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.
2. The Third Annual Report, by Dr. Choate, of the Hassachusetts State Lunatic Hospital, at Taunton
