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Idiocy has a very unequal distribution between the two sexes, the male idiots being greatly in excess. In 1875, there were in Massachusetts 835 males and 505 females in this class of unfortunates, -- 165 of the former to every 100 of the latter. The ratio to population is, among males, one in 951; among females, one in 1,698. This preponderance of idiocy among males has been observed to exist in other countries.

The ages of the idiotic class in Massachusetts are distributed as follows: --

Two inferences at once suggest themselves upon a review of the foregoing analysis: the comparatively small proportion of idiots at ages under ten years indicates that a considerable number of idiotic children are overlooked in the enumeration, the parents of such children very naturally concealing the mental defects of their offspring through inability or unwill to recognize such an unhappy condition in those near to them, until the advancing age of the subject of the infirmity renders such concealment difficult; and, secondly, the excess of the proportion at ages over seventy suggests that the mental weakness and imbecility of the decline of life have been erroneously described as idiocy, -- the truth being, that idiocy, in the great majority of cases a congenital defect, should diminish in proportion to the population from youth onward. We may fairly conclude, however, that the former of these errors is cancelled by the latter, and that our aggregate number may still be accepted as a true approximation to exactness.

The causes of idiocy have always been an interesting study. Dr. Howe, whose authority in such matters will not be questioned, says with great emphasis: "We regard idiocy as a diseased excrescence of society, as an outward sign of an inward malady. It appears to us certain that the existence of so many idiots in every generation must be the consequence of some violation of natural laws." (5) Among the indirect or more immediate causes of mental defect, Dr. Howe mentions the intemperance of parents, self-abuse, intermarriage of relatives, and attempts to produce abortion resulting in permanent injury to the foetus in utero.

In the report upon the census of England and Wales for 1871, the following occurs: "Residence in deep valleys, damp and unwholesome climate, crowded dwellings or other unhealthy conditions, intermarriages among a limited number of families, and more especially where weakness of brain already exists, -- these are allowed to be predisposing causes, and as they are obviously within human control, the hope may be entertained that the extent oi this affliction may be limited in the future."

The data supplied by the recent census in Massachusetts are too meagre and indefinite to form a basis for satisfactory conclusions with regard to the causes of idiocy in this State; they serve merely as an expression of the popular notion of the matter, and as such alone they are here presented. Of course it is manifest that many of the causes assigned, being post-natal, are erroneous, and that exact investigation would find nearly all cases to be dependent on ante-natal conditions necessarily obscure to ordinary intelligence. Epilepsy is set down as the cause of 159 cases of idiocy. Fevers of various kinds are charged with 49 cases. In 18 cases, fright of the mother during her pregnancy is the alleged cause. Blows on the head, falls and injury at the time of birth, are assigned as having caused idiocy in 34 cases. Intemperance of the father is given in 11 instances. In 10 cases the parents were cousins. This matter of the close relationship of the parents, as contributing to idiocy as well as to other abnormal peculiarities, mental and physical, is well worthy of careful investigation. Among the less fertile and more remote causes assigned are the following: hydro (6), rickets (10), harsh treatment in childhood (3), sunstroke (3), measles (3), fright (4), masturbation (2), overdosing (2).

The Insane.

A correct enumeration of the lunatic class in any community is as desirable as it is difficult. It is important to ascertain the exact measure of this special burden upon the State and to determine its relation to pauperism. It is of great consequence, also, to learn whether the burden is in; whether the restless activity of our modern modes of life is impressing itself upon the public health in increasing degrees and necessitating the enlargement of the facilities for treating mental disease. But for the reasons mentioned previously, the sensitiveness of people with regard to the mental maladies of their kindred and the unwillingness to report such cases, many instances of insanity of mild or inter type inevitably escape mention upon the census schedules. This error of omission applies of course to those cases of lunacy remaining at home, not being violent enough to require treatment in hospital and not yet cast off by their kindred to become a public dependence as pauper lunatics; so that the deficiency, being limited to a special and numerically minor class of these unfortunates, while it should be; regarded in any analysis of the statistics of lunacy as affect the aggregate in some degree, is not of very great magnitude.