It was only when special attention was paid to the training of idiots, that an idea began to be formed of their actual number, and it is only within a few years back that in the census of civilized nations idiots were distinguished from lunatics, or as it is generally put, born insanity was distinguished from acquired insanity. Even yet to some people it will be startling to hear that in most countries there are as many idiots and imbeciles as there are lunatics, and that in some countries there are more. According to Koch, there are for every hundred lunatics in Prussia 158 idiots; in Bavaria, 154; in Saxony, 162; in Wurtemberg, 97; in Austria, 53; in Hungary, 140; in the Canton of Berne, 117; in France, 66; in Denmark, 58; in Sweden, 22; in Norway, 65; in England and Wales, 74; in Scotland, 68; in Ireland, 69, and in America, 79. Large as this proportion is, there are many reasons for believing that it is considerably understated, both in our own country and in America. In France I have already pointed out that, although in the census of 1872, there were only 35,133 idiots given, it was found by a special commission to inquire into the diffusion of cretinism, that there were about the same time in the country 122,000 cretins and idiots, that is, 230 idiots for every 100 lunatics. Moreover, from the known unwillingness of parents first to believe and then to admit that their children are imbecile, we may fairly assume that there must be a large number of idiots under five years of age, who are never returned as such in any census, and of whom a large proportion die in early years. Koch found that in Wurtemberg only 43 idiots were returned under 5, while between the ages of 6 and 10 years there were 294 returned.