and delinquent classes at the Tenth Census, says about pauperism: "The law which governs the distribution of pauperism in the United States (and which, we believe, has not been suspected by any student of the subjectat least I have never seen any reference to it) is brought out as clearly by the census of 1850 as by that of 1880, and it is confirmed by every census that has been taken. This law is as follows: The ratio of paupers to the total population diminishes alike from north to south and from east to west. In other words, if New England, or the principal New England state (Massachusetts), be taken as a starting point, it matters not in which direction a line be drawn, the largest amount of pauperism relatively to the population will be found. to exist in Massachusetts, and the smallest in the state farthest removed from Massachusetts, while the intervening states will exhibit, on the whole and with scarcely an exception, a gradual decline in something like the degree

of their removal from the extreme northeast." As clearly as Mr. Wines defines this law, it is rather strange that he did not discover the practically identical condition relative to the in

sane.

We have one other state of affairs in the United States that is worth while looking into. I refer to our large negro population. The ratio of insanity in the negro population is smaller than in the white population, being as I to 1,069 in the former and 1 to 505 in the latter (Census 1880). Although this is so, it is generally admitted that the percentage of insanity has been gradually increasing since the Civil War. Berkley* says on this point: "Before the Civil War there were few or no psychoses among them, and such organic degenerative diseases as syphilitic insanity and dementia paralytica were practically unknown. Today in communities where many are collected, as in Washington or Baltimore, the percentage of insane. * Ibid.

negroes, not to mention idiots and imbeciles, is already fully up to that of the Caucasian races, with whom they are associated, and bids fair to surpass it."

*The negro has been thrown upon his own physical and mental resources and has entered the strife for existence as an inferior; he is syphilized, alcoholized, his food is ofttimes unsuitable, *** his surroundings are usually unhygienic, and tuberculosis finds in him an easy prey. No wonder it is that under these circumstances we have in our asylums an ever-increasing number of idiots, of imbeciles, and of all types of the dementias from the colored race."

There are, however, some extremely interesting facts relative to this increase. The percentage of colored insane increases rapidly as we leave the

* A Treatise on Mental Diseases.

542

in any

natural home of the negro and go direction. In other words, as soon as the negro goes North and enters into active competition with the white, who is mentally his superior, he succumbs to the unequal struggle. So in Georgia, where we find the greatest number of negroes, there was I insane negro to 1,764 of the colored population in 1880, while in New York the ratio was I to 333, or almost exactly the same ratio as for the white population. (See outline maps Nos. V, VI.)

Then, again, if we take the Southern States alone, viz., Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Texas, and Virginia, we find the ratio of colored insane I to 1,277, while for the whites in the same territory it is 1 to 456. For the

remainder of the United States the ratio of colored insane as shown by the Tenth Census was I to 542, while for the whites it was 1 to 520. The ratio of colored insane in the United States, minus the Southern States, is then almost exactly the same as the ratio for the white in

sane.

It seems that all the lines of evidence I have followed up lead to the same conclusion; they are mutually confirmatory of the general law that the proportion of insane is highest where we find the greatest congestion of population, and, therefore, where the stresses incident to active competition are most severe. Our inquiry thus far, however, has been nothing if it has not been an inquiry into the causes of insanity, and I think I may fitly close by a general discussion of causes with a view to indicating some general conclusions relative to the comparative influence of these mental stresses I have been discussing in the actual production of insanity.

If we will take up any annual report of an institution for the insane and turn to the table giving the causes of insanity in the several patients under treatment, we will find assigned such causes as these: "business anxiety," "death of mother," "disappointment in love," domestic troubles,' excessive study," "loss of property,' "political excitement." How many of us but have suffered at some time or other from one or perhaps all of these so-called causes of insanity? Certainly we have all had business worries; certainly we have all lost property at some time, otherwise our good fortune is phenomenal; certainly we have all been subject to political excitement many times, and all of us presumably have lost a dear friend or relative, perhaps a father or mother. Dr Carlos F. MacDonald says very forcibly on this

*

subject, * *that substantially every individual at some time during his life is exposed, in many cases re

peatedly, to many of the so-called exciting causes of insanity, both mental and physical, and yet, despite this fact, we find that sanity is the rule-insanity, the exception."

In ascribing these causes what has been done is simply this: The particular set of conditions that happened to maintain at the time the patient was attacked with insanity have been tabulated as the causes of that attack, whereas the true cause was in all probability far removed from these which were in reality only accidental contemporaries. In reality the true underlying condition in all these cases for which such causes are assigned is the predisposition to insanity.

Predisposition to insanity may be either inherited or acquired. The former is more generally recognized and is what is referred to when insanity is said to be hereditary. Of all causes of insanity heredity is recognized as being by far the most important and as being most frequently present. The average for all countries has been estimated at from 60 to 70 per cent. This I believe, as a matter of fact, falls below the truth. But any one who is at all familiar with the collecting of statistics must know how impossible it is for them to fully represent the facts in such a matter.

Next to hereditary predisposition comes acquired predisposition as a factor in causation, and the two most important agents in bringing about this acquired predisposition are generally acknowledged to be, first, alcohol, and second, syphilis, both of which, however, may act as true exciting causes at times. It is further conceded that both of these causes are much more prevalent in civilized communities, and in fact seem to be fostered by that irregular life which the active struggle after wealth necessitates.

The inadequacy of predisposition alone to account for insanity, especially acquired predisposition due to alcohol,

syphilis, and tuberculosis, without the element of mental stress is well illustrated by the condition of the American Indian. Sorely afflicted as he is by the diseases and vices of civilization, his tendency is to an outdoor life, and as his land has disappeared and he has become physically incapacitated, the government has supported him, so that his sufferings have been in the main physical and not mental. Careless, slovenly, and improvident, he does not know much of worry for the morrow, and so we find that among his race "insanity is of rare occurrence.'*

Without wearying you with further figures I will simply call your attention to the new light in which our conclusions now appear. Insanity is most frequent in the older civilizations, in the more thickly settled communities, in urban centers in short, where competition is most active. Here the weakling, the man whose mental faculties are not quite up to grade, who enters in the struggle handicapped by a poorly equilibrated mind, goes to the wall. He is

the victim of heredity. Here are bred all the vices which only a high grade of intelligence can call into being; stimulants, narcotics, drugs of all kinds are available to help the overburdened on their way, until at last they react and bring ruin and desolation. The victims who fall a prey to these temptations are the victims of an acquired predisposition.

Of these two varieties of causes heredity is by far the more important. While civilization furnishes the environment that makes a bad heredity doubly dangerous, still it is the heredity which is the prepotent factor and not the environment. A bad heritage is always a source of danger, and its possessor can never know when the environmental conditions may appear

"The Civilized Indian, His Physical Characteristics and Some of His Diseases", by A. D. Lake, M. D. Trans. N. Y. Med. Soc., 1902.

which will make its latent activity kinetic. No people in the world are freer than we are from the taints of vicious inheritance. Inhabitants of the most glorious country on earth, a country whose future for greatness and power and good seems to have no limit, let us see that we make the best possible use of the bounties nature has showered upon us with so prodigal a hand.

But power and greatness are doubleedged; they cut both ways; and already we are threatened with the dangers they have brought in their wake. The offscourings of all Europe are hastening to our shores for that wealth they expect to find ready at hand, and today 50 per cent of the nearly 25,000 insane of New York State are foreign-born. The result of this great influx of defectives must of necessity have a constant leavening effect on the whole population. The danger from this. source, however, is as nothing compared to that from war, the greatest curse that can afflict a nation.

In war it is not the defective that goes down to death, but the flower of a nation's manhood, and if modern theories of heredity are correct, their place can never be filled. Once gone, they are gone forever, while the maimed, the diseased, the imbeciles and degenerates, unable to sustain the hardships of campaigning, stay at home and help populate the country with their ilk. believe one of the principal reasons for this country's great prosperity lies in its freedom from foreign wars, and I am convinced that no more terrible calamity could happen to it than to be engaged in one.

If we can control these two sources of evil successfully, I am sure that internal affairs will so shape themselves as not to seriously interfere with a future which, I believe, can today only be dimly imagined, a future which will outshine the glory of ancient Rome as good outshines evil.

T

HE announcement of Commander Robert E. Peary that he is to make one more attempt to reach the North Pole has been received with much enthusiasm. Every one has been hoping that he would be able to carry out the plan which he has adopted for his next Arctic campaign, a plan which he outlined some months ago when it was doubtful whether he would ever go north again. This plan differs in one very important respect from all his former campaigns in that he proposes to make his winter camp fully one hundred miles north of his previous winter quarters; so that when he is ready to start on his dash in spring he will be 100 miles nearer his goal. The distance thus saved-from Cape Sabine to Cape Joseph Henry-is the most difficult of traverse, and to overcome it has in the past taken several weeks of the short working season.

The distance from Peary's proposed winter camp near Cape Joseph Henry to the Pole and back again is less than the average distance of four sledging trips which he has made, and each of these trips was over rougher ice than it is believed will be encountered beyond the 84th parallel. Mr Peary will start north in July, 1904. He hopes to be able to reach Cape Joseph Henry with his vessel in the fall of that year, and to make his dash in 1905. In case he does not reach the cape in 1904, he will spend 1905 in getting there, and make his dash in 1906. His plan is outlined in the following letter, addressed to the Secretary of the Navy, asking for three years' leave of absence:

WASHINGTON, D. C.,
September 2, 1903.

SIR Referring to my application for leave of absence accompanying this, I beg to state for your information that I propose to secure a suitable ship, put her into one of our best shipyards, have

her reënforced and strengthened to the maximum degree and fitted with American engines, possessing the maximum of strength and power with the minimum weight and space, so that she may go north as an exponent of American skill and mechanical ability.

With such ship I should sail north about the 1st of next July, and on reaching the Whale Sound region should take on board my Eskimo, establish my permanent sub-base at Cape Sabine, and then force my way northward to my proposed winter quarters on the northern shore of Grant Land, establishing caches as far as practicable en route. By the earliest returning light of the following February I should start due north over the polar pack with a small, light pioneer party, followed by a large, heavy main party. I should expect to accomplish the distance to the Pole and return in about 100 days or a little more, an average travel of about 10 miles a day. Returning, I should break the ship out late in the same season and return home.

If ice conditions the first year were such as to prevent reaching the northern shore of Grant Land, I should winter as far north as practicable and force the ship to the desired location the following year. In this event the expedition would be gone two years.

This plan is the result of some twelve years of almost continuous experience in those latitudes, and is based upon an extended personal acquaintance with the region from Sabine to 84° north latitude and a thorough familiarity with climatic and other conditions and with Eskimo.

The distinctive features of my plan are: The use of individual sledges with comparatively light loads, drawn by dogs, giving a traveling unit of high speed and radius of reach, as opposed to the man sledge, with its heavy load, slow speed, and limited radius; the