ere are many cases where judicious treatment for months is
required, and there are a few where the mental alienation is permanent,
and the wife and mother is never restored to her sanity.

The question has been much discussed, Whether such a condition is to be
imputed to a hereditary tendency to insanity in the family, and also
whether a mother who has had such an attack is liable to transmit to
her children, male or female, any greater liability to mental disease.
We are well aware what deep importance the answers to these inquiries
have to many a parent; and in forming our replies, we are guided not
only by our own experience, but by the recorded opinion of those members
of our profession who have given the subject close and earnest
attention. To the first query, the reply must be made that in one-half,
or nearly one-half, of the cases of this variety of insanity there is
traceable a hereditary tendency to aberration of mind. Usually one or
more of the direct progenitors, or of the near relatives of the patient,
will be found to have manifested unmistakable marks of unsoundness of
mind. In the remaining one-half cases no such tendency can be traced,
and in these it must be presumed that the mania is a purely local and
temporary disorder of the brain. The incurable cases are usually found
in the first class of patients, as we might naturally expect.

The likelihood of the children, in turn, inheriting any such
predisposition, depends on the answer to the inquiry we first put. If
the mania itself is the appearance of a family malady, then the chances
are that it will pass downward with other transmissible qualities. But
if the mania arise from causes which are transitory, then there is no
ground for alarm.

An inquiry still more frequently put to the physician by the husband and
by the patient herself after recovery, is, Whether an attack at one
confinement predisposes her to a similar attack at a subsequent similar
period. There is considerable divergence of opinion on this point. Dr.
Gooch, an English physician of wide experience, is very strenuous in
denying any such increased likelihood, while an American obstetrician of
note is quite as positive in taking the opposite view. The truth of the
matter undoubtedly is, that where the mania is the exhibition of
hereditary tendency, it is apt to recur; but where it arises from
transient causes, then it will only occur again if such causes exist.

THE IMPORTANCE OF PRE