Geographical Distribution of Insanity 363 



Outline Map No. II. — Number Population for Each Insane Person, Census 1880 



temperature and barometric pressure, 

 or, on the other hand, where the mean 

 humidity is high or low, and, further, 

 if these conditions can not be shown to 

 have a causative effect upon its distri- 

 bution, what has? 



Let us start our inquiry by a stud}' 

 of a map of the United States upon 

 each state and territory of which the 

 ratio of insane to 100,000 population is 

 indicated, in accordance with the census 

 returns for 1880 (see outline maps Nos. 

 I and II). We are at once confronted 

 with a condition of affairs which is so 

 well marked that when I first saw it I 

 was very much surprised. The great- 

 est proportion of insanity is in the 

 Northeast — in the New England and 

 Middle States — of which New Hamp- 

 shire, Vermont, Massachusetts, Con- 

 necticut, and New York all have one in- 

 sane person to less than 400 of the pop- 

 ulation. If from this center of greatest 

 prevalence of insanity we draw a line in 



any direction — West, South, or South- 

 west — we see that no matter which way 

 we go we find a steady decrease until 

 we strike the Pacific slope. A slight 

 interruption of the continuity of the 

 decrease is noted in Michigan as we go 

 west, but is, I think, of little conse- 

 quence. As we go south along the 

 coast Delaware appears as a marked 

 exception. This is due to the fact that 

 previous to the organization of the Dela- 

 ware state hospital in 1889 no statistics 

 of insanity were reliable. The insane 

 were county charges and the care given 

 them was so atrociously bad that every 

 one took pains to conceal cases occur- 

 ring in their families. Despite these 

 minor variations the decrease of insan- 

 ity as we go from the northeastern part 

 of the United States— South, West, or 

 Southwest — must strike you as being 

 remarkably uniform and constant. This 

 uniform decrease only takes place if we 

 start from this northeastern center. If, 



