270 J. H. LANDMAN 



soon remedy this disproportionate representation of foreigners in the hos- 

 pitals for mental disease. 



Mental disease is a disease of adult life. Psychotic disorders in children 

 are rarities. Only 1.5 per cent of the mentally diseased patients are under 

 twenty years. The percentage in the successive quinquennial age groups 

 increases up to the group forty to forty-four years. With the decline of the 

 birth rate, the constancy of the death rate, and the general advances in 

 medicine and sanitation, we may anticipate the baneful result of a statistical 

 increase in the number of psychotics in the next decades. The dementia 

 praecox group of psychoses comprises about 43 per cent of all the psychoses, 

 the manic-depressive group, 15.3 per cent, and the other psychoses appear 

 in much smaller percentages. The frequencies of dementia praecox and 

 manic-depressive psychoses are so great and their resistance to treatment 

 are so stubborn that the situations are alarming. 



More than 52 per cent of the patients in all institutions are in institutions 

 for nervous and mental disorders. There were 427,135 patients in the 

 hospitals for nervous and mental cases in 1931. The American Medical 

 Association reports for the year 1931 that the average number of patients 

 constantly in all the hospitals of our country was 775,396 and for the year 

 1930, the average number was 763,382. The records of previous years show 

 a constant increase, i.e., 553,133 for the year 1923; 629,362 for the year 1925; 

 671,832 for the year 1927; 702,738 for the year 1928; and 726,766 for the 

 year 1929. 



In 1934 we have more than one-half million people in our nervous and 

 mental institutions, alone. Based on the census of the number of people 

 in the United States in 1930, one out of every 160 people in the United 

 States during 1930 was a patient in a hospital of some kind. One out of 

 every 290 people was a patient in an institution for nervous and mental 

 disorders, a larger proportion than for any other group of institutions. 

 From every 100,000 persons of the general population of the United States 

 there were 76 patients with mental disease, and 7.7 mental defectives and 

 1.2 epileptics admitted to institutions during the year July 1, 1928 to June 

 30, 1929. For every 100,000 persons of the general population there were 

 in the hospitals, schools and institutions at the end of the year 277.7 persons 

 with mental disease, 50.6 mental defectives and 8.1 epileptics. 



In the country as a whole, the number of feeble-minded and epileptics 

 under institutional care shows a steady increase, as shown by the following 

 figures: January 1, 1922, 43,579; January 1, 1923, 46,580; January 1, 1927, 

 58,367; January 1, 1928, 60,412; January 1, 1929, 64,253. Families that 



