The table next presented shows the feeble-minded in institutions in continental United States in 1904, as stated in the census report:

TABLE 4.-Feeble-minded in institutions in continental United States: 1904.

[Compiled from U. S. Census, Special Report, "Insane and feeble-minded in hospitals and institutions, 1904," Table III, p. 209.]

• Having one parent native and the other foreign, or one parent unknown and the other either native or foreign. Less than 0.05 per cent.

In this table the classification adopted is the same as that of the table which preceded it. The figures show the feeble-minded in institutions on December 31, 1903, together with those admitted during 1904. Of the 14,347 persons enumerated on December 31, 856, or 6 per cent, and of the 2,599 persons admitted during the following year, 182, or 7 per cent, were foreign-born whites. It will be noted that, as compared with the number of foreign-born insane persons, the number of foreign-born feeble-minded persons was very small. The proportion of aliens was also much smaller among the feebleminded than among the insane.

Combining the figures for the insane with those for the feebleminded it will be seen that there were, at the close of the year 1903, 47,934 mentally unsound persons of foreign birth in the hospitals and institutions of continental United States, and that 13,587 mentally unsound persons of foreign birth were admitted to the hospitals and institutions during 1904.

Separate information as to the feeble-minded aliens in institutions is not afforded by the report of the Commissioner-General of Immigration.

FOREIGN-BORN INSANE IN INSTITUTIONS, 1908.

More recent information as to the number of foreign-born insane persons in institutions in the United States is supplied by the annual report of the Commissioner-General of Immigration for 1908. In that year agents of the bureau made a census of foreign-born inmates of

charitable and penal institutions and institutions for the insane. At the time the census was taken there were 50,734 foreign-born insane persons detained in institutions for the insane. Of these 25,606 were aliens and 25,128 were naturalized citizens. The total number of native-born insane persons shown by the census was 121,451, the grand total of all classes being 172,185.

The distribution by States of insane aliens, naturalized citizens, and native-born persons, disclosed by the bureau's census, is shown by the following table:

TABLE 5.-Alien, naturalized, and native-born inmates of institutions for the insane in the United States in 1908, by geographic division and State.

[Compiled from Annual Report of the United States Commissioner-General of Immigration, 1908.]

TABLE 5.—Alien, naturalized, and native-born inmates of institutions for the insane in the United States in 1908, by geographic division and State-Continued.

It is obvious that neither the census figures nor those published by the Bureau of Immigration and Naturalization represent anything like a complete enumeration of the insane and feeble-minded persons in the United States. As has been stated, the investigation of the census was limited to hospitals and institutions. There were, at the time of the investigation, as is always the case, many thousand insane persons outside of the institutions studied, and for these no returns were secured. The following is from the census report:"

At the enumeration of 1890 no less than 32,457 insane were included who were not inmates of hospitals. It may be presumed that nearly one-half were found in almshouses and the remainder in private families. That an equally large or perhaps larger number of insane have not been accounted for in this report must be taken for granted. The statistics of paupers in almshouses for 1904 give 11,807 inmates as insane; and unquestionably a diligent search would have shown a larger number of insane persons who have not passed into the care of any institution.

The proportion of feeble-minded persons not confined in the institutions for whom data were secured for the census report was doubtless very much larger than the proportion of insane persons outside of institutions. Great numbers of feeble-minded persons are always to be found in private homes and in almshouses. The census report contains the following statement upon this point:"

But of the feeble-minded, relatively few are cared for in institutions of any kind. Of the 95,609 reported as feeble-minded at the census of 1890, only 5,254 were found in special institutions, and but 2,469 in asylums for the insane. The number of feebleminded in almshouses was not ascertained. Recent estimates made by competent authorities place the number of feeble-minded in the United States that is, of persons so pronouncedly feeble-minded as to stand in need of institutional treatment-at not less than 150,000. Yet, on December 31, 1903, the entire population of special public and private institutions for the feeble-minded numbered only 14,347. There were, in addition, 16,551 supposedly feeble-minded persons among the inmates of almshouses.

U. S. Census, Special Report, "Insane and feeble-minded in hospitals and institutions, 1904," p. 3.

b Ibid., p. 205.

82401°-VOL 2-11-16

It seems probable that the proportion of foreign-born persons is about the same among the insane outside of institutions as among those confined in institutions. In the case of the feeble-minded, upon the other hand, the proportion of persons detained in institutions is so small as to make the representative character of the data secured open to doubt.

The figures obtained from the several sources, though necessarily incomplete, suffice to show that there are in the United States a very considerable number of insane and feeble-minded persons of foreign birth, and that a very considerable proportion of all the insane and feeble-minded confined in the hospitals and institutions of the country are former immigrants.

THE RATIO OF INSANITY AMONG THE NATIVE-BORN AND AMONG THE FOREIGN-BORN.

A further study of the available returns makes possible a comparison in the matter of relative tendencies toward insanity of the native-born with the foreign-born and of the native-born of native father with the native-born of foreign father. Material for such a comparison is supplied by the special report of the Census Bureau. This report will, therefore, be quoted at length."

A per cent distribution by nativity of the white insane of known nativity in hospitals shows very little unless it is compared with a similar distribution of the general white population. A method preferable, however, to such a comparison would have been to show the ratio of insane to general population for each nativity class; but unfortunately general statistics were not collected for 1903, and therefore it is necessary to compare the per cent distribution of the insane enumerated in hospitals on December 31, 1903, and of those admitted during 1904, with a similar distribution of the general population for 1900.

In the following table the proportions of native and foreign born insane in hospitals in continental United States are compared with the proportions of native and foreign born persons in the general population:

TABLE 6.-Proportions of native and foreign born insane in hospitals in continental United States, 1904, and of native and foreign born persons in the general population, 1900.

[Compiled from U. S. Census, Special Report, "Insane and feeble-minded in hospitals and institutions, 1904, p. 20.]

a U. S. Census, Special Report, "Insane and feeble-minded in hospitals and institutions, 1904," pp. 20, 21, and 22.

In discussing this phase of the subject under consideration the census report referred to says:

If the general population of all ages be taken, the bases for the comparison will not be equable, for several reasons. The insane in hospitals are all at least 10 years of age. The immigrants are, for the most part, between 15 and 40 years of age. The number of children under 10 years of age is extremely small among the white immigrants as compared with native whites. Under these conditions a comparison of the proportions of each nativity class in the white insane population of known nativity in hospitals with the corresponding proportions in the general population of all ages would be manifestly unfair, for the inclusion of children under 10 years of age would so increase the proportion of natives in the general population that it would seem as if insanity were more prevalent among the foreign-born as compared with the native whites than is actually the case. Therefore children under 10 years of age are omitted, and the figures given for general population * * refer only to those at least 10 years of age. Even with this modification the figures are on the whole more unfavorable to the foreign-born white than the real facts warrant, as no account could be taken of the large immigration between 1900 and 1903. It is not thought, however, that this omission will seriously affect the conclusions drawn.

*

Of the whites at least 10 years of age in the general population of the United States in 1900, 80.5 per cent were native and 19.5 were foreign born; while of the white insane of known nativity enumerated in hospitals on December 31, 1903, 65.7 per cent were native and 34.3 were foreign born. Relatively, therefore, the insane are more numerous among the foreign-born whites than among the native.

*

* * *

It is not necessary to analyze in the same way the percentages of native and foreign born among the white insane admitted to hospitals during 1904. Although the percentages of native white insane are * * a little higher than on December 31, 1903, * * * it is evident that the foreign born continue to furnish much more than their proportionate share of insane. It should be remembered, however, that the distinction between native and foreign is rapidly losing significance as a means of gauging the real elements of population from which the insane are recruited most largely. With each year the number of native insane of foreign parentage becomes more and more conspicuous in the total number of insane of native birth.

THE NATIVE-BORN OF FOREIGN FATHER COMPARED WITH THE NATIVEBORN OF NATIVE FATHER.

When 34.3 per cent of the white insane of known nativity enumerated in hospitals on December 31, 1903, are foreign born-a proportion much greater than that which the foreign born constituted of the general white population of 1900-it might naturally be expected that a similar condition would be found among the native whites of foreign parentage. Such is not the case, however, * *.

*

In the following table the distribution by parentage of the nativeborn white insane in hospitals in continental United States is compared with the distribution by parentage of native-born white persons in the general population:

TABLE 7.-Parentage of native-born white insane in hospitals in continental United States December 31, 1903, and of native-born white persons in the general population, 1900.

[Compiled from U. S. Census, Special Report, "Insane and feeble-minded in hospitals and institutions, 1904," p. 22.]