Essays in War-Time Part 6

Macilwaine, in a little book ent.i.tled _Medical Revolution_, again advocated the same changes: the establishment of a Ministry of Health, a medical service on a preventive basis, and the reform of the hospitals which must const.i.tute the nucleus of such a service. It may be said that for medical men no longer engaged in private practice it is easy to view the disappearance of private practice with serenity; but it must be added that it is precisely that disinterested serenity which makes possible also a clear insight into the problems and a wider view of the new horizons of medicine. Thus it is that to-day the dreamers of yesterday are justified.

The great scheme of State Insurance was certainly an important step towards the socialisation of medicine. It came short, indeed, of the complete Nationalisation of Health as an affair of State. But that could not possibly be introduced at one move. Apart even from the difficulty of complete reorganisation, the two great vested interests of private medical practice on the one hand and Friendly Societies on the other would stand in the way. A complicated transitional period is necessary, during which those two interests are conciliated and gradually absorbed. It is this transitional period which State Insurance has inaugurated. To compare small things to great--as we may, for the same laws run all through Nature and Society--this scheme corresponds to the ancient Ptolomaean system of astronomy, with its painfully elaborate epicycles, which preceded and led on to the sublime simplicity of the Copernican system. We need not antic.i.p.ate that the transitional stage of national insurance will endure as long as the ancient astronomy. Professor Moore estimated that it would lead to a completely national medical service in twenty-five years, and since the introduction of that method he has, too optimistically, reduced the period to ten years. We cannot reach simplicity at a bound; we must first attempt to systematise the recognised and established activities and adjust them harmoniously.

The organised refusal of the medical profession at the outset to carry on, under the conditions offered, the part a.s.signed to it in the great National Insurance scheme opened out prospects not clearly realised by the organisers. No doubt its immediate aspects were unfortunate. It not only threatened to impede the working of a very complex machine, but it dismayed many who were not prepared to see doctors apparently taking up the position of the syndicalists, and arguing that a profession which is essential to the national welfare need not be carried out on national lines, but can be run exclusively by itself in its own interests. Such an att.i.tude, however, usefully served to make clear how necessary it is becoming that the extension of medicine and hygiene in the national life should be accompanied by a corresponding extension in the national government. If we had had a Council of National Health, as well as of National Defence, or a Board of Health as well as a Board of Trade, a Minister of Health with a seat in the Cabinet, any scheme of Insurance would have been framed from the outset in close consultation with the profession which would have the duty of carrying it out. No subsequent friction would have been possible.

Had the Insurance scheme been so framed, it is perhaps doubtful whether it would have been so largely based on the old contract system. Club medical practice has long been in discredit, alike from the point of view of patient and doctor. It furnishes the least satisfactory form of medical relief for the patient, less adequate than that he could obtain either as a private patient or as a hospital patient. The doctor, on his side, though he may find it a very welcome addition to his income, regards Club practice as semi-charitable, and, moreover, a form of charity in which he is often imposed on; he seldom views his club patients with much satisfaction, and unless he is a self-sacrificing enthusiast, it is not to them that his best attention, his best time, his most expensive drugs, are devoted. To perpetuate and enlarge the club system of practice and to glorify it by affixing to it a national seal of approval, was, therefore, a somewhat risky experiment, not wisely to be attempted without careful consultation with those most concerned.

Another point might then also have become clear: the whole tendency of medicine is towards a recognition of the predominance of Hygiene. The modern aim is to prevent disease. The whole national system of medicine is being slowly though steadily built up in recognition of the great fact that the interests of Health come before the interests of Disease.

It has been an unfortunate flaw in the magnificent scheme of Insurance that this vital fact was not allowed for, that the old-fashioned notion that treatment rather than prevention is the object of medicine was still perpetuated, and that nothing was done to co-ordinate the Insurance scheme with the existing Health Services.

It seems probable that in a Service of State medical officers the solution may ultimately be found. Such a solution would, indeed, immensely increase the value of the Insurance scheme, and, in the end, confer far greater benefits than at present on the millions of people who would come under its operation. For there can be no doubt the Club system is not only unscientific; it is also undemocratic. It perpetuates what was originally a semi-charitable and second-rate method of treatment of the poorer cla.s.ses. A State medical officer, devoting his whole time and attention to his State patients, has no occasion to make invidious distinctions between public and private patients.

A further advantage of a State Medical Service is that it will facilitate the inevitable task of nationalising the hospitals, whether charitable or Poor-law. The Insurance Act, as it stands, opens no definite path in this direction. But nowadays, so vast and complicated has medicine become, even the most skilful doctor cannot adequately treat his patient unless he has a great hospital at his back, with a vast army of specialists and research-workers, and a manifold instrumental instalment.

A third, and even more fundamental, advantage of a State Medical Service is that it would help to bring Treatment into touch with Prevention. The private pract.i.tioner, as such, inside or outside the Insurance scheme, cannot conveniently go behind his patient's illness. But the State doctor would be ent.i.tled to ask: _Why_ has this man broken down? The State's guardianship of the health of its citizens now begins at birth (is tending to be carried back before birth) and covers the school life. If a man falls ill, it is, nowadays, legitimate to inquire where the responsibility lies. It is all very well to patch up the diseased man with drugs or what not. But at best that is a makeshift method. The Consumptive Sanatoriums have aroused enthusiasm, and they also are all very well. But the Charity Organisation Society has shown that only about 50 per cent. of those who pa.s.s through such inst.i.tutions become fit for work. It is not more treatment of disease that we want, it is less need for treatment. And a State Medical Service is the only method by which Medicine can be brought into close touch with Hygiene.

The present att.i.tude of the medical profession sometimes strikes people as narrow, unpatriotic, and merely self-interested. But the Insurance Act has brought a powerful ferment of intellectual activity into the medical profession which in the end will work to finer issues. A significant sign of the times is the establishment of the State Medical Service a.s.sociation, having for its aim the organisation of the medical profession as a State Service, the nationalisation of hospitals, and the unification of preventive and curative medicine. To many in the medical profession such schemes still seem "Utopian"; they are blind to a process which has been in ever increasing action for more than half a century and which they are themselves taking part in every day.

[1] The result sometimes is that the ambitious doctor seeks to become a specialist in at least one subject, and instals a single expensive method of treatment to which he enthusiastically subjects all his patients. This would be comic if it were not sometimes rather tragic.

XIII

EUGENICS AND GENIUS

The cry is often heard to-day from those who watch with disapproval the efforts made to discourage the reckless procreation of the degenerate and the unfit: You are stamping out the germs of genius! It is widely held that genius is a kind of flower, unknown to the horticulturist, which only springs from diseased roots; make the plant healthily sound and your hope of blossoms is gone, you will see nothing but leaves. Or, according to the happier metaphor of Lombroso, the work of genius is an exquisite pearl, and pearls are the product of an obscure disease. To the medical mind, especially, it has sometimes been, naturally and properly no doubt, a source of satisfaction to imagine that the loveliest creations of human intellect may perhaps be employed to shed radiance on the shelves of the pathological museum. Thus we find eminent physicians warning us against any effort to decrease the vigour of pathological processes, and influential medical journals making solemn statements in the same sense. "Already," I read in a recent able and interesting editorial article in the _British Medical Journal_, "eugenists in their kind enthusiasm are threatening to stamp out the germs of possible genius."

Now it is quite easy to maintain that the health, happiness, and sanity of the whole community are more precious even than genius. It is so easy, indeed, that if the question of eugenics were submitted to the Referendum on this sole ground there can be little doubt what the result would be. There are not many people, even in the most highly educated communities, who value the possibility of a new poem, symphony, or mathematical law so highly that they would sacrifice their own health, happiness, and sanity to retain that possibility for their offspring. Of course we may declare that a majority which made such a decision must be composed of very low-minded uncultured people, altogether lacking in appreciation of pathology, and reflecting no credit on the eugenic cause they supported; but there can be little doubt that we should have to admit their existence.

We need not hasten, however, to place the question on this ground. It is first necessary to ascertain what reason there is to suppose that a regard for eugenic considerations in mating would tend to stamp out the germs of genius. Is there any reason at all? That is the question I am here concerned with.

The anti-eugenic argument on this point, whenever any argument is brought forward, consists in pointing to all sorts of men of genius and of talent who, it is alleged, were poor citizens, physical degenerates the prey of all manner of const.i.tutional diseases, sometimes candidates for the lunatic asylum which they occasionally reached. The miscellaneous data which may thus be piled up are seldom critically sifted, and often very questionable, for it is difficult enough to obtain any positive biological knowledge concerning great men who died yesterday, and practically impossible in most cases to reach an unquestionable conclusion as regards those who died a century or more ago. Many of the most positive statements commonly made concerning the diseases even of modern genius are without any sure basis. The case of Nietzsche, who was seen by some of the chief specialists of the day, is still really quite obscure. So is that of Guy de Maupa.s.sant. Rousseau wrote the fullest and frankest account of his ailments, and the doctors made a _post-mortem_ examination. Yet nearly all the medical experts--and they are many--who have investigated Rousseau's case reach different conclusions. It would be easy to multiply indefinitely the instances of great men of the past concerning whose condition of health or disease we are in hopeless perplexity.

This fact is, however, one that, as an argument, works both ways, and the important point is to make clear that it cannot concern us. No eugenic considerations can annihilate the man of genius when he is once born and bred. If eugenics is to stamp out the man of genius it must do so before he is born, by acting on his parents.

Nor is it possible to a.s.sume that if the man of genius, apart from his genius, is an unfit person to procreate the race, therefore his parents, not possessing any genius, were likewise unfit to propagate. It is easy to find persons of high ability who in other respects are unfit for the ends of life, ill-balanced in mental or physical development, neurasthenic, valetudinarian, the victims in varying degrees of all sorts of diseases. Yet their parents, without any high ability, were, to all appearance, robust, healthy, hard-working, commonplace people who would easily pa.s.s any ordinary eugenic tests. We know nothing as to the action of two seemingly ordinary persons on each other in const.i.tuting heredity, how hypertrophied intellectual apt.i.tude comes about, what accidents, normal or pathological, may occur to the germ before birth, nor even how strenuous intellectual activity may affect the organism generally. We cannot argue that since these persons, apart from their genius, were not seemingly the best people to carry on the race, therefore a like judgment should be pa.s.sed on their parents and the germs of genius thus be stamped out.

We only arrive at the crucial question when we ask: Have the characters of the parents of men of genius been of such an obviously unfavourable kind that eugenically they would nowadays be dissuaded from propagation, or under a severe _regime_ of compulsory certificates (the desirability of which I am far indeed from a.s.suming) be forbidden to marry? Have the parents of genius belonged to the "unfit"? That is a question which must be answered in the affirmative if this objection to eugenics has any weight. Yet so far as I know, none of those who have brought forward the objection have supported it by any evidence of the kind whatever. Thirty years ago Dr. Maudsley dogmatically wrote: "There is hardly ever a man of genius who has not insanity or nervous disorder of some form in his family." But he never brought forward any evidence in support of that p.r.o.nouncement. Nor has anyone else, if we put aside the efforts of more or less competent writers--like Lombroso in his _Man of Genius_ and Nisbet in his _Insanity of Genius_--to rake in statements from all quarters regarding the morbidities of genius, often without any attempt to authenticate, criticise, or sift them, and never with any effort to place them in due perspective.[1]

It so happens that, some years ago, with no relation to eugenic considerations, I devoted a considerable amount of attention to the biological characters of British men of genius, considered, so far as possible, on an objective and impartial basis.[2] The selection, that is to say, was made, so far as possible, without regard to personal predilections, in accordance with certain rules, from the _Dictionary of National Biography_. In this way one thousand and thirty names were obtained of men and women who represent the flower of British genius during historical times, only excluding those persons who were alive at the end of the last century. What proportion of these were the offspring of parents who were insane or mentally defective to a serious extent?

If the view of Maudsley--that there is "hardly ever" a man of genius who is not the product of an insane or nervously-disordered stock--had a basis of truth, we should expect that in one or other parents of the man of genius actual insanity had occurred in a very large proportion of cases; 25 per cent. would be a moderate estimate. But what do we find? In not 1 per cent. can definite insanity be traced among the parents of British men and women of genius. No doubt this result is below the truth; the insanity of the parents must sometimes have escaped the biographer's notice. But even if we double the percentage to escape this source of error, the proportion still remains insignificant.

There is more to be said. If the insanity of the parent occurred early in life, we should expect it to attract attention more easily than if it occurred late in life. Those parents of men of genius falling into insanity late in life, the critic may argue, escape notice. But it is precisely to this group to which all the ascertainably insane parents of British men of genius belong. There is not a single recorded instance, so far as I have been able to ascertain, in which the parent had been definitely and recognisably insane before the birth of the distinguished child; so that any prohibition of the marriage of persons who had previously been insane would have left British genius untouched. In all cases the insanity came on late in life, and it was usually, without doubt, of the kind known as senile dementia. This was so in the case of the mother of Bacon, the most distinguished person in the list of those with an insane parent. Charles Lamb's father, we are told, eventually became "imbecile." Turner's mother became insane. The same is recorded of Archbishop Tillotson's mother and of Archbishop Leighton's father. This brief list includes all the parents of British men of genius who are recorded (and not then always very definitely) as having finally died insane. In the description given of others of the parents of our men of genius it is not, however, difficult to detect that, though they were not recognised as insane, their mental condition was so highly abnormal as to be not far removed from insanity. This was the case with Gray's father and with the mothers of Arthur Young and Andrew Bell. Even when we allow for all the doubtful cases, the proportion of persons of genius with an insane parent remains very low, less than 2 per cent.

Senile dementia, though it is one of the least important and significant of the forms of insanity, and is entirely compatible with a long and useful life, must not, however, be regarded, when present in a marked degree, as the mere result of old age. Entirely normal people of sound heredity do not tend to manifest signs of p.r.o.nounced mental weakness or abnormality even in extreme old age. We are justified in suspecting a neurotic strain, though it may not be of severe degree.

This is, indeed, ill.u.s.trated by our records of British genius. Some of the eminent men of genius on my list (at least twelve) suffered before death from insanity which may probably be described as senile dementia.

But several of these were somewhat abnormal during earlier life (like Swift) or had a child who became insane (like Bishop Marsh). In these and in other cases there has doubtless been some hereditary neurotic strain.

It is clearly, however, not due to any intensity of this strain that we find the incidence of insanity in men of genius, as ill.u.s.trated, for example, by senile dementia, so much more marked than its incidence on their parents. There is another factor to be invoked here: convergent morbid heredity. If a man and a woman, each with a slight tendency to nervous abnormality, marry each other, there is a much greater chance of the offspring manifesting a severe degree of nervous abnormality than if they had married entirely sound partners. Now both among normal and abnormal people there is a tendency for like to mate with like.

The attraction of the unlike for each other, which was once supposed to prevail, is not predominant, except within the sphere of the secondary s.e.xual characters, where it clearly prevails, so that the ultra-masculine man is attracted to the ultra-feminine woman, and the feminine man to the boyish or mannish woman. Apart from this, people tend to marry those who are both psychically and physically of the same type as themselves. It thus happens that nervously abnormal people become mated to the nervously abnormal. This is well ill.u.s.trated by the British men of genius themselves. Although insanity is more prevalent among them than among their parents, the same can scarcely be said of them in regard to their wives. It is notable that the insane wives of these men of genius are almost as numerous as the insane men of genius, though it rarely happens (as in the case of Southey) that both husband and wife go out of their minds. But in all these cases there has probably been a mutual attraction of mentally abnormal people.

It is to this tendency in the parents of men of genius, leading to a convergent heredity, that we must probably attribute the undue tendency of the men of genius themselves to manifest insanity. Each of the parents separately may have displayed but a minor degree of neuropathic abnormality, but the two strains were fortified by union and the tendency to insanity became more manifest. This was, for instance, the case as regards Charles Lamb. The nervous abnormality of the parents in this case was less profound than that of the children, but it was present in both. Under such circ.u.mstances what is called the law of antic.i.p.ation comes into play; the neurotic tendency of the parents, increased by union, is also antedated, so that definite insanity occurs earlier in the life of the child than, if it had appeared at all, it occurred in the life of the parent. Lamb's father only became weak-minded in old age, but since the mother also had a mentally abnormal strain, Lamb himself had an attack of insanity early in life, and his sister was liable to recurrent insanity during a great part of her life. Notwithstanding, however, the influence of this convergent heredity, it is found that the total insanity of British men and women of genius is not more, so far as can be ascertained--even when slight and dubious cases are included--than 4.2 per cent. That ascertainable proportion must be somewhat below the real proportion, but in any case it scarcely suggests that insanity is an essential factor of genius.

Let us, however, go beyond the limits of British genius, and consider the evidence more freely. There is, for instance, Ta.s.so, who was undoubtedly insane for a good part of his life, and has been much studied by the pathologists. De-Gaudenzi, who has written one of the best psychopathological studies of Ta.s.so, shows clearly that his father, Bernardo, was a man of high intelligence, of great emotional sensibility, with a tendency to melancholy as well as a mystical idealism, of somewhat weak character, and p.r.o.ne to invoke Divine aid in the slightest difficulty. It was a temperament that might be considered a little morbid, outside a monastery, but it was not insane, nor is there any known insanity among his near relations. This man's wife, Porzia, Ta.s.so's mother, arouses the enthusiasm of all who ever mention her, as a creature of angelic perfection. No insanity here either, but something of the same undue sensitiveness and melancholy as in the father, the same absence of the coa.r.s.er and more robust virtues.

Moreover, she belonged to a family by no means so angelic as herself, not insane, but abnormal--malevolent, cruel, avaricious, almost criminal. The most scrupulous modern alienist would hesitate to deprive either Bernardo or Porzia of the right to parenthood. Yet, as we know, the son born of this union was not only a world-famous poet, but an exceedingly unhappy, abnormal, and insane man.

Let us take the case of another still greater and more famous man, Rousseau. It cannot reasonably be doubted that, at some moments in his life at all events, and perhaps during a considerable period, Rousseau was definitely insane. We are intimately acquainted with the details of the life and character of his relations and of his ancestry. We not only possess the full account he set forth at the beginning of his _Confessions_, but we know very much more than Rousseau knew. Geneva was paternal--paternal in the most severe sense--in scrutinising every unusual act of its children, and castigating every slightest deviation from the straight path. The whole life of the citizens of old Geneva may be read in Genevan archives, and not a sc.r.a.p of information concerning the conduct of Rousseau's ancestors and relatives as set down in these archives but has been brought to the light of day. If there is any great man of genius whom the activities of these fanatical eugenists would have rendered impossible, it must surely have been Rousseau. Let us briefly examine his parentage. Rousseau's father was the outcome of a fine stock which for two generations had been losing something of its fine qualities, though without sinking anywhere near insanity, criminality, or pauperism. The Rousseaus still exercised their craft with success; they were on the whole esteemed; Jean-Jacques's father was generally liked, but he was somewhat unstable, romantic, with no strong sense of duty, hot-tempered, easily taking offence. The mother, from a modern standpoint, was an attractive, highly accomplished, and admirable woman.

In her neighbours' eyes she was not quite Puritanical enough, high-spirited, independent, adventurous, fond of innocent gaiety, but a devoted wife when, at last, at the age of thirty, she married. More than once before marriage she was formally censured by the ecclesiastical authorities for her little insubordinations, and these may be seen to have a certain significance when we turn to her father; he was a thorough _mauvais sujet_, with an incorrigible love of pleasure, and constantly falling into well-deserved trouble for some escapade with the young women of Geneva. Thus on both sides there was a certain nervous instability, an uncontrollable wayward emotionality. But of actual insanity, of nervous disorder, of any decided abnormality or downright unfitness in either father or mother, not a sign. Isaac Rousseau and Susanne Bernard would have been pa.s.sed by the most ferocious eugenist. It is again a case in which the chances of convergent heredity have produced a result which in its magnitude, in its heights and in its depths, none could foresee. It is one of the most famous and most accurately known examples of insane genius in history, and we see what amount of support it offers to the ponderous dictum concerning the insane heredity of genius.

Let us turn from insanity to grave nervous disease. Epilepsy at once comes before us, all the more significantly since it has been considered, more especially by Lombroso, to be the special disease through which genius peculiarly manifests itself. It is true that much importance here is attached to those minor forms of epilepsy which involve no gross and obvious convulsive fit. The existence of these minor attacks is, in the case of men of genius, usually difficult to disprove and equally difficult to prove. It certainly should not be so as regards the major form of epilepsy. Yet among the thousand and thirty persons of British genius I was only able to find epilepsy mentioned twice, and in both cases incorrectly, for the National Biographer had attributed it to Lord Herbert of Cherbury through misreading a pa.s.sage in Herbert's _Autobiography_, while the epileptic fits of Sir W.R. Hamilton in old age were most certainly not true epilepsy. Without doubt, no eugenist could recommend an epileptic to become a parent. But if epilepsy has no existence in British men of genius it is improbable that it has often occurred among their parents.

The loss to British genius through eugenic activity in this sphere would probably, therefore, have been _nil_.

Putting aside British genius, however, one finds that it has been almost a commonplace of alienists and neurologists, even up to the present day, to present glibly a formidable list of mighty men of genius as victims of epilepsy. Thus I find a well-known American alienist lately making the unqualified and positive statement that "Mahomet, Napoleon, Moliere, Handel, Paganini, Mozart, Schiller, Richelieu, Newton and Flaubert" were epileptics, while still more recently a distinguished English neurologist, declaring that "the world's history has been made by men who were either epileptics, insane, or of neuropathic stock," brings forward a similar and still larger list to ill.u.s.trate that statement, with Alexander the Great, Julius Caesar, the Apostle Paul, Luther, Frederick the Great and many others thrown in, though unfortunately he fails to tell us which members of the group he desires us to regard as epileptic. Julius Caesar was certainly one of them, but the statement of Suetonius (not an unimpeachable authority in any case) that Caesar had epileptic fits towards the close of his life is disproof rather than proof of true epilepsy. Of Mahomet, and St. Paul also, epilepsy is alleged. As regards the first, the most competent authorities regard the convulsive seizures attributed to the Prophet as perhaps merely a legendary attempt to increase the awe he inspired by unmistakable evidence of divine authority. The narrative of St. Paul's experience on the road to Damascus is very unsatisfactory evidence on which to base a medical diagnosis, and it may be mentioned that, in the course of a discussion in the columns of the _British Medical Journal_ during 1910, as many as six different views were put forward as to the nature of the Apostle's "thorn in the flesh." The evidence on which Richelieu, who was undoubtedly a man of very fragile const.i.tution is declared to be epileptic, is of the very slenderest character. For the statement that Newton was epileptic there is absolutely no reliable evidence at all, and I am quite ignorant of the grounds on which Mozart, Handel and Schiller are declared epileptics. The evidence for epilepsy in Napoleon may seem to carry slightly more weight, for there is that in the moral character of Napoleon which we might very well a.s.sociate with the epileptic temperament. It seems clear that Napoleon really had at times convulsive seizures which were at least epileptoid. Thus Talleyrand describes how one day, just after dinner (it may be recalled that Napoleon was a copious and exceedingly rapid eater), pa.s.sing for a few minutes into Josephine's room, the Emperor came out, took Talleyrand into his own room, ordered the door to be closed, and then fell down in a fit. Bourrienne, however, who was Napoleon's private secretary for eleven years, knew nothing about any fits. It is not usual, in a true epileptic fit, to be able to control the circ.u.mstances of the seizure to this extent, and if Napoleon, who lived so public a life, furnished so little evidence of epilepsy to his environment, it may be regarded as very doubtful whether any true epilepsy existed, and on other grounds it seems highly improbable.[3]

Of all these distinguished persons in the list of alleged epileptics, it is naturally most profitable to investigate the case of the latest, Flaubert, for here it is easiest to get at the facts. Maxime du Camp, a friend in early life, though later incompatibility of temperament led to estrangement, announced to the world in his _Souvenirs_ that Flaubert was an epileptic, and Goncourt mentions in his _Journal_ that he was in the habit of taking much bromide. But the "fits" never began until the age of twenty-eight, which alone should suggest to a neurologist that they are not likely to have been epileptic; they never occurred in public; he could feel the fit coming on and would go and lie down; he never lost consciousness; his intellect and moral character remained intact until death. It is quite clear that there was no true epilepsy here, nor anything like it.[4] Flaubert was of fairly sound nervous heredity on both sides, and his father, a distinguished surgeon, was a man of keen intellect and high character. The novelist, who was of robust physical and mental const.i.tution, devoted himself strenuously and exclusively to intellectual work; it is not surprising that he was somewhat neurasthenic, if not hysterical, and Dumesnil, who discusses this question in his book on Flaubert, concludes that the "fits" may be called hysterical attacks of epileptoid form.

It may well be that we have in Flaubert's case a clue to the "epilepsy"

of the other great men who in this matter are coupled with him. They were nearly all persons of immense intellectual force, highly charged with nervous energy; they pa.s.sionately concentrated their energy on the achievement of life tasks of enormous magnitude, involving the highest tension of the organism. Under such conditions, even in the absence of all bad heredity or of actual disease, convulsive discharges may occur.

We may see even in healthy and sound women that occasionally some physiological and unrelieved overcharging of the organism with nervous energy may result in what is closely like a hysterical fit, while even a violent fit of crying is a minor manifestation of the same tendency.

The feminine element in genius has often been emphasised, and it may well be that under the conditions of the genius-life when working at high pressure we have somewhat similar states of nervous overcharging, and that from time to time the tension is relieved, naturally and spontaneously, by a convulsive discharge. This, at all events, seems a possible explanation.

It is rather strange that in these recklessly confident lists of eminent "epileptics" we fail to find the one man of distinguished genius whom perhaps we are justified in regarding as a true epileptic.

Dostoievsky appears to have been an epileptic from an early age; he remained liable to epileptic fits throughout life, and they plunged him into mental dejection and confusion. In many of his novels we find pictures of the epileptic temperament, evidently based on personal experience, showing the most exact knowledge and insight into all the phases of the disease. Moreover, Dostoievsky in his own person appears to have displayed the perversions and the tendency to mental deterioration which we should expect to find in a true epileptic. So far as our knowledge goes, he really seems to stand alone as a manifestation of supreme genius combined with epilepsy. Yet, as Dr.

Loygue remarks in his medico-psychological study of the great Russian novelist, epilepsy only accounts for half of the man, and leaves unexplained his pa.s.sion for work; "the dualism of epilepsy and genius is irreducible."

There is one other still more recent man of true genius, though not of the highest rank, who may possibly be counted as epileptic: Vincent van Gogh, the painter.[5] A brilliant and highly original artist, he was a definitely abnormal man who cannot be said to have escaped mental deterioration. Simple and humble and suffering, recklessly sacrificing himself to help others, always in trouble, van Gogh had many points of resemblance to Dostoievsky. He has, indeed, been compared to the "Idiot" immortalised by Dostoievsky, in some aspects an imbecile, in some aspects a saint. Yet epilepsy no more explains the genius of van Gogh than it explains the genius of Dostoievsky.

Thus the impression we gain when, laying aside prejudice, we take a fairly wide and impartial survey of the facts, or even when we investigate in detail the isolated facts to which significance is most often attached, by no means supports the notion that genius springs entirely, or even mainly, from insane and degenerate stocks. In some cases, undoubtedly, it is found in such stocks, but the ability displayed in these cases is rarely, perhaps never, of any degree near the highest. It is quite easy to point to persons of a certain significance, especially in literature and art, who, though themselves sane, possess many near relatives who are highly neurotic and sometimes insane. Such cases, however, are far from justifying any confident generalisations concerning the intimate dependence of genius on insanity.

We see, moreover, that to conclude that men of genius are rarely or never the offspring of a radically insane parentage is not to a.s.sume that the parents of men of genius are usually of average normal const.i.tution. That would in any case be improbable. Apart from the tendency to convergent heredity already emphasised, there is a wider tendency to slight abnormality, a minor degree of inaptness for ordinary life in the parentage of genius. I found that in 5 per cent.

cases (certainly much below the real mark) of the British people of genius, one parent, generally the father, had shown abnormality from a social or parental point of view. He had been idle, or extravagant, or restless, or cruel, or intemperate, or unbusinesslike, in the great majority of these cases "unsuccessful." The father of d.i.c.kens (represented by his son in Micawber), who was always vainly expecting something to turn up, is a good type of these fathers of genius.

Shakespeare's father may have been of much the same sort. George Meredith's father, again, who was too superior a person for the outfitting business he inherited, but never succeeded in being anything else, is another example of this group of fathers of genius. The father in these cases is a link of transition between the normal stock and its brilliantly abnormal offshoot. In this transitional stage we see, as it were, the stock _reculer pour mieux sauter_, but it is in the son that the great leap is made manifest.

This peculiarity will serve to indicate that in a large proportion of cases the parentage of genius is not entirely sound and normal. We must dismiss absolutely the notion that the parents of persons of genius tend to exhibit traits of a grossly insane or nervously degenerate character. The evidence for such a view is confined to a minute proportion of cases, and even then is usually doubtful. But it is another matter to a.s.sume that the parentage of genius is absolutely normal, and still less can we a.s.sert that genius always springs from entirely sound stocks. The statement is sometimes made that all families contain an insane element. That statement cannot be accepted.

There are many people, including people of a high degree of ability, who can trace no gross mental or nervous disease in their families, unless remote branches are taken into account. Not many statistics bearing on this point are yet available. But Jenny Roller, in a very thorough investigation, found at Zurich in 1895 that "healthy" people had in 28 per cent. cases directly, and in 59 per cent. cases indirectly and altogether, a neuropathic heredity, while Otto Diem in 1905 found that the corresponding percentages were still higher--33 and 69. It should not, therefore, be matter for surprise if careful investigation revealed a traceable neuropathic element at least as frequent as this in the families which produce a man of genius.

It may further, I believe, be argued that the presence of a neuropathic element of this kind in the ancestry of genius is frequently not without a real significance. Aristotle said in his _Poetics_ that poetry demanded a man with "a touch of madness," though the ancients, who frequently made a similar statement to this, had not our modern ideas of neuropathic heredity in their minds, but merely meant that inspiration simulated insanity. Yet "a touch of madness," a slight morbid strain, usually neurotic or gouty, in a preponderantly robust and energetic stock, seems to be often of some significance in the evolution of genius; it appears to act, one is inclined to think, as a kind of ferment, leading to a process out of all relation to its own magnitude. In the sphere of literary genius, Milton, Flaubert, and William Morris may help to ill.u.s.trate this precious fermentative influence of a minor morbid element in vitally powerful stocks. Without some such ferment as this the energy of the stock, one may well suppose, might have been confined within normal limits; the rare and exquisite flower of genius, we know, required an abnormal stimulation; only in this sense is there any truth at all in Lombroso's statement that the pearl of genius develops around a germ of disease. But this is the utmost length to which the facts allow us to go in a.s.suming the presence of a morbid element as a frequent const.i.tuent of genius. Even then we only have one of the factors of genius, to which, moreover, undue importance cannot be attached when we remember how often this ferment is present without any resultant process of genius. And we are in any case far removed from any of those gross nervous lesions which all careful guardianship of the race must tend to eliminate.

Thus we are brought back to the point from which we started. Would eugenics stamp out genius? There is no need to minimise the fact that a certain small proportion of men of genius have displayed highly morbid characters, nor to deny that in a large proportion of cases a slightly morbid strain may with care be detected in the ancestry of genius. But the influence of eugenic considerations can properly be brought to bear only in the case of grossly degenerate stocks. Here, so far as our knowledge extends, the parentage of genius nearly always escapes. The destruction of genius and its creation alike elude the eugenist. If there is a tendency in modern civilisation towards a diminution in the manifestations of genius--which may admit of question---it can scarcely be due to any threatened elimination of corrupt stocks. It may perhaps more reasonably be sought in the haste and superficiality which our present phase of urbanisation fosters, and only the most robust genius can adequately withstand.

[1] A Danish alienist, Lange, has, however, made an attempt on a statistical basis to show a connection between mental ability and mental degeneracy. (F. Lange, _Degeneration in Families_, translated from the Danish, 1907). He deals with 44 families which have provided 428 insane or neuropathic persons within a few generations, and during the same period a large number also of highly distinguished members, Cabinet ministers, bishops, artists, poets, etc. But Lange admits that the forms of insanity found in these families are of a slight and not severe character, while it is clear that the forms of ability are also in most cases equally slight; they are mostly "old" families, such as naturally produce highly-trained and highly placed individuals. Moreover, Lange's methods and style of writing are not scientifically exact, and he fails to define precisely what he means by a "family." His investigation indicates that there is a frequent tendency for men of ability to belong to families which are not entirely sound, and that is a conclusion which is not seriously disputed.

[2] Havelock Ellis, _A Study of British Genius_, 1904.