tion only of those sent are entirely subject to the control of the management. In one of these three institutions, adults over twenty years are thus admitted; in the second, females between the ages of sixteen and forty-five years; in the other, patients who are committed as custodial. In two institutions the matter has never been pushed to a final decision. In one the matter is left entirely to the superintendent, who regards the wishes of the parents as supreme, even in cases where children have proved very troublesome in their neighborhood, and the probate judges have protested against their discharge. In ten the superintendents know of no legal right that they have to detain cases, although they throw all the moral influence they possess against such release in improper instances.

The possible reason why rules regarding removals are not more stringent may be from the fact that many of the old institutions were opened as schools, when their object was to instruct children as thoroughly as possible, with a view to dismissal to their homes at a fixed period. That hope—that mental weakness, in many cases at least, was a temporary condition, which could be largely or wholly removed by the proper system of training - has been disappointed. Institutions have changed their character, largely, to furnish a permanent residence with congenial surroundings for these unfortunates; but the rules regarding the admissions and discharges have remained without any radical change. If the question of discharge were left to probate or county judges, they change quite frequently, or they forget the exact circumstances under which children were sent to institutions, or they yield to importunities of friends or influential neighbors. In any case they can hardly form as accurate a judgment of inmates as those who are brought in daily contact with them. I have myself seen more than one instance of that. Should we honor the claims of parents who practically abandon their children during their more hopeless days, and only desire their return when they are sufficiently instructed to become profitable to them? Should we do this when their tendencies are such as would lead to their ruin, and the parents lack either the character or ability to restrain them? Where the permanent good of the child is not affected and the home is suitable, the custody not only might, but should, be transferred. But I have seen too many cases where children have been practically abandoned, where no inquiry has been made regarding them for long periods. When, however, the children were sufficiently developed as

to promise to become a source of revenue, the affection for them was rekindled with a suddenness and violence that was almost startling; and the parents have insisted that their children no longer be subjected to the "deprivation and confinement" of the institution. This sudden interest does not always endure for any long period after they are informed that the state will still retain the guardianship of the child.

Of what do we deprive the confirmed imbecile that he needs to make his life complete and happy, who has been separated from his family, by making him a permanent resident in an institution? I recently asked the aunt of three of our charges, from a family that contained a large number of irresponsibles, what she could give the children that we could not furnish. She said she could think of nothing but more liberty, which was the last thing that these girls could safely have. We often hear the phrase of "lifelong confinement" used. But why should the institution be made a place of confinement? It constitutes a community, or colony, as large as a reasonably complete village, where they can have all needed entertainment suited to their mental capacity, and life's greatest boon, usefulness, which constitutes pure happiness, through occupation that their limited ability is capable of pursuing. In the Wisconsin institution and I think the same is true of all others of a similar character - our brighter boys have free range of the institution grounds, with the stipulation that they shall keep absolutely away from the girls' buildings and out of all mischief,- a privilege which they rarely abuse. Our girls are allowed less liberty, but can go almost anywhere under no more supervision than they absolutely require. Is this not safer and better than the sidewalks and street corners ? What further liberty could they have in safety? They are denied the privilege of marrying; but is this not right? Where children are to be returned to parents who are able and willing to care for them, no shadow of opposition is placed in their way.

Supplementing this control, a law should be passed in all states curtailing the right of known defectives to marry or any one to join them in marriage. Attempts have been made in several states for passing such a law. In many others, however, nothing has been accomplished. This has been due partly to the indifference of those on whom this responsibility should fall, partly to the indifference of legislators who do not fully realize the harm, as well as the bless

ings, which the marriage tie brings, and partly to the effort to pass laws so stringent in their provision as to be repulsive to the public, and which would probably be impracticable of enforcement if passed.

I know of no law better than that in the State of Connecticut, which is so simple in its provision, and yet imposes penalties so severe on those who violate its provisions, that it appears to me ideal. It confines itself simply to the provisions of marriage between known defectives, and, further, prevents people of normal mind from contracting marriage or living as husband and wife with any such person. This prevents marriage in other states and return for the purpose of evading the statute. Laws which contain a much wider provision than that, and especially laws which impose physical examination or other hardship on those who have no moral or mental fault, would be extremely difficult of enforcement; and no law at all is better than a dead law. I have been somewhat interested in noting the objections which have been raised against this effort toward curtailing this source of increase among the defective classes. One is that the law could never be fully enforced. I do not think that any law was ever passed with the expectation that it would entirely control or prevent the evil at which it was aimed. The most that could be expected or even hoped for would be that it would mitigate the evil to some extent, and serve even the better purpose of drawing public attention to the fault at which it was aimed, and the desirability of its extinction. A medical journal of high standing recently stated that the laws of degeneracy were always active, and, if this law was effective in this generation, in the next we would still find defectives. This is certainly true, but they would be found in greatly diminished numbers.

When the state has taken the imbecile, and by training has brought out the best there is in him, when it has corrected his faults, so far as education can do it, when it has possibly taught him to read and write, to be more engaging in his manners and more attractive in appearance and bearing, and then has discharged him with his inherent defects in no ways removed, to marry and perpetuate his kind, has it really done a commendable deed? Using the words of a former president of this Conference, it should rather say to each one: "My child, your life has been one succession of failYou cannot feed and clothe yourself honestly: you cannot con

ures.

trol your appetites and passions. Left to yourself, you are not only useless, but mischievous. Henceforth I shall care for you." Instead it should give him such community to live in as would be entirely suited to his needs and desires. The large number of residents should be divided into families, where the imbecile of high mental grade should not be forced to mingle with those of much lower mental powers except as care-takers. In such capacity of care-takers they readily grasp the dignity of their position, and have no tendency to copy the characteristics of those depending on them. The vicious should be separated from the harmless. Each child should be educated, as every American child should be, to the extent of his capacity. His whole education should be preparatory to a career of usefulness in his immediate community. Each child should be given the utmost liberty that his condition would allow; and this care should be continued, at least until such time as the danger of perpetuating his kind should cease. Given such conditions, I am confident that every one who can speak from experience on the subject will support me in the statement that a very large majority of our children would find themselves more at home under such circumstances than they would under other surroundings, and that those who would not thus be satisfied are children whose vicious tendencies crave the entire removal of restraint, that such tendencies may be exercised. The measures I have described do not apply to a large proportion of our inmates. The helpless idiot appeals only to our sympathy, and his best friend is rather the nurse than the teacher. The child from the good home may certainly be returned there, though we sometimes find that he is not always satisfied, and longs for the company of those with whom he is congenial. Those who are engaged in the noble charity of finding homes for the homeless find, occasionally, one who is not acceptable. The superintendents of institutions for the improvement and reform of youth of both sexes find a few whose minds are sterile ground, so far as planting seeds of morality and rectitude are concerned, and are found to be more sinned against than sinning; for their temperament is their birthright. Girls are found in homes who never acquire the most precious qualities of true womanhood, and find on the street the most congenial associations. They are found in very small proportion anywhere; but their aggregate number is enormous, their influence on our social life is most unfortunate, and their

power of increasing and transmitting evil is the more to be feared. because so little appreciated.

I beg the influence of those assembled toward the attainment of such condition of affairs that no living soul shall be allowed to enter this life handicapped with the strong probability of a career of suffering, of crime, of poverty, or persistent mental degradation, where it can be foreseen and prevented, confident that the public opinion on this point would certainly allow the adoption of measures to reduce this evil to a minimum.

THE IMBECILE AND EPILEPTIC versus THE
TAX-PAYER AND THE COMMUNITY.

BY MARTIN W. BARR, M.D.,

CHIEF PHYSICIAN OF PENNSYLVANIA TRAINING SCHOOL FOR FEEBLE-MINDED CHILDREN, ELWYN, PA.

Of all dependent classes there are none that drain so entirely the social and financial life of the body politic as the imbecile, unless it be its close associate, the epileptic.

Charitable associations, state and municipal authorities, awakening to the need of self-preservation in disposing of such increasing numbers, are striving to provide for both dependent and delinquent classes, but too often with a sad mixing up of the two, whether from lack of co-ordinated effort or of ignorance. Only the other day I noticed an order for the removal of a number of cripples and feeble-minded from a house of correction as a place wholly unsuitable.

Now there is much the same misapprehension in the distribution of mental defectives,- those whom the public know only under the one name of idiots. It would be well for all, could it once be clearly understood that the effort to include helpless idiots, trainable imbeciles of all grades, incorrigibles, and epileptics all under one jurisdiction but defeats its own end in not getting the best returns for amounts expended.