TABLE I. 

 Statistics of 3,042 Related Cases in the London County Asylums. 



The above table shows the proportion of males to females; the latter 

 are much more numerous ; it will be observed that owing to a lower death- 

 rate of the females, they tend to accumulate. This is no doubt due to 

 the fact that general paralytic males are three times as numerous as 

 females, whereas other non-fatal forms of insanity are much commoner in 

 females. It will be observed that of the 3,042 relatives who are at present 

 or have been in the London Asylums 1,533 still remain resident, a little 

 more than half. I shall have occasion later to refer at length to some 

 important deductions made from the age incidence of the first attack of 

 insanity in these insane relatives. 



Nature and Nurture. 



)C No child is born insane, though it may be born feeble-minded either 

 from actual organic disease or inborn germinal cerebral deficiency^ The^ 

 fojrmer being an acquired character is not heritable^Ca fact of verjrcorF^ 



^siderable importance in diagnosis and segregation witrrtrie~ view of pre-? 



^-vention of transmission of feeble-mindedness. 



We should endeavour to study every case of nervous or mental disease 

 as a biological problem, ascertaining as far as possible what the individual fc 

 ^as born with, ancestral inheritance (Nature) ; what happened during., 

 development after conception (congenital) ; finally what happened at 

 <va^ter^bnj;j! . (mirlur.^. The collection of statistics and pedigrees merely 

 relating to the question of certifiable insanity or epileptic fits is quite 

 inadequate for scientific purposes, as the neuropatJtic predisposition mani- 

 fests itself in many ways ; and it is necessary to seek the first stages and 

 less obvious conditions of degeneration in a stock. Morel, who studied 

 this question more than fifty years ago, pointed out that nervous irritable 

 weakness, the neurotic temperament, neurasthenic predisposition, may be 

 the first evidence of degeneration of a stock. The inborn morbid neurotic 

 temperament may be manifested in a variety of ways by the behaviour 

 and conduct observed in various members of the stock. The signs of 

 degeneracy which may be exhibited are self centred narrow-mindedness in 



