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and Wales alone was 140,466, and this number does not include cases of mental deficiency, nor cases of insanity in those early stages when certification has not become imperative. The contemplation of these figures will alone suffice to bring home the vital importance of the problem to the health of the nation. With regard to nervous disorders statistics do not exist, but every doctor knows how considerable a proportion of his patients fall into this group, and it may at least be said that they are extremely prevalent, and that they constitute a problem the importance of which is as great as that of insanity, perhaps even greater.
Now what are the present facilities for dealing with mental and nervous disorder? For actual insanity there is a plentiful supply of asylums, which for comfort and care are among the best in the world. But these are only for fully developed cases, cases which have so far progressed that legal certification has become absolutely necessary. For the early cases, patients on the road to actual insanity, in those stages when treatment obviously has the best chance of success, there is almost nothing at all. Something can be done for the rich, but for the great bulk of the population nothing. The only course for them, a course which would be Gilbertian were it not so tragic, is to wait patiently until they are sufficiently bad for certification to be necessary. Then they will receive every care and attention. The words "almost nothing" were used above because here and there a few attempts have been made to provide what is required. Some of the general
