ALCOHOLISM 275 



but it is difficult to determine whether the alcoholism causes the 

 instability, or whether the instability causes the alcoholism, or 

 whether, as seems most likely, both are expressions of some 

 germinal defect. 



Prof. F. W. Mott concludes that " Alcohol is responsible for a 

 large number of admissions to asylums." But " how far it acts 

 as the efficient cause of insanity, and how far it is only a co- 

 efficient or coincident in relation to antisocial conduct in an 

 individual potentially insane, rendering such a person certifiable, 

 it is difficult to gauge until more accurate and scientific data are 

 forthcoming" (1911). 



And again : " Coincidence and cause may thus be confused, 

 for a lapse from moderation to intemperance may be the first 

 recognisable sign of the mental breakdown. Especially is this 

 the case with the involutional psychoses occurring at the 

 climacteric period in women ; also men and women between fifty 

 and sixty who suffer from melancholia, and at the same time are 

 the subjects of artero-sclerosis. Again, general paralytics and 

 cases of adolescent insanity may take to drink. There can be 

 no doubt that neurasthenics, hysterics, epileptics, imbeciles, de- 

 generates, eccentiics, and potential lunatics — all those, indeed, 

 with an inherent narrow margin of highest control — possess a 

 marked intolerance to the effects of alcohol, and the failure to 

 discriminate between what is the result of alcoholism and what 

 is innate and due to inheritance has been the cause of much 

 confusion " (1911). And again this authority sums up, " Alcohol 

 is a powerful coefficient, but not of itself the main cause, in the 

 production of insanity, except in the rather infrequent cases of 

 alcoholic dementia." 



(6) It is certain that parental alcoholism and instability 

 (taking the two together) are often associated with alcoholism 

 and degeneracy in the offspring, but this may depend on the 

 inheritance of a " general controlling determinant " responsible 

 for both alcoholism and instability. It is difficult to prove that 



