THE We Mi OF ERE jUL & 1926 ayers TY OF tM THE PSYCHOPATHIC DELINQUENT Report of Special Committee of the - State Commission of Prisons ~ sa ay THE PSYCHOPATHIC DELINQUENT Report of Special Committee of the State Commission of Prisons TO THE STATE COMMISSION OF PRISONS: At a meeting of the State Commission of Prisons, held June. 2, 1925, the undersigned were appointed a special committee to make a. study of the Psychopathic Delinquent. After an investigation of the records of the State Penal and correctional institutions, conferences with psychiatrists, psychologists and clinical experts, and an examination of special studies, surveys, reports and statistics concerning mentally abnormal and defective delinquents in this and other States, your committee respectfully reports: MENTAL DISEASE AND DELINQUENCY The State Commission of Prisons in 1918 issued a report of a special committee appointed to investigate mental diseases and delinquency. The report showed that the percentages of nervous and mental abnormalities among the inmates examined in the New York State penal and correctional institutions were: Institution Authority Percentage Auburn Prison for Men Dr. FRANK L. HeaAcox 61.7 Sing Sing Prison Dr. BERNARD GLUECK 59. Western House of Refuge for Women Dr. Jessie I.. HERRICK 82.1 New York State Reformatory oe Soe ik AR, 5a Westchester County Penitentiary Dr. BERNARD GLUECK 57. Clinton Prison Dr. V. V. ANDERSON pms On hy eee 2) 2 SPECIAL REPORT ON Feeble-mindedness varied from 21 to 35 per cent. The segregable feeble-minded, unfit for confinement in penal and correctional institutions, constituted at least 15 per cent. Following the report, the State of New York, in 1921, established an institution for the custodial care of mentally defective male delinquents at Napanoch. Previously, a portion of the New York State Reformatory for Women at Bedford was set apart for the custodial care of mentally defective female delinquents. Low grade male feeble-minded delinquents have been, in the main. committed and trans- ferred to the institution at Napanoch. The investigation revealed that a large number of inmates in the penal and correctional institutions were psychopaths. Later clinical studies in the New York State penal and correctional institutions and institutions throughout the country, showed that a good percentage of the inmates are psychopaths. All of the data on this particular class of mental deviates emphasized the need of more definite understanding and more sceintific treatment of the psychopath if the large number of crimes which they com- mit and the economic waste for which they are responsible are to be re- duced. THE PSYCHOPATH During recent years a group of mentally abnormal, designated as psy- chopathie personalities or psychopaths, have been separately classified. No comprehensive definition has been generally accepted. The classifica- tion remains vague or, aS some experts claim, a make-shift, descriptive of mental abnormalities that do not fall under other forms of diagnosis. “It is a term which in the last five years has come to have a more specific meaning, although at the present time it is vague enough * * * * * not enough has yet been written that is specifically representative of the facts’—Dr. WILLIAM HEALY. “Psychopathic as a prefix has come to be a waste basket into which all sorts of things have been thrown. It is a sort of middle ground for the dumping of odds and ends, as the praecox group used to be’”—Dr. WILLIAM A, WHITE. “They are individuals who do not indicate a defect in intelligence nor a definite psychosis, but whose behavior is of an unusual or deviated sort’—Dr. A. L. JACOBY. “A psychopathic individual is one whose mental processes are such that there is the tendency toward the establishment of (1) abnormalities of thought usually in the form of a mental conflict and attended with con- siderable emotional disturbance, (2) a social behavior, (3) a certain con- stancy or periodicity in the appearance of the two foregoing symptoms. Thus psychopathic is simply a generic term which includes all manner of in THE PSYCHOPATHIC DELINQUENT 3 mental disorders. Usually when the asocial behavior becomes marked enough for the individual to be a menace to the community we call him psychotic and place him in an insane asylum. Emotional disturbances in the psychopathic individual are frequent. When the emotional state is fairly pure and mental conflicts are not much in evidence, it would seem preferable to call these people emotionally unstable rather than psycho- pathic. The constitutional psychopathic personality is a subdivision of the _ psychopathic”—Dr. V, C. BRANHAM. —-_—— Although psychopaths have not been clearly delineated, sufficient of their mental characteristics have been observed and tabulated to be recog- nized as underlying causes of misbehavior, inefficiency and delinquency. Certain distinctive abnormalities characterize the psychopath. Some of them are found in one personality and some in others in varying degrees and may, in part, be summarized as emotional instability, volitional con- flicts, disassociation of ideas, excessive excitability and irritability, spas- modic impulses, abrupt changes of personality, extreme egotism, excessive and unnatural sex indulgences, unmoral reaction and persistent or periodic anti-social behavior. Psychopaths are loosely classified into three groups:—The emotion- ally unstable, the inadequate, and the paranoid or egocentric. The dis- tinctions are not rigid, as personalities diagnosed in one group may show evidence of abnormalities attributed to other groups. The emotionally nnstable posesses average intelligence. They are, how- ever, dominated by their emotions and are impulsive, excitable, hysterical, changeable, and their behavior is uncertain, inconsistent and undependable. The inadequate have inferior intelligence and their psychopathic state is often complicated with some other form of psychosis. They find it diffi- cult to control their volitions, successfully accomplish ordinary duties, fail in simple and sustained effort and easily fall into self-indulgence, vice and delinquency. The paranoid or egocentric, while intelligent, are illogical and self- centered, almost approaching delusion. They are egotistical, arrogant, cruel, selfish, resentful, moody and desperate, often displaying great physi- cal courage. The psychopath is distinguished from the feeble-minded, although both mental states may exist in the same person. The psychopath does not or- dinarily have a low intelligence quotient. Some of them are intellectually brilliant. The eccentricities of some geniuses indicate a psychopathic per- sonality. Many of them are superficially bright but vague, incapable and futile. The psychopath should not be confused with the insane. The margin between the simpler forms of insanity and extreme psychoputhie manifes- tations is at times thin. and the actually insane are sometimes classified as psychopaths. Dr. William J. Hickson, referring to the psychopathic classification, says: “It is used mostly, though perhaps unknowingly, by many workers to designate dementia praecox simplex and the lighter forms of dementia praecox hebephrenia and katatonia.” 4 SPECIAL REPORT ON The psychopathic personality was at one time attributed solely to con- stitutional, congenital and pathological causes. Inherited nervous (is- arrangements, congenital disturbance of the endocrine glands, physical and mental affections of the mother during pregnancy are responsible for psy- chopathic conditions, Later studies are pointed out that many psychopaths believed to be constitutional may be the product of environmental influences, emotional crisis, psychological changes and other causes in early years, which have - produced a deviated or abnormal state of mind. In a symposium on the subject, published in the January, 1924, number of “Mental Hygiene” and arranged by Dr. Ben Karpman, Dr. William A. White and associates of St. Elizabeth Hospital, discuss the probability that psychopaths, or a good proportion of them, may be the product of post natal conditions and ex- periences. Considering the multitude of psychopaths, this viewpoint, if correct, opens wide the door for treatment and readjustment. The old prognosis, like that of the discredited criminal type, created a hopeless class. Dr. White says: “The term constitutional, as qualifying psychopath, is unfortunate because it indicates that necessarily the condition is congenital and in- herited and therefore hopeless. It were better, I believe, to leave that ques- tion open until it can be solved unequivocally. The psychoanalytic school has taught us how what appear to be well marked constitutional character traits may,be traced to early infantile fixations and how they may be modi- fied by psychotherapy.” Children early show evidence of psychopathic personality. Many of them, it is highly probable, are the victims of heredity. Defective glands, constitutional nerve mal-adjustments and congenital defects mark them. It is equally probable that a larger proportion than is generally realized are the product of environment, emotional and otber post natal causes. It is advanced that the psychopathic manifestations in children, both constitu- tional and acquired, are in a developing state and do not become fixed until adolescence. As the facts are still so indefinite and the subject so unsettled, some psychiatrists claim that children should not be stigmatized as psychopaths but be classified as emotionally unstable or pre-psychopathic. Dr. Sanger Brown, 2nd, in an article published in the Medical Journal and Record, August 6, 1924, says: “If we are to use the term psychopathic, therefore, as applied to children, we must realize that we are not talking about the same condition as psychiatrists mean when they speak of a psychopathic state in an adult. Possibly these nervous conditions and bad environmental conditions and physical defects, handicap the developing child in such a way that he may indeed become psychopathic in later years. Certainly those who have had experience in schools and clinics see young people to whom such a term is applicable. One suggestion would be, therefore, to use the term psy cho- pathic as applicable only to adolescents and adults, and not children, _USIRE a more descriptive term for the latter. Ww THE PSYCHOPATHIC DELINQUENT 5 “In any case, it is interesting to see the soil from which the adult psy- chopaths may develop. They develop from conditions which are recog- nizable during childhood and possibly avoidable.” The National Committee for Mental Hygiene have from time to time made State-wide surveys and special studies in various parts of the United States. A report recently issued combining the results of these surveys of school children in twelve widely separated States showed that 2.1 per cent. of them are psychopathic. The following table of 52,514 school children was kindly furnished to the Committee: Mental Diagnosis Number Percent. (a ey Rha hap te cy RO aa a 32,948 62.7 nr 1,789 3.4 OLY PA a EO Pees peed eae Pee era Reena Seen eee ore oe 9,183 17.5 Beno ere ouacoil (ioe wos toll iunuw ii Auer hi | 5.3 Borderline mental defect ~.-_____-___~_ ot os pil 1,922 ed TOC Ue cen, a ee ek ee 1,659 3.2 SeEICIEL IC) ee ee ee 69 0.1 ee COC eee eee cin as ee aici 488 0.9 Psychopathic personality ..:.-_.-..-..--..-- ta ew 1,098 mal Bemeuetienrosesr ys; wou Coo lis erty 2g) ta oooe 177 0.3 imileneion vor! epilepsy” a. eo Ue eh ee) a ee 9 pene rr nn Se ee oe 78 0.1 Pemerrineinbalance, Lotte vo ee ee 182 0.3 PoSstrauinate Constitution 2-2-2 ok le 1 ates Cee inet ee ee a ee es 1 at he Mental disease or deterioration ~-___-..------- 14 DAs Srbegeerpinenn ior lite (iid? oes bie 124 0.2 Parte Mae C1100 BOM NG Oe ha NL Siri a Linn Ld Mien denies 62,514 100.0 In the Mental Hygiene Survey, made in the city of Cincinnati by the National Committee for Mental Hygiene, under the direction of Pr. V. V. Anderson in 1921-22, 4,326 school children were carefully examined in an effort “to get a picture of the average school child.” Commenting on the psychopathic child, the report states: “This type of child is neither insane nor feeble-minded. He may have good intelligence and would often be classed on purely an intellectual basis as normal, yet these children furnish the most difficult problems to be met with in the public schools and in later life are one of the largest sources of delinquency and insanity. “These children show outstanding handicaps of personality that mark them as being different from other children. Their adaptive difficulties 6 SPECIAL REPORT ON are the expression of mental attitudes, mental trends and twists which con- stitute a very marked departure from normal mental health. ~ “Various types of psychopathic children are to be seen in the public schools, the very thin, under nourished, over-active, restless, neurotic emo- tional, violent-tempered child; the apathetic, weak-willed, physically-inert, sluggish, over-suggestible, inadequate child; the eccentric, selfish, egotis- tic, unappreciative, cruel, ungrateful, individualistic child; the shut-in, self-centered unapproachable child; the timid, hypersensitive child with feelings of inferiority, and many other types with psychopathic traits that seriously handicap them in adapting themselves to their environment. “We shall not endeavor to go into the many causes for these condi- tions. They are varied and are found within the individual himself (in disorders of the physical organism, in mental conflicts, etc.) or are environ- mental in origen (factors in the home, in the school, at work, and at play). We do not wish to emphasize, however, the importance of early recogni- tion of these psychopathie conditions among school children. Daily it is becoming more and more upparent that many adult breakdowns are direct- ly traceable to child: life. A psychopathic personality forms the very richest soil possible for insanity in adolescence and in adult life, and is a very large factor in juvenile delinquency.” “Three and five-tenths per cent. of the public school children exam- ined came within this particular grouping. If this percentage is borne out among the entire population of public school children, and we believe it is, then it can be seen how important is this problem; how urgent is the need of adequate clinical facilities for dealing with the problems these children present if we are to prevent behavior difficulties later on.” Sufficient data has been gathered to reasonably deduce that from two to three and five-tenths per cent. of all school children in the United States and a much larger percentage of adults are psychopathic personalities, or, in the case of children, emotionally unstable or pre-psychopathic, if such terms be preferred; that some of them are the victims of heredity and others the product of emotional, environmental and various causes, in early years; that it is a mental state which gradually becomes fixed, and is open to treatment, and possibly correction if reached in time and pre- ventive and curative processes furnished. II. EDUCATION, TRAINING AND TREATMENT The salvage of the psychopath will be a substantial contribution to public welfare.’ What can be done to treat, correct and prevent an increase of this vast number of our population? They form a great reservoir from which is constantly flowing a good proportion of the delinquents, the fail- ures, and misfits of society. The criminal, the drunkard, the drug addict, the vagrant, the prostitute and pauper are largely recruited from their ranks. Their treatment, correction, social adjustment or segregation when necessary, are worth all the efforts and cost involved. THE PSYCHOPATHIC DELINQUENT 7 All evidence points to childhood as the pivotal period when preven- tion and salvage can principally be accomplished. Whether constitutional] or acquired, after the psychopathic conditions become fixed at adolescence, successful treatment meets with grave difficulties and relapses. Proper training and education of the child are essential if substantial headway is to be made. The primary requirement is the understanding of the child. The earlier such knowledge is acquired the more effective becomes the treatment. As soon as a child manifests nervous abnormalities and persistent misbehavior, it should be mentally and physically examined. Plementary treatment ought to begin in the home. Advice and instruc- tions for discovering and training mentally abnormal and defective children should be conveyed to parents. Facts and discussions relative to the child should be disseminated by the press, periodicals and private and public agencies and organizations. Whenever the behavior of the child is ab- normal and deviated, the parents should be advised and persuaded to use a psychopathic clinic. As soon as the mental status of the child is accurately diagnosed. methods of treatment can intelligently be recommended and the child scientifically supervised and guided. The Cincinnati Survey, previously referred to, made a special study of home conditions in relation to the psychopathic child. Numerical values or points in attributing causes, were allotted to home necessities, sanita- tion and neatness of the home, size of home, parental conditions, and parent- al supervision. The report says: “No learn at what points the home of psychopaths were consistently deficient, and at what points there was but infrequent failure, should both contribute to our understanding of this interesting group of children and aid in the formulation of a program to bring mental good health to many of them. “On the first three items evaluated, which cover the immediate physi- cal surroundings of the child, few homes were found that were marked- ly deficient. Only one home scored one on necessities (that of a colored family) and only three homes scored one on either neatness or size. Hous- ing conditions for these children were not entirely satisfactory, however, since 29 per cent. lived in homes that gave evidence of definite overcrowding. “For the last two items of the scale—‘parental condition’ and ‘parent- al supervision’—a very different situation existed. Twelve homes received the absolute minimum on the first point; seven homes received the mini- mum on the second point. A score of less than three on either of these two factors which so intimately affect the life of the emotionally maladjusted child indicates that most unfortunate conditions surround him and greatly increase the difficulty of social adjustment. “Forty percent. of the homes from which the psychopaths came re- ceived a score of less than three on ‘parental conditions’; 35 percent. re- ceived a score of less than three on ‘parental supervision’. 8 SPECIAL REPORT ON “We cannot say definitely whether the failure of thé homes of the psychopathic children on-these two points may serve primarily as an ex- planation of the beginning of the child’s difficulties, or acts as an aggra- vation of already well-developed handicaps. Our figures secured for the whole group and from a study of individual cases indicate that there is an intimate relation between these deficiencies in the home and the malad- justment of the child.” In regard to the broken home as a factor in developing the psycho- pathie child, the report says: “There are no relationships in a child’s life that are more important than that between the child and its parents. If the original home has been broken by separation of the parents, the child is left not only under abnor- mal conditions in regard to guardianship, but he has often passed through an emotional experience that may place a mark upon his mental life not easily to be effaced. “One out of every three children diagnosed as cases of psychopathic personality comes from homes in which the child’s own mother and father are not living together. The psychopathic children, more frequently than the defective or the normal children, live in homes where a re-marriage of either parent has taken place. There were more than twice aS many psychopathie children living in homes with other relatives than there were defectives.” Subsequent to the homes is the school. Psychiatric clinics should be made a part of the educational systems. In dealing with inanimate matter, exact knowledge is sought by those who seek success, but in the adminis- tration of public affairs and institutions, lack of knowledge of human material is often profound. The Cincinnati Survey, in a discussion of the influence of the school on the training of the psychopathic child, says: “With our changing attitude towards insanity and crime, with our present realization that these conditions often show their beginnings in childhood and are, in a large measure, preventable, there can be no excuse for our neglect to deal intelligently and understahdingly with psycho- pathie children in the public schools. The examination of these children should be conducted in a clinic equipped to deal with both mental and physical issues. The great importance of a searching physical investiga- tion is now made evident from the frequency with which disorders of the ductless glands, ovaries, testicles, thyroid, ete., are encountered. These children should receive a thorough-going study from a psychiatric as well as a psychological point of view. The question of psychotic and psycho- neurotic tendencies, the child’s personality make-up, his abilities and dis- abilities should all receive careful consideration. A course of treatment for each psychopathie child should he mapped out only after such a com- prehensive examination has been made.” The school offers the greatest public opportunity for discovering and treating the psychopathic personality. 'The control of the child in the school is impersonal and free from parental ignorance and indulgence. THE PSYOHOPATHIC DELINQUENT 9 If every child manifesting deviated behavior characteristics were examined, his defects noted, and a constructive plan of training and education out- lined, many a child developing into a psychopathic personality, and~ pos- sibly doomed to wreckage, would be saved. Evil effects of mis-grading, dislike of teachers, truancy, emotional conflicts, mental twists, misplaced fear, flighty imagination and other psychological defects can be overcome by study and observation. Educational methods have greatly advanced during recent years. Scien- tific methods are being applied in the kindergarten and in special and prob- lem classes. Special attention has been given to backward and defective and retarded children. The visiting teacher is an effective method of treat- ment. A good deal more can, and should be, done in the training of the psychopathic child. Study given to the individual child should be the ideal in school administration, and automatic, conventional and stereotyped processes discouraged. The function of the church in any plan of correction must not be over- looked. Religion is the greatest formative influence in life. When a child is found to have psychopathic tendencies and exhibits mental abnormali- ties endangering its future, religious teaching and influences should be brought to bear in a natural and normal manner but never forced, inciting opposition or emotional conflicts. As instability and overplay of the emotions underlie the mental state of the psychopathic child, contacts and experiences which contribute to their excessive development should be avoided. Moving picture shows are becoming one of the chief recreations of children. The scenes por- trayed powerfully affect their emotions. When of a sensational or immoral character, they undoubtedly ccntribute to the growth of psychopathic ten- dencies. Dr. Max G. Schlapp, psychiatrist in charge of the Clinic of the Children’s Court, of New York City, has observed the effects of moving picture scenes on delinquent children, and considers them the cause of mental and moral deviations which brought about their delinquency. The psychopathic, pre-psychopathic or emotionally unstable child, who is the prototype of the criminal, the social failure and misfit, early displays the danger signs and is more or less plastic to guidance. The responsi- bility rests on the parents, the school and the church, and public and private agencies, of saving such children from the evil and suffering that will surely follow neglect and indulgence. II! THE PSYCHOPATHIC DELINQUENT Many psychopaths—the percentage cannot at present be estimated— become delinquents. Most of them, like a good proportion of the feeble- minded. conform, in a measure, to social standards and become in a reason- able degree socially adjusted. They may be eccentric, peculiar, contentious, futile and “cranks’’, but are harmless and occasionally achieve great suc- cess. 10 SPECIAL REPORT ON Their mental abnormalities, unstable emotions and infirmities expose them to temptations, self-indulgence and crime. Starting in early years, persistent anti-social behavior crystalizes into a confirmed psychopathic mental state which is responsible for repeated delinquencies. All mentally defective and abnormal individuals are potential delin- quents, especially the feeble-minded and psychopaths. The feeble-minded have a low order of intelligence and are not as dangerous or destructive. A good proportion of the psychopaths possess average or superior intelli- gence and commit not only minor offenses, but many of them have excep- tional ability in planning and executing desperate and ingenious crimes. A comprehensive picture of the psychopath as a potential criminal is given in “Die Psychopathischen Verbrecher”’—“The Psychopathic Crim- inal”—by Karl Birnbaum, reviewed by Dr. Bernard Glueck: “The general emotional dullness of the psychopath, his pathological inconsistency and infirmity of character, his pathological levity and the frivolity of the psychopathic constitution, the pathological degree of im- pressionability and suggestibility which makes of the psychopath such a ready victim of bad example and guidance, the instability and weakness of will which are responsible to so large a degree for the lives, without goal or definite object, so characteristic of the psychopath, the heightened effectivity, the pathological irritability, the queerness, oddness and patho- logical passionateness of these natures, the over-valuations and pathologi- cal lusts and cravings to which they are slaves, the peculiar effective dis- positions, impulses, trends and instincts which serve as such strong direc- tives of the psychopath’s behavior, the various habituations, or rather manias, which seem to be so essential to gratify the emotional cravings of the psychopath—such as the passion for gambling, collecting various ob- jects, senseless buying and speculation, the various psychic compulsions and sexual psychopathies, or pathological sex trends, the pathological ego con- Sciousness and paranoidism which serve so frequently as a casus belli for serious conflicts with their environment, the pathological fluctuation of mood which is expressed now in chronically and constitutionally depressed and anxious natures, and again, in constitutionally manic personalities, the penchant for the fantastic and fear or timidity of reality, the dreamers, Swindlers, pathological liars, and those exquisitely interesting and trouble- Some, hysterical natures, the querulousness and intolerance, the ready soil for pseudo-delusional or delusional interpretation of events which is as- sisted by the great facility for fallacious sense perceptions and finally, the moral obtuseness or moral idiocy.” According to more recent Studies, many of the above characteristics, formerly considered constitutional and pathological, are possibly acquired in early years, but are none the less dangerous. The reduction of crime will depend upon the procedure and equipment provided to discover, treat, combat and, when necessary, segregate the de- linquent psychopath. The two most troublesome and destructive types of offenders are the shiftless and ineffectual who fill up the county jails and the professional and dangerous criminals who commit serious felonies. THE PSYCHOPATHIC DELINQUENT 11 The psychopaths contribute largely to both of these types of offenders. Society should protect itself by an intelligent attack on these particular delinquents. Until constructive plans are devised, no marked progress will be made in the restriction of crime. Fitful excitement over crime waves and excessive punishment and penalties are hysterical and unscientific and do not improve conditions. The psychopathic delinquents are divided, according to legal distinc: tions in court procedure, into the psychopathic juvenile delinquent, the psychopathic minor offender and the psychopathic felon. _ , The psychopathic or pre-psychopathic juvenile delinquent is often class- ified as emotionaliy unstable and is treated in the Children’s Court, which is more and more becoming a constructive and reformative institution. The psychopathic minor offender is found, in increasing numbers, a- mong the great aggregation of social derelicts, alcoholics, drug addicts, vagrants, tramps, sex degenerates and prostitutes. They are flowing in a mighty tide in and out of county jails. They receive no constructive treatment. They are merely removed for a short period from the commun- ity and confined in an institution in which the environment and associa- tions add to their deterioration and degradation. They present an insen- sate spectacle of human waste. Society some day will awake to the duty of trying to rehabilitate them. The most constructive plan so far proposed is to abolish the county jails as prisons of confinement and establish in their place State industrial in- stitutions on farms, to which the inmate will be committed on an indeter- minate sentence, built up physically and morally and released under com- petent parole supervision when found fit to mingle again in society. No constructive plan has been adopted for the treatment and disposi- tion of the psychopathic felon and confirmed recidivist. They are com- mitted under varying and inconsistent sentences to penal and correctional institutions. They eonstitute a dangerous menace to the social order. A custodial institution is becoming more and more necessary in which these enemies of society can be permanently segregated or confined until they change their predatory character, if such change is possible. John S. Kennedy, President of the New York State Commission of Prisons, in 1924 inspection report of the New York State Reformatory at Elmira, after quoting Dr. Frank L. Christian, the Superintendent, in ref- erence to the need of custodial care of the psychopathic criminal, states: ‘Although several efforts have been made to provide care for psycho- paths, nothing definite has been done up to date. The whole question of the treatment of this class of delinquents is one that might well engage the attention and efforts of the Legislature and those interested in putting the penal, correctional and reformative institutions on a stable basis.” Dr. Sanger Brown, 2nd, Chairman of the New York State Commission for Mental Defectives, suggests the following treatment: “1. The excessively psychopathic individual who has developed well established criminal tendencies. For a type of this kind, who exhibits as 12 SPECIAL REPORT ON complete irresponsibility as if he were insane, continuous custody should be afforded. This should not be in the nature of punishment but as a pro tection against himself and others. “2. Psychopaths who are only occasionally criminal offenders. These undoubtedly must serve their sentence for their criminal conduct. But after they are released from prison they should be continued under the supervision of a parole officer. These cases do not require close custody for life but a certain amount of supervision. “3. CO 4 10 z . a ~ _ . ON 16 SB OD 19 oD G COD OANA CO Nr ra OwOIimw DOM M Or N bas! = moowoOP-woorri AanNnrarE N rH 1 0 © 00 OD G2 ay xt OF OOratrin nsw N Ye.) MESA! Puc! va at tenes) cb . . . . . . a) . . SE eee See eae . . . . . 7 . Sle be, Oa 5 2 Or tiee O Ae'et BAe Sel es Da Sire Gag) sc et) Rh we eens s 6 Qt ot 4g Bn te Si Set s : as; a ets Moly) x, = * h4 4 oat etc ee MP a= gah oi aD Sra et or Oh. lesigy: at "Oo mn ~-V@ e .¢ ~~ om ~-RAgw 7 :Age8 3 8 ach fer ct foe he ~-VOw DS aes =05 Aan 3 Ge peeseasss SEs toescscovion HoH ES pr a Cp OVananRtaea ZAMSAAA SAP 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 3 1288 369 117 404 32 128 225 10 Total SPECIAL REPORT ON O°00T = $8 | POUL SO-0G1= = OO0Te== O0Ors 7 0°00 Loa OT Boe 61-4 060 80h! S8eb oo ee ee ed 0 T | oe ‘0 oe L'0 G0 vA e* iL o-. 9 9 ©..4. 0°39 6m © 0.4ne 6 oS ELe te 6. ws, pouleyiadsvupy sh § | 9°¢ og 8°V LY bm Sf SI BE v1 02 8s ress ceececerescss qojajep Ap[Buosieg 68 OL | 6°0T a9 Eo Lv SL Vv 6& él 8I 026 v6 “'** UOTZBAOLIoJep 10 oSBoSIp [e}PUS]T EL 6 3°0 C0 g FO i L'0 60 o. g T G g aI SR aletene we, one aha a, aaa) eae ahete 4, BLS Asdopidy Ae OL | 9°0 0°Z rT LZ GT oe Z y y 6 61 ae 6 4 ap etel se 6 4 6 BM Ag = 0. < 4m stsornasuoyoAsSg L°8P VIP | 609 GOP v9 1°66 Gov G ITS 16 LOT Al PC ss sso sess Ayrpeuossed oryyedoyoAsq 3°8 GL | L’°9 9°6 6°6 8°g 9°L T VS 61 66 GZ 86 ae eS ee Se Ba ae ee OO sO Pe LOI 9°F 68 | "8 9°F 19 oh v's poe oe She ae ae "cc 1* qoayep [eve sUl[1eps0g L'9 Le | ZT ZOOL Gq), v8 7°), oe GI 0% Zo 9g 26 a tet BE Ce Pa he ee ae I Ce ay parey[[ng a9T OVI | L°6 ae al 6 9G 0°98 6°63 T G$ 86 LL vaT SOG ee merece. 7 Sr ot aaa aa ee aan eae NL OCEAN *yu99 Jaq dJaquinn SoUIT} d10Ur sour} aa1M : 20uQ [JO], peurez sour sour ao1M L a0ugQ. e109, iets, soe sisouserp equa v10Ul 10 io in0q s2914] -1gd8StUy ANOY y%IY], qU99 bad AO QuUun N SISIAIPWIA 7D10,], PIISIAMD SOWAT SISONDVICG IVINGW OF GHLWIGY SV GULSHUUV SHNIL € ON ALVA THE PSYCHOPATHIC DELINQUENT 0°00T 0°O0T 0°O0L 0-001 0°00T OL 6g¢ L61 b62 Sor Seel-le Pye sce Te ae ee Pe 6°8 Uy L's gs eg 3S o& 8 II ST Eee Nae ee ec ae ee 1as0 pue sivesk Og 9 9°g 0% 0°§ Le oe Zo ( 9 I ST .,8-6.0 6s os @.8 82 e's 608 ¢ ore SIBOA 6g 04} Gg v's 9°83 VS e°E VS I og ie Ne TL 69 oer ee wee eee ee ee ree eoree sre9k 7S 04 0g L'6 Ts 8°38 67 9°) oe cE oT 9Z [IZ 86 eoereees ero eoerereeer eo eeevee siBor 6F 0} GTP QoL 9°8 6 TT 9°83 GOT T Sv LI Ge L& $8T~ tS Ll ES Se ee Sh eT OF lst ost vst 8°sT aa 3 LV 9% 0S Lg 981 niin “ee ee. ee sseecces sieakt 6§ 07 Gg 6ST e°LT SLT LST 8°ST T 0g vs Tg L9 £06 OT ae. | ae "tes saieakt 7g 0F 08 8s Lor 9°FT 9°6T sr T 9F &3 &V 08 661 et EE ae oes a ed a ee eae 958 SLT 6ST 0°8T mas 3G T& GE IP LL 98T eae heb cee mp Lb oe ee eee 7 g°g 9 8°9 0'OL G°), oe 1¥A aL 0Z oP 96 eee ereeer eee ere eee eeeeee siveod 61 04 cI SIUII} JOU SoUTTy IMT I3uC [e810], peulez Souli} e10UI sautl, %2IMT aug = [ezO0L dnoiy a3y AO INO sIY] -lavstugQ) AOAINOg s9014], JUID AOd ADQUNN P2SAL4D SOWA, CAHLSHUUV SHNLL AO HHAWON OF GHLIVIHY SV SALVANNI FO SHDV VON Id Vil SPECIAL REPORT ON 22 0°00T 0°00T TI 6&Z Ze CLL S8z1 O05 e's p elehe Gels c'eleets cases deseces [e1OL 70 6°0 Lo G0 T I g T 9 CC peulejiaoseuyQ 6% eg 9°F g"y I L LI gg 8g nrestesseesssessss uoroajep ApTBUOSIEd e'cl 9°6 9°¢ e"), ag Le te 9% ¥6 tere c's UOIVBIOLIaJap IO asBasIp [eyUOTT 6°2 QT ove 6°0 oe J, G o. ZI CMC TSC Me Tn UC tM Ya wth ay ee or ey Wc yet er Asdaidq ee 6°T L'°0 QL bd ae: 8 9 c 61 cee lees 8 618 80 Ont Oe © 2 8 ee stsoinsuoyossg v9P a 6°68 GOV v IIT aad G82 sre stresses eescees AqrpRuossed oryyedoyoAsg 2°83 9°6 2°9 9°), I IZ te CP 86 eC qoajyep [eqUeW 9°7 0°F &°9 v's £ qe! SI cv OL see ees’ “Poop [eyuswu osul[teps10g 0's e°¢ 8°38 ZL T ZI LI e9 26 0 OL esah se 0 Sir ce 6 6 6 00s wee wre) s 4 Obes) alee Are preying 0 1°62 6°22 Z 74 tg ZIZ c6Z 016 BL OxG 6b, © 0 6 0:0. 0:0 B10 6 aie a eXe whe etl neta tee [BULION pooy [®}0L pauie} 100g ssieg pooy [210], sisouseIp [ejUusy ~190seul) 1U99 Od A2QUnN Uoutpuod .noshyd SISONOVIC IVINGW OL GHLVIGH SV NOLLIGNOO TYOISAHd G°ON ATAVL )9 ak ENT y | ~, THE PSYCHOPATHIC DELINQU O°;00T O°00T 0°00T 0°00T 0°00T 0°00T 0°00T 0°00T 0°00T 0°00T 0°00L eoeeveerereeeaeeeerinee [#10], eoeewpvr eee eanvreeeeeee Peuleylo0seu Ly eoeereoereeeeeoee yoojop Ajl[BVuosie J UOIZVIOLIaJap AIO asBasIp [BUI e@eereeereeeeevreeeeeeerereoe Asdopidy eooerereree ers svereene SIsSOINsUOYyIAS ce *s Aylpeuosied oiyyedoyoAsg es qoojop [e1UeTL ** qgoojep [e}JUeUL sUI[1epsi0g eeoeaereer eee ee ee eeeeee pzel[ng eoereeweereer eee eee eee [ewuso yy . 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OL mis e. 6°0 oO ae &°8 6°8 g°9 ae I 4 TS ST NT §°s ar 6'T +h 4 LOT ov L's Ly 6S 38 L0r vg OTT g OT ar Ter ae 2 er zee oe 70 — rT 3°0 ses lz ve 0°98 60 6°0 n — oS GG L% QT 6°0 OT 9S ee 6°0 eT p98 SS& 61g ULV v'0g 3&0 6°88 8°87 vss 6°86 0°se 3 SS SOP Ver a; L°0 Sv La T'S TT Lot 9°ST 3ST 0°ST 0°ST 9°L 0°s = -s ae! vv TY 6°9 Lot v6 GOT 0°03 T'sT Lo EQ ov L°0 0'r red OTT ool 8°6 ov 8ST 0°06 ort ob L°Gs 3°Sv p08 £°66 TVG 9°33 yr O°LT 8°3T SOT 0°S L’8T 6°36 4U99 ddI 99 ¥Z Sst 9LS LET 9FT T&I aa 96 88 02 LOT 88o1 z I I ee ee oe a sis I oe a I 9 a é él 8I 8 L Vv 3 T 3 = 4 8g [T T g &T v él VI 9 Vs IT L LG 8V¢ Fs i; Vv T 2) a T 24 LE be Si ae ¥6 a ni a 9 § v 6 I 6 ee) T T éL vG 8 OL 0st 69 &9 Tg 67 T T f I 61 8 a T él L t.s ST a G1 9 § 9T 86 3G sa * Vv 9 9 6 ras 6 Vv v VI OL v IT T IT L 9T 9T TT v 9 v ae &6 ST Il lv 18 && && 6I 61 SL v T 02 G66 AOQUNN PeUulezIvIsSBUL_, IsaIJOQ. «~[OOYIgG speis speis apeis ospeis opeis epeig opeis aepeis ouoN [810], YSIH = YISIA YWUeAVG YIXIG YW YUnog = pay Puovg 4saAy sSIsOoOusStvIg [eyuI A JOOYIS UL PIAUIDZYD apdAy SISONOVICG 'IVINUW OL GHLWIAU SV NOLLVONGG 9°ON ATAVL 24 SPECIAL REPORT ON Out of the 1,288 prisoners studied, 543 or 42.2 per cent. were psycho- paths. Relatively, a higher percentage of females was psychopathic than males. The psychopath had the highest percentage in the commission of crimes of acquisitiveness, violence, sex offenses, and in violation of liquor and drug laws; 416 psychopaths out of the 548 had been arrested more than once, and 216, or almost half of them, four times or more. Their physical condition was relatively poor. They had a fairly good education; 270 out of 519 ascertained, had been in the 7th grade of the public or private schools, or above; 130 in the 8th grade; 70 in the High School; and 8 in college. Accordingly, this particular group of offenders, who compose al- most one-half of the county jails and penitentiary population, may be sum- marized as intelligent recidivists, of whom a good proportion habitually commit crimes of theft and violence and habitually indulge in drunkenness and vice. To quote from the report: “They present problems of the greatest difficulty, but problems that must be met. When first seen as prisoners, their mental habits and person- ality traits have become so fixed that such fundamental changes as are necessary in their make-up are exceedingly difficult to accomplish, and in some cases, at the present time, probably impossible of accomplishment. Treatment should have been applied in the public school, as these mental habits and personality traits were in the process of forming. In dealing with the more or less final product in the county-jails stage, it is obvious to anyone familiar with the problems of individuals of this type that in- carceration in jails is futile. It is not believed that at this time any general rule can be laid down for the management of such individuals. Kach presents a problem peculiar to himself. Only after observation and a searching examination can a plan of treatment be devised in any given case. The success of any plan will depend upon the skill used in selecting individuals for various methods of handling. Treatment, however, is what is required. Some are proper patients for hospitals for mental diseases. Some would profit by vocational training if the training were properly devised. In some cases, probably the chief hope of success lies in a combi- nation of psychiatric and social treatment.” Vil. THE PSYCHOPATH IN STATE PRISONS AND REFORMATORIES Many of the most dangerous and vicious psychopaths become inmates of State prisons and reformatories. The earliest thorough study of mentally abnormal prisoners in the New York State prisons was made by Dr. Bernard Glueck, in Sing Sing Prison. He examined mentally and analytically studied 608 out of the 685 who were received in that institution during the nine months ending April 30, 1917. THE PSYCHOPATHIC DELINQUENT 25 Of the 608, 359 were classified as mentally abnormal as follows: Mental Diagnosis Number Percent. Mentally diseased or deteriorated ~------------. 73 12. PmIenLuny Gelective: 22022. ...-2.-- 2-2-2 1g @) 28:1 Psychopathic or constitutionally inferior ___-__-.. 115 18.9 Ninety-one of the 115 psychopaths were born in the United States. Of the native-born, 79 or 86.8 per cent. were recidivists serving sentences of from two to ten times; 66 or 72.5 per cent. of them committed crimes of an acquisitive nature; 19 or 20.9 per cent. committed crimes of a pugnacity nature; 5 or 5.5 per cent. crimes of a sex nature; 38 or 41.8 per cent. ex- cessively indulged in liquor; 21 or 23.1 per cent. were addicted to drugs; and 24 or 26.4 per cent. to excessive gambling. The history of 79 showed traits indicating marked deviation from the normal during childhood. Sex perversion was found in 8 and excessive sexual indulgence in 31. ‘The industrial careers of practically all of them were extremely irregular and inefficient.” Dr. Glueck, commenting on the psychopaths, says: “In contemplating the foregoing facts one cannot escape the convic- tion that the psychopath with anti-social tendencies is by far the most dangerous individual with whom we have to deal, and one would expect that society would exercise an unusual degree of effort in its attempt to solve the problem which he presents. We find, however, that here, too, there seems to be a total lack of appreciation of the gravity of the situa- tion. Thus, before another year elapses, twenty-three of these cases will have returned to society; and before two years pass, twenty-one more will leave the prison; and before five years pass, thirty-ome additional cases will find their way back to their former haunts, In other words, before five years elapse, seventy-five out of the ninety-one cases, or 82.4 per cent., will have been returned to the community and will be at the point at which they were prior to their last conviction.” Dr. Frank lL. Heacox, psychiatrist in Auburn State Prison, has, for the past five years, conducted psychiatric examinations of practically all the male inmates received at and discharged from Auburn Prison, and the psychological tables have been yearly published in the annual reports of the Superintendent of State Prisons. The Committee has prepared from these tables the following combined tables covering the five years from June 30, 1921 to June 30, 1925: SPECIAL REPORT ON ayy edoysASg oO a]ueg o13dap1dg L ‘OV SrsEt ee xag 6g 8V aqes jAdAIIg JPIPPYV +3139 anig SLIGVH g°VP SLYT ey o1[0Y -09[V 8 3s TLOT jen “98H NOILV)O IdISSVTO TVNIWINO cS eee ere ewer eee e eee eer eee GCaNINVXa LON { 9§ 0 ‘TE eeeereeereerrere . “LNGO Udd LT@I LZOT O°OOT -3133S xeg SnIiq -OdJyY -iIqeH -B59Q -LDIY = g SLICVH NOILVOIMISSVIO 'TIVYNINIYO NOILVOIMISSVWTIO TVOIDOTOHOASd oe s. HAISNIONI ‘GZ6T O© TZ6T ‘OG aNaAL ONIGNYW SUVAOA TVOSIA AHL ONIYOdC CHLLINGVY NAW JO NOILVOIAISSVID TIVOIDOTIOHIDASA TON WTAE Vi 28 SPECIAL REPORT ON Three hundred fifty-nine or 11.1 per cent. of all the prisoners received during the five years, and 382 or 11.5 per cent. of all prisoners discharged, were psychopaths. One hundred forty, or 39 per cent., who entered, had records as habit- ual criminals, and 147 or 41. per cent. were of the segregable type. Among the psychopaths returned to the community from the prison, 158 or 41.4 per cent. were habitual criminals, and 162 or 42.4 per cent were segregable. These statistics demonstrate the inadequacy of the present criminal System and existing institutions which permit habitual and segregable felons to keep coming in and going out of the prisons at a tremendous loss and cost to society. Substantial relief could be obtained by the establish ment of a custodial institution. An intensive study was made of selected mentally abnormal and defec- tive delinquent women in the Psychopathic Hospital at the New York State Reformatory for Women at Bedford Hills, under the direction of Dr. Edith R. Spaulding, from September, 1916 to July, 1918. Forty-four mentally abnormal and defective inmates received scientific diagnosis and treatment in the laboratory of Social Hygiene; 22 of them were psychopaths. About five years later, in September, 1922, an investiga- . tion was made of their careers subsequent to release from the institution. Of the psychopaths, some had died, some had disappeared, Some were com- mitted to State hospitals for the insane. The majority of them had re lapsed into crime or vice. Eight were leading fairly decent lives. The details of the study and the history of the cases are set forth in “An Hxperimental Study of Psychopathic Delinquent Women.” Dr. Spauld- ing deduces from her study and experiences: “The time has come, however, when the shifting of responsibility re- garding the psychopathic delinquent should cease and everyone who can should take up his share of the burden, which promises to be a heavy one for many years to come, for the solution of the problem’ will be attained only when everyone is willing to put a shoulder to the wheel and do his part. They are a too varied and heterogenius a group of individuals to be herded together and treated successfully. They represent too many situa- tions—mental, educational and social and Segregable and non-seg- regable. The line of demarcation of the group is too indistinct and the nature of its constituent parts too elastic for a single educational, social or legislative procedure.” Psychiatrie and physical diagnoses have been made during recent years of all the inmates committed to the New York State Reformatory at Elmira. The following tables, prepared by Dr. John R. Harding, Psychia- trist, give the mental classification of 4,500 inmates admitted to the institu- tion during the six years beginning July 1, 1919, and ending June 30, 1925, and their division into normal, dull-normal, Sub-normal and segregable groups: > TABLE NO. 1 MENTAL CLASSIFICATION Classification 1920,,, 31921 .<: 1992S 1998.) Miobae wae Adtcidental Uo ee Sars!” 17 6 11 8 5 3 Responsible __________. 169 218 256 147 126 77 Psychopathic <=... 2__ 79 74 170 280 387 ~ 418 Defective Delinquent __ 134 117 108 63 45 92 MOTON | 228 ce eee ae 266 276 254 116 145 zak Unclassified —____.___. 16 9 9 1 ps y “ cin es annie a 1081 24.0 286 6.3 13867 30.4 CU | I Sa 9 0.2 10 «0.2 23 0.5 oy 01 47 1.0 2.6 719 16.0 4500 100.0 ME yelha ss ae aeaeie ec 585 13.0 827 18.4 2369 52. Of the inmates committed to the Reftormatory during: the six years, 1.408, or 3.13 per cent., were psychopaths. Dr. Frank L. Christian, Superintendent of the Institution, who has ,given special study to the psychopathic criminals, characterizes them as follows: “There is another class of criminals which is equally dangerous and likewise recidivistic in its tendencies. This class comprises the psychopaths, or the little-understood individuals who commit the spectacular crimes and who are in the limelight of publicity. They are the ones who are featured on the front pages of the sensational press—they aim at doing something ‘big’, and their ego must have an outlet whether they are in jail or at liber- ty; they are not insane and neither are they sane; they cannot adjust themselves to the humdrum of every-day life; they must experience new emotions, new thrills, and psychic sensations of startling origin. They have no thought of the future or of consequences or of results. They may or may not have a high intelligence quotient, but they have a superficial understanding of the problems of every-day life, and their assurance is as annoying as is their limited conception of life’s values. “Phe non-criminal individual who is psychopathic is usually known as ‘queer’, a ‘crank’, or a silly egotist who is harmless and directs his egocentric personality into foolish but nevertheless harmless channels. “The psychopath who is a criminal is a dangerous felon who is turned foose from prison and is not in the least understood by his associates. He _is always a psychopathic individual, whether he is safe-guarded in an insti- tution or thrust out into the world to take his chances with social condi- tions to which he is not adjusted. His next criminal offense is partly the fault of the State, which permits the dangerous and semi-responsible in- dividual to be at large. Some day we are going to protect the community from this form of delinquency, as we are already doing with his feeble minded brother.” 9B A REMEDIAL PROGRAM The difficulties and jerplexities in the way of prevention, reduction of the number and constructive treatment of psychopaths, seem almost in- superable. They are diffused so widely and are so integral a part of the community that their education, training and treatment become a com- munity problem. Their prevention and social adjustment will go far in Se a crime, vice and poverty, and efforts to that end are a paramount uty. No single remedy or set of remedies will suffice. It will require the marshalling of social, educational and scientific remedies and the cooper- 30 SPECIAL REPORT ON ation and coordination of community forces. It is evident that existing procedure, methods and institutions are insufficient and inadequate and that new procedure, methods and institutions must be adopted and estab- lished before the causes and conditions producing the psychopath can be successfully attacked and the resultant social evils eradicated or amelior- ated. HOME TRAINING Irrespective of whether psychopaths are consitutional or post natal products, their care and training center primarily in the home. They emenge in the highest percentage out of neglected and broken homes and homes lacking proper parental supervision and discipline. Parents. should be instructed in the early symptoms of psychopathic children and advised to have them examined in psychiatric clinics. A constructive course of’ treatment and training should be furnished to the parents for the up-br.ng- ing of such children. II SCHOOL TRAINING Psychiatric clinics should be provided in all educational systems and _the training of the psychopath made an essential part of the school cur- riculum. The educational departments of the State and its municipalities should outline definite courses and methods for the treatment of mentally abnormal and defective children and furnish instruction by teachers spec: ially trained and equipped, paying particular attention to the study of each psychopathic child. III RELIGIOUS TRAINING The Church should interest itself in the welfare of mentally abnormal and defective children. Pastors should be informed of such children be- longing to their congregations and religious influence ‘brought to bear, not only for the guidance of the children but for the guidance of the parents to secure the proper home care and treatment of the children. IV OUT-PATIENT TREATMENT Out-patient clinics should be established in the counties of the Siate under the direction of the State Department of Mental Hygiene, equipped with psychiatric and social workers, in which selected psychopaths can be treated and supervised without requiring conviction for delinquency, crime or criminal offense. & THE PSYCHOPATHIC DIELINQUENT ol V CHILDREN’S COURTS Psychiatrie clinics should be attached to all children’s courts and all children appearing before the court be examined, and when found mentally abnormal or defective, committed to a proper training school and when placed on probation, receive supervision from officers specially equipped for that particular work. VI CRIMINAL COURTS Psychiatrie clinics should be made available for the criminal courts, and all adults convicted of crime and criminal offenses be examined. When psychopaths are placed on probation they should be under the oversight of qualified officers who will study the needs of each individual and give special and constructive supervision. VL CLEARING HOUSES The Sing Sing Clearing House should be opened and all male adult felons sentenced to State penal and reformatory institutions sent to it in the first instance for examination, observation and study. Female adults convicted of offenses should be sent to the Clearing House at the New York State Reformatory at Bedford Hills. Several clearing houses should be established in various parts of the State, to which adults convicted of minor crimes and criminal offenses wil) be sent, in the first instance, for examination, observation and study. Would ABOLITION OF COUNTY JAILS AND PENITENTIARIES AND THE ESTABLISHMENT OF STATE INDUSTRIAL FARMS County jails for the confinement of sentenced prisoners, and county penitentiaries, should be abolished, and the State should establish in their place industrial farms, taking over such county penitentiaries as are pro- perly situated and equipped and discontinuing the others. These institu- tions should supply employment to the inmates and provide instruction in simple vocations and in letters. All commitments should be made on the indeterminate sentence. IX PAROLE An efficient parole system should be established and special care and treatment given by trained parole officers to the supervision of psycho- paths released on parole from State penal and correctional institutions. 32. SPECIAL REPORT ON THE PSYCHOPATHIC DELINQUENT be A CUSTODIAL INSTITUTION FOR CRIMINAL PSYCHOPATHS A custodial institution should be established, preferably in the vicini- ty of Clinton Prison and the State Hospital for Insane Criminals at Dan- nemora, to which psychopaths who are confirmed criminals and dangerous and segregable can be committed directly by the courts or transferred from penal and correctional institutions and held in custody as long as they are unfit to return to society, organized and conducted on the general plan of the Institution for Defective Delinquents at Napanoch. Respectfully submitted, (Signed) FRANK E. WADE, Chairman JOHN 8. KENNEDY. | LEON GC. WEINSTOCK, WALTER W. NICHOLSON, Committee, Dated December 1, 1925. 12 098211003 KAU