Page:Encyclopædia Britannica, Ninth Edition, v. 13.djvu/121

INSANITY 111 was entirely abolished in an English public asylum. This took place at Lincoln, where Dr Gardiner Hill did away with all engines of restraint. Shortly afterwards Conolly adopted the same line of treatment at Hanwell, near London, and through the influence of his example and precept the measure extended over the whole of Great Britain. Experience has shown that, as restraint of all forms is abandoned, the management of lunatics becomes easier. Walled-in airing-courts, barred windows, and strong- dark rooms have almost entirely disappeared, and in some Scotch asylums it is found practicable to discontinue. the use of lock and key. It has been said that the type of insanity has changed within the last forty years ; it would be more true to say that the type of treatment has changed. It is much less common nowadays to meet with those extremely violent forms of madness which entered into the descriptions of many authors. With the reduction of restraint a higher order of supervision on the part of attendants is demanded, and as they, are trained to rely more and more on the moral influence they can exercise over their charges, and less on mechanical apparatus, the patient is not so apt to resent control, and therefore a greater calm and contentment pervades the atmosphere of our asylum wards. This has been mistaken for a change in the type of the disease. Statistics. The statistics of lunacy are merely of interest from a sociological point of view ; for under that term are comprised all forms of insanity. It is needless to produce tables illustrative of the relative numbers of lunatics in the various countries of Europe, the systems of registration being so unequal in their working as to afford no trustworthy basis of comparison. Even in Great Britain, where the systems are more perfect than in any other country, the tables published in the Blue Books of the three countries can only be regarded as approximately correct, the difficulty of registering all cases of lunacy being insuperable. On the 1st January 1880, according to the returns made to the offices of the Commissioners in Lunacy, the numbers of lunatics stood thus on the registers : Mules. Females. Total. England and Wales 32,164 39,027 71,191 Scotland 4,541 5,083 9,624 Ireland 6,359 6,460 12,819 Grand total 43,064 50,570 93,634 These figures show the ratio of lunatics to 100,000 of the popula tion to be 279 in England and AVales, 217 in Scotland, and 236 in Ireland. The next table is of interest as bearing on the question of the alleged increase of lunacy as a disease. Similar returns arc not available for Ireland. Numbers of Lunatics on the 1st January of the Years 1858-80, inclusive, according to Returns made to the Offices of tJie Commis sioners in Lunacy for England and Wales and Scotland. England and Wales. Scotland. England and Wales. Scotland. 1858 5,823 1870 54,713 7,571 1859 36,762 6,072 1871 56,755 7,729 1860 38,058 6,273 1872 58,640 7,849 1861 39,647 6,327 1873 60,296 7,982 1862 41,129 6,398 1874 62,027 8,069 1863 43,118 6,386 1875 63,793 8,225 1864 44,795 6,422 1876 64,916 8,509 1865 45,950 6,533 i 1877 66,636 8,862 1866 47,648 6,710 , 1878 68,538 9,097 1867 49,086 6,860 1879 69,885 9,386 1868 51,000 7,055 1880 71,191 9,624 1869 52,177 7,310 There is thus an increased ratio in England and Wales of lunatics to the population (which in 1859 was 19,686,701, and in 1880 was estimated at 25,480,000) of 1867 per 100,000 as against 279 "4, and in Scotland of 157 as against 217 per 100,000. The publication of these figures has naturally given rise to the question whether lunacy has actually become more prevalent during the last twenty years, whether there is real increase of the disease. There is a pretty general consent of all authorities that if there has been an incrcacs it is but very slight, and that the apparent increase is due, first to the improved systems of registration instituted by the boards of lunacy, which have brought under their cognizance a mass of cases which were formerly neglected, "who would not have been dealt with as paupers in 1858, but who are now dealt with as such, so as to obtain for them the advantage of accommodation in pauper asylums." Secondly, a further and far more powerful reason is to be found in the increasing tendency among all classes, and especially among the poorer class, to recognize the less pronounced forms of mental disorder as being of the nature of insanity, and requiring to be dealt with as such. Thirdly, the grant of four shillings per week which in 1876 was made by parliament from imperial sources for the maintenance of pauper lunatics has induced parochial authori ties to regard as lunatics a large number of weak-minded paupers, and to force them into asylums in order to obtain the benefit of the grant and to relieve the rates. These views receive support from the fact that the increase of private patients, i.e., patients who are provided for out of their own funds or those of the family, has advanced in a vastly smaller ratio. In their case the increase, small as it is, can be accounted for by the growing disinclination on the part of the community to tolerate irregularities of conduct due to mental disease, and the consequent relegation of its victims to asylums for the sake of family convenience. And again, careful inquiry has failed to show a proportional increase of admissions into asylums of such well-marked forms as general paralysis, puerperal mania, &c. The main cause of the registered increase of lunatics is thus to be sought for in improved registration, and parochial and family convenience. If there is an actual increase, and there is reason for believing that there is a slight actual increase, it is due to the tendency of the population to gravitate towards towns and cities, where the conditions of health are inferior to those of rural life, and where there is therefore a greater disposition to disease of all kinds. Bibliography. The following are systematic Avorks : Bucknill and Tuke, Psychological Medicine, 4th edition, 1879 ; Blandford, Insanity and its Treatment, 1877; Griesinger, On Mental Diseases, N"ew Sydenham Society, 1867; Maudsley, The Pathology of Mind, 1879. Conolly, On the Treatment of the Insane, 1856, bears chiefly on asylum management. Every question connected with lunacy will be found discussed in the Journal of Mental Science, to the first twenty-four volumes of which a general index has been prepared by Dr Fielding Blandford, 1879. The works of Pinel and Esquirol are well worthy of attention. Consult also Kratl t-Ebing, Lehrbuch dor Psychiatric, Stuttgart, 1879, and Dr Heinrich Schiile, If and- buch dcr Geistcskrankhciten, the latter being the sixteenth volume of Von Ziemssen s Handbuch dcr specicllcn Pathologic und Therapic, Leipsic, 1878. (J. 13. T.) LAW. The effect of insanity upon responsibility and civil capacity has been recognized at an early period in every system of law. In the Roman jurisprudence its con sequences were very fully developed, and the provisions and terminology of that system have largely affected the subsequent legal treatment of the subject. Its leading principles were simple and well marked. The insane person having no intelligent will, and being thus incapable of consent or voluntary action, could acquire no right and incur no responsibility by his own acts ; his person and property were placed after inquiry by the magistrate under the control of a curator. The different terms by which the insane were known, such as demens, furiosus, fatiius, although no doubt signifying different types of insanity, did not infer any difference of legal treatment. They were popular names which were used somewhat indifferently, but which all denoted the complete deprivation of reason. During the Middle Ages the insane were but little protected or regarded by law. Their legal acts were annulled, and their property placed under control, but little or no attempt was made to supervise their personal treatment. In England the wardship of idiots and lunatics, which was annexed before the reign of Edward II. to the king s prerogative, had regard chiefly to the control of their lands and estates, and was only gradually elaborated into the systematic control of their person and property now exercised in chancery. Those whose means were insignifi cant were left to the care of their relations or to charity, In criminal law the plea of insanity was unavailing except