From venereal diseases, syphilis and gonorrhea, more Italians and Hebrews were treated than of either English, Germans or Irish, but in no case was the percentage higher than 1.3 per cent., this being the percentage among the Italians, to only 0.8 and 0.5 of I per cent. among the Irish; among the Germans 1.4 per cent. for syphilis and 0.4 of 1 per cent. for gonorrhea. The negroes, native born of native father, suffered most from these diseases, 2.9 per cent. of the negroes being treated for syphilis, 1.5 per cent. for gonorrhea. Among the negroes only 3.6 per cent. were treated for alcoholism.

On the whole, the medical inspection of immigrants at foreign ports, while not absolutely effective, seems to be reasonably satisfactory. A considerable time must elapse between embarkation at European ports and arrival in the United States. Moreover, doubtless, in spite of the best efforts that can be made, there will be occasionally an avoidance of inspection; but taking all circumstances into account, the present control of immigrants as regards contagious diseases seems to be quite satisfactory.

It has frequently been suggested that some system should be devised by which immigrants may be inspected before leaving their homes for a port of embarkation. Such an arrangement would, of course, prevent many hardships now suffered by the thousands that are annually turned back at foreign ports of embarkation; but this is a subject over which our government has no supervision, the governments of the home country being the only ones which could take effective action.

The policy adopted by the United States, of holding steamship companies responsible for bringing to the

United States those physically and mentally diseased, seems to be right, and to have been of increasing effectiveness in late years. Inasmuch, however, as the circumstances in different cases vary materially, it seems desirable that the penalty provided for evasion of the law either through carelessness or connivance might also be varied so that under certain circumstances as heavy a fine as $500 might be levied.

The Mentally Defective

It is much more difficult, in many instances, to de'tect the mentally than the physically defective. Often there is nothing to indicate to the medical inspector mental disease, unless the immigrant can be kept under observation for a considerable period of time, or unless the history of the case is known. Under the law, "All idiots, imbeciles, feeble-minded persons, epileptics, are excluded, insane persons, and persons who have been insane within five years previous; and persons who have had two or more attacks of insanity at any time previously." It is the custom invariably to hold for observation any patient who shows any evidence whatever of mental disease; but despite this care not a few cases are found of those who have developed insanity within a comparatively short period after landing. In some instances this might have been anticipated if the history of the patient had been known, but otherwise there was no means of detection. The present law on this point seems to be satisfactory, and its enforcement generally good under the very difficult conditions; but it would be desirable, if it were practicable, to provide some better means for securing the history of arriving immigrants.

The tables opposite, taken from the Special Report of the United States Census, which some observations by the Immigration Commission in Bellevue and allied hospitals in New York and reports of the Bureau of Immigration tend to confirm, throw some light on the relative tendencies of certain races toward insanity, and show that certain aliens are more inclined toward insanity than are native-born Americans.

RACIAL OR NATIONAL TENDENCIES

The high ratio of insanity prevailing among foreignborn persons in the United States may be due, in a measure at least, to racial or national tendencies.

Data showing the number of insane and the ratio of insanity in the principal European countries and in Canada are afforded by the special report of the Census Bureau. These data, together with like data for the United States, obtained from the same source, are presented on the opposite page.

Paupers

Altho in the earlier days before strict regulation of immigration had been provided by law many poor people came from Europe, their home country paying the expenses of their shipment in order to rid themselves of the burden of their support, our present regulations excluding those who are liable to become a public charge have practically stopt the immigration. of this undesirable class. The Immigration Commission, with the assistance of the Associated Charities in forty-three cities, including practically all the large immigrant centers excepting New York, reached the

NUMBER AND RATIO OF INSANE IN UNITED STATES AND IN FOREIGN COUNTRIES

[Compiled from United States Census, Special Report, "Insane and feebleminded in hospitals and institutions, 1904," pp. 9 and 10.]

December 31, 1903, compared with the total foreign-born population of continental United States in 1900, by country of birth; per cent. distribution. [Compiled from United States Census, Special Report, "Insane and feebleminded in hospitals and institutions, 1904"; pp. 23 and 24.]

conclusion that only a very small percentage of the immigrants now arriving applied for relief.

In this statistical investigation,* covering 31,374 cases actually receiving assistance, it was found that 28.7 per cent. had applied for assistance because of the death or disability of the bread-winner of the family; 18.9 per cent. on account of the death or disability of another member of the family; 59 per cent. from lack of employment or insufficient earnings; 18.7 per cent. on account of neglect or bad habits of the breadwinner; 16.2 per cent. on account of old age; and 10 per cent. from other causes.

It will be noted that because more than one reason was given in some cases, this total amounts to more than 100 per cent., but the relative proportions of the cases under the different classes is probably substantially accurate. If we attempt to discriminate among the different races, it appears that it is among the immigrants of the earlier period or those coming from Northern Europe that we find apparently the largest number of cases of neglect or bad habits of the breadwinner. For example, among the South Italians, only 8.7 per cent. give this cause, whereas the Irish give 20.9 per cent., the English 14 per cent., the German 15.7 per cent., the Norwegians 25.9 per cent. The Hebrews, again, as representatives of the later immigrants, give 12.6 per cent., but the Lithuanians, by exception, give 25.6 per cent.

In the case of those giving lack of employment as the cause, the highest percentage is found among the Syrians, 75.4 per cent.; the lowest among the French Canadians, 38.9 per cent. There do not seem to be striking differences in this regard among the other Reports of Immigration Commission, Vol. 1.