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INCREASING YOUR 
 MENTAL EFFICIENCY 
 
Heredity and Mental Defect 
 
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Increasing Your 
 Mental Efficiency 
 
 By 
 
 Edward Huntington Williams, M.D. 
 
 Formerly Associate Professor of Pathology in the State 
 
 University of Iowa; Assistant Physician, New York 
 
 State Hospital Service. Author of "The Walled 
 
 City; A Story of the Criminal Insane," "The 
 
 Question of Alcohol," "The Wonders of 
 
 Science in Modern Life," etc., etc. 
 
 Illustrated 
 
 Hearst's International Library Co. 
 New York MCMXiv 
 
Ab^'s^I 
 
 Copyright, 1914, by 
 Hearst's Ihtesnatiohai. Libbabt Co., Iho. 
 
 All rights reserved, including that qf translation 
 into foreign languages, including the Scandinavian 
 
CONTENTS 
 
 CHAFTEB FAQB 
 
 I Caring foe the Child's Mind ... 11 
 
 II Mild Forms of Disturbed Equilibriitm 47 
 
 III Danger Signals 68 
 
 IV Nourishing the Mind 95 
 
 V Stabilizing the Faculties .... 112 
 
 VI The Problem of Ancestry and Envi- 
 ronment 156 
 
 VII Increasing Our National Efficiency 175 
 
 Vni A National Movement to Improve 
 
 Mental Efficiency 224 
 
ILLUSTRATIONS 
 
 Heredity and Mental Defect . Frontispiece 
 
 FACINQ FAOE 
 
 The Old vs. the New- 
 Hogarth's " Bedlam" 
 Patients ' Tea Party in a State Hospital 66 
 
 Structural Changes in Mental Diseases . 114 
 
 Patients Playing Croquet at St. Lawrence 
 
 State Hospital 176 
 
INTEODUCTION 
 
 rpHE care of the mind involves development, 
 ■■■ education, and training. The terms are by 
 no means synonymous. A highly developed mind, 
 for example, is not always a well-balanced one. 
 If not, it offers proof that too many years and too 
 much energy have been devoted to mental develop- 
 ment at the expense of proper training in correct 
 introspective judgment. 
 
 That the number of badly balanced persons is 
 increasing is shown by hospital records. It is an 
 open secret that insanity is steadily making head- 
 way — increasing at a rate out of proportion to 
 the growth of our population. And this at a time 
 when Education is the watchword of every com- 
 munity, and when illiteracy is steadily decreasing 
 in all portions of the civilized world. 
 
 But actual insanity is simply the more tangible 
 form of disturbed mental balance; and for each 
 person who exemplifies this extreme degree of 
 aberration there are scores who suffer from purely 
 mental maladies far less patent to the casual 
 observer but nevertheless just as surely the result 
 of disturbed mental balance. The vast army of 
 " neurasthenics " — a horde that has been steadily 
 
 7 
 
8 Introduction 
 
 increasing since the days of our grandfathers — 
 offers evidence that mental hygiene is not keeping 
 pace with hygiene of the body. And the existence 
 of that still larger army— those peculiarly endowed 
 persons who are able to cure their imaginary ills 
 by the simple process of believing that the ills 
 are imaginary — demonstrates that a vast number 
 of persons are suffering from maladjustment of 
 their mental balance-wheels. 
 
 For we must always bear in mind this fact: 
 The diseased conditions of the mind which per- 
 vert the judgment in one individual to make him 
 a lunatic, in another to produce hysteria or neu- 
 rasthenia, and in a third, the plastic medium of 
 the faith healer, are dangerously close of kin. In 
 most instances the ailment represents a differ- 
 ence in degree rather than a difference in kind. 
 And one condition lapses into the other so imper- 
 ceptibly that not even the wisest physician can 
 say where one ends and the other begins. 
 
 When, therefore, the psychiatrist warns us that 
 we are showing grave symptoms of a nation 
 afflicted with " nerves," he is simply telling us 
 metaphorically that our minds are not being well 
 cared for, and are showing the effects of misuse. 
 
 Professor Dubois recently expressed this in 
 more direct and unmistakable terms. ' ' There are 
 some individuals whose reason is disturbed and 
 whose actions are guided by strange sentiments, ' ' 
 says Dubois. ' ' When the mental disorder is very 
 
Introduction 9 
 
 pronounced we confine these patients as madmen 
 or lunatics. They are numerous, for, according 
 to statistics, it is necessary to consign nearly ten 
 persons out of a thousand to the asylum. In 
 slighter degree, the disease permits of the sub- 
 ject living still in society, though his actions may 
 be peculiar and often culpable; we speak then of 
 the semi-insane or unbalanced, and endeavor to 
 establish the degree of their responsibility. 
 Finally, when the mentality of the patient ap- 
 proaches the normal, and somatic functional symp- 
 toms seem predominant, the pathological condi- 
 tion is termed a neurosis. These ' nervous ' cases 
 constitute the great bulk of the clientele of the 
 neurologist, while the psychoses properly so- 
 called belong to the domain of the alienist. * * * 
 There are only differences of degree between these 
 conditions. In all of them we find abnormal states 
 of mind." 
 
 In other words, this ever increasing army offers 
 proof that we have over-exerted ourselves in the 
 direction of mental development at the expense 
 of mental poise. At the same time it suggests 
 that it is high time to consider the balancing, as 
 well as the developmental process. To do this we 
 must raise mental hygiene to the level of physical 
 hygiene, so that soundness of mind will be con- 
 comitant with soundness of body. 
 
Caring for the Child's Mind 
 
 "T ^rHETHEE a person becomes nervous or 
 " ' not," says Professor Lewellys F. Barker, 
 " depends upon two great factors (a) the consti- 
 tution he inherits from his parents and through 
 them from his ancestors generally; (h) the influ- 
 ences to which his body, especially his nervous 
 system, is exposed during Ufe, and particularly 
 during childhood." 
 
 The italics are my own. For I believe that it 
 is almost impossible to overestimate the impor- 
 tance of the first few years of life, in determining 
 the physical and mental condition of the adult. 
 It is possible to wreck the physique of the man 
 by a few years of improper feeding and hygiene 
 in childhood. The distorted little figure of the 
 hunchback offers convincing evidence. Yet those 
 familiar with psychic abnormahties know that 
 the proportion of mental dwarfs and hunchbacks 
 is far greater than those showing physical defects 
 — individuals whose minds have been distorted by 
 bad mental pabulum administered in childhood. 
 The two conditions often go together. But as a 
 
12 Increasing Your Mental Efficiency 
 
 rule, improper nourishment is the penalty of 
 poverty, while bad mental training is observed 
 more frequently in the upper walks of life. 
 
 But in any station in life it is possible to pro- 
 duce one or both conditions, by improper nourish- 
 ment and care during childhood. Improper care 
 of the child's physical condition is frequently the 
 first direct stepping-stone to a regime of bad 
 mental traiaing. Thus the mother -who allows the 
 caprice of the child to influence her in selecting 
 its diet, is courting two dangers — ^physical deteri- 
 oration and mental perversion. Once the child 
 learns that its capriciousness about diet may be 
 gratified through wilfulness, it has entered the 
 highway leading to improper nourishment. The 
 result is inevitably a puny, sickly child, stunted 
 intellectually, and often morally depraved. 
 
 The remedy for food-caprices is obvious: the 
 child should be taught to eat what we know it 
 should eat, regardless of its likes and dislikes, 
 which, after all, are not strongly developed in 
 childhood. " The child that learns to eat and 
 digest all wholesome foods," says Professor Bar- 
 ker, ' ' and who is not permitted to cultivate little 
 food antipathies, makes a good start and avoids 
 one of the worst pit-falls of life with which medi- 
 cal men are very familiar, namely a finical anxiety 
 concerning the effects of various foods, all too 
 likely to develop into a hypochondriacal state." 
 
 In the days of our grandparents it was cus- 
 
Caring for the Child's Mind 13 
 
 tomary to allow the cMld a wide latitude in kinds 
 of food, even very young eliildren eating the same 
 foods as their elders. Later came the fad of 
 giving children measured portions, and greatly 
 restricting the variety in diet. But the accepted 
 modern method is a more rational intermediate 
 course between these two extremes. Give the child 
 a liberal variety of simple foods, such as meat, 
 vegetables, and fruits, avoiding such things as rich 
 pastries, and such beverages as tea, coffee, and 
 alcohol. 
 
 For it has been found by practical experiment, 
 and laboratory observations, that a variety of 
 foods tends to increase digestive powers ; and that 
 even indiscretions of diet, although temporarily 
 distressing, tend to make the child hardy. Pam- 
 pered children are likely to have weak digestive 
 tracts — largely because those tracts have never 
 been called upon to resist improper foods. The 
 little urchin who munches green apples, green 
 cucumbers, and almost anything else that gets 
 within reach, is flirting with colic and other dis- 
 tresses. But the colic is seldom of very serious 
 nature; and it is a matter of common observation 
 that these same children rarely have digestive 
 troubles later in life. 
 
 Of course no one would advise feeding green 
 apples or cucumbers to youngsters, although they 
 will surely eat them occasionally without help or 
 knowledge of their elders. But, nevertheless, there 
 
14 Increasing Your Mental Efficiency 
 
 is a measure of compensation for such indiscre- 
 tions, m the fact that the occasional eating of 
 improper food is unlikely to have a deleterious 
 effect upon a stomach accustomed to a great va- 
 riety in diet — a digestive tract that is able " to 
 meet all comers," so to speak. The child that has 
 developed that kind of a fighting stomach will not 
 be found later in life measuring his portions in 
 deadly grams and cubic centimeters, or choosing 
 his rations for the " calories " they represent, 
 fletcherizing, or dabbling in " health-food " fatui- 
 ties, which are the highways to dypepsia and the 
 dispensary. 
 
 Giving the child a variety of simple foods, then, 
 is simply a practical system of hardening his in- 
 ternal organs, and preparing them for the battle 
 of life. A somewhat analogous system of l;iarden- 
 ing the nervous and muscular systems should be 
 pursued at the same time. Indeed one system 
 should supplement the other. 
 
 Building up Resistance 
 
 Most mothers dress their children too heavily, 
 particularly in infancy, before the little ones have 
 reached an age at which they can express their 
 feelings intelligently. But during the first few 
 months of life this is of little consequence if 
 practiced consistently. "When the child begins to 
 run about, however, a gradual course of judicious 
 
Caring for the Child's Mind 15 
 
 hardening of the body is most desirable, to 
 strengthen the resistance to colds and other dis- 
 eases; and to insure an indifference to climatic 
 changes later in life. An active child requires 
 less clothing than an adult, and, unless it is of the 
 non-reacting, feeble type, should be clothed much 
 lighter. In this way the skin becomes hardened 
 to ordinary changes of temperature, sometimes to 
 an astonishing degree, and this condition will per- 
 sist through life, and be a great source of comfort 
 in our changeful climates. 
 
 A robust child should be given a cool bath every 
 morning, and should of course be encouraged to be 
 out of doors taking bodily exercise most of its 
 waking hours, regardless of weather. It is as- 
 tonishing how immune to colds and common child- 
 hood complaints such children become — sturdy 
 little citizens, well-equipped to battle successfully 
 with the great problems of life, the most important 
 of which is health. 
 
 Strengthening the constitution, if we may so 
 call it, increases the resistance to pain. And this 
 resistance produces an insensibility, or indiffer- 
 ence, particularly in children who play with other 
 youngsters of their own age, unhampered by the 
 solicitous supervision of a doting parent. For 
 children make light of the bumps and trifling hurts 
 of their companions, and learn to regard their 
 own injuries with indifference. Thus an obtuse- 
 ness to trifling injuries lays a secure foundation 
 
i6 Increasing Your Mental Efficiency 
 
 for resisting, with proper fortitude, those greater 
 injuries, both physical and mental, that will surely 
 come later in life. In this manner a most bene- 
 ficial psychic and physical hardening process is 
 accomplished. 
 
 A child whose physical training has been along 
 the lines just outlined until its tenth year, let us 
 say, has taken a tremendous stride toward sound 
 physical adult life. If its mental training has 
 been correspondingly good, we may predict with 
 greatest certainty that, barring some extra- 
 neous calamity, such a child will round into 
 full manhood, or womanhood, with considerably 
 more than even chances for a long, vigorous 
 life. 
 
 It is obvious, therefore, that the principles of 
 mental hygiene should be applied at quite as early 
 an age as those of physical hygiene. They should, 
 indeed, begin in earliest infancy. For the task is 
 most important, and requires far greater intelli- 
 gence and persistence on the part of the instructor, 
 than mere physical training. The kind of mental 
 training that the child receives during the first six 
 or seven years of its life may taint or tarnish its 
 entire future. Obviously, then, the common type 
 of nursemaid is quite as incompetent to direct the 
 child's mind, as to supervise the later, or " finish- 
 ing-school " stage. Indeed, an ignorant nurse- 
 maid would do far less harm in a boarding-school 
 than in the nursery. 
 
Caring for the Child's Mind 17 
 
 Harmful Early Impressions 
 
 It is impossible to overestimate the effect of 
 early impressions upon the mind of a sensitive 
 child. If you will think back over your own child- 
 hood for a moment, I venture to predict that you 
 will recall some early (and probably false) impres- 
 sion that you still remember vividly, to bear out 
 my assertion. It is not merely the baleful effect 
 of momentary mental tortures that children suffer 
 from such impressions as fear of the dark, fear 
 of goblins, and fantastic animals, that is impor- 
 tant, but suppressed fears that may cause actual 
 insanity later in life. The child that is instructed 
 properly is unlikely to become a prey to these 
 haunting fears, because it develops a rational, in- 
 stead of a superstitious trend of mind — an atti- 
 tude that tends to keep the ship of mentality on 
 an even keel, even m the roughest waters. 
 
 Children with bad heredity require more care- 
 ful instruction than those with a good heritage. 
 But unfortunately these delicately balanced chil- 
 dren usually live in a tainted atmosphere, even 
 when their actual instruction is excellent, since 
 one, or both of their parents are neurotic. Chil- 
 dren learn quite as much from observation of the 
 deportment in their associates, as by any course 
 of didactic instruction. Indeed, it still remains 
 an open question as to just how much inherited 
 instincts are responsible for the peculiarities in 
 
i8 Increasing Your Mental Efficiency 
 
 the children of neurotic parents, or to what extent 
 environment influences the child. Both conditions 
 play an important part, and undoubtedly environ- 
 ment tends to develop the inherited tendency to 
 instability. 
 
 There can be no doubt, however, that even a 
 nervous child with a bad heredity may have its 
 mental balance firmly centered by proper environ- 
 ment. We see examples of this in orphan asylums. 
 On the other hand, the bad example of parents 
 may produce distressing nervous conditions even 
 in children of stable organization and good 
 heredity. 
 
 " In this domain of nervous diseases it is easy 
 to prove the contagion of example," says Dubois. 
 " We see little girls imitate their nervous father 
 or hysterical mother, throwing themselves upon 
 the sofa at the slightest fatigue and complaining 
 of backache and headache. They are sensible to 
 all exterior influences, cannot take food which they 
 do not like, and become unnerved like their 
 mother. They play so well the part of little nerv- 
 ous women that they are caught in the snare and 
 become so really. Nervous parents, think of this 
 danger of moral contagion." 
 
 What is to be done with a nervous child placed 
 in such surroundings ? The remedy that suggests 
 itself is removal to other surroundings. But this 
 is usually impracticable, and for several reasons 
 is not desirable if such a change implies denying 
 
Caring for the Child's Mind 19 
 
 the child parental care. We could, indeed, correct 
 many of the tendencies to nervous outbreaks in 
 the child by making its surroundings similar to 
 those of the " institution children " reared in 
 children's homes. But while such surroundings 
 stabilize the nervous system, they also stifle the 
 higher psychic centers, because in such places the 
 subtle " mother's influence " is wanting. In a 
 phrase, the institution reared child tends to be 
 stable, stoical — and stupid. And stupidity is a 
 poor substitute for individuality, even though that 
 individuality be neurotic. 
 
 The only practical method at our command is 
 to impress upon parents the importance of teach- 
 ing by example, particularly in little, and appar- 
 ently inconsequential things. One of these ap- 
 parently unimportant things is the use of the 
 word " nervous " by many neurotic parents. 
 These persons use the term to express their own 
 wavering condition, or to excuse wilfulness in a 
 child; but in either case the use of the word is 
 pernicious, and cannot be condemned too severely. 
 It is a word that should be eliminated from con- 
 versation with, or in the presence of, children. 
 Parents who constantly speak of " being nerv- 
 ous " or of certain things " making them nerv- 
 ous "; or who excuse their own actions, or those 
 of the child, on the ground of " nervousness "; 
 are preparing fertile soil for nervous outbreaks in 
 the child later in life. 
 
20 Increasing Your Mental EfEciency 
 
 Nothing can be more demoralizing to nervous 
 stability than constant reference to the opposite 
 condition. The impressible child seizes upon the 
 fact that there is such a condition as " nervous- 
 ness " — a thing that no normal and healthy chUd 
 should realize — and makes this an excuse for cer- 
 tain actions that are simply the result of wilful- 
 ness or selfishness. One exhibition of childish 
 temper that is excused or condoned on the ground 
 of " nervousness " leads to another, and still 
 another. 
 
 If the word must be used at all, it should be 
 given the same interpretation as " naughty," or 
 something reprehensible. Above all things do not 
 let the child of nervous temperament, if it must 
 be pampered or favored in certain ways, know 
 that it is so favored on account of its delicate 
 nervous organization. For these children are 
 quick to seize upon this excuse for exhibitions of 
 lack of self-control, or other erratic actions, which 
 lay the foundation for mental instability. 
 
 Another greatly abused term, one that should 
 be stricken from the lexicon of the nervous child 
 and its parents, is " temperament." Many per- 
 sons use this term to explain a peculiarity or 
 defect, or condone a fault. Others seem to 
 regard the expression, "he is temperamental," 
 synonymous with "he is a genius." But 
 psychiatrists give a very different, and much 
 less flattering interpretation. To these the 
 
Caring for the Child's Mind 21 
 
 "temperamental" person is a very unstable 
 one. 
 
 But whatever the intent — ^whether the word is 
 intended to convey the impression that a certain 
 person is unusually bright, unbalanced, has ex- 
 cessive nervous energy, or is simply a degenerate 
 — ^it is a bad word to use in the presence of chil- 
 dren. For it is used far too often as a cloak 
 to screen eccentricities. And whether these 
 eccentricities be the early manifestations of 
 genius, or, what is far more likely, abnormality, 
 it is bad mental hygiene to gloss over peculiarities 
 by the use of such an ambiguous term. 
 
 The fact that a child shows great precocity is 
 no valid reason for giving it a special training 
 that differs materially from that of less brilliant 
 children. There is little danger that such training 
 may stifle a budding genius. For genius will not 
 be suppressed by discipline intended to correct 
 eccentricities. On the contrary, an attempt to 
 hold the precocious child's mind to the normal 
 channels of childhood, will be far more beneficial 
 than encouraging it to run off on peculiar tan- 
 gents. Moreover, one can never be certain that 
 the child's apparent genius may not be simply 
 eccentricity, or abnormality. Most precocious 
 children fail to rise to a height even approaching 
 the realm of genius. And therefore it is doubly 
 important that these children be schooled in nor- 
 mal trends of thought. A race-horse that cannot 
 
22 Increasing Your Mental Efficiency 
 
 run, but which has been trained for no other pur- 
 pose, is indeed a worthless creature. 
 
 The Dangers from Moral Contagion 
 
 Another reason why these highly organized, in- 
 telligent, and sensitive children, require more 
 careful training than the phlegmatic ones, is the 
 fact that such children are more susceptible to 
 " moral contagion " from the actions of their 
 parents. It behooves the parents of such chil- 
 dren, therefore, to encourage them to indulge in 
 the occupations and amusements of normal child- 
 hood, supplementing such training by good ex- 
 ample. The companionship of other robust chil- 
 dren has a healthful, stabilizing effect. 
 
 The practice of frightening young children, or 
 (arousing their apprehensions unnecessarily, is 
 most reprehensible. This is especially true as 
 regards the kind of fright that appeals to the 
 moral nature, such as superstitious fears of un- 
 natural things, referred to a moment ago. There 
 appears to be a great difference in ultimate effect 
 upon the nervous system, between ordinary physi- 
 cal frights, such as a narrow escape from falling 
 while at play, or a passing automobile, and the 
 kind of psychic terror produced by the fear of 
 goblins or ghosts. Frights caused by physical 
 danger are quickly forgotten; but superstitious 
 fear is persistent, and its evil effects can hardly 
 
Caring for the Child's Mind 23 
 
 be overestimated. We are just beginning to ap- 
 preciate that some of the most incurable forms 
 of insanity, like many of the intractable nervous 
 diseases, such as stuttering, are the direct result 
 of childhood frights. " Every ugly thing told to 
 the child," says Mosso, " every shock, every 
 fright given him, will remain like a minute splin- 
 ter in the flesh to torture him all his life long." 
 
 The foolish mother, or ignorant servant girl, 
 who frightens a child into obedience by tales of 
 ogres, bogey-men, or anything mysterious, is pre- 
 paring fertile soil for the development of mental 
 instability. We may go farther, and say that the 
 teaching of any superstition whatever, is likely 
 to give the child an entirely perverted attitude of 
 mind. For the mind of a child is above all things 
 logical — much more so, indeed, at this period of 
 life before habits of thought have stifled logicality, 
 than the mind of the average adult. It does not 
 distinguish between one kind of superstition and 
 another, simply because no logical distinction 
 exists. And for this reason the thoughtless or 
 ignorant teaching of a single harmless supersti- 
 tion may pave the way to a belief in innumerable 
 harmful ones. 
 
 Possible Consequences of Little Deceptions 
 
 Let us consider, for example, the most common 
 form of deception practiced upon young children, 
 
24 Increasing Your Mental Efficiency 
 
 that of the belief in Santa Glaus. To the majority 
 of people there appears no possible harm in de- 
 ceiving the child during its early years about 
 the jolly reindeer driver, and later correcting the 
 deception. And undoubtedly this in itself is one 
 of the most harmless of foolish deceptions, be- 
 cause it lacks the fear-producing element. The 
 tales about good fairies are likewise relatively 
 harmless in themselves, and for the same reason. 
 But even these seemingly harmless myths may lay 
 the foundation in the child's mind for a belief in 
 all manner of supernatural beings. If there is a 
 mysterious person who can fly through the air 
 and drop down chimneys, as Mother and Father 
 have taught, what is there inconsistent in some 
 ignorant servant girl's tales of goblins, or 
 ghosts? To the child's mind one is quite as 
 reasonable as the other. And so the foundation 
 is laid for a superstitious trend of mind that is 
 not consonant to practical twentieth-century en- 
 lightenment. 
 
 On the other hand, if the child has been told 
 that Santa Claus is a purely imaginary person, 
 it will be less ready to believe stories about 
 goblins or other imaginary monsters. To state 
 the case frankly, then, children should not 
 be deceived about Santa Claus, or any other 
 myth. 
 
 But, it is objected, by doing away with Santa 
 Claus you are robbing childhood of one of its 
 
Caring for the Child's Mind 25 
 
 greatest pleasures — killiDg what little romance 
 is left in this all too prosaic life ! Not at all, my 
 dear reader. I have among my acquaintances 
 several children, now almost grown, who were 
 never taught to believe in the existence of Santa 
 Claus. They were told, as little children, that 
 Old Kris Kringle was purely a mythical person, 
 and that the hangings of stockings for him to fill 
 was simply a pretty custom. Never for one mo- 
 ment did any of those children believe that there 
 was really a Santa Claus. And yet I have never 
 seen children take greater delight in hanging up 
 their stockings on Christmas eve, or in planning 
 for the mysterious visits of this purely imaginary 
 character. 
 
 The good effect of this training was shown 
 in an incident that happened when one of these 
 children was six years old. This child had been 
 informed about the chimerical nature of all 
 " mysterious beings " as well as Santa Claus. 
 One day while playing with a little neighbor, she 
 heard a harrowing ghost story told by a super- 
 stitious maid. The child at once expressed her 
 doubts about the truth of the story, since her 
 father had told her that ' ' ghosts were like Santa 
 Claus, just imaginary things." Nor could the 
 maid shake her skepticism: her father's word 
 was, in her mind, the highest court. 
 
 A child with that attitude of mind is not likely, 
 later in life, to stumble on the rock of supersti- 
 
26 Increasing Your Mental Efficiency 
 
 tion — a rock that fills our asylums and sani- 
 tariums. 
 
 , Early Religious Training 
 
 In this connection the question arises as to the 
 age at which the religious training of the child 
 should begin. I am fully aware that in this field 
 each parent is likely to be guided by his own 
 particular religious bias, and ready to challenge 
 the wisdom of all others. It is the one depart- 
 ment of education in which the standards and 
 methods of our parents and grandparents are 
 likely to be considered all-sufficient for our chil- 
 dren. But nevertheless, the practicalities of re- 
 ligious beliefs, like most other fields of thought, 
 have changed and progressed in the last century. 
 And our attitude toward the teaching of religious 
 subjects to children should have changed cor- 
 respondingly. 
 
 Fortunately, the tendency of religious teaching 
 to-day is to exalt the beautiful side of religion, 
 and suppress the terrifying doctrine of eternal 
 punishment. But for those who accept the literal 
 interpretation of this ancient belief (if, indeed, 
 there be any such persons) the warning given a 
 moment ago against the dangers attending psychic 
 frights in childhood should be repeated and em- 
 phasized. Terrifjdng the child at this receptive 
 age with stories of eternal punishment, is laying 
 
Caring for the Child's Mind 27 
 
 a powder mine for a future explosion. If the 
 child is the nervous, sensitive type, this explosion 
 will come almost inevitably in one form or another 
 sooner or later. 
 
 Its worst form, of course, is some type of re- 
 ligious mania — an all too common form of mental 
 aberration which shows the effect of the exploded 
 powder mine. But besides this most terrible dis- 
 aster there are less pronounced afflictions that 
 " will remain like minute splinters in the flesh " 
 just as in the case of any other childhood fright. 
 
 " Keep out all fear of the brutal things men 
 have taught children about the future," says 
 Luther Burbank, the lover of plants and children, 
 in his book. The Training of the Human Plant. 
 " I believe emphatically in religion. God made 
 religion, and man made theology, just as God made 
 the country, and man made the town. I have the 
 largest sympathy for religion, and the largest con- 
 tempt I am capable of for a misleading theology. 
 Do not feed children on maudlin sentimentalism or 
 dogmatic religion; give them nature. Let their 
 souls drink in all that is pure and sweet. 
 
 " Rear them, if possible, amid pleasant sur- 
 roundings. If they come into the world with souls 
 groping in darkness, let them see and feel the 
 light. Do not terrify them in early life with the 
 fear of an after world. Never was a child made 
 more noble and good by the fear of a hell. Let 
 nature teach them the lesson of good and proper 
 
28 Increasing Your Mental Efficiency 
 
 living, combined witli an abundance of well-bal- 
 anced nourishment. Those children will grow to 
 be the best men and women. Put the best in them 
 by contact with the best outside. They will ab- 
 sorb it as a plant absorbs the sunshine and dew." 
 
 The Persisting of Early Impressions 
 
 Any one who doubts the persistency throughout 
 life of childhood impressions will find food for 
 thought by observing the acquired habits that per- 
 sist even in those whose minds are completely 
 wrecked. It would be possible to cite specific in- 
 stances by hundreds. 
 
 A middle-aged man who was under my care for 
 some time had become so completely unbalanced, 
 a few years before, that it was necessary to confine 
 him in an asylum. He was, indeed, considered 
 dangerous, showed violent fits of temper, and had 
 to be watched constantly night and day. Event- 
 ually, however, he became less agitated, although 
 still greatly confused, and much demented. His 
 disease was incurable, but his condition had im- 
 proved sufficiently so that, with proper supervi- 
 sion, he could be given many liberties, and was 
 able to enjoy many of the pleasures of life. 
 
 When the hunting season arrived this patient 
 asked his medical adviser to be allowed to go 
 shooting. The request seemed preposterous, com- 
 ing from an irresponsible man who was subject 
 
Caring for the Child's Mind 29 
 
 to violent fits of temper. But the physician had 
 had a wide experience with similar cases ; and he 
 had learned, moreover, that this patient as a boy 
 had been given unusually careful instruction about 
 handling a gun while hunting. Thus it had become 
 instinctive with him to carry his weapon with the 
 muzzle always pointing away from his companion, 
 and never in any circumstances to point a gun at 
 a person. 
 
 Feeling confident that his patient's early train- 
 ing would dominate his actions, the physician de- 
 cided to grant his request to go shooting. More- 
 over, the doctor decided to join him in the hunt, 
 although fully aware that the patient disliked him 
 thoroughly, and had threatened him repeatedly. 
 
 The physician's decision will strike most per- 
 sons as foolhardy. But subsequent events ,proved 
 the soundness of his judgment. For although the 
 patient was at times violently angry with the doc- 
 tor during their hunting trips, the thought of using 
 his gun as a weapon never suggested itself. Or, 
 if suggested, was at once rejected. The early 
 training in the use of weapons still dominated a 
 certain portion of this demented man's mental 
 mechanism, although most of that mechanism was 
 so badly askew. 
 
 Since habits of thought established iu childhood 
 undoubtedly lay the foundations for future mental 
 attitudes, it is obvious that certain habits should 
 be encouraged, while other tendencies should be 
 
30 Increasing Your Mental Efficiency 
 
 diplomatically but persistently suppressed. In- 
 dustry, either in work or play, should be stimu- 
 lated to become a habit; for idleness in children, 
 as in adults, breeds all manner of mental and phys- 
 ical disorders. Once the habit of industry is ac- 
 quired it tends to persist through life. 
 
 Professor Ernst Haeckel, whose life has been an 
 almost continuous series of great achievements, 
 attributes his activity to his early training. ' ' My 
 mother," he says, " would never permit me to be 
 idle for a moment. If I stood at the window day- 
 dreaming, she would always urge me to be up and 
 doing. ' Work or play,' she would urge, ' but do 
 not stand idle.' Through this reiterated admoni- 
 tion, physical activity became a life-long habit 
 with me, and work almost a necessity of my being. 
 If I have been able to accomplish my full share of 
 labors, this is the reason. I am never idle, and I 
 scarcely know the meaning of ennui." 
 
 Idleness is the handmaiden of another fault, in- 
 decision. Indeed, the habit of idleness generates 
 indecision. The child that shows this tendency to 
 wavering should be taught tactfully to make de- 
 cisions, and abide by them. It is good mental dis- 
 cipline to acquire the habit of making some deci- 
 sion, even though it be a bad one. 
 
 Didactic Training Versus Muscular Development 
 
 It should not be understood that encouraging 
 activity in children implies urging the child to 
 
Caring for the Child's Mind 31 
 
 make unusual efforts in its school work. The 
 bright, nervous child, frequently needs restraint 
 rather than urging in this particular field of ac- 
 tivity. Our modern school curriculums tend to 
 hurry the little ones on much too fast in the lower 
 grades for the welfare of their nervous systems ; 
 and err in the opposite extreme in the higher 
 grades, and colleges. 
 
 Instead of sending precocious children to school 
 early, and holding them to the task, it is far better 
 to devote more time to the development of their 
 muscles, and strengthening their nervous systems 
 (a " psychic hardening ") for a few years. For 
 if the child is below standard physically, as is fre- 
 quently the case, this driving process tends to 
 restrict, instead of develop, its natural capaci- 
 ties. And even in the exceptional cases, where 
 the mind develops at the expense of the muscu- 
 lar system, this brilliancy of intellect is scant 
 compensation for the halting, unstable physical 
 mechanism. 
 
 On the other hand, hard study is not injurious 
 to the normal, healthy boy or girl. It is good for 
 them. It teaches them to use their faculties, even 
 though the studies themselves may be of little 
 actual value later in life. Indeed, the real test of 
 value in a school or college course is its efficiency 
 in teaching students how to acquire knowledge, 
 rather than in the amount of knowledge actually 
 imparted. The college graduate is often singu- 
 
32 Increasing Your Mental Efficiency 
 
 larly lacking in useful information. But if he has 
 learned the knack of acquiring knowledge during 
 his college course, his training may he considered 
 successful. Failure to acquire this, however, is 
 indeed utter failure. 
 
 Highly organized, sensitive children should not, 
 as a rule, be permitted to indulge in strenuous 
 mental contests, such as striving for prizes at 
 school. But if such contests are permitted, the 
 parent should note very carefully the effect upon 
 the child's mind and nervous system. Children 
 present two types of mental attitude in these con- 
 tests. In one, the pleasure of success predomi- 
 nates ; in the other, it is rather the fear of defeat. 
 In other words, one " loves to win," the other 
 *' hates to lose." And psychologically these atti- 
 tudes of mind may be very different. There are 
 types of persons who gloat over winning, but who 
 feel little or no humiliation in defeat; there are 
 others who feel relatively little elation at success, 
 but who are absolutely dejected by failure. If 
 your child is of this latter type — and no one can 
 determine this as well as the parent — do not let 
 him enter contests which require prolonged pre- 
 liminary effort. Contents brought about on the 
 spur of the moment have a far less deleterious 
 mental effect. 
 
Caring for the Child's Mind 33 
 
 Beneficial Influence of the Playground 
 
 Nervous children are greatly benefited by play- 
 ground contests with other children of their own 
 age. If denied the companionship of other chil- 
 dren, or kept in the presence of older people, the 
 nervous systems of such children suffer from over- 
 protection. Such children are greatly benefited by 
 attendance at public schools. Even large private 
 schools, at least in America, do not serve the same 
 purpose. For the beneficial association with 
 " mixed classes " of children is wanting in such 
 schools, since the pupils are, almost without ex- 
 ception, the children of well-to-do parents. This 
 has its advantages, of course; but these are out- 
 weighed by the disadvantages. For every child, 
 when it reaches maturity, will be thrown in con- 
 tact with persons from all walks of life; and its 
 future success may depend largely upon its ability 
 to interpret the mental attitudes of persons in 
 every class. In other words, to understand human 
 nature. 
 
 No amount of experience in adult life will give 
 the peculiar intuitive capacity to estimate char- 
 acter that the child acquires by association with 
 heterogeneous playmates. Moreover, this min- 
 gling tends to stabilize the equilibrium of the 
 nervous child. 
 
 Persons of either sex, who have been denied 
 these playground associations, lack a well-rounded 
 
34 Increasing Your Mental Efficiency 
 
 education, even though the didactic part of their 
 teaching may have been most complete. For the 
 playground, rather than the classroom, is the 
 builder of character. Here the child finds himself 
 placed in a niche consonant to his ability, physical 
 and mental. Paternal wealth, or position, counts 
 for nothing, only inherent worth as judged by the 
 peculiarly accurate standards of playfellows. 
 Thus the child learns, by contact with its play- 
 mates, to gauge its own abilities very accurately. 
 The conceited only child, obsessed with self-impor- 
 tance, soon learns his own shortcomings. It is a 
 helpful " leveling process " for the bumptious 
 youngster, and equally helpful to the intelligent 
 but timid child, by teaching confidence and self- 
 assurance. 
 
 Some mothers hesitate to send their children 
 to a public school for fear of the " coarsening 
 effect " of contact with such heterogeneoTis com- 
 panions. Children of such mothers are usually 
 mollycoddles — the very children who would be 
 benefited by contact and competition with all 
 classes of children. A proper home influence will 
 counteract any coarsening effect, while the play- 
 ground offers a kind of useful education that no 
 home supplies. 
 
 Many a doting mother has shed bitter tears at 
 the sight of her usually carefully pressed and 
 creased boy, returning from school, bruised and 
 bespattered after a set-to with some schoolmate. 
 
Caring for the Child's Mind 35 
 
 But her tears miglit be spared : this same encoun- 
 ter may " be the making " of her boy. No single 
 event in a child's life is likely to have such positive 
 and permanent — and in the end, beneficial — effect 
 as a square-toed fight. 
 
 Most mothers will take radical exception to this 
 statement. But mothers are not competent 
 judges: they lack practical experience. Most 
 fathers, I feel sure, will concur in the assertion, 
 if they will recall the sensations produced by their 
 first youthful encounter. This sensation cannot be 
 produced by any other experience. In such con- 
 test, the boy for the first time, finds himself 
 thrown upon his own resources — a test of wit, 
 strength, and courage. And, win or lose, a new 
 sensation — one that the child will never quite for- 
 get — is born forthwith. It is a practical manifes- 
 tation of the primal fighting instinct — an instinct 
 which every successful man must possess. And 
 thus, just as the companionship of girls has a re- 
 fining influence on the boy's mental fibre, contests 
 with boys develop that other, and equally essential 
 quality. 
 
 And so I believe that any boy who is reared in 
 seclusion from boys of his own age, and grows 
 up without having at least one good square-toed 
 fight, has been deprived of a most important part 
 of his education. And being deprived of it, will 
 always retain a somewhat perverted outlook on 
 life, — a defective insight into human nature. 
 
36 Increasing Your Mental Efficiency 
 
 Moreover, the boy who is a good fighter, is far 
 less likely to be quarrelsome than the coddled 
 nursery boy. 
 
 One must not confuse the petulant child, who 
 flies into a passion and strikes his smaller play- 
 mates or larger companions knowing that there 
 will be no retaliatory blow, with the sturdy play- 
 ground fighter. There is a wide gulf between the 
 types. Yet the playground itself is one of the 
 best remedies for petulancy. 
 
 On the other hand, pent-up emotions are danger- 
 ous elements in the developing child. The child 
 who sulks needs just as positive discipline as the 
 one that strikes. " Especial care should be exer- 
 cised to prevent disagreeable feelings and emo- 
 tions becoming transformed into the more persist- 
 ent moods," says Professor Barker. " It is often 
 better for an emotion to discharge itself in the 
 form of some definite act and thus bring it to an 
 end rather than through the partial suppression of 
 it, have it last in the form of a disagreeable mood, 
 for a considerable length of time. Pouting, sulki- 
 ness, harboring a grudge, or bearing malice, should 
 be regarded as symptoms seriously to be consid- 
 ered and corrected. For if they are tolerated in 
 the child, habits may be begun which will prepare 
 the soil for the development, later in life, of the 
 seeds of enmity and suspicion; the full-grown 
 plants are the persecutory ideas of the paranoiac 
 states. 
 
Caring for the Child's Mind 37 
 
 The Remedy for Petulancy 
 
 " How to manage a child in a fit of temper has 
 been discussed. When possible it is desirable to 
 cut it short at the beginning. Some parents re- 
 joice to see their children reveal violent temper, 
 and are glad that they can fly into a passion, turn 
 red as a beet, clench the fists, and attack the in- 
 dividual with whom they are angry. Such attacks 
 if frequently repeated are very deleterious to the 
 nervous system. Some parents try to stop them 
 by petting and indulging the child, a kind of licens- 
 ing of irritability which rarely, if ever, pays; 
 others threaten the child or corporeally punish 
 him ; a mistake, usually, in the other direction. As 
 a rule most may be accomplished by purposefully 
 ignoring the attack, perhaps isolating the child 
 for a short period ; in some cases a warm bath and 
 the bed may be the best remedies. 
 
 " In older children the habit of giving way to 
 temper may sometimes be broken by inculcating 
 the conviction that one who loses his temper makes 
 a fool of himself, loses his dignity and excites the 
 disdain aud contempt of his fellows : the horror of 
 looking ridiculous, of making a donkey of one's 
 self, may be a most powerful lever in conquering a 
 tendency to attacks of fury. . . . 
 
 " Let no one think, however, that lack of feel- 
 ing, or a nature impoverished on the emotional 
 side is desirable or that it protects against nervous 
 
38 Increasing Your Mental Efficiency 
 
 disease. The elevating emotions, hope, joy, ex- 
 pectation, . love — are constructive and are judi- 
 ciously to be cultivated ; the depressing emotions — 
 despair, sorrow, regret, and fear — are damaging 
 to the nervous system if long maintained. The 
 highest feelings of all, including the religious, the 
 ethical, and the aesthetic — inspire noble and useful 
 conduct, and in the education of nervous children 
 these sentiments are to be favored in their de- 
 velopment, in due degree, at a suitable age." 
 
 Defective eyesight, when it exists, is frequently 
 overlooked in young children. This defect ac- 
 counts for quite a high percentage of apparent 
 backwardness in school children, and may give rise 
 to temperamental peculiarities. Parents should, 
 therefore, have their children's eyesight tested at 
 an early age if there is any reason to suspect de- 
 fect. They can, indeed, make tests at home that 
 will determine with sufficient accuracy whether 
 the child is near-sighted — the most frequent con- 
 genital defect. 
 
 A very simple method of doing this is to select 
 pictures of objects with which the child is familiar, 
 such as the domestic animals from the "ABC 
 Book." By placing these one at a time at a dis- 
 tance at which their outlines are just discernible 
 with certainty by the parent's eyes (supposing, of 
 ■sourse, that the parent's vision is normal) and ask- 
 ing the child to designate each, the vision of a 
 child can be readily determined. For the normal 
 
Caring for the Child's Mind 39 
 
 length of vision, even of a young child, is the same 
 as that of the adult. 
 
 Special symptoms that should arouse suspicion, 
 particularly in school-children old enough to read, 
 are headaches, and nausea that is produced by 
 scrutinizing the printed page. Here the defect is 
 probably astigmatism — an irregularity in the 
 shape of the lens, or eyeball — which requires the 
 attention of an oculist, and should be corrected 
 by properly fitted glasses. 
 
 Every parent is confronted, sooner or later, 
 with the problem of choosing an occupation for 
 his child, or acting upon the child's own selection. 
 The general consideration of the question as to 
 just what part of the determination should rest 
 with the parent, rather than the child, is much too 
 complicated for discussion here. But there are 
 certain elements in the general proposition that 
 present themselves in the case of every child, and 
 should not be evaded. The two most vital ones 
 are, (1) the child's adaptation to the calling se- 
 lected — that is, its ability to perform its part suc- 
 cessfully; and, (2) the parents' ability to perform 
 their part, which is, in the last analysis, usually 
 the pecuniary item. To this should be added the 
 parental influence in guiding the child in making a 
 selection best adapted to its abilities and condition. 
 
 Even when the financial part need not be con- 
 sidered it is frequently most diflScult to make the 
 child's choice and its natural ability coincide. 
 
40 Increasing Your Mental Efficiency 
 
 Moreover, it is quite impossible to determine dur- 
 ing the early years of childhood, for what calling 
 the child will be best adapted. For those who are 
 unhampered financially, this is, of course, the' 
 great item for serious consideration. And this 
 suggests the reason for the general rule that it is 
 better not to make any definite selection during 
 the child's early life. For the wisest person 
 in the world is unable to predict with certainty 
 what the inclinations and ability of a child of six 
 will be at sixteen, or twenty. 
 
 There are well-advertised men who make a 
 " specialty " of " fitting round pegs into round 
 holes." Were these charlatans actually able to 
 do even a tithe of what they claim, they would be 
 the greatest benefactors of mankind. For a very 
 large proportion of unhappiness and discontent 
 in this world is caused by misfitted " pegs." But 
 no single element can be determinative in this peg- 
 fitting problem. Circumstances, temperament, in- 
 clination, and natural adaptation must each be 
 taken into account, and the opinions of the child, 
 parents, and teachers must all be considered. And 
 finally, the child's capacity to carry out his part 
 of the compact, and the parents' ability to per- 
 form their part, must be largely determinant, 
 after all the other elements have been considered. 
 
 To attempt to determine in infancy what the 
 grown-up child shall follow as a vocation, is court- 
 ing disaster. Such early selection is, and should 
 
Caring for the Child's Mind 41 
 
 be, the privilege of Royalty only. But most of us 
 doubt the wisdom of this practice, even in king- 
 making. For although there have been great kings 
 who were the sons of kings, we cannot forget the 
 numberless exceptions. None of the five greatest 
 rulers of Rome who reigned in succession were 
 hereditary monarchs. 
 
 " Find out what each child is capable of doing — 
 that is to say, his actual aptitudes ; and teach him 
 to succeed in these," says a modern philosopher. 
 And this is but an echo of the philosophical wis- 
 dom of all ages. 
 
 Sex Hygiene 
 
 One cannot consider the question of mental 
 hygiene for the child without specific reference to 
 the subject of sex hygiene which has recently be- 
 come a popular fad. Yet it should be evident to 
 every one that there is no real reason, or justifica- 
 tion, in this sudden activity about a subject that 
 is as ancient and as immutable, as civilization 
 itself. 
 
 Any subject is fraught with grave dangers when 
 it is promulgated as a fad. Likewise any vice 
 which is inherently attractive is likely to be dis- 
 seminated, rather than restricted, by propaganda. 
 Certainly the practice of giving great publicity to 
 the sex problem — treating the subject openly in 
 the presence of children — ^will do much more harm 
 
42 Increasing Your Mental Efficiency 
 
 than good. For it is likely to direct the child's 
 mind into channels of investigation that should 
 not be explored until a later period in life. 
 
 The fact that such channels should, and do, 
 eventually become open highways, suggests the 
 only ground upon which the child may logically 
 be instructed. It is worse than futile to attempt 
 to frighten the child into believing that a thing 
 must be wholly bad, when this child will discover 
 very shortly (much quicker than most parents 
 realize) that grown up persons do not consider 
 the subject with any such degree of condemnation. 
 But it is possible to impress upon it the fact that 
 what may be a natural attitude of mind for adults, 
 is harmful for children. 
 
 If presented on any other ground the natural 
 logicality of the child will prick the bubble of de- 
 ception. But by impressing upon its mind the fact 
 that children should shun certain things, just as it 
 is better for them to avoid the use of tobacco, 
 alcohol, tea, or coffee, in their early years in order 
 to reach full development, the desired effect may 
 be accomplished. But do not, under any circum- 
 stances, attempt to instruct the child by frighten- 
 ing it ; for such a course is likely to have exactly 
 the opposite effect from the one intended. More- 
 over such a course may result in produc- 
 ing an abnormal suppression of a natural instinct, 
 with vitally disastrous consequences later in 
 life. 
 
Cving for the Child's Mind 43 
 
 Pope may have had this particular vice in mind 
 when he wrote: 
 
 Vice is a monster of so frightful mien 
 As to be hated needs but to be seen; 
 
 Yet seen too oft, familiar with her face, 
 We first endure, then pity, then embrace. 
 
 In any event, the statement of the poet-philoso- 
 pher applies just as surely to the problem of sex 
 hygiene, and just as definitely to conditions to-day, 
 as it did to conditions existing a hundred years 
 ago. 
 
 The proper person, and the only person, to in- 
 struct the child in matters of sex hygiene, is the 
 parent. And in the case of very young children, 
 the mother can do this much more tactfully, as a 
 rule, than the father. The confidential relation 
 existing between mother and child is the logical 
 reason for this. For the subject is one that should 
 be treated only in strictest confidence. And if the 
 mother does not feel herself competent, she should 
 seek advice from the family physician, and trans- 
 mit her information to the child m her own way 
 and as the proper opportunity presents itself. 
 
 Teachers, ministers, or doctors, should not be 
 selected for this delicate task. For the instruc- 
 tions of such persons do not carry the same weight 
 as those of the mother, and are less likely to be 
 heeded. Moreover, the statements of an outsider 
 
44 Increasing Your Mental Efficiency 
 
 — the fact that any other person may broach the^ 
 topic — detract from the sacred secrecy of the sub- 
 ject which Mother may refer to without arousing 
 curiosity or apprehension, just as she may give 
 instructions about other necessary bodily func- 
 tions. 
 
 Determining the age at which the child should 
 receive this essential instruction is important. 
 Most parents deceive themselves in the belief that 
 their little ones remain utterly unsophisticated un- 
 til the age of puberty, at least. But this is not true 
 in a majority of instances, and should not be so. 
 For the period of puberty is the most important 
 of the child's life; and if the little girl is ignorant 
 of the natural and normal physical change that 
 takes place at this time, she may receive a psychic 
 shock, or be careless or indiscreet in the necessary 
 physical precautions, that may have disastrous 
 consequences. 
 
 We may make it a rule, therefore, that children 
 should be instructed before the age of puberty. 
 But this instruction should be of the most general 
 character, avoiding all but absolutely essential 
 details about natural biological functions, and 
 cleanliness. Moreover, the subject should be care- 
 fully avoided after the initial instruction. For 
 the child will remember every word that is told it 
 in this connection, and frequent reference to the 
 subject robs it of its confidential nature, and may 
 result in unnatural and morbid curiosity. 
 
Caring for the Child's Mind 45 
 
 Every father should warn his son against the 
 pernicious " medical " advertisements published 
 so widely for the purpose of frightening young 
 men and bringing them into the merciless toils of 
 unscrupulous quacks. These advertisements play 
 upon the ignorance and credulity of the young men" 
 who may have committed some youthful and 
 harmless indiscretion, by describing chimerical 
 dangers, and professing to cure diseased condi- 
 tions that do not exist. 
 
 Few persons, except physicians, realize the 
 amount of positive harm and protracted unhappi- 
 ness produced by this pernicious literature. The 
 lives and usefulness of thousands of young men 
 have been permanently blighted by these adver- 
 tisements, to say nothing of the severe depletion 
 of their pocket books. 
 
 The deplorable thing about the whole obnoxious 
 subject is, that the claims and insinuations of these 
 criminal charlatans which so many boys read and 
 believe, are unmitigated lies. They play upon the 
 boy's credulity by leading him to believe that a 
 very common boyhood indiscretion — one that is so 
 common that it may be considered almost a normal 
 trait of youth — has blighted his life, or will do so 
 unless he patronizes the perpetrators of the ad- 
 vertisement. Whereas physicians know that little 
 harm comes from such indiscretion, which, in any 
 event, is self-corrective. 
 
 Fathers should explain the nature of these ad- 
 
46 Increasing Your Mental Efficiency 
 
 vertisements to their boys. Or, if they feel that 
 their word will not carry sufficient weight in this 
 medical subject, they should arrange with the 
 family physician to do so. In this way the boy 
 will be given a correct understanding of many 
 seeming mysteries, and rendered immune to the 
 seductive literature of these discountenanced 
 medical sharks. 
 
 Failing in this, the boy may go through life 
 carrying a most oppressive burden — a closet skele- 
 ton that he would not reveal even to his most inti- 
 mate friend. And this sort of closet skeleton is 
 always a menace to mental stability. 
 
n 
 
 Mild Forms of Disturbed Equilibrium 
 
 WE cannot hope to combat an evil without 
 some knowledge of its nature. So be- 
 fore suggesting methods of stabilizing mental 
 equilibrium, something should be said about the 
 various conditions that influence stability, and the 
 more tangible things that indicate a state of men- 
 tal unbalance. 
 
 Needless to say the indications will not be ex- 
 actly alike in any two cases, either in their course 
 or their termination, — that is, in any condition 
 which does not result in actual death. But in the 
 main they follow fairly well-defined highways, all 
 terminating in the condition included in the com- 
 prehensive term, insanity. 
 
 Unfortunately there are many derangements of 
 personality which, if uncorrected, may result in 
 this catastrophe. But if we can gain a clear con- 
 ception of some of these premonitory conditions 
 we shall have taken the most important step to- 
 ward correcting them. For it must be borne in 
 miad that although actual insanity is one of the 
 most incurable conditions, in the initial stages 
 when the mental balance is wavering on the bor- 
 
 47 
 
48 Increasing Your Mental Efficiency 
 
 derline before taking the final plunge, it may be 
 prevented. 
 
 A recognition of this borderland state is our 
 ■greatest safeguard ; since, contrary to popular be- 
 lief, insanity is seldom of sudden onset. Even in 
 cases where the mental balance appears to have 
 been unhinged by some sudden catastrophe, such 
 as some great shock, grief, or fright, we find al- 
 most invariably that there have been indications 
 of wavering equilibrium for some time — symp- 
 toms that an expert would recognize as danger 
 signals. Moreover, the nature of those signals is 
 usually such that even members of the victim's 
 household would have recognized them, were the 
 disease, insanity, as well understood as are many 
 of the physical ailments. 
 
 So that we can say with all but absolute cer- 
 tainty that, short of actual physical injury, no 
 mental or moral calamity will produce sudden in- 
 sanity in a healthy-minded individual. 
 
 The effect of the Titanic disaster upon the men- 
 tal condition of the survivors offers striking con- 
 firmation of this statement. There have been few 
 catastrophes in modern times in which the sur- 
 vivors suffered greater mental and physical 
 shock, and grief. To those unfamiliar with the 
 causes of mental aberrations it seemed that few 
 persons could pass through such an ordeal and 
 retain their normal mentality. Indeed, the rumor 
 that the incoming rescue ship, Carpathia, was " a 
 
Mild Forms of Disturbed Equilibrium 49 
 
 floating mad-house " became so persistent, that 
 special arrangements were made to care for the 
 insane in the receiving wards of the City hospitals. 
 
 Yet when the Carpathia arrived at her dock, not 
 one of the Titanic survivors was insane. There 
 were many bowed with grief, several disabled 
 physically from exposure, or injury; but every one 
 was normal mentally. Moreover, a canvas of these 
 survivors a year later showed that no case of in- 
 sanity had developed. 
 
 On the other hand, several neurotic persons on 
 shore — persons having neither friends nor ac- 
 quaintances on the doomed ship — became insane 
 on hearing of the disaster. Yet in every one of 
 these cases the individuals were flying signals of 
 tottering mentality, and news of the great disaster 
 simply acted as the spark to set off the mine al- 
 ready laid. 
 
 We are powerless to prevent a certain number 
 of great calamities which result in terrible sacri- 
 fice of human life. But it is within our power to 
 avert many of the mental disasters that follow 
 in their wake. 
 
 Some Familiar Forms of Mental Instability 
 
 What particular form a mental aberration may 
 take in any individual case is of far less impor- 
 tance for our present purpose than a survey of 
 the premonitory shadows cast by the approaching 
 
50 Increasing Your Mental Efficiency 
 
 cloud. Bearing in mind tliat every disturbance of 
 the emotions such, as unnatural elation or depres- 
 sion, fear, worry, suspicions, or doubt, when ex- 
 hibited to excess and without adequate cause is a 
 stepping stone to actual insanity, let us consider 
 somewhat in detail some of the peculiarities of 
 mental aberrations with which every person 
 should be somewhat familiar. 
 
 Without attempting to draw a fine distinction 
 between actual insanity and closely allied states, 
 we may examine some of the characteristics of 
 certain abnormal conditions which closely resem- 
 ble the more serious form, without necessarily 
 merging into it. The one with which every person 
 is more or less familiar, is hysteria. 
 
 Although the emotional manifestations of this 
 disease, such as excessive and unrestrained 
 laughter and weeping, are familiar to every one, 
 these are only the better known signs of a subtle 
 condition that may present a great diversity of 
 symptoms. Instability of temper, a tendency to 
 aimless dreaming, or an inclination to change from 
 one task to another, whether work or play, char- 
 acterizes the hysterical type of child. These chil- 
 dren are given to exaggeration, and love to do 
 startling and fantastic things, particularly in the 
 presence of susceptible and gullible parents. They 
 are often elated to a stage of ecstasy by trivial 
 events, and are depressed correspondingly by 
 trifling adversities. 
 
Mild Forms of Disturbed Equilibrium 51 
 
 As a rule they are untruthful and unreliable, 
 are given to practicing deceptions, and lack the 
 frankness that is characteristic of normal child- 
 hood. They are likely to be bright and precocious, 
 frequently capricious about their food, and usually 
 (though by no means always) of poor physical 
 development. 
 
 These children have an abnormal craving for 
 sympathy, and resort to all manner of subter- 
 fuges to obtain it. If their self-absorption takes a 
 hypochondriacal form, they will simulate ill- 
 nesses in every gradation of severity from a 
 trifling cough to what appears to be actual paraly- 
 sis and even convulsions, — conditions that keep 
 the members of the sympathetic household danc- 
 ing attendance. And invariably they receive this 
 ' ' danced attendance ' ' ; for even neuropathic chil- 
 dren seldom develop severe hysteria except when 
 surrounded by over-sympathetic, or foolishly in- 
 dulgent, parents. 
 
 The hysterical type of woman differs very little 
 in general characteristics from the hysterical child 
 except in those differences common to the two 
 periods of life. Indeed, most hysterical women 
 have been hysterical children. These women are 
 essentially childish in their attitudes of mind, and 
 tend to reproduce the peculiarities shown in child- 
 hood, somewhat altered to fit the changed condi- 
 tions. They demand the same attention of the 
 members of their households, exhibit a want of 
 
52 Increasing Your Mental Efficiency 
 
 self-control, the tendency to impulsive actions, 
 irritability of temper, and the craving for novelty 
 and excitement. The basis of this condition is 
 undoubtedly defective will-power; although this 
 defect may be masked by a persistent stubborn- 
 ness that gives the impression of extreme wilful- 
 ness, particularly to the members of their own 
 households. 
 
 Their craving for sympathy is insatiable, and 
 represents a type of selfishness, which, with the 
 defective will-power, is a fundamental element of 
 the condition. There is scarcely any limit to the 
 length they will go to gain this sympathy. They 
 have been known to mutilate themselves to the 
 extent of producing serious injuries, starve them- 
 selves to the point of death, and simulate strange 
 and puzzling symptoms that are easily mistaken 
 for obscure pathological conditions. Every new 
 disease that is described in the popular press is 
 sure to be adopted by some of these patients. And 
 it is remarkable how faithfully they will imitate 
 in the minutest details symptoms that are un- 
 known to most laymen. Little wonder, therefore, 
 that they deceive sympathetic friends, and all too 
 frequently the family doctor. 
 
 Perhaps the most common form of deception is 
 a simulated paralysis in which the patient refuses 
 to walk, becomes bedridden, and lies in bed for 
 months, or years. Medical men have perfectly 
 definite methods of detecting this deception; but 
 
Mild Forms of Disturbed Equilibrium 53 
 
 it is singularly difficult to convince the members 
 of neuropathic households of the real state of 
 affairs, even when the evidence is absolutely con- 
 clusive to others. 
 
 Some Radical Methods of Treatment 
 
 Sometimes a fortunate calamity is the means of 
 revealing the deception, where mere medical 
 science has failed. It has happened more than 
 once that actual peril, such as the burning of a 
 house, has stimulated the bedridden hysteric to 
 use her perfectly good limbs to save her life in a 
 manner that left no room for doubt about her 
 actual condition. The ' ' paralytic ' ' who can move 
 under the stimulus of danger is not suffering from 
 true paralysis. 
 
 The subterfuges resorted to by the old-time 
 physicians to ' ' bring these peculiarly afflicted 
 patients to their senses " are numberless. For 
 our medical ancestors did not regard hysteria as 
 a disease, but a mental state characterized by a 
 " devilishly persistent obstinacy." Yet some of 
 the methods of curing it were often most effective, 
 even if much too hard and crude to appeal to our 
 refined twentieth-century sensibilities. 
 
 The basis of these " cures " was the fact that 
 sudden danger sometimes caused the hysterical 
 paralytic to walk, demonstrating that the nervous 
 and muscular mechanisms were intact, but in need 
 
54 Increasing Your Mental Efficiency 
 
 of proper stimulation. This naturally suggests a 
 remedy, which has been utilized in one form or 
 another many times, if we may believe popular 
 traditions that have been handed down through 
 generations of medical men. 
 
 One of the classic stories, which may well have 
 a basis in fact, is that of a certain young woman 
 who had been paralyzed and bedridden for many 
 months despite the efforts of the half dozen 
 physicians who were the medical scions of the 
 small town in which she lived. Each of these 
 physicians had been called successively to minister 
 to the sufferer; each had reached the conclusion 
 that the case was one of hysteria; and each had 
 been indignantly dismissed as soon as he an- 
 nounced his decision to the family — ^illustrating 
 the characteristic attitude of neuropathic families. 
 When the sixth, and last, physician had been dis- 
 charged the distracted father was at a loss to know 
 where next to turn for assistance, since the list 
 of available medical talent had been exhausted. 
 
 It happened that there was living in the town a 
 retired physician, a decrepit old man who was still 
 the medical oracle of the vicinity, although no 
 longer able to minister to the sufferings of his 
 worshipful townsmen on account of infirmity. As 
 a court of last appeal the distraught father sought 
 this venerable physician, and begged him for old 
 time's sake to try his skill upon the bedridden 
 victim. 
 
Mild Forms of Disturbed Equilibrium 55 
 
 The old physician, who was still in touch with 
 the medical gossip of his confreres if not in active 
 competition with them, was cognizant of the true 
 nature of the form of " paralysis " with which 
 the girl was afflicted. And deeply sympathetic 
 with the distressed father, and probably somewhat 
 impatient with the girl for her wilful selfishness, 
 he finally agreed to take charge of her case. But 
 only on this condition : He was to treat her in his 
 own way, without interference from any relative, 
 friend, or outsider. 
 
 The father thankfully agreed to this condition, 
 and arranged for the treatments to begin the fol- 
 lowing morning. At the appointed hour, there- 
 fore, the old doctor appeared in the dooryard, 
 driven there in a light wagon, in the back of which 
 was a well-stuffed straw tick. This mysterious 
 therapeutic implement was deposited in the front 
 dooryard by his muscular assistant who had acted 
 as driver, while the physician visited the patient. 
 
 Without wasting any time over unnecessary 
 preliminaries, and disregarding the solicitous in^ 
 quiries of the mystified father, the old doctor or- 
 dered the girl to get up. And when she protested 
 her inability to do so, commanded her mother to 
 dress her. ' ' For I intend to have her take a little 
 walk all by herself before I leave," the old man 
 announced. After which he held a whispered con- 
 versation with the muscular driver, and returned 
 .with him to the sick-room when the dressing was 
 
56 Increasing Your Mental Efficiency 
 
 completed. At a nod from the doctor this assist- 
 ant picked the girl up bodily, carried her into the 
 yard, and deposited her on the straw tick. Then 
 he took his station beside the agitated, and now 
 thoroughly apprehensive father, while the doctor 
 began his treatment. 
 
 The preliminary part of this treatment was a 
 speech by the aged physician in which he explained 
 matters very thoroughly to the astonished and 
 highly indignant patient. He pointed out to her 
 that her condition was purely imaginary, and that 
 she could walk if she chose to do so ; but since she 
 was selfish, she preferred to stay in bed and keep 
 her poor old father and mother waiting upon her, 
 regardless of the fact that she was wrecking their 
 lives and their fortunes. 
 
 " You have been fooling these poor old people 
 long enough," the physician said, shaking his 
 trembling finger at the bewildered patient ; ' ' but 
 you can't fool everybody. I know you can walk 
 if you care to, and I'm going to prove it right 
 now." 
 
 With that the old man drew a match from his 
 pocket, and lighted one corner of the straw tick. 
 
 " Now walk or burn," he commanded. 
 
 By this time the distressed father was thor- 
 oughly convinced that the old man had gone stark 
 mad; and when the physician set fire to the mat- 
 tress he was certain that he had consigned his 
 daughter to the care of a maniac. Disregarding 
 
Mild Forms of Disturbed Equilibrium 57 
 
 his promises of yesterday, therefore, he sprang 
 forward to rescue his suffering child from the 
 flames and the impending disaster he had brought 
 upon her. But he got no farther than the waiting 
 embrace of the muscular driver, who pinned his 
 arms and held his struggling prisoner at a safe 
 distance from the blazing mattress. Meanwhile 
 the good old mother, herself too feeble to effect 
 the rescue, collapsed in a distracted heap on the 
 door-step. 
 
 Thrown absolutely upon her own resources, with 
 no alternative but to burn or run, the girl made 
 the inevitable hysterical choice, sprang from the 
 blazing couch and ran into the house — demon- 
 strating conclusively that the old doctor had diag- 
 nosed her condition correctly. 
 
 The Secret of Miraculous Cures 
 
 Now in all probability this particular incident 
 never occurred exactly as related here. Yet it is 
 perfectly certain that if any one of these bedrid- 
 den hysterics were placed on a blazing mattress, as 
 this one is alleged to have been, she would sud- 
 denly regain the use of her limbs. But the defect 
 of this method of treatment lies in the fact that 
 " cures " attempted by it are usually only tem- 
 porary. It would not necessarily change the vic- 
 tim's attitude of mind; and unless this were ac- 
 complished, she would presently develop some 
 
58 Increasing Your Mental Efficiency 
 
 other form of subtle malingering to deceive and 
 distress her afflicted family. For this reason the 
 modern physician does not resort to the crude ex- 
 pedients of his predecessors, but directs his efforts 
 to getting at the basis of the malady, instead of 
 striking at its peculiar manifestations. 
 
 Moreover, we know now that hysteria is an 
 actual disease with definite pathological manifes- 
 tations that may be easily demonstrated, such as 
 areas of insensibility of the skin, and mucous sur- 
 faces, the existence of which is not suspected by 
 the patient. Yet the condition is so closely de- 
 pendent upon the patient's attitude of mind, that 
 it is only by changing and correcting this attitude 
 that permanent cures are effected. In proof of 
 this, witness the number of " miraculous cures " 
 effected by faith alone — the piles of crutches that 
 psychic cripples have left at a hundred shrines 
 when their will-powers have been strengthened by 
 faith. The evidence is indisputable; but many 
 people fail to interpret correctly the meaning of 
 the seeming miracle. 
 
 We see these same miracles performed in a 
 much less spectacular, although quite as effective 
 a way, in sanitariums every day. And the secret 
 of these cures is a perfectly open one — that of 
 changing the patient's introspective trend of 
 thought into better channels leading to a different 
 and more rational attitude toward herself, thus 
 strengthening the will-power. Such cures are 
 
Mild Forms of Disturbed Equilibrium 59 
 
 much more likely to be permanent than the tem- 
 porary improvement produced by sudden frights, 
 or kindred methods, because they reach the foun- 
 dation of the diflSculty, instead of merely touching 
 a surface manifestation. 
 
 It should be said in extenuation of the selfish- 
 ness that lies at the bottom of hysteria, that the 
 condition is due partly to an inherited defect for 
 which the patients cannot be justly blamed. 
 Neither should they be censured, if their early 
 training and environment have been such as to in- 
 crease, rather than suppress, their hysterical tend- 
 encies. But no such exoneration can be given 
 the parents who were responsible for this environ- 
 ment. 
 
 If these victims had been given proper train- 
 ing in childhood, and helpful surroundings, most 
 of them would escape hysterical manifestations 
 later. In short, the onus of responsibility for 
 hysteria frequently rests with the relatives of the 
 patient, rather than the patient herself. Nervous, 
 hysterical parents produce hysterical offspring; 
 the stable type do not. And this fact should be 
 borne in mind by the members of every neurotic 
 household in dealing with children, or adults, 
 whose mental attitudes are directly influenced by 
 environment. 
 
 Hysteria may have its origin in some forgotten 
 shock or disagreeable experience' of early child- 
 hood — a suppressed emotion of the subconscious 
 
"6o Increasing Your Mental Efficiency 
 
 mental life, whicli still remains a source of dis- 
 turbance. The course of development of every 
 cMld is punctuated by these suppressed emotions ; 
 but in stable individuals these emotions remain 
 dormant throughout life. In neuropathic children, 
 however, they tend to assert themselves later. Yet 
 even in such children they may be kept in a quies- 
 cent state by parents who exercise that highest 
 form of mental hygiene usually characterized as 
 " common sense." A similar course in mental 
 hygiene will be just as effective in suppressing 
 the tendency in the nervous individual later in 
 life. 
 
 The point of interest in hysteria here is that it 
 sometimes precedes and merges into a condition 
 of actual insanity. And falling short of this, it 
 may permanently blight an otherwise useful life, 
 which a little intelligent direction might have 
 saved. 
 
 The Physical Effects of Worry 
 
 Another condition which has become very com- 
 mon in recent years, is that symptom of mental 
 and nervous exhaustion which we call neuras- 
 thenia. Many persons suppose that this condi- 
 tion is merely a form of hysteria. But such is not 
 the case. 
 
 The great difference in the two conditions is 
 that hysteria may be the result of a forgotten 
 
Mild Forms of Disturbed Equilibrium 6i 
 
 shock, plus a neuropathic make-up ; while neuras- 
 thenia is usually the result of conscious worry 
 accompanying, or producing, brain fatigue. This 
 brain-fatigue may be the result of an actual ill- 
 ness, although it is more likely to follow overwork 
 with the accompanying factor, worry. It should 
 be added, also, that most sufferers from neuras- 
 thenia have a highly developed, sensitive, and 
 somewhat unstable nervous organization. 
 
 I have emphasized the element, worry, as a fac- 
 tor in producing neurasthenia, because I believe 
 that it is this, rather than overwork, that is largely 
 responsible. Indeed, if we eliminate those cases 
 of neurasthenia which come as the direct result of 
 some organic illness, we find that mental agitation 
 is responsible for practically all cases. 
 
 "When we consider the mechanisms by which 
 physical and mental work is performed we find 
 the explanation of why either of these factors 
 separately, or both of them together, without the 
 added element, worry, are unlikely to produce 
 more than temporary neurasthenic conditions. 
 The amount of work that our muscular systems 
 can perform is limited by the muscles themselves. 
 When a certain stage of exhaustion is reached the 
 muscle refuses to contract, no matter how much 
 we may " will " it to do so. We can, by sheer 
 force of will-power, drive it up to a certain point — 
 much farther than is desirable, frequently — ^but 
 there is a fixed limit beyond which it cannot be 
 
62 Increasing Your Mental Efficiency 
 
 driven. And when this point is reached the mus- 
 cle stops acting, to rest and recuperate. 
 
 The point of limitation is just as clearly defined 
 in the mental mechanism as in the muscle, al- 
 though less patently so. The muscle rests itself 
 by actually stopping the contraction of its fibres ; 
 while the mind, which is normally active in one 
 of a thousand ways during every moment of con- 
 sciousness, finds means of resting any overworked 
 portion of its structure by throwing into activity 
 some other less fatigued portion. And this 
 process of mental resting by shifting the " cen- 
 ter " of activity is beyond the control of the will. 
 
 Most persons have had illustrations jof this 
 when performing some task which required pro- 
 tracted and concentrated mental effort. After a 
 certain number of hours of work, varying of 
 course in different individuals, the mind tends to 
 wander from the task in hand, and it requires con- 
 stant effort of the will to keep the attention 
 focussed. For a time it is possible to do so, if one 
 is accustomed to concentrated mental effort. But 
 presently a stage of exhaustion is reached in 
 which the mind absolutely refuses to " stick to 
 the subject " — goes skylarking off into some other 
 channel of thought. It has, in short, called off the 
 work in hand for the time being, and is resting 
 itself by wandering into fields where the con- 
 stellations of brain cells are less exhausted. 
 I Thus the brain has its own insistent method of 
 
Mild Forms of Disturbed Equilibrium 63 
 
 recuperation even in our waking hours, and will 
 take its modicum of rest whether we will or no. 
 This mental safety-valve makes it practically im- 
 possible to injure the brain with work. And ex- 
 perience shows that hard work alone, or even a 
 combination of mental and physical exertion of 
 the most strenuous kind, seldom cause a mental 
 breakdown. 
 
 But when we add the additional factor, worry, 
 we form a combination that spells disaster. For 
 the brain is incapable of automatically switching 
 off this tormentor, as it does legitimate work. In- 
 deed the brain that is exhausted by work seems to 
 offer a particularly fertile field for the invader. 
 Eestful sleep does not come. Disturbing, half 
 waking dreams, keep the brain active during the 
 night, and daylight finds an exhausted nervous 
 system that should be fully recuperated. 
 
 This condition of exhaustion may be demon- 
 strated in the changed structure of the brain cells 
 themselves. It is found that such things as shock, 
 grief, fright, worry, and work, both muscular and 
 mental, produce a degenerative change in the 
 brain cells that may be demonstrated microscop- 
 ically — an actual wearing out of the tissues. Eest, 
 even for a very short period, replenishes this 
 waste, as shown in the restored brain cells. But 
 if these cells are kept in a constant state of ex- 
 haustion by worry, they are given no chance for 
 recuperation, and a mental breakdown may result. 
 
64 Increasing Your Mental Efficiency 
 
 The Penalty of Mental Agitation 
 
 We hear constantly of " nervous prostrations " 
 from overwork. Students break down from over- 
 study; business men collapse under the strain of 
 excessive work; and women succumb to social 
 activities. But in every case, practically without 
 exception, it is the insidious element, worry, that 
 causes the collapse. And so there is full justifica- 
 tion for the old adage that, " Work kills no man, 
 Worry many." 
 
 In no field of mental derangement is this better 
 illustrated than in neurasthenia. And in this term 
 we include every gradation between mere mental 
 waverings and complete prostrations. The dis- 
 ease is, indeed, the penalty and product of our 
 modern strenuous methods of life, in which men- 
 tal agitation is a conspicuous element. 
 
 Nearly every person who is subjected to pro- 
 longed mental application with attendant worries 
 suffers from neurasthenic symptoms temporarily. 
 But this state of transient mental fatigue cannot 
 be considered as true neurasthenia. Even in 
 highly organized, emotional individuals, this con- 
 dition is usually self-corrective, unless accom- 
 panied by some exhausting physical disease. 
 
 True neurasthenia is likely to begin with pro- 
 longed periods of insomnia, which may alternate 
 with periods of unrefreshing sleep. The sufferer 
 feels dull, and lacks energy on arising, his general 
 
Mild Forms of Disturbed Equilibrium 65 
 
 condition improving as the day advances — a con- 
 dition almost pathognomonic of debility. He 
 notices, also, that his memory is dulled for recent 
 events, and he finds difficulty in concentrating his 
 thoughts. Frequently after reading a page he 
 finds that he has not understood a line, his 
 thoughts having gone wool-gathering while his 
 eyes scanned the words. He reads the page again 
 — re-reads it several times, perhaps — but is unable 
 to fix his attention upon the subject after the first 
 few lines. 
 
 Obviously his mentality is below par ; and this 
 condition becomes at once a source of worriment, 
 and apprehensive introspection. He begins to 
 dread the tasks which were formerly routine day- 
 duties for him, and to doubt his ability to perform 
 them. Little things irritate and annoy him un- 
 duly, and his usual cheerfulness may be replaced 
 by moody melancholy. In some cases marked 
 irresolution, hesitation, and lack of will-power are 
 characteristic. The victim is harassed by indeci- 
 sion over trifling matters. He cannot decide what 
 suit or tie he shall wear, which train he will catch 
 to town, and doubts his ability to take the train at 
 all once he has reached the station. 
 
 He may be obsessed with the idea that he will 
 make mistakes in his work, and makes mountains 
 out of a hundred and one little mole-hills that are 
 sure to be encountered in his everyday employ- 
 ments. Thus he is worried about his mental con- 
 
66 Increasing Your Mental Efficiency 
 
 dition ; and in the wake of these obsessions comes 
 the inevitable worry over bodily ailments. 
 
 One of the early symptoms of this disorder is a 
 loss of appetite, and also a disinclination to take 
 sufficient quantities of liquids. The neurasthenic 
 seldom seeks relief from his troubles in drink. 
 And thus he is deprived of the three elements 
 necessary to repair his organism and restore his 
 lost energy, — foods, liquids, and sleep. The result 
 is a deranged digestive tract added to a weakened 
 nervous system. The sufferer is indeed ill, phys- 
 ically as well as mentally. 
 
 The chain of morbid symptoms exhibited by 
 these hypochondriacal persons, while differing in 
 each individual, of course, follows fairly well-de- 
 fined trends of thought in most cases. Some of 
 them have a dread of open places (agoraphobia), 
 such as an open square or city street ; others fear 
 enclosed places (claustrophobia), such as a car, or 
 room, with the doors closed. In some the dread 
 of a particular disease such as cancer, appendi- 
 citis, or tuberculosis predominates ; or they cannot 
 bear noises such as the rustling of paper, or have 
 a morbid fear of cats, dogs, or horses. Indeed, if 
 we were simply to catalogue the names of the mor- 
 bid " phobias," the list would fill many pages. It 
 would require a vivid imagination to conceive any 
 form of " phobia " that has not been exhibited by 
 this type of sufferer at one time or another. 
 
 As we shall see in another place, many of these 
 
Hogarth's " Bedlam " 
 
 Patients' Tea Party in- a State Hospital 
 THE OLD YH. THE NEW 
 
Mild Forms of Disturbed Equilibrium 67 
 
 peculiarities are characteristic of certain forms of 
 actual insanity. And no one will question the 
 abnormal mental condition of a man who has 
 changed from a vigorous, active, clear thinker, to 
 one who spends hours in deciding what suit he 
 shall wear, turns pale if the family cat enters his 
 room, fears to cross a street he has crossed a 
 thousand times, cannot trust himself to sign his 
 name, and firmly believes that he is stricken with 
 tuberculosis although assured to the contrary by 
 trusted medical advisers. He is abnormal, mani- 
 festly ; and he is dangerously near the borderline. 
 But in several ways he differs from the man ac- 
 tually insane. He is still amenable to reason, at 
 least temporarily, still hopes to recover, and wishes 
 sympathy. Whereas the person actually insane is 
 not open to reason, is past caring for sympathy, 
 and neither desires nor hopes for recovery. 
 
 The importance of this condition from our pres- 
 ent point of view is (1) that it may merge into 
 actual insanity; (2) even in its worst forms it is 
 curable; and (3) it is a condition which may be 
 prevented by proper mental discipline. In any 
 event, it should not be regarded as a purely imagi- 
 nary illness, even though it is frequently a condi- 
 tion so closely dependent upon the mental state 
 that it may be cured by rigid mental, and physical 
 hygiene, without the aid of medication. The 
 method of applying this mental discipline will be 
 suggested in a later diapter. 
 
m 
 
 Danger Signals 
 
 UNDOUBTEDLY the least understood of all 
 diseases among the generality of people is 
 insanity, or what the modern alienist refers to as 
 the psychoses. Every intelligent person has a fair 
 degree of more or less accurate knowledge about 
 the symptoms of quite an imposing array of other 
 diseases. It is a part of common knowledge to 
 know the symptoms of threatening throat, lung, 
 and intestinal troubles, and among better in- 
 formed persons there is a fair understanding of 
 the more obscure maladies, such as those involv- 
 ing the internal organs, and even the nervous 
 system. 
 
 But there are few persons indeed who have any 
 true conception of insanity itself, or what the 
 symptoms leading up to this calamity may be like. 
 And yet the importance of such knowledge can 
 hardly be overestimated. There are few diseases 
 that give such prolonged premonitory warnings 
 of its approach, or in which the early recognition 
 of these symptoms is of such vital importance. 
 For despite the fact that the causes, symptoms, 
 
 68 
 
Danger Signals 6g 
 
 and course of mental diseases are well understood 
 by the modern physician, the methods of treating 
 these diseases, once they have become established, 
 are scarcely more effective now than in the days of 
 our grandfathers. 
 
 Our chief defence against insanity, then, like 
 contagious diseases, is prevention. But this de- 
 fence, to be successful, cannot be left to medical 
 oflScers, or quarantine laws alone, but requires the 
 cooperation of all intelligent laymen. For we can- 
 not exclude this pestilence by shutting the gates 
 of a city, or closing a few ports of entry, since 
 there are " foci of infections " in every city, vil- 
 lage, and countryside. To suppress these foci we 
 must learn to recognize certain premonitory symp- 
 toms that indicate their existence, just as we have 
 learned to recognize the important symptoms of 
 incipient bodily ailments. 
 
 For this purpose it is not necessary that the in- 
 telligent observer should possess an accurate 
 knowledge of the varied forms of insanity, but 
 rather the general character of the more pro- 
 nounced symptoms. He must, first of all, remem- 
 ber that insanity is a disease, or group of diseases, 
 that affect personality — a certain definite change 
 in conduct, which, in the beginning, may depart 
 very little from the normal conduct of the in- 
 dividual. 
 
70 Increasing Your Mental Efficiency 
 
 Adjustment to Social Environment 
 
 " Speaking in a broad, general way," says Dr. 
 M. S. Gregory, " mental health may be defined as 
 the ability of the individual to adjust himself to 
 his social environment. By this, I mean his ability 
 to adapt himself to society, its customs and con- 
 ventions — the social fabric in which he lives and 
 of which he is a part. Mental life thus consists 
 of a continuous process of adjustment, and the 
 measure of mental health of an individual is 
 directly proportionate to his ability to adapt him- 
 self to his social environment. 
 
 ' ' However, we are not bom equal. Many come 
 into the world burdened with traits, tendencies, and 
 defects which seriously impair their power of ad- 
 justment; while others, in addition to a vicious 
 heritage, have the still greater misfortune of being 
 exposed to faulty and unfavorable environmental 
 factors which accentuate their inherent defects 
 and tendencies, thus completely depriving them of 
 the ability to adjust themselves. 
 
 " Some suffer maladjustment by reason of 
 faulty habits — mental and physical ; by misunder- 
 standings of themselves and their relations to 
 others. Many of us have desires, longings, and 
 ambitions which must be repressed and sup- 
 pressed, as they cannot be gratified, but neverthe- 
 less make our adaptation to our social environ- 
 ment extremely difficult. Intellectual or social 
 
Danger Signals 71 
 
 adjustment is obviously more difficult than phys- 
 ical, because the elemental factors of mental life 
 are more complex and variable. 
 
 " As in the case of physical life, one meets with 
 all gradations of maladjustment from total dis- 
 ability to slight deviation. Thus among those 
 wholly unable to adjust themselves are found the 
 imbeciles, idiots, and profoundly demented. These 
 require segregation and an institutional life. In 
 lesser degree, we find the weak-minded, and some 
 types of chronic insane who show some slight 
 power of adjustment. Another class includes 
 those who have a higher but still incomplete de- 
 gree of adjustment — such as in epilepsy or the re- 
 current mental disturbances. Another large 
 group comprises those who are capable of com- 
 plete adjustment with assistance, such as neuroses, 
 neurasthenics, psychopathies, alcoholics, and so- 
 called nervous people. Finally, we might mention 
 persons who are odd, eccentric, have the so-called 
 artistic temperament, who show only a very slight 
 degree of maladjustment." 
 
 In a general way we may group the symptoms 
 of approaching, or threatened, mental derange- 
 ment in two grand divisions — those in which there 
 is abnormal depression, or those exhibiting the 
 opposite condition of abnormal excitement, or ex- 
 altation. 
 
72 Increasing Your Mental Efficiency 
 
 The Significance of Mental Depression 
 
 Unreasonable or unusual depression, particu- 
 larly in a person of nervous temperament, should 
 be regarded with suspicion, always remembering 
 that fleeting feelings of depression are experienced 
 by every normal person. But when the feeling of 
 depression persists, and is accompanied by loss of 
 appetite, failing nutrition, and sleeplessness, it 
 should be regarded with apprehension, particu- 
 larly in persons of usually buoyant spirits. Great 
 grief, or distress, will, of course, produce depres- 
 sion in every normal individual ; but in the case of 
 persons with stable equilibrium this is naturally 
 and normally mitigated, and the usual state of 
 buoyancy restored by new interests and aspira- 
 tions. In this manner the mind adjusts itself to 
 its new surifoundings. There has been a definite 
 cause for the depression, and a normal, healthy 
 reaction from it. 
 
 But the beginning of the form of depression 
 which may develop into actual melancholia is fre- 
 quently more insidious. Trifling annoyances 
 about household duties or business matters pro- 
 duce needless worries; the sufferer seeks seclu- 
 sion, loses interest in work or is disinclined to 
 work at all, and does not indulge in his ordinary 
 recreations. He is alert and irritable with those 
 about him at times ; but, in general, his actions are 
 slower than formerly, and it is apparent that his 
 
Danger Signals 73 
 
 mind works with corresponding tardiness and dif- 
 ficulty. 
 
 His intellect is still intact, but the flow of 
 thought is noticeably retarded, and his whole atti- 
 tude is one of dull apathy. More than likely he 
 will become careless about his dress and appear- 
 ance — a most significant symptom. And as there 
 is a sluggishness of bodily functions, he is hkely 
 to have digestive disturbances. 
 
 If the person showing these symptoms has hith- 
 erto been of cheerful, buoyant disposition, the 
 change in his condition is quickly noticed. This 
 change is less apparent in those who are naturally 
 quiet, reserved, or seclusive. Yet in either case 
 the symptoms are important danger signals which 
 demand active interference and correction if the 
 sufferer is to be saved from actual insanity. If 
 such correction is undertaken at once, however, 
 the chances for recovery without any perceptible 
 mental deterioration are favorable. 
 
 We need not, for our purpose here, picture the 
 next stage of mental deterioration. But it is of 
 vital importance to know that at this initial 
 stage, if the patient is given proper surroundings, 
 with the right kind of physical and mental 
 hygiene, that the graver calamity can be averted 
 in a majority of cases. 
 
 It should not be understood that all cases of 
 incipient melancholia exhibit the' symptoms of 
 approaching derangement in the order just out- 
 
74 Increasing Your Mental Efficiency 
 
 lined. In some instances peculiar delusions and 
 hallucinations manifest themselves early in the 
 attack. The sufferer may believe that he has per- 
 petrated frauds, ruined his health, betrayed his 
 friends, or committed an unpardonable sin for 
 which there is no hope of forgiveness. Or he may 
 fancy that he sees disagreeable sights, is convinced 
 that all the food offered him is poisoned, or hears 
 voices calling to him, commands from the Deity, 
 or temptations by the devil. In this state of hope- 
 less distress he may commit suicide or attempt 
 the destruction of the members of his family " to 
 save them ' ' — an example of the illogicality of his 
 distorted reason. 
 
 But when any of these symptoms are exhibited 
 early in the attack, although they indicate a con- 
 dition less favorable to ultimate recovery, they 
 usually attract the attention of the friends, and 
 thus insure early, and perhaps curative treat- 
 ment. 
 
 Brain Cells That Are too Active 
 
 Curiously enough a condition similar to the one 
 just described sometimes alternates with one in 
 which the main symptoms both physical and men- 
 tal are of an exactly opposite type. Exaggerated 
 bodily activity, exalted feelings of euphoria, and 
 a rapid flow of ideas rather than a retarded train 
 of thought, are the curtain raisers for the tragedy. 
 
Danger Signals 75 
 
 These may be simply an exaggeration of a normal 
 condition, and if so are likely to remain unnoticed 
 for a longer time. The patient is verbose and 
 talks in a mildly exalted manner to every one 
 about him; he is ceaselessly active, busying him- 
 self with trifles and dabbling in first one thing 
 and then another, writing numerous letters on un- 
 important subjects to chance acquaintances, chang- 
 ing rapidly from one diversion to another, making 
 witty remarks, puns, and jests, retailing funny 
 anecdotes, and showing a sense of well-being 
 not unlike the general effects of mild alcoholic 
 intoxication. Indeed this condition is fre- 
 quently mistaken for mild inebriety, particu- 
 larly in those who are addicted to alcoholic ex- 
 cesses. 
 
 These patients exhibit also peculiar irritability 
 and petty animosities, sometimes seeking contro- 
 versies without provocation or reason; and al- 
 most invariably they exhibit peculiarly resistant 
 insomnia. 
 
 The condition is, indeed, a true ' ' intoxication ' ' 
 in the medical sense. But it should be borne in 
 mind that this kind of intoxication differs from 
 that produced by alcohol or drugs in that it never 
 begins or ceases suddenly. Almost invariably the 
 person shows slight abnormalities for some time 
 without arousing the suspicion, or apprehension, 
 of his friends. And curiously enough the general 
 character of this initial abnormality is usually 
 
75 Increasing Your Mental Efficiency 
 
 that of mental depression — precisely the opposite 
 condition to the one now exhibited. 
 
 The immediate friends will frequently recall 
 that the sufferer had been given to brooding for 
 some time, and in many ways has shown gradually 
 increasing inaptitude or incapacity for work. 
 They may have observed, also, a tendency to re- 
 vert to a condition of depression (which is gen- 
 erally far less pronounced than in actual melan- 
 choha), after a certain period of the exalted 
 condition just described. Indeed, alternation of 
 these two conditions is characteristic of certain 
 forms of insanity. 
 
 The mild condition of exaltation, or depression, 
 just described is only the prelude to the more 
 serious catastrophe. But from our present point 
 of view it is by far the most important stage. 
 For in this condition, which at worst should only 
 be regarded as a state of hypomanic excitement, 
 rather than actual insanity, the case is amenable 
 to curative treatment. 
 
 It is peculiarly desirable, therefore, that every 
 person should have a reasonably clear working 
 knowledge of the significance of these danger 
 signals, and realize the importance of heeding 
 their warnings before it is too late. We need 
 not picture the symptoms of the later stage. The 
 frenzy of the maniac has been so frequently de- 
 scribed in every field of literature that it is 
 familiar to every one. Once this stage is reached 
 
Danger Signals 77 
 
 the mental hygiene of the home is entirely inade- 
 quate. So also, we admit regretfully, is any other 
 known form of treatment in a vast majority of 
 cases. 
 
 One of these two conditions of exaltation or 
 depression with their somewhat characteristic 
 premonitory signals of mental waverings, char- 
 acterize the initial stages of the majority of men- 
 tal aberrations. There are other forms, however, 
 in which the signals are so obscure, or that are so 
 closely akin to temporary exaggeration in normal 
 mental states, that they are less likely to be 
 recognized. 
 
 It was said a moment ago that persons who 
 are odd, eccentric, and have so-called " artistic 
 temperament," frequently show a mild degree of 
 maladjustment to their surroundings. We may, 
 indeed, make the statement somewhat more com- 
 prehensive. Persons who develop that peculiar 
 form of mental aberration called paranoia, — the 
 class from which the calculating assassins are 
 drawn — have usually been odd, eccentric, or ' ' tem- 
 peramental " from childhood. Knowing this, it 
 is readily understood why any parent who en- 
 courages eccentricity in his child, or any adult 
 who purposely exaggerates or fails to restrain 
 his own eccentricities, is courting ultimate dis- 
 aster. 
 
78 Increasing Your Mental Efficiency 
 
 The Significance of Eccentricities 
 
 The man who goes bare-headed in societies 
 where the custom of wearing hats is universal; 
 the man who wears flowing locks in cropped haired 
 communities; the freak who dresses in Greek 
 robes, or goes barefooted in a leather-shod world 
 — each of these is treading a dangerously narrow 
 borderline. For such unusual actions of noncon- 
 formity demonstrate an exaggerated egoism — a 
 false estimate of one's own importance and mal- 
 adjustment to surroundings, that keeps the trend 
 of mentality in the general direction of the asylum. 
 I say asylum, rather than hospital: for no case 
 of true paranoia ever recovers. 
 
 This disease is the result of delusions acting 
 on a mind having a constitutional taint — an in- 
 heritance that may have been developed by bad 
 training in childhood. Yet paranoiacs are fre- 
 quently persons of unusual intelligence. They are 
 the victims of delusions that tend to become sys- 
 tematized — that is, the delusions arrange them- 
 selves sequentially in support of a fixed idea, ia 
 a manner that can be logically explained by the 
 victim, although obviously grotesque to others. 
 Unfortunately, this idea is usually unpleasant in 
 character, a delusion of persecution. 
 
 The disease is likely to begin about the time 
 of puberty, and as its development is slow, may 
 not be detected for several years. A very com- 
 
Danger Signals 79 
 
 mon symptom in the beginning is a suspicion on 
 the part of the victim that there is something 
 queer in his personal appearance, and that people 
 stare at him. He imagines that persons who pass 
 him, turn and look at him, and he suspects that 
 groups of persons are talking about him, criticis- 
 ing, and later, plotting against him. 
 
 He is unhappy, and feels himself out of har- 
 mony with his surroundings and fellow men. 
 He feels that "he is not understood "; and fre- 
 quently his idioscyncrasies are mistaken for 
 marks of genius. And so they may be. But these 
 " misunderstood " individuals are much more 
 likely to be paranoiacs than genuises. 
 
 Unlike the unhappy melancholiac who blames 
 himself for his unhappiness, the paranoiac blames 
 others for his misfortune. To the melancholiac 
 the world is right, himself wrong : to the paranoiac 
 the world is all at fault. 
 
 With this attitude of mind, then, he sees things 
 in strange relations. For that matter, so does 
 genius. But the genius proves his title by turn- 
 ing his unusual insight to practical account, while 
 the visions of the paranoiac come to nothing ex- 
 cept disaster. 
 
 The mind of the paranoiac is clear, and may be 
 even brilliant. Thus the disease is not one of 
 clouded intellect as in some other forms of aber- 
 ration, but rather a condition of faulty judgment. 
 Frequently these paranoiacs show great logicality 
 
8o Increasing Your Mental Efficiency 
 
 in reasoning from eertaia premises on many sub- 
 jects; but their shortcomings lie in their false 
 judgment of themselves, and their abnormal sus- 
 picion of the motives of others. 
 
 A few years ago I witnessed a series of amus- 
 ing episodes which illustrate the characteristic 
 paranoiac attitude of mind. Two farmers of my 
 acquaintance were joint owners of a valuable stal= 
 lion. One of these men was a typical hard-headed 
 Yankee, the other a man with a distinctly para- 
 noid type of mind. As some disagreement had 
 arisen about the care of the animal, the para- 
 noiac-partner offered to sell his share in the 
 horse. 
 
 The Yankee considered the proposition for a 
 few minutes, and then expressed his willingness to 
 buy, offering two hundred and fifty dollars for 
 his partner's share. 
 
 Now this was a perfectly fair valuation, and an 
 amount that the other partner would have been 
 glad to accept — ^until it was offered. But the 
 moment his partner expressed his willingness to 
 buy he became suspicious. He reasoned thus: 
 This man has made me the offer because he knows 
 that he can sell the horse for more. Why should 
 I not get the benefit of this profit, too ? My part- 
 ner is trying to cheat me. 
 
 All this, be it understood, was not thought out 
 on the spur of the moment, but after several days 
 of careful consideration. Then he sought his 
 
Danger Signals 8i 
 
 partner and flatly refused the offer, intimating 
 his reason for refusing. 
 
 " Very well, then," said the partner, " I'll sell 
 you my half interest for two hundred and fifty 
 dollars. ' ' 
 
 A chance to buy was the very thing that the 
 suspicious partner was now seeking. But the mo- 
 ment the chance was offered he demurred. After 
 all, he thought, his partner would not be so anx- 
 ious to sell unless there was some very good 
 reason for doing so. Something was wrong with 
 the horse ; or the former offer to buy was simply 
 a blind to wheedle him into buying instead of 
 . selling. And so, after brooding over the matter 
 for a day or two he decided not to buy, just as he 
 had decided not to sell. 
 
 Now in a general way the reasoning of this sus- 
 picious partner was closely similar to the usual 
 circumspection necessary to carry out any careful 
 business transaction. But the subsequent events 
 showed that the suspicious partner's attitude of 
 miad was abnormal. For at the end of three 
 years of intermittent haggling back and forth, 
 during which time almost every conceivable kind 
 of give-or-take offer was made and refused, there 
 had been no change in ownership of the horse. 
 Then the animal itself settled the matter by dying 
 of pneumonia. 
 
82 Increasing Your Mental Efficiency 
 
 The Goal of False Suspicions 
 
 The characteristic thing about this paranoiac's 
 attitude was that his arguments were perfectly 
 logical, and might very well be founded on facts. 
 This attitude of mind typifies paranoia in the be- 
 ginning; frequently the delusions of persecution 
 are founded on facts. But in cases in which the dis- 
 ease is destined to develop into paranoid insanity, 
 this need not be so, and frequently is not. Many 
 of the fancied wrongs are of a purely imaginarj'- 
 nature, perhaps a single focus in the beginning. 
 But by adding and magnifying one fact here, and 
 another there, always giving it the ' ' squint ' ' that 
 makes it fit into the general scheme of persecuting 
 thought, the paranoiac weaves an unbroken chain 
 of evidence to support his false premise. 
 
 The danger mark in true paranoia is when hal- 
 lucinations make their appearance, hallucinations 
 that usually manifest themselves as imaginary 
 voices almost without exception threatening, or 
 bidding the patient do some violent deed. Thus 
 the voices may seem to come from enemies, or may 
 come as messages from God commanding the 
 death of a king, or a president. In either event 
 they are likely to result in violence, such as the 
 assassinations of a Garfield, a McKinley, or a 
 King Humbert. Yet the overt act seems entirely 
 justifiable to the paranoiac, to whom the halluci- 
 natory voices are absolutely real. 
 
Danger Signals 83 
 
 It does not follow, of course, that every para- 
 noiac who has delusions of persecution, as prac- 
 tically all of them do, will eventually conunit some 
 violence. There are many of these unfortunates 
 who bear a cross, not a weapon. But there is al- 
 ways danger that the. burden of the cross may 
 become intolerable, and a spirit of revenge replace 
 the one of humble submission. 
 
 It is important to remember that the signs of 
 approaching, or threatened, paranoia are fre- 
 quently apparent to the immediate relatives and 
 friends of the afflicted person long before an out- 
 sider, unfamiliar with his normal conduct, would 
 suspect it. When such symptoms are detected, 
 active measures should be taken immediately to 
 try and correct them ; for if the disease progressed 
 to the stage of hallucinations, it is practically im- 
 possible to check its progress. 
 
 Despite the fact that the violent paranoiac is 
 the most dangerous type of lunatic because of his 
 logicality and apparent normality of thought, a 
 vast majority of the milder types of paranoiacs 
 remain at large in their communities. Frequently 
 they are regarded as queer or eccentric persons. 
 Many of them are unable to hold positions for any 
 length of time, because they believe that their as- 
 sociates persecute them in various petty ways. 
 They imagine that their mail is tampered with, 
 that other employes complain of them to their em- 
 ployers; or they suspect that misplaced articles 
 
84 Increasing Your Mental Efficiency 
 
 have been purposely concealed to annoy them. 
 Sooner or later they take their troubles to their 
 employers; and frequently the reassurance they 
 receive quiets their suspicions for the moment. 
 For the paranoid type of person usually performs 
 Ms tasks with great proficiency; and for this rea- 
 son is likely to be in good standing with those for 
 whom he works. But the effect of the employer's 
 reassurance soon wears away, the ideas of per- 
 secution again dominate the diseased mind, and 
 in the end the paranoiac leaves his position and 
 seeks employment elsewhere'. 
 
 Of course his persecutors do not confine their 
 efforts to his place of business, but carry their 
 activities to the home or boarding-house of the 
 victim, and follow him to his new place of employ- 
 ment. He sees evidences of their influence in his 
 places of amusement and on the street, in the hun- 
 dred and one petty annoyances of everyday life. 
 And so the unfortunate goes about in an atmos- 
 phere charged with dismal suspicions — a maze 
 of tangled mysteries which center about himself. 
 These are the men who are forever in litigation — 
 righteous litigation in every instance in their 
 honest opinions. And these are the patients who, 
 when committed to the asylums, secure habeas 
 corpus hearings, conduct their own cases in court, 
 and are forever convincing lay jurors that they 
 are sane and should be liberated because of their 
 ability to reason with such apparent logicality. 
 
Danger Signals 85 
 
 Eventually they drift back into the insane hos- 
 pitals again; but unfortunately this return may 
 be deferred until their delusions have driven them 
 to commit some frightful crime. In that event it 
 is often the electric chair, rather than the asylum, 
 that closes the dismal chapter. 
 
 The less pronounced types wander from one 
 place of employment to another, and from one 
 place of abode to another, always seeking to evade 
 their persecutors, but forever jfinding them haunt- 
 ing each new environment. As a rule they are 
 great faddists; and this faddishness may be the 
 first symptom that excites suspicion of their men- 
 tal abnormality. 
 
 Narcotics and Mental Stability 
 
 There is one quite common danger signal in- 
 dicative of a somewhat unstable nervous make-up 
 that every individual can gauge, and should heed. 
 This is the effects of alcohol. Persons who are 
 abnormally sensitive to small quantities of alco- 
 holic drinks have less stable mental equilibrium 
 than those who are not affected by reasonable 
 potations. And persons of this peculiarly sensi- 
 tive type should avoid alcohol in every form, and 
 should practice mental hygiene, at least to the ex- 
 tent of avoiding the better known dangers to men- 
 tal equilibrium, such as bursts of anger, brood- 
 ing, and tendencies to despondency, or excesses of 
 
86 Increasing Your Mental Efficiency 
 
 any kind. For their idiosyncrasy is most sig- 
 ficant. 
 
 Besides these individuals, there are many per- 
 sons whose inherent mental tendencies may be 
 judged by the effect that alcohol produces upon 
 them. In a general way, all persons fall into one 
 of two classes. One of these includes the persons 
 in whom alcohol produces an extreme degree of 
 exhilaration — who become " crazy," and entirely 
 irresponsible after a few drinks. The other (and 
 a far larger class, I believe) do not experience the 
 same exhilaration, even with copious imbibitions 
 — cannot, in short, " drive away all oare " with 
 liquor. 
 
 Of these two types, the person who is more 
 easily affected and becomes highly exhilarated by 
 alcohol, is likely to be of a more unstable, or 
 neuropathic make-up. This is shown in another 
 way. Such persons are much more likely to be- 
 come addicted to drugs, since drugs have the same 
 peculiarly exhilarating effects upon them. The 
 type of person not unduly exalted or excited by 
 alcohol is usually more phlegmatic and more 
 stably balanced, and less likely to become the vic- 
 tims of narcotics. 
 
 There is one hopeless form of mental aberration 
 for which no curative treatment can be given, even 
 if the initial symptoms are detected early. This 
 form of insanity is called paresis. The course of 
 this disease is usually rapid, and death inevitable 
 
Danger Signals 87 
 
 within a comparatively short time. But, even 
 though a detection of the early symptoms will not 
 avert the ultimate calamity, it is highly important 
 that such symptoms be recognized, since these 
 patients tend to do things that are likely to bring 
 disaster upon their households as well as them- 
 selves. 
 
 It seems paradoxical that this most incurable 
 form of mental aberration is the most preventable 
 — is, indeed, the result of the specific disease, 
 syphilis. But fortunately it does not develop as a 
 common sequence of this infection, although there 
 is every reason to beheve that there is no case of 
 paresis that is not preceded by syphilis, either 
 hereditary or acquired. Not every person who 
 has contracted, or inherited, a specific infection — 
 perhaps not over one in one hundred — will become 
 paretic. And in any event, even the initial symp- 
 toms of this disease will not appear until several 
 years after the specific disorder. 
 
 " The most suspicious of all circumstances, 
 which may indicate the inception of general pa- 
 ralysis (paresis)," says Hollander, " is a gradual 
 but obvious alteration in the mental character- 
 istics of the individual." There may be also an 
 alteration in the patient's physical system which 
 may give definite indications of disease quite as 
 pronounced as the mental symptoms. 
 
 The most frequent and characteristic mental 
 change is a general state of mild exhilaration, 
 
88 Increasing Your Mental Efficiency 
 
 quite unlike the patient's usual state of mind. He 
 expresses himself as being in perfect health — 
 never felt better in his life. And the expression 
 of his face shows a pleased satisfaction with him- 
 self, which may continue for months without 
 other very pronounced mental changes. Mean- 
 while, however, his family may have noticed that 
 some peculiar and entirely unusual physical 
 symptoms have developed. There are tremors 
 of the Ups and tongue, with accompanying diffi- 
 culties in speech when attempting to pronounce 
 certain words, and the handwriting may change 
 entirely and become almost illegible. The patient 
 is likely to be irritable over small matters, make 
 unusual demands of those about him, and whim- 
 sical about his food. Yet all this time he asserts 
 insistently that he is feeling better than ever 
 before. 
 
 This feeling of well-being, which characterizes 
 most cases, does not always accompany the other 
 symptoms. Some paretics are depressed; and 
 even the elated states are likely to be interspersed 
 with periods of depression, or moroseness. But 
 the physical symptoms are fairly constant, and 
 even the tremulous, depressed patient may have 
 delusions of grandeur completely subversive of 
 his physical condition. He asserts that he is the 
 strongest man in the world, the most skilful, and 
 the richest, even though penniless and infirm. 
 
 It is a peculiar feature of the early symptoms 
 
Danger Signals 8g 
 
 of this disease that the patients are likely to enter 
 into extravagant business ventures, which leave 
 their families penniless later on. They are prone 
 to conceive stupendous undertakings, such as buy- 
 ing or manufacturing articles on an enormous 
 scale. And, if they have been successful in busi- 
 ness ventures hitherto, the visionary nature of 
 these schemes may escape detection, until too late 
 to avert the fatal crash and resultant ruin. 
 
 The moral sense is usually dulled rather early 
 in the disease. The patient may perpetrate frauds, 
 or actually steal things for which he has no use; 
 and detection causes him no remorse. Eventually 
 he becomes careless of his personal appearance, 
 and in his deportment, even though formerly most 
 exemplary in such matters. But by the time this 
 stage is reached his mental abnormality will cer- 
 tainly have been detected. Let us hope that this 
 detection has not been delayed until this doomed 
 man has dragged his friends into ruin with 
 him! 
 
 Some of the visionary schemes of these paretics 
 are presented with such logicality, that they defy 
 controversion except by the dictum of common 
 sense. I knew one patient who conceived a gigantic 
 scheme for making a million dollars yearly profit 
 by raising " white navy beans." Beans would 
 bring one dollar a bushel ; an acre of ground will 
 produce two bushels ; the cost of production is not 
 over one dollar per acre. Ergo: rent a million 
 
go Increasing Your Mental Efficiency 
 
 acres of ground, raise two million bushels of 
 beans at a cost of one million dollars; sell the 
 crop for two millions ; and clear a million. What 
 could be simpler! 
 
 Stated thus, the scheme is too obviously gro- 
 tesque for consideration. But as presented by the 
 patient it was most convincing. For he could 
 give a logical explanation to every possible objec- 
 tion, or apparent obstacle, and meet them with an 
 array of figures seemingly unanswerable. Some 
 less patently fantastic, but no less visionary 
 scheme, has brought financial ruin upon many a 
 paretic and his unsuspecting friends. 
 
 Transient Mental Waverings 
 
 Closely allied to the insane states, and fre- 
 quently merging into them, are abnormal mental 
 conditions which, in their milder manifestations, 
 have been experienced by every one. I refer to 
 perverse obsessions, such as a desire to do, or say, 
 things suggsted by some compelling impulse — im- 
 peirative conceptions, as they are called. The 
 normal mind resists such impulses. But neuro- 
 pathic persons sometimes find great difficulty in 
 suppressing them, particularly when in a state of 
 high nervous tension, or exhaustion. 
 
 A recent writer on this subject describes these 
 persons as " feeling an irresistible desire to tell 
 persons they see to do some harm; if they see a 
 child, to tell it to break things or set the place 
 
Danger Signals gi 
 
 on fire. Ruffianly looking men give rise to the 
 desire to tell them to kill or to do some harm. 
 These imperative conceptions are often associated 
 with a feeling of doubt as to their having per- 
 formed some act; thus they often doubt if they 
 had told these persons to do harm." 
 
 These are the words of a modern psychiatrist. 
 But nearly three quarters of a century ago this 
 condition was described by a writer of fiction in a 
 manner that leaves no room for improvement. 
 The description occurs in Hawthorne's Scarlet 
 Letter, and shows the author's marvelous insight 
 into the abnormalities of the human mind. Few 
 physicians in Hawthorne's time had any such 
 clear understanding of this peculiar mental phe- 
 nomenon : none to-day has any better. Indeed the 
 terse description given above could have been 
 drawn from Hawthorne's masterful delineation. 
 
 The incident in the Scarlet Letter which inspired 
 this description is the one in which the erring, 
 but unsuspected and revered minister, Mr. Dim- 
 mesdale, has just reached the determination to 
 throw off the oppressive secret yoke that had shat- 
 tered his body and set his mind tottering. 
 
 " At every step he was incited to do some 
 strange, wild, wicked thing or other," runs the 
 description, ' ' with a sense that it would be at 
 once involuntary and intentional, in spite of him- 
 self, yet growing out of a profounder self than 
 that which opposed the impulse. For instance, he 
 
92 Increasing Your Mental Efficiency 
 
 met one of the deacons. The good old man ad- 
 dressed him with the paternal affection and pa- 
 triarchal privilege which his venerable age, his 
 upright and holy character, and his station in the 
 church, entitled him to use; and, conjoined with 
 this, the deep, almost worshipping respect, which 
 the minister's professional and private claims 
 alike demanded. Never was there a more beauti- 
 ful example of how the majesty of age and wis- 
 dom may comport with the obeisance and respect 
 enjoined upon it, as from a lower social rank, and 
 inferior order of endowment, towards a higher. 
 
 " Now, during a conversation of some two or 
 three moments between the Reverend Mr. Dim- 
 mesdale and this excellent and hoary-bearded 
 deacon, it was only by the most careful self-control 
 that the former could refrain from uttering cer- 
 tain blasphemous suggestions that rose into his 
 mind, respecting the communion supper. He ab- 
 solutely trembled and turned pale as ashes, lest 
 his tongue should wag itself in utterance of these 
 horrible matters, and plead his own consent for 
 so doing, without his having fairly given it. And, 
 even with this terror in his heart, he could hardly 
 avoid laughing, to imagine how the sanctified old 
 patriarchal deacon would have been petrified by 
 his minister's impiety. 
 
 " Again, another incident of the same nature. 
 Hurrying along the street, the Eeverend Mr. Dim- 
 mesdale encountered the oldest female member of 
 
Danger Signals 93 
 
 his church, a most pious and exemplary old dame, 
 poor, widowed, lonely, and with a heart as full of 
 reminiscences about her dead husband and chil- 
 dren, and her dead friends of long ago, as a burial- 
 ground is full of storied gravestones. Yet all this, 
 which would else have been such heavy sorrow, 
 was made almost a solemn joy to her devout old 
 soul, by religious consolations of the truth of the 
 Scripture, wherewith she had fed herself con- 
 tinually for more than thirty years. And since 
 Mr. Dimmesdale had taken charge, the good 
 grandam's chief earthly comfort — which, unless 
 it had been likewise heavenly comfort, could have 
 been none at all — was to meet her pastor, whether 
 casually, or of set purpose, and be refreshed with 
 a word of warm, fragrant, heaven-breathing Gos- 
 pel truth, from his beloved lips, into her dulled, 
 but rapturously attentive ear. 
 
 " But, on this occasion, up to the moment of 
 putting his lips to the old woman's ear, Mr. Dim- 
 mesdale, as the great enemy of souls would have 
 it, could recall no text of Scripture, nor aught else, 
 except in brief, pithy, and, as it appeared to him, 
 unanswerable argument against the immortality 
 of the human soul. The instillment thereof into 
 her mind would probably have caused this aged 
 sister to drop down dead, at once, as by the effect 
 of an intensely poisonous infusion. What he really 
 did whisper, the minister could never afterwards 
 recollect. There was, perhaps, a fortunate dis- 
 
94 Increasing Your Mental Efficiency 
 
 order of his utterance, wMeli failed to impart any 
 distinct idea to the good widow's comprehension, 
 or which Providence interpreted after a method 
 of its own. Assuredly, as the minister looked 
 back, he beheld an expression of divine gratitude 
 and ecstasy that seemed like the shine of the celes- 
 tial city on her face, so wrinkled and ashy pale." 
 Some similar attitude of mind, in a less exag- 
 gerated form, — some imperative conception, in 
 one form or another — is likely to obsess the highly 
 strung, over-wrought normal person. It is usually 
 suppressed and soon forgotten. But it is a danger 
 signal — a red light signal of impending disaster, 
 if you please — ^which should be heeded and cor- 
 rected. Yet unlike many of the others just enum- 
 erated, its detection and correction rest almost ex- 
 clusively with the individual himself. His actions 
 may finally reveal his obsessions to his friends; 
 but the time for correction is before this — ^before 
 his mentality succumbs to such a degree that he 
 cannot resist acting on the impulse created by the 
 impelling thoughts. 
 
IV 
 
 Nourishing the Mind 
 
 A MERICA is a country of enthusiasts. And 
 ■^*- enthusiasm is undoubtedly a valuable na- 
 tional asset. But great enthusiasm about too 
 many subjects indicates a somewhat faulty judg- 
 ment in many instances — a type of credulity that 
 leads to the chasing of one phantom after another 
 without any very definite accomplishment. 
 
 There is no nation in the world that has so little 
 cause to worry over what it eats as our own ; yet 
 no country is so obsessed with diet-fads. Break- 
 fast-food fads, and chewing fads, carry us off our 
 feet in mad enthusiasm — at least until some other 
 tempting fad crosses our path, and turns us into 
 fresh channels of pursuit. 
 
 Fortunately for ourselves we are not persistent 
 in our fad-chasing, so that no great amount of 
 harm results from our escapades. Indeed most of 
 the fads are so innocuous in themselves that they 
 would do little harm if pursued persistently. But 
 occasionally one is created that would prove dis- 
 astrous to its votaries if pursued too persistently. 
 
 Some one has said, and with a great deal of 
 truth, that if " they [the food faddists] were not 
 
 95 
 
96 Increasing Your Mental Efficiency 
 
 busy chasing one fad they would be busy chasing 
 another." They are, in short, faddists chroni- 
 cally, and by nature. But the recent episodes in 
 our last-but-one-or-two eating fads, " Fletcher- 
 ism," demonstrates that few persons are entirely 
 immune to the influence of well-aimed faddism. 
 For this fad draws a horde of usually well-bal- 
 anced persons into the vortex temporarily — per- 
 sons who should have known that any fad which 
 attempts to overthrow estabhshed customs in eat- 
 ing, sleeping, or clothing ourselves by radical 
 changes in methods, will be ephemeral. 
 
 The history of the beginning of Fletcherism is, 
 briefly, as follows: Mr. Horace Fletcher, an 
 American gentleman, middle-aged, fat, dyspeptic, 
 and in a generally demoralized physical condition, 
 hit upon the idea of self -cure by eating less food 
 and chewing that small quantity mouthful by 
 mouthful many more times than is usually con- 
 sidered necessary for proper mastication. There 
 was really nothing novel in the essential features 
 of this " cure." Even the ancients knew that 
 middle-aged men in easy circumstances usually 
 eat too much and chew too little. And in more 
 recent times Gladstone had set the example of 
 better food mastication by making it a rule to 
 " give every tooth a chance " — thirty-two masti- 
 cations to each mouthful. 
 
 But Gladstone was a man busy with so many 
 things that he did not ride his chewing hobby to 
 
Nourishing the Mind 97 
 
 the exclusion of all others. With Mr. Fletcher the 
 case was different: he had but one hobby in his 
 stable, and he focalized his equestrian feats upon 
 that one. Moreover, he was no ordinary rider. 
 He had no goods to sell — ^no new kind of break- 
 fast-food to foist upon the guileless and gullible — 
 simply a philanthropic and entirely worthy pur- 
 pose to tell the world a great discovery that 
 would make the world much better. The principle 
 of the new fad was simply to eat Uttle food, 
 but chew it and chew it, and then chew it some 
 more, until it was tasteless and nauseating. 
 By such means weak men would be made strong, 
 and strong men stronger, on a mere pittance 
 of food. 
 
 As proof of this, Mr. Fletcher could point to 
 the great change for the better in his own physical 
 condition. And there is no denying that this 
 change was revolutionary. But there are two 
 vitally weak points in the evidence, which Mr. 
 Fletcher, lacking expert medical knowledge, could 
 not to be expected to appreciate. The first is, that 
 simply because the multi-chewing method had 
 cured one man it need not necessarily cure any 
 other man ; the second, what might indeed be very 
 good treatment for a sick man (as Mr. Fletcher 
 certainly was) might be positively harmful for a 
 well person. 
 
gS Increasing Your Mental Efficiency 
 
 The Dangers of Diet Fads 
 
 Medical men learned many generations ago that 
 " one man's food was another man's poison," 
 literally; and experience has taught them not to 
 found any hard and fast rules on the results of 
 experiments upon a single individual. Moreover, 
 as I shall show in a moment, our knowledge of 
 physiology, which surely cannot be completely at 
 fault, seems to show that Fletcherism could not be 
 a scientific cornerstone upon which to build a per- 
 fect health temple. 
 
 But " scientific caution " was singularly lack- 
 ing among the converts to the new fad, several 
 of whom were stamped into the herd from the 
 ranks of the medical men themselves. Some of 
 these were undoubtedly sincere, even if somewhat 
 too credulous. Others, we may strongly suspect, 
 were influenced by the prospect of getting aboard 
 a very well patronized and well advertised excur- 
 sion. 
 
 We need not chronicle the stream of adulatory 
 literature that the new fad called forth. An ex- 
 ample or two will suffice. One learned professor 
 wrote to the instigator of this stampede: " What 
 you have done to unfold physiological mastication 
 means more for human weal than all the mere 
 medical prescribers have given the world from 
 Adam to the present time! " A sanitarium 
 keeper carolled in this mawkish strain : ' ' We are 
 
Nourishing the Mind gg 
 
 chewing hard at , chewing more every 
 
 day. . . . We have gotten up a little Chewing 
 song which we sing to the patients. ... I read 
 some of your notes to my colleagues, and they 
 were so much affected that tears came into their 
 eyes." 
 
 And yet, half a decade after this affecting, 
 lachrymose scene, Fletcherism was not only dead 
 as a fad, but was known to be a " physiological 
 monstrosity " instead of the great physiological 
 discovery. In the meanwhile it had demonstrated 
 from a somewhat unusual angle the well-known 
 fact that enthusiasm may play havoc with judg- 
 ment — even about such a prosaic thing as eating. 
 
 The Fleteherites overlooked some fimdamental 
 truths that should be self-evident. It should be 
 apparent to any intelligent person that it is quite 
 as impossible to create matter by chewing it, as 
 by any other known method. Moreover, the 
 amount of matter required for bodily nourishment 
 is much more than the Fleteherites advocated. 
 That much for quantity. 
 
 As to quality, every one knows that three kinds 
 of food are necessary to life: (1) proteids, rep- 
 resented by meats, fish, and eggs; (2) carbohy- 
 drates, such as the starch furnished by vegetables ; 
 and (3) fats, of one kind or another. What effect 
 does mastication have upon these various essen- 
 tials ? On the proteids it has practically none, the 
 digestion of these important kinds of foods taking 
 
100 Increasing Your Mental Efficiency 
 
 place farther along in the alimentary canal. 
 Similarly, the fats are not influenced by mastica- 
 tion or ensalivation in the mouth to any very 
 great extent; while the starches are converted 
 into a form of sugar — g, necessary step to absorp- 
 tion of this form of food. 
 
 It would appear, then, that the advantages of 
 excessive mastication were appropriate and help- 
 ful, only when eating starchy foods. In short, one 
 might consistently bolt his meat, but must chew 
 his vegetable soup thoroughly, if his digestion is 
 to remain perfect. But Nature has made provi- 
 sion for toothless infancy and old age, and does 
 not place a very severe digestive task upon the 
 secretions of the mouth at any period of life. In- 
 deed, the important part in the digestive process 
 of those substances upon which the saliva acts in 
 a helpful manner, is carried on in the intestines 
 through the agency of a much more powerful and 
 active digestive ferment secreted by the pancreas. 
 So that prolonged mastication will, at most, simply 
 help to perform a digestive act in the mouth, with 
 its relatively ineffective mechanism, and thus re- 
 lieve an efficient organ, the pancreas, of a task 
 for which nature specially designed it. 
 
 Moreover it has been found by recent experi- 
 ments that excessive mastication may reduce the 
 food to such a degree of minute division that it is 
 not handled properly by the natural processes of 
 absorption. Like finely ground powder grains in 
 
Nourishing the Mind loi 
 
 a great gun, it causes a premature explosion of 
 energy in a too circumscribed area, instead of 
 being distributed properly along the bore. 
 
 But all this is simply an explanation of why ex- 
 cessive mastication is an unnecessary, as well as 
 a somewhat disgusting practice. It offers no ex- 
 planation of why Fletcherism lost its popularity 
 as a fad. Yet such explanation is scarcely neces- 
 sary. The fact that it was simply a fad suffi- 
 ciently explains its decline in popularity : for such 
 is the fate of all fads. And, as regards this par- 
 ticular hobby, it was most fortunate. For if we 
 had actually carried out the plans of the Fletcher- 
 ites, and attempted to raise the younger genera- 
 tion of growing boys and girls by the regime of 
 chewing and parsimonious diet that had cured an 
 elderly and pathological gentleman, we should 
 have produced a race of sickly weaklings. 
 
 Value of Established Customs in Diet 
 
 Normally healthy persons should shun all eat- 
 ing-fads. For it is a clinical observation, trans- 
 mitted through many generations of physicians, 
 that faddishness about eating is a sure road to 
 dyspepsia. " The generalized food customs of 
 mankind," said Sir William Eoberts, " are not to 
 be viewed as random practices adopted to please 
 the palate or gratify an idle or a vicious appetite. 
 These customs must be regarded as the outcome 
 
102 Increasing Your Mental Efficiency 
 
 of profound instincts which correspond to cer- 
 tain wants of the human economy. They are the 
 fruit of a colossal experience accumulated by 
 countless millions of men through successive gen- 
 erations. They have the same weight and signifi- 
 cance as other kindred facts of natural history, 
 and are fitted to yield to observation and study 
 lessons of the highest scientific and practical 
 value." 
 
 This being the case we should be able to find 
 some reason why we have formed the habit of 
 eating our meals with the various dishes served 
 in certain definite order, if it is not merely a 
 caprice of fashion or conformity. In short, why 
 we eat soup first and pastries last, instead of the 
 reverse. 
 
 Some recent investigations offer an entirely 
 satisfactory explanation for doing so, on physi- 
 ological grounds. According to a recent writer, 
 " we have unconsciously established a routine of 
 courses in the dinner that takes thorough cog- 
 nizance of the physiological principles upon which 
 digestion is founded. Even such matters as fes- 
 tive attire, floral decorations, and music, we are 
 told, have their share in composing a generally 
 favorable stage-setting, as it were, for digestion; 
 for it has been abundantly shown in recent years 
 that a person's mood is of the greatest significance 
 in the performance of the digestive functions." 
 
 This last fact should be borne in mind in seek- 
 
Nourishing the Mind 103 
 
 ing a reason for the undoubted success of Fletch- 
 erism in some instances. The faddist is an enthu- 
 siast, for the time being at least, and undoubtedly 
 in many instances his mood rather than his method 
 accounts for the beneficial results. 
 
 Why Soup Precedes Pastry 
 
 But to return to the physiological reason for 
 the order of our meals. Dr. Leverson's explana- 
 tion of the logicality of having the dessert course 
 composed largely of carbohydrate preparations — 
 pastry, sweets, fruit, flavors, and cream — is en- 
 Jightening. " Foods of this order, as is well 
 known, are not primarily digested by the gastric 
 juice, but are acted on by the salivary ferment 
 known as amylopsin. This ferment is incor- 
 porated with the food in the mouth, and will con- 
 tinue to act until it is neutralized by the gastric 
 juice. It was formerly assumed that such neu- 
 tralization must take place almost immediately 
 on the swallowing of the food. Eecent studies 
 discredit this view, it being alleged that the food 
 last ingested occupies a central position in the 
 stomach for some time, and that only the periph- 
 eral portions are actively in contact with the 
 gastric juice. 
 
 ** Thus the carbohydrates that make up the des- 
 sert are so placed as to be acted on advantageously 
 and for a long period by the salivary ferment in- 
 
104 Increasing Your Mental Efficiency 
 
 corporated with them; whereas had the same 
 foods been ingested early in the meal they would 
 have been brought at once in contact with the pe- 
 riphery of the stomach, and their digestive changes 
 arrested." 
 
 Here is another reason, then, why persons in 
 health should not be too ready to disregard es- 
 tablished customs in eating. Of course the case 
 is entirely different when there is organic bodily 
 disease. In such conditions, clinical and labora- 
 tory experiences of competent observers must be 
 the guide. But this guidance should be entrusted 
 to a thoroughly competent and trained observer, 
 and under no circumstances should self-guidance 
 be attempted. No person who is actually ill 
 should attempt to prescribe for himself in the 
 matter of diet any more than in kinds of medicine. 
 
 We may feel sure that there is a sound physio- 
 logical reason for the dietary differences that 
 exist between widely separated communities, such 
 as those at the equator, and those living near the 
 Arctic circle. There is conclusive evidence of this 
 in the fact that persons who visit these regions, 
 and remain for any considerable time, find it ad- 
 vantageous to adopt the food, and food customs, 
 of the natives. The people of any community, 
 taken collectively, choose the proper kind of foods 
 best adapted to their needs, guided by an instinct 
 created by experience. Individually there are 
 marked exceptions to this, particularly in highly 
 
Nourishing the Mind 105 
 
 civilized communities. This last is, indeed, re- 
 iterating the statement that "one man's food is 
 another man's poison " — in individual cases only, 
 however. Taken collectively, one man's food is 
 another man's food. And it is better to follow 
 established customs than to attempt to overthrow, 
 or disregard them. 
 
 The perennial fad of vegetarianism is a case in 
 point. The life of this fad seems to be perpetuated 
 by the application of the sophistic rule that what is 
 food for certain individuals is food for the race. 
 There are certain healthy persons who live and 
 thrive on a vegetable diet; and there are patho- 
 logical conditions in which a careful vegetable 
 diet undoubtedly prolongs life. 
 
 Vegetables and Mental EfHciency 
 
 It may be pointed out with entire truthfulness 
 that vegetables contain all three of the essential 
 food elements — proteids, carbohydrates, and fats. 
 To be sure these elements are not offered in 
 ideal proportions for the use of our systems ; but 
 the human organism is such a wonderfully adapt- 
 able mechanism that it will select out the right 
 proportions for itself if supplied with sufficient 
 quantities. The system will " keep up steam " on 
 this bad fuel, just as a boiler can be made to steam 
 Avith poor coal. But if a bad quality of coal is 
 used, there must be more stokers and more labor. 
 
io6 Increasing Your Mental Efficiency 
 
 which is poor economy. Moreover, poor fuel 
 tends to foul the boiler and shorten its life. 
 
 A purely vegetable diet makes poor fuel for the 
 human engine. Yet by putting on extra " stok- 
 ers," in the form of expended vital energy, this 
 poor fuel will keep the body machinery running. 
 As a result, however, the system expends vital 
 energy for the somewhat lowly purpose of stoking, 
 which might otherwise have been utilized for much 
 higher fields of creative work, both mental and 
 physical. 
 
 It is a significant fact that meat-eating races 
 lead the world in everything — war, commerce, 
 science, and art. The relative positions of the 
 Orient and the Occident exemplify this. The 
 Orientals consume far less meat than the people 
 of Europe and America, partly from necessity, 
 and partly on account of religious belief. And for 
 centuries they have lagged far behind the Euro- 
 peans in progress, and in war. 
 
 Japan is making a strong bid to become the one 
 exception among Eastern nations. In the arts of 
 peace she is certainly climbing to a high level; 
 and the recent war with Russia demonstrates what 
 she can do in war. But is she doing these things 
 on a vegetarian diet as of old? Not at all. Her 
 fighting seamen received the same proportion of 
 proteid foods in proportion to their body weight 
 as the British tars ; and her soldiers, in her recent 
 conflict with Eussia, " had a more abundant pro- 
 
Nourishing the Mind 107 
 
 teid diet than any other army in the field has 
 ever enjoyed." 
 
 Thus we see that Japan offers no exception to 
 the rule that meat-eating races are the leaders 
 physically and mentally. And this suggests an 
 answer to the question which is frequently asked, 
 and which concerns us principally in this chapter, 
 as to what foods are " brain foods " if we may 
 use the term. So far as we know, it is quite im- 
 possible to feed the brain except through the gen- 
 eral process of feeding the body. The old idea, 
 which still persists, that fish acts as a food for 
 the brain rather than the body, has no basis in 
 fact. 
 
 If the child during its early years has been 
 given proper training, its own instincts will be its 
 best guide in the selection of proper nourishment 
 later in life. Ill health, of course, frequently 
 causes caprices about eating; but this is quite 
 another matter. 
 
 Most children at the age of puberty develop an 
 appetite for meat, and at this period should be 
 encouraged to gratify it. Important, vital changes 
 are taking place in the system at that time — 
 changes that have a direct bearing upon future 
 mental, as well as physical states — that require a 
 full protein diet for their development. Later the 
 craving for meat will gradually subside, and a 
 well-balanced regime be established. 
 
 The question is asked frequently whether active 
 
io8 Increasing Your Mental Efficiency 
 
 mental or physical exertion should be indulged in 
 immediately after eating. As a general rule it is 
 not advisable to do either one or the other shortly 
 after a meal ; but here again the habits of the in- 
 dividual must be considered. Some persons, even 
 athletes,, are accustomed to taking strenuous ex- 
 ercise regardless of meal time. Indeed some 
 vocations make this necessary. But we do not 
 find that persons following these occupations are 
 more subject to digestive disturbances than 
 others. 
 
 I once inquired about the eating habits of a 
 champion wrestler who was doing strenuous train- 
 ing for an important match. This athlete made it 
 his regular practice to take a hearty meal at noon, 
 and go at once to the gymnasium to wrestle with 
 his trainers. When I expressed astonishment at 
 this, and asked the athlete if he considered his 
 method a good one, he declared that he had always 
 found it so. 
 
 " How can I work if I don't eat? " he inquired. 
 And this was the key to his point of view. 
 
 Of course his theory was entirely wrong. The 
 food taken into his stomach fifteen minutes before 
 beginning his exertions would not be utilized to 
 furnish strength until several hours later. Yet 
 in practice his method seemed to work satisfac- 
 torily, judged by results. 
 
 We must not interpret this wrestler's methods, 
 however, as indicating that violent exercise im- 
 
Nourishing the Mind 109 
 
 mediately after eating is advisable, for athletes 
 or others; but rather that a vigorous body fre- 
 quently overcomes by adaptation obstacles that 
 oppose rational hygiene. Possibly if the excessive 
 mastication votaries of parsimonious diet had hit 
 upon a method similar to that of this wrestler, 
 instead of their particular hobby, this sort of fad 
 would have become popular in place of chewing. 
 And then we should have had still another ex- 
 ample of mistaking physical adaptability for 
 physiological need. 
 
 It seems to be a perfectly natural thing for chil- 
 dren to take violent exercise regardless of the time 
 that food is ingested; and as no harm seems to 
 come from this it is not advisable to interfere with 
 this natural process by compelling the child to rest 
 after eating. The case is somewhat different as 
 regards mental effort. Children should not be 
 forced to study immediately after taking a full 
 meal. 
 
 This seeming paradox may be explained on 
 physiological grounds. Physical exercise is a 
 heritage handed down through countless thou- 
 sands of generations, and has established itself 
 as a natural process ; whereas close mental effort 
 is a recent iimovation and may, therefore, be re- 
 garded as an artificial one. When close mental 
 application to printed pages has become a natural 
 process through ages of indulgence, it is probable 
 that the children of that future age will be able 
 
no Increasing Your Mental. Efficiency 
 
 to eat and study with the same impunity that they 
 may eat and play at present. But this result of 
 future evolution need not concern us now. 
 
 The rule that applies to children about mental 
 effort immediately after eating, applies also to 
 their parents; and for the same reason. But the 
 child's craving for protein food, and the neces- 
 sity for it, falls into another category. Adults of 
 sedentary habits should not indulge too freely in 
 a meat diet. There is a grain of truth in the 
 " vegetarian's " theory (as there must be in any 
 fad that gains a hearing) to the extent that many 
 persons of sedentary habits indulge too freely in. 
 a protein diet. In short, a necessity of childhood 
 may be a menace to old age. 
 
 The habit of overeating may be placed in the 
 same category, and may be explained on the same 
 physiological grounds. Normal children are in a 
 state of almost continuous physical activity, while 
 their minds remain relatively inactive. Adults 
 are prone to become slothful creatures physically, 
 with exaggerated mental activities — a condition 
 precisely the reverse of that in childhood. So that 
 there are substantial physiological reasons for re- 
 versing the methods of nourishing the individual 
 at these two periods of life. And practical results 
 demonstrate the soundness of the theory. 
 
 But this theory, like many others, should be in- 
 terpreted only on broad general lines. A finical 
 anxiety about the kind or quantity of food to be 
 
Nourishing the Mind iii 
 
 eaten is quite as harmful as gross carelessness in 
 the opposite extreme. A healthy person should 
 think little about his food, either before or after 
 eating. Too close scrutinizing is likely to be the 
 gateway to hypochondriasis. 
 
Stabilizing the Faculties 
 
 THERE is no one, short of the actual imbecile, 
 who does not appreciate that mental stability 
 is a valuable individual asset. But I think very 
 few persons fully realize what a terrible calamity 
 the shaking of that stability really is, largely be- 
 cause most people have given the matter very 
 little thought. If we pause and consider even for 
 a moment what permanent mental incapacitation 
 means, however, I think that any one will agree 
 that death itself is relegated to a minor position 
 by comparison. 
 
 Nothing approaching full compensation can be 
 returned for the toll taken by death. Yet it is 
 possible for every man to make such provision 
 against the ravages of the Grim Reaper, through 
 the medium of insurance, that his loved ones will 
 not be lacking in material comfort, if he is sud- 
 denly taken away. But no insurance can be taken 
 out to compensate for mental unsoundness. 
 
 Moreover, the person who becomes insane not 
 only ceases to be a provider, but himself becomes 
 a dependent burden. So that his incapacitation 
 represents a loss more disastrous than actual de- 
 
 112 
 
Stabilizing the Faculties 113 
 
 raise, because it may add many years of continu- 
 ous incumbrance to his relatives. 
 
 It is evident, therefore, either from a selfish 
 standpoint or an altruistic one, that the mainte- 
 nance of mental stability is a great desideratum. 
 Nor is the quest a hopeless one, even among those 
 predisposed to mental unsoundness. For fully 
 half the cases of disturbed mental equilibrium are 
 preventable. 
 
 Every one knows how easily the vertical position 
 of a rolling hoop is maintained by a slight touch 
 on one side or the other just at the moment when 
 it begins to waver, but how impossible it is to 
 avert the fall once the hoop is deflected beyond 
 a certain point. Just so with mental equilibrium. 
 A deft touch here and there at the right moment 
 will keep the mental mechanism in a flexibly firm 
 " vertical position," as it were, and avert the 
 impending catastrophe. 
 
 One of the first and most constant symptoms of 
 threatened mental instability, is insomnia, or the 
 unrefreshing sleep that is frequently its forerun- 
 ner. It is a clinical indication in childhood, and 
 a danger signal later in life. At either period its 
 warnings should not be disregarded. We must 
 not, of course, confuse true insomnia with the 
 dreamy states that accompany over-sleeping, or 
 the habit of " slovenly sleeping " that is acquired 
 by some persons. 
 
 Sleep itself is still one of the great mysteries of 
 
114 Increasing Your Mental Efficiency 
 
 life. And we are not able as yet to explain satis- 
 factorily just what mysterious mechanisms pro- 
 duce sleep, or its antithesis, insomnia. But we do 
 know very definitely the general effects of both 
 these conditions. 
 
 The Mystery of Sleep 
 
 ' ' The marvel of sleep is lost upon us owing to 
 the unfortunate peculiarity that our ability to 
 wonder is soon abolished by mere repetition," 
 says Dr. W. H. Thomson, " Because the recur- 
 rence of sleep is as certain and regular as sunset 
 itself, it does not occur to us to wonder at it, or 
 to ask what it all means." 
 
 We are certain that a change in the blood sup- 
 ply of the brain takes place during sleep, less 
 blood going to the head at that time than in the 
 waking hours. This may be demonstrated by 
 exactly balancing a person horizontally on a spe- 
 cially prepared tilting board. So long as the 
 person remains awake and motionless the balance 
 is maintained, but as he falls asleep the board 
 gradually tilts downward, showing that the blood 
 has been transferred from the head to the other 
 parts of the body. As the sleeper regains con- 
 sciousness the horizontal position is again as- 
 sumed as in the beginning of the experiment. 
 
 This, and other experiments, make it certain 
 that an anemic condition of the brain is produced 
 
Struclurdl Changes in Mental Piscasas 
 
 The brain In, qeueraL paresis: M mental disease dependart 
 
 upoTL syphilid. 
 
 Tin essentialli/ noniuil hraui 
 
 Brain in general paresis. 
 
Stabilizing the Faculties 115 
 
 during sleep, and probably the extent of this 
 anemia, or blood depletion, determines the pro- 
 foundness of the sleep, although this is by no 
 means certain. But for our purpose it suffices to 
 know that there is more blood circulating through 
 the brain during wakefulness, and less during 
 sleep, and we need not concern ourselves with the 
 nervous or chemical action that may produce these 
 conditions. I shall show in a moment why it is 
 important to understand this fundamental fact 
 in combating wakeful conditions. 
 
 We should distinguish very exactly between 
 true insomnia and certain " habits " of sleepless- 
 ness. Most persons who sleep badly do so be- 
 cause they have not learned to sleep properly, or 
 because they do not put their knowledge into prac- 
 tice. Many persons form bad habits of sleeping, 
 just as they do about eating or drinking. Some 
 sleep too little, others too much. Of the two faults 
 I believe the latter is the more common one, al- 
 though too little sleep is more harmful than too 
 much. The person who lies awake some little 
 time after going to bed, or lies in a half wakeful 
 state for any considerable time before getting up, 
 does so usually because he is trying to take more 
 sleep than he requires. 
 
 Such a person usually feels stupid on arising, 
 his mind does not work readily, and it may be 
 several hours before he feels himself to be keenly 
 awake. The normal feeling after a good night's 
 
ii6 Increasing Your Mental Efficiency 
 
 sleep should be one of vigorous refreshment, 
 which continues throughout the day, with the usual 
 fatigue, but not exhaustion, at the end of the day's 
 work. 
 
 A condition of very different significance is that 
 of feeling exhausted in the morning, even after 
 an apparently good night's sleep, which is fol- 
 lowed by a feeling of well-being, or even exhila- 
 ration toward the end of the day. This condition 
 is pathological, and indicates that the system 
 is run-down and debilitated, and needs atten- 
 tion. For it may be the beginning of physical de- 
 pression, a condition that may be corrected easily 
 if taken in hand in the beginning, but which leads 
 to serious illness if neglected. Frequently it is 
 the result of nervous exhaustion, or mental agita- 
 tion. 
 
 One of the essentials of good sleeping is to make 
 a practice of going to bed as regularly as possible 
 at the same hour, and rising with a corresponding 
 regularity in the morning. In this way a correct 
 " habit " of sleeping is quickly formed. Our 
 bodies, like our minds, acquire habits very quickly, 
 and tend to retain them tenaciously. 
 
 As to the exact time of retiring, that must be 
 determined by each individual, for himself in ac- 
 cordance with his habits and walk of life. The 
 old rule, " early to bed and early to rise," is 
 useful only in the sense that its practice implies 
 regularity in sleeping. We may stamp as false, 
 
Stabilizing the Faculties 117 
 
 also, the aphorism that " an hour's sleep before 
 midnight is worth two after midnight." For in 
 point of fact it is the number of hours of good 
 sleep that count, not the particular time at which 
 they are taken. 
 
 It is true, of course, that if a person goes to 
 bed at eight o'clock, his most profound slumber 
 will be taken before the middle of the night. For 
 the mind sinks quickly into its deepest uncon- 
 sciousness, remains so for three or four hours, and 
 then gradually approaches the conscious state. 
 But this cycle will be produced just as readily and 
 just as certainly, whether the hours be from ten 
 to six, or from one to nine. The advantages 
 of the earlier hours lie solely in the fact that 
 the distracting sounds of a busy world are less 
 likely to be a disturbing factor during the earlier 
 period. 
 
 We should remember that the rule about early 
 retiring was made in an age when night meant 
 darkness, and does not apply to the present age, 
 when gas and electricity have made the day 
 twenty-four hours long instead of twelve. More- 
 over, there are many persons — the majority of 
 adults in cities, at least — whose social or other 
 duties keep them up until midnight several nights 
 in each week. For such persons the rule about 
 retiring early would be made only to be broken 
 irregularly; and for this reason it is far better 
 for them to choose the later hour as the usual one 
 
ii8 Increasing Your Mental Efficiency 
 
 for retiring. Indeed, it is advisable for any per- 
 son who is likely to be up until midnight two or 
 three nights in the week to make that time the 
 one for retiring regularly as a matter of habit. 
 
 Most people find it necessary (and it is cer- 
 tainly advisable) to arise at practically the same 
 hour each morning. If they make it a practice 
 to retire three nights in the week at twelve, and 
 three at ten, rising at their regular hour each 
 morning, they will obviously be sleeping too much, 
 or too little, at least half of the time. It is far 
 better to make the hour for retiring more nearly 
 imiform, particularly if there is a tendency to 
 sleep badly. 
 
 But six nights only account for the working 
 days of the week. What of the seventh? 
 
 A few years ago the Medical Record published 
 an editorial on " Blue Monday." In this the 
 writer exonerated Monday for any responsibility 
 in producing the proverbial " azure hue," and 
 placed the onus upon the foolish, unnatural, and 
 physiologically bad practices of the preceding 
 day — the * ' hang over ' ' effects of irregular sleep- 
 ing, of eating, drinking, working, and playing, 
 common to our Sabbath Day customs. If we 
 would conduct ourselves on Sunday as we do on 
 week days, the writer averred, ' ' Blue Monday ' ' 
 would be striken from the calendar. 
 
Stabilizing the Faculties iig 
 
 The Habit of Irregular Over-sleeping 
 
 A great majority of people make it a practice 
 to loll in bed on Sunday morning, thus disregard- 
 ing the established habits of the other six morn- 
 ings. If asked why they do this, many would 
 assert that they are " catching up " the sleep lost 
 during the week, thus attempting to correct in one 
 day the losses of six. 
 
 In point of fact this is seldom the real reason 
 for protracted sleeping, and this method would 
 not correct the fault if it were. For it is impos- 
 sible to force more than a certain amount of pro- 
 found sleep upon the brain — one cannot force him- 
 self to stay asleep as he can to keep awake. It has 
 been demonstrated repeatedly that the person who 
 stays awake seventy-two consecutive hours, let us 
 say, thus losing twenty-four hours of sleep, does 
 not " catch up " the lost hours by twenty-four 
 consecutive hours of slumber even if given abun- 
 dant opportunity to do so. Experiments have 
 shown that the average man will not take over 
 seventeen hours of sleep after the long period of 
 wakefulness, and thereafter require only his regu- 
 lar number of hours' sleep each night. 
 
 This suggests that the system is capable of in- 
 tensifying the quality of sleep to meet emergen- 
 cies. Indeed, this mysterious intensifying process 
 seems to be normal in some favored individuals, 
 who require far less sleep than most of their fel- 
 
120 Increasing Your Mental Efficiency 
 
 lows, because their sleeping apparatus is more 
 efficient. Napoleon was an example, and Franklin 
 another. And undoubtedly it was this special 
 faculty of the American philosopher that led him 
 to make the rule for the number of hours required 
 for sleep as, ' ' six for a man, seven for a woman, 
 eight for a fool." But his standard is undoubt- 
 edly much too low, both for man and for woman ; 
 and the amount of sleep required by the fool is of 
 no consequence. 
 
 The implication that most persons sleep more 
 than is really necessary, however, is probably well 
 founded. But each individual is a law unto him- 
 self, and must determine for himself what his re- 
 quirements really are. If he stays in bed nine 
 hours and does not sleep soundly during all that 
 time, or is not refreshed and in vigorous men- 
 tality on rising, he is probably trying to force 
 more sleep upon his system than it requires. His 
 symptoms are proof of this. If he sleeps only six 
 hours, and does not feel himself completely re- 
 cuperated, he is being too parsimonious. 
 
 There is one form of insoronia which is char- 
 acteristic of a definite pathological condition, and 
 should be regarded with apprehension. It is char- 
 acterized by a period of wakefulness that comes in 
 the middle of the night to persons who are usually 
 good sleepers, and which follows a period of sound 
 sleep earlier in the evening. When such a thing 
 occurs repeatedly night after night without any 
 
Stabilizing the Faculties 121 
 
 apparent cause, particularly in persons in middle 
 life or older, it is likely to be a symptom of high 
 blood-pressure which is the forerunner of or- 
 ganic disease. The persons with this symptom 
 should seek the advice of a physician at once. 
 For in this early stage it is quite possible to cor- 
 rect the sleeplessness by correcting the underlying 
 cause — which is vastly more important. Later on, 
 when organic changes in the blood-vessels have 
 actually taken place, it is impossible to correct 
 either the symptom or its cause. 
 
 Habitual dreaming is abnormal, although an 
 occasional dream can hardly be considered as an 
 abnormality. Too much food taken late at night, 
 too many hours of sleep, high mental tension and 
 worry, usually account for most dreams of the 
 occasional variety. When the dreams are fre- 
 quent and distressing, even when correct habits in 
 sleeping are rigidly practiced, some physical ab- 
 normality should be suspected. 
 
 Some confusion has arisen in the minds of cer- 
 tain persons as to whether it is a bad practice to 
 eat heartily just before retiring, since physicians 
 sometimes prescribe a glass of hot milk, or beer, 
 at bed-time to aid in inducing sleep. There need 
 be no confusion on this point, however, since the 
 effect of a glass of hot milk is very different from 
 that of a full meal. The glass of milk being easily 
 digestible does not tax the circulation except to 
 the extent of diverting enough blood from the 
 
122 Increasing Your Mental Efficiency 
 
 head to aid in the mechanism of sleep production. 
 A full meal, on the other hand, sets the blood 
 pounding through the vessels, and tends to in- 
 crease, rather than diminish, the cerebral circu- 
 lation. 
 
 We know, of course, that there are thousands of 
 persons who habitually take a full meal before re- 
 tiring without experiencing any unpleasant re- 
 sults. But here again habit is a determining fac- 
 tor. In such cases the system has adjusted itself 
 to this untimely, but regularly ingested meal, and 
 is vigorous enough to counteract the effects of a 
 habit that is physiologically bad. In any event, 
 these exceptions do not vitiate the soundness of 
 the general rule against eating before retiring. 
 
 How Sleep May Be Induced 
 
 Persons engaged in mental work which does not 
 stop at the end of the ordinary working day with 
 the usual evening idleness or lethargy, frequently 
 find that the mental activity, with its flood of 
 ideas, continues when they cease work and attempt 
 to sleep. In such persons the sudden change from 
 active thinking to the exact antithesis, sleep, is 
 too great to be accomplished suddenly, without 
 some kind of " tapering off " process. Many 
 things suggest themselves for this purpose, but 
 the basis of all is really a change of vocation — a 
 mental " stepping down," diverting the mind into 
 
Stabilizing the Faculties 123 
 
 less active channels, and thus gradually diminish- 
 ing the tension. 
 
 Some persons find that a brisk walk in the open 
 air for half an hour has the relaxing effect; but 
 to others this muscular exercise is irksome, and 
 consequently disturbing rather than helpful. A 
 very effective method, as innumerable persons 
 have discovered, is to indulge in some kind of light, 
 pleasant reading for an hour before bed-time. 
 Beading in itself is such a reflex act that it re- 
 quires very little mental effort ; while the interest 
 of the text, such as that of a story, relaxes the 
 mind without taxing it, and prepares it for sleep. 
 
 Some such expedient seems almost necessary 
 for those who spend most of their waking hours in 
 reading or writing; for to such persons the ab- 
 sence of the accustomed printed page before the 
 eyes does not check the activity of the mind. 
 When, however, the printed page is there, but its 
 contents of such nature that it requires practically 
 no cerebral effort to interpret it, a distinctly re- 
 laxed mental condition is produced. It is said 
 that the great German historian, Mommsen, whose 
 mind was wonderfully active and retentive, rested 
 his brain by devouring all manner of ' ' yellow- 
 backed " novels during his resting periods of the 
 day or evening. Thus an unusually receptive 
 mind, which retained desirable information with 
 remarkable" precision, was rested and recuperated 
 by the kind of careless novel reading that ordi- 
 
124 Increasing Your Mental Efficiency 
 
 narily is so detrimental to the memory. But 
 Mommsen took his novels as medicine, so to speak, 
 not as real mental pabulum. 
 
 The method of preparing the mind for sleep by 
 reading or other diverting process, may be re- 
 garded as psychic rather than physical, although 
 it is probable that the ultimate effect of depleting 
 the brain of blood is the same by whatever process. 
 But there is at least one way of producing this 
 condition mechanically that is most effective and 
 often expedient. This is through the agency of a 
 prolonged tepid bath taken just before retiring. 
 
 In order that the bath may be effective, some 
 little care about certain details is necessary, since 
 carelessness in these matters may result in effects 
 exactly opposite to the one desired. Thus a bath 
 that is too hot, or too cold, or one that is taken 
 for a very brief period, may tend to constrict the 
 vessels of the skin, producing a cerebral conges- 
 tion rather than depletion. On the other hand if 
 the water in the tub is slightly warmer than the 
 natural heat of the body, which can be determined 
 by the hand without the aid of a thermometer, the 
 desired effect is readily produced. 
 
 The person taking such a bath should do so 
 just before getting into bed. He should lie in the 
 tub with the body completely submerged, with 
 a cool wet towel placed on the head, and remain 
 for fully fifteen minutes. He should then dry 
 himself quickly and get into bed at once. 
 
Stabilizing the Faculties 125 
 
 In this way the blood is mechanically diverted 
 from the head to other parts of the body. The 
 prolonged bath distributes the blood all through 
 the body by relaxing the vessels in the trunk and 
 limbs, while the cool towel on the head helps to 
 constrict the cranial vessels, and thus aids actively 
 in the depleting process. 
 
 But of course it is not always convenient to 
 take a prolonged bath before retiring; and in any 
 event, if one were obliged to continue taking such 
 baths habitually to induce sleep, a truly bad 
 habit would be formed. As an occasional aid, 
 however, the prolonged bath is of greatest useful- 
 ness. 
 
 As a ready means of inducing sleep, one of the 
 various purely mental expedients is probably bet- 
 ter for those who are habitually prone to sleep- 
 lessness without definite physical cause. The 
 author of ' ' The Science of Happiness ' ' suggests 
 one of these methods that seems particularly com- 
 mendable. 
 
 " Challenge systematically any line of thought 
 that appears, and banish it from consciousness," 
 he instructs. ' ' The thing is not difficult for a dis- 
 ciplined mind. You have simply to vow mentally 
 as you find yourself thinking on any subject, ' I 
 will not think about that,' and as it were you shut 
 off the current in that direction. Of course 
 through association your mind is instantly sup- 
 plied with some other line of thought; but this 
 
126 Increasing Your Mental EfHciency 
 
 also you challenge in the same way as soon as it 
 appears, and so on as long as you are conscious. 
 You thus prevent any single line of thought from 
 becoming paramount in consciousness, and one 
 line after another being subordinated, the tendency 
 is to a lower and lower level of mental activity, 
 till presently consciousness is lost. It is possible 
 for some persons to put themselves to sleep vol- 
 untarily in this way at any time when they choose 
 even during the day and in the midst of most 
 active thinking. The boon which such an accom- 
 plishment furnishes the tired brain on occasion, 
 makes the acquisition of this power well worth 
 the effort." 
 
 It is probably superfluous here to call attention 
 to the necessity of thoroughly ventilating the 
 sleeping apartment during the night, as a knowl- 
 edge of the recuperative effects of fresh air has 
 become a part of our education. Yet experience 
 shows that, even to-day, there are many cases of 
 insomnia, or at least bad sleeping, due to neglect 
 of this fundamental principle of hygiene. The 
 sleeping-porch, and cool bedrooms with all win- 
 dows hoisted, will correct many cases of sleepless- 
 ness. Nothing supplants fresh air as a soporific. 
 And we may add that no room, even with many 
 windows, and all wide open, quite equals the open- 
 air bedroom. Any one who will make the experi- 
 ment even for a single night will be convinced 
 that there is a very distinct difference between the 
 
Stabilizing the Faculties 127 
 
 night air in the open, and the air that circulates in 
 an open hedroom. 
 
 Most persons who make the experiment of sleep- 
 ing out of doors are loth to discontinue it. A few 
 nights of open-air sleeping make the bedroom 
 seem stuffy and intolerable. And herein lies the 
 one disadvantage of the sleeping-porch : if it can- 
 not be used habitually the discomforts of the in- 
 tervening nights spent indoors may offset the re- 
 freshing effects of the nights in the open. 
 
 Under favorable circumstances, then, the use of 
 the sleeping-porch is ideal. But if one is so sit- 
 uated that he must spend half his nights within 
 doors, it is probably better to substitute wide-open 
 windows, particularly if the individual is so sen- 
 sitive to atmospheric conditions that the nights 
 spent in the bedroom are likely to be restless ones. 
 
 We said a moment ago that insomnia was fre- 
 quently a most important danger signal fore- 
 shadowing possible mental unbalance. Concomi- 
 tant with this, and in many instances producing it, 
 is the tendency to worry — the basis of the great 
 majority of cases of mental breakdown, referred 
 to in a preceding chapter. 
 
 It would, of course, be impossible, except in a 
 most exhaustive treatise, to touch upon the multi- 
 farious forms and causes of the all-pervading and 
 most complicated mental condition indicated by 
 the single word ' ' worry. ' ' The life-quest of each 
 person is happiness, in the particular form which 
 
128 Increasing Your Mental Efficiency 
 
 fulfils his conception of the term: the opposing 
 factor which prevents its consummation is worry, 
 in one or another of its varied forms. Obviously 
 then the term is too comprehensive for more than 
 general consideration. In one form or another 
 it touches upon every phase of human life. 
 
 When there is a definite cause for the mental agi- 
 tation the remedy is obvious, although frequently 
 difficult to apply. But sometimes an obscure 
 physical ailment that is not suspected, pro- 
 duces an apparently causeless kind of apprehen- 
 sive depression. This condition is so well known 
 — although less frequently understood — that it has 
 been a subject for facetious comment for genera- 
 tions. It was, indeed, the theme for the caption 
 of a humorous sketch in one of our " lighter 
 vein " weeklies a short time ago. Two intimate 
 acquaintances were pictured as meeting casually 
 on the street, one of them greatly agitated. 
 
 " Margaret," the agitated one exclaimed, "I'm 
 just worried to death about something." 
 
 " Why — er — why, for the life of me I can't re- 
 dear? " inquires Margaret. 
 
 " Why — er — why, for the life of me I can't re- 
 member." 
 
 Now the theme for this little pleasantry may be 
 found in innumerable eases, and its import is not 
 a matter for jesting. It is a kind of apparently 
 causeless worry that is most significant, and 
 should not be lightly disregarded. Whether the 
 
Stabilizing the Faculties 129 
 
 person so afflicted can fathom the cause of the 
 anxiety or not, the cause actually exists, and 
 should be sought out and corrected. It represents 
 a state of abnormality in which the mental symp- 
 tom is likely to be caused by some definite physical 
 difficulty, usually the improper functioning of 
 some of the organs of the body. Our ancestors 
 placed the burden of responsibility upon the liver. 
 At present we are inclined to exonerate that organ 
 in most cases. But whatever the exact cause, the 
 person afflicted with this type of apparently cause- 
 less mental agitation — the feeling that " some- 
 thing dreadful is going to happen " — is approach- 
 ing a danger zone and should seek medical advice. 
 
 Sometimes this condition may be corrected by 
 proper mental training alone; for mental uplift 
 and fitness tend to induce physical fitness. And of 
 course it is part of the physician's art to com- 
 bine his psychotherapy with his more tangible rem- 
 edies. But, knowing as we now do, that there is 
 usually a definite physical basis for mental states, 
 one should not trust to psychic remedies alone until 
 it is clearly determined that the physical basis is 
 wanting, or unimportant. 
 
 Much more tangible physical causes for mental 
 aberration are the venereal diseases. And, despite 
 the fact that the prevention of this fertile cause 
 of insanity rests entirely with each individual, 
 save in a few exceptional instances, the number of 
 cases of aberration resulting from venereal dis- 
 
130 Increasing Your Mental Efficiency 
 
 ease is conspicuously large. A single disease of 
 this category is responsible for at least twelve 
 per cent, of all cases of insanity to-day — seven 
 thousand deaths annually from its sequence, 
 paresis, in the United States. It is therefore of 
 greatest significance and of gravest importance. 
 But since this condition ■will be considered some- 
 what in detail in a later chapter, we need merely 
 touch upon it here to emphasize the dreadful na- 
 ture of the penalty which this most easily prevent- 
 able form of mental aberration exacts. 
 
 The special symptoms that we should regard 
 with suspicion when occurring in ourselves, or in 
 others, as pointing, or leading to, mental insta- 
 bility, may be summarized in a sentence : A tend- 
 ency to brooding, changeability, mental irrita- 
 bility, unusual susceptibility to mental fatigue, 
 headaches, suspiciousness, over-sensitiveness, — 
 any one of these, or combination of them, should 
 be regarded as warnings. To this list we may add, 
 an unusual sensibility to small quantities of alco- 
 hol, although this is an inherent defect, rather 
 than a symptom of progressive pathological con- 
 dition. 
 
 Normal Exhaustion and Abnormal Fatigue 
 
 Without examining them too categorically, let 
 us consider the exact implication of some of these 
 terms, such as mental fatigue. There is a great 
 
Stabilizing the Faculties 131 
 
 difference between the normal exhaustion that fol- 
 lows prolonged mental effort, and the pathological 
 condition in which even a very small amount of 
 effort causes a feeling of fatigue. In the main 
 this effect must be gauged by each individual for 
 himself, measured by his own past experience. If 
 he finds that he is no longer able to sustain his 
 usual mental efforts — his normal standard, in 
 other words — he should at once seek the reason 
 for this change. But in seeking this reason, he 
 should not be misled by the common fallacy of 
 attributing this fatigue to an overworked brain. 
 For ' ' brain fag ' ' is usually merely a symptom of 
 some obscure physical depression. 
 
 Activity of mind does not tend to wear out the 
 brain, but quite the reverse. Indeed by constant 
 exercise the brain increases, rather than dimin- 
 ishes, its capacity for work. And this activity is 
 not maintained at the expense of bodily vigor, as 
 shown by the fact that men whose intellectual 
 pursuits require constant exercise of their brain 
 cells are usually long-lived. On the other hand, 
 mental lethargy, like sedentariness, foreshadows 
 early decadence, indicating that the brain, like the 
 body, is far less likely to wear out than to rust out. 
 
 It is obvious, therefore, that any person below 
 the age of actual senility, who finds that mental 
 exertion fatigues him to an unusual degree, should 
 take careful inventory of his condition. More than 
 likely he will discover that his body, rather than 
 
132 Increasing Your Mental Efficiency 
 
 Ms brain, is at fault. In all probability he will be 
 able to locate the cause as his failure to give that 
 body the same healthy exercise that he has given 
 his mind. The remedy is obvious. A little active 
 muscular exercise, carried out systematically, 
 usually brings back the mental activity, frequently 
 with renewed and even increased vigor. 
 
 The question as to what sort of exercise should 
 be taken cannot be answered in a sentence ; for the 
 same prescription is not appropriate for all cases. 
 Age, environment, and previous habits must all be 
 considered in making the choice. Healthful exer- 
 cise for a man of thirty might be fatal to a man of 
 sixty; and environmental conditions are fre- 
 quently determinant factors. But, whatever the 
 form selected, it must be pursued regularly and 
 persistently. Spasmodic efforts are practically 
 valueless. And yet nothing is more diflScult for 
 most of us than to force ourselves to take regular 
 and persistent exercise. 
 
 Open-air exercises are, of course, infinitely bet- 
 ter than those taken indoors, largely for the rea- 
 son that such exercises afford greater pleasure 
 than most indoor " grinds." The effect of the 
 exhilarating open air itself must not be minimized ; 
 but the pleasure derived from taking any exercise 
 is even more important than atmospheric condi- 
 tions. Little benefit is gained from any muscular 
 exertion that becomes mere drudgery. 
 
 For the man past forty, probably golf offers 
 
Stabilizing the Faculties 133 
 
 more practical advantages as an exercise than al- 
 most any other game — providing, of course, one 
 likes golf, or can learn to like it. Indeed, for the 
 man who has never taken to any form of violent 
 exercise during his younger life, there is really 
 little choice. Tennis is too strenuous; and base- 
 ball and football out of the question. Rowing 
 is a fine exercise, but requires special conditions, 
 and is not adapted to all seasons. Horseback rid- 
 ing fulfils all requirements, but cannot be indulged 
 by most persons, while stream-fishing and hunt- 
 ing, although excellent in themselves, can only be 
 pursued spasmodically, for obvious reasons. 
 
 The long-lost art of archery offers incomparable 
 advantages as an outdoor exercise — if one would 
 only practice it. It is a wonderful developer of 
 chest, back, and arm muscles, trains the eye, and 
 steadies the nerves. A lawn, some convenient 
 vacant lot, or even a porch, can be requisitioned for 
 a range, and all members of the family participate 
 in exhilarating contests. But, unfortunately, 
 archery is no longer fashionable. And where is 
 the person with the temerity to flout Dame Fash- 
 ion for mere health's sake? 
 
 One who has been accustomed to violent athletic 
 sports requires a somewhat different routine of 
 exercise later in life from the person who has 
 never been athletic. The athlete should, of course, 
 continue systematic and regular exercise through- 
 out life. But even if he has neglected his muscular 
 
134 Increasing Your Mental Efficiency 
 
 system for several years, — between the age of 
 twenty-five and forty, let us say — and is still or- 
 ganically sound, he can quickly accustom his sys- 
 tem to even very violent exercise, such as wrest- 
 ling, without danger. 
 
 The person who has never done any violent ex- 
 ercises in early life, however, should be warned 
 against attempting them later. His heart and 
 blood-vessels have never been developed to full 
 capacity, or tested by violent exertions, as have 
 those of the young athlete; and it is dangerous 
 to make such a test after forty-five, unless under 
 the most careful supervision. Moreover, such an 
 undeveloped system does not require the same 
 sort of stimulation as that of the fully developed 
 athlete. It has so adjusted itself to this lack of 
 muscular development, that its standard of nor- 
 mality is greatly lowered ; and moderate exercise, 
 in a very restricted sense, is usually sufficient to 
 maintain a healthy muscular tone. 
 
 Such persons are often fond of walking; and 
 for them walking in the open air affords sufficient 
 exercise. But this moderate exertion does not 
 suffice, as a rule, for the former athlete, or the 
 person accustomed to the violent outdoor games 
 of youth. The muscular effort is so little more 
 than that of the ordinary daily routine, and is of 
 such similar nature mechanically, that it can 
 hardly be considered exercise in the therapeutic 
 sense. Moreover, unless one is fond of walking 
 
Stabilizing the Faculties 135 
 
 he does not do it with zest, or get the exhilaration 
 produced by some of the more unusual forms of 
 exertion. 
 
 However, it is much better than nothing, and 
 unfortunately is frequently the only kind of exer- 
 cise available. And when it is combined with 
 systematic indoor gymnastics, it may serve to 
 complete an ideal combiuation. 
 
 At the present time there are at least a score 
 of books, or " systems," which may be had for a 
 few cents, that give instructions for courses of 
 simple exercises, which, if followed, will put the 
 system into good physical condition. Miiller's 
 My System, and Gulick's Ten Minutes Exercise 
 for Busy Men, are excellent. But no prescription 
 is useful unless filled. And most persons find 
 the regime prescribed in these " systems " so irk- 
 some, that despite their good intentions, very few 
 carry it out persistently. 
 
 It is perfectly certain, however, that fifteen 
 minutes of exercise daily, with or without any spe- 
 cial apparatus, will keep any person in good 
 physical condition. In proof of this, if proof were 
 needed, is the fact that gymnasts who do a daily 
 turn on the stage involving about fifteen minutes' 
 work each day, take no other exercise. And yet 
 nothing is more difficult for most persons than to 
 force themselves. to take those few helpful minutes 
 of systematic work each day. Many of my readers 
 can testify to the truth of this assertion, I feel 
 
136 Increasing Your Mental Efficiency 
 
 sure. But when health is to be weighed in the 
 balance against ten or fifteen minutes of odd time, 
 there should be no hesitancy in making the selec- 
 tion, and pursuing that selection systematically. 
 
 At first this daily grind is most irksome, and re- 
 quires considerable urging of flagging will-power. 
 But as soon as the muscles begin to respond, and 
 become firm and elastic, as they do after a few 
 days, the task becomes less onerous ; and presently 
 it becomes a positive pleasure. The difficulty in 
 the undertaking lies in getting safely through 
 those first few days of halting muscles, and flag- 
 ging will. 
 
 One of the most destructive factors to mental 
 equilibrium and stability is the habit of har- 
 boring gloomy thoughts — in other words the 
 tendency toward pessimism instead of optimism. 
 It may be objected that some persons are " nat- 
 urally " pessimistic, while others inherit a happy 
 disposition. There is, of course, more than a 
 grain of truth in this : some individuals are more 
 fortunate than others in their natural endow- 
 ments. But we cannot emphasize the fact too 
 strongly that disposition is not an inherent qual- 
 ity which is irrevocably fixed by nature. A happy 
 disposition, or a gloomy one can be cultivated and 
 enhanced by persistent effort. Moreover, indivi- 
 dual dispositions are not determined by sur- 
 rounding conditions or circumstances, in most in- 
 stances. 
 
Stabilizing the Faculties 137 
 
 We find a tendency to pessimism in persons who 
 have no extraneous reason for such an attitude of 
 mind rather more frequently than among those in 
 whom the feeling would seem justifiable. We may 
 be certain, therefore, that the development of this 
 mental attitude is the result of faulty training 
 quite as much as any inherent tendency. And 
 since the gloomy, brooding tendency is the dan- 
 gerous one, we should follow the dictates of the 
 philosophers of all time, and sedulousy avoid it. 
 
 " It is our own ills, not those of others which 
 we should treat with philosophical disdain," says 
 Dubois. And it is excellent advice. 
 
 In criticism of this philosophy it may be pointed 
 out that persons whose minds have become ac- 
 tually unbalanced do not reaUze their mental 
 abnormality — cannot appreciate that their atti- 
 tude of mind is perverted. The statement is, in- 
 deed, almost axiomatic. But this introspective 
 obtuseness is a later phase of the disorder. In the 
 early stages of mental aberration the afflicted per- 
 son usually realizes that something is wrong with 
 him, even though his most intimate friends may 
 not suspect it. Most normal or even semi-insane 
 persons appreciate their own shortcomings far 
 better than any one else; and if these shortcom- 
 ings are of a nature that tends toward harmful 
 peculiarities, or habits, it is the part of ordinary 
 wisdom to correct them before they become per- 
 manently fixed. 
 
138 Increasing Your Mental Efficiency 
 
 We have said in another place that if the child 
 has received proper training in its early years 
 it will have developed a normal trend of mind that 
 will persist throughout life. It follows, therefore, 
 that most persons who become unbalanced have 
 not received such training, excluding, of course, 
 those cases of mental aberration caused by injury, 
 or organic diseases. The abnormalities exhibited 
 by the child are likely to develop in somewhat 
 similar form later in life, unless thoroughly sup- 
 pressed by training. This fact is helpful in in- 
 dicating the point from which danger may be ex- 
 pected, and thus suggest methods of avoiding it. 
 And these methods differ very little in principle 
 from those suggested for correcting abnormal 
 tendencies in children, although in the adults they 
 must usually be self-applied. 
 
 Frequently, of course, friends notice changes in 
 the personality of others before such changes are 
 fully appreciated or admitted by the individual. 
 In such cases it is the part of duty, and of wisdom, 
 frankly to point out the discovery and cooperate 
 in the process of correction. The fact that others 
 have discovered these changes, which the patient 
 may only vaguely appreciate, or may have 
 striven to conceal, helps him to overcome the 
 threatened affliction. 
 
 We must not confuse passing changes of mood 
 with those that are persistent and harmful. All 
 persons are subject to such changes, which are en- 
 
Stabilizing the Faculties 139 
 
 tirely natural, normal, and, within reasonable 
 limits, helpful. The passionless, colorless life 
 that seldom fluctuates from a monotonously 
 level plane, is likely to be a very useless one. 
 But prolonged changes in disposition, without 
 adequate cause, should be regarded with suspi- 
 cion. 
 
 These changes tend to take one of two courses, 
 one toward unnatural excitement or exaltation, 
 the other toward depression and degradation, 
 more frequently the latter. Stated in another 
 way, the person with wavering mental balance is 
 far more likely to neglect the niceties of deport- 
 ment than to exalt them. We see examples of 
 these two conditions exhibited in the temporary 
 form of insanity caused by alcoholic excesses. 
 Some drunken men become ludicrously punctilious 
 in their deportment ; but far more frequently the 
 opposite extreme of carelessness in dress and de- 
 portment is exhibited. And a similar carelessness, 
 rather than punctiliousness, is characteristic of 
 most forms of mental aberration. 
 
 Any person who is subject to violent outbursts 
 of anger should labor ceaselessly until he over- 
 comes his affliction. For the tendency to indulge 
 in such outbreaks is likely to become progressively 
 worse if not curbed ; and these explosions are most 
 destructive to the mental structure. There is an 
 actual and rapid destruction of brain tissue during 
 such outbursts, and the more frequently they 
 
140 Increasing Your Mental Efficiency 
 
 occur, the less time is given the system to repair 
 the physical change. The complete exhaustion 
 and collapse that follow such outbreaks is indica- 
 tive of brain-cell changes much more destructive 
 than many hours of intense, but controlled, mental 
 effort. 
 
 It is a matter of common observation that the 
 type of person who is naturally " quick tem- 
 pered, ' ' but who has learned to control his temper, 
 is likely to rise intellectually far above the level 
 of the passionless and placid individual. For 
 quick wits and quick tempers frequently go to- 
 gether; and the suppression of one tends to en- 
 hance the other. 
 
 The person who expends his energy in bursts of 
 anger depletes his mental magazine by an amount 
 exactly proportionate to the violence of his pas- 
 sion — harmful expenditure that might otherwise 
 have been diverted into useful mental processes. 
 With his temper under control, however, his full 
 quota of energy becomes available for concentra- 
 tion along helpful, rather than destructive, chan- 
 nels. 
 
 One of the best known examples of a hot-tem- 
 pered man who had learned to control his passion 
 is that of Washington — not the " sickly, cherry- 
 tree " Washington, but the man as he was. Dur- 
 ing his long career of protracted trials, and ex- 
 asperations, only on a few occasions did violent 
 anger get the mastery of that forceful personality 
 
Stabilizing the Faculties 141 
 
 — just enough, to show that the fiery demon was 
 chained, not destroyed. 
 
 Probably the best way to conquer bursts of 
 anger is to review the actual effects of such out- 
 breaks in calmer moments. A little reflection will 
 show that anger puts one at a disadvantage, phys- 
 ically and mentally. Quick, straight thinking, is 
 one of the assets of ability : the man in a passion 
 may think quickly, but his judgment is proverbi- 
 ally bad. And so when pitted against a calm mind 
 of equal ability his disadvantage is obvious. The 
 force that should be directed to correct thinking 
 is consumed in the false thinking created by anger. 
 This fact alone — the fact that anger gives advan- 
 tage to the opponent — should offer sufficient stim- 
 ulus for conquering the tendency to violent out- 
 bursts. 
 
 The physical disadvantages of great anger are 
 just as demonstrable as the mental. It is one of 
 the fundamentals of boxing, for example, to keep 
 one's temper. " Get the other fellow mad " is 
 elemental in the boxer's training. 
 
 I recall an illustration of this principle during 
 the early training of a promising beginner with 
 the padded gloves. The young man, who had been 
 led to overrate his fistic ability by successful con- 
 tests with fellow amateurs, was taking his first 
 serious lesson from a master instructor. The fact 
 that the veteran eluded him at every turn at first 
 surprised, and then nettled him into obviously 
 
142 Increasing Your Mental Efficiency 
 
 suppressed anger. At tMs stage, the instructor,' 
 who was studying his pupil's mood with thorough 
 understanding, began deftly tapping the young 
 man's face just hard enough to sting and irritate, 
 and with exasperating frequency. 
 
 Stung by the blows, and by the laughter of the 
 onlookers, the boy lost every vestige of self-con- 
 trol and rushed upon his tormentor to annihilate 
 him. But instead of accomplishing this, he now 
 received more frequent and more stinging blows, 
 despite his frantic efforts. Finally he stopped 
 from sheer exhaustion, sobbing with impotent 
 rage. When the boy had regained his breath, and 
 bis equanimity, the instructor went over to him, 
 patted him on the back, and gave him some good 
 advice — excellent advice for every person, regard- 
 less of the source. 
 
 ' ' Never get mad, my boy, ' ' he said. ' ' No mat- 
 ter what happens, smile. If the other fellow 
 nearly knocks your head off, just grin at him — 
 but don't get mad. For if you do, you can't think, 
 and then he'll hit you hard and often. But if you 
 just smile he'll think that he didn't hurt you, and 
 it will shake his confidence in himself. Pretty 
 soon perhaps he'll get mad — and then you'll beat 
 him." 
 
 This is the accepted philosophy of the ring — 
 accepted because it works. But it is just as ap- 
 plicable as a guiding philosophy in the higher 
 callings which require better, although no more 
 
Stabilizing the Faculties 143 
 
 intense, mental efforts. For any intense excite- 
 ment such as violent anger, whicli throws a per- 
 son into a state of temporary confusion, may be 
 the portal to a permanent condition of mental 
 instability. 
 
 A certain degree of sensitiveness and a reason- 
 able amount of suspicion govern the deportment 
 of every normal person. Moreover, the limits of 
 these normal variations are elastic, and differ in 
 each individual. Every self-respecting person 
 must be sensitive in some degree; and even ordi- 
 nary business ventures require that a certain 
 amount of the kind of suspicion which is engen- 
 dered by caution, must be exercised. 
 
 But hypersensitiveness, which is frequently ac- 
 companied by an excessive amount of baseless 
 suspicion, denotes bad mental balance. We must 
 always be questioning the motive of others to a 
 certain extent — it is the basis of all our business 
 transactions, and studies of human nature. But 
 a strong tendency to read evil motives between the 
 lines is a paranoid one that leads away from the 
 paths of normal optimism. 
 
 The person who is forever on the lookout for 
 fancied slights will usually find them, and be 
 caused much unnecessary unhappiness by a thou- 
 sand and one meaningless incidents. So long as 
 the mind of such a person is open to reason, how- 
 ever — so long as a plausible explanation convinces 
 him of his error, his attitude of mind, while un- 
 
144 Increasing Your Mental EfHciency 
 
 fortunate, eaanot be considered abnormal. But if 
 constant suspicions drive him to a point where 
 reasonable explanation does not convince, a point 
 at which he reasons from false premises, he has 
 reached a state of mind that is crowding the inner 
 border of the danger zone. 
 
 Such a person must take himself firmly in hand, 
 cultivate the habits of overlooking trifles, and re- 
 gard the generalities of everyday life from an 
 optimistic point of view. He may, to advantage, 
 adopt and amplify the rules once given me by a 
 village carpenter, whose mind evolved a helpful 
 philosophy, while his body pursued its more 
 plebeian tasks. His philosophy may be summar- 
 ized thus : If your friend fails to notice you in the 
 passing crowd, very well : there are other friends 
 — plenty of them. Or, more likely, he did not see 
 you. If you are sensitive, and suspect that people 
 are talking about you, What of it? They are talk- 
 ing about their betters, and can be ignored. Thus 
 putting aside each obtruding disagreeable impres- 
 sion and substituting an optimistic one, you stifle 
 the paranoid tendency, by a healthful process of 
 introspection and self -education. 
 
 " This work of self -education is less difficult 
 than one would think, ' ' says Dubois. * ' I see every 
 day sick people who during all their lives have 
 suffered cruelly from this impressionability which 
 renders them incapable of performing their duties. 
 Often in some days, almost always in some weeks 
 
Stabilizing the Faculties 145 
 
 they succeed in altering their point of view, in see- 
 ing things from another angle. In proportion as 
 they recover their mental calm under the empire 
 of healthy reflections, functional troubles disap- 
 pear, sleep returns, and appetite arises, the body 
 becomes stronger, and the success of this mental 
 treatment demonstrates the supremacy of the 
 mind over the body." 
 
 It is helpful and gratifying in reviewing our 
 own shortcomings, to reflect that even the wisest 
 man is utterly incapable of fathoming the motives 
 of others in a vast majority of instances. It fol- 
 lows, therefore, that it is folly to waste one's time 
 on so futile a task ; and it is positively harmful if 
 the motive is engendered by brooding suspicions. 
 
 I knew a man — a man who was an exceptionally 
 good judge of human nature — who made the fol- 
 lowing experiment to determine just how accu- 
 rately he could interpret the motives for certain 
 actions in others : Each day he took note of inci- 
 dents that came to his attention among his friends 
 and acquaintances, studying them carefully until 
 he had reached a conclusion as to the motive, and 
 then writing down his interpretation. When he 
 had accumulated a long list in this manner he went 
 to each individual, explained what he had been 
 doing, and asked each one to affirm or deny 
 whether his interpretation was correct. In not 
 one instance was his interpretation entirely cor- 
 rect, and in most instances it was utterly wrong ! 
 
146 Increasing Your Mental Efficiency 
 
 His culminating experiment gives a general 
 idea of the methods pursued. An editor had re- 
 cently returned him a manuscript with the usual 
 polite editorial form that " it was not available 
 for our publication." The experimenter had 
 formulated three reasons for its refusal : (1) it was 
 not written well enough; (2) the subject was not 
 interesting; (3) it was either too long or too short. 
 These he submitted to the editor, who promptly 
 gave him a fourth (the real reason) by show- 
 ing the author a manuscript dealing with the same 
 subject as his own, written and accepted some 
 time before. 
 
 Closely allied to the suspicious, paranoid atti- 
 tude of mind is one of excessive and unreasonable 
 jealousy. Frequently the two are concomitant. 
 The difficulty here, just as in the case of suspi- 
 ciousness, is to draw the line that exactly marks 
 the division between normal and abnormal jeal- 
 ousy. But when any one is obsessed by unre- 
 strained doubts his judgment becomes very 
 quickly impervious to evidence, and the line shifts 
 towards abnormality. The inevitable result is 
 unhappiness: the possible result, disturbed 
 mental equilibrium, unless the tendency is cor- 
 rected. 
 
 " The cultivation of a thankful spirit and a 
 reasonable humility," says Hollander, " and the 
 determination not to let the pin-pricks of life up- 
 set them, would do much to prevent men and 
 
Stabilizing the Faculties 147 
 
 women getting on the slide whicli ultimately leads 
 to the quick descent into unsoundness of mind." 
 
 One cannot emphasize too forcibly the effects 
 of these " pin-pricks," both in the giving and the 
 receiving. They are the basis of more mental 
 distress and unsoundness than all the cataclysms. 
 The household that is cursed with a nagging mem- 
 ber is far more liable to disruption than one in 
 which a member is subject to fits of temper. 
 
 The term ' ' nagging ' ' needs fuller explication. 
 There are all gradations in kinds and degree, from 
 the vituperating " scolds " of ducking-stool no- 
 toriety, to the quiet, insidious, insinuating pin- 
 prick type. The fault-finding scold is the more 
 detestable; but undoubtedly the quietly obtrusive 
 type is the more dangerous one, judged by ultimate 
 results. The explanation of this has a sound 
 physiological basis. The person who is subjected 
 to periodic beratings with intervening periods of 
 calm, is given opportunity for mental recuperation 
 between castigations. But the mind that is sub- 
 jected to continual nagging, fault-finding, and 
 criticism, is placed in a state of continuous appre- 
 hension — a condition of high mental tension in 
 which there are no resting periods for recupera- 
 tive repair. 
 
 Few persons, aside from the physicians familiar 
 with the causes of mental unsoundness, appreciate 
 the amount of actual insanity, and the number of 
 premature deaths from organic diseases, produced 
 
148 Increasing Your Mental Efficiency 
 
 by the quiet, smoothtongued type of " naggers." 
 Yet their peculiar capacity for creating evil may 
 be little suspected except by their immediate 
 friends. For this particular type of person is 
 found most frequently among the cultured classes 
 in the upper walk of life, whose esthetic training 
 causes them to repress their feelings in public bet- 
 ter than those in less exalted social positions. 
 
 Every veteran physician, did he choose, could 
 cite specific cases in his community in which the 
 nervous systems of entire families had been de- 
 moralized by one nagging member. And fre- 
 quently this particular person is the one that would 
 be least suspected by an outsider. Let me cite 
 one typical case that was the subject of personal 
 observation for several years. 
 
 The woman who was responsible for this par- 
 ticular tragedy was bom of wealthy parents, given 
 the kind of education fashionable among the 
 " aristocracy " of our grandfathers' time, and 
 launched upon life mated to a man who was her 
 equal in culture, her superior in intellect. His 
 only inferiority was in the matter of worldly 
 goods — a thing that, looked at in retrospect, 
 played an important part in the ultimate catas- 
 trophe. 
 
 This woman had one quality of mind that is 
 seen so frequently iu the highly cultured mem- 
 bers of " old families," namely, obstinacy — a 
 thing by no means synonymous with firmness. 
 
Stabilizing the Faculties 149 
 
 And the manner in whicli this peculiar type of 
 obstinacy manifested itself was in a not unusual 
 trait of making every one do things her way, not 
 their own. But this somewhat characteristic fem- 
 inine quality obtruded itself into every depart- 
 ment of her family life, even dominating the 
 amusements of her two sons in a peculiar manner. 
 Her attitude of mind may be summarized as wish- 
 ing her children to enjoy themselves, but only 
 in the manner which she prescribed, or in the 
 amusements she selected. 
 
 While the children were young this attitude was 
 entirely commendable, as her selections were 
 usually good. But as the boys grew older they, 
 very naturally, wished to be their own choosers of 
 amusements and companions. They were, in 
 short, approaching a state of manhood, with the 
 tastes peculiar to men, and beyond the under- 
 standing even of a mother. 
 
 Yet the mother's peculiar obsession did not 
 change. Whatever the boys proposed doing, and 
 wished to do, was always rejected, and some sub- 
 stitute offered. If they selected skating, she sug- 
 gested coasting; if they chose the theatre, she 
 advised a concert; if they had planned a duck- 
 shooting excursion on the river, she insisted on a 
 quail hunt. And, what is more significant, she inva- 
 riably carried her point. So that although the boys 
 were given all manner of amusement and enter- 
 tainment, they were in reality never doing what 
 
ISO Increasing Your Mental Efficiency 
 
 they really wanted to do most. They suffered 
 from " over protection " of a peculiar kind; or, 
 stated in another way, were " tied to an elastic 
 apron string," — elastic, but with tension that 
 never completely relaxed. 
 
 Had these boys been of the deceitful type, who 
 would pretend to go quail hunting but in reality 
 be shooting ducks, as they preferred, I believe they 
 would have profited in mental stability, despite the 
 deception. Yet had they rebelled, and insisted on 
 their own form of amusements, they would have 
 been confronted with a subtle obstinacy which of- 
 fered no loop-hole to direct attack. They had no 
 choice but to take the form of amusement that 
 their mother decided they should enjoy, — and so 
 half enjoy themselves. The result was the crea- 
 tion of an attitude of mind in which the essential 
 element of complete gratification was wanting. 
 
 The fact that the mother's method was one of 
 quiet, insinuative persistency, explains its effi- 
 ciency. Open opposition on her part would have 
 produced open rebellion in the boys, who were 
 sturdy, manly fellows. But hers was the more 
 subtle, effective method of seemingly gently lead- 
 ing, which was in effect obstinate driving. 
 
 The mother's peculiar attitude did not change, 
 even after the older boy had grown to manhood, 
 and graduated from college. Indeed her peculiar- 
 ity had rather increased, as is usual with any 
 eccentricity that is nurtured by persistent exer- 
 
Stabilizing the Faculties 151 
 
 cise. She still continued to select, or oppose, the 
 companions, amusements, and occupations for her 
 son, just as she had been doing for years. 
 
 The result was inevitable. Inheriting from his 
 naother her temperamental peculiarities which 
 were aggravated by her attitude, the mind of the 
 older boy gave way, and he became hopelessly in- 
 sane. Hard study caused the catastrophe, the 
 friends said. It had nothing to do with it. Per- 
 sistent, insinuative, insidious nagging (I know of 
 no better term) was the exciting, and determina- 
 tive cause. 
 
 A brief summary of the later phases of this 
 tragedy is illuminative. The unfortunate young 
 man was placed in the care of the greatest physi- 
 cians of Europe and America successively. But 
 for several years his condition made confinement 
 in an asylum necessary. Then, as his mind had 
 become more enfeebled, and his attitude less 
 aggressive, he was allowed to travel about accom- 
 panied by companions and physician. Meanwhile 
 he had developed a peculiar " negatism " similar 
 to that of his mother, — an obstinate persistency in 
 refusing to do things that others suggested, even 
 when he really wished to do them. 
 
 Moreover, like many cases of alienation, he had 
 taken a decided aversion to the members of his 
 family. This attitude was particularly apparent 
 when his mother visited him. During those visits, 
 which were made at intervals of several months, 
 
152 Increasing Your Mental Efficiency 
 
 the son became progressively more unhappy, dis- 
 turbed, and confused, as a result of the active 
 stimulus to his repressed emotions. 
 
 For the passing years, and accompanying sor- 
 row, had wrought no change in the mother's atti- 
 tude, or activity in selecting recreations for her 
 son; and meanwhile, as we have seen, the son 
 had developed a similar active negatism of his 
 own. Thus their points of agreement were quite 
 as far apart as ever. The mother's carefully laid 
 plans for her son's recreations (and she was for- 
 ever making them) were always promptly re- 
 jected, and a substitute suggested; while the son's 
 plans met the inevitable rejection, or substitution. 
 Or if, by chance, both hit upon the same plan at 
 the same time neither could resist the opportunity 
 to switch to some other. 
 
 Even in these peculiar circumstances things 
 would have run along fairly well had the mother 
 been willing to exercise a reasonable flexibility 
 of mind. But she would not — probably could not, 
 at least in later years. One does not change one's 
 mental attitude at three score and ten. And so 
 the distressing drama was enacted day after day 
 during her periodic visits. 
 
 You will say at once that this woman was ab- 
 normal, — quite as insane as her son. Had you 
 known her, however, even as an intimate acquaint- 
 ance without the knowledge of her immediate 
 family, you would probably be inclined to change 
 
Stabilizing the Faculties 153 
 
 your opinion. A brilliant, active mind, a tireless 
 reader and intelligent interpreter of good litera- 
 ture, a charming hostess, and a matchless house- 
 keeper — where would you find ground by ordi- 
 nary standards of observation for your diagnosis? 
 
 And yet you are not far wrong. Her natural 
 mother's love, which she believed governed her 
 every action, was really dominated by an intense 
 selfishness which had become a form of mania. 
 This selfishness constantly perverted, and in ef- 
 fect, replaced the natural affection. 
 
 There is a valuable lesson that may be learned 
 from this strange, although in its essentials, char- 
 acteristic example, and one that every person who 
 is given to chronic mental antagonism, or kindred 
 attitudes, should heed. For "nagging" is not 
 merely a disagreeable habit, but a manifestation 
 of that most despicable human trait, selfishness. 
 Moreover, its effects are much the same whether 
 it be exhibited in perverse actions, couched in the 
 strident voice of the termagant, or spoken with 
 the carefully modulated intonation of cultured re- 
 finement. Like continual bursts of anger it is 
 progressively destructive of the nervous system. 
 But its effects are somewhat different from those 
 of bursts of temper in being less self -destructive, 
 but more harmful to the nervous system of others. 
 
 The popular metaphor, comparing the unfor- 
 tunate lunatic to a " cracked pot," is an ancient 
 one. Its exact origin is uncertain. But if we carry 
 
154 Increasing Your Mental Efficiency 
 
 the comparison between mental misfortunes and 
 broken cbinaware one step farther, we can see 
 how this crude comparison may have originated. 
 
 Every one knows that cracks in earthenware 
 cannot be completely concealed or repaired. But 
 there is another condition which, in its ultimate 
 effects is just as destructive to the piece of ware 
 as the more palpable cracks. This is the minute 
 system of cracklets that occur in the over-glaze 
 of a piece in which this glaze is not properly 
 adapted to the body of the ware. At first these 
 minute and apparently harmless cracklets are in- 
 conspicuous, although they may be discovered by 
 close inspection. But presently they become ob- 
 trusive, covering the ware with a fine network of 
 discolored lines — a condition seen in old pieces of 
 badly made china. When this stage is reached 
 the substance of the ware is beginning to disinte- 
 grate, little as one might suspect it. It has lost 
 its ringing tone, and presently it falls to pieces — 
 destroyed much more completely beyond repair 
 by this network of cracklets than by any single 
 gaping fissure. 
 
 The difference between these two conditions is, 
 that although the actual fissure can never be re- 
 paired so as to conceal the crack even when use- 
 fulness is restored, the little cracklets may be re- 
 paired by a proper system of appropriate glazing, 
 and the piece made as good as new in every par- 
 ticular — provided, always, that this re-glazing is 
 
Stabilizing the Faculties 155 
 
 done before the underlying body-structure is 
 affected. 
 
 Curiously enough the name that potters give 
 this fine cracking of the glaze, is " crazing." 
 
 In the human piece of china, analogous condi- 
 tions present themselves. The conspicuous and 
 irreparable fissures that occur, represent the 
 cataclysms caused by injury and specific disease, 
 which produce incurable mental aberrations. The 
 little cracklets are the eccentricities, obsessions, 
 worries, and maladjustments to surroundings — 
 just as the minute fissures in the china are the 
 maladjustment of the glaze to the body-ware — 
 which, if not corrected in the beginning, eventually 
 lead to complete disintegration. 
 
 " Nearly all the world is cracked," says one 
 writer, " but some succeed in covering up the 
 cracks better than others. ' ' If actual cracks exist, 
 however, it will not be possible to conceal them 
 for any very great length of time. And if they 
 are simply little " crazings " — minute cracklets in 
 the mental over-glaze — it is far better to repair 
 them than to attempt the impossible task of con- 
 cealing, or rendering them innocuous. 
 
VI 
 
 The Problem of Ancestry and Environment 
 
 " rpHE human race to-day is the expressed sum 
 -■■ of all the good, bad, and indifferent that 
 have existed in the world from the beginning," 
 says a modern philosopher. Or, stated otherwise, 
 each individual is a composite picture of all his 
 ancestors. 
 
 No one has ever seriously doubted the com- 
 ponent elements of the picture ; the only difference 
 in opinion has been concerning the perspective, 
 and the arrangement of the figures. Some have 
 been inclined to give undue prominence to remote 
 ancestors in the composition, while others have 
 practically ignored them, placing the figures of 
 recent ancestors conspicuously in the foreground. 
 Still others have brought environmental condi- 
 tions to the front, thus concealing the remote an- 
 cestors completely and crowding back the more 
 recent. In short there have been no fixed rules 
 for composing the picture, at least until the clos- 
 ing' years of the nineteenth century. 
 
 To be sure Sir Francis Galton had formulated 
 his laws of heredity some little time before this. 
 
 IS6 
 
The Problem of Ancestry and Environment 157 
 
 And Galton's empirical rules have proved to be 
 fairly accurate. But it remained for an Austrian 
 monk, Gregor Mendel, to fathom the riddle of 
 heredity, and formulate accurate laws whose truth 
 could be demonstrated by practical application. 
 
 Mendel's experiments were not made with 
 human beings, not even with the lower animals, 
 but were largely concerned with the little plant 
 familiarly known as the garden pea. What pos- 
 sible relation, you may well ask, have the laws 
 governing the heredity of a little plant to those 
 of the supreme animal, Man? or, for that matter, 
 to the lowest member of the animal kingdom? 
 The answer is simple and precise: they have 
 everything to do with it. The same fundamental 
 laws of heredity that govern the garden pea apply 
 to all other plants, and all members of the animal 
 kingdom, including man himself. 
 
 At the present time the knowledge of these laws 
 is being utilized in the practical development of 
 better plants and better animals. Eventually, we 
 may feel sure, they will be the means of produc- 
 ing a race of better men. The popular eugenics 
 movement of the present time is an earnest of this. 
 For bad heredity plays a leading role in a vast 
 majority of nervous disorders, particularly in 
 cases of mental instability; and the science of 
 eugenics, and the application of mental hygiene, 
 may insure future generations a better heritage 
 than our own. 
 
158 Increasing Your Mental Efficiency 
 
 Some of the miraculous transformations that 
 have been wrought in plants, particularly the pro- 
 duction of disease-resisting species, suggest the 
 probability that similar effects will be produced 
 eventually in human beings, since the Mendelian 
 laws govern the heredity and methods of propaga- 
 tion in both. An interesting instance of the appli- 
 cation of these laws is the production of a rust- 
 resisting strain of wheat created by Professor 
 Biffin, which seems destined to restore the almost 
 obsolete wheat-raising industry of Great Britain. 
 
 A few years ago the ravages of the rust-fungus 
 had practically destroyed wheat-growing as an in- 
 dustry in the British Isles. Microscopic studies of 
 this fungus revealed the fact that in order to com- 
 plete the cycle of its existence it must live for a 
 time in barberry bushes ; and these bushes are used 
 extensively in Great Britain for hedges. By de- 
 stroying the barberry bushes the rust-fungus 
 would be exterminated. But such a radical cure 
 seemed almost as bad as the malady itself. 
 
 Professor Biffin found a substitute for this 
 wholesale destruction of the hedges. By breed- 
 ing experiments, based on Mendelian laws of 
 heredity, he produced a strain of wheat which re- 
 sembled ordinary English wheat in its quality as 
 a foodstuff, but differed in the important par- 
 ticular that it resisted the attacks of the rust- 
 fungus. Thus the scholarly old Austrian monk, 
 pottering with the pea-vines of his little garden 
 
The Problem of Ancestry and Environment 159 
 
 half a century before, made it possible for the 
 modern English, agriculturist to raise his wheat 
 and keep his hedges. 
 
 This is but one example in a thousand that might 
 be cited as showing the practical value of know- 
 ing the laws of heredity. The California wizard, 
 Mr. Luther Burbank, has created hundreds of new 
 varities, and modified thousands, by his wonderful 
 application of these laws. 
 
 But obviously the application of Mendelian laws 
 for the creation of new species of plants, which 
 have neither muscular nor nervous systems, is a 
 much simpler process than its application to the 
 complex organisms of animals. Yet even in the 
 animal kingdom these difficulties are not insuper- 
 able ; and although the laws of heredity are more 
 difficult to interpret in the higher organisms, 
 enough has been accomplished already to show 
 that these laws apply with the same fixity here 
 as in the less complex ones. 
 
 Thus it is possible to produce predetermined 
 changes in color and anatomical peculiarities, with 
 almost mathematical accuracy in the offspring of 
 certain domestic animals and birds. Further- 
 more, the mental characteristics of such offspring 
 may be changed along definite lines under the 
 magic touch of the Mendelian experimenter. 
 
 It is one thing, of course, to predetermine that 
 a certain egg in a nest will produce a thin, active, 
 laying hen, its nest-mate a fat, stupid sterile fowl 
 
i6o Increasing Your Mental Efficiency 
 
 for market purposes, and quite another to produce 
 at will a criminal or a philosopher. But if we 
 could control the ancestry of the criminal or the 
 philosopher, as we can those of the fowl; and 
 control, also, the additional item of environment, 
 which enters so largely into the problem of 
 eugenics, we should undoubtedly be able to pro- 
 duce results quite as definite in human beings as 
 in the lower animals. 
 
 In a way our civilization is doing this very 
 thing at the present time, and has been doing it 
 for ages — doing it badly when it produced a crim- 
 inal, and doing it well when a philosopher was 
 created. But, in either case, the individual was 
 simply a happy or unfortunate result of hap- 
 hazard natural selection. Had these selections 
 been governed by the standards of modern 
 eugenics during all past ages we should to-day 
 have more philosophers and fewer criminals and 
 degenerates. 
 
 One of the greatest difficulties in making com- 
 parisons between the effects of heredity in man 
 and the lower animals or plants, is the great dif- 
 ference in the time-element of generations in- 
 volved. The cycle of development in the lower 
 order of animals may be completed in months, or 
 even weeks, whereas in man the cycle is reckoned 
 in years. For this reason the student of human 
 heredity must make his deductions from, and base 
 his applications largely upon past records. But 
 
The Problem of Ancestry and Environment i6i 
 
 even with this handicap he has been able to pro- 
 duce some very definite working data — enough, at 
 least, to demonstrate the soundness of his theories. 
 
 The evidences of heredity on normal anatomi- 
 cal structures are too patent to admit of argu- 
 ment. The commonplace example of a child's 
 resemblance to its parent is sufficiently demon- 
 strative. But we are more particularly concerned 
 here with the influence of heredity on mental 
 traits, especially those that have a pronounced 
 effect on mental unsoundness. And curiously 
 enough, it is through our studies of the hereditary 
 element in mental and physical abnormahties that 
 we are able to reach definite conclusions governing 
 the development of normal minds and bodies. 
 
 We have learned, for example, that near-sight- 
 edness (myopia) is frequently an inherited defect. 
 And this knowledge is most useful in studying the 
 children of a myopic parent. We have learned, 
 also, that the peculiar defect known as color- 
 blindness is inherited from the male, but trans- 
 mitted through the females of the strain. Thus 
 a color-blind father rarely has color-blind chil- 
 dren. But some of his nephews may be color- 
 blind ; and if his daughters bear him male grand- 
 children, we can predict with relative certainty 
 that some of them will inherit the defect. 
 
 It has been definitely determined that the color 
 in the eye is transmitted with the same exactness, 
 and according to the same fixed laws that govern 
 
1 62 Increasing Your Mental Efficiency 
 
 the transmission of color to the flowers of the pea, 
 or the coat of the guinea pig. Thus, if both par- 
 ents have blue eyes, every one of their children 
 will be blue-eyed — a useful piece of knowledge 
 in certain legal complications. And whatever the 
 color, if the ancestry of the parents is known, we 
 can predict with great precision what the color of 
 the children's eyes will be. 
 
 It is evident, therefore, that certain abnormali- 
 ties of the eyes, as well as normal peculiarities, are 
 governed by the laws of heredity about which we 
 have some very precise knowledge. And we are 
 certain that the other anatomical structures are 
 subject to these same laws, even though we are un- 
 able to demonstrate the fact with the same pre- 
 cision as in the organs of sight. Moreover, since 
 mental traits are simply manifestations of definite 
 physical conditions, it follows that these traits 
 must be determined primarily by the same laws of 
 heredity as those governing physical conditions. 
 In short that the Mendelian laws apply to plants, 
 animals, human anatomy, and mental character- 
 istics. 
 
 We must remember, of course, that mental 
 traits are subject to the influence of environment 
 (training) to a far greater degree than are 
 anatomical structures. The preponderance of evi- 
 dence seems to show that all such traits, whether 
 inherited or acquired, are likely to be transmitted 
 to the offspring, particularly those acquired traits 
 
The Problem of Ancestry and Environment 163 
 
 (or the tendency toward them) that concern the 
 higher intellect. 
 
 Galton, who inaugurated and named the modem 
 science of eugenics, believed that an individual 
 inherited from his parents one-half his traits ; one- 
 fourth from his grandparents; one-eighth from 
 great-grandparents, and so on. Many recent 
 observers are inclined to credit the parents with 
 rather more influence, and the more remote an- 
 cestors with less, than did Galton. The difference 
 at most, is one of small fractions. But the signifi- 
 cance of each of these estimates is the burden of 
 responsibility for the future of the child that it 
 places upon the parents — the only individuals in 
 the line of descent over whom we may hope to 
 have any direct control. 
 
 What we are chiefly concerned with here is the 
 extent to which mental defects, or the tendency 
 toward such defects, are transmitted, and to just 
 what extent they may be corrected by training and 
 environment. 
 
 The task of determining the effects of heredity 
 becomes increasingly difficult as we ascend the 
 scale of intelligence. We can, to be sure, point to 
 successive generations of persons possessing un- 
 usual mental endowment — the Darwins, the Her- 
 schels, and the descendants of Jonathan Edwards 
 — and no one will seriously question the important 
 part that heredity has played in determining the 
 superior intellects of these groups. But the in- 
 
164 Increasing Your Mental EfEciency 
 
 fluence of heredity is shown even more exactly in 
 persons at the other extreme of the mental scale. 
 In other words, it is far easier to predetermine 
 mental incapacity, than to predict the limit of 
 mental capacity, from the known ancestry. 
 
 We cannot predict with certainty that the chil- 
 dren of two parents of unusual mental capacities 
 will rise to the supreme height of genius ; but we 
 are absolutely certain that all the children of two 
 imbecile parents will be feeble-minded without ex- 
 ception. And we know also that no child of un- 
 usual mental endowment will be born to parents, 
 either one of whom is below the normal standard 
 of intellect. 
 
 We know that the children of two epileptic par- 
 ents will all be defectives, — many of them epilep- 
 tics, and some of them imbeciles. The results of 
 three such matings have been recently recorded by 
 Dr. D. F. Weeks, as follows : " In three matings 
 both of the parents were epileptics. Of the 28 
 conceptions, 2 were still-births, 3 miscarriages, 3 
 died before two years of age, and one (an infant) 
 is too young for classification, leaving 19 about 
 whom something definite is known. Of these, 
 8 were epileptic, 3 feeble-minded, and 8, who 
 came from parents who developed epilepsy late in 
 life, were tainted." By " tainted," it should be 
 understood, is meant persons of unstable equilib- 
 rium, who are prone to lapse into mental unsound- 
 ness. 
 
The Problem of Ancestry and Environment 165 
 
 Another group observed by Dr. Weeks offers the 
 following appalling record : " In 9 fraternities in 
 which both parents were feeble-minded, there 
 were 56 conceptions. Of these, 4 died before 2 
 years of age, and 14 were too young for classifica- 
 tion. Of the other 38 ." . .7 were epileptic, 29 
 feeble-minded, and 2 were drunkards, who may or 
 may not have been feeble-minded." 
 
 We see from these records that the mental de- 
 fects represented in imbecility, epilepsy, alid in- 
 sanity, are so closely related that they may be 
 transmitted interchangeably, so to speak. All of 
 them seem to represent negative qualities — actual 
 omissions of a positive element in the physical 
 make-up that is present in normal individuals. 
 And since a thing that does not exist obviously 
 cannot be transmitted, we find an explanation of 
 why imbecile parents, each of whom lacks certain 
 essentials to normal mentality, beget imbecile chil- 
 dren with deadly certainty. We find here, also, 
 the scientific explanation of why it is not advis- 
 able for near relatives, such as first cousins, to 
 marry, since both may have inherited similar 
 negative qualities, thus doubling the chances of 
 transmitting defects to their children. 
 
 Recent investigations of the ancestry and de- 
 scendants of persons of unstable mental balance, 
 enable us to make certain definite predictions. 
 We know, for example, that two normal persons 
 with normal ancestry will beget only normal chil- 
 
1 66 Increasing Your Mental Efficiency 
 
 dren. But the case becomes complicated with' the 
 introduction of a single element of marked mental 
 instability. 
 
 Thus if a man who has been insane marries 
 a woman of normal mentality with pure normal 
 ancestry, all their children will probably be nor- 
 mal. But some of their grand-children are almost 
 certain to be defective. 
 
 If one of the parents have been insane, and 
 the other normal but inheriting a neuropathic 
 make-up even from one grand-parent, half of the 
 children will show mental or nervous instability, 
 and all will be capable of transmitting such in- 
 stability to their children. 
 
 If both parents are mentally unstable all their 
 children will inherit a tendency to mental in- 
 stability. 
 
 To summarize these conclusions, it appears that 
 any person whose parents are both abnormal has 
 considerably less than an even fighting chance 
 of keeping normal under ordinary circumstances, 
 although his case is by no means hopeless. On the 
 other hand, the individual with one defective par- 
 ent has considerably better than an even chance 
 under ordinary circumstances; and with proper 
 environment and training will in all probability 
 remain normal throughout life. 
 
 It is obviously of greatest importance, there- 
 fore, (1), to protect future generations by some 
 method of regulating or preventing marriage. 
 
The Problem of Ancestry and Environment 167 
 
 among the unfit; and (2), to follow some system 
 of psychic training for those members of the pres- 
 ent generation of children with neuropathic taint 
 so as to fortify them against mental unbalance. 
 For that character of the child's mind which we 
 designate " stability," may be greatly increased 
 by environment, even when handicapped by bad 
 hereditary defects. 
 
 The child that inherits a stable mental equilib- 
 rium needs no special training to maintain its 
 poise. It is doubtful, indeed, if anything short of 
 actual physical injury to the brain, either by 
 traumatism or specific disease, will ever produce 
 aberration in such an individual. But needless 
 to say the number of children who come into the 
 world with such an enviable heritage, is limited; 
 and, on account of the complexity of our ancestry, 
 it is usually impossible to determine just how 
 preponderant the dominant traits in any particu- 
 lar individual may be. 
 
 On the other hand, no children, short of those 
 actually congenitally defective, are born with such 
 a bad hereditary taint that they are hopelessly 
 predestined to become insane. But it is obvious 
 that children with bad heredity require far more 
 careful training than those whose heredity is 
 good. 
 
 " Mental training " should not be confused 
 with education in the generally accepted sense. 
 For in some instances the ordinary forms of 
 
i68 Increasing Your Mental Efficiency 
 
 didactic education are detrimental, and may very 
 advantageously be restricted rather than ex- 
 panded. Manual training, followed by some 
 humble vocation, is sometimes far better for a 
 nervous, sensitive child, of restricted mental 
 capacity, than the kind of education given in our 
 schools. 
 
 In any event we must distinguish between mere 
 learning and inherent mental capacity. One per- 
 son may have great mental capacity and little 
 learning, while another may have considerable 
 learning without very great mental capacity. It 
 is quite possible to increase our knowledge, but 
 mental caliber is an inheritance that cannot be 
 increased by training. Moreover, mental ca- 
 pacity, in most instances, has little to do with 
 mental equilibrium. In effect they are separate 
 organisms. But the man of great mental capacity 
 is far more capable of correcting the " wobbling 
 of his mental balance wheel " than the man who 
 is poorly endowed, because his introspective judg- 
 ment is more highly developed. 
 
 As referred to a moment ago, an exact knowl- 
 edge of certain phases of heredity enables us to 
 predetermine what the limits of mental capacity 
 in the child of imbecile parents will be, and also 
 the limits of mental capacity in children whose 
 parents are of mediocre mentality. This knowl- 
 edge may be of great practical value, since many 
 of the children from this mediocre stock are 
 
The Problem of Ancestry and Environment 169 
 
 precocious in their early years, thus giving prom- 
 ises that they will never fulfil. In such cases an 
 early appreciation of the child's limitations may 
 be the means of making a useful, instead of a use- 
 less, adult. 
 
 Many of us will recognize instances of natural 
 limitations, if we compare the ultimate attain- 
 ments of our schoolmates with the promise of 
 their early school years. In the primary grades 
 of school the brightest and most promising pupils 
 frequently come from the most humble walks of 
 life — the children of the village cobbler, tinker, or 
 day-laborer, who have neither good heredity nor 
 inspiring environment. Apparently these chil- 
 dren defy our laws of heredity. But if we observe 
 them in their later years we usually find a strik- 
 ing confirmation of those laws. For most of them 
 drop into stations of life scarcely above the level 
 of those held by their parents. And in the case of 
 the exceptions — or rather, apparent exceptions — 
 we shall usually find that, despite their humble 
 social position, one or the other parent (usually 
 the mother, it appears) had ancestors of more 
 than ordinary mental capacity. 
 
 I recall a typical case among my own boyhood 
 acquaintance, the son of a cooper whose wife was 
 the type of ordinary domestic. This boy entered 
 the primary class in the village public school when 
 five years old, a bright, fine-looking little fellow, a 
 favorite with his mates and the leader in his 
 
170 Increasing Your Mental Efficiency 
 
 classes. As social lines among the children were 
 not closely drawn, this little boy had the same 
 advantages as the more favored scholars, going to 
 parties and participating in all manner of child- 
 ish festivities. So that, aside from his actual 
 home surroundings, he had all the advantages of 
 the children of better parentage. 
 
 Moreover, since his parents were fairly well to 
 do, and greatly interested in educating their son, 
 there was no apparent reason why this boy should 
 not acquire a good education, and become a lead- 
 ing citizen in his community. But in his four- 
 teenth year he stopped going to school for no good 
 reason (he offered as an excuse that " he didn't 
 like the new teacher "), loafed about as an idle 
 boy for a year or two, finally drifting away from 
 his classmates. Eventually he married a girl in 
 his own station of life; and is now the village 
 cooper, occupying about the same social position 
 as that of his parents before him. 
 
 Those of village bringing up will recognize this 
 type of boy. He exists in every American com- 
 munity; and he exemplifies the limitations of in- 
 herent mental capacity. Leaving school at an 
 early age was significant. For he really did not 
 dislike his teacher more than the other boys in 
 his class — no more, indeed, than seems to be the 
 normal amount for a healthy boy of fourteen. 
 But he lacked that indefinable mental quality that 
 
The Problem of Ancestry and Environment 171 
 
 the " winner " possesses — a quality that is in- 
 herent, not acquired. 
 
 Judged by the success of his early school years, 
 this boy inherited a highly organized brain. But 
 his later actions refute this assumption. The 
 quality he inherited was that of a rapidly develop- 
 ing brain, which quickly reached its limits of 
 capacity. 
 
 " Even if all education, including that of the 
 universities, were made free," says Hollander, 
 " there would always be some whose organiza- 
 tions, even after all educational efforts have been 
 tried, would fit them only for the position of 
 a shoeblack or a kitchen maid." 
 
 Yet as a young child, as we have seen, this same 
 shoeblack may have shown great precocity of in- 
 tellect — is quite likely to do so, in fact. For the 
 less highly organized type of brain, like the brain 
 of the lower animal, often develops more quickly 
 than the highly organized one, or may do so con- 
 spicuously in certain instances. Thus we find our 
 cobbler's boy the brightest pupil at six, and a dul- 
 lard at thirty; while an Oliver Goldsmith, appar- 
 ently a dullard at ten, is a genius at forty. 
 
 It is not always so, but the higher organisms 
 usually require more time for development; and 
 if quickly developed by forcing, are often poorly 
 balanced. The penalty of culture and refinement 
 seems to be the creation of a tendency to nervous 
 and mental instability. But perhaps this is only 
 
172 Increasing Your Mental Efficiency 
 
 another way of saying that complicated machines 
 are likely to be delicate ones. Yet in the case of 
 the mental mechanism it is possible to correct 
 most maladjustments by proper training. And 
 once this training is completed, the resulting 
 mechanism tends to maintain its equilibrium quite 
 as firmly as those less complicated. 
 
 There are, of course, many manifestations of 
 the laws of heredity which as yet are not under- 
 stood, and which we have therefore no means of 
 correcting. Thus we know that fecundity and 
 fertility are physiological qualities that may be 
 inherited; and that these tendencies tend to de- 
 cline in the higher walks of life. We do not know 
 the explanation of this class favoritism of Nature ; 
 simply the fact. Since women in the upper circles 
 of life are not so well fitted physiologically for 
 bearing children, as a rule, as those in the lower 
 walks, Nature may be thus removing the burden 
 from the unfit. If so, we have a striking example 
 of the antagonism between the workings of 
 natural phenomena and those of our artificial 
 civilization; for economically, if not physiologic- 
 ally, the infertile upper classes are better fitted to 
 rear children than the prolific lower classes. 
 
 In still another physiological phenomenon we 
 see how Nature is out of harmony with our es- 
 tablished customs of civilized life. This is the 
 transmission to the offspring of certain age de- 
 fects. Nature has made it possible for mother- 
 
The Problem of Ancestry and Environment 173 
 
 hood to begin at a period several years before a 
 woman may legally marry, and at a still longer 
 period before marriage usually takes place. In 
 this particular instance the man-made customs 
 are better than those of Nature. For the children 
 of extremely young mothers are likely to inherit 
 their imperfect development and weaknesses. So 
 that there is a good eugenic, as well as an eco- 
 nomic, reason for our laws prohibiting early mar- 
 riages. 
 
 On the other hand, we find that the children 
 of parents at the other extreme of life — children 
 born at the period of paternal decadence — are 
 somewhat more likely to show defects than those 
 of an earlier period, that is, between the ages of 
 twenty and sixty. Here Nature has set limitations 
 for the woman with better judgment, it would ap- 
 pear, than for the earlier period of life; but it 
 would probably be advantageous to the race if 
 some corresponding limit had been fixed for man. 
 
 There is nothing novel in this observation that 
 the children of old men are likely to be defective. 
 The Eomans observed it two thousand years ago, 
 and acting upon their observation, prohibited 
 marriage to a man over, sixty. But since the 
 period of woman's immaturity and man's decad- 
 ence are both relatively short, there seems little 
 practical need for changing or adding to our 
 present marriage laws as regards age limitations. 
 
 What we need in practical eugenics is enlighten- 
 
174 Increasing Your Mental Efficiency 
 
 ment rather than laws. As soon as we have suffi- 
 cient positive knowledge about the practicalities 
 of heredity, controlling laws will follow as a 
 natural sequence ; and such laws will work effec- 
 tively. But until we have this very definite 
 practical knowledge, supported by comprehensive 
 enlightenment, we cannot hope that effective laws 
 will be enacted, or enforced. 
 
vn 
 
 Increasing Our National Efficiency 
 
 AT the present time there are a number of state 
 •^^^ and national societies engaged in the study 
 and practical promotion of mental efficiency. Re- 
 cently two of these societies, one a national, the 
 other a state organization, held a joint conference 
 for the purpose of disseminating as widely as pos- 
 sible their ultimate aim — national efficiency. At 
 this meeting Dr. Lewellys F. Barker, of Johns 
 Hopkins University, made some observations on 
 unsoundness of mind as a national handicap that 
 deserve the thoughtful consideration of every per- 
 son interested in our national efficiency, which is 
 directly dependent upon the personal efficiency 
 of each individual. Dr. Barker's statements 
 were, in part, as follows : 
 
 It is believed by those who are studying the 
 subject that a proper application of the knowledge 
 already at our disposal could gradually do much 
 to improve the minds of the individuals who col- 
 lectively make up the nation. The number of chil- 
 dren born into the nation with defective brains 
 could be diminished. Through a stricter super- 
 
 175 
 
176 Increasing Your Mental Efficiency 
 
 vision of immigrants many inferior brains could, 
 with advantage, be denied admission to this coun- 
 try. Social and educational conditions could be 
 improved so that the sum of the influences acting 
 upon the nervous systems of children, adolescents, 
 and adults would be more favorable to brain and 
 mind than now. 
 
 In the narrower sense, " unsoundness " of mind 
 refers to those graver disturbances of the mental 
 faculties which we call insanity, idiocy, and imbe- 
 cility. Idiocy and imbecility, due to imperfect de- 
 velopment of the brain, may be the result either of 
 bad heredity, or of serious disease in the earliest 
 period of life. The forms of insanity which 
 occur later in life may also be due in part to bad 
 heredity, in part to bad environment. As ex- 
 amples may be mentioned the insanity of adoles- 
 cence (sometimes called dementia praecox), the 
 manic-depressive insanities with their maniacal 
 and melancholic states, paranoia and the so-called 
 paranoid states, general paresis, due to syphilis, 
 the insanities due to alcoholism, and the insanities 
 accompanying thickening of the arteries of the 
 brain, or senility. 
 
 In the broader sense, " unsoundness " of mind 
 is a much more inclusive term. Thus epilepsy, 
 hysteria, hypochondriasis, and psychasthenia 
 are, in reality, conditions in which the mind is to 
 a greater or less extent disturbed. Even in the 
 conditions commonly designated as " neuras- 
 
Increasing Our National Efficiency 177 
 
 thenia " and " nervous breakdown " the mental 
 functions are, usually, temporarily slightly dis- 
 turbed. 
 
 Again, many people seem ignorant of the fact 
 that mind includes not alone " intellect," but also 
 the " affections " and the " will "; to such people 
 " unsoundness " of mind means disturbances of 
 the reason, and it is hard for them to realize that 
 abnormal expressions of emotion, or disorders of 
 the will manifesting themselves in anomalies of 
 conduct, can be evidences of " unsoundness of 
 mind." For the medical man, however, a knowl- 
 edge of the perversions of feeling and of the 
 deviations from normal behavior which accom- 
 pany defect or disease, is of the greatest impor- 
 tance in making diagnosis of abnormal mental 
 states and of the disorders of brain-activity which 
 underlie them. It is just here that the legal con- 
 ception of responsibility ceases to be synonymous 
 with medical conceptions of responsibility — a 
 notable example of that ambiguity of language 
 which leads so often to disputes. It is encourag- 
 ing that even in law, which is necessarily and de- 
 sirably conservative, the idea of " degrees " and 
 varieties of mental unsoundness has in recent dec- 
 ades been gaining currency, and with it the 
 conception of " artial," " diminished," or " at- 
 tenuated " responsibility as well as that of the 
 " individualization of punishment." 
 
 If we keep in mind the fact that conduct, 
 
178 Increasing Your Mental Efficiency 
 
 whether good or bad, is directly related to mental 
 states — using the term mental in the wider sense 
 to include all parts of the mind — will and emotion 
 as well as intellect — we can scarcely fail to recog- 
 nize the close relations which exist between 
 mental unsoundness (in the broader sense) and 
 all those forms of abnormal conduct which charac- 
 terize the delinquent classes. More than ever 
 before society is coming to recognize that the 
 problems of criminality, of inebriety, of vagrancy, 
 of prostitution, and of pauperism are closely in- 
 terwoven with the problems of brain disorder, 
 and that efforts directed toward the diminution of 
 the amount of delinquency will be effective only in 
 as far as they succeed also in improving brain 
 quality and brain function, that is, in as far as 
 they provide for better acting minds. 
 
 A Burden to the Nation 
 
 Unsoundness of mind is a burden to the nation 
 in more ways than one. In the first place the 
 economic burden is enormous. Dr. Charles L. 
 Dana estimated, in 1904, that the actual cost of 
 caring for the insane and the feeble-minded in the 
 United States amounted to sixty million dol- 
 lars per year, and that the loss to the nation in 
 industrial activity due to insanity and idiocy was 
 at least twenty million more. He believed that 
 the care and cost of the diseased and defective 
 
Increasing Our National Efficiency 179 
 
 brains of the country amounted to over eighty-five 
 million dollars annually, and that the amount 
 was increasing absolutely at the rate of four per 
 cent. Other investigators believe that to-day the 
 cost is much more than one hundred millions. 
 And these figures, bear in mind, refer to the in- 
 sane and the feeble-minded only. If we add the 
 cost of criminals and the delinquent classes gen- 
 erally, the expense will be seen to be stupendous. 
 In addition to the economic burden we must 
 consider also the cost in human suffering, not only 
 that of the mentally unsound themselves, but also, 
 and more particularly, the cost in sorrow to those 
 to whom these unfortunates are near and dear. 
 This is a burden not measurable in money. This 
 is a load incomparably harder to bear. Some of 
 you who have come in contact with ill-fated 
 families will have learned from that contact what 
 I mean better than words of mine can tell. 
 
 Every Nation Bears a Similar Burden 
 
 It is calculated that some 250,000 people in the 
 United States are insane. The number is not 
 excessive when compared with the prevalence of 
 insanity in other countries. The number of de- 
 linquents of various sorts is unfortunately large 
 in every land. The fact is that every nation has, 
 at present, to bear a similar burden of insanity, 
 imbecility, and delinquency. How long will this 
 
i8o Increasing Your Mental Efficiency 
 
 continue? It is impossible to say, but judging 
 from the alertness which peoples in modern times 
 manifest with regard to conditions making for 
 national advantage, it seems probable that stren- 
 uous efforts will soon be made by the more ad- 
 vanced and cultured nationalities radically to 
 reduce the load of mental disease and deficiency 
 by which they are handicapped. There are a good 
 many who hope and believe that the United States 
 of America will be among the first successfully to 
 move in this direction. Is it not probable that the 
 nations that remain backward in the campaign for 
 mental hygiene, once one or more of the great 
 peoples have made progress in it, will run some 
 risk of failure in the world rivalries in which they 
 may be compelled to participate? 
 
 Can the Occurrence of the Unsound Mind Be 
 Diminished? 
 
 Is the burden to which I have referred remov- 
 able ? Before answering this question it is neces- 
 sary to consider the origin of mental unsound- 
 ness. Biologically viewed, unsoundness of mind 
 means badly functioning brain. Now a brain may 
 function badly because it has a bad structure to 
 begin with, or because it has been subjected to in- 
 fluences incompatible with good functioning, or 
 from a combination of these two conditions. 
 
 Certain qualities of brain, which we designate 
 
Increasing Our National Efficiency i8i 
 
 as innate, depend upon heredity, that is to say, 
 upon the qualities of the germ-plasms inherited 
 from father and mother, but the development of 
 the brain in the child and its functioning through- 
 out life are dependent also upon influences outside 
 itself, acting upon it. Such influences arise partly 
 in the body of the bearer of the brain, partly out- 
 side his body in the environment. This doctrine, 
 that the kind of mind an individual has (his 
 thoughts, his feelings, his conduct) depends upon 
 the kind of brain he is born with, and upon the 
 external circumstances which act upon his brain, 
 shows us the direction in which we must look for 
 an answer to our question, Is the burden of un- 
 soundness of mind removable? 
 
 Theoretically, the answer is obvious. We shall, 
 on the one hand, have to see to it that children 
 are born with brains of such inherent qualities as 
 will make them capable of development to a cer- 
 tain grade of individual and social usefulness, 
 and, on the other hand, we shall have to regulate 
 the influences which are permitted to act upon the 
 brains of children and adults so that the welfare 
 of their mentality shall be favored and not in- 
 jured. 
 
 Difficulties 
 
 The practical application of the broad prin- 
 ciples involved is, however, far from easy. Pro- 
 vision for well-bom children is the special field 
 
i82 Increasing Your Mental Efficiency 
 
 of eugenics. The control of external circum- 
 stances is the problem of euthenics. But there are 
 barriers in the way of practical eugenics which 
 will be hard to pass, and the impediments to 
 progress in bettering environment are familiar to 
 every social worker. We must take care that the 
 cause of mental hygiene is not injured by rash 
 enthusiasts who propose panaceas, who promise 
 the unattainable, or who fanatically urge the im- 
 mediate adoption of ill-considered plans of re- 
 form. There will be plenty of distrust and 
 apprehension, even of the most sensible applica- 
 tions of sound principles. It is important, 
 therefore, that the advocates of mental hygiene 
 shall endeavor to purge their ranks of the narrow- 
 minded, the imprudent, and the precipitate. 
 
 A careful examination by sane investigators of 
 the various measures which have been proposed is 
 needed in order to ascertain which of them may 
 be unhesitatingly advised; and only with such 
 measures should the work of application be begun. 
 We possess now a large body of facts bearing 
 upon heredity and environment as they affect the 
 brain and its functions, about which there is 
 unanimity of opinion among men with the train- 
 ing which makes them competent to judge ; many 
 of these facts can undoubtedly be applied to the 
 betterment of the brain power of the nation. The 
 public should be systematically instructed regard- 
 ing such facts. Beyond this, we should be content 
 
Increasing Our National Efficiency 183 
 
 with stirring up interest in the general subject 
 and with the stimulation of researches which may 
 bring us more definite information to be used 
 later on. 
 
 To recapitulate, then, unsoundness of mind in 
 its various forms is alarmingly prevalent in this 
 and in all civilized countries. It is veritably a 
 heavy burden borne by every nation. Its occur- 
 rence can be and should be diminished. There are 
 difficulties in the way, but they must be overcome. 
 For the present, we can do most by stimulating 
 investigation and by educating the public regard- 
 ing well-established facts. Surely, the work is 
 wide and noble in its purpose. It is worthy, 
 surely, of the devotion and enthusiasm of our 
 most patriotic citizens ; in such work they can find 
 ample opportunity for the exercise of their high- 
 est faculties.' 
 
 Early Manifestations of Mental Disorders 
 
 There are two methods of making the reader 
 familiar with the symptoms of certain well-de- 
 fined and important forms of mental disorders 
 that may at any time come under his observation. 
 One method is to describe these conditions in a 
 general way ; the other is to select individual cases 
 and describe their symptoms in detail. 
 
 ' From an address on " Unsoundness of Mind, a National Handi- 
 cap," delivered by Prof. Lewellys F. Barker before the Mental 
 Hygiene Conference, New York City, November, 1912. 
 
1 84 Increasing Your Mental Efficiency 
 
 In the earlier chapters I have given a general 
 survey of certain forms of aberration, as a 
 familiarity with general conditions is desirable, 
 and necessary, if the peculiarities presented by 
 individual cases are to be fully appreciated. But 
 having thus touched upon the general features of 
 the subject, it seems advisable to consider some- 
 what more in detail certain mental states that are 
 peculiarly prevalent at the present time. 
 
 In a recent address Dr. August Hoch, Professor 
 of Psychiatry, Cornell University Medical Col- 
 lege, presented some features of this subject in 
 such a masterful way, and in a manner so entirely 
 comprehensible to the general reader, that I take 
 the liberty of quoting him at length. 
 
 Mental hygiene, said Dr. Hoch, has many points 
 of contact with hygiene in general, not only in the 
 sense that the bodily condition, naturally, reflects 
 upon the mental state, but also in the sense that in 
 the prevention of insanity a considerable portion 
 of our task does not belong, strictly speaking, in 
 the realm of mental, but in that of general, 
 hygiene. It is necessary to constantly repeat that 
 insanity is not one disease but a comparatively 
 large number of diseases or disorders which dif- 
 fer widely, not only in their manifestations but in 
 their causes ; so that in everything which refers to 
 the practical dealing with treatment and preven- 
 tion we have to follow quite different principles 
 in the different kinds of diseases. In some of 
 
Increasing Our National Efficiency 185 
 
 these diseases we are dealing with plain physical 
 causes or conditions, such as syphilis, diseases of 
 the blood-vessels, the premature wasting of brain 
 tissue in advanced years, or we are dealing with 
 alcohol or other poisons introduced into the body. 
 The prevention of some of these diseases which, 
 in part at least, have clean-cut causes, is theoretic- 
 ally simple and the task before us clear enough, 
 as clear as it is, for example, in tuberculosis. 
 That nevertheless even in these disorders the task 
 is a difficult one, is due essentially to such human 
 factors as ignorance, selfishness, and prejudice. 
 
 In the organic mental diseases the early mani- 
 festations are much more an integral part of the 
 disease ; they indicate the beginning of the actual 
 breakdown, they represent the first indications 
 that a severe brain disease has started. On the 
 other hand, in the other group of mental disorders 
 we find frequently even in early childhood, or at 
 the age of puberty, or during adolescence or later, 
 here and there certain peculiarities of character, 
 certain defects of self-management which we must 
 regard as danger signals and which should be 
 taken much more seriously than is commonly the 
 case. Such evidence we psychiatrists have 
 learned to recognize, above all, through careful 
 inquiries into the life histories, the characters, the 
 habits of those individuals who are brought to us 
 after the mental breakdown has occurred. And 
 the conviction has more and more been borne in 
 
i86 Increasing Your Mental Efficiency 
 
 on us that the public and, above all, the physicians 
 have not paid enough attention to such signs, and 
 that a better knowledge of these early danger sig- 
 nals should be useful to all those who have to deal 
 with children and young people. 
 
 Of course one might ask then, whether we have 
 a right to speak of such danger signals as early 
 manifestations of insanity at all. It might be 
 said that these are essentially defects of constitu- 
 tion, of make-up, of habits, and moreover, 
 defects which need by no means always be fol- 
 lowed by insanity. And it might further be 
 said that, in treating of these more particu- 
 larly, we are really not talking on the sub- 
 ject which was announced. But whether or 
 not we should regard such signs as true early 
 manifestations is, after all, a purely academic 
 question which sinks into insignificance beside the 
 essential question, namely: what is of practical 
 importance ? and from that point of view it seems 
 to me that these earliest signs deserve more par- 
 ticularly to he pushed into the foreground. How- 
 ever, they undoubtedly represent unhealthy ways 
 of living, and, though they may be, and undoubt- 
 edly are in part, the expression of a poor endow- 
 ment, there is, we are convinced, much in them 
 which, through better understanding, through the 
 fact that our attention and our studies are di- 
 rected to them, we shall learn to manage better. 
 "While there has been a certain tendency, on the 
 
Increasing Our National Efficiency 187 
 
 one hand, to disregard these earliest manifesta- 
 tions of insanity, there has also been, on the other 
 hand, a tendency to emphasize unduly heredity 
 and degeneracy as unalterable factors in the in- 
 dividual which lead to a somewhat fatalistic sizing 
 up of the situation. There is much which goes to 
 show that such a view is one-sided, and we hope 
 that the future will prove that it is unnecessary. 
 
 Two ways are open to treat the subject in hand. 
 Either we might give you a summary of observa- 
 tions which have been made in regard to these 
 earliest signs of lack of mental balance, or we 
 might briefly consider some concrete instances, 
 some living examples of individuals, some life 
 histories which illustrate definite defects which 
 were present for years or throughout life, and 
 which show clearly that the breakdown did not 
 come out of the clear sky but was rather an event- 
 ual outcome of inadequate self-management and 
 inadequate management by the environment — to 
 be sure in addition to a certain weakness inherent 
 in the individual. I shall choose the second 
 course, and briefly make you acquainted with some 
 actual observations. 
 
 The first patient is a young woman, about whose 
 early life we are fairly well informed. We are 
 told that even as a child she was hard to manage 
 and took advice badly. While I cannot find any 
 very concrete examples or instances under which 
 this behavior manifested itself, the notes give 
 
1 88 Increasing Your Mental EfBciency 
 
 enough to show that the difficulties which the 
 parents and teachers experienced in managing the 
 child were not due to any very active traits on the 
 part of the latter, not to that kind of boisterous 
 childish vivacity which is seen in normal children 
 who are hard to manage ; but rather to a passive 
 resistance. She got along pretty well when left 
 alone, but even simple adaptations were difficult 
 for her. Thus it troubled her when her things 
 were touched, or when she was interfered with 
 in any way. Her reaction then to such interfer- 
 ences was, however, not an aggressive one from 
 which a certain healthy shaping of the situation 
 might be expected, but a rather fruitless irrita- 
 tion, and more particularly, as is stated, a ' ' going 
 off by herself. ' ' Again, and quite consistent with 
 what we have said, we are told that she played lit- 
 tle with other children, was apt to cry when things 
 did not go just her way, and then left her play- 
 mates. It is also specifically said that she was not 
 liked by others. Children have a quick apprecia- 
 tion of barriers which another child, or for that 
 matter an adult, erects about him, and shun that 
 kind of personality. In company she was silent, 
 took no part in what was going on, and very often 
 left the room. She seemed ill at ease and bashful. 
 But she was not stupid, on the contrary rather 
 above the average in intelligence, and she worked 
 hard at school and had good marks. 
 At sixteen she became over-religious, a change 
 
Increasing Our National Efficiency 189 
 
 which was not accounted for by anything that 
 happened in her environment. Then came a year 
 at business college, which, so far as the work was 
 concerned, was also passed satisfactorily, though 
 her general traits did not change. But when the 
 time came to use her knowledge, that is, to change 
 from a mere receptive situation, which makes 
 infinitely less demands than the much more diffi- 
 cult task of stepping out into the world of respon- 
 sibility, then she was unprepared and shrank from 
 it; instead of taking positions which, evidently, 
 under the force of example and promptings from 
 home she did seek for a time, she found fault with 
 every one, and remained inactive. She married at 
 eighteen, and after the birth of the first child de- 
 veloped a serious mental disorder, from which she 
 has not and will not recover. 
 
 A somewhat similar situation is seen in the fol- 
 lowing patient, though here the gradual changes 
 are more plainly shown. This patient is described 
 as a girl who was also shy and retiring, inclined 
 to be afraid that what she did she did not do right, 
 afraid that she was not obedient enough, and she 
 was apt to tell other children to be more obedient. 
 Though she had the opportunity, she did not play 
 much with others, but preferred to be by herself, 
 and somehow she was always unable to get into 
 real contact with those about her and to derive 
 satisfaction from this. Yet she, too, was quite in- 
 telligent and good at school. 
 
igo Increasing Your Mental Efficiency 
 
 When puberty came on, with its physical 
 changes, she was unable to take this naturally and 
 had warped ideas about it. At fifteen, though she 
 continued to look healthy and was a rather strap- 
 ping girl, she began to sleep badly and appeared 
 more absorbed. She also became fault-finding, 
 dissatisfied; and even when changes were made 
 according to her wishes, this did not bring satis- 
 faction and she could not be aroused. This had 
 been the case during the summer. When she went 
 back to school it was soon found that she worked 
 badly, but it was months before the mother made 
 inquiries at the school, and then she was told that 
 the child acted funnily, got rattled, and was the 
 laughing-stock of the class. She was taken home. 
 
 Then attempts were made to divert her by tak- 
 ing her to parties and theatres, which, however, 
 in her condition, did not improve matters. Again 
 some months passed without any one suspecting 
 anything more serious, until suddenly she made 
 a strange remark. But this was soon forgotten, 
 and when vague thoughts and quandaries ap- 
 peared about the meaning of life and death, about 
 the universe, and so on, they were not regarded 
 as especially important or strange in a 15-year- 
 old girl. However, the catastrophe was now not 
 very far off. After a while she suddenly turned 
 against her mother, spoke of the devil being after 
 her, and finally got into a state of frenzied excite- 
 ment. When she was finally brought for treat- 
 
Increasing Our National Efficiency igi 
 
 ment she was in a stupor-like state in which her 
 interest and her contact with the environment 
 were extremely interfered with, a state in which 
 she had completely turned inward, so to speak, 
 and from this she has never and will never 
 emerge. 
 
 Somewhat different is the following ease, that 
 of a girl whose early history presented nothing 
 very striking. It is said, however, that she always 
 ohjected to control of any sort, but she got along 
 fairly well until some six or seven years before 
 the marked mental symptoms appeared, that is to 
 say, she got along moderately well until her nine- 
 teenth year. At that time she went to a Normal 
 school. There she was moody and unnatural, 
 was given to all sorts of fads about her diet, which 
 is always to be looked upon with some suspicion. 
 She felt tense, complained of cold feet and various 
 digestive disturbances. In order to escape this, 
 as she herself says, she lived a rather dissolute 
 life for a time but, of course, without getting any 
 real satisfaction from it. Later she began to 
 study music but developed again what was called 
 neurasthenia, was dissatisfied, uncomfortable, 
 tense. Again, she made faddish attempts at treat- 
 ment, this time by all sorts of absurd relaxation 
 exercises which, of course, did not go to the root 
 of the matter, and at the same time she lived in 
 an environment in which vague thoughts pre- 
 vailed, while balance and robust common sense 
 
192 Increasing Your Mental Efficiency 
 
 were lacking. Suddenly tlie outbreak came when 
 she proposed to a man whom she knew but 
 slightly. She rapidly lost weight, thought she 
 was married, and her conduct, in other ways, was 
 absurd. 
 
 The following instance I desire to speak of, not 
 because the patient showed similar traits in her 
 earlier life to those already mentioned, but be- 
 cause it is an excellent example to show how 
 poorly understood were the danger signals, even 
 when they appeared in a very marked form, and 
 just how that step was taken which, above all, 
 should have been avoided. The situation was 
 this: A predisposed girl begins to show mental 
 symptoms when she becomes engaged. Neverthe- 
 less she is allowed to marry, and upon this the 
 psychosis at once breaks out full-fledged. The 
 patient is a girl of 22. She was not very bright 
 at school; sometimes when the teacher asked her 
 questions she gazed at her without answering. 
 But on the whole she was not very peculiar, not 
 decidedly unsociable. Frona the seventeenth year 
 on, however, a change came over her and she then 
 became more reticent and less sociable. Seven 
 months before admission she became acquainted 
 with a man, is said to have become very much in- 
 fatuated with him, and got engaged after a short 
 acquaintance. Soon after this she began to show 
 an indefinite fear and, having lived away from 
 home, she now returned to her parents' house. 
 
Increasing Our National Efficiency 193 
 
 She soon developed fancies, thought her fiance 
 might come after her with a knife. She had cry- 
 ing spells without saying why, was morose, and 
 asked her sister to chop her head off. 
 
 In spite of this plain beginning of the psychosis, 
 as we have said, she was married some weeks be- 
 fore admission, and very soon got much worse 
 and developed a grave psychosis from which she 
 will not recover. Now, any one who is at all ob- 
 servant would have been struck by the fact that 
 definite symptoms appeared when she became en- 
 gaged. This should have been a warning, but of 
 course it was not a warning because no attention 
 is paid to such things, very often not even by 
 physicians. To a psychiatrist the situation would 
 have been very plain, for not only did she show 
 mental symptoms, but mental symptoms which 
 directly pointed to the fact that they were con- 
 nected with a lack of adjustment to this marriage, 
 although this, to be sure, was not conscious. 
 
 The popular belief that marriage cures nervous 
 and mental trouble, a belief which is not only 
 common among the laity, but also among doctors, 
 is a dangerous one. It is precisely a question of 
 defects of sexual adaptation which are so common 
 among these individuals, and therefore we should 
 do everything we can to eradicate this belief. 
 That it exceptionally holds good must be admitted, 
 but usually the opposite is the case, and I could 
 cite many instances in which the advice to marry 
 
194 Increasing Your Mental Efficiency 
 
 was full of serious consequences in individuals 
 who were predisposed. The psychosis broke out, 
 as was to be expected, with a peculiar attitude 
 towards her husband and she was afraid of him 
 and began to doubt whether he was her husband, 
 and in other ways showed that she was utterly in- 
 capable of this adaptation which was demanded 
 of her by the marriage. 
 
 These characteristic cases must suffice to show 
 some of the traits which patients who develop in- 
 sanity presented long before a breakdown was 
 thought of. It is surprising how rarely we find 
 that any such calamity was expected, even when 
 the indications became only too plain. The stories 
 which I have presented refer to that form of men- 
 tal disorder which we call dementia prsecox, or, at 
 any rate, to disorders closely related to this. I 
 shall presently try to make clear what is meant 
 by this disease. For the present it seems not out 
 of place to state that the yearly admissions to our 
 hospitals which belong to this general group, 
 represent nearly a quarter of all the cases ad- 
 mitted, and to further state that it is a conserva- 
 tive estimate when we say that the New York 
 hospitals for the insane at the present moment 
 take care of about 15,000 such patients, that is, 
 half the inmates of all the institutions. 
 
 And now as to the meaning of this condition: 
 We are becoming more and more convinced that 
 some mental disorders are reactions of a similar 
 
Increasing Our National Efficiency 195 
 
 nature, as we find in normal people ; and, as in the 
 normal these reactions to life are adjustments, so 
 are these mental diseases attempts at adjustments, 
 but no longer adjustments which take account of 
 the facts, or of the world as it is, but fictitious ad- 
 justments — they are poor instinctive attempts at 
 getting satisfaction which life did not furnish, 
 partly on account of the inherent difficulty in the 
 individual to accomplish proper adaptations to 
 the difficult business of life, but partly also, as we 
 have said, on account of often unnecessarily poor 
 self -management on the part of the individual, or 
 defects in the environment. Hence, we are learn- 
 ing to understand many even grotesque manifes- 
 tations of insanity. 
 
 We can, when we are able to penetrate into the 
 devious trends of thoughts and feelings of our 
 patients, see a meaning and a purpose in them. 
 But it is precisely this which gives us the convic- 
 tion of a continuity between the personality, with 
 its faulty self-management before the mental 
 breakdown, and the disease proper. But it also 
 gives us the conviction of a continuity of these 
 forms of insanity with milder forms of mental 
 disorder which are not called insanity, or with 
 neurasthenic and nervous states, or with the in- 
 ternal disharmonies of many so-called normal 
 people. The nervous person of any kind is some- 
 what out of touch with his environment and does 
 not get his full satisfaction out of life; we find 
 
igS Increasing Your Mental Efficiency 
 
 that those natures are most in danger of breaking 
 down with dementia praecox in whom the interfer- 
 ence with the proper touch with the environment 
 is most marked. They are natures who turn away 
 from reality, who shun the more difficult adapta- 
 tions to life. And, when we analyze the symp- 
 toms of this disorder, we find that they are essen- 
 tially the expression of this attitude of turning 
 inward and the growth of fancies which in- 
 variably result when the interest in the real world 
 stops. 
 
 We have seen that the chief early manifestations 
 in this group of diseases, the chief characteristics 
 of the persons, were those of reticence, seclusive- 
 ness, stubbornness, brooding, sensitiveness, a cer- 
 tain suspiciousness, together with oddities and 
 strange behavior. Such peculiarities, which have 
 their causes not only in unalterable innate per- 
 sonal traits, have a tendency to grow. It is not 
 surprising that such persons should (be found 
 unprepared when adaptations to new situations 
 are required through internal or external changes 
 as those which come with puberty, with stepping 
 out into life, with marriage, etc. 
 
 Dementia praecox is not the only disorder of 
 which I wish to speak. A similar number of ad- 
 missions to the hospitals is furnished by those 
 forms which we call mania and melancholia, dis- 
 orders which may be regarded essentially as exag- 
 gerations of normal emotions. These diseases are 
 
Increasing Our National Efficiency . 197 
 
 less serious. They are apt to begin much more 
 abruptly and, as a rule, they lead to recovery; 
 though relapses are common which, however, 
 again tend to the reestablishment of the normal 
 state. A considerable number of these disor- 
 ders occur in later life, especially melancholias. 
 In harmony with the better outlook of these dis- 
 orders we find the fact that the individuals who 
 develop them are much more natural, though we 
 find among them many who habitually have a 
 tendency to look on the dark side of life, or we find 
 slight traits like those mentioned above, or ner- 
 vousness, or emotional instability, or other traits. 
 I cannot refrain mentioning here a case which 
 belongs in this group, a case which may serve to 
 show how an early treatment would have avoided 
 more serious consequences. The patient is a 
 woman of 31, who, though not very bright, was a 
 conscientious worker in a shop. She always wor- 
 ried a good deal, cried easily. She was called a 
 home-body and had little association beyond that 
 of her mother. A young man called on her occa- 
 sionally for a number of years. For a year he 
 did so more frequently and finally spoke of an en- 
 gagement. Nine months before admission the pa- 
 tient had found out that he was already engaged. 
 She was much upset, cried, walked the floor, slept 
 poorly, said she had nothing more to live for, and 
 was unable to work. Now, this patient should 
 have been placed under treatment at that time 
 
igS Increasing Your Mental Efficiency 
 
 when the condition was one of a simple depression 
 well accounted for. Instead of this she was kept 
 at home. She did improve a little, but friends 
 kept telling her all about the man's doings, that 
 he was married, and so on, and her worry again 
 increased, and finally the mental disorder took a 
 more serious form — a sudden change came over 
 her, a change which she expressed by saying that 
 she had no feeling. 
 
 Under observation she complained essentially 
 of this change, said she was not herself, her body 
 was changed, her head empty, and she was very 
 much agitated. This is a well-known condition 
 and one from which the patient will finally re- 
 cover, but is one which is more serious than the 
 one she had presented at first and one which is 
 apt to last much longer. It could plainly have 
 been avoided if the public fully appreciated that 
 treatment should be instituted earlier in the at- 
 tack and not only when the condition is so ad- 
 vanced that we have gone beyond the point of elas- 
 ticity, or that at any rate very much less can be 
 done than would have been possible at first. The 
 case teaches some other lessons, but I fear it 
 would take too long if I were to go into details. 
 
 And it is not insanity only of which we should 
 speak in this connection. We have already men- 
 tioned the fact that there is a continuity between 
 these forms of insanity and milder abnormalities. 
 Here all sorts of nervous symptoms should be 
 
Increasing Our National Efficiency igg 
 
 mentioned: moodiness, depression, insistent 
 doubts and uncertainties, abnormal lack of deci- 
 sion, unfounded suspicions, uncalled-for feeling 
 of being at a disadvantage, feelings of inferiority, 
 exaggerated anxiousness and timidity, sexual un- 
 certainties and doubts, visionary tendencies, pe- 
 culiarly warped mental attitudes and many oddi- 
 ties of behavior, etc. Although many such people 
 do not break down, they often suffer enough. 
 Think of the colossal amount of energy which is 
 expended in their struggles and taken away from 
 useful activity, and think of the trouble which 
 some of them make in the world and the hardship 
 which they impose upon others, and yet many of 
 these traits are often regarded, I might say, as 
 legitimate traits, or at any rate as traits which 
 are the expression of such and such a personality, 
 and therefore are looked upon as settled. 
 
 It is not within the scope of a paper which is 
 supposed to call attention essentially to the early 
 manifestations of insanity, to speak at length of 
 remedies. And, moreover, I could not offer any 
 simple means of combating all these ailments of 
 which I have spoken this evening. They are the 
 outcome of many internal and external factors 
 and each case is a problem by itself. All treat- 
 ment, even that with medicines, consists in the 
 application of two principles — that of training 
 and that of rest. It is not different from these 
 nervous conditions. Here the principle of rest, or 
 
200 Increasing Your Mental Efficiency 
 
 of relieving the strain, consists in getting below 
 the surface, in trying to find out what are the 
 real causes of these peculiarities of feeling and of 
 behavior, what are the conflicts, the internal atti- 
 tudes and ideas of the individual; and the same 
 principle also takes into account the correction 
 of wrong influences of the environment. 
 
 Reconstructing the Mental Attitude 
 
 The principle of training, on the other hand, 
 is represented by the teaching of healthy living 
 under reconstructed conditions. All this is a task 
 which may be quite laborious and which requires 
 skill and knowledge. But one thing is certain and 
 that is that not only are too few attempts made 
 in this direction, but the danger signals as a rule 
 have not even been recognized, or have not been 
 regarded as such, and nothing at all has been done 
 to modify them. We have looked upon them, as 
 I have said, rather as legitimate traits which this 
 or that person also presented more or less, with- 
 out coming to serious grief. What must be de- 
 veloped is a feeling that all these traits are impor- 
 tant and are to be taken seriously. We must learn 
 that even slight abnormalities of self-management 
 or conduct are matters which need to be dealt 
 with, as matters which not only interfere with the 
 full development of the personality, of which we 
 are all so much in need, but which later may lead 
 
Increasing Our National Efficiency 201 
 
 to more serious consequences, and while it is diffi- 
 cult to give simple uniform ways of handling 
 these conditions, they will nevertheless at times 
 be found to be much more manageable than would 
 seem, especially when taken early. Many people 
 often stand at crossroads; in one direction lies 
 health, in the other nervousness or perhaps in- 
 sanity. Many turn in the right direction from 
 innate sense, others turn the other way because 
 they are constitutionally doomed. But we are 
 sure that many could be guided better if we only 
 paid more attention to these nervous conditions, 
 and would be thoroughly impressed with the fact 
 that they are wrong, to say nothing of the neces- 
 sity of getting away from a certain admiration of 
 some of them. It might of course be justly stated 
 that much good also comes from people who have 
 certain nervous tendencies, indeed that it is in 
 part these tendencies which create the good. But 
 this is true only of those individuals who find, 
 from their disharmonies and conflicts, a way 
 toward altruistic or artistic pursuits of value, 
 therefore a way toward adaptation after all. 
 This of course is the cause for our admiration of 
 nervousness which for that reason has a certain 
 justification, but that should not prevent us from 
 pointing to the dangers as well. This is one of the 
 tasks of the mental hygiene movement — to call at- 
 tention to these conditions. What the future will 
 have to bring us is the development, gradual to 
 
202 Increasing Your Mental Efficiency 
 
 be sure, like all healthy developments, of provi- 
 sions for a better management of not only the 
 intellectually defective, but the nervously abnor- 
 mal children. But mental hygiene should begin 
 even earlier in life, namely, with the infant, and 
 we should constantly insist on the importance of 
 the early years of life for the formation of char- 
 acter and modes of reaction, and upon the neces- 
 sity of paying much more attention to these years 
 of infancy and early chilhood from the point of 
 view of mental hygiene. 
 
 But we need also much further study along 
 these lines, and intensive occupation on all sides 
 with the question of nervousness and peculiarities 
 of behavior. We need more and more a psy- 
 chology which will occupy itself with character 
 formation and with the individual and its strag- 
 gles and disharmonies, and, on the part of the 
 school, an appreciation that dry knowledge is not 
 the only thing that is needed, but training to 
 efficiency, and efficiency on the level adapted to 
 the individual, at the bottom of which lies 
 adequate self-management.^ 
 
 Syphilis and Insanity 
 
 The relationship of venereal diseases to certain 
 forms of mental unsoundness has been referred 
 
 ' From "Early Manifestations of Mental Disorders," an ad- 
 dress delivered by Dr. August Hoch before the Mental Hygiene 
 Conference, New York, 1912. 
 
Increasing Our National Efficiency 203 
 
 to somewhat at length in an earlier chapter. But 
 as the subject is one of the most important in the 
 field of mental hygiene, it merits the fullest con- 
 sideration, particularly since recent discoveries in 
 science have given us the means of detecting the 
 presence of the specific germs that cause the 
 initial disease, and of eliminating them from the 
 system. 
 
 At the recent Mental Hygiene Conference, Dr. 
 George H. Kirby, of the Manhattan State Hos- 
 pital, presented some features of this subject in 
 a way that it has seldom been presented to a body 
 of laymen by an acknowledged authority. With 
 Dr. Kirby 's permission I have incorporated a por- 
 tion of this important paper in this chapter. 
 
 In referring to syphilis and insanity Dr. Kirby 
 says : The subject deals with one of the most im- 
 portant, as well as one of the most clearly defined, 
 problems to be found in the entire field of mental 
 hygiene. It is a problem, however, which, in 
 common with all others that come closely into re- 
 lation with the sexual life, has been always 
 tabooed as a subject for frank discussion in open 
 meetings, and likewise strictly excluded as unfit 
 to be mentioned in the public press, except under 
 veiled statements or by mere allusion. 
 
 Physicians have, therefore, in the past had little 
 opportunity to present to the public even the sim- 
 ple established facts of the case made out against 
 syphilis as a cause of insanity. Happily there 
 
204 Increasing Your Mental Efficiency 
 
 are at the present time many indications that this 
 " hushing up " and " keeping quiet " policy will 
 not much longer block the way against the en- 
 lightenment and proper education of the people 
 regarding the part played by this venereal disease 
 in the production of mental unsoundness. 
 
 In order to approach this whole subject of the 
 syphilitic caused diseases fairly one must guard 
 against a certain attitude, founded on error, yet 
 all too prevalent in the popular mind: many in- 
 telligent persons not only have no interest in the 
 social problem of syphilis, but they feel little or 
 no sympathy for individuals who suffer as a re- 
 sult of syphilis. There is often something of the 
 feeling that these people are afflicted because of 
 wilful transgression of religious and moral laws. 
 Many think only of the disease as something ut- 
 terly loathsome, associated always with vice, 
 crime, and the lowest sort of moral depravity. 
 This, as every physician knows, is untrue. While 
 prostitution is the chief means by which syphilis 
 is disseminated, its victims are claimed in every 
 stratum of society from the highest to the lowest. 
 Among the men admitted to the hospitals whose 
 insanity is due to a syphilitic infection, 75 per 
 cent, of them are married men, most of whom, if 
 guilty of transgression in earlier years, have long 
 since mended their ways and settled down to a 
 moral family life. 
 
 Among men, particularly young men, ignorance, 
 
Increasing Our National Efficiency 205 
 
 thoughtlessness, submission in a moment of weak- 
 ness, and the influence of suggestion by compan- 
 ions, account for the wrecking of many a life. 
 Temptation comes to almost every man. Igno- 
 rance and a wholly wrong attitude towards the 
 sexual instinct make the fall easy for many. One 
 is amazed to hear young men speak lightly, or 
 even jokingly, of venereal disease with no knowl- 
 edge of what the results may be if this disorder 
 is once contracted. 
 
 I could quote to you many cases from my per- 
 sonal knowledge of young men and even boys who 
 acquired syphilis more or less accidentally with- 
 out ever having been instructed or warned of the 
 danger to which they exposed themselves. We 
 have a patient in the hospital at the present time 
 whose insanity is due to syphilis contracted when 
 he was fourteen years old, at an age when he 
 knew nothing of venereal diseases and had no 
 realization of the possible consequences of an act 
 which he was induced to commit by a person he 
 accidentally met. 
 
 It is not within the scope of my paper to dis- 
 cuss the wider social aspects of syphilis or the 
 best means of combating the evil, nor shall I at- 
 tempt to recount the multitude of diseases which 
 it causes and the consequent suffering and misery 
 which it brings to innumerable homes and fam- 
 ilies. My task is to present to you briefly what 
 we now know regarding the damage done by 
 
2o6 Increasing Your Mental Efficiency 
 
 syphilis in one particular direction, namely, in the 
 production of mental unsoundness. It will, how- 
 ever, be necessary for me to say a few words re- 
 garding the nature of syphilis and its mode of 
 transmission in order that you may appreciate 
 fully the problem which confronts us. 
 
 A Germ That Causes Insanity 
 
 Although this disease has been described and 
 studied by physicians for centuries, its true cause 
 has only recently been definitely established. 
 Syphilis is now known to be an infectious disease 
 caused by a germ, a micro-organism, which has 
 been identified and its characteristics well studied. 
 Syphilis spreads in two ways: it is transmitted 
 from parent to child or it is communicated di- 
 rectly from one person to another during the 
 sexual act. Occasionally, one might say rarely, 
 it is communicated by accidental contact in other 
 ways. On the parts of the body exposed to the 
 infection the signs that the poison has entered the 
 system may be so slight as to pass almost un- 
 noticed ; if, as is usual, a small sore occurs it tends 
 to heal up rapidly with little indication of the 
 direful results which may follow. The germs 
 having once gained entrance into the system, any 
 part of the body or any organ may later be at- 
 tacked and partially or completely destroyed. By 
 appropriate treatment we may, however, as a 
 
Increasing Our National Efficiency 207 
 
 rule, control the symptoms that arise within the 
 first few years after infection takes place, and it 
 may appear that the disease has been eradicated 
 from the body. It is, however, well-nigh impos- 
 sible to say that this has been actually accom- 
 plished, for the syphilitic germs possess the re- 
 markable property of lying dormant for a long 
 space of time, often many years, and then begin- 
 ning to cause trouble again. 
 
 This peculiar tendency of the syphilitic germ to 
 remain quiescent for years while all obvious 
 symptoms of the disease disappear, served to keep 
 us long in the dark regarding the true cause of 
 some of the most serious nervous and mental 
 troubles with which physicians have to deal. It 
 was naturally difficult to establish a connection 
 between a nervous or mental breakdown 10, 20 or 
 30 years after a venereal disease when, during all 
 these years, there had been few, if any, signs that 
 the syphilitic poison was still in the system. For- 
 tunately for our better understanding of these 
 diseases, which develop years after the initial in- 
 fection, the missing link in the chain of evidence 
 against syphilis has recently been supplied and 
 we can now present conclusive evidence, whereas 
 we formerly spoke merely of probabilities and 
 could not prove what we suspected. 
 
 The proof was furnished by the discovery of a 
 very delicate blood test now known the world over 
 under the name of the physician who devised it 
 
2o8 Increasing Your Mental Efficiency 
 
 as the Wassermann test for syphilis. By this test 
 one can, through examination of a few drops of 
 blood, determine whether or not any trace of 
 syphilitic poison exists in the body of the person 
 tested, and this in spite of the fact that the 
 syphilis may have been acquired many years 
 previously and the individual, at the time of the 
 test, may present no visible symptoms of syphilis 
 itself. 
 
 Smouldering Fires 
 
 Among the syphilitic diseases, there stands out 
 one in particular that, above all others, commands 
 our earnest attention, first, because of its great 
 frequency and, secondly, because it is not amen- 
 able to any known treatment; the result always 
 being death and that usually within two to five 
 years after the disease is recognized. This affec- 
 tion is variously known as paresis, general 
 paralysis, or softening of the brain. 
 
 Paresis, or as it is sometimes called, par-e-sis, 
 develops most often 10 or 20 years after the 
 original syphilitic infection, and as most individ- 
 uals who contract syphilis do so in the earlier 
 years of manhood or womanhood, paresis will 
 appear most often between the 35th and 45th 
 years, just the age at which one is considered to 
 be in the prime of life. Thus we find that appar- 
 ently robust, normal individuals are stricken in 
 the midst of an active life. The one attacked may 
 
Increasing Our National Efficiency 209 
 
 have almost forgotten the syphilitic infection of 
 years before and the patient as well as the family 
 and friends are sure to attribute the breakdown 
 to some more recent occurrence, such as over- 
 work, business worry, intemperance, accidental 
 injuries, etc., things which we now know can never 
 alone produce paresis. 
 
 The disease comes on, as a rule, slowly; the 
 finer feelings and the higher mental functions suf- 
 fer first; slight changes in disposition or charac- 
 ter are noticed, the ethical sense is impaired, rea- 
 son and judgment are insidiously undermined, 
 and very often, before the family or friends are 
 aware that actual mental disease exists, the af- 
 flicted individual has committed acts which too 
 often extend in their consequences far beyond the 
 patient himself, and may bring ruin upon his 
 family and others. As the mental symptoms be- 
 come more marked the patient's mind is apt to 
 be filled with all kinds of impossible schemes and 
 extravagant ideas, the judgment is abolished and 
 the memory is slowly lost, so that the patient may 
 finally have little knowledge of his past life. In 
 the terminal stages the greatest possible degree of 
 mental decay is reached — the patient being re- 
 duced eventually to a mere vegetative existence, 
 with little or nothing left to show that the sufferer 
 was once an intelligent being. Accompanying this 
 mental deterioration there are well-marked phys- 
 ical symptoms; the limbs tremble, the power of 
 
210 Increasing Your Mental Efficiency 
 
 speech is impaired, convulsions may occur, the 
 patient becomes bed-ridden from weakness or 
 paralysis, and so remains until death finally closes 
 the distressing scene. 
 
 The post-mortem examination of the body 
 shows us that the syphilitic poison has caused 
 widespread damage to the brain, the result of a 
 chronic inflammatory condition accompanied by 
 softening and shriveling of the brain matter itself. 
 
 Recently a very important remedy known as 
 " 606," or Salvarsan, has been brought forward 
 as a cure for syphilis. It appears to have a very 
 remarkable effect in checking various syphilitic 
 symptoms, particularly those that develop soon 
 after the primary infection takes place, but un- 
 fortunately we find that it is of absolutely no use 
 in the treatment of paresis. 
 
 During the past year 758 patients entered the 
 New York State hospitals suffering from paresis, 
 which number is equivalent to nearly 14 per cent, 
 of all the 5,700 new cases admitted. These 758 
 persons represent only a part of the cases of 
 paresis that develop in the population, as many 
 patients are sent to private institutions, others 
 are kept at home, and some die in general hos- 
 pitals. Among all the admissions to the State 
 hospitals we find, with one exception, more cases 
 of paresis than any other single form of mental 
 disorder. 
 
 Paresis is much more frequent among men than 
 
Increasing Our National Efficiency 211 
 
 among women — three times as many men as 
 women are admitted suffering from this disease; 
 we find that 18 to 20 per cent, of all men admitted 
 are suffering from paresis. 
 
 It is also known that paresis is much more prev- 
 alent in cities than in country districts. Among 
 all the admissions to the State hospitals we find 
 that 22 per cent, of the men who come from cities 
 have paresis, while only 8 per cent, of those who 
 come from the country have this disease. The 
 women show a similar difference, as we find twice 
 as many cases of paresis among city-women as 
 among country-women. These figures show 
 clearly that syphilis is more frequent where the 
 population is most compact. 
 
 Another interesting and important fact is that 
 paresis is much more prevalent among the 
 foreign-born population than among the native- 
 born inhabitants. In New York City, for instance, 
 we find that when we compare the foreign-born 
 with the native-born population, there are propor- 
 tionately twice as many cases of paresis among 
 foreigners as there are among the natives. 
 
 Last year 627 patients died of paresis in the 
 New York State hospitals. As had been pointed 
 out by Dr. Salmon, this large number of deaths 
 takes rank with the mortality rate of some of the 
 most dreaded diseases. Typhoid fever is one of 
 the most feared and widespread of the infectious 
 diseases, yet in this State paresis causes over half 
 
212 Increasing Your Mental Efficiency 
 
 as many deaths each year. Paresis claims more 
 victims annually than does erysipelas, one of the 
 most common of infectious diseases. Cancer of 
 the breast, a frequent and malignant disease, 
 causes yearly no more deaths than paresis. Sta- 
 tistics show that in this State more deaths result 
 each year from paresis than from dysentery, 
 malaria, smallpox, tetanus, and rabies all com- 
 bined. 
 
 These hundreds of cases of paresis that stream 
 into our hospitals every year represent only a 
 part of the damage that syphilis causes to the 
 mental health of the community. Thanks to the 
 Wassermann blood test and other investigations, 
 we can now definitely state that syphilis is re- 
 sponsible for many other conditions of mental 
 unsoundness. 
 
 The Penalty of Inherited Syphilis 
 
 In the first place, some very interesting studies 
 have been made on the families of paretic pa- 
 tients. We find that when either the father or 
 the mother suffers from paresis many other 
 members of the family may be infected with 
 syphilis, and furthermore, we find that a sur- 
 prisingly large number of children in these fam- 
 ilies are feeble-minded, nervous, or in other ways 
 abnormal. Dr. Plaut examined a group of 100 
 children, the offspring of cases of paresis, and 
 
Increasing Our National Efficiency 213 
 
 found that 45 per cent, were plainly damaged 
 mentally or physically or in both fields ; the blood 
 test showed that one-third of these 100 children 
 had the syphilitic poison in their systems. 
 
 Another investigator found in a group of 139 
 children, the descendants of parents who had 
 syphilitic nervous disease, that over 25 per cent, 
 were definitely feeble-minded or affected with 
 some serious nervous disorder. 
 
 Other studies indicate that there exists a close 
 relation between syphilis and many of the hitherto 
 unexplained cases of feeble-mindedness, including 
 idiocy, imbecility, infantile paralysis, and some 
 forms of epilepsy. While the question is not 
 yet settled, it appears that syphilis is the real 
 cause of many of these cases of mental defect in 
 children. 
 
 A striking example is furnished by the record 
 of a family studied by Dr. Plant. A thirteen-year- 
 old schoolboy was brought to the hospital because 
 he had a convulsion while at school. Examination 
 showed that he was a case of juvenile paresis in 
 the early stages, the blood giving the usual indi- 
 cation of syphilis. His parents were questioned, 
 but both denied positively that they ever had 
 syphilis. The father would not allow his blood 
 to be examined, but the mother permitted the ex- 
 amination, and she was found to have syphilitic 
 blood, although at the time of the test she ap- 
 peared to be in good health and claimed to have 
 
214 Increasing Your Mental Efficiency 
 
 no knowledge of ever having had syphilis. The 
 four other children in the family were then ex- 
 amined. Two were found to be feeble-minded and 
 the blood test was positive for syphilis. A third 
 child had previously been treated for a syphilitic 
 skin disease, and the blood test was again positive. 
 A fourth child appeared well and the blood test 
 was negative. It was thus found that in a family 
 of five children the blood test was positive in 
 four, and three of these were mentally abnormal. 
 The mother also had syphilitic blood, although 
 she did not know that she had ever contracted 
 syphilis, while the father, who was probably the 
 cause of all the trouble, would not submit to a 
 test. 
 
 Such observations as this are particularly in- 
 structive, because if the family had not been care- 
 fully examined and tested for syphilis, the true 
 reason as to why the children were mentally ab- 
 normal would not have been discovered. 
 
 In another group of cases of mental disorder 
 due to " syphilis of the nervous system," one 
 finds that the disease has directly attacked the 
 coverings of the brain and the small blood-vessels, 
 and inflammatory deposits occur which do serious 
 damage to the brain substance and consequently 
 impair the mentality. 
 
 A very frequent disease is arteriosclerosis, or 
 hardening of the blood-vessels, a certain number 
 of cases of which are caused by syphilis. When 
 
Increasing Our National Efficiency 215 
 
 the blood-vessels of the brain are attacked very 
 serious mental decay may result. We thus find 
 that many middle-aged or older persons may 
 suffer strokes of paralysis or have convulsions 
 and become insane or demented as a result of the 
 injury that syphilis does to the arteries of the 
 brain. 
 
 When we know the grand total of all of these 
 conditions of mental defect and disease, as repre- 
 sented by the hundreds of cases that are received 
 every year in the State hospitals and institutions 
 for the mentally defective, we do not even then 
 gain a correct idea of how great a menace syphilis 
 is to the mental health of the nation. Still the 
 figures which I have quoted to show the actual 
 number of cases of insanity due to syphilis ad- 
 mitted to the State hospitals, should impress 
 every thoughtful citizen with the urgent need of 
 lending his or her efforts to the solution of this 
 problem. As matters now stand, we know that 
 just as many hundreds of cases, and more, will be 
 admitted to the State hospitals next year as in 
 the year now passing. 
 
 Every parent and teacher, every spiritual and 
 moral adviser, should not fail to see that every 
 youth is warned and properly instructed before 
 the temptations of the world are faced. 
 
 Physicians are almost unanimous in their belief 
 that the first great step will be taken toward the 
 prevention of insanity from syphilis and the con- 
 
2i6 Increasing Your Mental Efficiency 
 
 trol of the disease itself when we begin to treat 
 syphilis as we do other infectious or contagious 
 diseases. We protect the community against 
 smallpox, diphtheria, scarlet fever, tuberculosis, 
 and other communicable diseases by reporting 
 them to the Board of Health and fighting them by 
 quarantine, isolation, disinfection, and all other 
 means within our power. Why should syphilis, a 
 dangerous, contagious, and infectious disease, be 
 excepted? For the protection of the community 
 every person infected with syphilis should be 
 registered with the health authorities and proper 
 means taken to limit the communication of the 
 disease to others. For the protection of families 
 and for the ultimate improvement of the race, 
 no person who has had syphilis should receive a 
 marriage certificate unless the blood test proves 
 that the poison is no longer in the system. 
 
 When we deal with syphilis in this manner, then 
 will the number of cases of hopeless insanity be- 
 gin to decrease, and fewer feeble-minded children 
 will be bom into the world. ^ 
 
 Educational Methods and Mental Efficiency 
 
 The question of mental efficiency is determined 
 by two great factors: natural endowment, and 
 education. The first is entirely beyond our con- 
 
 1 From an address on " Sjrphilis and Insanity " delivered by 
 Dr. George H. Kirby before the Mental Hygiene Conference, New 
 York, 1912. 
 
Increasing Our National Efficiency 217 
 
 trol in the present generation of cMldren. But 
 the second is well within our power to direct. 
 
 Until recently educational methods have been 
 left largely in the hands of lay-teachers engaged 
 in the didactic work of the schoolrooms. But it 
 is obvious that these teachers should include in 
 their special instructions the general features of 
 mental hygiene that have been investigated by 
 persons specially engaged in that part of our 
 education that applies to mental stability. This 
 can only be done in a general way, of course, but 
 even such general teaching should be most valu- 
 able as an adjuvant to the special school training. 
 
 Dr. Stewart Paton, of Princeton, recently in- 
 dicated the general attitude that teachers should 
 cultivate, based upon observations of persons who 
 have developed mental peculiarities largely 
 through lack of this very kind of education. His 
 attitude toward the subject is given in the follow- 
 ing passages from one of his recent addresses : 
 
 How much meaning there often is in a single 
 word ! It may decide great issues, epitomize our 
 hopes or fears or express our entire philosophy 
 of life. Think what the term " insanity " repre- 
 sents to the minds of the majority of people ; ap- 
 prehension, fear, despair — a very gloomy back- 
 ground. There is one lesson that should be re- 
 membered, namely, the possibility of discarding 
 the word insanity and substituting for it the term 
 maladjustment. We have been told that life is an 
 
2i8 Increasing Your Mental Efficiency 
 
 adjustment. As long as the process of this ad- 
 justment between the individual and environment 
 persists, life is present, but with its cessation 
 death intervenes. Disease is an imperfect ad- 
 justment of which mental disorders are a special 
 but not specifically different type. By substitut- 
 ing for insanity the word maladjustment we have 
 made a great advance. 
 
 By this change in our point of view we have 
 also unconsciously recast some old and difficult 
 problems in a new form. Think how the whole 
 educational problem now stands out clearly before 
 us. Where once we were blindly groping our way 
 we now follow a plain, straight path. 
 
 What is the function of education? What is 
 the first duty of the teacher? Does it not consist 
 in an attempt to estimate the adjusting capacity 
 of every student and then try to help him or her 
 find a place in life where adjustment is possible? 
 Think of the figures on the charts showing the 
 incidence of insanity in the United States. At the 
 first glance we seem to be looking at a very dark 
 picture. I do not think, however, that there is 
 any justification for a gloomy outlook. Eemem- 
 ber our substitution and then reflect upon the 
 actual significance of these figures. Do the num- 
 bers not indicate that there are so many individ- 
 uals in the community, who have been brought by 
 defective heredity, undesirable social conditions, 
 or a poor education into a position where they 
 
Increasing Our National Efficiency 219 
 
 cannot readjust? "Why do teachers not realize 
 that they should assist students to find positions 
 in life where it is possible for them to work easily, 
 with pleasure, and at the same time retain their 
 capacity of readjusting to meet the conditions of 
 life. We should not dodge the issue. Our present 
 educational system is to a large extent responsible 
 for many of the figures recorded on these charts. 
 If we analyze the statistics carefully there is no 
 reason to become pessimistic, while there are ex- 
 cellent grounds for facing the future with hope. 
 
 What then is the spirit of the whole movement? 
 Can we not sum it up in a single word? It seems 
 to me that such a course is possible. I should 
 have been very glad to have seen the word teach- 
 ing dropped from this programme and the word 
 learning substituted for it. The spirit of the 
 Mental Hygiene campaign is one of learning, not 
 of teaching. Dogmatic forms of belief as incul- 
 cated by many teachers have unfortunately led 
 directly to many cruel practices. Philippe Pinel 
 was fortunately a great learner. His spirit of 
 inquiry led him to afiirm that insanity is a disease 
 of the body not specifically different from other 
 physical disorders. Practical results of inesti- 
 mable value followed close upon his acceptance of 
 this fundamental principle. Henceforth the in- 
 sane were to be treated as patients and not as 
 prisoners nor as those possessed with a devil. 
 When Pinel stood in the old hospital in Paris and 
 
220 Increasing Your Mental Efficiency 
 
 ordered the chains to be removed from these un- 
 fortunate persons, he opened np a new epoch in 
 the history of humanity. He did a great deal 
 more than accomplish a great practical reform, as 
 he set people thinking along new lines. He form- 
 ulated many problems, that are of interest to 
 teachers, in a very striking manner. In his re- 
 markable book ' ' Nosographie Philosophique ' ' 
 the great number of volumes adorning the shelves 
 of libraries are contrasted with the meager record 
 of exact observations conducted upon individuals. 
 Possibly he had in mind the numbers of physi- 
 cians and laymen who did not consider insanity 
 to be a disease simply because writers of books 
 had entertained an opposite view. May we not 
 all pause and think about the valuable lesson ex- 
 pressed in this reflection! He appreciated the 
 spirit of learning and refers to its importance in 
 many interesting passages. His observations 
 taught him that there were not specific differences 
 between the activities of the sane and the insane. 
 " In nervous and mental diseases," he declared, 
 " I see the key which will unlock the secrets of 
 human nature as they are recorded in history and 
 moral philosophy. ' ' 
 
 In order to understand the activities of a 
 normal person we must often carefully study 
 those of the abnormal individual. The faculties 
 of the former are, as a rule, so perfectly balanced 
 and well adjusted that it is difficult to analyze 
 
Increasing Our National Efficiency 221 
 
 them. Disease sometimes comes to our assistance 
 in the process of analysis and brings out promi- 
 nently certain symptoms, thus giving a clew to the 
 interpretation, not only of the activities of the 
 insane, but which lays bare for us the secrets of 
 our own nature. 
 
 Is it not strange that more than two thousand 
 years have elapsed since the realization of self- 
 knowledge; " Know thyself," was represented to 
 be the highest attainment for which human beings 
 could strive? Mankind has waited for centuries 
 before any organized effort was made in this di- 
 rection. Unfortunately the spirit that Bacon de- 
 plored is still one of our chief characteristics — 
 the desire to theorize and to dwell on the top of a 
 mountain instead of profiting by a descent to the 
 plain has thwarted our efforts to know ourselves. 
 For centuries man has reiterated certain false 
 doctrines in regard to himself, and the din or ar- 
 gument has served to fix the ideas in conscious- 
 ness. He has seldom taken the trouble to see 
 whether these notions tallied with the results of 
 actual experience. The mental hygiene movement 
 represents an organized movement to know our- 
 selves, in order that the knowledge obtained may 
 be applied to making our lives happier and more 
 efficient. There are one or two ideas of impor- 
 tance that should be kept constantly before our 
 minds in the discussion of this subject. In the 
 first place we must try and incline people's minds 
 
222 Increasing Your Mental Efficiency 
 
 to receive the truth. Fact must be separated from 
 fiction, and to be capable of distinguishing be- 
 tween the two it is essential that students should 
 be trained to associate the study of biology with 
 the discussion of the human activities. It will be 
 a very fortunate thing when some university in 
 this country receives the endowment necessary to 
 establish a great department of biological psy- 
 chology entirely independent of the restricted in- 
 fluences imposed by speculative philosophy. 
 
 One of the most fertile ideas of biological 
 science is that there is an unbroken and uninter- 
 rupted chain linking the activities of the lowest 
 with those of the highest organism. If we wish to 
 understand our own complex activity it is often 
 necessary to return to the study of the simplest 
 organisms in order to comprehend the mental 
 adjustments of the human individual. There is 
 still another chain that science has shown to be 
 unbroken, by establishing the fact that there is no 
 specific qualitative difference between the thought 
 and conduct of a normal, healthy individual and 
 that of the patient afflicted with alienation. 
 
 A dependent section of the department of bio- 
 logical psychology should include one of Mental 
 Hygiene ; where students could go for information 
 in regard to themselves and for assistance in at- 
 tempting to estimate their own adjusting capaci- 
 ties. Practical experience teaches that it would 
 often be possible to avert many of the disasters 
 
Increasing Our National Efficiency 223 
 
 that occur later in life to those who have strug- 
 gled to attain what in conventionality are called 
 " the advantages of a higher education." The 
 surest protection insuring us against the possi- 
 bility of a mental breakdown is a good heredity 
 and of almost equal importance the early acquisi- 
 tion of good mental habits/ 
 
 1 From an address on " Educational Methods and Mental Effi- 
 ciency " delivered before the Mental Hygiene Conference in 1912 
 by Dr. Stewart Paton. 
 
vni 
 
 A National Movement to Improve Mental Efficiency 
 
 By Thomas W. Salmon, M.D., Director of Special Studies for 
 the National Committee for Mental Hygiene 
 
 ALL efforts to safeguard health are made in 
 the field of public hygiene (sanitation) or 
 in that of personal hygiene. In the prevention of 
 many diseases it is necessary to carry on activi- 
 ties in both fields. 
 
 The measures in public hygiene for the preven- 
 tion of typhoid fever, for instance, include the 
 protection of water supplies, the sanitary disposal 
 of sewage and the destruction of insects which 
 carry typhoid bacilli from infected material to 
 food, while in the field of personal hygiene are 
 the efforts of individuals to raise their immunity 
 to this disease by inoculation with typhoid vac- 
 cine and the detection and isolation of ' ' carriers, ' ' 
 those who while well themselves may bear the 
 disease to others. Again in the prevention of 
 malaria, destruction of the breeding places of 
 mosquitoes is a procedure in public hygiene, while 
 taking prophylactic doses of quinine is a matter 
 of personal hygiene. There are few diseases 
 
 224 
 
A National Movement 225 
 
 which can be successfully prevented by efforts 
 in one of these fields alone. 
 
 Until recently, the prevention of mental dis- 
 eases was thought to be almost wholly a matter of 
 personal hygiene. It has been shown, however, 
 that there are public measures in mental hygiene 
 without which the efforts of individuals are likely 
 to be unavailing and, on the other hand, much 
 must be done in the field of personal hygiene, if 
 the efforts of the community as a whole to lessen 
 mental disease are to succeed. The preceding 
 chapters of this book have been devoted very 
 largely to those principles which must guide the 
 individual in safeguarding his mental health and 
 increasing his mental efficiency. The following 
 short account of the work of a national agency for 
 mental hygiene may serve to show some means by 
 which such individual efforts may be initiated 
 and then coordinated and made effective for the 
 common welfare. 
 
 The National Committee for Mental Hygiene, 
 founded February 19th, 1909, came into existence 
 because of the conviction among some of those 
 whose work had brought them closely into contact 
 with the problem of mental diseases that there 
 was urgent need for a national agency to help 
 raise standards in the care and treatment of the 
 insane and to work for the prevention of mental 
 and nervous disorders. 
 
 The way in which this sentiment was crystal- 
 
225 Increasing Your Mental Efficiency 
 
 lized has been described as follows by Dr. 
 LeweUys F. Barker, in an address delivered at the 
 Fifteenth International Congress on Hygiene and 
 Demography: " This impulse, thanks to the 
 initiative of a layman, Clifford W. Beers, author 
 of ' A Mind That Found Itself ' (now Secretary 
 of the National Committee), whose personal suf- 
 ferings led him, on recovery, to devote himself to 
 the cause of mental hygiene, and who enlisted the 
 cooperation of a group of representative men and 
 social workers, has found expression in the vol- 
 untary formation of a National Committee for 
 Mental Hygiene." 
 
 While new methods of treatment and hopeful 
 measures for prevention have been eagerly wel- 
 comed and very effectively applied in other fields 
 of medicine, this has not been the case in the care 
 of the insane and the prevention of mental dis- 
 eases. In this country at the present time the 
 care of those ill with mental diseases varies in 
 the different States from the kind of treatment 
 which humanity requires for all other classes of 
 the sick to methods which have come down to us 
 from an age when the insane were looked upon 
 with superstitious fear and when cruelty and 
 neglect were their usual portion. It is apparent 
 that only a nation-wide movement — carefully 
 planned, scientifically directed and adequately 
 financed — can deal with the varied and complex 
 causes for these conditions or, indeed, even can 
 
A National Movement 227 
 
 secure the accurate information necessary for ef- 
 fective work in ameliorating them. 
 
 The Importance of the Problem 
 
 On the date of the last federal census, January 
 1, 1910, there were 187,454 persons in institutions 
 for the insane in this country. This number ex- 
 ceeds the number of students in all the colleges 
 and universities in the United States. It exceeds 
 the number of officers and enlisted men in the 
 United States Army, Navy, and Marine Corps, 
 and it exceeds the population of Columbus, Ohio, 
 the twenty-ninth city in size in this country. 
 About 30,000 new cases of mental disease are ad- 
 mitted to institutions in the United States each 
 year and the annual increase in the number of 
 patients under treatment is about 6,000. If all the 
 States provided for their insane as adequately as 
 do New York and Massachusetts, there would be 
 more than 300,000 patients in institutions. A 
 more concrete illustration of the prevalence of in- 
 sanity is the fact that the number of hospital beds 
 for the insane in New York City exceeds the 
 number of hospital beds in all the general hos- 
 pitals of that city. 
 
 The cost of caring for the insane in a State 
 making adequate provisions exceeds any other 
 single item of expense, except the amount ex- 
 pended for public education. The average annual 
 
228 Increasing Your Mental Efficiency 
 
 cost of maintenance in institutions for the insane 
 in the United States is about $175 per patient, 
 making the total cost during the year 1910 for 
 those in institutions, $32,804,450. As it is esti- 
 mated that the cost of the Panama Canal will be 
 $325,201,000, and that it has taken almost ten 
 years for its completion, it is seen that the annual 
 cost of caring for the insane is greater than the 
 annual cost of construction of that great work. 
 The latter sum is so great that it was deemed 
 necessary to distribute it over a number of years 
 by the issuance of bonds ; whereas the cost of car- 
 ing for the insane is an annual expense, which 
 has to be met from current revenues of the 
 States. 
 
 In order to state fairly the cost of mental dis- 
 eases there must be added to this great sum the 
 economic loss to the country through the with- 
 drawal from productive labor of so many people 
 in the prime of life. It has been stated by the 
 United States Commissioner of Labor that the 
 average value to the community of an adult be- 
 tween the ages of 18 and 45 is $700 a year. Esti- 
 mated upon this basis, the annual economic loss to 
 the United States through the confinement of 
 187,454 people in institutions for the insane is 
 more than $130,000,000. If this is added to the 
 cost of maintenance the total is more than 
 $162,000,000 — an amount equal to the entire value 
 of the wheat, corn, tobacco, dairy products, and 
 
A National Movement 229 
 
 beef products exported annually from the United 
 States. 
 
 Such statistics serve as a means of comparison 
 but they cannot convey an adequate idea of the 
 most serious results of mental diseases — the per- 
 sonal suffering and unhappiness, the social and 
 family disasters and the business troubles which 
 they cause. It should be remembered that the 
 same factors which bring about the commitment of 
 people to institutions for the insane are responsi- 
 ble for much inental disease which is never recog- 
 nized and for loss of efficiency, failure to meet 
 difficult situations of life and conflicts with 
 conventions and laws. These often depend upon 
 mental disorders or mental defects, although the 
 fact is not generally recognized. Accounts of 
 murders, suicides, marriage troubles and many 
 kinds of misdemeanors often have a very definite 
 meaning for those who are familiar with the ab- 
 normalities of conduct which result from mental 
 disease. The frequency of these social disasters 
 indicates the inadequacy of present methods of 
 dealing with the problem of mental diseases. 
 
 Humanitarian and economic reasons alike call 
 for organized efforts to control the spread of in- 
 sanity. It is known that there are certain essential 
 causes of mental disease and that some of these 
 essential causes are within our control. In 1913, 
 499 persons died from typhoid fever in New York 
 City, while more than 500 persons with general 
 
230 Increasing Your Mental Efficiency 
 
 paresis (all of them certain to die of their dis- 
 ease) were admitted during the same period and 
 from the same population to hospitals for the in- 
 sane. Syphilis causes other mental diseases, and 
 there is probably no other single cause for insan- 
 ity responsible for a greater number of cases. In 
 spite of this it is an amazing fact that many of 
 those most active in the field of venereal prophy- 
 laxis are not aware that such a prevalent and uni- 
 formly fatal disease as general paresis depends 
 upon previous infection with syphilis. About 20 
 per cent, of all first admissions to hospitals 
 for the insane are on account of the alcoholic 
 psychoses, forms of mental disease which depend 
 upon another essential cause of insanity. These 
 are two controllable causes of mental disease. 
 
 In the varied conditions capable of producing 
 mental disease there are many other controllable 
 causes, some of them deeply imbedded in the 
 social fabric and touching many phases of per- 
 sonal life, education, and general preventive 
 medicine. This fruitful and most important field 
 for work in the prevention of disease has prac- 
 tically been neglected thus far, very largely on 
 account of lack of popular information. 
 
 The most effective work in the prevention of 
 insanity, as well as in increasing the efficiency and 
 happiness of those who do not become insane, 
 must be done in early life. We know that much 
 mental disease and more disaster from imperfect 
 
A National Movement 231 
 
 adjustments to life of a little different sort depend 
 upon inadequate equipment to deal with difficult 
 situations and upon attempts of people to live 
 upon levels of activity for which their mental 
 equipment and training have not fitted them. We 
 know that in not a few cases these inadequacies 
 of equipment and this tendency on the part of 
 people to take up tasks for which they are mani- 
 festly unfitted may be recognized at a very early 
 period and we suspect that much could be done 
 by recasting educational methods and providing 
 for individual needs to remedy these conditions. 
 This, after all, is the true purpose of mental 
 hygiene. As issues become clearer and people 
 turn to the consideration of these subjects it will 
 fall to this Committee to give constructive sugges- 
 tions for including in the purposes of education 
 the determination of the levels of capacity of dif- 
 ferent individuals at which life may be conducted 
 the most successfully. We may be able to show 
 that any educational system should include the 
 recognition and possible correction in the schools 
 of tendencies which may wreck happiness and 
 usefulness in future years. 
 
 General Plan of the Work 
 
 What has been presented is a very broad outline 
 of the field which the National Committee for 
 Mental Hygiene has entered. It is realized fully 
 
232 Increasing Your Mental Efficiency 
 
 that in such an immense field efforts might easily 
 be so poorly directed as to accomplish few specific 
 results. With this in mind, a plan for systematic, 
 constructive work, by which different phases of 
 the subject are to be dealt with one at a time, has 
 been prepared. Nearly three years were devoted 
 to careful study before this plan was adopted 
 and it was decided that the time had come to com- 
 mence active work and to appeal for support. 
 The plan may be summarized under three prin- 
 cipal heads. The first is original inquiry regard- 
 ing the status of the care of the insane in this 
 country — including not only care of patients in 
 special institutions but care in the communities, 
 in general hospitals, and pending admission to 
 hospitals; regarding the opportunities for effec- 
 tive work in betterment, and prevention and, as 
 resources permit, regarding some of the more 
 important controllable causes of mental disease. 
 The second is popular education, by which the im- 
 portance of the subject can be impressed upon the 
 public, and facts already known and those ascer- 
 tained by special studies regarding conditions for 
 care and treatment, and the preventable causes of 
 mental diseases, can be made widely known. The 
 third is the orgamization of agencies to take part 
 in movements for betterment and prevention, in- 
 cluding existing agencies (Federal, State, and 
 local) and State and local societies for mental 
 hygiene organized for these special purposes. 
 
A National Movement 233 
 
 The following outline of the work proposed 
 under the heading original inquiry is from the 
 plan of work adopted: 
 
 " A study will be made of the operation of the 
 laws relating to insanity and the insane ; the offi- 
 cial methods of dealing with mental cases ; the ex- 
 tent and character of institutional care; the 
 extent and character of care outside of special in- 
 stitutions, the methods of discharge of patients 
 and their return to normal conditions, and such 
 other particulars as it may seem necessary to in- 
 quire into with a view of securing for the National 
 Committee full and accurate information concern- 
 ing the situation in the several States." 
 
 Work in accordance with these plans has been 
 carried on steadily during the past two years. It 
 seemed essential at the outset to obtain a clear 
 idea of the provisions for the care and commit- 
 ment of the insane in the several States which are 
 afforded by present statutes. The kind of care 
 received by the insane depends upon legislation 
 more than does the care of any other classes of 
 the sick. Indeed, good laws regarding the insane 
 are the essential foundation for good care, so we 
 secured the services of Mr. John Koren, who for 
 several years had been in charge of the statistical 
 studies of the insane made by the United States 
 Census Bureau, and who had already collected a 
 great deal of material on this subject. Mr. Koren 
 prepared a summary of these laws, which has 
 
234 Increasing Your Mental Efficiency 
 
 been published by this Committee, and which has 
 proved of great use not only to us but to others 
 interested. 
 
 Besides information regarding special topics, a 
 great deal of general statistical information relat- 
 ing to some of the larger aspects of our problem 
 (such as the prevalence of mental disease, its re- 
 lation to immigration, etc.) has been gathered 
 and made freely available to all who desire it. 
 
 In view of the vital importance of improving 
 facilities for early diagnosis and treatment of 
 mental diseases, special efforts have been made to 
 obtain all the information available regarding 
 psychiatric clinics and psychiatric wards, and pa- 
 vilions in connection with general hospitals. 
 Plans of nearly all such institutions in the United 
 States have been secured and redrawn to a uni- 
 form scale. A publication will be issued describ- 
 ing them and giving detailed information as to 
 their cost and cost of maintenance, the organiza- 
 tion of their medical and administrative services, 
 the purposes intended to be served and the actual 
 results obtained. It has been found possible to 
 have excellent prints in black and white made of 
 these plans. A number have been secured so that 
 persons seeking information on this subject can 
 be supplied. 
 
 Studies of a number of such special problems as 
 the unique mode of care known as the " Wiscon- 
 sin system " have been carried on. 
 
A National Movement 235 
 
 It has been encouraging and especially interest- 
 ing to have many spontaneous appeals made to 
 us for information on various phases of mental 
 hygiene. The following requests for information, 
 which were received during a very short period, 
 may serve as illustrations : 
 
 The medical examiner of a State Bureau of 
 Child Labor asked for detailed suggestions for 
 making mental examinations of children applying 
 for labor permits. 
 
 A vigilance association asked for information 
 regarding the relation between syphilis and in- 
 sanity and, after receiving it, printed a special 
 pamphlet on the subject. 
 
 The Master-in-Lunacy of the State of Victoria, 
 Australia, asked for information regarding the 
 early treatment of mental diseases in psycho- 
 pathic hospitals and psychopathic wards in gen- 
 eral hospitals. 
 
 The Tuberculosis Committee asked for infor- 
 mation regarding the relation between tubercu- 
 losis and mental disease. 
 
 The Director of Physical Training in the public 
 schools of a large city asked for an outline on 
 mental hygiene to include in a course on hygiene 
 for teachers. 
 
 The Secretary of the Young Men's Christian 
 Association in Peking, China, asked for publica- 
 tions on mental hygiene to be placed in a library 
 used by oflQcials and students. 
 
 A clergyman engaged in a " no-license" cam- 
 paign in the West asked for charts showing the 
 
236 Increasing Your Mental Efficiency 
 
 relation between alcohol and insanity for display 
 in store windows. 
 
 The Director of the Bureau of Social Welfare 
 in a western university asked for suggestions for 
 useful fields of effort for an extension division. 
 
 A number of teachers of biology and of sociol- 
 ogy in universities asked for data on various 
 phases of mental hygiene to use in their classes. 
 
 The editor of a magazine in the South asked for 
 information regarding the relation of immigration 
 to insanity. 
 
 An instructor in sociology in a southern college 
 asked for suggestions for a genetic survey of a 
 town of 1,200 inhabitants. 
 
 The Director of a hospital for the insane in 
 Canton, China, asked for data on the causes of 
 insanity to translate into Chinese for wide distri- 
 bution. 
 
 A member of a lodge of young men in the West 
 asked for a frank statement regarding the 
 physiological effects of contiaence, stating that 
 he had been delegated to do so by the others who 
 were sincere in asking for information for their 
 own guidance. 
 
 A Professor in Wellington College, Cape Col- 
 ony, South Africa, asked for information regard- 
 ing mental hygiene and the formation of a mental 
 hygiene exhibit. 
 
 The Attending Physician of a rescue home for 
 girls asked for advice regarding psychological 
 andjpsychiatrical studies of girls in her care. 
 
 A number of persons submitted proposed 
 amendments to insanity laws in different States 
 and asked for opinions as to their form and pur- 
 poses. 
 
A National Movement 237 
 
 The Bureau of Criminology Eesearch in the 
 Department of Sociology of a large university 
 asked for advice regarding certain researches 
 into the relation between mental defect and crime 
 which the Bureau was about to undertake. 
 
 These are typical inquiries. An attempt is 
 made to give a very careful answer in each case. 
 This necessitates, of course, a considerable 
 amount of inquiry and consultation with those 
 most familiar with the different problems. It con- 
 sumes a great deal of time, but it seems very de- 
 sirable to meet such demands adequately, for one 
 of the objects mentioned in the statement of our 
 plans is " to serve as a clearing house for the na- 
 tion on the subject of nervous and mental disor- 
 ders, and in the care and treatment of the in- 
 
 Social Service by Correspondence 
 
 While it is not one of the purposes of the Na- 
 tional Committee for Mental Hygiene to give aid 
 in individual cases, that being a function of local 
 agencies, many such cases have been presented in 
 a way making it impossible to withhold advice or 
 assistance. Several articles relating to the work 
 of this committee appearing at about the same 
 time in the " Outlook," the " Cosmopolitan," and 
 the " American " magazines, gave rise to a flood 
 of letters from nearly all the States, and from 
 
238 Increasing Your Mental Efficiency 
 
 several foreign countries. Some of these letters 
 could be answered by the statement that the ad- 
 vice desired could not be given without a personal 
 examination, or that publications on the special 
 topic mentioned were not, at the time, available, 
 but more than five hundred of these inquiries have 
 received careful personal attention, so urgent 
 seemed the need for advice. Quite a number of 
 persons suffering from mental diseases have, by 
 this means, been placed in touch with physicians 
 in different localities. In order that this may be 
 done most effectively, a card-index has been pre- 
 pared of the physicians in the different States 
 who are members of psychiatrical or neurological 
 societies or who are known to have devoted 
 especial attention to mental diseases. 
 
 Thus it will be seen that this purely philan- 
 thropic organization has become a national insti- 
 tution for increasing mental efficiency. It is a 
 unique organization, and is proving a most helpful 
 one. For it dispenses information about topics 
 of utmost importance to the individual — ^informa- 
 tion that it is practically impossible for most 
 persons to acquire in any other way at the present 
 time. In effect it is a national free clinic con- 
 ducted by competent persons whose object is to 
 better the condition of the individual directly, 
 and thus indirectly raise the general standard of 
 mental efficiency. 
 
A National Movement 239 
 
 One cannot help being impressed by the help- 
 lessness in dealing with mental illness which these 
 appeals disclose. They provide material for a 
 very convincing statement of the need for local 
 societies or committees for mental hygiene to deal 
 with personal problems. 
 
 Aid in Movements for Betterment 
 
 Efforts have been made to assist in every 
 movement to improve conditions among the in- 
 sane or to undertaken in prevention which has 
 come to our attention. We have furnished infor- 
 mation or advice, or have cooperated in other 
 ways, in attempts to secure better laws or to deal 
 with special problems in Alaska, California, Con- 
 necticut, Maine, Massachusetts, Minnesota, Mis- 
 souri, New Jersey, New York, Oklahoma, 
 Pennsylvania, Texas, and Wisconsin. 
 
 One of the stated objects of this Committee is : 
 " To enlist the aid of the Federal Government so 
 far as may seem desirable." The most important 
 step taken by this Committee toward this end 
 was an interview with President Wilson. The 
 importance of the subject of mental hygiene was 
 presented, and each of the points of contact which 
 the Federal Government has with mental hygiene 
 was mentioned. Some of these are the work of 
 the Public Health Service in general preventive 
 
240 Increasing Your Mental Efficiency 
 
 medicine, but particularly in the mental examina- 
 tion of immigrants, and in the dissemination of 
 information regarding the causes and prevention 
 of disease; that of the Census Bureau regarding 
 the insane in institutions; that of the Bureau of 
 Education; the care of the insane in Alaska and 
 in our insular possessions ; the care of insane In- 
 dians; the work of the Government Hospital of 
 the Insane, and the work of the recruiting services 
 of the Army and Navy. In this connection it is 
 not without interest that a very defective commit- 
 ment law and most inadequate quarters for the 
 detention of alleged insane persons pending their 
 commitment are to be found in the District of 
 Columbia. 
 
 This Committee has directed attention to the 
 importance of the exclusion of the insane and 
 mentally defective immigrants. Assistance and 
 advice has been given to several official Commis- 
 sions appointed to study this subject. Eepresent- 
 atives of the Committee have appeared before 
 Committees in Congress and they were present 
 at a hearing given by President Taft in 1913. In 
 all that has been done, especial pains have been 
 taken to make it clear that our interest in immi- 
 gration problems relates only to this particular 
 phase. Better and more humane methods of de- 
 portation have also received attention, and some 
 suggestions made by us have already been put 
 into effect. 
 
A National Movement 241 
 
 State Societies and Committees for Mental Hygiene 
 
 During the past year the growth of the work of 
 State Societies and Committees for Mental 
 Hygiene and the development of interest in such 
 agencies in States where they have not yet been 
 organized has been steady and gratifying. 
 
 State Societies are now in operation in Con- 
 necticut, Illinois, Massachusetts, and North Caro- 
 lina, and their equivalents, in the form of Mental 
 Hygiene Committees which are sub-committees 
 of some other organization, are in operation in 
 New York, Maryland, and Pennsylvania. These 
 seven agencies are affiliated with the National 
 Committee and look to it for advice and assist- 
 ance, thus making it possible for our National 
 agency to help standardize and coordinate th6 
 work. In Rhode Island, Maine, Indiana, Michi- 
 gan, California, and Texas, moves toward organ- 
 izing societies are also being made. 
 
 In this brief report, a description of the work 
 of the several State Societies and Committees 
 cannot be given. Suffice it to say, that such 
 agencies are now at work in States which on Jan- 
 uary 1, 1910, had 80,119 patients in hospitals for 
 the insane — nearly one-half of the total number of 
 patients in such institutions in this country. 
 "When the agencies now in process of organization 
 shall have begun work. State Societies for Mental 
 Hygiene will be working for improved care and 
 
242 Increasing Your Mental Efficiency 
 
 treatment for more than 110,000 of the 187,454 
 insane patients reported in institutions in the 
 United States on January 1, 1910. 
 
 Interest in Other Countries 
 
 In Canada, the Canadian Medical Society has 
 organized a Mental Hygiene Committee which 
 "will be represented at the Convention in Balti- 
 more. In South Africa, also, a Society, known as 
 the " South African Committee on Mental 
 Hygiene," was founded last June. Thus the 
 movement may be said to be already international 
 in scope. 
 
 It is the aim of the National Committee for 
 Mental Hygiene to bring about a new realization 
 of how the insane have failed to share in the ad- 
 vance in the care of the sick and cause, also, a 
 general awakening to the fact that the prevention 
 of mental diseases has thus far failed to become a 
 part of the advance in preventive medicine. 
 When these neglected responsibilities are as- 
 sumed, the returns will be as large as those re- 
 sulting from any other work for human 
 happiness and efficiency which is being under- 
 taken to-day.