*

shipping. The occurrence of insanity in any of the African races is said to be very rare; but there is plenty of evidence that the negro slaves suffered considerably from several kinds of insanity, and their offspring also. This is also true for the slaves derived from other dark African races, who are not true negroes. Idiocy was frequent amongst the descendants of the imported negroes, and a low type of perfect intelligence, which was often perverted, was common, but was difficult of distinction on account of the mechanical and automatic action of the life of the slave. Drs. Bucknill and Tuke quote the testimony of Dr. Moreau in reference to insanity in Egypt. He found an asylum for the insane at Cairo, but at Alexandria, where there was a population of from 80,000 to 90,000 inhabitants and many general hospitals, there was not even a ward assigned to the insane. He asserts that, on the authority of Dr. Gregson, surgeon-in-chief and resident in Egypt for nearly ten years, that insanity is very rare. The Doctor only saw one example of the disease in that period. Dr. Moreau says that as the civilization of Egypt is left behind and the Delta becomes more distant, lofty mountains and desert plains, tents and cattle, successively replace cultivated and fertile fields, habitations and bazaars. With the soil man becomes more degraded, his intellectual activity diminishes, and is at last reduced to a minimum, absorbed as he is in the necessary wants of physical life. Among this population the insane become fewer and fewer in number. I have not met with a single one, not even an idiot, writes Dr. Moreau, in all Nubia. Several of my friends, he continues, who have visited Sennaar, Cordofan, and Abyssinia, have found only here and there a few imbeciles. The same testimony has been adduced with respect to the Guinea Coast. Dr. Moreau suggests, however, that many of the Santons are really insane, and recent travellers in Eastern Africa might almost say as much for the brutal chiefs of some tribes. Nevertheless the rarity of insanity amongst the African populations appears to be established.

Dr. De Forest, of the Syrian Mission,† says "that it is impossible to obtain accurate statistics of the insane here; but I think the disease far less frequent than in our own land." There would appear to be more insanity amongst the Syrians than amongst the African races, the Syrians being a very mixed race. Insanity is said to be less frequent amongst the inhabitants of Bengal and less acute than amongst the civilized races of Europe; but its admitted increase is accounted for by the introduction of European vices. Polynesia appears to be comparatively free from insanity; and its natives, with those of the Australian and New Zealand islands, have received accessions of the disease simply * Some years since the lunatics in this asylum were treated just like wild beasts. + See Buckuill and Tuke, page 49.

through their contact with the worst parts of our civilization. The Chinese and the races associated under that name, and which constitute so large a proportion of the population of the world, are said to be remarkably free from mental diseases, if the prejudicial effects of opium be not considered. The majority of the cases of insanity observed by European physicians in China had their origin in opium smoking; and it is generally admitted, although the opportunities for a close examination of the question have been very slight, that mania and dementia are rare there. No country has passed through more exciting scenes during the last twenty years than China; and rebellion, wholesale massacres, wars with Europeans, and great social changes must have produced their exciting and depressing effects upon a race which is singularly domestic in its affections, much more industrious and saving, and more learned than any other of the Asiatics. The amount of insanity in this great empire can really not be estimated even approximately. In considering the question, some of the peculiarities of the race must be remembered. The ready disposition to commit suicide which is common to the races on the mainland and to those of the islands, including Japan, the sale by men of their own lives for comparatively trifling sums of money, and the suicidal despair which readily affects Chinamen under severe disappointments and hardships when working in distant countries, indicate that the insanity of the people may take on very different phenomena to those observed amongst European nations. The sudden outbursts of murdering passion observed in the Malay race may be taken as an evidence that the great peculiarity of insanity amongst its members is violence, and that ordinary monomania is hardly to be expected.

There is some amount of insanity amongst the rapidly decreasing New Zealanders; but here, again, the effects of European vices are evident. The history of the race is one continued warfare, and it may be conceded that in this instance, as in all others of the same kind, this constant pugnacity must hide a good deal of unreason. A chief whose insanity assumed the ordinary type observed amongst warlike savages, and was persevering in his enmity, cautious before the fight, and furious during and immediately after bloodshed, would not be deemed a madman. Doubtless there have been many such heroes in the world's history. These remarks will apply to the native tribes of the American continent and to the comparatively unknown races of Central and Western Asia; but it should be remembered that amongst the more nomadic nations the constant migrations and the frequent absence of a settled home must give any of the mentally afflicted a poor chance of keeping up with their fellows in the struggle for existence. The amount of insanity amongst the Mahommedan nations is probably much greater than is ordinarily believed, and there is no doubt that those religion

ists who manifest their sanctity by extraordinary physical exertions and tortures contain a large percentage of men who are not much more mad than the founder of the Faithful was.

It is impossible to admit that many of the great conquerors who were the curse of the world were sane. Cambyses, Alexander, and Attila were subject to attacks of homicidal mania, which were only salient points in a long period of unreason qualified by the prevailing warlike spirit. Their insanity took on the type which reflected the ordinary disposition of the age. So did that of Saul and Ajax. It is hard to believe in the sanity of Domitian and Nero, or of many of the emperors whose bloodthirstiness was appalling, and whose cruelties were atrociously wanton, and especially as madness was so common in the best days of Rome that its symptoms have been admirably rendered by the physicians of the period. Violence, homicide, and suicide, although the most marked of the symptoms of the earlier civilizations, were not unaccompanied by the melancholy madness so common at the present time. Hippocrates notices a case of melancholia in a woman of his day, "from an accidental cause of sorrow." She lost her power of sleep, and had aversion to food, and suffered from thirst and nausea, being of a melancholic turn of mind. Her cure by nature is recorded also. The method of madness simulated by David bears witness to the acquaintance of the Philistines of Gath with the complaint, otherwise the stratagem would not have had the desired result. Thus early in the history of the world the sanctity of the insane was clearly acknowledged. The unsatisfactory notices of uncivilized and ancient madness appear to indicate the prevalence of violent maniacal and homicidal attacks, and the opposite condition of imbecility. There is every reason to believe that the affliction does not increase amongst savage nations, and that it never attained a very great importance in classical times. Probably the mass of the demented of Europe was not represented by a corresponding type of disease in the olden time. The truth is melancholy enough now.

The increase of the population of England and Wales and Scotland year by year is beyond doubt; and unfortunately, so far as England is concerned, there is no doubt about the yearly increase of pauperism. Emigration has been compensated for by the annual excess of births over deaths, and it is certain that the exodus has not taken away a great proportion of the best of the peasantry, as it has in the case of Ireland. The condition of the agricultural labourers and miners has slightly improved; but that of the population of the worst parts of our great cities has retrograded.** On the other hand, commercial enterprise and great engineering opera

*At a recent meeting of the Liverpool Select Vestry, a brewer (sic!) attributed the fulness of the lunatic asylums which he had visited to indulgence in poisoned beer.

tions have raised a vast number into the lower middle class, and have excited increased mental activity and its corresponding anxieties. The mercantile world has passed through great ordeals, and wealth has been unusually uncertain during the last few years. There is hardly a small circle of acquaintance that cannot tell of some ruin amongst people who have been prosperous; and the details of the results of the immoral conduct of "financiers" abound with lists of the well-educated who have to put up with the greatest privations, and whose mental sufferings can better be imagined than expressed. According to the popular idea the increase of insanity should have been found amongst the middle and upper classes, and the private asylums should have received an unusual number of patients of late.

The following Table, taken from the last Report of the Commissioners in Lunacy, is singularly corrective of the popular idea, and confirmative of those opinions which connect insanity rather with defective constitutional vigour and a low state of the nutritive functions than with increased mental strain and anxiety.

INCREASE OF PRIVATE AND PAUPER PATIENTS IN THE ASYLUMS OF ENGLAND FROM 1863-67.

It will be seen that there is a steady increase of our pauper lunatics, at the rate of about 1000 a year, whilst there are only thirty-six more private patients in asylums than five years ago. The increase of the general population has been great, yet the small number of 36 when placed en rapport with its numbers amounts to nothing as regards increase, and infers a decided decrease.

The Table is carried on in the Report up to 1868 and 1869, and the number of pauper lunatics admitted into asylums in those years was 27,363 and 28,728 respectively. But this return does not refer to all the pauper lunatics; for the workhouses contained 7963 lunatics in 1859 and 11,181 in 1869; and there were 5798 insane paupers in 1859 living with their relatives, and 6987 in 1869. Thus the whole pauper lunacy of England and Wales amounted to 31,782 cases in 1859, and to 46,896 in 1869. The population in 1859 amounted to 19,686,701, and in 1869 to

21,869,607. That is to say, with an increase of population of 2,182,906, there were no less than 15,114 pauper lunatics. In the corresponding time, aud with the same increase of the general population, there was a gross increase of 840 cases amongst those who came under the notice of the Commissioners as private patients in asylums and at home with their friends and committees.

Doubtless many a lunatic whose friends are above the pauper class is kept at home and escapes the notice of the Commissioners, but any increase in the numbers of the "private" class which might accrue in this manner is compensated for, when the relative numbers of the insane are considered, by the number of pauper lunatics who are aged and simply demented, and who are not under supervision. There appears to be a reasonable foundation, then, that there is a decided increase in the lunacy of the pauper class, and that it is slight among the non-pauper class.

This assertion has been most ably and temperately contradicted by one of the late presidents of the Medico-Psychological Association, and in 1861 by the Commissioners in Lunacy. They then wrote the following sentence, which very properly heads Dr. C. Lochart Robertson's essay on the subject:-"We have not found any reasons supporting the opinion generally entertained that the community are more subject than formerly to attacks of insanity."* In 1869, Dr. L. Robertson wrote, "that the alleged increase of lunacy is a popular fallacy, unsupported by recent statistics." He quotes the words of the President's address, read July 31, 1867:-"During this period (1847-1867) the total number of pauper lunatics and idiots has increased from 17,952 to 42,943. While in 1847 one in every 880 of the whole population was a pauper lunatic, this proportion is now, in 1867, one in 494. I do not attribute these numbers to any actual increase in insanity, but rather to the fact of the more accurate returns which are now made of the pauper lunacy of the country, and also in some degree to a number of persons in the lower middle class successfully contriving to evade the restrictions of the poor law, in order to procure for their insane relatives treatment in the county lunatic asylums. This opinion of the absence of any positive increase in the lunacy of the country is further supported by the relative proportion of private patients to the population in the same period."

Popular fallacies and general impressions are very obnoxious to the dogmatic under any circumstances, and they become exasperating when they receive support from the most recent and official statistics. The following Table from the Commissioners' Report for 1868, published July, 1869, gives support to the "popular fallacy," if figures are of the least value, and unless the Commissioners wish to throw dust in our eyes.

* Report, 1861.