Death-Rate statistics of persons dying in large institutions are often inexact, as their accuracy depends to a very large extent on the personal factor of their compiler. Unfortunately, the statistics of the death-rate from tubercular disease, particularly phthisis, occurring in asylums leave no room for doubt that the insane, as a class, are particularly liable to contract tubercular disease. The English Lunacy Commissioners in their report for 1902 say: “The proclivity of the insane, whether confined in asylums or not, to tubercular disease, especially pulmonary, has long been recognised.” In all asylums, according to Clouston, who was amongst the first to draw attention to the fact, consumption is between three and four times more common than in the general population at the same ages.