INSANITY. 



537 



that there were then in that State 2695 lunatics 

 and idiots, or one to 713 of the population. Of 

 this number the committee considered five eiyhts 

 to be idiots. In 1821, the great number of recent 

 cases of insanity in Connecticut, led a few medical 

 gentlemen to attempt ascertaining the whole num- 

 ber of the insane in the State, and to devise the 

 means of providing an hospital for their reception 

 and cure. " To obtain information," they say in 

 their published report, " circulars were sent into 

 every town in the State, addressed to clergymen, 

 physicians, and other respectable gentlemen, re- 

 questing returns of the number of the insane, their 

 ages, sex, cause of disease, &c. The returns in 

 answer to these circulars, although many of them 

 were very imperfect, satisfied the committee that 

 at least one thousand individuals within the limits 

 of the State were mentally deranged, and that the 

 condition of most of them was truly deplorable." 

 As the population of the State was at that time 

 275,202, this would be one insane person to 275 of 

 the population ; a proportion so great that we sup- 

 pose some idiots were included ; though we know 

 it was the decided opinion of Dr Todd, the late 

 distinguished physician to the Connecticut Retreat 

 for the Insane, whose means of information on this 

 subject were better than those of others, that one 

 thousand was not above the actual number of the 

 insane in the State of Connecticut. In Massa- 

 chusetts insanity appears also to be very common. 

 Dr Parkman of Boston, stated in 1818, that 541 

 insane persons had come to his knowledge in that 

 State, though he supposed he had heard but of 

 part. In 1833, a committee of the legislature of 

 that State reported they had ascertained that in 

 sixty-eight towns, containing a population of 

 264,327, there were 168 insane persons and 111 

 idiots, in confinement in gaols, alms-houses, and 

 houses of correction. This would afford above 

 600 insane and idiotic persons in confinement in 

 the State, if we assign as many in proportion to 

 the rest of the population. But it is probable only 

 a small part are thus confined ; and no doubt an 

 accurate inquiry would exhibit more than double 

 or triple that number. From considerable know- 

 ledge of portions of Massachusetts, we are confi- 

 dent, that at the time referred to, not more than 

 one-fourth, or one-third, of the insane and idiotic 

 were in the places of confinement alluded to by 

 the committee. In New Hampshire, it appears 

 from recent inquiries that insanity is nearly as pre- 

 valent. A committee of the legislature of that 

 State reported, during 1837, 350 insane persons 

 in the State, exclusive of idiots. We are in- 

 formed that the committee, who made the report, 

 were of opinion this estimate was too low. But 

 this number exhibits one case of insanity to 800 of 

 the population ; and if we add as many idiots in 

 proportion to the insane, as there are in the State 

 of New York, there would be one crazy or idiotic 

 person to 300 inhabitants. A select committee 

 of the legislature of the State of Vermont recently 

 reported, that there were, in fifty-nine towns, 

 sixty insane males and eighty-four females, making 

 a total of 144, of whom forty-five are town pau- 

 pers, and forty are poor and destitute. This 

 committee estimate the whole number of the 

 insane in the State, exclusive of idiots, at 300, or 

 one to 1000 inhabitants. These statistics respect- 

 ing insanity, though few and imperfect, show, that 

 the disease is alarmingly prevalent in the northern 

 States of the Union. 



With respect to the treatment of this >ery dis- 

 tressing affection, the only hopes of cure rest upon 

 an early application for proper medical advice. The 

 average duration of the complaint under the care of 

 Pinel was from five to six months, but the great- 

 est number of recoveries took place in the first 

 month. This is also the opinion of Esquirol. 

 The greatest amount of recoveries is obtained in 

 the first two years, but the mean duration is less 

 than one, and after the third year, the chance of 

 cure is scarcely one in 30. This is a conclusion 

 at which Esquirol arrived, founded on an experi- 

 ence from 1804 to 1813 at Salpetriere. A similar 

 conclusion has been come to at the Gloucester 

 asylum. 



The most favourable age for recoveries is from 

 twenty-five to thirty, but women frequently 

 recover after forty-five ; and there are four cases 

 recorded at Charenton of recoveries where each 

 patient was seventy years old. Writers in general 

 admit that recoveries are more frequent in women 

 than men. 



Dr Burrows gives a report of cures in recent 

 cases ninety-one in 100, and in sixty-four old cases 

 nineteen cures. This is considered by some as 

 much too great, and they account for it by sup- 

 posing, that many were discharged before a com- 

 plete cure was effected. Esquirol states that, out 

 of the gross amount of admissions at Bicetre, of 

 12,592, 4968 recovered. At Bethlem, St Luke's, 

 and the York asylum, the admissions from 1748 

 to 1814 were 16,516, of whom 5918 recovered. 

 From this it appears that the cures in England 

 were formerly fewer than in France. In Lancas- 

 ter there were admitted, from 1817 to 1832, 1750 

 lunatics ; of these, 597 were cured, a proportion 

 of about forty in a hundred. In the Retreat, near 

 York, from 1812 to 1833 inclusive, 334 were ad- 

 mitted. Of these, 168 were cured, fifty died, 

 thirty-seven removed, ten improved, sixty-nine re- 

 mained. Here the probability of recoveries in 

 recent cases is nine to one. 



Insanity is not reckoned among the diseases in- 

 jurious to life. In this state the brain, though 

 unfit for intellectual operations, is able to carry on 

 other processes dependent on it, but which are 

 subservient to physical existence. In 1812 there 

 were at Bicetre one who was there fifty-six years, 

 three upwards of forty years, twenty-one more 

 than thirty years, fifty upwards of twenty years, 

 and 150 for ten years. The dates of entry for 

 seven cases, at Salpetriere, were from fifty to fifty- 

 seven years, eleven from fifty to sixty years, and 

 seventeen from forty to fifty. 



The admissions of males to females are, at Cha- 

 renton, as three to two. At Bicetre the case is 

 reversed, females are to males as three to two. In 

 the south of France there are more females than 

 males in asylums; the contrary obtains in the 

 north ; but throughout France the females are to 

 males as fourteen to eleven. In Spain there is an- 

 excess of females of one-fifth over males. In Italy 

 the males predominate. According to the returns 

 which Guislain has made of Holland and Belgium, 

 females are to males as thirty-four to twenty-nine. 



In Great Britain and Ireland the males are to 

 females as thirteen to twelve, and in the United 

 States the males are to females as two to one. 

 Esquirol shows, from the gross amount of lunatics 

 confined all over Europe, of 76,526, that there 

 were 37,825 males, and 38,701 females, about 

 thirty-seven to thirty-eight, without the fraction. 



