Insanity: Its Causes and Prevention

such as I have intimated in the preceding chapter, I think there exists at least a probability, that there will be an increase of this public interest and

bearing, of more or less importance, upon the discussion of the subject, and which may serve to i

n since the beginning of the nineteenth century, and yet, I think, we generally fail to realize how great

familiar, especially of those portions which now constitute the Empire of Germany, and of France and Englan

g and re-conquering of territories, constituted the great business of life among these nations, and furnished the themes of which historians wrote; while the conditions of life, pertaining to the great body of the common people, as to education, modes of living, occupations, a

then practically unknown. The people were divided, for the most part, into two classes, those who fought the battles, and those who tilled the soil, to obtain the wherewithal to sustain both

d of being in the open air, and breathing it in its freshness and purity, they are, for twenty or more hours of the twenty-four, in the confined and vitiated atmosphere of the factory, store, or counting-house, and, what is not unfrequently worse, that of the illy ventilated sleeping-room. In the one case, the blood is purified and nourished by the influence of a large supply of oxygen which it bears to every portion of the system, and

, enactments, so that there existed less care on their part, as to obtaining those things necessary for self and family, while in the present,

force or tendency of disease seems to be carried over (if I may so speak) into the nervous system, so that diseases affecting this portion of the body are much more frequent than formerly. People are more sensitive and nervous; indeed, nervousness has become exceedingly common among all classes, and modifies many forms of disease, thereby inducing an asthenic type, which requires the use of vastly larger quantities of those tonic medicines which act on the nervous system, than would have been tolerated fifty years ago. And the keen competitions in busi

te the probability that there have been in operation such powerful influences as would tend toward an

by some, to indicate a certainty of such increase of insanity. While there may be some show for such an inference, I do not t

atients and friends. There is much less of mechanical restraint used than was formerly considered necessary, and a larger amount of personal freedom; while the introduction of labor among the inmates more generally has served to render life in asylums more like that at home, especially for the chronic insane. In consequence, or partly in

ry than any other class in the community can have, and, consequently, very large numbers who were formerly detained in almshouses and i

on, were retained at home; but more recently persons are inclined to recognize the importance of placing these classes, also, in asylums, where they may be under the care of persons who have been edu

and relations with others, are now recognized as partially insane, and consequently society is less tolerant of their presen

ore likely to become so again; so that the fact that from thirty to fifty per cent. of the insane recover once, renders the probability of larger numbers hereafter greater. Then, of the numbers who do not recover and do not die, many live on for a much longer period than formerly. There can be no doubt that the existence of even such functional disease of the brain as may cause insanity, tend to shorten life in the vast majority of persons so aff

ed for by the public, it becomes necessary to take into the account all the above considerations, and perhaps some others. I

e may now refer to something more definite in the way o

t this has hitherto not been practicable in this country. Owing largely to the migratory character of large portions of the populations, the gre

to the statistics which have been yearly published since 1858, by the Boards of Commissioners in Lunacy for England and Scotland;

tes. The population is much more homogeneous; it is greatly more dense, there being about 25,000,000 of people on a number of square miles less than are contained in some of our single Sta

opose to introduce some of the statistics furnished by these Boards, from which we may learn in what direction has been the tendency of insanity there. In this procedure I shall divide those which I use from both Boards into periods of ten years each, the first,

ousand nine hundred and eighty (4,980): and there was an increase of this class in registered hospitals, during the fir

s, there has been an increase of one hundred and fifty-two

ounty and borough asylums, the

nd eight hundred and forty-four (9,844); and in registered hospitals, of one hundred and ninety-six (196); and in workhouses,

lass residing in licensed houses, o

), who have been provided for, since 1864, in a special asylum at Broadmoor; and deducting the sums of decrease which have occurred by removals and redistribution of pati

of society this large increase has mainly occurred. It will accordingly be observed that, while it has been only se

ease, without relation to the increase of the population. To enable us to appr

f the population being estimated at the middle of the y

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f the insane to the sane fo

l be more nearly perfect than those of the former period, as the system employed had been longer in operation, and the conditions of th

ht hundred and sixty-seven (26,867); in 1878, there were of the same classes of persons, thirty-seven thousand se

twenty-three hundred and fifty-two (2,352); and in 1878, twenty-seven hundred an

ninety-six (4,796); and in 1878, there were four thousand two hundred and

hundred and nine (209); and in 1878, three hundred and si

were four hundred and sixty-one (461); and in 1878, four h

ghty-one (11,181); and in 1878, sixteen thousand two hundred and sixty-fi

ee hundred and eleven (7,311); and in 1878, six thousand six hundred and ei

those of decrease, we have a total of increase during these ten

rst and second decade, amounts to one thou

al number of the population, from year t

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it has been less rapid during the second decade than the first. By reference to the last Report of the Commissioners, I find that in 1880 there is one insane person

the lay reader may be interested to understand something as to these points, in the care of the insane in England. As these method

oners in Lunacy for Scotland, it appears

ee hundred and seventy-nine (3,379); of the same class in p

(971); and in private dwellings, twenty-one (21): making a total

od to be exclusive of crim

e were under

housand four hundred and ninety-four (4,494); and in pr

eight (1,128); and in private dwellings, thirty-five (35): making a tot

, of which the Board had cognizance, advanced from six thousand two hundred and eighteen (6,218) to seven thous

to show the relation this bears

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e case in relation to that of England. There was a decrease for two o

e, from 1870 to 1879, inclusive, i

housand seven hundred and twenty-eight (4,728); and in privat

y-three (1,163), and in private houses forty-nine (49): making a total of t

9, the

thousand two hundred and ninety two (6,292); and in private

ight (1,358); and in private houses, one hundred and ten (110): making a

sand one hundred and fifty-eight (9,158); which equals one thousand seven hundred and forty-nine (1,749), as a

general populatio

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pulation for one year only of the decade, and on the

January 1, 1858, advanced to two hundred and seventeen (217) per 100,000, January 1, 1880, notwithstanding the fact, that during this period the number of pau

tely and relatively, a much larger element in

and Scotland during the last twenty years, but we know that it has been very considerable from both countries to Canada, Australia, and the United States; and I think it fair to assume that this emigration has generally been from those who have been in good mental health, at least at the time of

ion with the statistics of asylums, I still think the evidence all points toward a large incre

e be presented, but I think there can be no doubt that, when they appear, they will tend to confirm very strongly those already presented, which have been prepared with

AND CIV