RETROSPECT AND PROSPECT 371 



insane increased from 275 per hundred thousand in 1884 to 353 

 per hundred thousand in 1902, and to about 362 per hundred 

 thousand in 1907. Prussia shows a similar increase; while the 

 population of Prussia increased by one- third between 1875 and 

 1905, the number of insane in institutions increased fourfold, and 

 in Bavaria with about the same proportionate increase of popula- 

 tion the insane in institutions had increased more than threefold. 



Other European countries show much the same increase in the 

 reported numbers of the insane. But we cannot conclude that 

 the above statistics constitute a true index of the actual increase 

 of insanity. There are many reasons for believing that the in- 

 crease of insanity is much less than is indicated by the figures 

 quoted if we grant (which some deny) that insanity has increased 

 at all during recent years. 



As facilities for the care of the insane have increased and 

 improved a larger proportion of the insane come to be cared for 

 in institutions. The number who remain scattered through the 

 general population is inaccurately reported, if it is reported 

 at all in the enumerations of the insane. The further back we 

 go, the smaller is the percentage of insane segregated in institu- 

 tions, and hence the less complete is the enumeration. 



Estimates of the proportion of insane in institutions to these 

 outside have been made in Prussia in 1871, 1880, 1895 and 1905. 

 They give the following results: 



Proportions of Insane in Institutions in Prussia 



1871 21 per cent of all insane 

 188029 " " " " " 



1895-53 " " " " " 

 1905-55 " " " '' " 



It is probable that much the same situation would be found 

 in most European countries and in the United States; hence the 

 statistics of the rapid increase in the numbers of insane in institu- 

 tions need not be so disquieting as they at first appear. 



A further source of apparent increase of the insane is the 

 fact that, as conditions for the care of these unfortunates im- 



