In early life chiefly the degenerative or the hereditary type of insanity occurs, or some modification of it. The prevalent forms coming next are insanity of puberty and adolescence and the curious morbid psychological developments of lying, stealing, running away from home, all sorts of perversity of action and thought—impulse overpowering reason; often resulting in cure if wisely treated, but not seldom ending in various forms of so-called moral insanity, suicide, epilepsy, hysteria, primary insanity, prostitution, and offences against the laws. It is largely a matter of accident rather than a result of any established principle whether such boys and girls are sent to reformatories and prisons or to insane asylums. In the progressively advancing years of life organic {117} mental disease and the psychoneuroses are more common, the favorable or unfavorable type of which depends largely upon the degree of degenerative tendency in each case. The exhaustion and the disturbed cerebral circulation arising from acute and chronic diseases, profound anæmia, or prolonged mental strain, associated with emotional disturbance from any cause, are among the antecedents of insanity. By our asylum reports ill-health is second only to intemperance as an exciting cause of insanity, and ill-health comes probably more largely from poverty than from any other direct cause. Diseases and accidents to the mother during gestation and injuries to the infant's head during parturition may reasonably be supposed to so affect the fœtal brain as to predispose to insanity in later life. Of 18,422 admissions tabulated from reports of Massachusetts asylums, the prevalence of insanity by ages was approximately as follows: