The prevention of bad heredity affords a hope of reducing not only the constitutional mental disorders, but also those which develop on the basis of alcohol and drug addictions and of syphilis, as may be judged from the following considerations.

As regards alcoholic psychoses, it is not sufficient to know that they result from intemperance. In order to be able to. deal properly with the problem of prevention an answer must be sought to the question, Why do some persons drink alcohol in injurious quantities? - The general view is that initiation into habits of intemperance occurs as a result of convivial customs or through bad associations, and that in such ways a craving is established which leads to the development of chronic alcoholism. This is truth, but not the whole truth; for in the midst of the same social conditions, favorable or unfavorable, it is as certain that some persons will become alcoholic as it is that others will not. The difference is between the persons.

During the fiscal year ending September 30, 1914, 56 cases of alcoholic psychoses were admitted to the Kings Park State Hospital; in 18 of these data concerning heredity and mental make-up of the patients were unascertained; of the remaining 38 cases no less than 31 presented either a neuropathic family history, or an originally inferior mental make-up, or both; and only 7 gave a negative personal and family history.

The conditions under which such hospital statistics are compiled as a rule give rise to error in but one direction, namely, in the direction of omitting pertinent facts of family or personal history; thus tending to lead to an underestimation of the case from this point of view. Considering this, the remarkable showing of the figures must give one the feeling that the tendency to drink alcohol in amounts sufficient to produce mental disease is largely a neuropathic manifestation.

A study of this subject, made by Dr. D. Heron1 and published recently from the Galton Laboratory of Eugenics at the University of London, has yielded a similar conclusion: "We are on fairly safe ground in asserting that the relation between inebriety and mental defect is about 0.76. We have thus reached a definite measure of a relationship on which every authority on alcoholism has laid the greatest possible stress." "On the one hand, mental condition is usually regarded as being directly affected by alcoholic excess, and on the other hand the extent of the individual's education is very largely determined by causes which are pre-alcoholic; yet we find here that there is a close relationship between the two characters, and this is strongly in favor of the view that the defective mental condition of these inebriates, like the extent of their education, is pre-alcoholic and that the alcoholism flows from a pre-existing mental defect, not the mental defect from the alcoholism." "All this lends support to the view that the mental defect of the inebriate is not an actual growth; it is born, not bred; that' inebriety is more an incident in the life of the inebriate than the cause of his mental defect.' "

What has been said about alcoholism applies with equal force to drug addictions.

1Eugenics Laboratory Memoirs, xvii: A Second Study of Extreme Alcoholism in Adults. London, 1912.

As regards syphilis, in this connection, it is necessary to consider before all the manner in which it is spread so widely through the population.

Syphilitic infection, as is well known, may be of non-venereal as well as of venereal origin. Thus, of 887 cases reported by Fournier,1 45 were of non-venereal origin, among these being cases of inherited syphilis, of infection of wet-nurses by sucklings, midwives by women in labor, etc. Of the cases of venereal origin, not all result from immoral relations. Thus Fournier2 estimates that of all cases in women the infection in 19% is acquired by married women from their husbands. But even in cases in which the infection is acquired innocently, it can usually be traced indirectly to immoral sexual relations, particularly to prostitution, as its original source.

The prevention of syphilis and with it of psychoses of syphilitic origin is, therefore, closely linked to the prevention or control of prostitution.

To what extent can prostitution be controlled?

First of all, it must be noted that at no time has any state or nation as yet succeeded in abolishing prostitution, and as late as 1902 a Committee of Fifteen organized in New York for the purpose of investigating the social evil, were led in their report to express the view that the summary extirpation of prostitution "in the present state of the moral evolution of the race, is as yet impossible." 3

Since that time, however, important additions have been made to our knowledge of prostitution, so that to-day the case no longer seems so hopeless. The most significant contribution consists in the discovery of the close relationship existing between prostitution and feeble-mindedness and other mental disorders.

This relationship has been carefully studied by a special commission created for that purpose by an act of the House of Representatives of the State of Massachusetts.1 We would quote the following, from their highly interesting official report:

1 Fournier. The Treatment and Prophylaxis of Syphilis. English translation by C. F. Marshall. New York, 1907. P. 348.

2 hoc. cit., p. 351.

3 The Social Evil. New York, 1902. (G. P. Putnam's Sons) P. 178.

"The women examined were in three groups: young girls under sentence in the State Industrial School for Girls, the House of Refuge, and the Welcome House; those just arrested and awaiting trial in the Suffolk House of Detention in Boston; women serving sentence in the State Reformatory for Women, the Suffolk County Jail, and the Suffolk House of Correction.

"These three groups represent the young girls who have just begun prostitution, the women plying their trade on the streets at the present time and the women who are old offenders. The houses of prostitution, lodging houses, hotels and cafes named by these women as the places where they plied their trade are the same as those noted by the field investigators employed by the commission.

"The Binet tests were applied to 289 of the 300 women examined, and other psychological tests were used in doubtful cases.

"Of the 300 prostitutes, 154, or 51% were feeble-minded and 11, or 3% were insane. All doubtful cases were recorded as normal. The mental defect of those 154 women was so pronounced and evident as to warrant the legal commitment of each one as a feeble-minded person or as a defective delinquent. At the Massachusetts School for the Feeble-minded there are an equal number of women and girl inmates, medically and legally certified as feeble-minded, who are of equal or superior mental capacity.

"The 135 women designated as normal as a class were of distinctly inferior intelligence. More time for study of these women, more complete histories of their life in the community and opportunity for more elaborate psychological tests might verify the belief that many of them also were feeble-minded or insane.

"Some of the women seen at the Detention House were so under the influence of drugs or alcohol as to make it impossible to study their mental condition. Others at the Detention House and in the prisons had used alcohol to excess for years, and in the time available it was impossible to differentiate between alcoholic deterioration amd mental defect. These drunken, alcoholic and drug-stupefied women were all recorded as normal.

"Of the 135 women rated as normal, only a few ever read a newspaper or a book, or had any real knowledge of current events, or could converse intelligently upon any but the most trivial subjects. Not more than six of the entire number seemed to have really good minds.

1 Report of the Commission for the Investigation of the White Slave Traffic, so-called. February, 1914. House, No. 2281, State of Massachusetts.

"It has long been held that prostitution always has existed and always will exist, and that all remedies will be ineffective and of no avail, because it represents a variation of the most fundamental human instinct.

"Recent studies of prostitution and prostitutes in other cities, states, and countries, and, in connection with this investigation, the study and analysis of 300 prostitutes individually examined for the commission, the observation of prostitutes and prostitution, and of the immoral young girls who have not entered prostitution in cities and towns all over the State, have convinced the commission that this evil is susceptible of successful attack and treatment. The fact that one-half of the women examined were actually feeble-minded clears the way for successful treatment for this portion of this class. The mental status of the prostitutes under arrest should be determined, and such of them as are found to be feeble-minded or defective delinquents should be placed under custodial treatment. Thus would these women themselves be saved from an evil fate, pimps and procurers would lose their willing prey, and a non-self-supporting class who find in prostitution their only way of earning a living would be taken out of the community.

"The recognition of feeble-minded girls at an early age in the public schools, and proper provision for their protection in the community or custodial care in an institution, would prevent much of the observed immorality among young girls and the resulting temptations to boys. Precocious sex interests and practices are well-known symptoms of feeble-mindedness."

The situation, then, may be summarized as follows: at least three-fourths of all cases of mental disorders occur on the basis of bad heredity, alcoholism, drug addictions, or syphilis; an individual who is of normal ancestry, abstains from alcohol and habit forming drugs and remains free from syphilitic infection is not seriously threatened with a mental disorder. But since alcoholism and syphilis are, in their turn, so generally connected either directly or indirectly with inherent mental defectiveness, it follows that heredity is, as long taught with characteristic clearness of thought and diction by the French school of psychiatry, the cause of causes of mental disorders.

It may safely be said, therefore, that a movement for the prevention of mental disorders will lead the race in no mistaken path if it concentrates the bulk of its energies on the problem of bad heredity.