London County Asylum, Bexley Heath (Report for the year ending March 31st, 1904). – The average number of patients resident during the year was 2085, comprising 1012 males and 1073 females. The admissions during the year amounted to 585 – viz., 282 males and 303 females. Of these, 528 were first admissions. Dr. T. E. K. Stansfield, the medical superintendent, states in his report that “the hopeless character as to the possibility of recovery of the bulk of the admissions during the year is clearly demonstrated..... The axiom the sooner the disease can be brought under treatment the greater hope there is of recovery applies more to mental alienation perhaps than to any other form of disease.” Only 30 per cent. of cases came under treatment within three months of the beginning of the attack, owing to which, adds Dr. Stansfield, “not only is the possibility of recovery greatly diminished but when recovery does take place the permanent injury present in every case is proportionately greater. The importance of habit in relation to mental diseases is but little appreciated and yet to my mind it is one of the most powerful factors in the development of chronic insanity and it remains after the first causes have passed away, as is well illustrated by the bulk of cases in every asylum. All this points to the urgent necessity of patients being bought [sic] under proper observation and treatment at the earliest period of their alienation before insane habits of thought and action become fixed.” Melancholia was present in 23 per cent., paranoia and delusional insanity in 14 per cent., primary dementia in 13.5 per cent., and general paralysis in 6 per cent. of the admissions. Among the causes of insanity were arteriosclerosis, senile decay, alcoholic intemperance, insane parentage, and syphilis, in descending order of frequency. “The important part played by heredity in the causation of mental disease was demonstrated by the fact that insane heredity was made out in 132 cases or 22.5 per cent.” The number of cases discharged as recovered during the year amounted to 162 – viz., 56 males and 106 females, or 7.7 per cent. of the average number resident. The deaths during the year amounted to 167, or 8 per cent. as calculated on the same basis. Of the deaths seven were due to renal disease, nine to colitis, 13 to cerebral softening, 18 to cardiac disease, 19 to pulmonary and other forms of tuberculosis, 46 to general paralysis of the insane, and the rest to other causes. The Commissioners in Lunacy state in their report that the general scheme and management of the asylum deserved favourable commendation, that the patients appeared to be well dressed and well cared for, that the day-rooms and dormitories were bright throughout, and that the medical case books were kept in a highly satisfactory manner. They recommend that in case of fire the high level water-tank should be used. The committee of management states in its report that plans have been prepared and adopted for the erection of a hospital villa to accommodate 50 male patients and the necessary staff. The internal decoration of the asylum is now complete.