∗ With this yearly increase in the number of inmates of the public asylums we may contrast the statistics in the metropolitan licensed houses, where the numbers are yearly decreasing, or are at most stationary. In 1854 they had 1206 private patients and 1141 pauper, total 2347. In 1864 these numbers are 1480 private and 842 pauper, total 2322. In the decennium 1854–64 there is thug a decrease of 25 in the numbers in the metropolitan licensed houses. In the provincial licensed houses there has been a similar decrease. In 1854 and 1864 their total numbers were 2533 and 2133 respectively, being a decrease of 400 in the decennium. In 1854 the mean population resident in all the licensed houses (metropolitan and provincial) was 4604; in 1863 it was 4531, being a decrease of 73 on the number of inmates of all the licensed houses.Google Scholar

∗ 100 : 26 : : 120,000 : 81,200. The actual number resident at the end of the fifteen years is 27,338.Google Scholar

† I am indebted to Dr. Sankey, of Sandywell Park, for this information.Google Scholar

∗ In Scotland the practice of licensing lunatic wards for clironic cases in workhouses, viewed at first as a temporary expedient, has been finally confirmed by the 3rd section of the 25 and 26 Vict., cap. 54 (29th July, 1862). On the 1st of January, 1864, there were 878 pauper lunatics in these licensed wards. In their Report for 1863 the Scotch Commissioners made some remarks on this system, according with the view taken in this paper of the treatment of the insane in workhouses. “The chief motive,” they observe “of parochial boards in providing such accommodation is undoubtedly economy. They are of opinion that the rate of maintenance in poor houses will be less than in asylums; but this belief can be realised only by limiting the appliances of treatment and restricting the comforts and enjoyments of the patients; or by selecting only those patients who require no special attendance nor any particular care.” The whole section (‘Fifth Annual Report,’ pp. xlvi-lv) on lunatic wards in poor houses is worthy of careful consideration by those who in England would imitate the system.Google Scholar

∗ ‘The Insane in Private Dwellings,’ by Mitchell, Arthur, A.M., M.D., Deputy Commissioner in Lunacy for Scotland. Edinburgh, 1864, pp. 97. The notice which we have in this article given to this question renders it superfluous now to insert the review of Dr. Mitchell's interesting essay, prepared for publication in this Journal last April, but omitted both from the July and October numbers, owing to the continued pressure of other matter on our space. We would now refer those desirous of learning in detail the working in Scotland of the system of “The Insane in Private Dwellings,” to Dr. Mitchell's well-written essay. Were we disposed to criticism, we might add that his views betray a want of practical knowledge of the treatment of the insane in public asylums, and that he is thus disposed to assume the fitness of lunatics, whom asylum discipline alone renders bearable, for the greater freedom and excitement of the private dwelling.Google Scholar

∗ ‘Sixth Annual Report of the General Board of Commissioners in Lunacy for Scotland, 1864.‘Google Scholar

† Op. cit.Google Scholar

∗ In the ‘Journal of Mental Science,’ April, 1859, will be found a letter by Dr. Bucknill, on “Lunacy Reform,” addressed to the chairman of the Devon Committee of Visitors, and a member of the Parliamentary Committee on Asylums then sitting, containing suggestions in unison with those which I here advocate. “I propose,” he writes, “to remedy these evils by removing from boards of guardians all authority and control over lunatic paupers, by giving to the committees of justices power to visit union-houses and to order the removal of any lunatics found therein, and the power to order and direct the medical visitation and pecuniary relief of lunatic paupers at their own homes, or wherever else they may think it expedient that it should be administered.”Google Scholar

∗ In the ‘Journal of Mental Science’ for January, 1864, will he found a sketch by Dr. Bucknill of an asylum for 650, entirely constructed on the separate block system. I believe it is from this plan that the new asylum for the county of Surrey, in course of erection at Woking, was designed.Google Scholar At the last annual meeting of the Association of Medical Officers of Asylums and Hospitals for the Insane Mr. Toller read a paper (subsequently published, with plans, in the ‘Journal of Mental Science’ for October, 1864), “Suggestions for a Cottage Asylum for 525 Patients,” which is, however, merely a plan for an asylum on the separate-block system, carried to the minute subdivision of 35 blocks with 15 patients in each. While admiring Mr. Toller's ingenuity, I cannot regard his plan as likely to answer in practice. Thus, he proposes 35 separate kitchens—one for each block, with a patient for a cook in each. Again, he has only one attendant in each block, &c. How the night-nursing also is to be carried out in 35 separate buildings he does not say. Mr. Toller's whole plan strikes me as being capable of much improvement; and for a block-asylum plan, which it is, I regard it as inferior to Dr. Bucknill's.Google Scholar

† 1. “Cottage Asylums; by W. A. F. Browne, one of the General Board of Commissioners in Lunacy for Scotland;” ‘Medical Critic,’ April, 1861.Google Scholar 2. “Cottage Asylums : a Sequel;” ibid., July, 1861.Google Scholar

∗ In nearly 6000 cases by Esquirol, Desportis and Jacobi, the unmarried were more than double the married; nearly 1 in 10 were widowed.Google Scholar