348 E. BLANCHE STERLING 



be due to the fact that none of them had reached the age when they might 

 have been expected to show reliable signs of latent or frank psychosis. 

 Hence the non-occurrence of actually developed psychotic behavior was not 

 indicative of the "psychotic potentiality" of the group. 



In order to check the parent-child mental relationship among Maryland 

 psychotics Dr. Preston examined the records of 1040 patients in the State 

 Hospitals to determine whether their parents had, in turn, been hospital- 

 ized. It was found that only 29 had psychotic parents. 



There is a low marriage rate among people who become psychotic, and 

 the sterility rate among those who marry is high. In addition, the actual 

 size of completed families of psychotics is small. The figures from a group 

 of State hospitals for the insane, comprising about 3070 matings show an 

 average of 2.9 children per patient. This is quite close to the number (2.4) 

 of children in the so-called "normal group" which was drawn from an upper 

 middle class suburban community, in which the families would tend to be 

 small. 



The difference in this respect between the insane and the mentally re- 

 tarded is shown in the contrast between the size of the families of the State 

 hospital patients and of families containing retarded children in Baltimore 

 public schools. In the former group there was an average of 2.9 children 

 per family; in the latter the average was 4.4. 



Since it has been shown that there is a low marriage rate, a high sterility 

 rate, and small families among the psychotic cases, it would seem that Day- 

 ton is justified in saying "it appears that this stock is barely holding its own, 

 if not actually decreasing." 



These findings certainly give support to the statement of Gill, when he 

 declared in 1930 that "the great majority of certifiable defectives are not 

 the progeny of mentally defective parents, and that sterilization of the in- 

 sane at any given period would have little effect on the number of in- 

 sane individuals in the next generation." These English and American 

 data "do not deny the hereditary nature of the liability to some forms of 

 insanity," but do call attention to a tremendously important fact. That 

 it is not the actually insane who constitute the real problem of mental hy- 

 giene from the eugenics point of view, but the stock which is subject to some 

 mental disease. The carriers are more dangerous than the cases. 



The control of the development of insanity means that we must bring our 

 preventive work to bear on the carrier. Control of the carrier of physical 

 disease results in lessened incidence of disease itself, and it is the carrier 

 problem that confronts us in mental hygiene. Perhaps it is too much to 

 assume that all members of a stock which had produced cases of insanity 



