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the rest of England are too incorrect to afford fair ground for the estimates that have been made, while the knowledge of each other which prevails among the Quakers, brings nearly all the cases which occur among them into the calculation.”
That the estimates for France and England are too small, is rendered probable from the fact, that in other countries, where more care has insured greater accuracy, the number of the insane has been ascertained to be considerably greater than in either of those countries. The statistics of insanity in the Prussian Provinces on the Rhine, are more accurate than those of England or France, though the learned Dr. Jacobi thinks they are far from correct. According to this writer, there is in these provinces one insane person to 666 of the population.
But the most complete statistical accounts that exist of the deranged persons of any country, are those of Norway ; and these exhibit one case of insanity to 551 of the population. Still most of the known causes of this disease prevail to even greater extent in England and France than in Norway, and we have no other way of accounting for the difference in the above estimates, than by supposing those of the former countries to be very inaccurate.
We have no means of determining the number of the insane in Russia and other northern countries, or in Italy, Spain, and Portugal. From all we can learn on this subject, we
, believe the disease to be much less frequent in these countries than in France, England, Germany, and the United States. According to M. Brière, who recently visited the lunatic establishments of Italy, only one case of insanity is found to 4879 of the population. That there has been but little of the disease in Spain, we infer from the fact, that, but a few years since, the Hospital for Lunatics at Madrid contained but 60 patients, and that at Cadiz only 50.
In the foregoing accounts of the number of the insane, probably some idiots are included. Indeed, it is often very difficult to distinguish insanity from idiocy, as the former frequently passes into the latter, in a gradual and imperceptible manner. Thus a person may be insane one month, and the next be idiotic.
The statistics of insanity in the United States are less complete than those of Europe. In many of the States nothing is known upon the subject, no measures having as yet been adopted to ascertain the number of the insane. A few of the States have made some partial investigations ; but the object of these bas generally been to ascertain if the insane were sufficiently numerous, and their situation sufficiently necessitous, to require the assistance of the state for their support. That there was such a number, and such want, has soon been ascertained, and then further investigations ceased.
A committee of the legislature of the State of New York, appointed to examine this subject, reported in 1831, that there were then in that State 2695 lunatics and idiots, or one to 713 of the population. Of this number the committee considered five eighths to be idiots. In 1821, the great number of recent cases of insanity in Connecticut, led a few medical gentlemen to attempt ascertaining the whole number of the insane in the State, and to devise the means of providing an Hospital for their reception and cure. “ To obtain information," they say in their published Report, “circulars were sent into every town in the State, addressed to clergymen, physicians, and other respectable gentlemen, requesting returns of the number of the insane, their ages, sex, cause of disease, &c. The returns in answer to these circulars, although many of them were very imperfect, satisfied the committee that at least one thousand individuals within the limits of the State were mentally deranged, and that the condition of most of them was truly
deplorable.' As the population of the State was at that time . 275,202, this would be one insane person to 275 of the population; a proportion so great that we suppose some idiots were included; though we know it was the decided opinion of Dr. Todd, the late distinguished physician to the Connecticut Retreat for the Insane, whose means of information on this subject were better than those of others, that one thousand was not above the actual number of the insane in the State of Connecticut. In Massachusetts insanity appears also to be very common.
. Dr. Parkman, of Boston, stated in 1818, that 541 insane persons had come to his knowledge in that State, though he supposed be had heard but of part. In 1833, a committee of the legislature of that State reported they had ascertained that in 68 towns, containing a population of 264,327, there were 168 insane persons and 111 idiots, in confinement in jails, almshouses, and houses of correction. This would afford above 600 insane and idiotic persons in confinement in the State, if we
person to 300
assign as many in proportion to the rest of the population. But it is probable only a small part are thus confined ; and no doubt an accurate inquiry would exhibit more than double or triple that number. From considerable knowledge of portions of Massachusetts, we are confident, that at the time referred to, not more than one fourth, or one third, of the insane and idiotic were in the places of confinement alluded to by the committee.
In New Hampshire, it appears from recent inquiries that insanity is nearly as prevalent. A committee of the legislature of that State reported, during the present year, 350 insane persons in the State, exclusive of idiots. We are informed that the committee, who made the report, were of opinion this estimate was too low. But this number exhibits one case of insanity to 800 of the population; and if we add as many
; idiots in proportion to the insane, as there are in the State of New York, there would be one crazy idiotic inhabitants.
A select committee of the legislature of the State of Vermont recently reported, that there were, in 59 towns, 60 insane males and 84 females, making a total of 144, of whom 45 are town paupers, and 40 are poor and destitute. This committee estimate the whole number of the insane in the State, exclusive of idiots, at 300, or one to 1000 inhabitants.
These statistics respecting insanity, though few and imperfect, show, that the disease is alarmingly prevalent in this country, especially in the northern States of the Union. We believe it is not equally so in those of the south and west, though our means of judging are not such as to enable us to speak confidently.
From a review of these facts respecting insanity in some of the States, we can hardly avoid the conclusion, that the disease has of late considerably increased. This conclusion is supported by the fact, that within a few years several large establishments for the accommodation of lunatics have been opened and almost immediately filled, while the numbers in the older ones have not diminished, but on the contrary considerably increased. Previous to October, 1818, there was no public institution exclusively for the reception of lunatics in the New England States. At that time the McLean Asylum at Charlestown, Massachusetts, was opened. April 1st, 1824, the Connecticut Retreat for the Insane went into VOL. XLIV. —NO. 94.
operation; and in January, 1833, the Massachusetts State Lunatic Hospital at Worcester was completed, and commenced receiving inmates. Each of these hospitals is now, and for some time past has been full, and obliged to refuse many applications for admission. But, besides these public institutions, there are several private asylums for lunatics in these two States, and many are yet confined in almshouses; and in Connecticut some are in jails, and in the State Prison. Undoubtedly the erection of these hospitals, their success in curing the disease, and other causes have contributed to make cases of insanity more generally known of late years, and therefore the increase may not be so great as it appears; still, as Dr. Prichard observes, respecting the increase of insanity in Europe, “the apparent increase is everywhere so striking, that it leaves on the mind a strong suspicion that cases of insanity are far more numerous than formerly ; and this sus
; picion can only be removed by a series of observations that may prove the negative. It is also encouraged by the reflection that the state of society is in most countries such, as appears likely to multiply the exciting causes of madness."
That insanity is now a very frequent disease in some parts of this country, may be evidenced in another way, namely, by ascertaining the number of new cases that occur in one year in a known population. The State of Massachusetts having two public hospitals for lunatics, (one of them for pauper lunatics, and both popular and well conducted,) it is probable that a majority of the cases, that now occur in that State, are sent to one or the other of these institutions. say a majority, as we do not believe that all, or that nearly all,
Into these two institutions there have already been received, or have applied for admission, one hundred and seventeen patients belonging to Massachusetts, who became crazy in the
year 1835. When we consider, that there are one or two private asylums in that State which receive insane patients, that the House of Industry at Boston usually contains a considerable number, and that the Connecticut Retreat has received eight from Massachusetts who became crazy in the same year, together with the fact that these hospitals are still receiving, occasionally, more patients who became deranged during the same year, but have remained with their friends, we are obliged to conclude that insanity is a common disease in that State. One hundred and twenty-four cases are known
to have occurred in the year 1835, as that number has been received into three institutions; and it is not probable that this is much more than half, as friends, for various reasons, are often opposed to sending their relations from home when deranged. That some belonging to that State, who became deranged in 1835, recovered without going to any institution, and some still remain deranged with their relatives, are facts within our knowledge.
If for many years there have occurred 124 new cases of insanity annually in Massachusetts, the success in curing the insane, without hospitals for their reception, must have been greater than it is with them, or else at the present time there are more than 1000 insane persons in the State. It
may be said that many have died. But it should be recollected that insanity is not a disease very dangerous to life. M. Desportes informs us, that among the lunatics at the Salpetrière and the Bicêtre in France, 12 patients have been there in a deranged state from 50 to 60 years, 20 upwards of 40, and a vast number more than 20 years. The records of the lunatic hospitals in this country exhibit similar facts. In the Massachusetts State Lunatic Hospital are several cases that have existed 30 years, and many of persons that have been deranged 15 and 20 years. The last Report of the Asylum for the relief of persons deprived of the use of their reason, at Frankford, near Philadelphia, states, that of the 46 patients now in the Asylum, 15 have been insane above 20 years. The Report of the committee of the legislature of New Hampshire states, that the average period of the existence of the disease in the 350 insane now in that State, is between 13
and 14 years.
From these facts, we cannot well avoid the conclusion that insanity is now much more frequent than formerly. But whether this is correct or not, the foregoing statements cannot fail to awaken attention to the importance of adopting early measures for the cure of the disease, when it does occur.
And it is gratifying to be able to state, that no fact relating to insanity appears better established, than the general certainty of curing it in its early stage. The following statements render this evident. Dr. Willis, in his evidence before a committee of Parliament in 1789, averred, that nine out of ten cases of insanity recovered, if placed under his care within three months from the first attack. Dr. Burrows has