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Certain types of defect are usually if not always due to accidental or sporadic causes, viz., the Mongolian, hydrocephalic, post-meningitic, the cerebral hemorrhagic, etc. Acquired characteristics are not likely to be transmitted, but there is reason for the belief that alcoholism, syphilis, tuberculosis and other environmental factors may initiate germinal variation which may become hereditary. The cases of purely accidental origin with no morbid heredity are not likely to be followed by other cases in that family. The purely accidental cases themselves would probably beget normal progeny.

To sum up, there is a large number of feeble-minded persons in our community. The great majority of these persons are feeble-minded because they come from a stock which transmits feeblemindedness from generation to generation in accordance with the laws of heredity. Many of the members of these families are not defective themselves, but to a certain extent these normal members of tainted families are liable to have a certain number of defectives among their own descendants.

There is a popular belief that feeble-mindedness is greatly on the increase. We do not know, and are not likely to know, whether or not there is now relatively more feeble-mindedness than there was fifty or one hundred or five hundred years ago. There is some reason for the belief that the remarkable shift of population from rural to urban conditions in the last half-century, with the resulting industrial and social stress, and a greater liability to syphilis, tuberculosis and alcoholism, has increased the ratio of defectives in the families with hereditary predisposition. It is certain that the feeble-minded girl or woman in the city rarely escapes the sexual experiences that too often result in the birth of more defectives and degenerates. At the same time the steady withdrawal of the more sturdy and virile individuals from the country to the towns leaves the ineffective and defective men and women in the country to marry and beget offspring even less efficient than themselves. Recent study of certain isolated rural communities in Massachusetts where the more vigorous families have migrated for several generations, shows a marked deterioration in the quality of the population, with a large number of the feeble-minded and a notable amount of immorality, intemperance and shiftlessness. The defective persons in these communities are very apt to be attracted to each other, and to marry or to intermarry, thus intensifying the degenerative process. The members of this society are only too familiar with these rural foci of feeblemindedness, immorality, crime and destitution.

The social and economic burdens of uncomplicated feeble-mindedness are only too well known. The feeble-minded are a parasitic, predatory class, never capable of self-support or of managing their own affairs. The great majority ultimately become public charges in some form. They cause unutterable sorrow at home and are a menace and danger to the community. Feeble-minded women are almost invariably immoral, and if at large usually become carriers of venereal disease or give birth to children who are as defective as themselves. The feeble-minded woman who marries is twice as prolific as the normal woman.

We have only begun to understand the importance of feeble-mindedness as a factor in the causation of pauperism, crime and other social problems. Hereditary pauperism, or pauperism of two or more generations of the same family, generally means hereditary feeblemindedness. In Massachusetts there are families who have been paupers for many generations. Some of the members were born or even conceived in the poorhouse.

Every feeble-minded person, especially the high-grade imbecile, is a potential criminal, needing only the proper environment and opportunity for the development and expression of his criminal tendencies. The unrecognized imbecile is a most dangerous element in the community. There are many crimes committed by imbeciles for every one committed by an insane person. The average prison population includes more imbeciles than lunatics. The term "defective delinquent" is applied to this special class of defectives where the mental lack is relatively slight, though unmistakable, and the criminal tendencies are marked and constant.

At least twenty-five per cent. of the inmates of our penal institutions are mentally defective and belong either to the feeble-minded or to the defective delinquent class. Nearly fifty per cent. of the girls at the Lancaster reformatory are mentally defective. The class of defective delinquents of both sexes is well known in every police court, jail, reformatory and prison. There is a close analogy between the defective delinquent and the instinctive criminals who form a large proportion of the prison rounder type. Under present conditions these irresponsible persons are discharged at the expiration of their sentences to lay tribute on the community, to reproduce their own kind, to be returned to prison again and again.