MODERN LIFE AND INSANITY. 433 



stances into which our limits forbid us to enter, account for the greater 

 part of this alarming apparent increase, is certain. Whether, how- 

 ever, there is not also an actual increase, unaccounted for by popula- 

 tion, or by accumulation, remains an open question, which statistics 

 do not absolutely determine. At the same time we think that it is 

 quite probable that there has been some real increase. 



To what social class do the great mass of our lunatics belong, and 

 to what grade of society does the striking apparent increase of the 

 insane point? The large majority of lunatics under legal restraint 

 undoubtedly belong to the pauper population. On the 1st of January, 

 1877, of the total number of patients in asylums and elsewhere (in 

 round numbers 66,600), about 59,000 were pauper, and only 7,600 

 private patients. These figures, however, fail to convey a correct 

 statement of the relative amount of insanity existing among the class 

 of the originally poor and uneducated masses and the class above 

 them, because in a considerable number of instances members of the 

 middle and still higher classes have become paupers. Again, the 

 wealthy insane remain very frequently at home, and do not appear in 

 the official returns. We believe this class to be very large. Probably 

 we get a glimpse of it from the census of 1871, which contained 69,- 

 000 lunatics, idiots, and imbeciles (and we have good reasons for 

 knowing that this return was very far short of the truth), yet it ex- 

 ceeded the number given by the Lunacy Commissioners in the same 

 year by 12,000! A large number no doubt lived with their families 

 because these could well afford to keep them at home. None would 

 be in receipt of relief, or they would have appeared in the Commis- 

 sioners' Report. Another most important qualifying consideration 

 remains the relative numbers of the classes of society from which the 

 poor and the well-to-do lunatics are derived. Several years ago the 

 Scotch commissioners estimated the classes from which private pa- 

 tients are derived at only about an eighth of the entire population of 

 Scotland ; a proportion which would make them at least as relatively 

 numerous as the pauper lunatics. No doubt in England the corre- 

 sponding class of society is a larger one ; but whatever it may be, 1 

 a calculation based upon the relative proportion of different social 

 strata in this country would vastly reduce the apparent enormously 

 different liability to insanity among the well-to-do and the poorer sec- 

 tions of the community, although, with this correction, the pauper 

 lunatics would still be relatively in the majority. 



The disparity between the absolute number of pauper and private 



1 We are informed by Dr. Fair that the proportion between the upper and middle 

 classes on the one hand, and the lower classes on the other, is as 15 to 85. Calculated 

 on this basis, the proportion of private and pauper lunatics to their respective popula- 

 tions would be one in 484 for the former, and one in 353 for the latter a very different 

 result from that obtained by the usual method of calculating the ratio of private and 

 pauper lunatics to the whole population, viz., one in 3,231, and one in 415. 

 vol. xii. 28 



