The following table (II.) shows the re sult in the same asylums as to cures and deaths during the same period. This com parative table is recommended by the commissioners, in addition to the tables showing the percentage of cures and deaths on the average number.
The cures are taken as 1.
The term "Removed" includes all discharged improved or uncured, or es caped.
This table likewise shows the number remaining iu the different public asy lums at the latest dates to which we have been able to make up the returns, and which appears to be 5143 males, 5052 females, and 236 of whom the sex is not specified.
The greater number of cures, and smaller number of deaths among females must be in a great measure ascribed to their comparative immunity from epi lepsy and paralysis ; which, when com bined with insanity, render recovery very nearly, if not quite, hopeless. It is said also that women more frequently recover from the acute stage of mania, while men die of exhaustion.
The reverse of this apparent rale is found only in the results of some of the smaller asylums, where the deaths of either sex are few. In those returns where the sexes are not distinguished we have reckoned the proportion as equal.
The tables of percentage of cures and deaths published by the commissioners have unfortunately not been compiled upon any fixed plan. All computations, excepting upon the average number of patients in the asylum during the specified year, must be fallacious. The following tables have been made upon that prin ciple; the blanks indicate the cases in which correct returns are wanting. Some asylums do not publish their average number of patients ; others calculate the percentage of cures and deaths upon the whole number admitted ; but this is an entirely delusive method, as these num bers must be continually increasing, while the proportion of patients remaining de creases.
We have, as far as possible, made an average of all the public asylums for ten years past.
The mean number of cures thus ap pears to be 21•3 per cent., and of deaths 9.64 per cent.; but many asylums depart very widely from this standard. Beth lem, St. Luke's, and Liverpool, receive only recent cases ; and in the Liverpool institution their probation is very short.
The large asylums at Ilanwell, Surrey, and Lancaster are consequently compel led to receive almost entirely incurables, which accounts for their small number of cures. The large number cured in the Irish asylums may be in some measure accounted for by the peculiar ‘tharacter of their patients. The Irish patients in English asylums usually recover rapid ly, the form of disorder being frequently pure excitement, which is soon allayed by quiet, by temperance, and the orderly re gulations of an asylum.
Many attempts have been made to obtain a uniform system of keeping sta tistical tables; at present a different plan is adopted in almost every asylum. A great improvement would be effected if every report, in addition to its informa tion for the current year, contained a condensed statement from the opening of the institution as to admissions, cures, and deaths ; and there would be little difh eulty in adding the ages, forms of disease, the causes of death, and other tables. Much important information as to the most favoarable and unfavourable ages, and the results of immediate and delayed ad mission, would be easily gained, if a re ference to the last report of any asylum were sufficient to show the experience of that institution from its opening in a con densed form. No asylum has yet pub lished any such tables; but in the nume rous new asylums which will be built in the course of a few years, nothing could be more easy than to adopt them. The legislature may possibly enforce certain tables ; and such a law would be exceed ingly desirable, if we could hope that the practical experience of the superintend ents of lunatic asylums would be allowed to be of any weight : but if the returns are to be made out according to the fancy of men ignorant of the subject upon which they legislate, the present system, by which every superintendent follows his own dis cretion, is far preferable.
The following points seem to deserve attention in any plan for uniform regis tration : I. Admissions for the current year: 1. Form of disease.