The science of life : fully illustrated in tone and line and including many diagrams

BOOK 8

find that the outer layers of cells in his cerebral cortex were definitely underdeveloped. He is a congenital idiot; he has never had any mind worth mentioning.

Idiocy and imbecility may be caused by the most varied influences—any influences that retard or prevent the proper development of the cerebral cortex. ‘Toxic poisoning before birth, injuries at birth, water on the brain, and especially the inheritance of certain defective genes, are perhaps the most important. Perhaps the most striking fact about the condition is that nowhere between the grossest idiocy and the brilliancy of genius is there any sharp line to be drawn. The two extremes are connected by an unbroken series, via talent, ability, normal capacities, backwardness, mental defectiveness, mild imbecility. Some combinations of genes over-equip us for life ; others are a sad under-equipment.

Here is another patient, who looks miserable and depressed. If you talk to him you will find that he believes he is eternally damned, for he is a renegade from the Catholic faith. He would like to commit suicide, were it not that he is sure of going straight to hell if he did so. His will-power and his capacity for feeling normal emotion, he will tell you, have disappeared, together with his interest in the ordinary things of life. This feeling is the basis for his belief that he is damned; for his soul feels already lost. When left to himself he sits alone and broods all day. Fear, misery, and self-reproach make up _ his habitual state. Before he was brought to the asylum his wife had scoffed at his religious beliefs, which he cherished at the back of his mind long after he had given up being a practising Catholic, and in this gloomy state the thought of her unbelief fills him with fear and horror.

But this same man, the asylum doctor will tell you, will at other times be altogether different. There is then no sign of gloom, but he looks cocksure and confident ; he is bright-eyed and active—too active—with a running spate of talk. And his talk is the antithesis of what it was. He is now a thorough-going sceptic, and one who feels it his mission to destroy the superstitions of the credulous believers in revealed religion. What pleases him most is to get into religious controversy with one of the doctors or visitors ; the more distinguished his opponent the better—he likes a foeman worthy of his steel. But if he is thwarted, he flies into a violent passion ; and then you must look out that he does not smash up his furniture,

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THE SCIENCE OF LIFE

CHAPTER 7

or attack one of the attendants. If he thinks of his wife during this active violent phase, it will be to fly into a jealous passion on account of her propensity for going out with other men; though while he was in the melancholy phase it was impossible to arouse his jealousy at all. And at still other times he will be a normal human being for months together, and can then be discharged from the hospital.

He is what the psychiatrist calls a manicdepressive, a man in whom the exaltation and excitement of mania oscillates with the gloom and melancholy of depression. In one or other of its forms, the manicdepressive disorder comprises a very large number of asylum patients. It is one of the kinds of insanity which most often comes on and passes off again, leaving the patient normal between attacks. In its most interesting types, the depression and the excitement regularly alternate; and then, as in true multiple personality, the actual physical make-up changes with the mental. In the melancholic phase, secretions are diminished, temperature is often a little subnormal, and the “reaction-time,” or time needed to perform a simple voluntary action at command, is slow. The reverse holds for the excited phase—secretions of all kinds are over-abundant, the pulse is rapid, the reaction-time is very short. The attitudes adopted in the two phases are, we should expect, very different; a queer feature is that the maniac generally shakes hands with arm outstretched from the shoulder, the melancholic only from the wrist, with arm drawn into the side.

In our round of the asylum we shall find other cases who show only one of the two abnormal phases. Some are always depressed, and never pass into the excited manic state, while in others this is the only symptom of madness, and they never become melancholic. The chronic cases of either sort are very troublesome—the maniac grows violent, abusive and destructive, the melancholic must be constantly watched to prevent attempts at suicide.

What is disorganized here? It is the faculty of self-criticism, which in its turn is based upon a proper balance of the impulses of self-assertion and its opposite. In the normal man these two opposites are continually at work; self-criticism and sober judgment are the outcome of their balanced hostility. The machinery whereby one of the two impulses gets the upper hand completely is not yet fully understood, though it seems akin to that by which dissociation