HEALTH AND DISEASE 349 



wheels until they lost consciousness. Keepers restrained their wards with 

 threats of death, and often beat them into insensibility. The same treatment 

 was meted out to the poor and the rich. Wallowing in their own excrement, 

 they fell victim to every passing epidemic. 



Before 1850 most of the insane in the United States were housed in 

 prisons or almhouses. Poormasters boasted of how cheaply they could keep 

 their wards alive. Similar conditions prevailed in Europe. When William 

 A. White, a director of St. Elizabeth's Hospital in Washington, one of the 

 largest and most advanced of such institutions in the world today, visited 

 Europe twenty-five years ago he saw: "One ward occupied by some forty 

 men, every one of them stark naked and strapped to his bed. There was only 

 one bed that was not occupied by a patient, and that was occupied by a 

 giant of an attendant who was asleep. He jumped up as I came in and 

 walked through the ward with me, and I remember those naked men curs- 

 ing and spitting at us as we went by." To this day some insane asylums, 

 even in civilized countries, reek with primitive ideas and methods. But 

 most of the old lunatic asylums are now things of the past, gone with the 

 rack and other instruments of torture, London's Bedlam, open until 1777, 

 and the Lunatics' Tower of Vienna, closed in 1853, where caged insane 

 were exhibited to sightseers who paid for admission, have been banished 

 forever. Lunatic asylums have been changed to hospitals in more than 

 name. 



Many things have been listed as causes for insanity. In one form of 

 mental disease, there seemed to be some strong indications of connection 

 with a bacterial infection. Ten per cent, of all new admissions to insane 

 asylums were general paretics. Their Wassermann blood tests were often 

 positive and their spinal fluid was always positive. Their histories showed 

 venereal infection of some ten or more years' standing. Syphilis and paresis 

 seemed linked. Often they had fared well socially for more than twenty 

 years after infection, until suddenly a strange change came over them. 

 Their memory began to fail, they became contrary, irritable, suspicious, 

 and sufi"ered from illusions. Frequently, hke Ivan the Terrible of Russia 

 who was undoubtedly a paretic, they were drawn to acts of violence. The 

 deterioration of the mind was progressive. Half of the victims died within 

 a year after reaching the hospital; few survived as long as five years after 

 commitment. 



A diagnosis of paresis was a verdict of a sure and ugly death. There were 

 few exceptions and no method of treatment. Syphilis was shown to be the 

 sine qua non of paresis. But no one knew just how the connection existed. 

 Salvarsan, the magical chemical weapon which Ehrlich had forged in his 

 laboratory, brought healing to some syphilitics, but never to paretics. These 

 were doomed. Some talked about sexual excesses, sunstroke, religious ex- 

 citement, and the stress of life. Emil Kraepelin taught the equation. Syphilis 

 plus Alcohol equals Paresis, but nothing had really been proved. Then 



