182 On Insanity. [April, 



the cures were about 43 in 100 admissions. In Wakefield County 

 Asylum from 1819 to 1826 the cures were 42 in 100. In Lan- 

 caster Comity Asylum from 1817 to 1832 the cures were about 40 

 per cent. 



The Gloucester Asylum from 1823 to 1832 dismissed nearly 

 50 per cent, of its inmates cured. The same average result was 

 obtained in the E err eat, near Tort, from 1812 to 1833. 



X ow it must be admitted that the treatment of the insane was, 

 so far as comfort and science were concerned, at a very low ebb 

 during the early twenty-five years of this century. The " magni- 

 ficent period" has lasted from 1835 to the present day. What 

 do the statistics of recoveries (which relate to the past thirty years) 

 prove in comparison with those just mentioned, and which belong 

 to the past ! In the Somerset County Asylum 3284 patients were 

 admitted from 1848 to 1868, and the recoveries were 42 per cent. 

 T_T BrYGcage number of the cures of the Scottish Asylums amounts 

 to about from 37 to 40 per cent. The average percentage of reco- 

 veries to admissions into English asylums during the past ten 

 years has been, for the county and borough asylums, 33'93 ; and for 

 the private licensed asylums of the metropolis, 27*60. It follows 

 that the cures of the insane in our fine asylums are not more 

 numerous than they were from 174S to 1814, when the treatment 

 of the insane was a disgrace to humanity. If anything is to be 

 made out of the statistics, the percentage of cures has rather fallen 

 off. Whilst every other disease has been less persistent and has 

 been more curable, insanity remains as a dead-weight on the statis- 

 tics of our social miseries. To refer this unsatisfactory state of 

 things to the comforts of asylums, or to the system of treatment 

 adopted by the able men who labour in this thankless part of the 

 medical profession, is simply absurd. 



The cause of the mass of incurabihty is tolerably evident, and 

 the defects of the system which prevent a cure are so also. 



It is admitted that the majority of the insane are more curable 

 during the first year of the attack than subsequently, and that 

 mania is, as a rule, followed by recovery in from 90 to 95 per cent. 

 of cases. But every month that elapses without amendment in 

 the mental condition complicates the affliction and diminishes the 

 chance of recovery. Eveiy relapse acts in the same manner. The 

 quiet and chronic cases are of course those whose persistence in the 

 same state renders the percentage of causes so unsatisfactory. Kot 

 only is the malady produced in them, either by hereditary predis- 

 position, by a long perversion of the nutrition of the brain by reason 

 of mental and moral abuse, or by organic disease, but it is perpe- 

 tuated by the rest-and-be-thankful treatment which sooner or later 

 must be adopted under the present system. The routine of an 

 asylum and its moral and physical atmosphere act after a while per- 



