But when all is said, the fact remains that there are several hundred thousand insane persons in the United States, many of whom are not prevented from reproducing their kind, and that by this failure to restrain them society is putting a heavy burden of expense, unhappiness and a fearful dysgenic drag on coming generations.
The word "insanity," as is frequently objected, means little or nothing from a biological point of view--it is a sort of catch-all to describe many different kinds of nervous disturbance. No one can properly be made the subject of restrictive measures for eugenic reasons, merely because he is said to be "insane." It would be wholly immoral so to treat, for example, a man or woman who was suffering from the form of insanity which sometimes follows typhoid fever. But there are certain forms of mental disease, generally lumped under the term "insanity," which indicate a hereditarily disordered nervous organization, and individuals suffering from one of these diseases should certainly not be given any chance to perpetuate their insanity to posterity. Two types of insanity are now recognized as especially transmissible:--dementia precox, a sort of precocious old age, in which the patient (generally young) sinks into a lethargy from which he rarely recovers; and manic-depressive insanity, an over-excitable condition, in which there are occasional very erratic motor discharges, alternating with periods of depression. Constitutional psychopathic inferiority, which means a lack of emotional adaptability, usually shows in the family history. The common type of insanity which is characterized by mild hallucinations is of less concern from a eugenic point of view.
In general, the insane are more adequately restricted than any other dysgenic class in the community; not because the community recognizes the disadvantage of letting them reproduce their kind, but because there is a general fear of them, which leads to their strict segregation; and because an insane person is not considered legally competent to enter into a marriage contract. In general, the present isolation of the sexes at institutions for the insane is satisfactory; the principal problem which insanity presents lies in the fact that an individual is frequently committed to a hospital or asylum, kept there a few years until apparently cured, and then discharged; whereupon he returns to his family to beget offspring that are fairly likely to become insane at some period in their lives. Every case of insanity should be accompanied by an investigation of the patient's ancestry, and if there is unmistakable evidence of serious neuropathic taint, such steps as are necessary should be taken to prevent that individual from becoming a parent at any time.