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The excessive proportion of the deaf and dumb at ages between 60 and 80 is extraordinary and difficult of explanation.

Of the total number of deaf-mutes, 350 (194 males and 156 females) are returned as having been affected from birth. The acquired defect is therefore less than the congenital, of the former being to those of the latter as 100 to 110.

Among the principal causes assigned for the cases of the acquired deafness upon which the loss of speech so largely depends, the following may be mentioned: --

Scarlet fever is charged with 112 cases. Is not this a suggestive fact to be considered in connection with efforts for the prevention and limitation of this infectious disease? Of the cases of deaf-dumbness not congenital, scarlet fever is blamed, and probably upon good grounds, for nearly one-third.

Various forms of fever, other than scarlet fever, caused 29 cases.

Falls and other accidents caused injury in 28 cases which resulted in deaf-mutism.

Eighteen cases are ascribed to measles.

Cerebro-spinal meningitis is the alleged cause of 15 cases.

Inflammatory affections of the ear, of a nature not specified, caused loss of speech and hearing in fourteen instances.

Of diseases of the nervous system, we have paralysis (4), hydrocephalus (5), disease of the spine (6); in all, 15 cases.

The less direct and definite causes assigned were scrofula, whooping-cough, convulsions, cholera infantum, and croup.

Small-pox and diphtheria were credited with one case each.

The Idiotic.

The total number of persons described as idiotic or imbecile in the population of Massachusetts is 1,340. Compared with the entire population, this number gives a ratio of one idiot in every 1,232 persons. This ratio is considerably less than that found in England and Wales in 1871 (one in 771), but it exceeds that found according to the census of Massachusetts in 1865 (one in 1,468). The most careful and alto trustworthy enumeration of the lunatic and idiotic classes in Massachusetts with which we are familiar is that undertaken in 1854 by a commission on lunacy appointed under a legislative resolution. According to the report of this commission, (4) Dr. Jarvis found as the result of correspondence with the physicians in all parts of the State, and by means of careful research, that the idiotic class was then in the proportion of one in 1,034 of the entire population. This ratio is based upon a much more careful canvass than is likely to occur where the ordinary agencies of the census are employed, and is probably as nearly accurate as is practicable. Persons are naturally sensitive about giving information con the mental deficiencies of their kindred, idiocy being generally regarded as a humiliating infirmity, to be concealed rather than described in detail to official canvassers. Especially would this condition of feeling be found in cities where cases of idiocy are less a matter of common cognizance than in rural communities in which family affairs arc kept private with comparative difficulty. But the medical profession, the family physicians of the State, while they appreciate the technical distinction between mental defect or idiocy and mental disease or insanity, are able also to give exact numerical data of the cases which at one time and another come under their charge.

The number of idiots ascertained by the census, approach as it does the proportion found by Dr. Jarvis twenty years ago, is undoubtedly a close approximation to the exact statistics of idiocy in Massachusetts at the present time. The diminution in the ratio may be explained partially by the increased number of immigrants within our territory, who, in forsaking their homes for a new world, have left behind them as far as might be those of their kindred who would encumber them in the efforts to get a living. Idiocy is distributed among the counties of Massachusetts as follows: --

The Idiotic in Massachusetts, their number in each County in 1875, and their proportion to the General Population.

It will be observed that considerable diversity is shown with regard to idiocy in the several counties; the proportion varies from one in 510 in Barnstable to one in 1,779 in Suffolk. If we omit from the account of Suffolk the 94 inmates of the Massachusetts School for Idiotic and Feeble-Minded Youth (the only public institution of the kind in the State) , the ratio for that county would be considerably lessened, -- one in 3, 287 . The excess of idiocy in the country as compared with the city finds most ready explanation in the facts already suggested concerning the migration of people to the centres of population these centres attracting not only the younger and stronger elements from foreign lands, but the productive and self-sustaining portion of the native stock from our own rural sections.