fact of the number of insane persons under care and treatment." Yet a glance at his tables shows that forty-two per cent of the cases admitted to the New York State hospitals for the year ending September 30, 1895, are to be noted as suffering from constitutional degeneracies, and so presumably to be incurable. The more than twenty per cent of cases of insanity reported to have had hereditary antecedents, although undoubtedly as accurate as possible under the circumstances, merely chronicle the more obvious matters, and must necessarily have left out of account all the less obvious but in many respects even more important ones. And so with all the other series thus far published. They are good as indicating where we are to look for some of the steps toward insanity, but for the most part they are quite inadequate for a basis of comprehensive discussion or anything like accurate conclusion.
The pressing need, then, is that there shall be obtained a series of statistics which shall be founded upon the most definite, penetrating, and far-reaching studies of cases that it is possible for the trained scientist, with the help of an intelligent, willing laity, to make. In this respect it may be said that the assistance of the latter is just as essential as the painstaking devotion of the former; for it is upon the facts which an intelligent laity can observe and report that the scientist can bring his training to bear in such a way as to arrive eventually at accurate and therefore most useful generalizations. But such concurrent observation and study will never be until the public shall have come to look upon insanity as merely an unfortunate disease instead of a stigmatized disgrace, which, with certain exceptions, it should not be considered to be. Nor will this be the case until professional examiners in lunacy shall regularly ask for such family records, and thus create a need for their being made. When both the public as well as the profession lay aside entirely the common notions of a transcendental origin of insanity, and set to work to study the perfectly natural steps through which degeneration and breakdown eventually come to be, all will see the desirability of such health records being accurately and fully kept not only as a help toward determining the nature and prospects of any given case, but also toward preventing the development of those constitutional tendencies which lead to trouble, as well as in helping on those that provide against it.
When we come to study the causes of insanity with a view to successfully preventing it, we are led to the supposition that the nearer to very first steps we can push our investigations the greater will be our service. Remembering that the well-born, well-bred personality generally bears almost every sort of stress with comparative impunity, it becomes us to ask just how does the opposite—the ill-
