It has always appeared to me that the various figures that are supposed to indicate an increase of insanity are not only inconclusive, but do not really show anything of the sort, and that there are even some vague and indefinite indications that there is really a decrease in the annual production of insanity. Some years ago I tried to find some figures amongst the various statistics we possess that would throw some light on this point, but practically without success. It seemed that such increase in the annual admissions to asylums as was beyond that due to increase of population was more than accounted for by slighter (i.e., less demonstrative) cases of acute insanity and various forms of chronic, senile, and degenerative disorders being yearly sent to asylums more freely, but I could get no figures proving this. A somewhat suggestive fact in this direction is the often-made remark that acute mania is less abundant, melancholia more so than formerly; acute mania of an active (i.e., demonstrative) type was always sent to asylums pretty well up to its actual amount. Melancholia used to be very largely left at home or treated in workhouses. But where shall we find such facts embodied in figures. Acute mania of our statistics includes the milder as well as the more demonstrative cases, and so shows an increase just as the total figures do. There are, then, so far as I know, no figures showing the real annual occurrence of insanity that are comparable year by year. There are, indeed, no figures that give the actual annual production of insanity apart from chronic and recurrent cases. There are no figures of any definite form and intensity of acute insanity. True the Commissioners' Reports give us statistics of general paralysis, but this is precisely the one form of acute insanity that is not an insanity; that is, it belongs to a different natural order of diseases from the other diseases we mean by insanity. I have elsewhere stated that this always appears clearly on a comparison of the statistics of general paralysis with those of insanity proper, and the same opinion has been expressed by authorities who have approached the matter from a pathological and therapeutical standpoint. Its remarkable geographical distribution and its specially urban character equally show it to be different from the other insanities, which have no similar features. That this disease is increasing owing to the more and more urban character of our population affords no ground for assuming a similar progress in the true insanities. The annual recoveries must, however, be largely dependent on, and proportional to, the annually occurring cases, but will, of course, so regarded, be vitiated by the increase of population and by the increased admissions of milder forms of insanity and by the recoveries of recurrent cases.
Geographical Distribution of the Herpes Simplex Virus Type 1 BgKL Variant in Japan Suggests Gradual Dispersion of the Virus from Shikoku Island to the Other Islands
