Degeneracy: Its Causes, Signs and Results

by Eugene S. Talbot

Frequently efforts are unsuccessful either because the family physician and the educator have no time to superintend treatment, or because they are unable, for many reasons, to individualise treatment properly. Hence the high value of well-organised special boarding schools for the degenerate.

The special aim, says Koch, is to teach the patient to govern himself, to repose confidence in himself. To reach this end a great deal is required of him who undertakes the treatment. He has to exercise himself with patience. He must know how to divide the time for work and the time for rest. For many of these ill-balanced subjects variety is wanted as well in physical work as mental training.

Those charged with these remedies, exercising good judgment, are soon able to distinguish the more favourable cases from the more difficult. They can soon say that a favourable remedy for the one may be noxious for another, and vice versâ. Tonics, spirits, cold baths, &c., and even hypnotism may be tried, but great caution is to be exercised, and these remedies should never be employed except by prescription of physicians.

Even subjects of congenital mental instability suffering from obsession (imperative ideas) without delusions are not inaccessible to treatment. In these cases naturally the most important part belongs to the medical treatment as in most mental cases. The more serious cases, dating from the first youth and aggravated in proportion to the age, are not to be completely cured. The progressive evolution can be stopped and patients ameliorated in such a way that improvement makes their life bearable.

The same results can be obtained with less degenerate subjects. Success occurs often when patients are enabled to understand the nature of their sufferings, to discern that their disease does not belong to insanity, that it is unlikely to lead to mental disease. This understanding is one of the best of all anodynes. Donders, of Utrecht, said to one of his patients suffering from optic hyperæsthesia of neurasthenic origin: “What medicine cannot do, time and oftentime hygiene realise.” The intelligent patient having thus received assurance of his sight, good hygiene and mental rest soon after produced a cure. Acquired mental depreciation may exist from the first years of the child’s life. These depreciations in proportion to their intensity are characterised by fatigue and even nervous exhaustion accompanied with physical weakness and functional trouble in one or more organs of sense, by pathological debility of the intelligence and impaired memory especially for recent facts, difficulty of comprehension and of associating ideas and judgment, as well as worries, fears, despairs, especially in cases of intoxications by morphine, cocaine, bromides, coffee, &c. These are increased by irritability and excitability when the troubles arise from onanism, puberty, or other periods of transformation in the sexual life.

Fight from the first the symptoms of predisposing and occasional causes, because if aggravation be prevented recovery is possible. Especially in these depreciations must the physician utilise all his knowledge and prove that only mental science is sufficient to cure such patients. Not only has he to guide the intellectual life, and life of sensibility and will, but he has also to remedy the morbid physical conditions, to superintend the general régime, times of work and rest, air, light, dressing, preservation from alcoholic and other excesses.

One great element of possible danger of the first importance is training in the sexual sphere. To avoid and at the same time to enlighten is the problem presented. In dealing with this problem the great requirement, balance, not repression, must be kept in mind. Masturbation is very frequently an expression not of mental or moral deficiency, but of purely local (first in at least most cases) physical conditions. Irritation (from the presence of worms in the rectum or vagina, an intensely acid state of the urine, or constipation) to male foreskin and female clitoris has produced a local itching, the attempt to relieve which has led to masturbation. Granting all that has been said about the deteriorating effects, especially in degenerates, the source should first be sought here. Attention to these physical states will often prevent the development of this practice and its resultant moral deterioration.

In dealing with the sexual appetite the fact should be remembered that encouragement of healthy modesty is a duty in both sexes, and pre-eminently so in the male. Too much of what is called “sexual purity” is very often an expression of sexual perversity. While great stress has been laid on the evil effects of association between boys, too little stress has been laid on the danger of the training of boys by women. The sexual history of boys often demonstrates that their initiation into the sexual life was first at the instance of women older than themselves, often servants, but not rarely sexual “purists” or persons whose ostentatious religiosity covered a sexual perversity. In the healthy association of the sexes there is very little danger, but in such morbid association there is great danger, the more that the morbid conceals itself under religiosity and the allied phases of sexual perversion. Great stress has been laid on the dangers of co-education, but the growing opinion is that education limited to one sex is the source of even greater dangers to both boy and girl. It is a matter of common observation among genito-urinary specialists, alienists and gynecologists, that much of the alleged “purity” so ostentatiously displayed by graduates of colleges limited to one sex, is often the offspring of a sexual perversion which, whether congenital or not, has been fostered by the environment of one sex without the modifying, healthy influence of the other.

In dealing with these cases the stigmata first likely to attract the physician’s attention are in the milder cases those of the jaws, teeth, nose, throat, ear, and eye. Rapid decay of the teeth often leads to the discovery not merely of constitutional degeneracy, but also of the effects of certain strains which aggravated this. Dentists, mouth, throat, ear, and to a lesser degree eye specialists, are hence in a position to detect degeneracy at its outset. If they do not put the cart before the horse, and refer the constitutional symptoms to the local disturbances, they are in a position to be of eminent service to the race.

What Jules Morel has said of the more evident degenerates is equally true of the others. Education should be conducted along the lines which Froebel indicated when he pointed out that play is the child’s work, and that a development of this work is the natural problem for education. Extension of the general training of the whole body, from the properly conducted kindergarten to the school, is the principle on which all education should be conducted. This is recognised by advanced educators, as previously it had been recognised by the physician confronted with the effects of school strain resulting from the opposite theory. Manual training is a principle long adopted by idiot schools, where training of certain muscles through both mental and physical methods precedes intellectual training alone. Manual training may, however, be the source of equal dangers with the excessive abuse of intellectual training which preceded it. In the education of the degenerate, as in the education of the other members of the race, the true source of success is to avoid “the falsehood of extremes.”