The following discussion in the form of questions and answers may prove of interest to the physician and to the intelligent layman. The discussion occurred in the course of correspondence. A friend of mine thought the subject of sufficient importance to have it brought to the attention of the cultured public.

The questions are as follows:

“Are not all neuropathic conditions the results of a morbid, unstable nervous organism, the basis of which lies in a faulty heredity?

“Are not weak nerves the cause of hysterical, neurasthenic and neuropathic affections in general?

“Is not all neurosis due to defective parent stock?

“If the occasions for fear, as some psychopathologists claim, were more frequent in primitive times than now, then the cave men must have had more psychopathic affections than civilized man.”

To these questions the following answers are given:

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Psychopathic diseases are not hereditary—they are acquired characteristics, having their origin in the abnormal, hypertrophied growth of the fear instinct which is at the root of the primal impulse of self-preservation. This is proved by psychopathological studies of clinical cases; and it can be further demonstrated by experimental work in the laboratory even in the case of animals. “Weak nerves,” “a run down, exhausted nervous system,” whatever the terms may mean, may overlap psychopathic conditions, but the two are by no means equivalent, much less identical. Psychopathic, psychoneurotic states are not “weak nerves” or “fatigued nerves.” Above all, there is no need to obscure the matter and resort to the much abused, mystical and mystifying factor of heredity. It is easy to shift all blame on former generations, when, in most cases, the fault is close at hand, namely, a debased environment, a defective training, and a vicious education.

There is good reason to believe that primitive man had a far greater tendency to dissociation, to subconscious psychopathic states than modern man. Even the Middle Ages teem with psychopathic mental epidemics of the most puerile type. In the course of evolution, social and individual, this neurotic, psychopathic tendency has gradually diminished, but has never been completely eliminated. Increase of knowledge, better education, the increase[273] of social safeguards, sanitary and hygienic conditions with consequent increase of safety from dangers, have all helped materially in decreasing the occasions for the cultivation of the fear instinct.

Under the rigorous conditions of primitive life individuals who have been unfortunate and have become affected with mental troubles and emotional afflictions of the fear instinct are mercilessly exterminated by the process of tribal and social selection. Each generation weed............