295
Art. X.?LUNACY IN ENGLAND. We have
just
received the
Thirty-first Report
of the Commis-
sioners in Lunacy. Every year we see an increase in the number of lunatics on the official books of the Commissioners. On the 1st of January this year there were 66,636 persons of unsound mind in England and Wales, being an increase of 1,720 upon that of the previous year; this number is exclusive of 252
Chancery patients residing with committees.
The
following
is
the summary of the classification and distribution of persons of
unsound mind
:?
Private
Total
Pauper
Where maintained
In
county and borough asylums
In
registered hospitals
In licensed houses
M.
F.
T
196
242
438
31.
M.
F.
16,066 19,019 35,085 16,262 19,261 35,523
1,370 1,267 2,637
50
44
94
1,420
1,311
2,731
1,807 1,650 3,457
471
794
1,265
2,278
2,444
4,722
In naval and military hospl tals and Koyal India Asylum
343
15
358
343
15
358
In State Criminal
196
53
249
390
104
494
175
283
458
283
458
Private
Asylum
single patients
In workhouses
.
.
Out-door paupers
Total
3,510 7,597
175
6,836
9,202 16,038
6,836
9,202 16,038
2,461
3,851
6,312
2,461
3,851
6,312
32,961 59,039 30,165 36,471 66,636
The average increase of the last ten years has been 1,755. Of the stated number of lunatics 7,597 are private patients and 59,039 paupers. By this we see that the number of the former class of patients has'increased by 88, and of the latter by 1,632. As compared with the previous year, the Report contains some valuable statistical tables, and we wish to draw especial attention to Tables 14 and 15 ; these refer especially to the various as obtained by the Commissioners from causes of insanity, certain data obtained from the superintendents of the various asylums. On this important subject we read as follows :? We have long been desirous, concurrently with the publication of details as to the number, classification, and distribution of the insane of setting forth some statistics as to the causes of insanity. Consider-
296
LUNACY
IN ENGLAND.
have always stood in our way, The only of information in our possession were the statements of " supposed causes" annexed to the Statutory Orders of reception, signed either by the friends of private patients, or by the relieving officer in the case of paupers. These, as our experience shows, are too conjectural to be depended upon for statistical purposes. On consideration there appeared little hope of procuring trustworthy returns as to the prevalent causes of insanity without the co-operation of the medical superintendents of the County and Borough Asylums, many of whom, in their annual reports to their committees of visitors, had already been accustomed to give a table of causes of insanity verified by their own inquiries, though differing in form and detail in each institution. able
difficulties, however,
sources
Hence, though naturally reluctant
to add
to the labour of these
determined, early last year, to ask, not only the medical superintendents of asylums, but also the medical officers of all other institutions (except workhouses) receiving insane patients, to keep (for one year only, and as an experiment) a special register on a certain prescribed uniform plan, to be forwarded to our office at the end of the and tabulation. The year for examination help thus requested was, with one exception, at once promised, and in the solitary instance where it was at first refused, it was subsequently given, so that the returns ultimately became so far complete as to include particulars relative to gentlemen,
we
all the admissions of 1876 into County and Borough and State Asylums, and Licensed Houses in England and Wales. We desire here to offer our best thanks to all those who have thus so willingly and ably assisted us. The keeping of our register demanded, in every case, patient inquiry and observation, and in the larger asylums must doubtless have involved the expenditure of considerable time and
Registered Hospitals,
trouble.
Of the chief causes enumerated may be mentioned intema perance, with large percentage both as an exciting as well as Of 3,141 patients admitted a predisposing cause of insanity. into private asylums during the past year, 453 are stated to have become insane from intemperance; the second in rotation being mental anxiety and worry, the number here being 311. Of the various causes for insanity occurring in county hospitals and borough asylums, out of 11,011 patients 1,661 are stated to have been driven mad from drink. It is appalling to see the great ravages made by intemperance on our fellow creatures, and yet we have no power to restrain the victims from continuing their excesses. The tables referred to are a most valuable addition to the study of psychological research, and are most carefully drawn up and arranged for easy reference. There is one very valuable table to which we wish to draw especial attention, and the first of this kind we have as yet seen. We refer to that in which the professions and occupations are given as bearing directly on the various assigned causes of insanity. After carefully considering the various causes of
LUNACY
IN
297
ENGLAND.
the Report gives the occupations and professions and orders of those admitted in the asylums during the past year. The Commissioners draw attention again to the defective watching of epileptic cases during the night in several asylums, and particularly in county and borough asylums. The Report contains accounts of various suicides which have occurred in asylums during the past year, and some instances appear to us The death by violence of a to have been caused by neglect. patient in the Durham County Asylum having given rise to much correspondence by the Commissioners, we append particulars of the case.
insanity,
The death of a patient named T. D. in this asylum, on the 4th of gave rise to much correspondence between ourselves, the of State, and the Visitors of the asylum, and led eventually to a special inquiry by two members of the Board. The facts of the case, as stated at the inquest, which was im-
January, Secretary
mediately held, The
were
patient,
who
restless and unsettled
shortly these: was suffering
from
general paralysis,
was
in
a
mind, and was therefore placed in No. 4, the refractory ward. On the evening of the 2nd of January it was alleged that he attempted to pull another patient, M. M., from his chair,
but that the
patient
state of
seized him
by
the
legs,
threw him
violently
on
the
floor, and then jumped upon him. The attendant in charge, named Gunner, who was at the other end of the room, immediately ran across, but was not in time to stop the assault. Shortly afterwards T. D. molested another patient, had another fall, and Avas kicked by the person with whom he interfered. The next morning the attention of the assistant
called to T. D. on account of a cut at the back of ; but this was not of a severe character, until the evening of nor Avere any serious consequences apprehended the same day, when the patient appeared to be very unwell, and after careful examination it was discovered that there were extensive fractures of the ribs and other injuries, from which he died on the morning of the 4th. The jury found that death was caused by M. M. jumping did not ascribe any blame to any upon the deceased's chest, and they of the officers or attendants. Upon the evidence so given it appeared At the same to us that there was no ground for further proceedings. time we considered that the attendant Gunner was much to be censured for not having immediately reported the assault. In consequence, however, of communications addressed to the Home Office by the guardians of the union to which T. D. belonged, the Secretary of State requested us to make a special inquiry into the matter. Accordingly, two members of our Board held the inquiry at the in the of which a patient, J. W., Asylum on the 24th February, to thecourse time of the alleged assault evidence that, subsequently by gave M. M., he had witnessed an assault by two of the attendants (of whom Gunner was one) and a patient on T. D., the alleged cause of which he stated to be the unruly conduct and bad language of T. D. towards the attendants and other patients. Our colleagues were of opinion that NEW SERIES. VOL. III. PAET II. U medical officer
was
his head having been noticed
298
LUNACY IN ENGLAND.
the fatal
injuries had been received at this time, and not at the time by Gunner. They considered, however, that the mental condition of J. W. was such that, though before them he was able to give his evidence satisfactorily, he would probably be incapacitated by excitement from repeating that testimony in the witness box. They could not, therefore, recommend that proceedings should be taken against Gunner and the other attendants (Gunner resigned his situation the on the inquest), but in communicating their report to the day after Visitors of the asylum, they urged that a careful watch should be kept who on the other spoken
to
attendant, remained in their employment. This has been done, and reports have been subsequently furnished to us, in which the Visitors state their thorough confidence in him.
We see that many of the county asylums have been enlarged, and that plans have been submitted to the Commissioners for further alterations in structure. These have taken place in the Essex Cambridge, Glamorgan,
Kent, Northampton, Somerset, Surrey, Warwick, Wiltshire, and York Asylums. The cost of patients per head, including clothing, care, and medicine, averaged 9a. lOJd, and in borough asylums Us. lid., making an average together of lOg. Igd. The cost of patents in thesi asylums is greater than last year, and this is chiefly in consequence of the high price of provisions. The patients in the registeied hospitals on the 1st of January amounted to 2 731
and the admissions during the year were 450 males and 488 females; the discharges were 819, of whom 322 were discharged The deaths were 184. The as recovered. recoveries that hive in the taken place hospitals have been at the rate of 40-7 ner cent, as compared with the admissions of the The mor year tality upon the average number daily resident during the year in the 16 hospitals is 6-6 per cent. In the provincial and metropolitan asylums, amounting in all to 100 in number, there were 2,278 males and 2,444 females of on the 1st January 1877. There were 16,038 persons of unsound mind detained in workhouses on the 1st ofJanuary. the year the Commissioners During have visited 309 of these workhouses. We contend that this is not a proper place for a person of unsound mind to he placed, and sufficient accommodation should be furnished in our asylums for these inmates. W e append a case of suicide at occurring ? one of these workhouses:? A suicide at Market Ilarborough Workhouse, in August last, further demonstrates the danger of dealing with recent cases by removal to a workhouse. A relieving officer was, it seems, told that a young man m his district was "not quite right"; he called in the medical officer of the Union to see him ; that gentleman was unwilling to certify for the man s removal to an asylum, but the person with
LUNACY
whom the
man
lodged
IN
ENGLAND.
299
would not allow him to remain in her house any
longer, therefore the man was brought to the workhouse under an order, it seems, of the guardians. According to the evidence given at the coroner's inquest by the woman with whom the young man lodged, he had wished to get out of the window, and he had threatened
The master of the workhouse denied any to drown himself. knowledge that the man had shown any disposition to destroy himself. At 3 p.jik next day, the lunatic cut his throat in the workhouse, with a razor abstracted by him from a cupboard in a room the door of which was We may add that this occurred in a workhouse, the not kept locked. master of which, subsequently writing on this case to the Commissioners, took considerable credit to himself for having taken extra precaution on account of a previous report by one of the members of this Board, which had attracted his notice.
The Report contains an account of prosecution of various attendants for ill-treatment and neglect of patients. A fine of ?20 and imprisonment in some of these cases has been inflicted. One case is cited in which a prosecution by the Visitors was made in consequence of a patient receiving a blow from an attendant and causing a fracture of one of his ribs in consehe was sentenced to quence. He was fined ?15, but, in default, two months' imprisonment. The Commissioners draw attention to improvements which in some of the private licensed houses, and to have taken
place
the transfer of licences. On the 1st of January there were 458 persons of unsound mind taken care of as single patients. We are much opposed to if it is patients remaining under certificate in private houses, the We give following possible to treat the cases in asylums. case of the death of a lady,' who, though decidedly suicidal, was removed from an asylum and placed as a single patient in a medical man's house. Some people have a certain prejudice to to place lunatics in well*asylums; but it is far more preferable to allow them to be detained under than institutions managed the supervision ot two attendants in a private house. It is an obvious fact that such a case is unsuitable to be treated as a
private patient. A lady, formerly a patient in Brooke House, was transferred on the 13th of December 1875, at the request of her brother, as a single patient to the care of Dr. Dawson, of Brighton, and two days afterwards she destroyed herself by throwing herself out of her bedroom window on the second floor, fracturing her thigh and skull. Previous to sanctioning the transfer of this lady, we received, in reply to our usual letter, a statement from Mr. Adams, of Brooke House, dated 27th November, that she was suffering from melancholia, was in good bodily health, and a proper person to be transferred to single charge. Upon u
2
300
LUNACY IN ENGLAND.
subsequent inquiry, however, it transpired that the patient, who on admission laboured under suicidal melancholia, had put her head through a pane of glass a few days before she was removed to Brighton, and tried to get possession of a piece of the glass; and the day after she went into a cutler's shop with her nurse and secreted a knife, with which, on her return, she tried to cut her throat. We considered that these facts should have been at once communicated to us, when no doubt we to should have declined sanction the removal of this lady to single care, and we expressed to Mr. Adams our great surprise that he should have omitted doing this. In reply, he stated that he detailed fully those occurrences to the friends of the patient, and explained to them the risk there would be m removing her, and also to Dr. Dawson he communicated his opinion that she ought to have two nurses, should be watched at night should not be allowed the use of sharp knives or scissors, and should be kept under special Two nurses supervision. were indeed engaged specia ly to attend upon the patient, but only one was m the room when she threw herself out of the window, which she was powerless to prevent That the most ordinary precaution of on the window, so as to placing stops prevent the sashes from being opened more than a few inches, showed great want of care on the part of Dr. Dawson in dealing with a patient so disposed to destroy herself. The
Report contains
a complete list of all public and.private and the full entries made by the Commissioners in the books of the various county asylums and large hospitals Our space will not permit us to discuss these at length; but, from a of careful perusal the Commissioners' entries, we are of opinion that the care of the insane is considered in everyway in the public asylums of England. The Commissioners' Report, taken is a as a whole, faithful account of the condition of lunacy in England and W ales, and is the result of the combined efforts of gentlemen who devote their energy and skill to protect this unhappy class of human beings. The contents of the Report is a wonderful contrast to the fallacies and untruths extraordinary stated by many witnesses before the Lunacy Committee, a consideration of which we propose in our next issue to discuss in detail.
asylums
Art. X.?LUNACY IN ENGLAND. We have
just
received the
Thirty-first Report
of the Commis-
sioners in Lunacy. Every year we see an increase in the number of lunatics on the official books of the Commissioners. On the 1st of January this year there were 66,636 persons of unsound mind in England and Wales, being an increase of 1,720 upon that of the previous year; this number is exclusive of 252
Chancery patients residing with committees.
The
following
is
the summary of the classification and distribution of persons of
unsound mind
:?
Private
Total
Pauper
Where maintained
In
county and borough asylums
In
registered hospitals
In licensed houses
M.
F.
T
196
242
438
31.
M.
F.
16,066 19,019 35,085 16,262 19,261 35,523
1,370 1,267 2,637
50
44
94
1,420
1,311
2,731
1,807 1,650 3,457
471
794
1,265
2,278
2,444
4,722
In naval and military hospl tals and Koyal India Asylum
343
15
358
343
15
358
In State Criminal
196
53
249
390
104
494
175
283
458
283
458
Private
Asylum
single patients
In workhouses
.
.
Out-door paupers
Total
3,510 7,597
175
6,836
9,202 16,038
6,836
9,202 16,038
2,461
3,851
6,312
2,461
3,851
6,312
32,961 59,039 30,165 36,471 66,636
The average increase of the last ten years has been 1,755. Of the stated number of lunatics 7,597 are private patients and 59,039 paupers. By this we see that the number of the former class of patients has'increased by 88, and of the latter by 1,632. As compared with the previous year, the Report contains some valuable statistical tables, and we wish to draw especial attention to Tables 14 and 15 ; these refer especially to the various as obtained by the Commissioners from causes of insanity, certain data obtained from the superintendents of the various asylums. On this important subject we read as follows :? We have long been desirous, concurrently with the publication of details as to the number, classification, and distribution of the insane of setting forth some statistics as to the causes of insanity. Consider-
296
LUNACY
IN ENGLAND.
have always stood in our way, The only of information in our possession were the statements of " supposed causes" annexed to the Statutory Orders of reception, signed either by the friends of private patients, or by the relieving officer in the case of paupers. These, as our experience shows, are too conjectural to be depended upon for statistical purposes. On consideration there appeared little hope of procuring trustworthy returns as to the prevalent causes of insanity without the co-operation of the medical superintendents of the County and Borough Asylums, many of whom, in their annual reports to their committees of visitors, had already been accustomed to give a table of causes of insanity verified by their own inquiries, though differing in form and detail in each institution. able
difficulties, however,
sources
Hence, though naturally reluctant
to add
to the labour of these
determined, early last year, to ask, not only the medical superintendents of asylums, but also the medical officers of all other institutions (except workhouses) receiving insane patients, to keep (for one year only, and as an experiment) a special register on a certain prescribed uniform plan, to be forwarded to our office at the end of the and tabulation. The year for examination help thus requested was, with one exception, at once promised, and in the solitary instance where it was at first refused, it was subsequently given, so that the returns ultimately became so far complete as to include particulars relative to gentlemen,
we
all the admissions of 1876 into County and Borough and State Asylums, and Licensed Houses in England and Wales. We desire here to offer our best thanks to all those who have thus so willingly and ably assisted us. The keeping of our register demanded, in every case, patient inquiry and observation, and in the larger asylums must doubtless have involved the expenditure of considerable time and
Registered Hospitals,
trouble.
Of the chief causes enumerated may be mentioned intema perance, with large percentage both as an exciting as well as Of 3,141 patients admitted a predisposing cause of insanity. into private asylums during the past year, 453 are stated to have become insane from intemperance; the second in rotation being mental anxiety and worry, the number here being 311. Of the various causes for insanity occurring in county hospitals and borough asylums, out of 11,011 patients 1,661 are stated to have been driven mad from drink. It is appalling to see the great ravages made by intemperance on our fellow creatures, and yet we have no power to restrain the victims from continuing their excesses. The tables referred to are a most valuable addition to the study of psychological research, and are most carefully drawn up and arranged for easy reference. There is one very valuable table to which we wish to draw especial attention, and the first of this kind we have as yet seen. We refer to that in which the professions and occupations are given as bearing directly on the various assigned causes of insanity. After carefully considering the various causes of
LUNACY
IN
297
ENGLAND.
the Report gives the occupations and professions and orders of those admitted in the asylums during the past year. The Commissioners draw attention again to the defective watching of epileptic cases during the night in several asylums, and particularly in county and borough asylums. The Report contains accounts of various suicides which have occurred in asylums during the past year, and some instances appear to us The death by violence of a to have been caused by neglect. patient in the Durham County Asylum having given rise to much correspondence by the Commissioners, we append particulars of the case.
insanity,
The death of a patient named T. D. in this asylum, on the 4th of gave rise to much correspondence between ourselves, the of State, and the Visitors of the asylum, and led eventually to a special inquiry by two members of the Board. The facts of the case, as stated at the inquest, which was im-
January, Secretary
mediately held, The
were
patient,
who
restless and unsettled
shortly these: was suffering
from
general paralysis,
was
in
a
mind, and was therefore placed in No. 4, the refractory ward. On the evening of the 2nd of January it was alleged that he attempted to pull another patient, M. M., from his chair,
but that the
patient
state of
seized him
by
the
legs,
threw him
violently
on
the
floor, and then jumped upon him. The attendant in charge, named Gunner, who was at the other end of the room, immediately ran across, but was not in time to stop the assault. Shortly afterwards T. D. molested another patient, had another fall, and Avas kicked by the person with whom he interfered. The next morning the attention of the assistant
called to T. D. on account of a cut at the back of ; but this was not of a severe character, until the evening of nor Avere any serious consequences apprehended the same day, when the patient appeared to be very unwell, and after careful examination it was discovered that there were extensive fractures of the ribs and other injuries, from which he died on the morning of the 4th. The jury found that death was caused by M. M. jumping did not ascribe any blame to any upon the deceased's chest, and they of the officers or attendants. Upon the evidence so given it appeared At the same to us that there was no ground for further proceedings. time we considered that the attendant Gunner was much to be censured for not having immediately reported the assault. In consequence, however, of communications addressed to the Home Office by the guardians of the union to which T. D. belonged, the Secretary of State requested us to make a special inquiry into the matter. Accordingly, two members of our Board held the inquiry at the in the of which a patient, J. W., Asylum on the 24th February, to thecourse time of the alleged assault evidence that, subsequently by gave M. M., he had witnessed an assault by two of the attendants (of whom Gunner was one) and a patient on T. D., the alleged cause of which he stated to be the unruly conduct and bad language of T. D. towards the attendants and other patients. Our colleagues were of opinion that NEW SERIES. VOL. III. PAET II. U medical officer
was
his head having been noticed
298
LUNACY IN ENGLAND.
the fatal
injuries had been received at this time, and not at the time by Gunner. They considered, however, that the mental condition of J. W. was such that, though before them he was able to give his evidence satisfactorily, he would probably be incapacitated by excitement from repeating that testimony in the witness box. They could not, therefore, recommend that proceedings should be taken against Gunner and the other attendants (Gunner resigned his situation the on the inquest), but in communicating their report to the day after Visitors of the asylum, they urged that a careful watch should be kept who on the other spoken
to
attendant, remained in their employment. This has been done, and reports have been subsequently furnished to us, in which the Visitors state their thorough confidence in him.
We see that many of the county asylums have been enlarged, and that plans have been submitted to the Commissioners for further alterations in structure. These have taken place in the Essex Cambridge, Glamorgan,
Kent, Northampton, Somerset, Surrey, Warwick, Wiltshire, and York Asylums. The cost of patients per head, including clothing, care, and medicine, averaged 9a. lOJd, and in borough asylums Us. lid., making an average together of lOg. Igd. The cost of patents in thesi asylums is greater than last year, and this is chiefly in consequence of the high price of provisions. The patients in the registeied hospitals on the 1st of January amounted to 2 731
and the admissions during the year were 450 males and 488 females; the discharges were 819, of whom 322 were discharged The deaths were 184. The as recovered. recoveries that hive in the taken place hospitals have been at the rate of 40-7 ner cent, as compared with the admissions of the The mor year tality upon the average number daily resident during the year in the 16 hospitals is 6-6 per cent. In the provincial and metropolitan asylums, amounting in all to 100 in number, there were 2,278 males and 2,444 females of on the 1st January 1877. There were 16,038 persons of unsound mind detained in workhouses on the 1st ofJanuary. the year the Commissioners During have visited 309 of these workhouses. We contend that this is not a proper place for a person of unsound mind to he placed, and sufficient accommodation should be furnished in our asylums for these inmates. W e append a case of suicide at occurring ? one of these workhouses:? A suicide at Market Ilarborough Workhouse, in August last, further demonstrates the danger of dealing with recent cases by removal to a workhouse. A relieving officer was, it seems, told that a young man m his district was "not quite right"; he called in the medical officer of the Union to see him ; that gentleman was unwilling to certify for the man s removal to an asylum, but the person with
LUNACY
whom the
man
lodged
IN
ENGLAND.
299
would not allow him to remain in her house any
longer, therefore the man was brought to the workhouse under an order, it seems, of the guardians. According to the evidence given at the coroner's inquest by the woman with whom the young man lodged, he had wished to get out of the window, and he had threatened
The master of the workhouse denied any to drown himself. knowledge that the man had shown any disposition to destroy himself. At 3 p.jik next day, the lunatic cut his throat in the workhouse, with a razor abstracted by him from a cupboard in a room the door of which was We may add that this occurred in a workhouse, the not kept locked. master of which, subsequently writing on this case to the Commissioners, took considerable credit to himself for having taken extra precaution on account of a previous report by one of the members of this Board, which had attracted his notice.
The Report contains an account of prosecution of various attendants for ill-treatment and neglect of patients. A fine of ?20 and imprisonment in some of these cases has been inflicted. One case is cited in which a prosecution by the Visitors was made in consequence of a patient receiving a blow from an attendant and causing a fracture of one of his ribs in consehe was sentenced to quence. He was fined ?15, but, in default, two months' imprisonment. The Commissioners draw attention to improvements which in some of the private licensed houses, and to have taken
place
the transfer of licences. On the 1st of January there were 458 persons of unsound mind taken care of as single patients. We are much opposed to if it is patients remaining under certificate in private houses, the We give following possible to treat the cases in asylums. case of the death of a lady,' who, though decidedly suicidal, was removed from an asylum and placed as a single patient in a medical man's house. Some people have a certain prejudice to to place lunatics in well*asylums; but it is far more preferable to allow them to be detained under than institutions managed the supervision ot two attendants in a private house. It is an obvious fact that such a case is unsuitable to be treated as a
private patient. A lady, formerly a patient in Brooke House, was transferred on the 13th of December 1875, at the request of her brother, as a single patient to the care of Dr. Dawson, of Brighton, and two days afterwards she destroyed herself by throwing herself out of her bedroom window on the second floor, fracturing her thigh and skull. Previous to sanctioning the transfer of this lady, we received, in reply to our usual letter, a statement from Mr. Adams, of Brooke House, dated 27th November, that she was suffering from melancholia, was in good bodily health, and a proper person to be transferred to single charge. Upon u
2
300
LUNACY IN ENGLAND.
subsequent inquiry, however, it transpired that the patient, who on admission laboured under suicidal melancholia, had put her head through a pane of glass a few days before she was removed to Brighton, and tried to get possession of a piece of the glass; and the day after she went into a cutler's shop with her nurse and secreted a knife, with which, on her return, she tried to cut her throat. We considered that these facts should have been at once communicated to us, when no doubt we to should have declined sanction the removal of this lady to single care, and we expressed to Mr. Adams our great surprise that he should have omitted doing this. In reply, he stated that he detailed fully those occurrences to the friends of the patient, and explained to them the risk there would be m removing her, and also to Dr. Dawson he communicated his opinion that she ought to have two nurses, should be watched at night should not be allowed the use of sharp knives or scissors, and should be kept under special Two nurses supervision. were indeed engaged specia ly to attend upon the patient, but only one was m the room when she threw herself out of the window, which she was powerless to prevent That the most ordinary precaution of on the window, so as to placing stops prevent the sashes from being opened more than a few inches, showed great want of care on the part of Dr. Dawson in dealing with a patient so disposed to destroy herself. The
Report contains
a complete list of all public and.private and the full entries made by the Commissioners in the books of the various county asylums and large hospitals Our space will not permit us to discuss these at length; but, from a of careful perusal the Commissioners' entries, we are of opinion that the care of the insane is considered in everyway in the public asylums of England. The Commissioners' Report, taken is a as a whole, faithful account of the condition of lunacy in England and W ales, and is the result of the combined efforts of gentlemen who devote their energy and skill to protect this unhappy class of human beings. The contents of the Report is a wonderful contrast to the fallacies and untruths extraordinary stated by many witnesses before the Lunacy Committee, a consideration of which we propose in our next issue to discuss in detail.
asylums
