Being Well Born Part 13

=Probable Origin of Altruistic Human Conduct.--=Those phases of human conduct which find expression in consideration for others seem no less than other mental attributes to have their origin in certain fundamental instincts. Altruistic conduct, in last a.n.a.lysis, apparently resolves itself back largely to certain very fundamental impulsions, namely those which arise out of certain obligations for the welfare of others which are necessarily a.s.sociated with the marital, parental and filial relations that must exist where the young require post-natal care. Looked at from the standpoint of natural selection, this would come about as a mere matter of survival value. Where the young, as in man, are helpless for a long period of time, more opportunity would be afforded for the development of both conjugal and filial affection. The sympathetic emotions once established in such family relations would partly through habit, partly through community of interest, readily become extended to clan or tribe and as a final consummation to all mankind.

=Training in Motive Necessary.--=In the training of children, then, we must recognize first of all that there are decided inclinations or bents which, as long as they are not anti-social in nature, must be respected if not always encouraged. While it is necessary to utilize these as much as possible in their training still we must bear in mind that although it is natural for a child to follow certain interests, the fact remains that as regards social worth these natural interests may not be the most valuable.

When this is true we must strive to develop others which will compel attention and thus become impelling factors in conduct. Where certain fundamental impulsions run contrary to the common welfare it is necessary to practise the child in the setting up of inhibitions or counter-impulses until this becomes habitual. He must be led to construct a protective mantle of appropriate scruples, doubts and fears. It is all important to get the proper motives for action to prevail in his mind.

=Actual Practise in Carrying Out Projects Is All Important.--=But on the other hand it is equally important to see that the action is effectively carried out. In the matter of self-discipline, particularly, we may have many ideal impulses and realize that they should prevail over certain of our natural propensities, but unless we put forth effort to overcome the propensities our ideal impulses are of no avail. The world has many such moral paralytics to-day who can not seize their "languor as it were a curling snake and cast it off." It is training in this very overcoming of reluctance, in this putting forth of actual effort toward worthy ends instead of merely memorizing precepts about the desirability of such accomplishments, that is so sadly lacking in our school and home life to-day. We prate of the importance of self-control, we say with our lips that the way to learn to do is by doing, we proclaim that it is more vital to instil good mental and physical habits into our pupils than to stock them with information, we preach that mere fact training is as conducive to making a first-cla.s.s rascal as an upright man, yet we jog on complacently in the well-beaten ruts of memory routine which require the memorizing of symbols rather than real understanding. We seldom require that our proteges make intelligent judgments based on evidence, we rarely exact of them decisions in matters of ethics, and almost never demand that they put their knowledge into efficient accomplishment. It can not be too strongly urged that we need less of formulae learned by heart, less dead erudition pigeonholed in the brain like so many foreign bodies, and vastly more a.s.similation of knowledge into the living personality of the individual.

Where in school or home to-day do we find provision for such training? Our tendency is, in fact, just the opposite. According to the modern code, as it works out in many instances at least, the child must be taught through play. Though it is a truism that he who has not learned obedience can never be master of himself, the child of to-day must not be made to obey but be wheedled into changing his mind. If a given subject of study proves distasteful to him, the fault is the teacher's for not making it interesting, for he must always be led on by the thrill of fascination. In other words, the child must not only be allowed but be encouraged to take the path of least resistance. His own pleasure is to be the standard of his actions. Let no stern demands of duty interfere!

Is it any wonder that the products of such tutelage come into the activities of life self-indulgent and undisciplined, and although often recognizing our private and public shame in business, politics and conduct, still remain supine, evasive of the unpleasantness or hardships of reform, or inefficient or unwilling in accomplishing unselfish ends?

=Interest and Difficulty Both Essential.--=The writer does not wish to be understood as minimizing the importance of interest on the part of the child in what he is doing. Interest is undeniably the open sesame to desirable mental development; but what he does protest against is that not uncommon interpretation of interest which deems it necessary to eschew most serious consideration of a subject and evade such parts as present difficulties. Certainly if there is any fact that stands out prominently in human experience it is the fact that nothing conduces to the development of moral stamina so much as the overcoming of difficulties, particularly distasteful difficulties.

=Conduct Developed Through Actual Performance.--=Self-control and the will to do can be trained and crystallized into habit as well as can any other activity. It is a fact that one well grounded in morals by habit will successfully resist subconscious impulsions to wrongdoing even when suggested in the hypnotic state. Conduct is largely a matter of growth through actual performance. For proper guidance of this growth there must, of course, be high ideals around which the feelings are led to cl.u.s.ter and by which they gradually come to be controlled.

=Construction of Ideals.--=The construction of such ideals through example, through precept, through appeal and through actual practise in self-denial and self-control on the part of the child, should be the foremost duty of the parent or teacher. Above all it should be remembered that imitation of teacher, of parents, of companions, is more of a factor than intellect in the moral action of children. At present educationally we are in a fever for vocational training, for "practical" work, and in general for all things conducive to coaching our pupils in how to make a living, yet commendable as all this may be, is it not of even more fundamental importance to train them how to live?

=The Realization of Certain Possibilities of the Germ Rather Than Others Is Subject to Control.--=It may be said in a sense that there exists potentially in any germ all the things that can possibly come out of it under any obtainable conditions of environment. The very initiation of a given mode of expression by some environmental factor, however, often mutually excludes many of the others. We get a given average result ordinarily because development normally takes place in a given average environment.

As may be easily shown by experiment, this is manifest even in the instincts of lower animals. In the young the various instincts do not come into expression at the same time, and it not infrequently happens that if one of the earlier instincts becomes operative toward certain objects or situations, later instincts will have a wholly different relation toward these objects or situations than they would otherwise have had. As a result the whole life conduct of the animal is markedly modified. For example, young animals immediately after birth have no instinct of fear.

They do, however, have a strong instinct to attach themselves to some moving thing and follow it. The utility of such an instinct, as for instance in the case of young chickens, is obvious. The object of attachment is usually the parent, but man may take the place of a parent and the young animal will fearlessly follow him about. However if the young animal has had no experience with man during its earliest infancy a later instinct, that of fear or wildness, will have come into play and it will flee from him. It is clear, therefore, that by familiarizing the young animal with man before its instinct of fear has come to expression, certain habitual reactions are set up in it which inhibit or limit the application of its instinct of wildness as regards man. In other words, the whole course of its life has been altered by this simple experience.

The same principle applies in even greater degree to the young of man.

We have seen in a former chapter that what in the ordinary course of nature was "predestined" to become one individual nevertheless contained the possibility of becoming four or more if the environing conditions were made such as to bring about a separation of the cleavage blastomeres. Or a fish egg that contained the possibility of becoming a normal two-eyed form also contained the possibility of becoming a one-eyed form and could be made to do so by certain unusual modifications of the conditions under which it develops. However we must not be led so far by the plausibility of this comparison that we are misled, for the fact is that we are not creating anything new by these environmental upheavals, but are mainly altering features that already exist. Beyond doubt the nature of the material is of greater import in the specificity of the outcome than are the external forces brought to play on it. The only point I wish to make is that even what seem ordinarily to be predestined ends can be altered by environment, and that the probabilities are that certain features are relatively indifferent at their inception, the environmental factor adding the final touch of specificity. And our common experience in education would indicate that the same is true of mental conditions, including behavior. The actual appearance of a particular trait is not necessarily always a matter of an initial trend, but may be due merely to the fact that its development is possible under certain conditions of environment and that these conditions have prevailed in the given instance. And even where there is a specific bent it may be arrested through the awakening of a contrary impulse, or, on the other hand, its exercise may prevent the engendering of the opposite impulse.

=Our Duty to Afford the Opportunity and Provide the Proper Stimuli for the Development of Good Traits.--=It is clearly our duty to see that the expression of good traits is made possible. We must throw a sheltering screen of social environment around the young individual which will fend off wrong forms of incitement and chances for harmful expression, and we must provide proper stimuli and afford opportunity for development of proper modes of expression. We must not forget that a normal instinct denied a legitimate outlet will not infrequently find an illegitimate one.

Above all we must not forget the vital importance of establishing correct habits nor the possibility of even replacing undesirable ones by good ones. If training can redirect the machine-like behavior of as lowly a creature as the starfish into new courses, why should we be so willing as some of our genetists would seem to be to throw up our hands and admit failure in the case of man before we have even made a rational attempt to correct the evils in question? Even in lowly organisms we have seen that behavior is not only the result of an innate const.i.tution but also of the degree and kind of stimulations to which it has been subjected.

If the individual himself has not the initiative or will to make the attempt to set up proper or corrective habits, or to cultivate the necessary specific inhibitors, then all the more is it our duty to see that he is led by suggestion and drill into the proper routine of activities for their establishment. For if the individual with propensities toward moral obliquity is to be saved to society it must be through the stereotyping effects of good habits.

=Moral Responsibility.--=Beyond question different men have different degrees of capacity for mental and moral training. All can not be held equally responsible ethically, but the lowermost limit of obligatory response to social and ethical demands necessary to rank one as within the pale of normal conduct is at such a level that any one not an actual defective can in a reasonably wholesome environment surmount it. All normal men are responsible for their conduct.

CHAPTER VIII

MENTAL AND NERVOUS DEFECTS

Some of the most important and serious problems which confront humanity to-day lie in the realm of mental and neural maladjustments. For human progress and social welfare are in last a.n.a.lysis based fundamentally on the results of normal reactions of human nervous systems. Any serious derangement of the latter may, and in certain cases must, lead to more or less disaster for the individual and disorder for society of which he is a unit. So appalling has the number of neuropathic subjects become in modern times that the matter may well cause even the most thoughtless citizen to pause and consider.

=Prevalence of Insanity.--=As to the prevalence of insanity, one learns from recent charts prepared by a member of the National Committee for Mental Hygiene that in 1910 we had more insane (187,454) in our inst.i.tutions than there were students (184,712) in all our colleges and universities in the United States, or officers and enlisted men (142,695) in our combined United States army, navy and marine corps; further, the yearly cost ($32,804,450) of caring for these insane is greater than the annual cost of construction ($32,520,100) on such a stupendous undertaking as the Panama Ca.n.a.l. In New York over twenty per cent. of the revenues of the state go to support the insane. Doctor Lewellys F. Barker, President of the National Committee for Mental Hygiene, says: "It is calculated that some 250,000 people in the United States are insane. One of every five men discharged from the United States army for disability is discharged because of insanity, 60 per cent. of the cases being _dementia prec.o.x_."

Even in individual states with exceptionally large university populations we still find these outnumbered by those of the insane. Thus in Wisconsin by 1914 the state university had attained a population of about 4,700 students resident at the university during the regular school year, and of approximately 6,000 attending during some part of the year, but the number of insane under restraint in public inst.i.tutions in the state June 20, 1912, was 6,851, with an additional 1,284 on parole. This does not include the insane in various private sanatoria, and moreover a considerable greater number of patients had been treated in these public inst.i.tutions than were resident there June twentieth.

To make such comparisons complete one should, of course, know the average length of residence of students in college, and of insane patients in inst.i.tutions. No accurate data on this point are at hand. The average period of residence in hospitals for the acutely insane is doubtless considerably shorter than the average period of attendance of students in college, while on the other hand the average period of residence of inmates in asylums for chronic insane is probably considerably longer. For example, the Wisconsin State Hospital for the Insane reports a total of 1,224 patients under treatment, but an average population at any one time of only 622 during the year 1911, and the Northern Hospital for the Insane, a total of 1,194, with a daily average of 613 during the same period. The combined thirty-four county asylums in Wisconsin, for chronic insane, had a total population of 5,384 during the year 1911, with a loss of 517, or approximately 10 per cent. During 1912 the figures for these same inst.i.tutions run 5,758 and 742 respectively, or a loss of over 12.5 per cent. The conditions in other states are probably much the same.

In other representative states we find the number of insane in public inst.i.tutions as follows: California, 7,909; Michigan, 7,703; Minnesota, 5,329; Pennsylvania, 16,992. Epileptics are estimated by alienists to be about equal in number to the insane, feeble-minded to be more numerous.

The estimate that in the United States there are 300,000 feeble-minded is probably a minimal figure.

=Imperfect Adjustments of the Brain Mechanism Often Inheritable.--=The outside layer or "cortex" of the brain is the region in which the more complicated adjustments occur, especially such as pertain to human behavior, and inasmuch as this portion of the brain is extremely complex and delicate in its mechanism, it is peculiarly liable to derangements which, even when slight, may have far-reaching effects.

This brain-mechanism is as much a product of ancestry as is any other structure of the body, and it is obvious therefore that imperfect adjustments of its structure must be as subject to the laws of inheritance as are other malformations of the body. And just as with other defects, mental disorders may thus flow from pre-existing ancestral maladjustment of the nervous system or from immediate causes thrust upon it, such as syphilis, alcoholism, degeneration of the blood vessels and traumata. Or, in other words, the mechanism of mentality may be faulty from the beginning, or it may be made faulty by bad environmental conditions.

The records of the inheritance of insanity, imbecility, feeble-mindedness and other forms of nervous and mental defects are truly startling. Active researches in this field have been in progress now for several years, and as each new set of investigations comes in the tale is always the same. It is questionable if there is a single genuine case on record where a normal child has been born from a union of two imbeciles. Yet the universal tendency is for defective to mate with defective. Davenport gives a list of examples, beginning with such a one as this: "A feeble-minded man of thirty-eight has a delicate wife who in twenty years has borne him nineteen defective children." Little wonder, in the light of such facts as these, that the number of degenerates is rapidly increasing in what are called civilized countries.

=Many Mental Defectives Married.--=But, it may be urged, these are exceptional cases, there is surely no considerable number of mental defectives who are married. Let us look at the available facts. In Great Britain in 1901, of 60,000 known feeble-minded, imbeciles and idiots, 19,000 were married, and in the same year, of 117,000 lunatics, 47,000 were married; that is, a sum-total of 66,000 mentally defective individuals were legally multiplying, or had had the opportunity to multiply their kind, to say nothing of the unmarried who were known to have produced children.

In the state of Wisconsin I note from the tenth biennial report of the Board of Control that of 574 patients admitted to the Northern Hospital for the Insane during the year from July 1, 1908, to June 30, 1909, 274 were married and 29 others were known to have been married; this is a total of 303 out of 574, considerably over half. At the Wisconsin State Hospital for the Insane we find the conditions are no better, for out of 499 admitted in the year 1909-10, 208 were married and 65 others had at some time been married, or a total of 273 out of 499. There is every reason to believe that conditions are approximately similar in other states.

=Disproportionate Increase in the Number of Mental Defectives.--=Writing of conditions in England the Commissioners in Lunacy state in their fifty-fourth report that now (1901) there is one officially known lunatic to 301.32 individuals of population, whereas in 1859 there was only one to 536 individuals of population. In Great Britain, taking into account mental defectives of all kinds, the 1901 census showed a total of 485,507, or 1:85 of total population. Rentoul estimates that 1:50 would be nearer the truth because of the fact that the number of officially known mental defectives is much less than the actual number. The conditions in Ireland are even more impressive, for in 1851 there was one known lunatic to 657 individuals of population; in 1871, one to 328, and in 1901 one to 178.

When all allowance is made in these statistics for the greater accuracy of recent enumeration, and for other modifying influences, such as migration, we are still forced to believe that an alarming increase in insanity is in progress and that society is woefully derelict in permitting the marriage of such unfortunates.

A census of the insane under public care in Wisconsin June 30, 1910, not counting the paroled, shows 6,537, or one to each 357 of population, since the population of the state was then 2,333,860. If, however, we should add the number of insane in private sanatoria and the number unconfined the proportion of normal individuals would be very much reduced.

In the United States as a whole, while I know of no data giving the number of married insane, it is estimated that at least one-fourth of the insane are not in asylums or hospitals. In all states the number of insane in state inst.i.tutions (there are no available records of most private inst.i.tutions) is rapidly increasing. According to the special census of 1903 covering a period of fourteen years, during which the general population increased thirty per cent., the number of insane in inst.i.tutions increased one hundred per cent. This is due doubtless in part to the fact that because of better facilities for keeping them a proportionately greater number of insane are being sent to state hospitals than in former years. Moreover, improved sanitation has cut down the death-rate in asylums. The increase is in such vastly greater proportion than the increase in general population, however, that it seems impossible to attribute it wholly to the greater accuracy of recent enumerations and the increasing custom of confining the insane in asylums. This is a matter that demands our gravest attention and one that should be investigated with the greatest thoroughness. One of the most disquieting facts in the situation in most states is that many patients--an average of approximately one thousand a year, in Wisconsin for example--are on parole subject to recall. This means that although it is recognized that these patients are likely to have to be returned to the asylum or hospital, little or no restraint in the meantime is placed on their marital relations.[8]

=Protests Voiced by Alienists.--=Is it any wonder under the circ.u.mstances that we find Doctor Charles Gorst, superintendent at the Mendota Hospital, voicing in his 1910 report the following vigorous protest--and certainly such men as he are in the best position to know. He says: "No one doubts for a moment that defective mental conditions are transmitted from parent to child as surely as the physical defects and deformities. Every one knows that it is common for defectives to be attracted to each other and marry, and that the defects of both parents are liable to be transmitted to the children. It is also true that there are more children born in such families; and for that reason the percentage of defectives is continually on the increase. The report of the state of Illinois shows the increase to be alarming, and many other states are no better. It is absolutely wicked that the persons suffering from periodical insanity should be allowed to return to their homes to propagate and scatter their children about the state as dependents."

=Examples of Hereditary Feeble-Mindedness.--=No one can look at the remarkable series of charts and records brought together by Doctor G.o.ddard of the inst.i.tution at Vineland, New Jersey, and by other directors of similar inst.i.tutions, and doubt for an instant the inheritability of feeble-mindedness and allied defects. In some instances the family history has been followed back as far as five generations, and it is always the same dire sequence of insanity, idiocy, epilepsy or feeble-mindedness, from generation to generation. For example, Fig. 33, p. 236, is one of Doctor G.o.ddard's charts. It shows thirteen descendants of a supposedly normal father (possibly a carrier) and a feeble-minded mother, of whom seven were feeble-minded, the others dying in infancy. The mother herself was one of seven feeble-minded children, who were in turn the descendants of feeble-minded parents, of whom the woman had five feeble-minded brothers and sisters. In Fig. 34, p. 237, he shows mental defects running through four generations. Fig. 35, p. 238, is a remarkable exhibit which, starting in the fifth generation back with a feeble-minded, alcoholic man--the mental condition of his wife being unknown--shows that in every generation down to and including the present there has been nothing but feeble-minded (or worse) offspring, leaving out of account two unknown and a number who died in infancy without revealing their mental condition.

This is true notwithstanding the fact that in the course of the various generations there had been several matings with apparently normal individuals. The new blood, however, instead of redeeming the tainted stock, itself became vitiated. The numerous specific cases of inheritance of family traits reviewed in recent books or in special reports of trained workers give us abundant confirmatory evidence of the inevitable inheritance of various nervous and mental defects.

[Ill.u.s.tration: FIG. 33

Inheritance of feeble-mindedness (after G.o.ddard): squares represent males, circles females; F, feeble-minded; N, normal; E, epileptic; I, insane; C, criminal; T, tuberculous; d. inf., died in infancy; the hand shows the individual from whom the record was traced back; small black circle indicates miscarriage.]

=Difficult to Secure Accurate Data.--=It is obvious, of course, that in tabulations such as these there may lurk considerable margins of error.

Notwithstanding our Binet-Simon and other tests for feeble-mindedness, for example, there is yet much to be desired in the way of accuracy. Many cases just bordering normality are by no means easy to decide. Then again in most human records, when one gets back beyond the third or, at most, the fourth generation, the investigator has to depend on the hearsay evidence of relatives, friends or neighbors, and how vague this generally is can only be appreciated by those who have themselves tried to collect such data. But in spite of all the difficulties, there is little doubt that the more carefully prepared records are sufficiently accurate to establish the fact beyond dispute that defective tends in large measure to breed defective.

[Ill.u.s.tration: FIG. 34

Inheritance of feeble-mindedness (after G.o.ddard); symbols same as in Fig.

33, p. 236.]

One serious drawback in making a study of the inheritability of insanity and other nervous disorders is that so far we have dealt mainly with ma.s.s effects rather than specific neuroses. But even when the latter is attempted we are confronted by the fact that there are various intergradations of the recognized types of defect, that because of varying degrees of defect in the same type a standard is hard to establish, and above all that what appears as a specific mental malady in one individual may crop out in his descendants in an entirely different guise. Moreover, not only the predisposition of the individual, but age and precipitative cause enter as factors in determining the ultimate symptoms.

[Ill.u.s.tration: FIG. 35

Inheritance of feeble-mindedness (after G.o.ddard); symbols same as in Fig.

33, p. 236.]

=Feeble-Mindedness and Insanity Not the Same.--=Authorities make a sharp distinction between insanities on the one hand and feeble-mindedness on the other. According to G.o.ddard, not only is there no close relationship between the two conditions, but in reality they stand at opposite ends of the psychical scale. In general, insanity is a degenerative process, whereas feeble-mindedness is an arrest of development. In the first case the victim loses part of the mentality he once had, in the second he stops short of normal development.