THE TWENTIETH CENTURY.
CHAPTER I.
PROGNOSIS.
Our long and sorrowful wandering through the hospital—for as such we have recognised, if not all civilized humanity, at all events the upper stratum of the population of large towns to be—is ended. We have observed the various embodiments which degeneration and hysteria have assumed in the art, poetry, and philosophy of our times. We have seen the mental disorder affecting modern society manifesting itself chiefly in the following forms: Mysticism, which is the expression of the inaptitude for attention, for clear thought and control of the emotions, and has for its cause the weakness of the higher cerebral centres; Ego-mania, which is an effect of faulty transmission by the sensory nerves, of obtuseness in the centres of perception, of aberration of instincts from a craving for sufficiently strong impressions, and of the great predominance of organic sensations over representative consciousness; and false Realism, which proceeds from confused æsthetic theories, and characterizes itself by pessimism and the irresistible tendency to licentious ideas, and the most vulgar and unclean modes of expression. In all three tendencies we detect the same ultimate elements, viz., a brain incapable of normal working, thence feebleness of will, inattention, predominance of emotion, lack of knowledge, absence of sympathy or interest in the world and humanity, atrophy of the notion of duty and morality. From a clinical point of view somewhat unlike each other, these pathological pictures are nevertheless only different manifestations of a single and unique fundamental condition, to wit, exhaustion, and they must be ranked by the alienist in the genus melancholia, which is the psychiatrical symptom of an exhausted central nervous system.
Superficial or unfair critics have foisted on me the assertion that degeneration and hysteria are the products of the present age. The attentive and candid reader will bear witness that I have never circulated such an absurdity. Hysteria and degeneration have always existed; but they formerly showed themselves sporadically, and had no importance in the life of the whole community. It was only the vast fatigue which was experienced by the generation on which the multitude of discoveries and innovations burst abruptly, imposing upon it organic exigencies greatly surpassing its strength, which created favourable conditions under which these maladies could gain ground enormously, and become a danger to civilization. Certain micro-organisms engendering mortal diseases have always been present also—for example, the bacillus of cholera; but they only cause epidemics when circumstances arise intensely favourable for their rapid increase. In the same way the body constantly harbours parasites which only injure it when another bacillus has invaded and devastated it. For example, we are always inhabited by staphylococcus and streptococcus, but the influenza bacillus must first appear for them to swarm and produce mortal suppurations. Thus, the vermin of plagiarists in art and literature becomes dangerous only when the insane, who follow their own original paths, have previously poisoned the Zeitgeist, weakened by fatigue, and rendered it incapable of resistance.
We stand now in the midst of a severe mental epidemic; of a sort of black death of degeneration and hysteria, and it is natural that we should ask anxiously on all sides: ‘What is to come next?’
This question of eventuality presents itself to the physician in every serious case, and however delicate and rash, above all, however little scientific any prediction may be, he cannot evade the necessity of establishing a prognosis. For that matter, this is not purely arbitrary, not a blind leap into the dark; the most attentive observation of all the symptoms, assisted by experience, permits a generally just conclusion on the ulterior evolution of the evil.