Insanity: Its Causes and Prevention. Henry Putnam Stearns
numbers are understood to be exclusive of criminals and imbecile children.
In 1869 there were under observation:
1. Of pauper patients in asylums and poorhouses, four thousand four hundred and ninety-four (4,494); and in private dwellings, one thousand and five hundred (1,500).
2. Of private patients in asylums, one thousand one hundred and twenty-eight (1,128); and in private dwellings, thirty-five (35): making a total of both classes of seven thousand one hundred and fifty-seven (7,157).
During these ten years, therefore, from 1860 to 1869, inclusive, the total number of insane persons in Scotland, of which the Board had cognizance, advanced from six thousand two hundred and eighteen (6,218) to seven thousand one hundred and fifty-seven (7,157), giving a net increase amounting to nine hundred and thirty-nine (939).
I introduce the table as before to show the relation this bears to the number of the population:
| In | 1860 | one in | 487 |
| " | 1861 | "" | 487 |
| " | 1862 | "" | 480 |
| " | 1863 | "" | 490 |
| " | 1864 | "" | 490 |
| " | 1865 | "" | 487 |
| " | 1866 | "" | 480 |
| " | 1867 | "" | 473 |
| " | 1868 | "" | 467 |
| " | 1869 | "" | 458 |
It will be observed that the increase has not been uniform, as was the case in relation to that of England. There was a decrease for two of the ten years, 1863 and 1864, but from that time forward an increase.
Referring next to the second decade, from 1870 to 1879, inclusive, it is found that in 1870 there were:
1. Of pauper insane persons in asylums and poorhouses, four thousand seven hundred and twenty-eight (4,728); and in private dwellings, one thousand four hundred and sixty-nine (1,469).
2. Of private insane persons, in asylums, one thousand one hundred and sixty-three (1,163), and in private houses forty-nine (49): making a total of the private and pauper insane of seven thousand four hundred and nine (7,409).
In 1879, there were:
1. Of pauper lunatics in asylums and wards of poorhouses, six thousand two hundred and ninety two (6,292); and in private dwellings, one thousand three hundred and ninety-eight (1,398).
2. Of private lunatics in asylums, one thousand three hundred and fifty-eight (1,358); and in private houses, one hundred and ten (110): making a total of both classes of nine thousand one hundred and fifty-eight (9,158).
The advance, therefore, during this decade was from seven thousand four hundred and nine (7,409), to nine thousand one hundred and fifty-eight (9,158); which equals one thousand seven hundred and forty-nine (1,749), as against nine hundred and thirty-nine (939) during the preceding decade, or nearly one hundred per cent. larger.
In relation to the general population it was as follows:
| In | 1870 | one in | 448 |
| " | 1871 | "" | 440 |
| " | 1872 | "" | 438 |
| " | 1873 | "" | 434 |
| " | 1874 | "" | 436 |
| " | 1875 | "" | 432 |
| " | 1876 | "" | 420 |
| " | 1877 | "" | 408 |
| " | 1878 | "" | 400 |
| " | 1879 | "" | 392 |
exhibiting a decrease in relation to the total of population for one year only of the decade, and on the whole a steady increase for the whole twenty years.
It further appears from the tables of statistics, that the number of insane paupers per 100,000 of the population, which was one hundred and fifty-seven (157), January 1, 1858, advanced to two hundred and seventeen (217) per 100,000, January 1, 1880, notwithstanding the fact, that during this period the number of pauper-persons per 100,000 of the general population diminished from two thousand six hundred and thirty (2,630) to one thousand seven hundred and eighteen (1,718).
It thus appears that insanity is, both absolutely and relatively, a much larger element in the pauperism of the country than ever before.
In considering the force of the above statistics there is one element which may, I think, properly be referred to as entering into the calculation, to which I have nowhere found any allusion, namely—that of emigration. I have not at hand the statistics to show how great this has been from England and Scotland during the last twenty years, but we know that it has been very considerable from both countries to Canada, Australia, and the United States; and I think it fair to assume that this emigration has generally been from those who have been in good mental health, at least at the time of leaving these countries; and if at this time they had relatives who were insane, these would be left behind. Therefore, so far as this would have an effect upon the statistics of insanity, it would be toward exhibiting a higher ratio of the insane to the whole population than would otherwise appear.
Having made due allowance for this, and other considerations, which were alluded to in connection with the statistics of asylums, I still think the evidence all points toward a large increase of insanity, both absolute and relatively to the population, in both England and Scotland.
At