themselves that they have accomplished this feat.
There are many other mental peculiarities not usually considered as abnormal, which no less surely reveal the hereditary evil. In families where insanity prevails, the practised observer readily discerns the signs of the morbid tendency in peculiar modes of thought and feeling, in a disregard of logical distinctions, in irrelevant suggestions, in unusual forms of expression, in ways and manners more original than natural, and in a singular lack of plain common sense, associated perhaps with every grace and gift. For the first time by any English writer, this mental condition has been described, and designated as the insane temperament, in a recent work, which, with all its faults, and they are many and serious, abounds in original and vigorous thought. "He has," says Maudsley, alluding in general terms to a, person exhibiting this kind of heritage," a native constitution of nervous element, which, whatever name we give it, is unstable or defective, rendering him unequal to bear the severe stress of adverse events. In other words, the man has the insane temperament; he is liable to whims, caprices of thought and feeling; and though he may act calmly and soberly for the most part, yet now and then his unconscious nature, overpowering and surprising him, instigates eccentric or extravagant activity, while an extraordinary and trying emergency may upset his stability entirely."
Another frequent manifestation of the hereditary evil consists in alternate exaltation and depression. In the former state every prospect is bright, every undertaking promises success, and every scene is tinged with roseate hues. In a few weeks or months, or it may be years, the whole face of things has changed. All that abundant self-confidence has fled. Nothing hopeful, nothing cheerful, sends a gleam of light through the darkness that envelopes the soul, and the duties VOL. CIX. —No. 224.
of life are pursued with unvaried weariness and pain. In process of time, under the wear and tear of daily trial, the exaltation may become high excitement, the depression be accompanied by a tendency to suicide, and the line fairly passed that separates sanity from insanity.
Again, the abnormal state is shown in an habitual distrust and suspicion of everybody else, amounting almost to a fixed belief on the part of the subject that he is purposely thwarted at every turn. In cases of this description, the slightest pretext is sufficient for misconstruing the acts even of the best friends, while the most simple and natural things are twisted into signs of hostility or opposition. The subjects of such delusions live and move under a persistent impression that they are the victims of great injustice; that, while the smiles of Providence and the favor of men are freely bestowed on others no better than themselves, their merits are unacknowledged, and they are slighted and despised. In fact, the rewards bestowed on others are apt to be regarded as a personal affront to themselves, and at times the restraints of prudence and regard for propriety are cast away, and the pentup feelings of the heart break forth in words of wrath and bitterness.
In another class of persons we observe an extreme susceptibility to every obstacle and trial that comes in their way. While the sea is smooth and the winds fair, their course is quiet and hopeful; but let the slightest adversity befall them, and their sky becomes overcast, and there is no longer any hope or comfort for them. The least opposition to their plans or purposes excites a storm of passion, ending, perhaps, in scenes of violence and blood. Though they may be correct in their morals and pleasing in their manners, they prove to be uncomfortable neighbors, and in the midst of their own families they are feared rather than loved. In the world they pass for men of ungovernable tempers, and, when brought into judgment for their acts of violence, they get no indulgence on the score of abnormal inability to control their passions.
Others there are who give no sign of mental imperfection until they commit some terrible deed entirely opposed to their habitual character, with no apparent or adequate motive, or for
reasons so contrary to all true sense of moral and legal propriety as to raise the suspicion of insanity. Thus a person of blameless life is converted, almost in the twinkling of an eye, into a very monster of wickedness. He may undertake to explain and justify his conduct, but his reasons are so opposed to ordinary modes of thinking and feeling as to indicate, at the very least, an extreme confusion of moral distinctions.
No part of the mental economy suffers more severely from hereditary disease than that which consists of the appetites, affections, and emotions. In insanity generally, the moral powers participate in the mental disorder in a far greater degree than is usually supposed. "This moral alienation is so constant," says Esquirol, says Esquirol, "that it seems to be an essential character of insanity. There are those among the insane in whom intellectual aberration is hardly perceptible; but there are none whose passions and moral affections are not disordered, perverted, or annulled." There are people in whom a proclivity to mischief predominates over every other sentiment. Cursed, it may be, with the vilest passions, they are determined to indulge them at whatever cost. Nothing delights them more than to stir up strife and mar the comfort of those around them. They lie, they steal, they are without kindness or natural affection. Many of them begin in early life to manifest a moral disorder, which, not flagrant at first, grows with advancing years. They are indolent, fickle, steady to no pursuit, addicted to low vices, quarrelsome, passionate, violent. How many families in which the purest morality and religion have always been carefully and steadily inculcated, are afflicted with members of this description! They are generally keen, cunning, abounding in resources; and to the world at large they seem to differ from other people only in their superior capacity for mischief. The medical inquirer, however, believing that such characters do not appear by chance, but are the result of some organic law, searches until he finds, if not the law itself, at least the path that leads to it. He observes actual insanity in other members of the family, or ascertains that a parent was hysterical or epileptic, or, in common phraseology, "highly nervous," and here he sees the effect of the inexorable law of heredity.