The special report of the Commissioners in Lunacy to the Lord Chancellor has lately been issued. They state that whereas in 1859 the number of lunatics, idiots, and persons of unsound mind in England and Wales, reported to the department as resident in asylums and other establishments for the insane, and in workhouses, or with their relatives or others, was 36,762, the number had increased in 1896 to 96,446, showing a ratio to every 10,000 of the population of 31·38, as compared with 18·67 at the previous period. The replies received from the Medical Superintendents of Asylums indicated that 10 were of opinion that occurring insanity has increased, while 30 were of a contrary opinion, and 22 were unable to arrive at a definite conclusion. The Commissioners point out that it is a noticeable and important fact that while the increase in the number of pauper patients has been from 31,401 to 87,417, that in the private class has only been from 4,679 to 8,265, the ratios having risen from 15·95 to 28·44 for paupers, and from 2·38 to 2·69 only for private patients, per 10,000 of the population. It is obvious, therefore, that the increase in numbers and ratios has been almost entirely confined to pauper patients, and that the class upon whom some of the insanity-producing causes often referred to would have been most likely to operate severely have scarcely suffered in any degree. Indeed, the ratio for private patients is actually lower than in 1879, and is still undergoing an annual diminution. The increase in the numbers and ratios of paupers is, however, strikingly large, and out of all proportion to that of the population. It would be of extreme interest to ascertain if the apparent decrease in private cases was not really due to the avoidance of certification, resulting from the magisterial intervention.
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