3 



soundest evidence that life segregation or sterilization would appreciably 

 diminish the numbers of the insane. 



I have endeavoured to ascertain some facts relating to this question. 

 The inference that can be drawn is that about one-fifth of the recurrent 

 cases or approximately one-twentieth of the female admissions have children 

 after their first attack of insanity and of 31 such cases examined, 73 

 children were born after the first attack of insanity in the parent. A 

 number of these were cases of puerperal insanity. I am unable to give 

 exact figures as to the fate of these children, but a good proportion of them 

 died in infancy, and the majority of them would be too young to decide 

 which might become insane. 



Recurrent insanity and epilepsy, with which it is closely allied, in relation 

 to hereditary transmission, is one of the most important problems requiring 

 scientific investigation by complete family histories and construction of 

 pedigrees, and I can conceive no more important work on the relation of 

 heredity to insanity than the following up, systematically, the history of 

 children born in the sane intervals of cases admitted to the asylum and 

 subsequently discharged. 



From the statistics of relatives a computation has been made of the pro- 

 portion of offspring who were born after the the first attack of insanity in 

 the parent; it was found that 46 offspring out of 581 were born after the 

 first attack of insanity in the parent, i.e., 7 '9%. That is to say, in the 

 case of 529 insane parents, the birth of only one-twelfth of their 590 off- 

 spring would have been prevented by sterilization or life segregation of the 

 parent after the first attack of insanity. These figures refer to the offspring 

 which become insane, but there are a large number of offspring who do not 

 become insane, and these would be cut off if life segregation or sterilization 

 were adopted. 



Single and Dual Neuropathic Inheritance. 



Every pedigree is a study in itself and occupies a whole book if sys- 

 tematically carried out as regards inheritance of characters, and the classi- 

 fication of the same is a matter of considerable difficulty. We have not 

 enough systematic pedigrees yet to form precise data and conclusions upon, 

 but perhaps I may be permitted to refer to indications from the examination 

 of pedigrees of three generations which I have obtained myself and com- 

 bined with those obtained by Dr. Wilson White and Dr. Daniel. I will 

 divide them into two groups : 



Group i. Those with a double pathological inheritance, that is, both 

 ancestral stocks show insanity, feeble-mindedness, drunkenness, epilepsy, 

 suicide, or nervous disease of various kinds, direct or collateral, within two 

 generations. In these 18 families there were 116 children born alive, and 

 100 reached adolescence, and among them were 39 insane, suicides, or 

 sufferers with nervous disease, and 61 apparently normal. Thus 39% of 



