184 On Insanity. [April, 



ment that the present condition of the pauperized, and of those 

 -who must become paupers in the ordinary course of events, is fa- 

 vourable to hebetude and to mental decadence, as well as to physical 

 degeneration. It is clear that the majority of the pauper insane 

 enter asylums with the malady in their very bones, and year after 

 year hereditary predisposition adds to its intractable nature. Our 

 social state is producing year after year an increasing amount of 

 insanity more than ever difficult of cure. 



It is evident to those who can consider the question dispassion- 

 ately that the method of treatment of the majority of the chronic 

 cases forming the bulk of the inmates of asylums is inordinately 

 expensive, unsatisfactory as regards its results, and not right in 

 principle. It is a failure. There is no doubt about the efficiency 

 of the treatment adopted in asylums in cases of mania and in those 

 where suicide is feared; moreover, there is a social necessity for 

 separating those thus afflicted from their fellow-men. The total 

 alteration of scene and diet, the moral influence of strange faces, 

 and of the clock-like regularity of the establishment, constitute, 

 however, with that valuable medicine, time, the principal curative 

 agents. Medicine, so far as drugs are concerned, has advanced 

 very slightly since the time of the Greeks in the treatment of 

 insanity, and no important addition to our knowledge concerning 

 the relation of drugs to insanity has emanated from the alienist 

 physicians of the past twenty years. Every severe disease has 

 attracted the urgent attention of the medical profession, and those 

 which were formerly very fatal are now so managed that a cure is 

 by no means rare, and, moreover, it bears a definite relation to the 

 administration of drugs. But the medical treatment of the insane 

 is in the hands of a few, and the alienists constitute a very close 

 borough : so of course no progress commensurate with the spirit of 

 the age is made. Kind Kature cures the majority of the lunatics 

 who recover, but she certainly does not get the credit. She is 

 opposed by the asylum system in the cure of the chronic cases, and 

 therefore they remain much the same as fifty years since. 



Our social errors produce such types of madness that even the 

 Commissioners are downhearted, and begin to be philosophical. 

 They write, despairingly, as follows: — 



" Hitherto our efforts have been mainly directed to the pro- 

 vision of asylums for the cure and care of the insane ; bat these 

 efforts, however beneficial they may be in many respects, have, as 

 we have seen, totally failed to meet the increase of lunacy. That 

 more successful results would be obtained from the rational educa- 

 tion of the people, and from the introduction of physiological in- 

 struction into schools, may very reasonably be expected. The pre- 

 vention of insanity is not only a far nobler aim than the provision of 

 accommodation after the mischief has been done, but it is one which 



