COMPARISON Or INCREASE OF INSANE PATIENTS , UNDER TREATMENT, IN VARIOUS COUNTRIES, 1890-1910.
(Compiled from official yearbooks and census reports). -.. .
Switzerland on 1 Jan. 1916 was caring for 9,916 insane patients in its 24 hospitals. The admissions of the preceding year totaled 4,070. In Sweden, in 1914, the 18 hospitals for the insane housed ah average patient population of -9,610. In 1910 the average number housed *as 7,866.• There were 1,978 admissions ist 1910. ' In Denmark, on 31 Dec. 1916, the insane in institutions numbered 4,644, a ratio of 168 per 100,000 of the general population.
The insane in public and private institutions in Germany increased from 78,155 in 1891 to 120,872 in 1901. Since 1901, the data in the German yearbooks concerning the insane have included feeble-minded,,epileptics, etc.
The total population of the hospitals for the insane in France on 31 Dec. 1912 was 77,237.
Sex of Insane.— The total number of in Sane enumerated in institutions in the United States on 1 Jam 1910, included 98,695 males and 89,096 females; the to number of insane admitted during the year 1910 included 34,116 males and 26,653 females. The rates per 100, 000 of the general population were: Males, 72.1; females, 59.7; total, 66.1. The ratio• of males to females among patients in institutions was 110.8 to 100; and among admissions, 128 to .100. In the general population of the United States in 1910 the ratio of males to females was 106 to 100.
• In New York State where the sexes are nearly equally distributed in the general popu lation, on 30 June 1917, there were 18,422 males and 20,342 females in institutions for the insane, a ratio ,of 90.6 males to 100 females. Among the first admissions td all institutions the insane in the State in 1917, there were ,878 ma/es and 3,462 females, a ratio of 112 Males to 100 females.
The excess of males among first admissions its' largely due to the greater prevalence of general paralysis and alcoholic insanity in this sex. As patients with general paralysis have a high rate of mortality and patients with alcoholic insanity improve rapidly, the average duration' of hospital life is less for males than for femalM. In the New York civil State
hospitals in 1917 the average duration of the hospital life of the male patients who died in the hospitals was 5.5 years, and of the female, 7.2 years.
Age Of the Insane.— Mental diseases occur 'principally during the period of adult life, the rate of incidence increasing with 'advancing age. The age distribution of the 6,877 first admissions, to the New York civil State hos phalli in 1917 as .eompared with the age dis tribution of the- general population of the State in 1910 it given in the following table: Causes of Insanity.- Causes of _mental diseases are multiple rather than single. Sev eral factors may operate together to cause the onset of a psychosis. Alcohol has always been a prominent factor in the causation of mental disease but its influence seems to have declined in recent years. Syphilis is the primary cause in all cases of general paralysis and of psychoses with cerebral syphilis. Opium and its derivatives, cocaine and other habit forming drugs cause psychoses in compara tively few cases. Arteriosclerosis by shutting' off the blood supply to important parts of the brain prevents this organ from performing its natural functions and thus causes various forms of mental disorder. Blows on the head cause insanity in a similar way by injuring brain tissues. Fevers and exhausting physical dis eases often give rise to mental disease.
Insanity may also be due to mental causes, such as fear, joy, anger, grief or anxiety.
Abnormal mental make-up in either the temperamental or intellectual sphere is a pre disposing cause in many cases. The abnormal mind gives way to unusual stress while the nor mal mind is able to withstand it. When the stress is prolonged or of extraordinary severity, as in army life, even the normal mind may give way.