HEALTH AND DISEASE 345 



up about 1 8 per cent, of the admissions to mental hospitals. As for the future 

 a factor which can not be overlooked is the changing composition of the 

 age groups in the population. Human life is lengthening, the birth rate is 

 falling, immigration has almost ceased. Furthermore the incidence of mental 

 disease increases steadily as age advances; the rates of mental disorder for 

 the respective age groups of the population are somewhat more than four 

 times at age 80 what they were at age 20. Whereas in 1900 only 4 per cent, 

 of the population was over 65, at present 6 per cent, is over 65, and it is 

 estimated that by 1980 somewhere between 14 and 16 per cent, of the popu- 

 lation will be over 6^.- In other words, there is every reason to beheve that 

 the number of patients in mental hospitals suffering from cerepsychoses 

 will probably increase rather materially as time goes on. It is difficult to see 

 how very much can be done about this. 



There is another group due to the infections, of which general paresis 

 is a conspicuous example. This disorder is one of the late results of syphilitic 

 infection, and until about twenty years ago was considered to be a rather 

 promptly fatal disorder once it had reached the stage of calling for hospital 

 care. During the world war considerable impetus was given to the cam- 

 paign against syphilis, and the campaign has been carried on since, having 

 been given more recently a very strong reenforcement through the splen- 

 did efforts of Surgeon General Thomas Parran and the symposium organ- 

 ized and presented by the American Association for the Advancement of 

 Science. Already the effects of the twenty-year-old campaigns are being 

 realized in a fall in the admission rate of general paresis; it is confidently 

 to be expected that as time goes on the rate will fall still further. Further- 

 more, since very striking advances have been made in the treatment of 

 this disease through the fever therapy devised by Wagner-Jauregg, the 

 prospects of this group, which now constitutes about 9 per cent, of first 

 admissions, are good.* 



As an example of another group of mental disorders we may mention 

 that due to intoxications; the alcoholic psychoses are a type. Although a 

 drop in admissions for this type of disorder began about 19 14, apparently 

 as the result of the campaign against the excessive use of alcohol, and al- 

 though there was a sudden drop in 1920 when prohibition went into effect, 

 there has been a rather gradual rise since 1920, with the result that we are 

 approaching the pre-war levels in the admissions of alcohohc psychoses, 

 now about 5 per cent. The educational program against alcohol was badly 

 disrupted by prohibition, and it will take a number of years to make this 

 effective again. Ultimately some drop in the rate of alcoholic psychoses 

 is perhaps to be expected. Mental disorders due to other drugs, such as 

 opium, cocaine and marihuana, are relatively negligible. Admissions due 



2 "Problems of a Changing Population," National Resources Committee, p. 25. 

 Washington, 1938. 



* Drug therapy with penicillin is a promising new approach. — Ed. 



