10

21. Statement no. VII—The causes and outcome of mental
disorders.—As in the other departments of medicine, so in
psychological medicine we find two classes of causes operative—
predisposing and exciting. The predisposing causes are made
up of those conditions existing within the individual and which
render him liable to the development of mental disorder under
favourable circumstances. The exciting causes are those circum-
stances and conditions which produce the actual attack of mental
disturbance operating usually upon predisposing soil.

Statement no. VII shows the Ætiological factors and
associated conditions in the patients admitted during the year
1932, and is self-explanatory. In majority of the cases no cause
could be ascertained due to practically no information being
supplied by the police in the descriptive rolls of patients. In
the Western countries, where statistics are reliable an inherited
predisposition to mental disorders is found at an average in 60
to 70 per cent of cases admitted into mental hospitals. But any
one who is at all familiar with the collection of statistics in India
must know how impossible it is for them to fully represent the
facts in such a matter. If one were to take up an annual
report of any institution for the insane and turn to the table
giving the causes of insanity in the several patients under treat-
ment one will find assigned such causes as the following:—

Business and domestic worries, loss of property, disappoint-
ment in love, domestic troubles, excessive study, loss of near
relatives, political excitement, sexual frigidity or starvation,
tyranny by mother-in-laws, cruelty and neglect by husbands,
excessive religious tendency, etc.

How many of us must have suffered at sometime or other
from some or perhaps all of these so-called above stated exciting
causes of insanity and yet despite this fact we find that sanity is
the rule—insanity the exception.

It therefore proves beyond doubt that whatever the exciting
cause of insanity may be, undoubtedly the chief predisposing
cause is unstable mental heredity. The term " hereditory predis-
position " here has a wider application than to those born of
insane parents only.

It includes such defects as extreme nervousness, eccentricity,
alcoholism, epilepsy, vagrancy, child-marriage, faulty up-
bringings, lack of moral training and any want of balance
in mental development. In addition to this, the offspring of
syphilytic, gouty, rheumatic and phthisical parents are infinitely
more liable to suffer from mental disorders than those sprung
from healthy stocks.