In France[B] there were 131.1 insane per 100,000 inhabitants in 1883, 133 in 1884, 136 in 1888. These figures indicate that the number of insane is larger in the most civilized countries, and is increasing every year. It may indeed be said that many of these insane are not produced but are only revealed by civilization, and that the opening of the large asylums has caused a considerable number to be brought into the light who were not known of before. It is true that the greater care we give now to the insane, as well as to consumptives, makes them longer-lived. And it is true that as the mind grows enlightened criminals come to be regarded as insane and thus increase the apparent number of such. But all this is not sufficient to explain a doubling in a decade, a tenfold increase in twenty years.
We know, too, that civilization has brought on the development of new forms of disease, which hardly existed before. For example, general progressive paralysis was formerly so rare that no special name was given to it till our time, while now it forms the larger quota of the maladies of the wealthy, of thinkers, and of military men. Epilepsy has greatly increased in its psychical form, so that what are called psychical and obscure epilepsy are a revelation of our times, and that its close association with crime (which I believe to be one of the sure facts of modern psychiatry) is still accepted by only a very few alienists, not to say that it is rejected with indignation, and, I will remark, with profound ignorance, by most modern jurists.
Alcoholism, too, has taken on enormous proportions. Not that the ancients did not drink, but rather that pure alcohol had not yet been introduced; while in the middle ages it passed for one of the most efficacious remedies--_aqua vita_, living water. Dr. Beard has made a most judicious observation in America which I have been able to verify in Sicily--that there must be a very advanced degree of civilization, or rather of degeneracy produced by civilization, for inebriety to be transformed into that aggregation of disasters, especially of the nervous system, which is called alcoholism. Now we have not alcoholism only, but morphinism, cocainism, all stimuli of the nervous system, which are used by barbarians as potent excitants, but not to the point of producing stable alterations except in rare cases, like the _amuck_ of the Malays.