A comparison of the more important psychoses represented by the various races, as reported by the New York State Hospital Commission in 1918, is shown in the following table[75]:—
| Psychoses | African | German | Hebrew | Irish | Italian | Slavonic | Mixed |
|---|---|---|---|---|---|---|---|
| Senile | 5.2 | 11.6 | 5.8 | 13.2 | 6.2 | 1.6 | 10.2 |
| General paralysis | 21.3 | 17.3 | 13.3 | 9.9 | 19.1 | 6.7 | 13.1 |
| Alcoholic | 5.2 | 4.5 | 0.2 | 10.6 | 2.3 | 10.3 | 4.5 |
| Manic-depressive | 12.4 | 12.2 | 24.0 | 9.8 | 22.0 | 14.0 | 12.4 |
| Dementia praecox | 29.6 | 25.5 | 35.2 | 26.7 | 26.6 | 47.3 | 24.0 |
Some variation is shown by a similar analysis of the New York admissions for the year 1919, as is illustrated by the following table[76]:—
| Psychoses | African | German | Hebrew | Irish | Italian | Slavonic | Mixed |
|---|---|---|---|---|---|---|---|
| Senile | 8.0 | 12.7 | 6.9 | 14.9 | 4.9 | 1.6 | 11.5 |
| General paralysis | 15.7 | 15.1 | 11.5 | 12.0 | 16.2 | 9.2 | 12.3 |
| Alcoholic | 4.0 | 4.0 | 0.4 | 7.9 | 2.4 | 7.0 | 3.0 |
| Manic-depressive | 10.4 | 13.7 | 21.6 | 11.1 | 20.6 | 17.6 | 13.1 |
| Dementia praecox | 31.3 | 24.2 | 32.0 | 25.5 | 29.7 | 42.3 | 23.8 |
For purposes of comparison an analysis of the psychoses shown by various races in the admissions of the Massachusetts state hospitals for a period of three years is added (1917-1918-1919):—
| Senile | Arterio- | General | Alco- | Manic- | Dementia | ||
|---|---|---|---|---|---|---|---|
| Race | No. | Psychoses | sclerosis | Paresis | holic | Depressive | Praecox |
| African | 211 | 5.68% | 4.73% | 6.16% | 7.10% | 4.26% | 27.96% |
| English | 3281 | 10.75 | 9.87 | 7.46 | 5.76 | 9.99 | 18.65 |
| French | 647 | 6.64 | 6.95 | 12.05 | 8.19 | 6.80 | 24.88 |
| German | 283 | 6.00 | 7.77 | 10.60 | 9.92 | 12.01 | 21.20 |
| Hebrew | 353 | .56 | 2.26 | 5.66 | 1.41 | 10.19 | 37.11 |
| Irish | 2994 | 9.01 | 7.11 | 7.11 | 16.13 | 7.11 | 23.31 |
| Italian | 522 | 3.44 | 2.66 | 7.66 | 5.34 | 10.34 | 35.44 |
| Mixed | 1244 | 8.76 | 12.62 | 7.70 | 8.11 | 7.55 | 24.35 |
| Slavonic | 635 | 6.77 | 7.08 | 12.28 | 8.35 | 6.93 | 25.20 |
This shows some very interesting results. It will be noted that the Hebrews and Italians have the highest rate for dementia praecox, the percentage shown by these races being much higher than any of the others. The Germans, Italians and Hebrews, in the order mentioned, have the highest rates for manic-depressive psychoses. The frequency of alcoholic psychoses as shown by the Irish is nearly double that of any of the others. The Slavonic race has the highest rate for general paresis, followed in close succession by the French and Germans. The highest rate for senile and arteriosclerotic psychoses combined is shown by the races of mixed origin, the next highest by the English, closely followed by the Irish. The most common psychosis in every instance is dementia praecox. In the admissions to the institutions for the criminal insane in New York the highest percentages are represented by the Irish, Italian and Hebrew races, as shown in another chapter. During a period of six years (1912 to 1918) a study of first admissions to the New York state hospitals shows an incidence of dementia praecox in the native-born of 75.2 per hundred thousand of the population and in the foreign born of 161.4. The importance of this is shown by the fact that over fifty per cent of the entire hospital population is made up of cases of dementia praecox.
The necessity of some supervision of immigration for the purpose of preventing the entrance of undesirable aliens has long been recognized. As early as 1824 the state of New York tried by legislation to prevent the admission of the insane and mental defectives. This effort was a failure, probably owing to the fact that the proposed enactments would have compelled the companies responsible for the entrance of undesirable aliens to remove them if they became a public charge. The introduction of discordant racial elements from abroad at one time disturbed the equilibrium of the entire country. The agitation for the restriction of immigration before the civil war led to the formation of a political organization known as the "Native American" or "Know Nothing" party, as it was usually called. It at one time had forty representatives in Congress and nominated a candidate for President in 1856. These disturbed conditions led to the consideration of this subject by Congress as early as 1838 and the Judiciary Committee recommended legislation prohibiting the entrance of idiots, lunatics and those suffering from incurable diseases or convicted of crime. The action of several foreign countries in pardoning murderers with the provision that they should emigrate to the United States led to a resolution of protest by Congress in 1860 and shortly thereafter a statute intended to encourage immigration was repealed. An investigation made by the United States Immigration Commission brought to light the fact that the great influx of foreigners was largely caused by the agents of the steamboat companies abroad and that they had "five or six thousand ticket agents in Galicia alone."[77]
The activities of those opposed to the indiscriminate entrance of objectionable aliens led to the federal enactment of August 3, 1882. The Secretary of the Treasury was charged with the duty of prohibiting the landing of lunatics, idiots and persons liable to become a public charge. The provisions for the execution of this law were not satisfactory and it was amended by an act of 1891. This made it a misdemeanor to bring in any of the above proscribed classes and imposed a fine of over one thousand dollars upon anyone guilty of so doing. Section 11 provided that aliens entering in violation of this law could be returned at any time within one year thereafter at the expense of the person or persons, vessel, transportation company or corporation responsible for their entry, and further, that those becoming public charges within one year from causes existing prior to landing should be considered as having entered in violation of law. The provisions of this statute were unchanged until the act of March 3, 1903. This excluded persons insane within five years previous to landing, those having had two or more previous attacks at any time, paupers and all others liable to become a public charge. Section 17 delegated to the officers of the United States Public Health Service the duty of determining the condition of all immigrants. Section 20 provided that aliens coming to the United States in violation of law, or who were found to be public charges from causes existing prior to landing, could be deported at any time within two years. Section 21 authorized the Secretary of Commerce and Labor to deport any alien within three years of entering in violation of the act.
An important step in the legislative restriction of immigration was the amendment of Feb. 20, 1907. This made mandatory the exclusion of idiots, imbeciles, the feebleminded, epileptics, insane, all who had been insane within five years and persons having had two or more attacks of insanity at any time, or who were likely to become a public charge, as well as individuals not comprehended in the foregoing excluded classes but found to be suffering from mental or physical defects of such a nature as to affect their ability to earn a living. Section 20 provided that an alien entering in violation of law or becoming a public charge from causes existing prior to landing should, upon the warrant of the Secretary of Commerce and Labor, be taken into custody and deported to the country from whence he came at any time within three years after the date of his entry into the United States. The cost of this removal was to be a charge upon the owners of the vessel or transportation line immediately responsible. When the mental or physical condition of the alien was such as to require personal care or attention, the Secretary of Commerce and Labor was authorized to employ a suitable person for that purpose. This was a great step in advance. There were, however, some very great difficulties to be overcome. The force placed at the disposal of the Public Health Service for the inspection and examination of incoming immigrants was entirely inadequate and one or two men were sometimes responsible for the examination of several thousands aliens in a day. This was, of course, impossible. The burden of proof in showing that the mental condition was due to causes existing prior to landing, furthermore, devolved upon the persons requesting deportation. It was impossible in many instances to submit actual proof even where there could be no reasonable doubt as to the facts. This led to great difficulties and much dissatisfaction. Another serious objection to the provisions of this law was the requirement that only such persons could be deported as were likely to become a public charge. In many instances such persons were supported by private funds until they were no longer deportable, after which they became a burden upon the state in which they resided.