THEODORE DAVIS ADLERMAN, A.B., M.D., BROOKLYN, N. Y.
The study of nervous and mental diseases as it applies to the evolution, progress or decadence of any nationality, or race, or people, presents so many distinct and peculiar phases and manifestations that it is almost impossible to do justice to the subject in the rather short time and space allotted to me in this paper.
It is a well-known fact that many nationalities are more liable to certain diseases and more prone to suffer from the results of these diseases than others. This rule seems to be particularly strong when taken in connection with neurology and psychology. This is nowhere so strikingly appalling as in the Jewish race. The predominance of nervous diseases among them has led me to take up the study of this particular subject, and the present paper is a result of the same. I am ready now to make the positive assertion that no race suffers so much from nervous and mental diseases as do the Jews. Statements and claims have been made by some of the most prominent neurologists, that nearly all, if not all, of the Hebrews are either neurasthenics or that they are hysterical.
While prolonged investigation into this statement has led me to take it cum grano salis, still I can not help but admit that these two diseases appear in such vast numbers that I am not surprised that men like Tobler produced proof and statistics which seem to show that nearly all Jewish women in Palestine are suffering from more or less hysteria. Neither am I surprised when Raymond goes even a little further and shows us that in Warsaw, Poland, there is not a Jew to be found who is not either a neurasthenic or hysterical. It seems to me, however, that both of these investigators are mixing up the purely emotional sides of the nature of the Jew with hysteria and that many of their cases were temporarily emotional from certain peculiar environments.
The great Kraft-Ebbing called our attention to the exceptional severity with which the Jewish population of Germany and Austria has been attacked by all kinds of nervous diseases. This claim can not be doubted and has since been fully substantiated by Oppenheim, Ferrie, Charcot, and others. In my own practice, the percentage presented by patients of the Jewish race and extraction is very large. The proportion of insane among the Jews is also very appalling, and statistics clearly prove that they are far more liable to insanity than any other nation, and the different statistics in this respect are rather remarkable.
In Italy, according to Lombroso, we have one insane Jew in every 391; thus it appears that the Jews are affected four times as much as the Catholic population. To quote another authority, we find that in 1870 there was one insane among every 1,775 Catholics in Italy, while among the Jews in Italy, at the same time, we find one insane in every 384. The same alarming and rather peculiar condition was found in other countries of Europe. For example, in Prussia in 1880, in every 10,000 population we find Catholic insane, 12.37; Protestants, 24.2; Jews, 38.9. In Hanover, Catholic insane per 10,000, 30.8; Protestants, 29.2; Jews, 62.9. In Silesia, per 10,000 population, Catholic insane, 19.3; Protestants, 22.1; Jews, 32.1. In Bavaria, in 1885, per 10,000 population, insane 16.4; Jews, 27.19. A very much similar condition was found in Russia, and here I am quoting from the proceedings of the "Twelfth International Medical Congress," which gives Russian insane, 0.91 per cent.; Poles, 0.92 per cent.; Jews, 2.19. In the Vienna Psychiatric Clinic, out of 1,219 insane patients treated there, 10.99 per cent. were Hebrews, out of which 64.9 per cent. were men and 35.1 per cent. were women.
In New York City, according to Hyde, who collected the statistics of the admissions of Jewish insane to different asylums from December, 1871 to 1900, out of 17,135 male insane, 1,722 (or 10.05 per cent.) were Hebrews, while from 1895 to the year 1900, out of 3,710 insane patients who were admitted to the different insane asylums of the city, 573 (or 15.44 per cent.) were Jews.
In England, for example, from statistics furnished by Beadle, it can be readily seen that the Jewish men suffer very much from dementia paralytica (21 per cent. of all male insane suffered from this particular insanity), and, taking in consideration the difference in numbers of the Jews as compared with the non-Jewish English, Beadle comes to the startling conclusion that dementia paralytica is 60 per cent. more frequent in Jews than among Gentiles.
Somewhat similar deductions are drawn from statistics which are furnished by Hirschi, who shows clearly that among his 200 cases of paralytic dementia, 40 were Jews, or 20 per cent. of his cases.
In the city of Vienna, statistics show that 18.75 of all paretics are Jews. From statistics furnished by Minor, of Moscow, Russia, we see that general paralysis of the insane was about six times more frequent among the Gentiles than among the Jews. While this is quite possible, it can not be taken as a rule, inasmuch as most of the nervous cases furnished a previous history of syphilis, a disease which is very rare among the Jewish population of Russia, which explains in a way the low percentage of Jewish paretics there.
In contradiction to Minor, we find Korsakoff furnishing us with a record of eighty-nine Jewish patients, sixty-nine of which had paralytic dementia. The acute psychoses are also very predominant among the Jews. Insanity following childbirth, puerperal mania, is more common among Jewish women than among women of other races. Melancholia is also a very strong factor and seems to predominate in many cases.
In conjunction with this, I must say a few words here in regard to paralysis agitans. This disease is certainly very frequent among the Jews. Kraft-Ebbing reports thirty-two cases out of one hundred to be Jews. If you will take in consideration that the Jewish population of Austria Hungary is only about 4 per cent. of the total population of that country, the thirty-two cases of Kraft-Ebbing becomes appalling as it becomes eight times greater than the proper proportion. The same fact in regard to paralysis agitans has been demonstrated in Russia among the Jews of that country, where it was found that paralysis agitans was three times more frequent among the Jews than among the Christians. With the above facts in front of us, two questions naturally come to our mind: First, what are the causes to which we can ascribe these particular ravages among the Jewish race?
This we can answer that we must remember that the Jews are dwellers of cities, that they partake abundantly of meats, and exercise their reproducing functions rather freely; second, that their occupations are mostly of such a nature as to require exhaustive brain work and brain strain; third, the peculiar conditions and environments to which they have been subjected for centuries, the persecution and abuses, which have produced a marked neurotic influence and taint, which in the natural course of things has been followed by functional derangements of the entire nervous system, and which, in course of time, became hereditary and have been transmitted from one generation to another, producing ultimately nervous degeneration, which accounts for the cases of tabes, paralytic dementia, paralysis agitans, etc.
I do not agree with Bushan and some other writers who claim that insanity is a racial characteristic of the Jewish race. It is true that some evidence of this is found in the Bible, that the ancient Hebrews suffered from mental troubles; but this can not be considered as scientific evidence. The fact must not be overlooked that a neuropathic tendency of one generation may manifest itself as hysteria, while in another generation it will come up in the form of some organic or functional nervous disorder, and then in the form of some insanity.
The second question which arises now is this: Will the Jewish race be consumed by insanity if this ravage makes the same strides as it has made till now? This question I can not answer just at present. It will require further study and more investigation before we can come to a positive conclusion. The figures quoted above, however, are appalling and staggering and should awake us to the means of combatting this scourge, as they also apply to a great many other nationalities.
The danger from insanity is more horrible, more apparent, more close to us than any of the other diseases which we, as doctors, are fighting daily.
910 St. Johns Place, Brooklyn, N. Y.
DR. A. J. ATKINS: I have had in my personal experience a great many Jewish patients, and I have noticed this one particular condition—the mental or nervous condition that exists among them. They are usually very nervous and anticipate everything. In my opinion, I think that is largely due to the fact that the Jewish race have intermarried so closely for thousands of years; but, as the doctor points out in his paper, we are not discussing the Jewish race—we are stating cold-blooded facts. One of the important factors in my mind that leads up to this extreme nervousness and perhaps insanity, is the close intermarriage of that race. The Jewish race has very largely isolated itself from contact with the laws of nature. They have been persecuted and have had to develop their commercial instincts to a high degree, and under these conditions they have become financiers and have not observed nature's laws and they are reaping their reward in insanity to-day.
DR. W. E. DANIELS: I would like to ask if the doctor finds that the moral condition has very much to do with the mental condition. Does the immorality in the Jewish nation have a tendency to produce insanity any more than any other people?
DR. F. M. ANDRUS: I wonder if some of the peculiar rites of the Jews might have something to do with it. Perhaps orificial surgery might benefit them.
DR. ADLERMAN (closing): I am not prepared to talk much about intermarriage. Perhaps it may have something to do with it. Those who know the history of Africa and know the history of the negro race know that intermarriage exists there to-day, and yet they have no insanity among them. The history of Australia shows intermarriage among the bushmen there and they have no insanity. Whether this will answer Dr. Atkins I do not know. Intermarriage may have something to do with producing a certain nervous taint, but whether that will produce insanity is a question in my mind. I am willing to admit that if a nervous father marries a nervous mother the issue probably will be nervous. But when you take an ordinary individual, whether Jew or Gentile, you can not say that intermarriage will produce insanity directly. It may produce a nervous taint, a certain neurosis, but I doubt whether it will produce insanity.
Dr. Daniels' question in regard to morality is a big question, too big to answer. In the first place, what is morality? I do not know what Dr. Daniels means by morality. I do not know what morality is. What may be morality in one section is immoral in another. I would consider it immoral if my wife would dress in a certain way, but we go into the Metropolitan Opera House and we do not consider it immoral to see women dress as they do there.
The Jews are no more immoral than any other race. They do exercise their productive functions very freely, but even then a man may exercise these functions freely, and if he will not abuse alcohol or a meat diet it is a question whether that will produce insanity. The term morality, as we understand it to-day, I do not think has much to do with insanity.
The question of Dr. Andrus, in regard to orificial surgery: Some years ago the statement was made by Dr. Dawson that he could cure any case of insanity by orificial surgery. I said if he could do that he was wasting his time in Kansas City; New York needs him. The reflex irritation may have an effect in developing insanity, but do not think you can cure it by orificial surgery. You can remove the reflexes, you can perform certain orificial surgery, but still we have our 2,700 women in our asylum and as many men in the same institution after a great many men have tried their hand on these cases. If you find a reflex condition that requires surgical treatment, of course remove it, but orificial surgery will not cure a case of insanity. If you think this you will be disappointed.
DR. E. B. STEVENSON: Has not the Jewish race a very low percentage of criminals?
DR. ADLERMAN: No, I think it is about the same as among other races, especially since the great immigration from Europe. When the number was limited the percentage was very small, but to-day we have statistics that will show that the average is about the same as other nations.
National Eclectic Medical Association Quarterly, Vol. 7, 1915-16, was edited by William Nelson Mundy, M.D.