begun to doubt this traditional view; they have found that it was not sufficiently demonstrated that the Jew differed in his liability to insanity from the Gentile, and some have gone so far as to assert that the converse is true.1 This conclusion was also reached a few years ago by the United States Department of Commerce which stated in its report: "On the contrary, facts from which deductions can be made point rather to a comparatively smaller amount of insanity among Jews than among people of several other races." 2 Studies of the incidence of insanity among Jews. have been made in a number of European countries where these people have lived for many centuries. Lombroso found that the seemingly larger percentage of insanity among Jews was not so much a matter of race as of intellectual work, for among the Semitic races in general (Arabs, Bedouins) insanity is very rare. The results of a more recent study of the problem as it exists in Germany were published in 1909 by Sichel, whose deductions were based on careful investigations of the records of the Frankfort Hospital for the insane. He found that although there were relatively more Jewish inmates than the corresponding percentage of the Jewish population in Frankfort, this could only be demonstrated in reference to certain groups of mental disorders; however, the other types revealed a smaller percentage of Jews than of non-Jews." Studies by A. Pilcz in Vienna and C. F. Beadles in London seem to indicate a higher percentage of insanity among Jews than

3

1 Brill, A. A., Adjustment of the Jew to the American Environment," Mental Hygiene, April, 1918, pp. 219-220.

'U. S. Dept. of Commerce Report, quoted in Mental Hygiene, April 1918, p. 219.

'Lombroso, E., Crime, Its Causes and Remedies, 1909, p. 39.

'Sichel, Max, Die Geistesstorungen bei den Juden (Leipzig, 1909), pp. 43-81.

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among non-Jews. In this country Spitzka, in 1880, came to the conclusion after a careful study of the problem, that on the whole the different forms of insanity occur in nearly the same proportions in the Anglo-Saxon, Teutonic, Celtic and Hebrew races." In considering the figures for Europe it should be remembered that in a number of the larger European countries as late as the nineteenth, and in some even in the present century, Jews have been harassed and forced to endure unusual stresses and strains and even the torture of violent death at the hands of their persecutors. For these reasons it would hardly be advisable for the purposes of scientific knowledge and accuracy to consider statistics gathered in such lands. The largest number of Jews within modern times congregated in a limited area are to be found in New York State and City; for this reason the admissions to the psychopathic wards of Bellevue Hospital, New York City, have been made the basis of the statistical study of the problem considered in this work.

(b) Insanity in Rural and Urban Districts. The total number of first admissions to the civil state hospitals in New York for 1917 was as follows: males 3,605; females 3,272; total 6,877. Of these 398 males and 402 females, a total of 800, were Jewish, or 11.0 per cent males and 12.3 per cent females, with a general average of 11.6 per cent. The total state population in 1917 was 9,917,438,* the total Jewish population was approximately 1,600,000, or 16.0

1Jewish Encyclopedia, article "Insanity," vol. vi, p. 606.

5

"Spitzka, Edward C., "Race and Insanity," Journal for Nervous and Mental Diseases, 1880.

'State Hospital Commission, 29th Annual Report, 1916-1917, p. 426. *S. H. C., 30th A, R., 1917-1918, p. 57.

5 Jewish Communal Register, New York City, 1917, p. 89; Dushkin, Alexander M., A Survey of Jewish Religious Education in New York City, (Dissertation Teacher's College, Columbia Univ., 1918) in which

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per cent of the general population. In 1918 the figures were about the same-total number of first admissions, 6,797; total number of Jewish patients, first admissions, 832.1 The figures indicate a much lower percentage of insanity among Jews in the state than in the remaining general population. It should be observed also that very close to 100 per cent of the Jews in the state live in New York City, only a small proportion living in the other cities in the state, with very few in the rural districts.

During the year 1910 the urban population of the United States contributed 102.8 admissions and the rural but 41.4 admissions per 100,000 of the population to the institutions for the insane and feebleminded." An important factor having a bearing upon this question is the difference between the two portions of the population in age distribution; only 27.2 per cent of the urban population and as many as 36.3 per cent of the rural population falls in the group under 15 years of age, a group contributing but a small fraction of the admissions to institutions for the insane. The marked difference between urban and rural commitments, especially in New York State, is still further emphasized by the fact that the rate of first admissions per 100,000 population is much higher in the counties of the state in which cities are located than in those in which there are few, if any, cities, of considerable size. Thus, the rate per 100,000 population for New York County in 1918 was 105.9, whereas it was

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the Jewish population for New York City in 1917 is placed at 1,500,000. Chalmers, Henry, "Jews in New York City,” Amer. Jour. of Statistics, 1914-1915, placed the Jewish population at 1,330,000 in 1913, pp. 68-75. American Jewish Year Book, 1919-1920, p. 605, estimates the Jewish population in New York State in 1918 as 1,603,923.

1S. H. C., 30th A. R., 1917-1918, p. 405.

Insane and Feebleminded in Institutions, Bureau of Census, 1914, p. 27.

'De Fursac, R. and Rosanoff, A., Manual of Psychiatry, 1916, p. 15.

only 29.9 in Warren County, 30.7 in Schoharie County, etc.1 As aforementioned, the Jewish first admissions to the civil state hospitals in 1917 and 1918 averaged about 11.6 per cent of the total first admissions, while they formed approximately 16.0 per cent of the general population of the state, indicating a rather low rate of first admissions to institutions for the insane.

(c) Jewish Insane in New York City. Another definite and perhaps somewhat more exact way to arrive at the ratio of the occurrence of insanity among Jews to their proportion in the general population is to consider the admissions to the psychopathic wards of Bellevue Hospital, New York City, for there the population is practically all urban, the admissions are all from the city proper (nearly altogether from the Boroughs of Manhattan and the Bronx), and the Jewish population is centered in the city.

The number of admissions to the psychopathic wards, male and female, of Bellevue Hospital from September 1, 1917 to August 31, 1918, totalled 6,878, of which 1,127 or 16.38 per cent were Jews. For the following year, beginning September 1, 1918 and ending August 31, 1919, the total number of admissions to the psychopathic wards. of Bellevue Hospital was 8,255, of which 1,133 or 13.72 per cent were Jews. During the second year, as has been noted, the total number of admissions was considerably larger than the year previous. This can be accounted for by stating that directly after the signing of the armistice on November 11, 1918, the number of cases of alcoholism and alchoholic psychoses admitted to the psychopathic wards increased considerably; also, during this year a number of soldiers who had become insane while in service in various camps in the United States were sent to Bellevue Hospital,

1S. H. C., 30th A. R., 1917-1918, p. 438.

psychopathic division, and later transferred to their relatives in the city. The incidence of alcoholism and alcoholic psychoses among Jews, as will be pointed out later, has been considerably less than in almost any other element. of the general population of New York, and for this reason, using the Bellevue Hospital figures, the percentage of insanity among Jews was 13.72 per cent for 1918-1919; whereas it had reached 16.38 per cent the year previous. The total population of New York City in 1917 was approximately 5,800,000;1 the total Jewish population about 1,500,000, or 25.8 per cent of the general population, with admission rates to the psychopathic wards of Bellevue Hispital of 16.38 per cent one year and 13.72 per cent the following year.

To Bellevue Hospital are brought the insane or alleged insane from the Boroughs of Manhattan and the Bronx only. Kings County Hospital in Brooklyn receives such patients from the Boroughs of Kings and Queens; Richmond Borough, with a Jewish population of only 5,000, sends its insane directly to Manhattan State Hospital after examination by two local physicians. A consideration of the total admissions to the psychopathic wards of both Bellevue and Kings County Hospitals for two years, thus including practically the entire city, will give a still better and more accurate index of the occurrence of insanity among the Jews of New York. The total number of admissions to Kings County Hospital, psychopathic wards, from September 1, 1917 to August 31, 1918 was 2,326, of which 392 or 16.85 per cent were Jews. For the following year, September 1, 1918 to August 31, 1919 the total admissions were 2,550, of which 429 or 16.82 per cent were Jews, there being in both years a markedly lower rate of

'Dept. of Health, New York City, estimated the total population on July 1, 1917, at 5,737,492, Weekly Bulletin, July 7, 1917, p. 223.