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"Epilepsy is one of the equivalents in polymorphic heredity. By this we imply that when the nervous mechanism governing the normal evolution of both body and mind is disarranged, the result is a condition of nervous instability which manifests itself in the descendants in some one of many forms. The result may be epilepsy, chorea, neurasthenia, hysteria, somnambulism, migraine, feeble-mindedness, idiocy, insanity, inebriety, criminal tendencies, or simple eccentricity. . . . These are all interchangeable manifestations of an unstable nervous system. . . . We may assume heredity as a cause of epilepsy in at least 33 per cent of the cases." (169)

Dr. Peterson mentions, among other causes, inebriety not only in the epileptic but in his parents; injuries to the head, infectious diseases, and emotional shocks to the mother or the child.

Epilepsy is now regarded as much more hopeful of cure than formerly, 50 per cent of those in institutions being improvable, and from 5 to 10 per cent even of the confirmed cases curable. (170) At the Massachusetts Hospital nearly half are physically and mentally capable of regular employment, and about 20 per cent more able to do some regular work at times.

In 1906 ten States had made provision for epileptics separate from insane, pauper, or feeble-minded persons in colonies, villages, or hospitals. There seems to be an agreement among all experts that colony or village grouping on large estates is the ideal method of providing for this class. Ohio established the first colony in 1893 and has now six large cottages for women and seven for men, accommodating about 900 patients with a building considerably removed, which accommodates 200 more of the helpless and insane class; a hospital and other buildings providing for about 1400 patients altogether. The Craig Colony, at Sonyea, western New York, has an estate of nearly 2000 acres and about 1000 patients, most carefully classified, in small cottages for the comparatively normal, and in larger buildings for the infirmary class. In scientific methods it has served as a model for the newer institutions. (171) The per capita cost at this institution has been reduced to $141.38. The patients who are able to work contribute on the average about $35 per year to their own support.

The organization of the National Association for the study of epilepsy and the care and treatment of epileptics in 1900 has had a marked influence in stimulating interest in the subject of institutional care. (172) The dissemination of information regarding the best foreign colonies especially Bielefeld, and the more advanced colonies in the United States, is gradually educating the general public to demand for the young epileptic opportunity for training and care, and for the incurable class occupation, so long as they remain capable, and custodial care when all capacity is lost by mental deterioration. The emphasis which scientists are placing upon the hereditary character of epilepsy is creating also a widespread belief that they should not marry and that society must protect itself from the reproduction of these as of others who are unfit.

To some it may seem improper to treat of the care of the inebriate in the same chapter with the feeble-minded and epileptic, but there is now substantial agreement among medical experts that habitual drunkenness is a disease, requiring custodial care, and that occasional drunkenness is frequently a symptom of neurotic heredity demanding prompt medical attention. (173) Intemperance as a cause of poverty has already been discussed in Chapter III.; the predisposing causes of drunkenness in neurotic heredity, lack of education in self-control, lack of wholesome recreation, and the presence of constant allurements of the saloon have also been briefly touched upon. (174) It is with the treatment of the drunkard that we are now particularly concerned. In the early part of the nineteenth century slight attention was paid to public drunkenness; in the last fifty years it has become a crime if accompanied by disorderly conduct. The better-class inebriate generally manages to escape the law, protected by his friends and for the sake of his family. The inebriate of the poorer class whose friends are unable to protect him is found drunk in the street, arrested, fined, and imprisoned; not being able to pay the fine, he is committed again and again to jail. (175) The system of short-term commitments for drunkenness in the county jails or in the houses of correction has no curative effect whatever. The person who has been convicted ten times for drunkenness and is convicted again is sentenced by the judge with the perfect knowledge that no good will result, except that the person will be kept from bothering the community during the time of the sentence, and that he will come out of jail as likely to offend against the law as before he was committed. In some cases as many as one hundred and twenty commitments have been registered against a single person. By alternating jails and almshouses in order to secure a change of diet and associates, the habitual vagabond drunkard is enabled to recuperate his shattered forces at the expense of the community, and prolong his life and evil influences indefinitely.

(174) Chap. III.

(175) In all American cities where prohibition is not in force the arrests for intoxication constitute from 40 to 50 per cent of all arrests.