UNSOUNDNESS OF MIND.• Sin THOMAS CLousToN—the title lately bestowed on
him gave pleasure to all members of his profession—has written a most excellent book, full of wisdom and of sympathy. He is of the highest authority on all questions relating to insanity : his former books are well known and widely read : he has been, these many years, a physician of great experience and skill in the study and treatment of mental cases : and his present book would be hard to beat.
A man of less authority, writing a medical book on this
subject, would not have ventured to adapt his work to the "general public " ; or, if he had ventured, would not have done it so well. That is why the Preface to this book deserves to be printed in letters of gold. " I have always held," it says, "that medical specialists owe a duty to the public, as well as to science and their profession. A part of that duty consists in enlightening the public on their Special problems, so far as this is rightly possible." And again : " I cannot but think that itmuat make for the ultimate
-sanity of mankind, to discuss the problem in such a way that it can in some measure be understood by the ' intelligent lay. man'" Sir Thomas Clouston has done this difficult duty in the best possible manner. He is on the side of those doctors who preach what they practise : he is not of Mr. Kipling's opinion, that the attempt to explain things medical to the .public is like trying to teach peacocks to sing. Of course, there is a wrong way of writing medical books for every- body to read: but, Heaven be praised, there is a right 'way. It is dreadful, when third-rate doctors write popular manuals on fashionable maladies ; it is pleasant when a really first-rate doctor writes, with grave and hard-won judgment, of some national disease which scourges the land with bitter sorrow.
We have a further reason for gratitude, that he gives us no metaphysical theories, and fights shy of the psychologists. He is content to say, with Herbert Spencer, that the absolute connexion between consciousness and the brain is " unthink- able" : and there is a refreshing sense of repose in the mere sound of Herbert Spencer's name. Indeed, the book is fault- less, except for a slight jerkiness of style, a fondness for short sentences and full stops. And even this defect has its merits : for, when he comes to describe this or that type of mind, he writes like Aristotle or Theophrastus : and what could be better than thatP The chapter which is called, by a strange title, "Eleven Orders of Brain" is a good instance of his compressed style, his indifference to fine writing : here is what he says of genius—" The fourth class is the least numerous of all. It is that of the genius, the god amongst men. His work and his thought have been the redemption or the curse of the race, as the case may be. He occurs rarely and his advent is always unexpected. Among his relations and his kindred there are apt to be a disproportionate number of cranks, im- beciles, and mentally unsound persons. It commonly takes several generations for the world to understand and appreciate him. He used often to be put to death. He is a 'sport' or a 'variation' according to the evolutionist. He is sometimes entirely sane, like Shakespeare and Darwin, exhibiting that quality in its ideal, but often enough he has a dash of brain instability. Only a few of his class occur in each generation."
Of course, to a doctor, the supreme interest of " mental eases" lies in the question: What forms of insanity can be stated, with our present knowledge, in terms of chemistry and of bacteriology P How far, at present, can we push our facts and our theories of toxins and antitoxins into the kingdom of the brain P We must admit, of course, the • 170soundness of Mind. By Sir Thomas Clouston, M.D., LL.D., F.R.S.E. With 14 Illustrations. London : Methuen and Co. [7s. Od.1
reality of " predisposing causes," the reality of " mental causes," and so forth. None the less, all the more, we long to bring all mental diseases into the material world. We desire to see with our own eyes, under the microscope, the degenerate nerve-cells, poor shrunken pigmented creatures that cannot do their work : we desire to isolate, and to express in the language of organic chemistry, the exact poisons which are insanity we are sure that they are there. A man after influenza, a woman after childbirth, become subject to melan- choly, or to delusions: it is physical, it is chemical, just as getting drunk, or going under ether, is physical and chemical. Above all, we are becoming, or become, sure that the disease called " general paralysis of the insane " is an infective disease. Its predisposing causes are of great interest and importance : but what of that, compared with the overwhelming interest and im- portance of its exciting cause ? If it be true, that the exciting cause of this disease be indeed a germ : if we can say, of general paralysis of the insane, what Koch said, in 1882, of tubercle, " Henceforth, in our warfare against this fearful scourge of our race, we have to reckon, not with a nameless something, but with a definite living invader of the body "— if this be so, then what on earth is so interesting as bac- teriology ? The study of Robertson's "bacillus paralyticans" is at the present time, as Sir Thomas Clouston says, in the stage of almost feverish scientific expectation of a great discovery : and Robertson's work at a serum treatment, or a vaccine treatment, of these unhappy cases keeps us at the fever-height. It is part of the immeasurable wonder of pathology : it is equal, in honour and importance, to Flexner's magnificent work on epidemic meningitis.
Nobody can read this Unsoundness of Mind without emotion : the hopes and the discoveries, the observations and the deductions, are of the most profound interest to all thoughtful men and women. Here are the lacrimae rerum, on every page of the book : and there are pages which the reviewer would like to transcribe, word for word. There is, for example, the " nervous family history of a parish " : there is the chapter on " borderland cases " : there is the chapter on heredity and the chapter on alcoholism. On this last point, it is pleasant to find the author vehemently opposed to Prof. Karl Pennon's recent statements.
"Professor Pearson's conclusions seemed to show that a drunken ancestry did not affect progeny unfavourably, but that the children were rather more healthy and more intelligent than the average children of the industrial classes, though the death-rate among them was somewhat higher. . . . It seems to me that the weight of evidence is greatly in favour of the transmission of evil results from drunken parents to their children, so that degenerations, bodily and mental, lowered intelligence, impaired moral qualities, liability to diseases of various kinds, and unsoundness of mind are liable to result in children from the effects of alcoholic poisoning of the parents, apart altogether from the necessarily degrading and unfavourable influences of the alcoholic home upon children."
But the whole book deserves to be read far and wide :. neither does such good wine require the bush of a review. Experience, wisdom, pity, hope, make it one of the best medical books of this present time, and far too good to be the special property of the medical profession.
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