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As conditions are at present in the United States, two young persons who by chance are thrown together acquire a mutual fondness for each other. They are too young to he controlled by anything but the physiologic instincts which mutually attract them. The serious and complex problems which we are discussing, are to them a sealed book. They are ignorant and in their ignorance go blindly forward until their feet are entangled for weal or woe in the meshes of the labyrinthine net which has spread in their unguarded pathway. They need advice, but who shall advise? The parents are less ignorant than the children only in so far as they have experienced the serious responsibilities which are sure to follow marriage; the teaching of science regarding the marriage relation is to them also a sealed book. If parents can be taught that the marriage of the unfit is not to secure the happiness of their children but to entail untold misery instead; if a young man can be made to understand that the silly, neurasthenic, untruthful girl will retain these qualities to the end and will bear to him a progeny of like-minded children who will bring "his gray hairs in sorrow to the grave;" if the young woman contemplating mar-riage can be made to see that her reckless, lawless, drinking, thriftless lover will not reform his ways under her gentle influence because these habits are but the outward expression of an inborn vice, penetrating and ramifying the warp and woof of his moral, physical and mental being; then, and only then, can we hope to stem the flood of recruits annually plunging downward to join the ranks of the submerged unfortunates who are failures in life at least or fill our eleemosynary institutions, reformatories, and prisons.

Having said so much regarding the origin and hopeless nature of degeneracy it becomes us to inquire as to our obvious duty to the imbecile placed in our custody. Broadly stated the community and the state require at our hands two things. First, that the community shall be protected from the harmful influence of these unfortunates. To this end they have been recog-nized as a distinct class of individuals and as such are set apart. Second, that once set apart and placed under the training or custodial supervision of professional men, especially trained for this service to the state, their physical condition should be ameliorated and their lives rendered more peaceful and happy by every device known to science and shown by experience to be efficient, safe and helpful. This ideal of duty is fully in accord with the ethical and altruistic ideals of our age.

I need not in this presence speak at length or in detail of the pathologic state of a considerable percentage of imbecile children; of their incorrigibility and their nervous disorders; of the absence of self-control; of the fatal dom-inance of their sexual lives; not only as out manifestations of the feebleness of their mental state, but also as a powerful reactionary influence in originat-ing and establishing more firmly their nervous derangements and sinking them more and more deeply in the quagmire of their degenerate lives. Every one at all familiar with them will know of these things.

As physicians, it does not fall within our province to deal, except in an advisory way or as educators of. the community, with legislation designed to safeguard the marriage contract, but it is our plain duty to accept the teach-ings of science in our treatment and management of the imbecile children under care in asylums and training schools. The baneful influence of the abnormal sexual dominance which characterizes the lives of these persons manifests itself in aggravating the nervous disorders already existing. Self--abuse, so prevalent among the feeble-minded, has long been held to be an im-portant etiologic factor in epilepsy and deranged mental states and other ner-vous disorders of ill-defined types. To remove from the imbecile this vicious tendency would in many cases render him or her more docile and amenable to efficient training. Their general health would improve and their lives, in some measure, be lifted from the slough of degradation. Where this has been done the incorrigible individual soon becomes an industrious member of the feeble-minded community of which he forms a part. While he may never be equal to the tasks and responsibilities of citizenship, he will be healthier, happier and at the same time cease to be a menace to succeeding generations.

So long as the imbecile is confined within the precincts of our institutions reared for his protection and control, he is not a serious menace to the com-munity, but it is well known that the parents of these wards are prone to remove them from custody for the purpose of reaping the benefit accruing to the family from their labor. This is frequently done as soon as improvement in their condition is manifested as the result of their training.

They are often by this means turned loose in their respective communities and soon manifest their vicious tendencies. Asexualization would at least render them innocuous. Under the aseptic precautious of modern surgery the necessary surgical procedure is practically free from danger and in the male does not require an anesthetic, since all that is required is to cut the vas defrens, and cause no deformitory. Under suitable legal restrictions its application would not be abused. Unfortunately a wide-spread prejudice exists against the legalization of the procedure as was recently exhibited in Penn-sylvania when the governor vetoed a bill which after a second attempt had passed both the house and senate. The message which accompanied the veto afforded a striking example of the strange psychologic tyranny of prejudice even over a mind trained at the bar and on the bench; but lacking in that mental calm and unerring judicial scrutiny probably never acquired except in the laboratory, where the human mind is drilled to accept only what is dem-onstrably and inevitably true by the unerring fiat of natural law.