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che anadian ne. But obviously this fact Western legislation is superior.

in assuming, for example, simply because the York has more insane persons per capita than ition is responsible for this difference. Yet been used repeatedly as an argument in favor legislation.

to be convincing must be made between - in every particular. Kansas and Nebraska ty in a more striking degree than almost any the Union. They are closely similar in size e geographical distribution of the population, relatively thickly settled eastern half, while sparsely settled. They have practically the native whites, negroes, foreign-born whites, nales, percentage of illiterates, percentage of d percentage of increase in rural population. y large city, and their gain in general populasus period was practically the same, Kansas while Nebraska gained 11.

they are strikingly similar in every important methods of controlling liquor traffic. Let us on between their insane populations will show. tistics issued recently by the Census Bureau of insanity committed per 100,000 population from 62.2 in 1904 to 52.4 in 1910. Meanwhile s a decrease from 62.1 (practically the same as 34.5 per 100,000 in 1910. Moreover, there

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oboration along other lines. Fortunately in this instance we ha ich evidence in the index given by the alcoholic psychoses.

It is understood, of course, that the excessive use of alco ay affect the mentality without producing alcoholic insani nd that indirectly it may be a factor in producing certain for f insanity without the usual manifestations of alcoholism. I he forms of insanity included in the well-defined group known he alcoholic psychoses are the direct result of the use of alcohol

It is apparent, therefore, that the number of cases of alcoh sanity committed to the institutions of similar communities ive a fairly accurate index to the relative amount of alcohol c umed. If prohibition is really effective, as claimed, such Sta s Kansas and North Dakota should have no alcoholic insani r, at worst, should make a far better showing than the lice tates, Nebraska and South Dakota. What the records rea how is as follows.

In the North Dakota Hospital for the insane a little less th per cent. of the patients admitted in 1910 had alcoholic insani n South Dakota the percentage of this form of insanity was j ver one per cent. in 1912. In the Nebraska hospitals the avera ercentage of alcoholic psychoses admitted last year was a lit ver 4 per cent. Meanwhile the Kansas hospitals admitted 5 ent. of this form of insanity during the same period.*

*This is the figure given by an officer of the Kansas State Hospitals ice after a careful study of the subject. The printed reports give this p entage as slightly lower, but the officer's estimate is probably correct. everal other instances I have been greatly aided by personal reports made taff members, and these reports are particularly valuable, since in seve nstitutions the printed classification of patients is wholly inadequate.

But this does not alter the fong-known fact

venereal diseases are usually concomitant here are eminent psychiatrists who maintain _ndirectly productive of paresis, judging from esis in communities addicted to alcoholic

therefore, that in communities where there olic insanity there will be a high percentage sa. It is not an absolute index in either case, nination of the records of a large number of his evidence is at least strongly confirmatory. to find, for example, in the Manhattan State its patients from New York City and has a oholic psychoses, a far higher percentage of al State of Iowa. And we do actually find e years there has been an average percentage to .09 of alcoholic psychoses in the Manhattan of paresis to about .05 of alcoholic insanity period.

herefore, to find that North Dakota in 1910 cases of paresis to about 4 per cent. alcoholic cota, paresis about 2 per cent. to alcoholic t. in 1912; Nebraska, paresis a little over 6 psychoses something over 4 per cent., and in hich I am assured by its officers is representaparesis 8 per cent. to alcoholic psychoses 5

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On the contrary, the facts seem to substantiate the claims e license advocates that in prohibition States the relative c umption of spirituous liquors is increased, and the amount of m everages diminished. For whiskey, not beer, is the cause of m coholic psychoses.

It has been suggested that the relatively small number of insa this group of Western States "may be simply an evidence of h porly these unfortunates are cared for." But such a suggest entirely unwarranted. The Western hospitals for the insa dividually and collectively, make as good a showing in ev articular as any group of similar institutions in the East.

The work done in the State Hospital for the Insane at Tope or example, and the hospital itself, compares favorably with a E the New York institutions. The superintendent, Dr. T. iddle, a veteran in psychiatry, is a man of progressive ideas a nusual executive ability. In addition, he has the rare facu f "putting the right man in the right place," as illustrated by ork done by the members of his staff.

The hospital itself affords opportunity for the most advan ethods of studying and treating insanity. The new Psychopat [ospital, completed last year, is one of the best in the country. the result of Dr. Biddle's long and careful personal studies milar institutions, East and West, and represents a combination Il their good qualities. Its equipment is complete, and the metho f observing and recording cases are thorough and systematic.

The laws governing the commitment and care of the insane Cansas, while unfortunate in some respects, are good as a wh

braska, or the Dakotas. So that the suganity rate is due to ignorance or indifference

on seems to be that the people and their = are different from those in the East-a on the average, with much better surrounde native Americans, and, as compared with fortable circumstances. Great wealth and unusual conditions there, and the average much higher than in most Eastern States. hown conspicuously in the character of the ne hospitals, who present a striking contrast New York or Massachusetts hospitals. The ypes that are the product of city slums are s of ignorant foreigners that congests our is practically unknown.

d in believing that Kansas and her sister general conditions, rather than any special on, for their relatively small insane popuedical Record, November, 1913)

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