iS6 SCIENCE PROGRESS 



a family than insanity, and no disease is more costly in its treatment or in 

 its custodial care. 



The great waste of mental and nervous energy implied by its incidence 

 and the loss of productive power as well as the enormous expense in its main- 

 tenance in this and other countries have set teachers of the young, social 

 economists, and other thinkers, to sound notes of warning as to its prevalence, 

 and our own press has recently urged the establishment of special institu- 

 tions for its study and the provision of modern means to cure it in its early 

 stages. The fact that there are nearly 130,000 certified insane persons in 

 this country and over 220,000 in the United States of America, of whom 

 about one-fifth are young people between the ages of twenty and twenty-five 

 years — and this proportion appears to be increasing — has created consider- 

 able anxiety and alarm. In consequence a Society for the special study of 

 this form of mental disorder has been started in America, and Dementia 

 Praecox, the distinctive term applied to this type, has of late received very 

 definite recognition and attention, particularly as it is a variety that tends 

 to become incurable and chronic, unless diagnosed in its earliest stages and 

 before the symptoms have become confirmed. 



It is becoming realised more and more that health rather than material 

 wealth is a people's greatest asset, as upon its health, its sanity, and its 

 vigour depend its progress, its prosperity, and its destiny. Indeed, health 

 and not wealth is the basis of a people's ambitions, aspirations, and achieve- 

 ments. 



Griesinger knew of this disease, and Esquirol described it as "acquired 

 imbecility," but it was known as far back as 1672 in this country, when 

 Willis, the anatomist, described its symptoms, and later, in 1772, Sydenham 

 referred to cases presenting definitely diagnostic features of dementia 

 praecox. Nevertheless it was not known to be a recognised entity until 

 Kraepelin gave it the name by which it is now most commonly known. The 

 Medico-Psychological Association in its nomenclature, which is accepted 

 throughout the mental hospitals of Great Britain, refers to it as Primary 

 Dementia, and this term accords better with the onset of the disease, which 

 is a dementia originating and beginning as a first and characteristic illness 

 rather than a dementia occurring in young persons as implied in dementia 

 praecox, for no age is immune to its incidence. Certain symptoms, such as 

 reserve, silence, and depression, occurring in young people and foreshadowing 

 dementia praecox have doubtless been regarded as adolescent melancholia, 

 and certain other symptoms of this disease, such as catatonic stupor and 

 mutism, have been included in the description of catalepsy, whilst the 

 impulsive excitement and automatic violence occasionally met with in these 

 cases have caused the disease to be described as mania, and so it has been 

 mistaken frequently for other conditions, each with a different prognosis. 



Thus it is a comprehensive disease. It is believed that not less than 

 one-fifth of all the admissions into American mental hospitals suffers from 

 it. We think that the proportion of one in ten would more accurately 

 represent its general incidence in this country ; and yet one-third of the 

 youth of this country certified as insane between twenty and thirty years of 

 age suffers from it ; and one in every 100 families has a sufferer from it also. 

 Dementia praecox is thus seen to be a most crippling disease, and one of 

 the first importance. Although the clinical term applied to the disease indi- 

 cates no etiological or pathological factor, it is nevertheless ascertained to be 

 distinctly inherited, an ancestry of insanity, alcoholism, nervous diseases, 

 or these combined being found to occur in a large proportion of the cases 

 investigated. The Society formed in America for this purpose has been 

 impressed by the fact that 15,000 youths suffer from it annually, and it has 

 therefore endeavoured to encompass three objects : (i) to make a diagnosis 

 possible before mental deterioration appears, which is the only chance of 



