To anyone watching carefully the figures given in the last five annual reports of the Commissioners in Lunacy for England it is quite apparent that one very distinct and unmistakable change has during each of the five years ending 1897 been taking place in the character of the admissions into asylums. There is no indication that lunacy is diminishing, rather the reverse, for the proportion of the average annual admissions in which the attack is stated to be the first, i.e., occurring insanity, which in the quinquenniad 1888–92 was 3·7 per 10,000 of population, rose to 4 in the five years ending 1897. The change of type in the admissions to which we refer is the diminution in the proportion of general paralytics. Not only is this characteristic of the quinquenniad as a whole, but it applies to each of the individual years, the percentage proportion for each five-year period ending with that for 1893–7 being 8·7, 8·5, 8·4, 82, 7·8. The change is all the more striking inasmuch as each of the three quinquenniads preceding this one was characterised by a steady increase in the occurrence of the disease, so striking, indeed, that one might have supposed that the Commissioners would have been justified in making a much more affirmative pronouncement than the one they do in their Fifty-third Report, viz. that “it would not appear that general paralysis is increasing in the general population.” Not only is it not increasing, it is diminishing, and that, too, progressively, during the past five years.
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