The number of persons in Great Britain registered as insane is now 62,023. Of these 54,713 are English and 7,310 Scotch. Ten years ago the numbers were 39,647 and 6,251, or 45,898 in all. An increase of 16,125 lunatics in ten years in this country is a most noteworthy fact. It has hitherto received no thoroughly satisfactory explanation. We can conceive of no question the solution of which would be more interesting medically, socially, and economically. It is to be earnestly hoped that the Commissioners in Lunacy will soon attempt it. They alone have the materials for working it out. They have already put forward partial explanations, or rather theories, supported by a certain amount of fact. But the subject in all its bearings is still in want of a satisfactory handling. All the facts and figures that bear on (1st) the cases registered as insane for the first time each year, (2nd) the mortality among the insane, (3rd) their mode of accommodation and treatment in each district from year to year, and (4th) the cases left as insane at the end of each year, would require to be ascertained and carefully considered before a true conclusion could be arrived at. Under the first heading a comparison of the numbers of well marked cases of the different varieties of recent insanity occurring each year would require to be made. And all the truth could not be got until a similar comparison of the varieties of chronic cases for the first time registered as insane each year was made, and also an attempt to discover the original forms of their insanity, the treatment to which they had been subjected, and its influence on their malady. Under the second heading, the death rate in each variety of insanity under the different kinds of treatment and distribution, the prospects of life and “natural termination” of the chronic cases, would have to be studied and compared with the numbers of new cases registered each year, and with the death rate and rapidity of increase of the population at large. The third point referred to would enable corrections to be made for certain counties in which changes in the accommodation for the insane had been made, and then all the preceding vital statistics applied to the figures under the fourth heading would bring out the whole truth in regard to the subject. In the Scotch report there is a new and able effort to take the question of age into account in dealing with the vital statistics of the insane; but unfortunately the chief value of the facts are not brought out, by not comparing them with the returns of the Registrar-General in regard to the numbers of the general population of different ages.

In the Annual Report of the Rainhill Asylum, the Medical Superintendent, Dr. Rogers, makes the following excellent remarks in regard to accidents in asylums, and the unjust accusations that have been based upon them:—

Among the various contributions which are appearing on all sides upon the value of the hydrate of chloral, we may quote the opinion of the able superintendent of the Devon Asylum. Dr. Saunders says:—

In the same chapter are brought forward numerous instances of delirium produced by toxic agents. Among these is a striking case of mania in a patient—the subject of syphilis— in whom, at an apparently hopeless stage, a cure was effected by iodide of potassium; and there are several cases of delirium in rheumatic fever, in connection with which the essentially neurotic character of this affection is affirmed. Other varieties of delirium considered are febrile and postfebrile, epileptic, traumatic, and puerperal; in the last, a nutritive or even stimulant treatment is decidedly recommended. The treatment of delirium is fully considered; blood-letting, general or local, is admitted to have value in certain cases; the cold douche, combined with the warm bath, is reported as exceedingly well worth trial; tartar emetic, with opium, is affirmed to be useful, but as contra-indicated by a weak heart; the use of hydrocyanic acid has a similar caution attached to its recommendation.

Dr. Thurnam, in his Report, tells us that comparing the Commissioners, “Returns of Pauper Lunatics” with the Returns of Population for 1861, it will be found that Wiltshire stands in the unenviable position of having a greater proportion of insane paupers than any other county of England and Wales. Those most nearly approaching it are Gloucester, Oxford, Berks, and Dorset, all agricultural counties; while the ratio of pauper insanity is lowest in Durham, Glamorgan, Stafford, Yorkshire, Cornwall, Derby, Chester, and Lancashire, the most influential in the mining, manufacturing and trading enterprise of the kingdom.

The efforts of our Transatlantic brethren to cure chronic drunkards by the establishment of “Inebriate Asylum,” demand our serious attention, for probably no class of persons brings so much perplexity to the readers of this journal. The “Medical Times and Gazette” (April 9th and 16th, 1870) gives an account of the labours of Dr. Albert Day in two asylums of which he has been superintendent. Dr. Day seems to be a remarkable man. The following particulars are gathered from an article in the “Atlantic Monthly,” entitled “Inebriate Asylums, and a Visit to One”:—

Dr. Clouston tells us in the annual report of the Cumberland and Westmoreland Asylum a fact which may be new to some superintendents, viz., that his patients have no beer.