A question that has been prominently before the public for the past few years, and which has not always been discussed with the cool reason so weighty a subject demands, is the control, custody, and treatment of the insane community known as private patients; and for the purpose of present argument I class those patients as private patients whose cost is defrayed without aid from the State—either in the matter of board, lodging, or attendance; for though private patients who reside in hospitals for the insane receive this aid, the building in which they reside is provided from special funds (and most hospitals have a small income from invested funds or annual subscriptions), it amounts to very little, and is absorbed in the free cost, or mitigation in the cost of maintenance, of a few patients. In speaking of lunatic hospitals, I leave out of the question the great Hospital of Bethlem, where the maintenance of the patients is entirely defrayed from the funds of the charity.

“Well, doctor, what do you think is the matter with my patient?”

Arethæus asserts that several physicians, and among them the famous Asclepiades, observed that venery cures epilepsy developed at the age of puberty. The same opinion was professed by Scribonius Largus, and, with these authors, the corruption of retained semen originated the spasmodic malady in such cases, Alfarins à Cruce, commenting on these primitive ideas, contends that, in similar instances, the change of age effects the cure improperly attributed to venery. His pupil Sinibaldi, declares venery powerless against fits, exploding after the age of fifteen, especially in adults, or individuals of an advanced or old age. But in epilepsy à putrescent, upon seminal retention, venery may prove of such great moment as to occasion altogether its cure.

From the short time at my disposal, and from not having beside me the complete records of the asylum, my remarks to-day must necessarily be more limited in their scope and desultory in their character than under other circumstances would have been the case. I must content myself with bringing before you, in a very general way, some facts relating to the proportion of insane amongst the different races and people which go to make up the much diversified population of British Guiana, and I may notice also a few of the more prominent forms of insanity seen in that colony. What I have to say may, I trust, possess sufficient novelty to be interesting, and may prove none the less suggestive, although its object be not to support any preconceived or pet theory. British Guiana, although a West Indian Colony, forms part of the mainland of the Continent of South America, and amongst its inhabitants is seen a diversity of races as great, if not greater, than in any other country of like extent. There are two large primary divisions into which the population may be separated, namely, those born in the colony—in local phraseology called creoles—and immigrants. In 1871, the date of the last census, the population of the country numbered 218,909, consisting of 103,775 creoles and 115,134 immigrants. Neither in these numbers nor in any subsequent calculations are the aboriginal Indians (bucks) included, who inhabit the interior of the Colony, and who do not supply any contingent to its known insane population. The first division or creoles comprises a very large population of blacks of fine negro blood, descendants of the local slaves of pre-liberation days and of black immigrants subsequently brought from Africa or the neighbouring West Indian islands. In this class are to be found the greatest number of the coloured people of mixed African and European extraction in various degrees of combination, with a few white creoles of pure European descent. Amongst the immigrants are included, firstly, the black and coloured people who have come from the other West Indian colonies, chiefly from Barbadoes; secondly, negroes born in Africa imported as free labourers, and who mostly belong to the West Coast tribes; thirdly, many East Indians (coolies) brought under indenture to work as labourers on the sugar estates; fourthly, a good number of Chinese, introduced for the most part under similar circumstances; fifthly, Portuguese who have come from Madeira and the Cape de Verde Islands; and, lastly, a comparatively small proportion of Europeans.

Much attention has been directed of late, more especially in America, by Dr. Pliny Earle, to the ordinary mode of calculating recoveries from insanity. Having examined with some care into the different results of several modes of making these calculations, I propose to state in this paper the conclusions to which I have been led, and to suggest an improved form of tabulating cures in the Reports of our asylums.