RT Journal T1 THe spread of insanity. JF Journal of the American Medical Association JO Journal of the American Medical Association YR 1899 FD May 27 VO XXXII IS 21 SP 1187 OP 1187 DO 10.1001/jama.1899.02450480051020 UL http://dx.doi.org/10.1001/jama.1899.02450480051020 AB At the recent meeting of the Nebraska State Medical Society, a lengthy debate occurred on the spread of insanity and how to prevent it. The conclusions were that the great increase in modern times was due to "hereditary causes, the discharge from asylums of half-cured patients left free to propagate their kind; the fostering care of Christian institutions; the effect on immature minds of dwelling on the doubts raised by dogmatic Christianity, and the cramming of young minds by modern educational methods." These are propositions that fall in with popular notions, but whether they are all equally correct is another question. Heredity is more effective now than formerly, only in a secondary way; if there are more insane now than there were, there are more to transmit their defect. Its importance, therefore, depends on the existence of other factors causing the increase. Undoubtedly there are many imperfectly-cured patients discharged, but