Mental Illnesses

Among the gravest dangers threatening the human race is the danger of mental illnesses and their wide spread in our present day. In my talk tonight I shall try to disclose to you some of the regrettable facts and figures which the specialists have arrived at concerning mental illnesses, and which I see today threatening the civilized world.

I believe in the biological force residing in mankind, which will inevitably overcome mental weakness when the human mind begins its steady advance, until it succeeds at last in triumphing over mental weakness and reaching a good result compared with the present state. But this requires time and patience.

I am sorry to say that this natural defense against mental illnesses is not active in our age; indeed, its course is even reversed. These conclusions are not from our reports — we specialist physicians — but from the reports of the mathematicians, who study our experiments and our personal reports on the insane, draw their conclusions from them, and impose them upon us; and we in turn, compelled, broadcast them to the civilized world — would that it were in our power to better them.

The decisive conclusion on which the mathematicians ("Mathematician") have agreed, as the outcome of our studies and our mental reports, is that these illnesses are in steady increase, that the intelligence of mankind in general grows weaker day by day, and that the children born feeble-minded double in number every twenty years. Twenty years from today — if the mathematicians' claim is correct, and there is no justification for calling them liars — the number of those who come to hear a lecture such as this will be half what it is today, while the other half will be busied with trivial concerns, for it will have declined mentally and will no longer have the endurance to listen to a scientific lecture that demands thought.

Since the situation is so grave that the number of those afflicted with mental illnesses will double every twenty years, it has become imperative for us to hasten to avert the danger and decide our fate before the adversary crowds us out and we, or our children after us, become victims of this terrible disease.

England claims — and its claim may well be true — that the proportion of the mentally sound among its sons is the highest proportion in the world; yet even so, the number of the feeble-minded counted in its hospitals shortly before the last war reached 160,000, and their number was increasing at the rate of 16,000 cases every year. Statistics on this subject have not been published since the beginning of the war, but it is known that the number of the afflicted has approximately doubled from what it was before the war. In 1939 the number of the feeble-minded in the hospitals of Scotland reached 20,000. These figures do not include those born feeble-minded, but are confined to those stricken with imbecility as adults... And there are today in England 600,000 children afflicted with mental deficiency — a proportion of ten percent (10%) of the number of children in England. And this number is in steady increase.

The figures of the United States are no less grave than these. The number of the feeble-minded in the government hospitals for mental illnesses reached, in 1938, 500,000 patients, and the number was increasing at the rate of 16,000 every year. As for the number of children born with a touch of insanity, it has not been counted exactly, but it exceeds a million.

As for the East, the number of the insane and the rate of their yearly increase are no less calamitous than they are in the West. I incline to believe they are greater, for this disease embraces the whole world without exception, and there is not a single nation that can claim a natural immunity against it.

The time has come for us to declare openly that the number of persons who fall short of mental soundness is in constant increase, and if this increase continues at the present rate, it is not unlikely that in the near future the number of the simple-minded will overrun the number of the sane. I can almost hear you saying to me and to physicians like me who specialize in this disease: "What are you doing about this invasion? And if mental medicine has advanced greatly, as you claim, why do you not cure this ill-starred class?" My answer to this is that we do cure these insane, always; we cure them by the thousands and the millions. But the time has come for us to consult you in the matter and take your opinion as to whether we may go on curing this class and permitting it to return to society — to mingle, then to marry, then to breed?

We — the physicians — are not prepared to bear the responsibility and give our decision on the basis of medical systems; we wish the opinion to be yours, on the basis of social and moral systems.

Fifty years ago, a man stricken with a mental illness had scant hope of recovery, and if a report was given that he was insane, he was confined in a locked room for the whole of his life and was treated kindly in the insane asylum. Today the situation differs greatly from what it was then, and the man stricken with a mental illness is treated as a sick man — even in a state of frenzy, when the patient is dragged to the hospital by force, his hope of recovery is fifty percent (50%).

The modern methods of treating the insane guarantee to more than a third of them a complete cure — and by complete cure we mean that the patient will no longer need to consult a mental physician or enter a hospital. But there is one thing on which the physicians can exert no influence, since they have no authority over it as yet — namely, hereditary predisposition, for many mental illnesses come by way of heredity. And when we cure individuals of their mental illnesses and send them out into society as free persons, they have full liberty to marry and to sow the world with weak-minded offspring... whereas fifty years ago this class spent the rest of its life in the insane asylum, and breeding was out of the question.

This is the regrettable truth, and this is the reality. Are we right or wrong in curing these insane? Are we right in curing them and returning them to their society as free persons, loading humanity with fresh calamities? Or would it be more fitting for us to keep these insane inside the hospitals and not set them at liberty until we have made certain of their sterilization and of the impossibility of their breeding — to ward off the crisis of the increase of the insane with which we are concerned?

This judgment is not for the physicians to give; the judgment is yours — you, the thinking class of this world. And let your decision be swift, before the matter grows worse and the calamity overwhelms you.

Among my patients, in one of the hospitals for mental illnesses, was a woman with acute insanity — a disease which excites the patient to

such a degree of savagery that she becomes a danger not only to those close to her, but to herself as well. Had this woman lived fifty years ago, it would have been her lot to spend the greater part of her life in the hospital; but her case today is among those easily cured. We have not, however, been able so far to guarantee against relapse, and so the patient's visits were repeated whenever the acute fit of insanity returned to her; each time, her stay with us took no more than a few days to restore her to her original normal state.

The husband of this woman was a man among my patients, afflicted with the falling sickness, "epilepcy," and his regular visits to my clinic were the greatest barrier to his entering the insane asylum. But for this modern scientific treatment, the asylum would inevitably have been his fate. This treatment of the man and his wife opened to them the way to permanent union, and they begot thirteen children. Now seven of them are permanent inmates of the insane asylum, four have been admitted temporarily, and two have married — against my will.

What could I have done about this? The law obliges me to treat every patient individually according to the latest methods. The law forbids me to place anyone in the insane asylum unless his remaining outside constitutes a danger to the health of the patient or of those close to him. The law forbids me to keep the man's wife a single day in the hospital after she has recovered from her fit of insanity. So the two spouses go out into the world to multiply, and the number of the insane in our hospitals doubles, and we physicians stand with folded hands, unable to bear the responsibility and settle the matter without your opinion. Public opinion must help solve this problem before the time passes and we repent when the hour of repentance is past.

I can almost hear you saying: "Since the picture is so black, what led you to claim, at the opening of your talk, that you are not pessimistic about the results of improving the race in the coming generations? So long as mental illnesses are on the increase and the proportion of mental balance is in retreat, where is the justification for this optimism of yours?"

In answer to this I say: "Let us suppose that the efforts expended in treating mental illnesses stopped, and nature took its course: the strong would inevitably crush the weak, these mental illnesses would be consumed in the furnace of the mind, and the race would come out victorious in its mind, triumphant over its weakness."

This is the conclusion reached by the men of research on this subject, and they have built their theory on two principal factors:

The first factor is heredity. I have already made clear to you that the predisposition to insanity is transmitted by heredity; but it has been proved that the sound mind surpasses the sick mind in strength, and that, given sufficient time, it overcomes the weakness and proves its strength in the end. This struggle between the strong and the weak may take a stretch of time exceeding hundreds of years, but the strong will inevitably triumph and subdue the weak.

The second factor which will assure the victory of the sound mind over the sick mind is nature itself — nature, which takes precautions against every weakness that may befall it through the workings of the civilized world, and therefore keeps in reserve a vast supply of its children who have not yet been tainted by this disease and who still live far from the world of civilization.

The situation is developing from bad to worse, and it will grow worse still before it steadies and improves.

Our knowledge of the causes of this disease grows stronger day after day. We hope that a day will come when we can supply you with ample information about the crushing of this disease.

This requires time, but we have faith that we shall triumph in the end, and our long experience with the insane will be our best guide to the road along which we must direct you for the mental improvement of the race.

The number of those afflicted with mental illnesses has doubled during the last twenty years, and our knowledge of the causes and effects of these illnesses has multiplied more than ten times during the same period; and it will keep on increasing so long as we treat and study these unfortunates. This requires enormous expenditures. In England, ten million English pounds are spent on research into this disease. If it is granted us to continue our studies for another twenty years, we may arrive at an answer for you as to how we can cure mental illnesses.

The work is arduous, and the number of those laboring for it is small, and the East is still at the beginning of its awakening. For us to reach our goal and win our victory, we need three things: first, we need a great deal of money, to be spent on research and investigation.

Second, we need the help of a number of educated young women and young men.

Third, we need the sympathy of public opinion, its support, its understanding, and its appreciation of our efforts and studies.