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 institutions (there are no available records of most private institutions) 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 institutions 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 circumstances 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 Goddard of the institution at Vineland, New Jersey, and by other directors of similar institutions, 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 Goddard’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.
Fig. 33
Inheritance of feeble-mindedness (after Goddard): 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.