334 H. M. POLLOCK, B. MALZBERG AND R. G. FULLER 



tient's childhood; the prevalence of mental and nervous diseases, mental 

 defect, alcoholism and criminality in the relatives of the parents, and in the 

 siblings of the patient, his wife (or husband) and children; the patient's 

 early environment; the composition of the household; his relations to step- 

 parents, foster-parents, or grandparents; the physical condition and char- 

 acter of the patient's early home; the patient's environment at the time of 

 onset of the disease; the developmental history of the patient; his social 

 history such as occupational record, sex history and marital relations; 

 and an account of all factors having a bearing on the onset of the psychosis. 

 It is thus evident that the final report will consider relationships in addition 

 to those usually included in a discussion of heredity. 



The study deals with 155 patients, of whom 60 were males and 95 females. 

 This agrees with the usual ratio of males to females found among all manic- 

 depressive first admissions to the New York civil State hospitals. The 

 females were older than the males, the average ages at first admission being 

 42.3 and 39.3 years, respectively. The average ages at the onset of the 

 psychoses were but slightly less, being 42.1 and 38.9 years, respectively. 

 Of the 60 males, 54 were described as of average mental status, and 6 as of 

 borderline mentality. Among the 95 females, 78 were of average mentality, 

 2 were morons, and 15 were of borderline intelligence. 



Table 1 summarizes the distribution of siblings in families of the patients. 



There was an average of 5.9 siblings per family among all patients. 

 Among the families of the male patients the average was 5.4, compared with 

 6.3 among females. These averages are high, and represent practically 

 completed families. They exceed the average size of families of schizo- 

 phrenic patients at the Bloomingdale Hospital as found by Dr. M. Bleuler, 

 but this is due largely to the fact that the two groups of patients come from 

 different social and economic levels. 1 



Table 2 summarizes the order of birth of the patients. 



From the fact that the female patients came from larger families, we 

 would anticipate that they are later in the order of birth. This is verified 

 by the average results which show 3.3 for males, and 3.8 for females. 



From this general description of the data we now turn to the problem 

 of heredity. In this analysis we shall refrain entirely from using the method 

 of genealogies, for such a method is, in this case, subject to gross errors arising 

 from subjective bias: Riidin has well described the weakness of this method 

 in his writings on inheritance in mental disease. 2 



1 See A Contribution to the Problem of Heredity Among Schizophrenics, in the Journal 

 of Nervous and Mental Diseases, Vol. 74, No. 4, October, 1931, page 397. 



2 See Vererbung und Entstehung Geistiger Storungen, by Ernst Riidin, especially 

 Chapter 1. 



