The revised scheme of registration put forth by the Medico-Psychological Association three years ago and officially adopted by the Commissioners in Lunacy is a noteworthy attempt to impart greater accuracy and precision to the record of facts relating to the insane. An important feature of this revision was a full and carefully designed schedule, compiled by a special committee, intended to replace the long-established list of the “causes of insanity,” which, whilst doubtless reflecting the knowledge of the middle of last century, lacked scientific precision and had become obsolete. The new schedule aimed at greater definiteness, and being framed on the teachings of experience by those most competent to the task, may well be considered to fairly embrace the whole field of ætiological inquiry. It is with the object of showing what may be learnt from its use that I have ventured to lay before the Association the results of a study of the records of the institutions for the insane in England and Wales during 1907—the first year of the adoption of the revised system—in so far as these refer to patients suffering from their first attack of insanity.
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