During a period of nearly twenty years' management of a private asylum for middle-class patients, and a like period of consultation practice in our specialty, I have had constantly brought to my notice the difficulty—very often, indeed, the impossibility—of finding proper accommodation for insane patients unable to pay fees of more than fifteen to twenty-five shillings per week, and the difficulty has vastly increased with the increasing numbers of pauper lunatics who now crowd out the already very small number of private patients provided for in county and borough asylums.