DISTRIBUTION OF PRIVATE PATIENTS.

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and the weekly maintenance and clothing of each patient. 95. 94d. If to this be added the interest on the cost of construction and asylum repair, the annual cost for each pauper lunatic in county asylums amounts to about £40.

The number of patients discharged cured, in county and borough asylums during the ten years 1871-1880, was 40.32 per cent. on the admissions, and the mortality 10:46 on the mean number resident.

The number of beds in registered lunatic hospitals (about 3000) ranges from 60 to 570, or, excluding idiot asylums, to 300, while the average weekly cost ranges from 14s. to £2 2s. The charges on the buildings are not included. For these Dr. Robertson adds five shillings a week, making the average weekly cost of mantenance £1 10s. or, including asylum construction and repairs, £1 155.

The distribution of private patients, numbering 7741, was as follows on the 1st of January, 1881 :-In registered hospitals, 2800, or 36'17 per cent.; in county asylums, 539, or 6.96 per cent.; in State asylums, 534, or 6.88 per cent.; in private asylums, 3420, or 44'17 per cent.; in private dwellings, 448, or 5.78 per cent.

The registered hospitals have, therefore, thirty-six per cent. of all the private patients, an important fact in looking to the future provision for this class in lieu of private asylums. Their statistics of recovery and mortality are satisfactory. The recoveries per cent, calculated on the admissions were 4648 per cent. during the ten years 1871-1880; the annual mortality being 7:06 per cent.

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PRIVATE ASYLUMS.

As regards private asylums, there were forty-four per cent. of the private patients in England and Wales cared for in these establishments. The recoveries per cent. in private asylums during the decennial period 1871-1880 were in the metropolitan division 3143, and in the provincial 35'11; the annual mortality being, in the metropolitan private asylums 1093, and in the provincial asylums 863. It should be remembered, in contrasting these figures with those of registered hospitals, that a considerable number of pauper patients are still sent to private houses, and it may therefore be said that, so far as difference in social position affects recovery and death, the comparison is not altogether fair. At the same time, it is noteworthy that in the pauper asylums, the percentage of recovery is higher than in the metropolitan and provincial private asylums, and the percentage of mortality lower than in the licensed houses of the metropolis.

Numerous general considerations arise from a retrospect of the history which this and the preceding chapter contain, but they will more fitly form a part of a subsequent chapter of this volume, when a sketch of the results achieved by Psychological Medicine will be given, as presented in the author's Presidential Address at University College.

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CHAPTER VI.

OUR CRIMINAL LUNATICS-BROADMOOR.

No one at the present day is likely to underrate the importance and interest of the subject of this chapter.

An Act was passed in regard to criminal lunatics in the year 1800 (39 and 40 Geo. III., c. 94). It was partially repealed in 1838 (1 and 2 Vict., c. 14); that is to say, so far as the former authorized magistrates to commit to jails or houses of correction, persons apprehended under circumstances denoting derangement of mind and the purpose of committing a crime. The Act of 1838 made other provisions for the safe custody of such persons. Persons in custody under the repealed provision of the previous Act, or hereafter apprehended as insane or dangerous idiots, might be sent to a lunatic asylum, hospital, or licensed house; two justices of the place where such person is apprehended having called to their assistance a medical man, and having satisfied themselves that he is insane or a dangerous idiot; nothing, however, herein contained preventing the relations from taking lunatics under their own care.

This Act did not alter the laws relating to the dis

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CRIMINAL LUNATICS' ACT, 1840.

charge of persons ceasing to be insane, or dangerous idiots, from any county asylum, hospital, or licensed house.

In 1840 an Act was passed (3 and 4 Vict., c. 54) “for making further Provision for the Confinement and Maintenance of Insane Prisoners."

It was enacted that if any person while in prison under sentence of death, transportation, or imprisonment, or under a charge of any offence, or for not finding bail, or in consequence of any summary conviction, or under any other civil process, shall appear to be insane, it shall be lawful for two justices to inquire, with the aid of two medical men, as to the insanity of such person; and if it be duly certified by such justices and medical men that he is insane, it shall be lawful for one of the principal Secretaries of State to direct his removal to such county asylum or other proper receptacle as the Secretary of State may judge proper, to remain under confinement. until it shall be duly certified by two medical men to the Secretary of State that such person has become of sound mind; whereupon he is authorized, if such person remain subject to be continued in custody, to issue his warrant to the person in whose charge he may be, directing that he shall be removed to the prison from whence he has been taken, or if the period of imprisonment has expired, then he shall be discharged. It was also enacted that when a person charged with misdemeanors is acquitted on the plea of insanity, he shall be kept in strict custody during Her Majesty's pleasure, the jury being required to find specially whether such person was insane at the

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time of the commission of such offence, and to declare whether such person was acquitted by them on account of such insanity.

The Earl of Shaftesbury introduced the subject of the provision for criminal lunatics in the House of Lords. in 1852, and moved for an Address to Her Majesty on the expediency of establishing a State Asylum for the care and custody of those who are denominated criminal. lunatics. He said that the subject had been never propounded before to them in a specific form, and the custody of these criminals had been a great bar to the improvement of public and private asylums. The Commissioners had already reported on these evils in 1849, 1850, and 1851. The Government alone had refused assistance. Having pointed out the four classes into which they are divided, he stated that the statutes by which they were confined were three in number, namely, 39 and 40 Geo. III., c. 94; 1 and 2 Vict., c. 14; 3 and 4 Vict., c. 54

He directed attention to a fifth class, those affected with some derangement of mind, who, unless restrained, were in danger of committing offences. Under the lastnamed Act, they were treated as criminals. Formerly any magistrate could commit them to jail, or other place for safe custody under 39 and 40 Geo. III.; but by the Act of 3 and 4 Vict. their condition had been somewhat alleviated, inasmuch as it required that two justices of the peace should commit the parties, under medical advice, and that they should not be sent to jail, but to an asylum or licensed house. None of these parties