Henry VI. of England, Eric XIV. of Sweden, Chris¬ and opposed by DrWarren. George III. was declared tian VII. of and Ivan the Terrible of Russia. sane by the English judges. Dr. Willis was given Much stress has been laid on the case of Charles II. a pension of 7,500 annually for twenty-one years, of Spain, who concluded the which ruled and his son one of 3,250 annually, for life. Insane Spain for nearly four centuries; but the European paroxysms recurred from time to time, until it became difficulties resulting therefrom would probably have demonstrated that the case was a chronic one, and a occurred on the extinction of the dynasty irrespective regency was established. George III. reigned fifty- of the mental state of its last member. The instances eight years. of most importance were those of George III., Chris¬ The same arbitrary characteristics and artistic tend¬ tian VII. of Denmark and Ludwig of Bavaria. encies, but with greater demonstrable sexual perversion George III., though the scion of a dynasty created and greater intellectual powers were legally shown to by a parliament representative of the people and des¬ be present in Ludwig of Bavaria and Christian VII. titute of hereditary right, attempted throughout his of Denmark. reign to be an absolute . His shrewd grandfather Christian VII. was coarser but less hypocritical in gave him credit in boyhood for just sufficient intelli¬ sexual debauchery than George III. He was equally gence to read to his mother. In mental make-up he suspicious, and while he had greater intellectual resembled closely his famous insane ancestor, Ernest power than George III. in art, science, music and the Pious of . His mother had filled him architecture, he was as inventively stupid in political with religious cant just sufficient to make him conceal matters. Neither of the two compared for political his liaisons in brutal fashion. He had an admiration foresight with Ludwig of Bavaria, the patron of for art of the artificial, weak, classic style; for music Wagner. Wagner would probably not have risen to of the street band style; for drama of practical joke, the height he did but for Ludwig, whose musical and realistic type, and for church architecture of packing- artistic criticism of the performances he insisted on box type. In these proclivities he displayed less enjoying alone, prepared Wagner for the onslaught intellectual power than his morally insane son, George he later encountered. IV., than Christian VII. of Denmark, or than Ludwig Ludwig, in 1867, then at the height of his renown, of Bavaria. In all these particulars he closely resem¬ courted at once by France, Prussia and the ultramon¬ bled his descendant, William II, of Germany. George tanes, highly esteemed as a discerning patron of art III. was several times violently insane and died chron¬ and music, met Morel, whose keen eye saw the mental ically insane. and physical stigmata of degeneracy, and who prophe¬ The country was ruled as a regency for several sied the coming catastrophe. Ludwig, by siding with years by the moral imbecile afterward George IV., Prussia, enraged the ultramontanes. All the material who himself had delusions about having won the they had collected was (like that collected by the battle of Waterloo. George III. was, like all para- Prussian agrarian party against William II.) placed noiacs, most dangerous when least demonstrably in the hands of the socialists. In 1384, the Zurich insane. During his periods of seeming lucidity he Social Demokrat detailed his mental and moral defects had all the cunning, inventive, stupid egotism of the and paralleled them with those of Nero. By June, paranoiac and, as Green (" History of the English 1886, Prince Luitpold, the king's uncle, was pro¬ People") remarks, the shame of the darkest hours of nounced regent, the immediate heir to the throne, English history lie wholly at his door. Lord Chatham, Otho, Ludwig's brother, being a paranoiac with homi¬ whose counsels might have thwarted much of this cidal tendencies. June 12, 1886, Ludwig drowned shame, was stricken down with gouty insanity during Dr. Gudden and himself. Otho became king, but the critical period of the American troubles. The Luitpold remained regent. Americans were taxed in defiance of Chatham's denunciation of the unconstitutionality of this and LEGISLATION AGAINST DEGENERACY. King George III. ruled the country through the min¬ One of the results of the vulgarization of the Lom- istry formed by Chatham. Harsh laws, repellant to brosian theories of human degeneracy by such works the spirit of the English common law, made death as those of Nordau and others, has been to give rise the penalty for almost all offenses against prosperity to a number of rather noteworthy propositions, some of person, in order to swell the coffers of the King of which it has been proposed to realize by legislation. with goods confiscated from the felon. A bill is said to be now before the Texas legislature, George III., when he became demonstrably insane, prohibiting the marriage of those affected with any was placed under the care of Dr. Willis, who kept serious hereditary disease or taint; an act has, it is said, a private insane hospital conducted on excellent prin¬ been passed in Connecticut forbidding the marriage ciples. When the paroxysmal excitement quieted of epileptics, and other similar legislation will prob- down, the tories asserted the king had recovered, and ably be attempted in other quarters. The difficulty in this were supported by Dr. Willis and his son, with all these propositions is not that they are not

Downloaded From: http://jama.jamanetwork.com/ by a Simon Fraser University User on 06/03/2015 good in themselves, at least in purpose, but that they can be kept of every individual's disabilities. This are all more or less impracticable. Besides the diffi- will not be open to the public, but is intended to serve culty of quelling or restricting the strongest animal as a check upon the declarations made by the parties, impulses, that is met with everywhere in the endeavor so that the State can intervene and prevent dangerous to keep up and improve the moral standard and meet alliances, for the public good. the needs of ordinary social morality, we have in this Dr. Toulouse's plan is in some respects better con¬ case an attempt to meet much less tangible conditions sidered than most of the others, but will be of interest which can sometimes even altogether escape detection. to see how it is received in France where the question Moreover, the public sense of justice would revolt of population is at the present time an important one, Sometimes against a strict construction and execution and such a check on marriage and the consequent of laws that restrict natural rights in cases where legitimate multiplication of citizens is hardly in the there is, as there may easily be, a possible doubt of line of the reforms for "which French economists are their applicability. In case of tuberculosis, for example, mostly concerned. It is for quantity rather than which is one of the diseases it is proposed to make a quality of population that they appear to be now most bar to marriage, we have learned to recognize, of late anxious, and the demands of modern European mili¬ years more than ever before, that it is an almost uni¬ tarism will have to be first considered. Even were versally disseminated infection from which few of us such plans perfectly satisfactory and practicable it is entirely escape and yet from which also the recoveries doubtful whether they could be adequately carried are much more numerous and complete than had hith¬ out so as to yield results that will show their utility, erto been supposed. Epilepsy also is a symptom and this is true of the comparatively well considered indicating cerebral instability, but it by no means inva¬ proposition of the French alienist as well as of the riably indicates an incurable organic defect. How is cruder attempts of the Texas and Connecticut legisla¬ a law against the marriage of epileptics to be enforced tors. It is a question as open to differences of opinion strictly when we know that there are many individuals as are any of the economic questions of the day, and who have had perhaps only one or two fits in the it is hard to say whether after all a laissezfaire policy course of a long life; or who have perhaps at some is not the best. The prohibition of the marriage of critical period had them frequently and none at any idiots, imbeciles, and the actual or periodic insane time thereafter? Nevertheless they can never be said may be a legitimate and practicable method of pre¬ to be absolutely free from the liability to the taint of venting the propagation of degeneracy, and the same epilepsy. As regards insanity, we yet know compara¬ may be said of the legal prohibition of consanguineous tively little of the real conditions underlying most marriages, though this is to some yet an open ques¬ types of mental disease, and there are very many cases tion ; but any such wholesale enactments as those pro¬ where injustice might be done by the legal disability posed are questionable. Degeneracy is largely an imposed by the proposed legislation. incident of evolution, at least in some of its details, The chief defect of all these proposals is that they and according to the law of natural selection so far as are too vaguely stated and provide no method for the it applies to men, carries with it its own cure. It is rational carrying out of the reforms they advocate. a direct result of human progress, a necessary con¬ The difficulties in their way seem to be not fully comitant of our civilization, and the increase of in¬ appreciated and the legislation is in this respect incon¬ sanity and other evils just now so prominent and siderate. One of the most elaborate and complete of alarming are only incidents in the general line of these projects is reported from France, where Dr. human advance. They are partly, at least, only signs Toulouse, a well known writer on mental diseases, of the higher standards of philanthropy that now who has recently also been prominently before the prevail, as compared with those of former periods, public as the author of a rather sensational analysis and the better statistical information of the present of a noted French novelist, is the author. He pro¬ day. As yet our information as to the causes of poses that epilepsy, mental weakness, cancer, syphilis, human defectiveness is incomplete, and we do not alcoholism, and tuberculosis should be made legal know that it would greatly add to the sum of human obstacles to marriage, and that persons intending to happiness to interfere very radically with the ordinary marry should declare these diseases before the mar¬ course of events in these respects. riage, and failure to do so shall be a legal ground for We will have, however, to expect more propositions divorce or for fine in case a defective offspring results. of this kind in the future, as an inevitable result of If marriage is insisted upon in spite of and after the diffusion of information or misinformation on declaration, the State shall have the right to interfere scientific or pseudo-scientific subjects, which always and prevent its consummation. has as one of its first effects the starting up of reformers. It is further proposed in Dr. Toulouse's plan that But while we are unable to legally suppress sexual physicians shall be compelled by law to report to the immorality the possible danger of such reforms is authorities all cases of these disorders, so that a record that they would only increase the number of illegiti-

Downloaded From: http://jama.jamanetwork.com/ by a Simon Fraser University User on 06/03/2015 mate degenerate's. The only real safeguards against 9. Two hundred and fifty Bassini Operations for the Cure of Hernia without Mortality. W. B. Degarmo, New York, N. Y. the propagation of degenerates are to be looked for in 10. The Sac in Inguinal Hernia. D. W. Graham, Chicago, 111. the higher moral education of the public, and the 11. Animal Suture, Its Preparation and Technique of Appli¬ cation. H. O. Marcy, Boston, Mass. cultivation of higher practical moral standards. 12. The Diagnosis of Minor Personal Injuries and their Rela¬ tion to Accident and Insurance Associations (with illustra¬ H. RAILROAD THE tions). L. Montgomery, Chicago, 111. RATES TO JUBILEE MEETING. 13. Appendicitis in its Relation to Life Insurance. D. W. Advices have been received from the Traffic Asso- Graham, Chicago, 111. 14. Report of a Case of Cyst of the Appendix with Presen¬ ciation of a uniform rate of a fare and one-third for tation of Specimen. E. E. Montgomery, Philadelphia, Pa. railways in the east of the Missouri River 15. Surgical Managements of Appendicitis. Joseph Price, territory Philadelphia, Pa. and west of Chicago, Peoria and St. Louis, on the 16. Pelvic Surgery. Mordecai Price, Philadelphia, Pa. in certificate plan. This includes : 17. The Differential Diagnosis of Surgical Lesions the Right Half of the Abdomen and Pelvis. George R. Fowler, Atchison, Topeka & Santa Fe Railway; Burlington, Brooklyn, N. Y. Cedar Rapids & Northern & Alton 18. Anchoring the Kidney. R. Harvey Reed, Columbus, Ohio. Railway; Chicago 19. Calculi in the Ureter. Weiler Van Hook, Chicago, 111. Railroad; Chicago & Northwestern Railway; Chicago, 20. The Comparative Merits of Different Operations for Burlington & Northern Railroad; Chicago, Burling- Stone in the Bladder. J. B. Deaver, Philadelphia, Pa. 21. Suprapubic Cystotomy, with a Report of Fifty Cases. ton & Quincy; Chicago Great Western Railway; Chi- John A. Wyeth, New York, N. Y. cago, Milwaukee & St. Paul Rock 22. Photography of the Bladder. W. K. Otis, New York, N.Y. Railway; Chicago, 23. A Hypospadias Operation. R. T. Morris, New York, N. Y. Island & Pacific Railway; Chicago, St. Paul, Minne- 24. Ligation of the Dorsal Vein of the Penis for the Cure of apolis & Omaha Railway; Hannibal & St. Functional Impotence. J. A. Murray, Clearfield, Pa. Joseph 25. The Dangers of Clap. F. C. Valentine, New York, N. Y. Railroad; Illinois Central Railroad; Iowa Central 26. Stone in the Common Duct. W. E. B. Davis, Birming¬ Railway; Jacksonville & St. Louis Minne- ham, Ala. Railway; 27. Demonstration of Technique of the Roentgen Rays, with apolis & St. Louis Railroad Co.; Missouri Pacific the Practical Application to Surgery. Illustrated by Stereop- Railway; Rock Island & Peoria St. Louis ticon Views. A. W. Goodspeed, Philadelphia, Pa. Railway; 28. The Treatment of Ununited Fractures. Edward Martin, & San Francisco Railroad; Sioux City & Pacific Rail- Philadelphia, Pa. road; Wabash Railroad; Wisconsin Central Lines. 29. Ichthyosis Papillaris Lingua?, with Report of Case. Joseph Ransohoff, Cincinnati, Ohio. 30. Treatment of Abscess of the Lung. Carl Beck, New York, N. Y. 31. The Use of Dry Heat and a High Temperature for the Treatment of Chronic Joint Affections, with a Report of Cases. Railroad Rates. W. E. Wirt, Cleveland, Ohio. 32. Unnecessary Complications in Operative Surgery. John Rankin, Ill., April 12, 1897. B. Roberts, Philadelphia, Pa. To the Editor:\p=m-\Will you please inform me what rates can 33. The Present Status of the Injection Treatment of Hem¬ be secured for physicians and their wives for transportation to orrhoids. L. H. Alder, Jr., Philadelphia, Pa. attend the of the American 34. Transperitoneal Ligation of the Iliac Artery, with Report meeting Medical Association in of T. Pa. and Cases. S. K. Morton, Philadelphia, June oblige? Yours truly, J. R. Lytle, M.D. 35. The Etiology and Classification of Tumors. S. H. Answer.\p=m-\Oneand one-third fare from all points for the Friend, Milwaukee, Wis. round trip. 36. Report of 200 Cases of Inoperable Sarcomata Treated by Injections of Mixed Toxins. W. B. Coley, New York, N. Y. 37. Serum Therapy in Acute Surgical Infectious Diseases. ASSOCIATION NEWS. Howard Lilienthal, New York, N. Y. 38. Amputation in the Treatment of Malignant Disease. C. A. Minn. Dinner of the Section of the Practice of Medicine.\p=m-\The of Wheaton, St. Paul, dinner 39. The Technique of Pirogoff's Amputation. G. G. Davis, the Section of the Practice of Medicine of the American Med- Philadelphia, Pa. ical Association will take place at 7 o'clock on the evening of 40. a, The Treatment of Colles Fracture ; b, The Passing of June 1, 1897. Gentlemen desiring to attend this dinner will Plaster. E. A. Tracy, Boston, Mass. 41. Morbus Exsection with Movable Joint Case. send in their names at once to Dr. J. H. Musser, 1927 Coxarius, ; please J. B. Cokenover, Des Moines, Iowa. Chestnut street, Philadelphia, Chairman of the Section. The 42. Gangrene of the Foot due to Uterine Myoma. S. H. subscription will be $2.00 if one hundred attend, and $3.00 if Weeks, Portland, Me. less than one hundred attend, so that it will be necessary for 43. Cicatricial Stenosis and Valve Formation as a Cause of with of Five Cases Relieved the list to be filled as as Pyloric Obstruction, Report by subscription early possible. Operation. W. J. Mayo, Rochester, Minn. Section on Surgery and Anatomy.\p=m-\Preliminaryprogram. Section Dinner, Tuesday, June 1 ; 7:30 p. m. 1. Address of the Chairman. Reginald H. Sayre, New Price of tickets S3, without wine. Those desiring to attend York, N. Y. the dinner who have not already notified the Chairman will 2. of the Common for a, Ligation Carotid Artery Trifacial please send their names to Dr. Reginald H. Sayre, 285 Fifth Neuralgia, with Experiments and Observations on Dogs ; b, Avenue, New York, N. Y. Specimens and Charts of the Arterial and Nervous Systems, illustrating the paper. B. Merrill Ricketts, Cincinnati, Ohio. Section on Obstetrics and Diseases of Women.—Preliminary pro¬ 3. The Nerve Element in Surgical Pathology, J. McF. gram : Gaston, Atlanta, Ga. 1. Address of Chairman. Milo . Ward, Topeka, Kans. 4. Operative Procedure for the relief of Occlusion of the 2. A Consideration of Some of the Conditions Influencing Jaws. I. Ewing Mears, Philadelphia, Pa. the Results of the Surgical Treatment of Uterine Retroposition. 5. Improvement of Brain Function by Surgical Interfer¬ Augustus P. Clarke, Cambridge, Mass. ence. Ernest La Place, Philadelphia, Pa. 3. Pathological and Surgical Complication in Abdominal and 6. Demonstration on the Cadaver of a new Surgical Engine. Pelvic Disease Requiring Supra-pubic Sections for their M. H. Cryer, Philadelphia, Pa. Removal. Joseph Price, Philadelphia, Pa. 7. Hernia of the Cecum. J. H. Gibbon, Philadelphia. Pa. 4. The Technique of Vaginal Section, Exclusive or Hysterec¬ 8. One of the Rarer Forms of Hernia. Frank Stahl, Chi¬ tomy, for Diseased Appendages and Small Pelvic Tumors. cago, 111. Augustin Goelet, New York City.

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