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TABLE 13.--Foreign-born white feeble-minded in institutions in continental United States, 1904, by country of birth.

[Compiled from U. S. Census, Special Report, "Insane and feeble-minded in hospitals and institutions, 1904," tables on pp. 211 and 222.]

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From this table it appears that of the 1,038 feeble-minded persons for whom data are presented, 274, or 26.4 per cent, were of German nativity; 149, or 14.4 per cent, of Canadian nativity; 127, or 12.2 per cent, of Russian or Polish nativity; 121, or 11.7 per cent, of Scandinavian nativity; 101, or 9.7 per cent, of English or Welsh nativity; and only 73, or 7 per cent, of Irish nativity. The proportion of feeble-minded persons of Italian, Hungarian or Bohemian, Scotch, and French nativity was relatively small. It is worthy of note that the Irish, who led all the other nativities in the proportion of alien insane in hospitals, contributed only a comparatively small proportion of the alien feeble-minded in institutions. As has been seen, the Germans, the Canadians, the Russians and Poles, the Scandinavians, and the English and Welsh all ranked ahead of the Irish in the proportion of feeble-minded in institutions.

The number of cases considered in the foregoing table is too small to permit of conclusions concerning the relative tendency of the various nationalities toward feeble-mindedness. In any event the number of feeble-minded persons found in institutions is not at all representative of the number in the country, because comparatively few who might fairly be classed as feeble-minded are so detained. Furthermore, it is impossible to say whether the practice of retaining feeble-minded and otherwise defective individuals in the home is more common with one nationality than with another.

THE TENDENCY TO INSANITY AMONG THE IMMIGRANTS, BY NATIONALITY OR RACE.

The relative liability to insanity of foreign-born persons of the different races or nativities can not be determined from the data of the foregoing tables alone. The tables show merely the number of alien insane of each immigrant race or nativity in its relation to the total number of alien insane. It is possible, however, by presenting data for the alien insane in connection with data for the general population, to compare the percentage of persons of a given nativity among

all the alien insane with the percentage of persons of the same nativity in the total alien population. Such a comparison will indicate the relative standing, in the matter of insanity, of the different immigrant nationalities.

In the discussion of insanity among the several alien nationalities, as in the discussion of insanity among the native-born and the foreign-born, the figures showing population and the figures showing insane persons are from different sources and for different years. The data showing the proportion of persons of each specified nativity in the general alien population are from the census of 1900, while the data showing the proportion of persons of each nativity among all the alien insane are supplied by the United States census special report upon the insane in hospitals in 1904. As the foreign-born of the different nativities reported by the population census presumably average about the same as to age, it is not necessary, in this connection, to deduct persons under 10 years of age from the returns for any group, as was done in comparing the native-born with the foreign-born.

In the following table the per cent distribution, by country of birth, of the foreign-born white insane enumerated in hospitals in continental United States on December 31, 1903, is compared with the per cent distribution, by country of birth, of the total foreign-born population in 1900:

TABLE 14.-Foreign-born white insane enumerated in hospitals in continental United States December 31, 1903, and total foreign-born population of continental United States in 1900, by country of birth; per cent distribution.

[Compiled from U. S. Census, Special Report, "Insane and feeble-minded in hospitals and institutions, 1904," tables on pp. 23 and 24.]

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The Irish, German, Scandinavian, and French nationalities show each a larger proportion of all the foreign-born insane in hospitals on December 31, 1903, than of the total foreign-born population in 1900. On the other hand, the English and Welsh, Canadian, Scotch, Italian, Hungarian and Bohemian, and Russian and Polish nationalities, and nationalities not specified, show each a smaller proportion of all the foreign-born insane than of the total foreign-born population. Per

sons of Irish nativity constituted 15.6 per cent of the total foreign-born population in 1900, while 29 per cent of the foreign-born insane in hospitals in 1903 were of Irish birth. Among the insane the proportion of Irish-born persons was thus almost twice as large, relatively speaking, as the proportion of Irish-born persons in the population, the difference in the percentages being larger than in the case of any other nationality. In 1900, 25.8 per cent of the foreign-born population of the country were of German birth, and in 1903 persons of German birth supplied 26.9 per cent of the foreign-born insane in hospitals. Persons of Scandinavian nativity constituted 10.3 per cent of the total foreign-born population in 1900, and on December 31, 1903, 11.5 per cent of the foreign-born insane in hospitals were of Scandinavian birth. Persons of French nativity constituted 1 per cent of the foreign-born population in 1900 and 1.2 per cent of the foreignborn insane in hospitals in 1903.

The English and Welsh show a relatively smaller proportion of insane persons than do the Irish, Germans, Scandinavians, or French. While only 7 per cent of the insane in hospitals in 1903 were of English or Welsh nativity, persons of this group constituted 9 per cent of the total foreign-born population in 1900. The percentages of the table indicate a smaller relative proportion of insane among persons of Canadian birth, than among foreign-born persons of any other nationality. Of the total foreign-born population as reported in 1900, 11.4 per cent were of Canadian nativity, while only 6.5 per cent of the foreign-born insane in hospitals in 1903 were born in Canada. The Scotch constituted 2.3 per cent of the foreign-born population and 1.7 per cent of the foreign-born insane; the Italians, 4.7 per cent of the foreign-born population and 2.3 per cent of the foreign-born insane; and the Hungarians and Bohemians, 2.9 per cent of the foreign-born population and 2.2 per cent of the foreign-born insane. Persons born in Russia and Poland constituted 7.8 per cent of the foreign-born population and 4.4 per cent of the foreign-born insane, while persons of unspecified nativities constituted 9.2 per cent of the foreign-born population and 7.3 per cent of the foreign-born insane.

In the census report the data are discussed very fully. The following quotations are from this discussion: "

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Relative to their numbers the Irish furnish a much larger proportion of the white foreign-born insane in hospitals than any other nationality. This is in keeping with the very high ratio of insanity in Ireland. * It has been suggested that the greater concentration of the Irish in the chief centers of population may account in part for the high ratio of insanity they show when compared with other foreign-born from western and northern Europe. But the concentration in urban communities of the Irish-born population is not much greater than that of the German-born, for instance, who show relatively a much lower ratio of insanity. * * *

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The proportion of German insane to the total foreign-born white insane is greater than the proportion of this nationality to the total foreign-born. * * The German immigration since 1900 has probably not perceptibly affected the actual percentage of Germans among all foreign-born, so that the comparison is fairly accurate. More favorable conditions, on the whole, are to be observed among the Canadians than among the English and Welsh. * * the percentage of Canadians is considerably larger among the total foreign-born than among the foreign-born white insane in hospitals. *

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a U. S. Census, Special Report, "Insane and feeble-minded in hospitals and insti tutions, 1904," pp. 24, 25, 26, and 27.

The Scandinavians (persons born in Sweden, Norway, and Denmark) are apparently much less liable to insanity than the Irish but somewhat more so than the Germans. * * *

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In the United States as a whole * * persons of Scottish birth form a smaller percentage of the foreign-born white insane in hospitals than of the foreign-born population. * * *

The comparisons of the percentages of the total foreign-born in 1900 with the percentage of foreign-born white insane enumerated in hospitals on December 31, 1903, are less equitable to the Italians than to the other foreign nationalities discussed so far, owing to the heavy immigration from Italy during the years intervening between the censuses. That is to say, the percentage which Italians form of all foreign-born has increased greatly since 1900. Nevertheless, the Italians show a proportion among the foreign-born in the general population very materially in excess of their proportion among the insane. * * Since the Italians in the United States are chiefly city dwellers in communities where the insane are quickly taken in hand by the proper authorities, it is impossible to construe the statistics adduced, except as indicative of a low ratio of insanity. While perhaps less inclined than some other foreigners to seek institutional care, experience does not show that the Italians commonly try to keep the insane in their homes, where such a course is possible. An enumeration of the Italian-born insane outside of the hospitals would therefore not be likely to show materially increased percentages. The comparative youthfulness of the Italian immigrants and the migratory character of the colonies may be factors in producing a low ratio of insanity, but the fact that not a single State shows an exception to the rule warrants the belief that the Italians are really less prone to insanity than the other nationalities enumerated.

In contrast to the Italians, the French in the United States constitute * * a higher percentage of the foreign-born white insane than of the total foreign-born. The French contingent is, however, numerically small, and, except in a few places, hardly typical of the French nation. * *

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The group of insane designated as persons born in Russia and Poland comprehends several distinct nationalities which it would have been desirable to separate for the sake of an accurate classification. The immigration from Russia is largely one of Hebrews, while that from Poland includes a large number of Polish Hebrews and also very many true Poles. But since the census of population does not distinguish the persons of Hebrew race from other immigrants of the same country, a statement of the number of Hebrews found among the insane would have lacked a basis for comparison. The term Poland, as used in this report, refers to the three divisions of Poland as given in the census publications.

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Conditions among the Russians and Poles of this country in respect to the proportion of insane among them approach those observed for the Italians. * * as in the case of the Italians, it should be remembered that an immigration of extraordinary magnitude from Russia and Poland has taken place since 1900, and the percentages given for that year do not indicate the full strength of Russians and Poles among all the foreign-born. In consequence, the possible comparisons really exaggerate the ratio of insanity among the Russians and Poles so far as hospital statistics reveal it. In the census report the foreign nationalities for which percentages have been computed are arranged, as far as possible, in the order of the relative prevalence of insanity among persons of each nationality. In this regard the report says:"

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The order of the foreign-born nationalities enumerated with regard to the relative numbers of insane they contributed to the hospital population in 1903 is about as follows:

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While the above arrangement can not be insisted upon as representing in all instances the exact positions occupied by these nationalities, so far as the frequency of insanity among them is concerned, it is confirmed by independent investigations and conforms to other recorded experience.

a United States Census, Special Report, "Insane and feeble-minded in hospitale and institutions, 1904," p. 27.

The data showing feeble-minded persons by country of birth presented in the census report, are so meager that an attempt to employ them for the determination of racial or national tendencies is considered inadvisable.

POSSIBLE CAUSES OF HIGH RATIOS OF INSANITY AMONG THE FOREIGNBORN.

The fact that the number of foreign insane persons in the United States is large, and the further fact that the proportion of insane persons among the foreign-born population is relatively high, may be due to several causes or combinations of causes. As has been stated, the immigration of mentally unsound aliens is prohibited by law. Any failure in the enforcement of this law would of course tend to result in the admission to the United States of mentally diseased persons and in a corresponding increase in the number of foreignborn insane in the country. On the other hand, racial traits or tendencies, as shown by the ratios of insanity in the countries from which the immigrants came, may be responsible, to a certain extent, for the relative prevalence of insanity among the foreign-born population of the United States. It is possible also that the tendency to insanity among the immigrants of the different nationalities is increased by the change in environment occasioned by immigration. These several factors will be separately discussed.

THE INEFFICACY OF THE IMMIGRATION LAW.

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It has been stated, in effect, by the New York state commission in lunacy, that, notwithstanding the inspection of immigrants with a view to discovering possible mental defects made by the federal officials at the ports of entry, mentally unsound aliens in considerable numbers are admitted to the country in violation of the provisions of the immigration law. In support of this statement the New York authorities make the assertion that many of the alien insane in the state institutions have been subject to insanity before leaving their native countries and have manifested symptoms of mental disease within a few months after their arrival in the United States. ing the Immigration Commission's investigation of immigrant homes and aid societies, the manager of one of the homes told an agent of the Commission that frequently immigrants brought directly to the home from the station, by the representatives, talked so wildly on arrival at the home that he felt sure they were insane. One immigrant girl, whose relatives failed to call for her at the immigrant station, was discharged to the representative of a certain home to be cared for in the home until such a time as the relatives could be located. The relatives of the girl afterwards went to the station and told the immigration authorities that they had not answered the telegram of notification of the girl's arrival because they knew that the girl had been insane for three years before her arrival in this country.

The following quotations are from the annual report of the state commission in lunacy of the State of New York for 1907."

New York State Commission in Lunacy: Annual report for the year ending Sept. 30, 1907, p. 45.

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