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The Sixty-Second Report of the Commissioners in Lunacy.
THE
SIXTY-SECOND REPORT
OF THE COMMISSIONERS IN LUNACY
881
may be still further insured. The After-Care Association, unfortunately only in a very small way, undertakes at the present time to do what it can for discharged patients and
deserves far
THE LANCET.
more
support from
the
public
than it receives.
quite possible that a considerable extension of this work might contribute in no small degree to a decrease in the amount of insanity in this country. LONDON: SATURDAY, SEPTEMBER 19, 1908. We are happy to note that the Commissioners are very decidedly of opinion that the asylums should be utilised to further the scientific study of insanity and higher medical of the The Report education. Too often the asylum is regarded rather as a Commissioners in place of detention where persons who are a nuisance to the THE statistics contained in this report are not materially (community are confined, instead of a place of refuge for the It is
Sixty-Second
Lunacy.
different from similar statistics of the last few years andsufferer where he may obtain appropriate treatment for his there is a continued increase in the number of insane personsdisease. Wecannot, however, but feel that there are known to be under care. The number of such persons on indications that the public are beginning to regard insanity Jan. 1st, 1907, was 123,988 and on Jan. lst, 1908, was as a disease which is to be studied and treated in precisely
126,084, being an increase
of 2096.
As, however, the annualthe same way as are those diseases in which disordered ending with 1907 was 2411. function is more obviously the result of organic alteration of by 315 than the annual1the tissues. A substantial part of this excellent change It was found that the- ratio offin public opinion must be attributed to the earnest
average increase for the ten years the increase for 1907 was less
average of the decennium. notified insane persons to the estimated population was Jan. lst, 1908, 1 to 280, or 35-67 per 10,000. This is
on scientific
working in this branch of our labours involving investigations in the
labours of those
an ascience and art, their the ratio of the year before of 0-53 per cent. and1 phenomena of mind and in the structure and function of an actual numerical increase of nearly 1-7 per cent. At theits delicate instrument and constant servant, the brain. But of 1898 the ratio of insane to the3 perhaps a yet larger factor in the production of this change beginning persons estimated population was 32’ 35, so that since then it hass has been the work of the Commission in Lunacy. From a
increase
on
increased by as much as 10 -2 per cent., the proportion of f insane persons having risen from 1 in 309 to 1 in 280. The e increase in the whole population has been 12’ 2 per cent.,,
disorderly
)f the known insane increased by 137’1per cent. The ratio of the insane to the population was at the beginning of 1869 23’93 per 10,000 and on Jan. lst of this present year
of the report now before us. But times have changed and the large increase of the insane population demands a larger Commission and one in which less prominence shall
35’67 per 10,000, being an increase of 49 per cent. The ie ’6 ratios for first admissions were 4-92 per 10,000 in 1898, 5 - 76 in The number 1907. of in 1902, 5-16 in 1906, and 5-18 not in the of at those 1907, patients counting beginning idiot establishments, in institutions, and in single private te of an 32 cent. on the was increase 98,521, being care, per number under similar care at the beginning of 1897. During these ten years the numbers in county and borough asylums had increased by 36 per cent., in registered hospitals by 3 ’6 per cent., in the State asylums by 26 ’ 4 per cent., and in single care by 17’ 3 per cent. It appears that nearly three-fourths of the number of
be
and sometimes
evolved under its
disgraceful chaqs there has been guidance a systematisation of philan-
thropic effort for the amelioration of the condition of the while in the number of the insane it has been 23. 7 per cent.’. insane. The.work of the Commission is now of such extent d that it cannot be efficiently performed by the present Examining the ratio for a larger number of years we find that while the estimated population increased by 57’ 2 per r number of the Commissioners. That the best that can be cent. between the years 1869 and 1907 the total number of f done is being done there can be nodoubt from a perusal
given to what we may call its police functions and more We trust more strictly medical aspects of the work. that the adoption of some of the recommendations of the Royal Commission on the Feeble-Mindedmay eventuate in such an improvement. to the
Huntington’s Chorea or Chronic Progressive Chorea. THIRTY-SIX years ago Dr. GEORGE HUNTINGTON, then a recently qualified practitioner of but 22 years of age, at the end of a paper on the subject of chorea in childhood,
in a few strikingly graphic sentences of a patients annually certified are suffering from their first gave description that form of chorea which has since that time been peculiar attack, while the remainder,represent recurrent cases. The called after him, a description so complete and report points out that it is highly probable that, at any generally so distinctive that from a clinical standpoint little or nothing rate among certain classes, the too speedy return to old
avocations and the environment under which the patient has since been added. It is always interesting, stimulating, originally broke down contributes to the recurrence of the and instructive to study the history of any scientific advance and to trace the evolution of knowledge in regard to it. We malady. It may be that at some future date it will be more have received an interesting pamphlet2 which, though of widely recognised to be desirable that the patient should be modest dimensions and of unpretentious character, is a very subjected to a more careful supervision on his discharge 1 See p. 890 of our present issue. from the asylum. To this end it may be found necessary to 2 Neurographs, vol. i., No. 2. Huntington Number. Brooklyn, New establish convalescent homes where the recovery of patients York : Albert T. Huntington. 1908.
SIXTY-SECOND REPORT
OF THE COMMISSIONERS IN LUNACY
881
may be still further insured. The After-Care Association, unfortunately only in a very small way, undertakes at the present time to do what it can for discharged patients and
deserves far
THE LANCET.
more
support from
the
public
than it receives.
quite possible that a considerable extension of this work might contribute in no small degree to a decrease in the amount of insanity in this country. LONDON: SATURDAY, SEPTEMBER 19, 1908. We are happy to note that the Commissioners are very decidedly of opinion that the asylums should be utilised to further the scientific study of insanity and higher medical of the The Report education. Too often the asylum is regarded rather as a Commissioners in place of detention where persons who are a nuisance to the THE statistics contained in this report are not materially (community are confined, instead of a place of refuge for the It is
Sixty-Second
Lunacy.
different from similar statistics of the last few years andsufferer where he may obtain appropriate treatment for his there is a continued increase in the number of insane personsdisease. Wecannot, however, but feel that there are known to be under care. The number of such persons on indications that the public are beginning to regard insanity Jan. 1st, 1907, was 123,988 and on Jan. lst, 1908, was as a disease which is to be studied and treated in precisely
126,084, being an increase
of 2096.
As, however, the annualthe same way as are those diseases in which disordered ending with 1907 was 2411. function is more obviously the result of organic alteration of by 315 than the annual1the tissues. A substantial part of this excellent change It was found that the- ratio offin public opinion must be attributed to the earnest
average increase for the ten years the increase for 1907 was less
average of the decennium. notified insane persons to the estimated population was Jan. lst, 1908, 1 to 280, or 35-67 per 10,000. This is
on scientific
working in this branch of our labours involving investigations in the
labours of those
an ascience and art, their the ratio of the year before of 0-53 per cent. and1 phenomena of mind and in the structure and function of an actual numerical increase of nearly 1-7 per cent. At theits delicate instrument and constant servant, the brain. But of 1898 the ratio of insane to the3 perhaps a yet larger factor in the production of this change beginning persons estimated population was 32’ 35, so that since then it hass has been the work of the Commission in Lunacy. From a
increase
on
increased by as much as 10 -2 per cent., the proportion of f insane persons having risen from 1 in 309 to 1 in 280. The e increase in the whole population has been 12’ 2 per cent.,,
disorderly
)f the known insane increased by 137’1per cent. The ratio of the insane to the population was at the beginning of 1869 23’93 per 10,000 and on Jan. lst of this present year
of the report now before us. But times have changed and the large increase of the insane population demands a larger Commission and one in which less prominence shall
35’67 per 10,000, being an increase of 49 per cent. The ie ’6 ratios for first admissions were 4-92 per 10,000 in 1898, 5 - 76 in The number 1907. of in 1902, 5-16 in 1906, and 5-18 not in the of at those 1907, patients counting beginning idiot establishments, in institutions, and in single private te of an 32 cent. on the was increase 98,521, being care, per number under similar care at the beginning of 1897. During these ten years the numbers in county and borough asylums had increased by 36 per cent., in registered hospitals by 3 ’6 per cent., in the State asylums by 26 ’ 4 per cent., and in single care by 17’ 3 per cent. It appears that nearly three-fourths of the number of
be
and sometimes
evolved under its
disgraceful chaqs there has been guidance a systematisation of philan-
thropic effort for the amelioration of the condition of the while in the number of the insane it has been 23. 7 per cent.’. insane. The.work of the Commission is now of such extent d that it cannot be efficiently performed by the present Examining the ratio for a larger number of years we find that while the estimated population increased by 57’ 2 per r number of the Commissioners. That the best that can be cent. between the years 1869 and 1907 the total number of f done is being done there can be nodoubt from a perusal
given to what we may call its police functions and more We trust more strictly medical aspects of the work. that the adoption of some of the recommendations of the Royal Commission on the Feeble-Mindedmay eventuate in such an improvement. to the
Huntington’s Chorea or Chronic Progressive Chorea. THIRTY-SIX years ago Dr. GEORGE HUNTINGTON, then a recently qualified practitioner of but 22 years of age, at the end of a paper on the subject of chorea in childhood,
in a few strikingly graphic sentences of a patients annually certified are suffering from their first gave description that form of chorea which has since that time been peculiar attack, while the remainder,represent recurrent cases. The called after him, a description so complete and report points out that it is highly probable that, at any generally so distinctive that from a clinical standpoint little or nothing rate among certain classes, the too speedy return to old
avocations and the environment under which the patient has since been added. It is always interesting, stimulating, originally broke down contributes to the recurrence of the and instructive to study the history of any scientific advance and to trace the evolution of knowledge in regard to it. We malady. It may be that at some future date it will be more have received an interesting pamphlet2 which, though of widely recognised to be desirable that the patient should be modest dimensions and of unpretentious character, is a very subjected to a more careful supervision on his discharge 1 See p. 890 of our present issue. from the asylum. To this end it may be found necessary to 2 Neurographs, vol. i., No. 2. Huntington Number. Brooklyn, New establish convalescent homes where the recovery of patients York : Albert T. Huntington. 1908.