In Scot/and, the custody of the insane was, like every other matter which demands both magisterial and executive intervention, connected with the system of local courts. The law on the subject is now em bodied in the 20 & 21 Vict. c. 71, as amended by the 21 & 22 Viet. c. 89, and the system of management of the insane in Scotland has, both in a purely medical and in an administrative point of view, been vastly improved. Until a comparatively late period the statute law was nearly inoperative, from a strong prejudice against the enforcement of general rules relziting to the treatment of the insane, and the consequent toleration for breaches of the statutory regulations. The rule adopted in practice was, that insane persons were allowed to go at large until they had proved themselves dangerous to the lives of their neighbours, and that when confinement was in any case resorted to, the proceedings were not very rigidly investigated. There are now 8 public asylums, 24 private asylums, and 27 poorhouses, in which lunatics are maintained, and there are 1784 paupers kept in private houses. The total number of lunatics at the end of 1858, was 5748, of whom 2713 were males, and 3030 females ; of this total 4737 were paupers. In the year, 188 males and 182 females had died. There had been 244 males and 379 females dis charged recovered, and 198 males and 216 females not recovered. The admissions in the year were, 705 males and 921 females. In 1859, the number had been a little over 5000, of whom 392 died, and 497 were cured. The proportion of cures to deaths had been improving every year since 1850.
In Ireland, two inspectors of lunatic asylums, with the requisite assistants, have been appointed ; and the erection of county lunatic asylums has been zealously carried forward. There are now 16 dis trict asylums in operation, several of them being for the reception of patients from two or more counties which have associated themselves for that purpose ; and a central one at Dundrum, county of Dublin. Between 1855 and 1860, there was expended on the construction of such asylums the steal of 356,114/. The ninth report of the inspectors of Irish lunatic asylums, gives the total number of the insane of all kinds on March 31, 1859, as 11,218, of this number (at the end of 1857), 4262 were at large, there nut being sufficient accommodation for them in asylums at that time ; the number being no doubt greatly reduced in the interval. Of the remainder, 2087 males and 2003 females were
in the district asylums ; 89 males and 41 females were in the central asylums ; in jails, 116 males and 107 females ; in poorhouses (April 2, 1859), 722 males and 1324 females ; and in private asylums (December 31, 1858), 254 males and 213 females ; giving a total of 3268 males and 3683 females under care and supervision. There are, in addition, 44 women and 30 men in tho Dublin Hospital for Incurables. The general management, treatment of the patients, and construction of the buildings, are similar to those adopted in Great Britain, modified in some unimportant details by peculiar circumstances.
So many public asylums having been built, there has been a great variety of construction. The chief requisites insisted on by the com missioners, are light, ventilation, proper means of warming, conve nience and cheerfulness in the furniture, aud, above all, ample means for out-door exercise. The only doubtful part of the arrangement is the dormitories, some good authorities preferring open wards, as admitting the most effective superintendence at night ; others advo cating separate sleeping apartments, as being less likely to admit of any one patient disturbing another. Both plans have been adopted ; and the remelts do not appear to differ materially.
A great improvement ha. taken place in the class of persons ap pointed as attendant., or. according to the old phraneoloKr, keepers. That all such persons should pewees benevolence and intelligence is weential to the effective working of a Iturnane end enlightened system ; and they should be liberally said. The proportion of attendants to patient.. in the different English public, asylums varies from oue to ten, to one to twenty ; the former does not seem too much, and is far less than that in all well-managed private asylums. No ward, however mall, should have lea than two attendants, in order that it should never be left without one; this is enforced by the rules of several asylums; and is most essential wherever n night attendance is adopted. In some asylums this attendance is endeavoured to be effected by making the day attendant. undertake night duty in turns; but this is taxing their physical powers too severely, even when they are released from duty for half the acceding day.