r 
 
STATISTICS OP THE 
 
 \V 
 
 ' 
 
 RETREAT 
 
 CONSISTING OF 
 
 & Report anK CaijUg, 
 
 EXHIBITING 
 
 THE EXPERIENCE OF THAT INSTITUTION 
 
 THE INSANE; 
 
 FROM ITS ESTABLISHMENT IN 1796, TO 1840. 
 
 YORK: 
 
 PRINTED BY JOHN LEWIS LINNEY, 15, LOW OTJSEGATE, 
 
a 
 
 o 
 
 & 
 
 The following Statistical Tables, exhibiting 
 the results of the experience of the Retreat during the forty- 
 four years of its existence, having been prepared by the Resident- 
 Surgeon of the institution, John Thurnam, were by the Com¬ 
 mittee directed to be presented to the General Meeting of 
 Directors, in 1840; which authorised their being printed, with 
 such elucidatory matter as might be found necessary, under the 
 care and revision of the Committee. 
 
 The results exhibited in these Tables and in the 
 Report prefixed to them have been drawn up, with much care 
 and labour, from the records of the Retreat and from other 
 authentic sources; and the Committee trusts that the informa¬ 
 tion which they convey may add a little to the knowledge of the 
 history and treatment of insanity; and likewise that the cir¬ 
 culation of them may tend to promote the free communication 
 of the results obtained by similar institutions. 
 
 By direction of the Committee, 
 
 SAMUEL TUKE. 
 
 York, 6th mo. 22nd, 1841. 
 
 
 

 - 
 
 - - • ' • sA ! 
 
 ■■■ 
 
 
 
 . 
 
 * 
 
 
 
 
 
CONTENTS. 
 
 Page of 
 Report. 
 
 Introductory Remarks.. 1 
 
 History and objects of the Institution. 2 
 
 § 1.—General View of the Experience of the Retreat since 
 its opening in 1796. 
 
 Tables 1, 2, 3, 4. 6 
 
 § 2.—Of the Condition and previous History of the patients. 
 
 . .Tables. 5, 6, 7, 8, 9, 10....... 12 
 
 § 3.—-Of the probable Causes of.the Mental Disorder. 
 
 Tables 11, 12, 13, 14. 17 
 
 § 4.— Of the Forms of Mental Disorder, and the general 
 Results of Treatment, as modified by Form of Disorder, 
 Duration, Sex, and Age. 
 
 Tables 15, 16, 17, 18. 25 
 
 —Of the Duration of Residence. 
 
 Tables 19, 20. 27 
 
 § 5.—Of the Recoveries, and their average proportions, &c. 
 
 Tables 20, 21, 22, 23. 29 
 
 § 6.—Of the Readmissions and History subsequent to dis^ 
 charge. 
 
 Tables 24, 25, 26, 27, 28. 33 
 
 —History subsequent to discharge. 
 
 Tables 29, 37, 38. 35 
 
11. 
 
 CONTENTS. 
 
 Page of 
 Report. 
 
 § 7.—Of the Deaths and average Mortality. 
 
 Tables 30, 31, 32, 33, 34, 35, 36, 37, 38, 39. .. 37 
 
 § 8.—Of the Cases remaining under Care. 
 
 Tables 40, 41, 42, 43. 45 
 
 § 9.—Of the internal Economy and general Management of 
 the Institution. 
 
 Tables 44, 45, 46, 47. 45 
 
 Moral Treatment. 45 
 
 Personal Restraint. 50 
 
 Number of Officers and Attendants. 52 
 
 Modes of Employment and Amusement. 53 
 
 Dietary. .. 56 
 
 Medical Treatment.*. 59 
 
 § 10.—Of the Finances of the Institution. 
 
 Tables 48, 49, 50, 51... 62 
 
 Appendix, No. 1. 
 
 Statistics of the York Lunatic Asylum; Tables A, B,C, D, E. 
 Appendix, No. 2. 
 
 Table shewing the Statistics of Recovery and Mortality in 
 several of the principal Hospitals for the Insane in Great 
 Britain, Ireland, the United States of North America, 
 and on the Continent of Europe. 
 
I 11-- V. 1 s 
 
 STATISTICAL REPORT, 
 
 ■ 
 
 V\< ' X ' ,, r «. t \\ ( 
 
 The statistical tables, fifty-one in number, now pre¬ 
 sented to the directors and friends of the Retreat, exhibit 
 the results obtained at that institution, during the forty- 
 four years that it has been in operation, from Midsummer 
 1796, to Midsummer 1840. They have been compiled 
 with considerable labour, after a very close examination 
 and correction of the records of the institution; an oppor¬ 
 tunity for which has been found, in consequence of the 
 earlier and more defective cases being, to a great extent, 
 within the recollection of different friends and officers of 
 the institution, whose assistance the compiler particularly 
 acknowledges.* Although, from the nature of the case, 
 the precise accuracy of every detail cannot be asserted; 
 yet it is believed that no important error exists in these 
 tables, and that their general accuracy may be relied on; 
 and it is supposed that they contain much information 
 upon the subject of mental disorders, which may be both 
 interesting and valuable to the friends of the institution, 
 and likewise to the public more generally. 
 
 It will be observed, that in most of the tables, the 
 cases occurring in persons belonging to, and connected 
 with, the Society of Friends are distinguished from those 
 not so connected; it being thought desirable to exhibit, 
 as much as possible, the peculiar characters, if any, of the 
 
 * The kind and varied assistance of the Treasurer, Samuel Tuke, requires particular 
 acknowledgement in this place. 
 
 A 
 
2 
 
 STATISTICAL 
 
 causes, forms, and terminations of mental disorders in a 
 separate religious community, such as the Society of 
 Friends. In some instances, likewise, it may be interest¬ 
 ing to compare the different results obtained in the two 
 classes of patients. The number, however, of persons of 
 other religious persuasions who have been admitted, is too 
 small to allow of confidence in the results of such a com¬ 
 parison in all cases. 
 
 Independently of the peculiar interests belonging to 
 the statistics of the Retreat for the reasons now alluded 
 to, a more general one is attached to them, from the 
 cases being derived from a much more definite portion 
 of the general population than is the case in most other 
 institutions. There is, indeed, every reason for conclud¬ 
 ing, that of those in this community who require care on 
 account of insanity, a very large majority has, during the 
 last thirty years, been admitted, and, in case of relapse or 
 subsequent attack of disorder, readmitted into the Retreat. 
 And it may be also remarked, that, from the free inter¬ 
 course so generally prevailing between the members of the 
 Society of Friends throughout the kingdom, much more 
 information, and that of a more accurate character, is 
 generally to be collected, respecting the history of the cases 
 admitted. And hence it appears just to conclude that, 
 after deducting what may be peculiar to the circumstances 
 of the society, the experience of the Retreat is well cal¬ 
 culated for the attainment of sound conclusions relative 
 to mental disorders; and for correcting inferences from 
 the statistics of much larger institutions, not possessed of 
 such facilities for enquiry. 
 
 History and objects of the Institution .—Previously to 
 entering into any explanatory remarks as to the inferences 
 to be drawn from the following statistical tables, it will be 
 
REPORT. 
 
 3 
 
 desirable to put the reader in possession of a brief sketch 
 of the history and objects of the institution^ the experience 
 of which they exhibit; since; for the purpose of any just 
 comparison of the results obtained at different hospitals 
 for the insane; it is essential to be acquainted with the 
 several points by which, in their general character; their 
 particular appropriation^ and in their rules and practice as 
 to the admission and discharge of patients^ they are 
 respectively distinguished. 
 
 The Retreat^ near York; was established by the Society 
 of Friends; for the use of the insane members of their own 
 community; and of those in profession with them. 
 
 It may perhaps be thought almost superfluous to remind 
 the reader that the Society of Friends; or Quakers; con¬ 
 sists of persons chiefly in the middle ranks of life; and 
 for the most part engaged in trade; commerce; manufac¬ 
 tures; and agriculture. In a statistical point of view, 
 however; it is important that this should be borne in 
 mind; as it would be desirable that the statistical results 
 which this community presents should be compared; not 
 with those afforded by the population at large; but with 
 those of the middle classes; could these be separately ob¬ 
 tained. There are several respects in which the vital sta¬ 
 tistics of the Society of Friends differ from those of the 
 general population; and in none more SO; perhaps; than 
 the greater average longevity: in what degree; however; 
 they differ from those of the middle classes of this country 
 is a question which; in many cases; we have at present no 
 means of determining. 
 
 The first steps towards the establishment of the Retreat 
 were taken in the year 1792. From prospectuses pub¬ 
 lished in that and the following year; it appears that the 
 following were the motives which chiefly influenced its 
 
4 
 
 STATISTICAL 
 
 original promoters in the formation of the new institution. 
 “It was conceived* that peculiar advantages would be 
 derived to the Society of Friends* by an institution of this 
 kind under their own care* in which a milder and more 
 appropriate system of treatment* than that usually practised* 
 might be adopted; and where* during lucid intervals* or the 
 state of convalescence* the patient might enjoy the society 
 of those who were of similar habits and opinions. It was 
 thought* that the indiscriminate mixture* in large public 
 establishments* of persons of opposite religious sentiments 
 and practices; of the profane and serious; the profligate 
 and virtuous; was calculated to check the progress of 
 returning reason* and to fix still deeper the melancholy 
 and misanthropic train of ideas* which* in some descrip¬ 
 tions of insanity* impresses the mineL^* 
 
 The institution when opened for the reception of 
 patients* in the summer of 1796* was designed for thirty 
 persons; but* by successive additions to the building* it 
 has been gradually enlarged* so as to be capable of afford¬ 
 ing accommodation to about one hundred.f It is seated 
 on an elevated ground* half a mile from the walls of the 
 city* commanding an extensive and diversified prospect*, 
 and affording excellent air and water. When first erected* 
 it was surrounded by about eleven acres of land; but* by 
 subsequent purchases* this has been increased to about 
 twenty-eight acres; nearly one-fourth of which is occupied 
 by gardens and pleasure-grounds. 
 
 The rules of the institution provide for the admission 
 of all classes of persons in regard to wealth* on term& 
 adapted to their several circumstances. The poorer class 
 
 * Description of the Retreat, 1813. p. 23. 
 
 t The Retreat cannot, from the circumstances under which it has been erected, be 
 looked upon as a model for institutions of this description in an architectural point 
 of view. 
 
REPORT. 
 
 5 
 
 of patients are admitted at 8s. per week; or at 4s. under 
 the recommendation of a privileged subscriber; and, with 
 a view of removing every obstacle to the placing of patients 
 under proper care at an early period of the disease, those 
 of this class who are sent to the institution within six 
 months of the attack, have, since the year 1?99, been ad¬ 
 mitted for one year, either gratuitously, or at 4s. per week. 
 For the information of those unconnected with the Society 
 of Friends, it must be here observed, that its internal 
 economy provides for the payment of these weekly charges, 
 where they cannot be met by the friends of the patient; 
 and thus it is to be supposed, that pecuniary considerations 
 in no case either retard admission into, or hasten discharge 
 from, the institution. Persons in more easy circumstances 
 pay from 10s. to 21s. per week; whilst the more affluent 
 are admitted at the rate of from one to three, four, or five 
 guineas, according to the circumstances of the patient, and 
 the extent of accommodation afforded. (See Table 48.) 
 
 It may be here stated, that about three-fourths of the 
 income of the institution has been derived from the pay¬ 
 ments on behalf of patients; and that the remainder has 
 arisen from annual subscriptions, donations, legacies, and 
 annuities. (Table 50.) 
 
 Except during short periods of time, the establishment 
 has always been able to receive all patients, connected with 
 the Society of Friends, whose admission has been applied 
 for; and during any temporary interruptions, in conse¬ 
 quence of alterations in the buildings being in progress, or 
 from other causes, the more recent cases have never been 
 excluded. 
 
 According to the original scheme of the institution, idiots 
 were not admissible, but this distinction has only been 
 imperfectly observed; and no insane person is refused 
 
6 
 
 STATISTICAL 
 
 admission on account of the long duration of the disorder* 
 of its being complicated with paralysis or epilepsy, or 
 of its supposed incurability from any other reason. As 
 there is no distinct establishment for incurable and imbe¬ 
 cile patients supported by the Society of Friends, those 
 who do not recover generally remain in the Retreat during 
 the remaining period of their lives. 
 
 In the year 1818, in consequence of the provision for 
 the higher class of patients being found greater than the 
 wants of the society required, it was agreed to admit into 
 this part of the institution a few patients wholly uncon¬ 
 nected with the Society of Friends, who could afford to 
 pay for the accommodation and advantages which this 
 department of the Retreat affords. Since the year 182(1, 
 when the first admission of this kind took place, there has 
 been^ on an average, ten or eleven patients ( 10 . 70 ) of this 
 class under its care. 
 
 In order to guard against misapprehension, and to 
 place the general results which have been obtained clearly 
 before the reader, the following explanatory notes to, and 
 brief observations upon, the several tables, are here 
 introduced. 
 
 § 1.—General view of the experience of the 
 Retreat since its opening in 1796. 
 
 Annual reports and general results during forty-four 
 years.—Tables 1 and 2 are republished from the annual 
 report of the institution for 1840. They exhibit the gross 
 results obtained during the year 1839-40; and also during 
 the whole period of forty-four years, 1796-1840, that the 
 institution has been in operation. The average numbers 
 resident during both these periods, which, in such tables 
 are so often omitted, are likewise given. 
 
REPORT. 
 
 7 
 
 The number of admissions during the forty-four years 
 was 615; of which 282 occurred in males; and 333 in 
 females. As 146 of these cases were readmitted ones 
 (Table 24); the number of persons treated; was 469; or; 223 
 men; and 246 women. The distinction between the num¬ 
 ber of cases admitted into any institution^ and the number 
 of persons in whom those cases occurred; is an important 
 one; in a statistical point of view; and; in the construction 
 of these tables^ has always been kept in sight. 
 
 Out of every 100 cases; of all descriptions; admitted 
 during the forty-four years; the proportions discharged; 
 under the several heads; and remaining under care; at the 
 end of that period; are shewn in the following table :— 
 
 
 Males. 
 
 Females. 
 
 Mean. 
 
 Recovered . 
 
 42.9 
 
 5lTl 
 
 47.3 
 
 Improved.. 
 
 14.5 
 
 7.2 
 
 10.6 
 
 Unimproved . 
 
 3.9 
 
 5.4 
 
 4.7 
 
 Died.,. 
 
 24.8 
 
 20.7 
 
 22.6 
 
 Remaining . 
 
 13.9 
 
 15.6 
 
 14.8 
 
 Total. 
 
 100. 
 
 100. 
 
 100. 
 
 The reader is referred to a future page; under the heads 
 of recoveries and deaths^ for some remarks upon these 
 aggregate results; which are of little value unless accom¬ 
 panied by a discriminating statement of the character of 
 the cases admitted. It \till be seen that; had the small 
 proportion of cases; in persons unconnected with the 
 Society of Friends^ been omitted; the proportion of 
 recoveries in the above statement would have been 50.18 
 instead of 47.31 per cent. The 22.6 per cent, of the whole 
 number admitted; who have died; it need scarcely be 
 stated^ does not express the actual mortality. This; 
 however; may be calculated from Table 2; and will be 
 found to have been at the annual rate of 4.70; or exclud- 
 
8 
 
 STATISTICAL 
 
 mg persons unconnected with the Society of Friends, 4.59 
 per cent, those constantly resident. 
 
 Results of experience at different periods.—Tables 3 and 4. 
 These tables exhibit the experience of the institution 
 during the forty-four years since its opening in 1796, the 
 numbers, admitted and discharged, the average numbers 
 annually resident, and the proportions of recoveries and 
 deaths, being shewn for each of the four successive periods 
 of ten years each, extending from 1796 to 1836, and for 
 that of four years, from 1836 to 1840. 
 
 The average numbers resident during the several periods 
 have been calculated from a quarterly register of the 
 numbers in the house, which has been regularly kept 
 since the establishment of the Retreat.* The average 
 number of 67-15 persons, thus obtained for the whole 
 period of forty-four years, differed by only a few fractions 
 from that deduced by adding together the duration of 
 residence of every case admitted, and dividing by 44, the 
 number of years over which the cases extended. This 
 latter plan was the only one, that could be resorted to, for 
 determining the average numbers resident, connected and 
 unconnected with the Society of Friends (Table 5); the 
 average numbers resident at the different ages (Table 9); 
 and the average numbers of persons in the different forms, 
 and various durations, of the disorder when admitted (Tables 
 16 and 17). It will be seen that the average number 
 progressively increased, from 37-53 during the first ten 
 years, 1796-1806, to 95.70 in the fourth, 1826-1836. In 
 consequence, however, of many applications for admission 
 in 1837; having been refused, on account of extensive 
 
 * During the last three years the average number resident has been calculated from a 
 monthly register; which has been found to afford results as accurate as those from daily 
 enumerations. 
 
REPORT. 
 
 9 
 
 alterations in the buildings; the average number for the 
 four years; 1836-40; has been temporarily reduced to 89. 
 At the date of this report there were 91 patients remain¬ 
 ing in the house. 
 
 In comparing the average proportions of recoveries and 
 deaths per cent . of the admissions during the several 
 decennial periods (Table 4 ), it is to be recollected; that 
 excepting the first decennium 1796-1806; and the entire 
 period 1796-1840; the numbers given do not precisely 
 express the actual proportions of recoveries and deaths; 
 but are above the true proportions. This arises from the 
 cases remaining under treatment at the beginning of each 
 of the periods alluded tO; not being taken into the account. 
 On the other hand; had the latter plan been adopted; the 
 same cases would have been counted again and again; and 
 the proportions of recoveries and deaths would have 
 appeared much below the actual ones. This is a consider¬ 
 ation which should not be forgotten; in estimating the 
 results obtained during a series of years only; and not dur¬ 
 ing the whole period of existence of any institution. No 
 such fallacy; however; attaches to the proportions of 
 recoveries and the mean mortality; given for the different 
 decennial periods; as calculated per cent . the average num¬ 
 bers resident . 
 
 As regards the results obtained in the several periods of 
 the institution^ existence; it will be seen that the propor¬ 
 tion of recoveries was greater and the mean mortality 
 considerably less in the second decennium; 1806-1816; 
 than in any of the others. This is a difference in the 
 results which; to a great extent; at least as regards the 
 recoveries; is explained by the fact; as shewn in the 
 subjoined table; of a larger proportion of recent; and a less 
 of very old cases; having been admitted during that period, 
 
 B 
 
10 
 
 STATISTICAL 
 
 There may, however, be some consideration due to the 
 increased experience of the officers of the institution in 
 that period, as compared with the previous one. 
 
 Table—Shewing the numbers or cases of shorter and longer dura¬ 
 tion, ADMITTED DURING THE DECENNIAL PERIODS, 1796—1840. An 
 appendix to Table 3. 
 
 
 ADMITTED. 
 
 PERIODS 
 
 FIRST CLASS. 
 
 SECOND CLASS. 
 
 THIRD CLASS. 
 
 FOURTH CLASS. 
 
 OF 
 
 First attack, and 
 
 First attack, 
 
 Not first attack, 
 
 First or not first 
 
 TEN YEARS. 
 
 within 3 months. 
 
 above 3, within 12 
 
 within 12 months. 
 
 attack, more than 
 
 
 
 
 
 months. 
 
 
 
 
 
 12 months. 
 
 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Male. 
 
 Fem. 
 
 Total 
 
 1796—1806 
 
 3 
 
 15 
 
 18 
 
 6 
 
 10 
 
 16 
 
 10 
 
 15 
 
 25 
 
 29 
 
 30 
 
 59 
 
 1806—1816 
 
 10 
 
 11 
 
 21 
 
 10 
 
 9 
 
 19 
 
 6 
 
 23 
 
 29 
 
 19 
 
 20 
 
 39 
 
 1816—1826 
 
 18 
 
 7 
 
 25 
 
 13 
 
 9 
 
 22 
 
 27 
 
 27 
 
 54 
 
 19 
 
 30 
 
 49 
 
 1826—1836 
 
 Period of four 
 
 9 
 
 13 
 
 22 
 
 17 
 
 12 
 
 29 
 
 32 
 
 42 
 
 74 
 
 30 
 
 26 
 
 56 
 
 years. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1836—1840 
 
 5 
 
 5 
 
 10 
 
 2 
 
 3 
 
 5 
 
 11 
 
 18 
 
 29 
 
 6 
 
 8 
 
 14 
 
 Period of forty 
 
 
 
 
 
 
 
 
 
 
 
 
 
 four years. 
 
 1796—1840 
 
 45 
 
 51 
 
 96 
 
 48 
 
 43 
 
 91 
 
 86 
 
 125 
 
 211 
 
 103 
 
 114 
 
 217 
 
 The relative proportions of each class admitted during 
 the respective periods, as deduced from the foregoing 
 table, were as follow:— 
 
 
 Class 1. 
 
 Class 2. 
 
 Class 3. 
 
 Class 4. 
 
 Total. 
 
 1796—1806 
 
 15.2 
 
 13.6 
 
 21.2 
 
 50.0 
 
 = 100. 
 
 1806—1816 
 
 19.4 
 
 17.6 
 
 26.9 
 
 36.1 
 
 = 100. 
 
 1816—1826 
 
 16.7 
 
 14.6 
 
 36.0 
 
 32.7 
 
 = 100. 
 
 1826—1836 
 
 12.1 
 
 16.0 
 
 40.9 
 
 31.0 
 
 = 100. 
 
 1836—1840 
 
 17.3 
 
 8.6 
 
 50.0 
 
 24.1 
 
 = 100. 
 
 Average. 
 
 1796—1840 
 
 15.6 
 
 14.8 
 
 34.3 
 
 35.3 
 
 = 100. 
 
 The largest proportions of the more recent cases, Class 
 1 and 2, it will be seen were admitted in the second 
 period, 1806—1816: that of very old cases, Class 4, in the 
 first period, 1796—1806. The number of cases in Class 4 
 has decreased during the successive periods, in nearly 
 
REPORT. 
 
 11 
 
 the same proportion as those in Class 3, containing cases of 
 relapse and second or subsequent attacks, have increased. 
 
 A more correct method, at least as regards the recove¬ 
 ries, of shewing the varying character of the results 
 obtained at different periods in the institution, than that 
 of giving them for separate decennial periods, as in Table 
 4, would have been to have given them for periods suc¬ 
 cessively increasing by ten years; i. e. first for ten, then 
 twenty, then thirty, then forty, and, lastly, for forty-four 
 years, as follows; also deduced from Table 3. 
 
 
 Average of Recoveries 
 per cent. 
 
 of the Admissions. 
 
 Mean Mortality 
 per cent. 
 
 Annually Resident. 
 
 Male. 
 
 Fem. 
 
 Mean. 
 
 Male. 
 
 Fem. 
 
 Mean. 
 
 10 years 1796 -1806 .... 
 
 27.08 
 
 38.57 
 
 33.90 
 
 8.47 
 
 2.14 
 
 4.52 
 
 20 years 1796—1816 .... 
 
 35.48 
 
 53.38 
 
 46.01 
 
 5.50 
 
 2.55 
 
 3.71 
 
 30 years 1796—1826.... 
 
 42.94 
 
 49.02 
 
 46.27 
 
 5.39 
 
 3.54 
 
 4.31 
 
 40 years 1796—1836 .... 
 
 42.24 
 
 50.16 
 
 46.50 
 
 5.38 
 
 3.98 
 
 4.57 
 
 44 years 1796—1840 .... 
 
 42.91 
 
 51.05 
 
 47 31 
 
 5.58 
 
 4.05 
 
 4.70 
 
 No fallacy whatever exists in this method; which shews 
 as was to have been expected from the previous state¬ 
 ment, a very great increase in the proportion of the 
 recoveries in the first twenty, as compared with the first 
 ten, years; and, after that, only a trifling increase. The 
 mean mortality is also remarkably low for the first twenty 
 years, as compared both with the more extended periods, 
 and with the shorter one of ten years. At the end of 
 thirty years the proportions of recoveries and the mean 
 mortality would appear to have become nearly station¬ 
 ary ; as during the subsequent fourteen years they have 
 undergone but little alteration. 
 
12 
 
 STATISTICAL 
 
 § 2.—Of the condition and previous history of 
 
 the patients; so far as these may be supposed 
 
 TO PREDISPOSE TO, OR INFLUENCE THE CHARACTER 
 
 OF, THE MENTAL DISORDER. 
 
 It must here be observed that, in estimating the influ¬ 
 ence of the various circumstances in the previous history 
 of the cases, and that of the probable causes of the dis¬ 
 order, as has been attempted in this and the following 
 sections, the same person has only been enumerated once 
 in these tables. No satisfactory results can be obtained 
 when^ as appears customary in tables of this kind; the 
 same circumstance is counted again and again, upon each 
 readmission of the same individual. 
 
 A reference to the numbers in the various tables will be 
 sufficient to shew, although not always so stated, that 
 many of the following observations have, for reasons 
 already given, been confined to the cases connected with 
 the Society of Friends; it not being always thought im¬ 
 portant to direct particular attention to the comparatively 
 small number not of that community, which have been 
 admitted. In several other instances however, where no 
 particular advantage was anticipated from such a division 
 of the cases, the two classes have been united without 
 distinction in the same tables; as in those of the last 
 section (§ 1), and in Tables 16, 17, 19, 20, 25, 27, 28, 
 29, 37, 38, 39, 41, and 43. 
 
 Connexion with the Society of Friends .— Table 5.—Of 
 the 469 persons admitted, there were 415 who were mem¬ 
 bers of, or connected with, the Society of Friends, and 54 
 not so connected. Of the mean number of 67.15 con¬ 
 stantly resident, there were, taking the average of the 
 whole period, 4.80 not connected, thus leaving 62.35 as 
 the average number of persons connected, with this com- 
 
REPORT. 
 
 13 
 
 munity. Of these, however, 58.90 only, or possibly even 
 a rather less number, were actually members of the 
 society. 
 
 Previous attacks.—Table 6.—Of those connected with 
 the Society of Friends, 91, or 22 per cent., and of others, 
 20, or 37 per cent., had suffered from more than one 
 attack of mental disorder when first admitted into the 
 institution. This table, and that which shews the num¬ 
 ber of persons readmitted after recovery from first attacks 
 (Table 25), will enable us to ascertain the proportion of 
 relapses and second attacks of insanity which have occurred 
 in persons who have been under the care of the Retreat. 
 
 Town or Country Life.—Table 7.—Of 415 patients, 228, 
 or about 55 per cent., have been admitted from cities and 
 large towns; including even in this class all places having 
 a population much exceeding 5000: 101, or 24 per cent., 
 were from small towns and villages; and 86, or 21 per 
 cent., from more completely rural districts. 
 
 Rank or Profession.—Table 8.—With a few exceptions, 
 there does not appear to be any marked dispropor¬ 
 tion between the numbers admitted of the different 
 professions and ranks in life, and what may be presumed 
 to be the numbers of the Society of Friends at large, 
 belonging to such ranks and professions. There may, 
 however, be some ground for concluding, that the number 
 of persons engaged in agriculture, 63, as compared with 
 that of persons in trade, 94, is above the proportion 
 existing in the society at large. The relative proportion 
 of females in the stations of housekeepers, seamstresses, 
 shopwomen, and especially in that of domestic servants, 
 amounting altogether to 66, or 30 per cent, of the whole 
 number of females admitted, may also perhaps be above 
 the average. But this rather large proportion may yet 
 
14 
 
 STATISTICAL 
 
 be chiefly, if not altogether due on the one hand, to the 
 great facilities which the rules of the Retreat and the 
 economy of the society afford for the admission of per¬ 
 sons of these classes; and, on the other, to a larger 
 proportion of patients of the more opulent classes beings 
 as is probably the case, under private care. 
 
 Sex.—Tables 5-10, fyc .—The number of cases occurring 
 among females at the Retreat, has exceeded that among 
 males by 20 per cent.; or, in other words, only 45 men 
 have been received to 55 women. This is not to be 
 accounted for by any greater facility for the admission of 
 women; and the fact appears to be, that, in this particular 
 community, there is at least a corresponding disproportion 
 in the numbers of the two sexes; and in all probability a 
 much greater one, when persons of adult age only are 
 considered. The excess, on the side of females, in the 
 average numbers of the two sexes resident during the 
 forty-four years was still greater, and amounted to 35 per 
 cent.; there having been a mean number of 26.55 men to 
 35.80 women. The reason for the average proportion of 
 females in the house, as compared with males, having 
 been still greater than that of females admitted, is to be 
 found in the much higher rate of mortality among males. 
 (Table 35.) 
 
 It is an old opinion, and one that is, at least, not con¬ 
 tradicted by the experience of the Retreat, that women 
 are somewhat less subject to insanity than men. When 
 attacked with the disorder, they have likewise an advan¬ 
 tage over the other sex; for, in them, the probability of 
 recovery is greater, and that of death considerably less. 
 
 Age.—Table 9.—The mean age at the origin of the 
 disorder appears to have been 34 years; the males, on 
 an average, being attacked two years earlier than the 
 
REPORT. 
 
 15 
 
 females. A similar difference appears in the mean age of 
 males and females upon admission, which; for the two 
 sexes, was 39 years. For obvious reasons, the specified 
 age upon admission, may be relied on with greater con¬ 
 fidence than that at the first attack; though it must be 
 stated, that much doubt respecting the latter did not 
 apply to more than twenty cases of the whole number 
 admitted. The average age of the cases constantly resi¬ 
 dent during the whole period, has been nearly 49 (48.9) 
 years; that of the females exceeding that of the males by 
 more than half a-year. It is interesting to observe, that 
 the average age at admission corresponds, within a slight 
 fraction, with that observed, during 25 years, at the York 
 Lunatic Asylum (Appendix 1, Table A); where a similar 
 difference w T as also noticed between the ages of the males 
 and females. Owing, however, to the greater mortality 
 at the asylum, the average age of those constantly resident 
 was little more than years (Appendix 1, Table C), or 
 less, by nearly eighteen months, than that of persons con¬ 
 nected with the Society of Friends at the Retreat. 
 
 As regards the origin of the disorder, by far the largest 
 proportion, amounting to one-third of the whole, is found 
 to be attacked from 20 to 30 years of age, and the pro¬ 
 portions gradually decrease for each subsequent decennial 
 period of life; as follows, deduced from Table 9. 
 
 Of 100 cases, at the origin of the disorder, there were at 
 
 0-10 
 
 10-20 
 
 20-30 
 
 30-40 
 
 40-50 
 
 50-60 
 
 60-70 
 
 70-80 
 
 80-90 
 
 years of age. 
 
 0.96 
 
 12.77 
 
 32.53 
 
 20.00 
 
 15.90 
 
 10.60 
 
 6.03 
 
 0.97 
 
 0.24 
 
 = 100 
 
 In order to ascertain the actual liability, at the several 
 ages, to insanity, the proportions attacked at each age 
 should be compared with the mean numbers living at the 
 
16 
 
 STATISTICAL 
 
 same age in this particular community, did the means for 
 doing this exist. 
 
 As regards the proportions for the different ages, at the 
 time of first admission, these will be seen, from the fol¬ 
 lowing statement, to have been much less for the ages 
 below, and greater for all the ages above, 20-30, as com¬ 
 pared with the proportions for the same ages at the 
 origin of the disorder. 
 
 Of 100 cases, at first admission, there were at 
 
 0-10 
 
 10-20 
 
 20-30 
 
 30-40 
 
 40-50 
 
 50-60 
 
 60-70 
 
 70-80180-90 
 
 years of age. 
 
 
 0.97 
 
 32.77 
 
 20.72 
 
 18.56 
 
 13.25 
 
 10.36 
 
 2.89 0.48 
 
 = 100 
 
 The mean numbers resident in the house, as shewn 
 below, gradually increased for every decennial period of 
 life, up to 40-50 and 50-60, when they attain their maxi¬ 
 mum. They then decrease, but still more gradually than 
 they had increased, for each subsequent period. 
 
 Supposing 100 cases constantly resident, there would have been at 
 
 0-10 
 
 10-20 
 
 20-30 
 
 30-40 
 
 40-50 
 
 50-60 
 
 60-70 
 
 70-S0 
 
 80-90 
 
 CO 
 
 o 
 
 o 
 
 o 
 
 
 1.44 
 
 11.31 
 
 19.48 
 
 21.11 
 
 20.75 
 
 15.48 
 
 7.91 
 
 2.31 
 
 0.21 j 
 
 Condition in reference to Marriage.—Table 10.—Of the 
 whole number admitted, two-thirds, or 66 per cent., (64 
 per cent, for the men, and 68 per cent, for the women), 
 had never been married. It is scarcely necessary to say, 
 that this is out of all proportion to the number of unmar¬ 
 ried persons of adult age existing in the Society of Friends. 
 Of those who were, or had been married, one-fifth had 
 never had offspring. 
 
REPORT. 
 
 17 
 
 § 3.— Of the probable causes of the mental 
 
 DISORDER. 
 
 In a very small proportion of the cases, or 43 only, 
 was no probable cause for the disorder either stated or 
 ascertained (Table 12). In more than a third of the whole 
 number, there appeared to have been two causes in opera¬ 
 tion in the same case. One of these had more frequently 
 been of long standing, and appeared to have predisposed 
 to the malady; whilst the other more often immediately 
 preceded the attack, of which it was regarded as the 
 immediate or exciting cause. The causes have, there¬ 
 fore, been classified under the two heads of predisposing 
 (Table 13), and exciting causes (Table 14). Great diffi¬ 
 culty attaches, in practice, to the determination of the 
 causes of insanity; and with the exciting causes in 
 particular, early symptoms of the disorder may very 
 readily be confounded. Hence the results which have 
 been arrived at, though very carefully scrutinized, are only 
 to be regarded as approximations to truth. It will be seen 
 that the same circumstance is, in several instances, intro¬ 
 duced into the table of predisposing, and also into that of 
 exciting causes; but it need scarcely be remarked, that in 
 no case is one and the same circumstance regarded as hav¬ 
 ing operated in both ways, in the same individual. The 
 causes are further divided, into the physical and moral; 
 the physical predominating, to a great extent, amongst 
 the predisposing, and the moral exceeding the physical 
 amongst the exciting, causes. Where two causes were 
 assigned, one was generally of a physical, and the other 
 of a psychical or moral character. 
 
 The causes of the recurrence of the disorder in cases 
 of readmission, were very seldom assigned; and, where 
 
 they were so, frequently consisted of the same cireum- 
 
 c 
 
18 
 
 STATISTICAL 
 
 stance as that alleged on the first admission. For the 
 reasons already stated, they have not been given in this 
 table; and they did not appear numerous nor important 
 enough to be made the subject of a separate one. In a 
 few instances, however, when no cause was ascertained 
 for the first attack, that which was alleged on readmis¬ 
 sion has been given in these tables. 
 
 Although all the alleged causes are deserving of very 
 serious attention ; bearing, as they do, upon the highest 
 department of the healing art,—preventive medicine or 
 hygiene;—yet, in this place, attention need only be directed 
 to such of them as, from one circumstance or another, 
 appear to call for particular comment. 
 
 The predisposing causes have generally attracted less 
 attention than the exciting; and, from their frequently 
 insidious character, are often altogether overlooked; 
 though there is every reason for believing that, of the two, 
 they are frequently the more important; whilst it is cer¬ 
 tain that they are also, in many instances, more easily 
 guarded against. 
 
 Predisposing Causes.—Table 13.—In 232, of the 415 per¬ 
 sons the predisposing causes were of a physical character. 
 Of these, there were 70 in whom hereditary predisposition 
 was the only predisposing cause known. In 72 other 
 cases, however, in which there were other predisposing 
 causes assigned, the same kind of predisposition also ex¬ 
 isted; so that 142, or about one-third of the whole num¬ 
 ber of persons admitted, laboured under an hereditary 
 predisposition to insanity (Table 11). This, though a large 
 proportion, when compared with results obtained at the 
 large pauper institutions, where so much less is known 
 of the history of the cases, is by no means so as compared 
 with other observations. It is, however, only proper to 
 
REPORT. 
 
 19 
 
 observe that in the above estimate, cases are not con¬ 
 sidered of an hereditary character, the history of which 
 had only been characterized by the existence of insanity 
 in collateral blood relatives; it being obvious that cases 
 of this description do not necessarily establish any direct 
 hereditary transmission. There were 71 known cases of 
 this kind; and had they been included, the proportion 
 would have been raised to about 51 per cent., or one 
 half. On the other hand, many cases not stated to have 
 been hereditary by the relatives and friends have, in this 
 estimate, been considered as such, in consequence of more 
 private information, or of the fact being well known. 
 
 There were 50 persons in whom congenital weakness of 
 mind, in different degrees, appears to have acted as the 
 predisposing cause of the insanity which supervened upon 
 it. In a few of the cases the deficiency was considerable, 
 and amounted nearly, if not quite, to imbecility, or partial 
 idiotcy; but by far the greater number were not of that 
 class, but consisted of persons decidedly below mediocrity 
 of understanding, and of that sensitive and fragile mental 
 constitution which is ill calculated for coping with the ills 
 and difficulties of life. A still larger number might per¬ 
 haps have been properly included under this head. 
 
 There were likewise 33 individuals who, though not of 
 particularly weak mind, yet from early life had evinced very 
 decided mental peculiarity, which, after the develop¬ 
 ment of actual insanity, could hardly be be looked upon 
 but as having constituted an original predisposition. The 
 8 persons who had been marked by extreme degrees 
 of the melancholic and nervous temperaments, might 
 perhaps have been included in the same group. 
 
 In 3 persons, a predisposition has been attributed to 
 lactation by a parent strongly predisposed to insanity. 
 
20 
 
 STATISTICAL 
 
 They consisted of a brother and two sisters, who laboured 
 under different forms of mental derangement; and who 
 all died in the institution. It was stated that, the only 
 member of the family who did not manifest more or less 
 decided symptoms of insanity, was also the only one who 
 had not, during his infancy,, been nourished by his mother. 
 There may, however, have been more of coincidence than 
 cause in this circumstance.* 
 
 Two blind persons were admitted, in whom the loss of 
 vision, acting in one case upon a suspicious temper, was 
 thought to have predisposed to the disorder. 
 
 Dyspeptic and other disorders of the stomach and 
 organs of digestion appear to have acted as predisposing 
 causes in 18; and, more doubtfully, as exciting causes in 
 11, cases. 
 
 Moral Causes .—The uncertainty, which must nearly 
 always more or less apply to the assigned causes of in¬ 
 sanity, may be observed, to do so with still greater force 
 to those of a moral, than to those of a physical character; 
 it being amongst the former, that the danger of mistaking 
 early symptoms of the disorder for causes is more particu¬ 
 larly found. 
 
 In 4 cases a neglected or perverted education, which 
 in three instances was extremely indulgent, and in one 
 
 * Though not given in the table, it may he stated as a curious fact that three persons, 
 consisting also of a brother and two sisters, were supposed, by their friends, to have been 
 predisposed to insanity, by being the offspring of first cousins. The parents were respect¬ 
 able, well educated persons, considered more than usually intelligent, and without 
 any known hereditary tendency to insanity. They had a family of one son and seven 
 daughters; and it appeared that, with but one or two exceptions, more or less singularity 
 or weakness existed in such of them as did not actnally become insane. The case may 
 be worthy of notice in connexion with the somewhat popular opinion of the undesirable¬ 
 ness of such connexions. The marriage of first cousins being of unfrequent occurrence 
 in, and being forbidden by the rules of, the Society of Friends may account, if the 
 opinion be correct, for these being the only cases of the kind that have occurred at the 
 Betreat. 
 
REPORT. 
 
 21 
 
 very rigid, appears more or less decidedly to have acted 
 as a predisposing cause; confirming the remark, “that 
 in several instances the foundation of the disease appears 
 to have been laid in an injudicious indulgence in early 
 life; by which the ill-trained man has been brought into 
 contact with the oppositions and difficulties of the world, 
 without the habits of endurance or self-government./** 
 
 Various degrees of ill-regulated temper and disposition 
 had been noticed before the supposed origin of the dis¬ 
 order, in eleven cases; but it is extremely doubtful 
 whether, in some of these, the characteristics alluded to 
 were not really indicative of an incipient or obscure form 
 of mental disorder, such as is now generally recognised 
 under the name of Moral Insanity. The predisposition 
 in ten persons appeared to be laid in the long-continued 
 operation of mental disquietude from various causes. 
 Under this head, perhaps, might also have been included 
 one case connected with political enthusiasm; and nine 
 with excitement connected with religious hopes, fears, 
 and speculations. Upon the latter subject some remarks 
 will be made under the same head in the table of exciting 
 causes. 
 
 Exciting Causes.—Table 14.—Of 121 persons in whom 
 the exciting cause was of a physical description, there 
 were 16 in whom it might be traced to fevers and 
 febrile diseases; 10 to mechanical injuries of the head; 
 and 6 to inflammation of the brain. In 5 persons the 
 exciting cause consisted in apoplexy or paralysis; and 
 in 12 cases, in epilepsy. In one case each, apoplexy 
 and paralysis, and in 4 other cases, epilepsy appear to 
 have acted as predisposing causes. Of the 16 cases 
 in which epilepsy had preceded the development of 
 
 * Sketch, &c , of the Retreat, 1828,. p. 36.. 
 
22 
 
 STATISTICAL 
 
 insanity, one only was discharged recovered, and he has 
 since had a recurrence of the disorder, which, after the 
 lapse of about eight years, has only been very partially 
 recovered from. It must be stated, however, that none 
 of these cases were of recent occurrence when admitted.* 
 Of the 5 cases which were connected with apoplexy, 
 either as an exciting or predisposing cause, two were dis¬ 
 charged recovered. Both the cases connected with 
 paralysis were discharged recovered, and the individuals 
 have for a long period been filling useful positions in the 
 world. In these two persons a state either of excitement, 
 or one of incoherence, which bordered upon dementia, 
 had supervened upon a palsied (hemiplegic) condition, 
 which had existed from infancy. Cases then which are 
 connected with diseases of the nervous system of these 
 descriptions should not, in every instance, be regarded as 
 hopeless. 
 
 Excepting in reference to the intemperate use of 
 alcoholic and fermented liquors, no particular remark, as 
 to the various exciting causes of a physical character, 
 which follow in the table, appears to be called for. 
 
 The number of persons connected with the Society of 
 Friends, in whom this was supposed to have acted as 
 an exciting causes of mental disorder, was 21. Of 
 this number five were females, two of whom were also 
 addicted to the use of opium. There were likewise seven 
 persons in whom intemperance and free living were 
 thought to have acted as a predisposing cause. Of the 
 
 * It may also be mentioned that, in one of the recent cases, in which the mania was 
 complicated with, but had not been preceded by, epileptic seizures, the patient recovered 
 from both, after a short residence at the Ketreat. At the date of this report he had 
 remained quite well for a period of fourteen years; but he has since been readmitted with 
 a second attack of mental disorder, without epilepsy; and, in the course of a few 
 weeks, was again discharged recovered. 
 
REPORT. 
 
 23 
 
 whole number of twenty-eight, not more than twelve were 
 members of the society. This is a somewhat larger pro¬ 
 portion of cases than has previously been computed as 
 connected with this cause, the difference being attributable 
 to further information respecting some of the old cases, 
 having been subsequently obtained. 
 
 But it must be observed that in several of the cases, it 
 was doubtful whether the intemperance which had pre¬ 
 ceded the attack of insanity could really be regarded as its 
 cause; in some of these instances the amount of intemper¬ 
 ance was so small as justly to lead to doubt in this respect; 
 and in a few others it appeared fully as probable that it 
 was one of the modes in which the disorder had manifested 
 itself. Indeed this was so evidently the fact in the instance 
 of two of the women, whose cases ought perhaps not to 
 have been included in this table, that the mental disorder 
 under which they laboured has been classed under the 
 head of monomania of drunkenness. (Table 15.) 
 
 It may perhaps be worth observing, that the proportion 
 of cases ascribed to intemperance, in persons unconnected 
 with the Society of Friends, was considerably more than 
 double that above ascertained; for out of the fifty-four 
 persons of this class, and who were generally from the 
 more opulent ranks of society, there were nine in whom 
 this cause was assigned. 
 
 Moral Causes .—Of the 135 persons in whom the ex¬ 
 citing cause appears to have been of a moral or psychical 
 character, there were 112 in whom this might be referred 
 to sorrow, anxiety, and disappointment from various causes. 
 The most prominent of these were anxiety respecting a 
 livelihood, and pecuniary losses, in 31 cases; sorrow from 
 the death of near relatives, in 18; distress from other 
 domestic trials, in 14; and disappointed affections, in 22 
 
24 
 
 STATISTICAL 
 
 cases. The proportion of men was greater under the first 
 of these heads; that of women under the three others. 
 
 None of the 4 cases under the head of anxiety as to 
 the success of business, were connected with large mer¬ 
 cantile speculations. It may also be observed, that of 
 the 7 persons in whom unhappy conjugal connexions 
 appear to have operated as an exciting cause, three were 
 women, who had married persons not of the Society of 
 Friends. 
 
 Excitement connected with religious hopes, fears, and 
 speculations was supposed to have acted as an exciting 
 cause in the case of 5, and as a predisposing one in that 
 of 9 individuals. It is right to observe, that several of 
 these were persons of rather weak minds; and that 2 of 
 them had only recently joined the society, in which they 
 were not educated. Another case, that of a youth, was 
 attributed, somewhat improbably, to his having attended 
 the singing at a Methodist chapel, where the disorder was 
 first manifested. In one of the females the mental dis¬ 
 order had supervened upon religious unsettlement, con¬ 
 nected with becoming a follower of Joanna Southcote. In 
 two other younger women a state of religious excitement 
 had originated during the progress of a religious contro¬ 
 versy in the place where they resided.* 
 
 Great confusion has arisen from not distinguishing 
 cause and effect in relation to the influence of the religious 
 feelings upon the development of mental disorders; and 
 the history of the cases at the Retreat fully confirms the 
 truth of Dr. Prichard^s remark, that “the circumstance 
 
 * In connexion with this subject, it may be stated, that during the forty-four years, 
 there have only been four persons in the station of religious ministers in the Society of 
 Friends admitted into the institution; and that in all these there were causes for the 
 mental disorder, wholly unconnected with the religious habits or opinions of the 
 individuals. 
 
REPORT. 
 
 25 
 
 of the mind of a lunatic being occupied during the period 
 of his disease with ideas and feelings connected with an 
 invisible world, is no proof whatever that the derangement 
 of his understanding was produced in the first instance, 
 by impressions related to the same subject.”* 
 
 § 4 ,—Of the forms of mental disorder, and the 
 
 GENERAL RESULTS OF TREATMENT, AS MODIFIED BY 
 
 FORM OF DISORDER, DURATION, SEX, AND AGE. 
 
 Forms of Disorder.—Tables 15 and 16.—The classifica¬ 
 tion of the cases according to the form of mental disorder 
 which has been adopted, is that usually recognised of 
 Mania, Melancholia, Monomania, Dementia, and Idiotcy 
 or Amentia. The separate head of Delirium has been 
 added, in order to embrace three or four cases of delirium 
 tremens and of delirium of fever, not properly belonging 
 to the province of the institution. Various subdivisions 
 of the foregoing primary forms of disorder have been 
 employed, for the sake of more clearly exhibiting the 
 character of the cases admitted; but not as offering a sys¬ 
 tematic classification of mental disorders. 
 
 Of the 615 cases, or whole number admitted, including 
 readmissions (Table 14), there were 277^ or more than 
 45 per cent, of mania; 215, or nearly 35 per cent., of 
 melancholia; 64, or somewhat more than 10 per cent., of 
 monomania; and 41, or about 8 per cent., of dementia. 
 Of congenital idiotcy and imbecility, five cases only have 
 been admitted, in which further mental disorder had not 
 supervened.f This small proportion can only, in a very 
 slight degree, be attributed to the original rule of the 
 
 * Treatise on Insanity, 1835, p. 187. 
 
 1 Two men and five women, in whom mania, and one woman in whom monomania, 
 was superadded to a state of original imbecility bordering upon partial idiotcy, have been 
 admitted. 
 
 D 
 
26 
 
 STATISTICAL 
 
 institution against the admission of such cases, which was 
 for a very short period, if at all, acted upon. 
 
 The relative proportion of cases of mania and mono¬ 
 mania was the same for the two sexes; melancholia was 
 10 per cent, more frequent in females; and dementia was 
 more than twice as frequent in males as in the other sex. 
 
 In consequence, however, of the changes which mental 
 disorders undergo during their progress, the above estimate 
 does not represent the the exact proportions of the differ¬ 
 ent forms of disorder treated in the institution. Even in 
 the earlier stages, and in the more acute cases, a state of 
 mental excitement is often followed by one of depression; 
 and, on the contrary, melancholy often passes into mania, 
 before complete recovery takes place. When the disorder 
 has become chronic, and especially if it have assumed a 
 recurrent form, these alternations perhaps still more fre¬ 
 quently occur. (Tables 28 and 39.) In cases, likewise, of 
 incurable insanity, the violence of the original disorder 
 for the most part gradually abates, and leaves, in general, 
 a weakened condition of the memory, judgment, and other 
 mental powers, with a consequent state of imbecility or in¬ 
 coherence. These are the first stages of dementia; which not 
 unfrequently terminate in a completely fatuous condition, or 
 in confirmed dementia; which, except by attention to the 
 history, can scarcely be distinguished from, and, especially 
 in parliamentary and other statistical returns, is often 
 confounded with, original idiotcy. In all institutions, 
 therefore, which combine the two objects of the recovery 
 and the care of the insane, a large number of cases of 
 more or less confirmed dementia will always be found. 
 And thus, although only 48 cases have been admitted, 
 and there has, on the average, been less than 11 ( 10 . 71 ), 
 who were admitted in that state, constantly resident 
 
REPORT. 
 
 27 
 
 (Table 16), yet as many as 44 have died (Table 39); and, 
 at the date of this report, there are as many as 41, or 
 45 per cent, of the whole number resident, who are in a 
 more or less confirmed state of dementia (Table 43). 
 Melancholia and monomania, when they have become 
 incurable, appear to have less tendency than mania to pass 
 into a demented condition. For of 87 cases of mania 
 there are 27 * or nearly one-third, and of 97 cases of 
 melancholia and monomania 17 only, or somewhat more 
 than one-sixth, which have merged into dementia. (Tables 
 39 and 43.) 
 
 A marked disposition to, or attempt at, suicide, was 
 noticed in sixty-two persons connected with the Society 
 of Friends, who, for the most part, laboured under 
 melancholia (Table 15). In 14 of these, the disorder 
 was chiefly marked by religious apprehensions and fears. 
 Of the whole number of persons admitted belonging to, 
 and connected with, this community, there have been 
 about fifteen per cent, marked by a suicidal tendency. 
 
 Although the hopes and fears connected with religion 
 and a future state do not, in many cases, appear to have 
 operated as a cause; they have perhaps had their full 
 share in modifying the form which the mental disorder 
 has assumed. Thus, out of 162 persons, who laboured 
 under melancholy, the disorder in 42 was chiefly marked 
 by fears and solicitude connected with a future state. In 
 9 persons, likewise, out of 52, admitted with monomania, 
 the hallucinations assumed a decidedly religious character. 
 
 Six cases are inserted under the head of apathetic 
 insanity; a form of mental disorder characterized by great 
 mental inaction and apparent loss of voluntary power. It 
 should be carefully distinguished from simple melancholy; 
 with which it is, perhaps, often confounded; though it is 
 
28 
 
 STATISTICAL 
 
 probably more nearly allied to dementia, into which it 
 often quickly passes. 
 
 Moral insanity, of which there have not been more than 
 4 marked cases, has, for the sake of convenience, been 
 made a subdivision of monomania; to which, indeed, 
 it appears to be often closely related. 
 
 DURATION OF RESIDENCE. 
 
 The average duration of residence in the Retreat has 
 been very high; and for the whole number admitted, has 
 hitherto been nearly five (4.80) years. For the whole num¬ 
 ber discharged it has been three and a half (3.52) years; 
 viz.: for those discharged recovered, a year and a third 
 (1.32); improved, two years and a quarter (2.25); unim¬ 
 proved, three years (3.06); and for those who have died, 
 nearly nine (8,83) years. For those remaining in the 
 house. Midsummer 1840, the average period of residence 
 had been twelve and a half (12.49) years. It is worth re¬ 
 marking, that more than a third of the cases that recovered 
 were discharged within six months of admission; whilst of 
 those that died, little short of a third resided from ten to 
 forty-four years in the institution. (Tables 19 and 20.) 
 
 At the York Lunatic Asylum, the average period of 
 residence during the last 25 years, has been little more 
 than half that at the Retreat; or, for the whole number 
 admitted, two and a half (2.52) years; and a difference, 
 for the most part nearly as great, is to be noticed in the 
 length of residence of those who have been discharged 
 recovered or otherwise, and of those who have died in 
 that institution; it having been barely two-thirds (.65) of 
 a year for those who recovered, and only four (4.03) years 
 for those who died. (Appendix 1, Table B.) 
 
 The long period of residence of patients in the Retreat 
 
REPORT. 
 
 29 
 
 should be borne in mind, in comparing its statistics with 
 those of other institutions. For not only is the average 
 number in the house materially increased by it, but it may 
 also, to a slight extent, account for the low rate of mor¬ 
 tality. It is to be attributed to the circumstance of the 
 period of the discharge seldom or never being hastened by 
 pecuniary considerations; and to the caution exercised in 
 removing patients before the apparent convalescence has 
 been tested by a sufficient duration. During this period 
 of probation, which is sometimes as much desired by the 
 patient himself as by the officers of the institution, a re¬ 
 lapse has in many instances occurred. The stay of the 
 patient is consequently still further prolonged, on the one 
 hand; and, on the other, one recovery only appears, 
 where, had the patient been discharged more speedily, and 
 readmitted upon relapse, two recoveries would, in many 
 cases at least, have been reported. 
 
 § 5.—Of the recoveries, and their average 
 
 PROPORTIONS, &C. 
 
 It must be stated that the term recovered , has been 
 applied only to those cases where the patient has been so 
 far restored as to appear fully capable of performing, with 
 propriety, the duties belonging to his station in the world; 
 though it is not pretended but that sometimes, perhaps, 
 upon a minute examination, traces of mental disorder 
 might still be detected. In the few cases, likewise, where a 
 state of mania had supervened upon one of original imbe¬ 
 cility, the patient has been considered recovered, when 
 restored to the care of his friends in the state he was in 
 before the attack. In a small number of cases likewise, 
 which have been removed in an advanced stage of con¬ 
 valescence, from the desire of their friends, or from its 
 
30 
 
 STATISTICAL 
 
 being supposed in the particular case desirable, the 
 patients have been considered recovered if the conva¬ 
 lescence have been confirmed. In cases which, upon 
 discharge, still required the particular care of their friends* 
 though so far benefitted by treatment, that further resi¬ 
 dence in the institution was thought unnecessary, patients 
 have been considered as discharged improved . 
 
 Proportion of Recoveries .—-Of the whole number of 615 
 cases admitted into the Retreat, 291, or 47.31 per cent., 
 were discharged recovered. (Tables 16, 21, &c.) But 
 it is, perhaps, fairer to limit this calculation to the cases 
 for which the institution is particularly designed; and we 
 then find, that of 550 cases in persons belonging to, or 
 connected with, the Society of Friends, 276, or 50.18 
 per cent., were discharged recovered. (Tables 18, 23.) 
 
 The recoveries, when calculated upon the average popu¬ 
 lation or upon the mean number constantly in the Re¬ 
 treat, were at the annual rate of 9.84 per cent, resident 
 (Table 21). In this estimate time, or the duration of 
 treatment, is taken into consideration. Thus 9.84 when 
 multiplied by the average length of residence, or by 
 4.80 years, gives 47.23, which is only a fraction less than 
 47.31, the average rate of recoveries per cent, of the 
 admissions. If the average duration of residence in 
 different hospitals were the same, the rates of recovery, 
 as calculated upon these two plans, would observe a cer¬ 
 tain proportion; and it would be indifferent which of the 
 methods was selected for comparison. But as the object 
 in the treatment of the insane is not merely to produce 
 a speedy recovery, but should combine that of fortifying 
 the system against a relapse, .it becomes obvious that the 
 time in which the recovery is effected is a question of 
 secondary importance; and that the proper and only 
 
REPORT. 
 
 31 
 
 method of estimating the relative proportions of recoveries* 
 is that calculated upon the number admitted or treated* 
 and not upon the average number resident. 
 
 Influence of the Duration and Form of the Disorder * of 
 Age and Sex upon the Proportion of Recoveries. —An 
 undiscriminating comparison* however* of the proportion 
 of recoveries out of the aggregate number of cases 
 admitted is extremely fallacious* and open to much objec¬ 
 tion; from the results being so greatly modified by the 
 character of the cases in several respects* but especially 
 as regards the duration of disorder when admitted. 
 
 The greater probability of recovery in the more recent 
 cases has always been recognized at the Retreat** and the 
 cases have* from time to time* been distributed into classes 
 according to the duration of disorder when admitted 
 and the results in each class then noted (Table 17). The 
 relative proportions of cases admitted in these several 
 stages of the disorder has already been shewn (page 10). 
 
 Of cases in Class 1* admitted within 3 months of the 
 first attack* 80 per cent, within a fraction (79.16) have 
 been discharged recovered. The expectation of recovery 
 in such cases is. therefore* as 4 to 1.+ Of cases in Class 2 
 of the first attack* and of 3 to 12 months duration when 
 admitted* 46.15 per cent, recovered. Of cases in Class 
 3* not of the first attack and of less than twelve months 
 duration when admitted* and which* consequently* em¬ 
 braced many recent cases of recurrent insanity* as many 
 
 * See Annual Reports, 1803, 1810, and 1820, 
 
 t Were the cases in this class excluded, which, upon admission, were complicated 
 with diseases in themselves fatal to life, such as pulmonary consumption and apoplexy, 
 as well as those which had previously been marked by so much eccentricity as, perhaps, 
 properly to constitute them old cases, though not so regarded by their friends, the 
 experience of the Retreat would shew that, when brought under care at this early stage 
 of the disorder, the probability of recovery is as great as 9 to 1. Of 20 cases in this 
 class admitted in ten years, 1798—1808, as many as 19 were discharged recovered. 
 
32 
 
 STATISTICAL 
 
 as 62.08 per cent, recovered. In Class 4, embracing the 
 cases whether of the first or subsequent attack, of more 
 than twelve months* duration, the proportion of recove¬ 
 ries was not more than 19.35 percent.: the expectation 
 of recovery in such cases being less than 1 in 5.* 
 
 Recovery, however, is not only more frequent, but is 
 also effected in a period which is shorter in proportion to 
 the recency of the attack. (Table 20.) Thus the average 
 length of residence in the institution, of those who 
 recovered who had been admitted within 3 months of the 
 first attack. Class 1, was three quarters (.78) of a year; 
 of those admitted from 3 to 12 months after the first 
 attack, Class 2, one and a quarter (1.23) year; of those 
 admitted within 12 months of a second or any subsequent 
 attack. Class 3, one and a half (1.47) year; and in those 
 admitted more than 12 months after the attack, Class 4, 
 two (1.97) years. That appropriate moral and medical 
 treatment are, to a very great extent, more available in 
 the early stages of the disorder, and that, consequently, 
 patients should be placed under proper care at an early 
 period after the attack, are thus on all hands evident. 
 
 The probability of recovery it will be seen is greater 
 where the mental powers are more generally affected, 
 ^whether by excitement, as in mania, or by depression, as 
 in melancholia, than when the mind is affected by partial 
 insanity, or monomania. In dementia recovery is very 
 rare. (Table 21.) 
 
 * The smaller proportion of cases of all descriptions dismissed recovered at the York 
 Lunatic Asylum, or 33.88 per cent., is probably partly due to the smaller proportion of 
 recent cases admitted; but it must be principally attributed to the circumstance (alluded 
 to in the Appendix) of patients being so often prematurely removed from the institu¬ 
 tion, by their friends. A comparison of the numbers under the heads “discharged, 
 improved, and unimproved,” in Table B, referring to the Asylum, with the correspond¬ 
 ing numbers 'in Table referring to the Retreat, will, I think, establish this. 
 
REPORT. 
 
 33 
 
 Age exerts a marked influence upon the number of re¬ 
 coveries. The probability of recovery is greatest in the 
 young, and undergoes a gradual and very regular diminu¬ 
 tion as age advances. Thus the recover^ at jl0-20 years 
 of age when admitted were 55.55 per cent.; and at 70-80 
 years; only 20 per cent.; of the admissions (Table 23). 
 Similar; but less regular results have been obtained at the 
 York Lunatic Asylum. (Appendix 1; Table D.) 
 
 The number of recoveries amongst women have been 
 more numerous than amongst men; under nearly all cir¬ 
 cumstances of form and duration of disorder and of age. 
 (Tables 21; 22; 23; and Appendix 1; D.) 
 
 § 6.—Of the re admissions and history subsequent 
 
 TO DISCHARGE. 
 
 Readmissions.—Tables 24 to 28.—The cases of read¬ 
 mitted were 146 in number; and occurred in 97 persons. 
 Of these; 135 occurred in 86 individuals connected with 
 the Society of Friends. (Table 24.) 
 
 Of the whole number of 146; 119 had been previously 
 discharged recovered; and of these 72; or 60.5 per cent.; 
 were again discharged recovered. This is a large propor¬ 
 tion; which is partly attributable to the tendency of recur¬ 
 rent insanity to assume a remittent form. For example; 
 of these 72 recoveries; 17 occurred in two females who; 
 during periods of fifteen and twenty-four years respectively 
 have each been ten times admitted; with intervals of sanity; 
 of from one to two years (Table 24). Nineteen; or one- 
 fifth of the whole number remaining in the house, at the 
 date of this report; were readmitted cases. (Table 27.) 
 
 The date of readmission only imperfectly represents that 
 of the second or subsequent attack; and the history of the 
 cases readmitted is not sufficiently precise to enable us to 
 
 E 
 
34 
 
 STATISTICAL 
 
 distinguish relapses from distinct recurrences, or second 
 attacks of the disorder. Thirty-six cases, however, were 
 readmitted within six months of discharge; and it is pro¬ 
 bable that at least this proportion, or one-fourth of the 
 whole, consisted of relapses; to be attributed either to a 
 too speedy removal, to the strength of the constitutional 
 predisposition, or to subsequent injudicious treatment; 
 rather than to the influence of any fresh exciting cause. 
 After the period in which a true relapse may occur has 
 passed by, the liability to a recurrence of the disorder 
 remains, but diminishes with the lapse of time. The 
 majority of readmissions, however, occurred within the 
 fifth year; though a large proportion, 28 per cent., oc¬ 
 curred between the fifth and the twentieth; and there were 
 five cases readmitted from 20 to 25 years after the pre¬ 
 vious discharge; (Table 26).* 
 
 Liability to relapse or recurrence .—What is the propor¬ 
 tion of relapses and second attacks, after recovery from a 
 first attack of insanity, according to the experience of 
 the Retreat ? 
 
 Of the total number of 291 recoveries, 149 occurred in 
 cases of the first attack (Table 17); and of this number, 
 47 persons (Table 25) were readmitted on account either 
 of a relapse or subsequent attack of the disorder. These 
 numbers would give 31.5 per cent., (27.3 per cent, for 
 men, and 35. per cent, for women,) or about one in every 
 three cases, as the proportion of relapses and recurrences 
 after recovery from the first attack. This, however, must 
 
 * This table (26) does not shew, as would have been desirable, the length of time 
 which elapsed before readmission, in the cases which had been discharged recovered, 
 distinguished from the others. As shewing, therefore, how far the interval between 
 discharge and readmission is to be regarded as one of sanity, it may be stated that, of 
 the 36 cases readmitted within 6 months, 28 had been discharged recovered; that of 
 the 38 from 5 to 20 years, 32 had been discharged recovered; and that the 5 readmitted 
 from 20 to 25 years, after discharge, had all been discharged recovered. 
 
REPORT. 
 
 35 
 
 be regarded as much less than the actual proportion; for 
 many 5 particularly of those who have been more recently 
 discharged, and have hitherto escaped, are yet liable to, 
 and will in all probability experience, a second attack. 
 In support of this statement it may be observed that since 
 the date of this report, and consequently not entering into 
 the above calculation, four men labouring under second 
 attacks have been readmitted.* In these cases intervals 
 of four, eight, fourteen, and nineteen years had elapsed 
 after their respective recoveries from the first attack. There 
 have likewise been 17 persons who have experienced sub¬ 
 sequent attacks, but have not been readmitted; and 6 of 
 these, three of each sex, had recovered at the Retreat 
 from the first attack of mental disorder (Table 29). 
 According to this experience, the liability to a relapse or 
 a recurrence of insanity, after recovery from a first attack, 
 all things considered, cannot be estimated as at all 
 less than 50 per cent.; or as one in every two cases dis. 
 charged recovered.-)- 
 
 In a large proportion of cases of recurrent insanity, as 
 has been already stated (page 33), the patient again re¬ 
 covers ; though the liability to a future recurrence of the 
 disorder must be regarded as increasing with every such 
 recovery in the same individual. 
 
 HISTORY SUBSEQUENT TO DISCHARGE. 
 
 The statistics of hospitals for the insane in general, lose 
 much of their value, in consequence of its not being known 
 
 * Three of these cases were readmitted in the course of a single month. 
 
 + From a more precise method of investigating this question, which this would not be 
 the place to enter into, 1 have found that the proportion of relapses and recurrences of 
 insanity after recovery from a first attack, in cases that have come under the notice 
 of the Retreat, has been as high as 65.6 per cent.; or as two in every three cases which 
 have recovered from the first attack. This calculation, however, includes cases of 
 recurrence in persons, who had not recovered from the first attack of the disorder at 
 the Retreat, 
 
36 
 
 STATISTICAL 
 
 how far the reported recoveries have been permanent or 
 otherwise. And it is therefore an important, as well as 
 remarkable, circumstance; that but little difficulty has 
 been experienced in tracings with scarcely an exception, 
 by particular enquiry or otherwise, the history of every 
 person who has been under the care of the Retreat, either 
 to the time of deaths or nearly to the date of this report. 
 And thus, when the information which is here given, is 
 taken in connexion with that relative to readmissions, 
 the exact value of the recoveries which have occurred in 
 this institution may be ascertained. (Table 29.) 
 
 There have been admitted into the institution 469 
 persons; and by deducting from this number those who 
 have died in the house, 139, and those who remained in 
 the house 91,, there will be left 239;* who after one or 
 more admissions have hitherto been finally discharged, and 
 whose general history has been traced. Of the whole 
 number, 172 were recovered, 44 improved, and 23 unim¬ 
 proved^ at the time of their last discharge. Seventy-two 
 of those who were discharged recovered, have since died; 
 and of these, 54 remained well, (in nearly half the cases, 
 after the lapse of from ten to forty-three years); 10 pre¬ 
 sented traces of disorder; and 8 had sustained fresh 
 attacks at the time of their respective deaths.f Of the 
 remaining 100 who were discharged recovered and are yet 
 living, 7§ are believed to have remained well, (in more than 
 half the cases, after the lapse of from ten to forty-three 
 years); 13 present traces of disorder; and 9 had sustained 
 
 * Twenty-five of these were unconnected with the Society of Friends, 
 t In two of these cases the return of the disorder was characterized by a suicidal dis¬ 
 position, and the individuals died by their own hands, after intervals in one case of 
 five, and in the other of fifteen, years. In a third case, that of a female, death was 
 the result, either of an intentional and suicidal, or of an accidental, fall from a window 
 during a state of delirious excitement. (Table 37,) 
 
REPORT. 
 
 37 
 
 fresh attacks previous to the date of this report. Of the 
 44 persons discharged improved, 9 have subsequently 
 recovered. Of the 23 discharged unimproved, none have 
 recovered. The proportion of cases in which the per¬ 
 manence of recovery has either been established by its 
 continuance to the time of deaths or is rendered probable 
 by the long period that has elapsed since discharge, is thus 
 seen to be very considerable. Several cases of a recur¬ 
 rence of the disorder have, however, occurred after intervals 
 of ten, twenty, and even thirty years of continued sanity. 
 
 It may be proper to observe that of those who have been 
 discharged recovered, the history of a few has since been 
 characterized by more or less of intemperate and irregular 
 conduct; that of one or two by fraudulent transactions; 
 and that of a few others by a somewhat enthusiastic and 
 roving disposition. Cases of this kind form however 
 quite the exception; and a large proportion, or even the 
 majority, have become respectable and useful members of 
 domestic and civil society; many have succeeded in busi¬ 
 ness and otherwise; and at least twenty-five, fifteen men 
 and ten women,, have formed matrimonial connexions. 
 
 § 7-—Of the deaths and average mortality. 
 
 There were 139 deaths during the forty-four years at 
 the Retreat; and of these, 126 were in those connected, 
 and 13 in those unconnected, with the Society of Friends. 
 
 Duration of Residence, Disorder, and age at the time of 
 Death .—Of the 126 there were 23, or 18.2 per cent., who 
 had resided from twenty to forty-four years in the institu¬ 
 tion^ at the time of death. The average duration of 
 residence in those connected with the Society of Friends 
 who died at the Retreat, was nine and a half (9.44); that 
 of the others, three (2.94) years. (Table 30.) 
 
38 
 
 STATISTICAL 
 
 Of the 126 persons connected with the Society of 
 Friends who died; as many as 48, or 38 per cent., had 
 suffered from the disorder, though in many cases with in¬ 
 tervals of sanity for periods of from twenty to sixty years. 
 The average duration of the disorder, as nearly as it could 
 be ascertained, was in those of this class who died 17.31 
 years; whilst in the few unconnected with the Society of 
 Friends, it was only 9.34 years. (Table 31.) 
 
 Of the 126 deaths, 57> or 45 per cent., were in persons 
 upwards of 60; and of these 14, or 11 per cent, of the 
 whole, were from 80 to 97 years of age. This is a pro¬ 
 portion of old persons, which is probably unequalled in 
 the annals of such institutions. The average age at death, 
 in persons connected with the Society of Friends at the 
 Retreat, was 56.5 years; in persons unconnected with the 
 Society of Friends, it was 47.7 years. At the York 
 Asylum it was 49.5 years. In both the institutions the 
 average age of females exceeded that of males by about 
 three years. (Table 32, and Appendix 1, Table C.) 
 
 Mean Mortality .—As there were 615 admissions at the 
 Retreat during the forty-four years, and as the deaths 
 were 139, the proportion of deaths to the admissions 
 was 22.60 per cent. This computation, however, affords 
 no index to the actual mortality as compared with that 
 of other institutions. Were, indeed, the average period 
 of residence the same in different institutions, such a 
 comparison would hold good; though even then the 
 proportion of deaths so calculated could not be com¬ 
 pared with the mortality in the general population, 
 nor with that of other communities. The uncertainty 
 which has hitherto so generally prevailed as to the 
 actual rate of mortality in the insane, may be attributed 
 partly to the calculation having nearly always been 
 
REPORT. 
 
 39 
 
 made upon this erroneous method. (Tables 33, 34, 
 and 35.) 
 
 As is now well known the mortality of any class of 
 people is only correctly expressed by the proportion of 
 deaths out of a given population, or number living a given 
 time: in other words, we have to ascertain the average 
 annual mortality per cent, of those constantly living. 
 Calculated in this way, as the average number resident 
 during the forty-four years was 67.15, the annual mor¬ 
 tality was at the rate of 4.70, or exclusive of those 
 unconnected with the Society of Friends, 4.59 per cent, 
 resident. This is a very low rate of mortality; and indeed 
 the lowest that has been published for any institution 
 which has been in operation during so extended a period. 
 (See Table, Appendix No. 2.) At the York Lunatic 
 Asylum during the twenty-five years, 1814—1840, the 
 mean annual mortality has been at the rate of 7*35 per 
 cent.; which is still a very favourable result, as compared 
 with that in similar institutions. 
 
 Influence of Insanity on the duration of life .—With the 
 data now before us (Tables 31 and 32), the average age at 
 which the 139 who died, were attacked with the disorder, 
 may be ascertained; and will be found to have been, for 
 those connected with the Society of Friends, 39.19 years; 
 and for the others, 38.36 years. (56.5 — 17.31 = 39.19; 
 and 47.7 — 0.34 = 38.36.) Now the expectation of life 
 at thirty-eight and thirty-nine years of age, according to 
 the most recent researches, is not less than twenty-eight 
 years;* so that the mean ages attained should have been 
 sixty-seven and sixty-six instead of fifty-six and forty- 
 
 * See Finlaison’s Tables of Expectation of Life; “ Macculloch’s Statistical Account of 
 the British Empire,” 1837, vol. 1 , p. 419. Also Table for the Society of Friends; " Rules 
 of the Friends’ Provident Institution,” 1836, p. 45. 
 
40 
 
 STATISTICAL 
 
 seven respectively (Table 32.) In those connected with 
 the Society of Friends, less than two-thirds, and in the 
 others, not more than a third of the expectation of life 
 at the time of attack was realized. This is one way in 
 which the prejudicial influence of insanity upon the 
 duration of life may be shewn. 
 
 The average age at death of those who recovered and 
 were discharged, differed but slightly from that observed 
 in the institution itself; and the average age at attack was 
 also very similar (Table 38). The experience out of the 
 institution, as to the influence of insanity upon the dura¬ 
 tion of life, even in those who had recovered, is thus seen 
 to confirm that in the Retreat itself. 
 
 The mortality in England and Wales for the seventeen 
 years, 1813—1830, was, according to Edmonds, 2.12 
 per cent, at all ages;* and that of persons of adult age, 
 with which the mortality of hospitals for the insane should 
 be compared, can only be estimated a few fractions higher. 
 The mortality then at the Retreat was double, and that 
 at the York Asylum treble, that of the general population. 
 As, however, there can be no doubt but that the mor¬ 
 tality of the Society of Friends as a body is considerably 
 less than that of the community at large, the lower rate 
 of mortality at the Retreat must, to a certain extent , be 
 ascribed to the general lower mortality in the Society of 
 Friends.f 
 
 * The mortality in England and Wales, according to the Registrar-General, during 
 two years, 1837—1839, was 2.17 per cent. 
 
 * The details of this interesting question would he unsuited to a report of this kind» 
 and I have, therefore, entered into it more at length, in a separate series of “ Obser¬ 
 vations on the Statistics of Insanity.” 
 
 Notwithstanding the lower mortality in the Society of Friends as a body, the very low 
 rate of mortality at the Retreat still satisfactorily accounts for the comparatively large 
 number of existing cases of insanity in that institution. On this subject the reader is 
 also referred to the “ Introduction,” by Samuel Tuke, to the English edition of Dr. 
 Jacobi’s work “On the Construction and Management of Hospitals for the Insane,” p. lv. 
 
REPORT. 
 
 41 
 
 The Sex and Age, the Form and Duration of the Dis - 
 order exert as marked an Influence over the Mortality of 
 the insane as they do over the proportion of recoveries; 
 and it is interesting to observe that for the most part, it 
 is under the same circumstances that the recoveries are 
 most numerous; that the mortality is the lowest. 
 
 The mortality amongst men at the Retreat exceeded 
 that amongst women by 35 per cent.; that of the former 
 being at the annual rate of 5.39; and that of the latter 
 3.99 per cent, the population. (Table 35.) 
 
 The rate of mortality in those admitted in a state of 
 mania; has been 3.99; in melancholia; 6.96; in monomania; 
 3.46; and in dementia; 4.45 per cent. It must be stated 
 that in this calculation the changes which had taken place; 
 in the form of disorder before death (Table 39); have not 
 been taken into the account: had this been done; the 
 mortality in dementia would have been found to be at least 
 double what has been stated. The mortality in idiotcy 
 appears to have been at the rate of 2.87per cent.; but the 
 number of cases under care have been too few to place 
 much reliance on this result. (Table 33.) 
 
 Of cases in Class 1; admitted within three months of the 
 first attack^ the mortality was 6.19 per cent.; of those in 
 Class 2; admitted from three to twelve months of the 
 first attack; 3.90 per cent.; and of cases in Class 4; of 
 more than twelve months* duration; 4.48 per cent. This 
 is sufficient to shew that the mortality of the insane is 
 greatest in the recent cases. And thus we find that of 
 cases in Class 3; not of the first attack but of less than 
 twelve months* duration; consequently embracing many 
 recent cases; the mortality was as high as 5.78 per cent. 
 Had the influence of the duration of disorder upon the 
 mortality been judged of by the proportion of deaths per 
 
 F 
 
42 
 
 STATISTICAL 
 
 cent, of the admissions, what an erroneous and completely 
 opposite conclusion would have been formed, may be seen 
 by an inspection of the table. This difference in the 
 results is to be explained by the very different propor¬ 
 tions of recoveries, and by the consequent difference in 
 the average duration of residence in these four classes. 
 (Table 34.) 
 
 The influence exerted by age upon the rate of mortality 
 in the insane was very decided both at the Retreat and in 
 the Asylum. (Table 35 and Appendix 1, Table E.)* 
 
 Fatal Diseases.—Table 36.—There was very little doubt 
 as to the cause of death, in any of the cases in which it 
 was not ascertained by post mortem examination. The 
 fatal diseases have been arranged upon the same plan as 
 that adopted under the sanction of the Registrar-General; 
 and they thus admit of comparison with the causes of death, 
 either in the kingdom generally, or in any part of it. 
 
 Excepting the Influenza of 1836 and 1837* of which 
 there were five fatal cases, no disease has at any time 
 prevailed epidemically in the institution. The few cases 
 of diarrhoea, dysentery, erysipelas, and fever which occur¬ 
 red, in no instance affected more than one person at once: 
 all of these, but particularly the three former, being 
 diseases which have often proved extremely fatal in 
 hospitals for the insane. Of the three cases of fever, only 
 one was attacked with the disorder in the house: the other 
 two died a few days after admission in a state of febrile 
 delirium, which had been mistaken for mania, and brought 
 as such to the institution. Only two cases of death from 
 (general) paralysis, are given in the table; but it must be 
 
 * The reader should have been previously referred to the table given in Appendix 
 No. 2, for the annual rate of mortality, as well as the proportions of recoveries, in dif¬ 
 ferent Asylums in this and other countries. 
 
REPORT. 
 
 43 
 
 stated, that there were at least three or four other in¬ 
 stances in which more or less marked general or local 
 paralysis existed, but which ultimately proved fatal from 
 other diseases; as for instance inflammation of the lungs,* 
 and mortification of the extremities. 
 
 The five deaths from mortification, chiefly of the ex¬ 
 tremities, occurred in persons whose ages averaged 65 
 years. In none of these was the mortification the result 
 of exposure to cold; nor unless this could be said to have 
 been the case in a female who had been bed-ridden from 
 paralysis, for a considerable period, was it at all connected 
 with confinement or the want of exercise. In one in¬ 
 stance the disorder existed at the time of admission, 
 three weeks after which the patient died; and in two 
 others, decided symptoms of a diseased state of the 
 heart and circulating organs, had for a long period been 
 observed. 
 
 Two or three of the six fatal cases attributed to atro¬ 
 phy, a form of death to which the insane have been 
 considered very liable, were most likely instances of 
 pulmonary consumption in a latent form. That this, 
 however, was not so in all these cases, was proved by 
 examination after death. 
 
 Exhaustion, from a state of long-continued maniacal 
 excitement, has not been a frequent cause of death at the 
 Retreat; and in two of the three instances of this descrip¬ 
 tion, the fatal event was at least hastened by the fatigue 
 of travelling. The patients had been brought in the one 
 case, 220, and in the other 27 p* miles, without being 
 allowed sufficient rest by the way; and they both died 
 within about a week of arriving at the institution. 
 
 * In cases of this description particularly, the pulmonary affection has often been 
 detected with great difficulty during life; and sometimes has appeared to manifest itsci/ 
 chiefly in disturbance of the nervous system, often of an apoplectic character. 
 
44 
 
 STATISTICAL 
 
 There were five deaths from suicide; all of which were 
 in males, and were effected by hanging. Three of the 
 number occurred in the infancy of the institution, when 
 the officers must have been less experienced in the care 
 of persons with this unhappy propensity. The two other 
 cases occurred since the year 1829.* 
 
 The information given in the table (37) relative to the 
 diseases which have proved fatal since discharge, may be 
 regarded as supplementary to that in the preceding one; 
 as Table 38, is supplementary to Table 32: both of 
 them referring to the deaths which have occurred subse¬ 
 quent to discharge from the institution. 
 
 Changes in the character of mental disorder before death . 
 Table 39.—The changes in the form of mental disorder 
 exhibited in this table have already been pointed out 
 (page 26). It is, however, also intended to shew that, 
 during the progress of fatal diseases and the advancing 
 bodily infirmity of the insane, the mental disorder has in 
 several cases undergone a marked degree of alleviation, 
 and in some instances even a decided remission. This 
 circumstance, called by the poets, “ a lightning before 
 death/* appears to take place oftener in mania than in 
 other forms of mental disorder. Thus of thirty-three 
 cases of mania, 8; of forty-five of melancholia, 8; and of 
 fourteen cases of monomania, 2 had decidedly improved 
 before death occurred: but of these there were two or 
 three cases in which the patient was considered convales¬ 
 cent, and was suddenly taken off by such disorders as 
 apoplexy and epilepsy. Much less often the mental 
 disorder assumes a more severe form on the approach of 
 
 # The four deaths which have occurred during the year 1840—41, which has elapsed 
 since the date of this report, have been from Biliary Calculi, and Apoplexy, in two men; 
 and from Cancer of the ^Esophagus and latent Inflammation of the Lungs in two women. 
 
REPORT. 
 
 45 
 
 death, and there were two cases of melancholia at the 
 Retreat in which this was the case. 
 
 § 8.-OF THE CASES REMAINING UNDER CARE. 
 
 Of the 91 cases remaining in the institution at the date 
 of this report, 13 have been in the house from twenty 
 to forty, and 4 from forty to forty-three years (Table 40). 
 Not more than 28, or less than a third of the whole, 
 offer the least prospect of recovery; but this result can¬ 
 not be regarded as at all probable in more than half that 
 number, or in 6 men and 8 women (Table 41). The 
 average age of those remaining is one year and a half less 
 than that observed during the whole period (see Table 9); 
 19 being from sixty to seventy, and 4 from seventy to 
 eighty years of age (Table 42). The cases may be 
 distributed into 27 of mania, the majority of which are 
 in a chronic form; 9 of melancholia; 12 of monomania; 
 41 of different grades of dementia; and 2 of partial idiotcy. 
 /Table 43.) 
 
 § 9.- OF THE INTERNAL ECONOMY AND GENERAL 
 
 MANAGEMENT OF THE INSTITUTION. 
 
 The foregoing statistical history of the Retreat would, 
 no doubt, be justly regarded as incomplete, without some 
 account of the internal economy and methods of treat¬ 
 ment pursued in the institution. Some tables illustrative 
 of these points have therefore been added; and a brief 
 sketch of the subject will be here introduced. 
 
 Moral Treatment .—It is not intended to enter into a 
 detailed description of the moral treatment pursued in the 
 institution; as this is now generally known, and as to do 
 so would extend this report to an undue length. It is 
 now generally admitted that the Retreat was the first insti- 
 
46 
 
 STATISTICAL 
 
 tution in this kingdom, the officers of which, decidedly 
 recognised the principle that it was not, speaking generally, 
 by means of fear and intimidation, but by judicious and 
 persuasive kindness, tempered by firmness, that the insane 
 were most efficiently managed and governed; and con¬ 
 sequently, that this was the plan of moral treatment most 
 favourable to recovery. All implements of punishment, 
 chains, and all severe means of coercion were, if not from 
 the very first, very speedily discarded; and, in the course 
 of a very short time, a conviction of the inefficiency of 
 the old method, and of the evils connected with it, was 
 established in the mind of the original superintendent, the 
 late George Jepson; under whose administration, the 
 superior efficacy of the mild system of treatment, both as 
 respects cure and security, was soon apparent.* 
 
 The primary object which the officers of the Retreat 
 have endeavoured, however imperfectly, to keep before 
 their view in the moral treatment of the insane, modified 
 according to the character of the individual and of the 
 disorder he labours under, has been that of cultivating in 
 the patient the moral sense of right and wrong, the power 
 of self-restraint, and the remaining mental faculties as 
 much as practicable. This has been effected in numerous 
 instances, by appealing to, and encouraging the natural 
 feelings of love of approbation, and self-respect; which, 
 under different forms, and in various degrees, appear to 
 be common to mankind under all circumstances; and 
 
 * By a singular and interesting coincidence, it was in 1792, the very year in which 
 the celebrated Pinel commenced the amelioration in the treatment of the insane in 
 France, by the truly courageous act of unchaining nearly fifty supposed incurable and 
 dangerous lunatics at the Bicetre, that the establishment of the Retreat was proposed to a 
 meeting of the Society of Friends at York, by the late William Tuke. The proceedings 
 of Pinel, however, were not known either to the directors or superintendent of the 
 Retreat, and it is thus evident that the reformation in the treatment of the insane had an 
 independent origin in the two countries at the same period. 
 
REPORT. 
 
 47 
 
 which are seldom altogether obliterated even in a state 
 of insanity; unless* indeed* in very old and confirmed 
 cases of the disorder* chiefly of the fatuous kind. An uni¬ 
 formly kind manner* and considerate conduct towards the 
 insane; a strict attention to their often morbidly sensitive 
 feelings; treating them* in fine* as much as possible as 
 though they were sane and as responsible beings * are the 
 means which have been* and still are* found most successful 
 in winning their confidence. 
 
 The effects of a patient* sympathizing* and hopeful 
 demeanour towards the depressed and melancholy appear 
 fully to warrant the statement* that “in the treatment of 
 nervous cases* he is the best physician* who is the most 
 ingenious inspirer of hope. 5 ** 
 
 Notwithstanding what has been said of the abuse of the 
 passion of fear in the treatment of the insane* there has 
 been sufficient evidence at the Retreat* that* particularly 
 in cases of violent and perverse insanity* its influence is 
 not to be altogether disregarded. Indeed the use* which 
 has been alluded to* of the feeling of hope * almost neces¬ 
 sarily implies that of its opposite* fear ; and it is no 
 doubt true that on the one hand the hope of acquiring* 
 and on the other the fear of losing* those greater degrees 
 of liberty and comfort which are granted upon the appear¬ 
 ance of amendment* have a beneficial action and reaction* 
 both on the patients as a body* and even on the same 
 individual. 
 
 The practice which has long prevailed at the Retreat of 
 not reasoning with patients on the subject of their several 
 hallucinations* and the substitution* for this generally worse 
 than futile practice* of various indirect means adapted to 
 "seduce the mind from its favourite but unhappy mu- 
 
 Coleridge, 
 
48 
 
 STATISTICAL 
 
 sings/* is now generally recognised as coreect; and ha^ 
 perhaps, in some hospitals for the insane, both in Great 
 Britain and on the Continent, been of late years carried 
 to a still further extent than in this institution. On the 
 other hand, however, it is also found important, especi¬ 
 ally in curable cases, to avoid even the slightest approach 
 to a deviation from truth, or to the practice of deceiving 
 patients; as although it is not uncommon for the insane 
 person to be temporarily gratified and pleased by the 
 assent of those around him to some favourite but erroneous 
 view or hallucination; yet, upon the return of a more 
 rational state of mind, he is generally found to resent hav¬ 
 ing been treated like a child, and so far to have lost his 
 confidence in the person who has so conducted himself 
 towards him. Although great patience in listening, and 
 prudence or even reserve in replying, to the conversation 
 of the insane, has appeared to be the best general rule of 
 conduct; yet an occasional serious expression of dissent 
 from the patient’s erroneous judgments has, in some 
 instances, been thought useful. 
 
 A due regard to the exercise and cultivation of the 
 religious feelings has always been recognised at the Retreat 
 as an important element in the treatment of the patients. 
 On an average, an eighth of the whole number are accus¬ 
 tomed, twice a week, to attend, accompanied by their 
 attendants, the usual meetings of the Society of Friends 
 in the city; whilst such as belong to other religious 
 denominations, are, when suitable, taken to their respec¬ 
 tive places of worship. Excepting in two rooms, one for 
 each sex, devoted to the fatuous and worst cases, a por¬ 
 tion of the Scriptures is daily read after breakfast by the 
 attendant to each company of patients. On the afternoon 
 of the first day of the week, as many as are able and can 
 
REPORT. 
 
 49 
 
 be induced to attend, generally amounting to nearly half 
 the number, are collected in a room specially appropriated 
 to this object, whilst the superintendent, or one of the 
 officers of the institution, reads several chapters of the 
 New Testament, and a portion of the Psalms; after which, 
 a period of silence is observed; and the whole occupies 
 somewhat more than half an hour. Several attend who are 
 disposed to various irregular actions, and the self-restraint 
 which, under these circumstances, is often exercised, is 
 no doubt frequently productive of great advantage. And, 
 independently of the higher moral and religious consider¬ 
 ations connected with the subject, the general effect is, 
 no doubt, from old associations, often soothing and 
 beneficial in other cases. 
 
 It may be remarked, that after twenty-seven years 
 further experience but little can be added to the following 
 summary of the general principles of the moral treatment 
 of the insane. “The attendant on the insane, ought 
 sedulously to endeavour to gain their confidence and 
 esteem; to arrest their attention, and fix it on objects 
 opposite to their allusions; to call into action, as much 
 as possible, every remaining power and principle of the 
 mind; and to remember that, in the wreck of the intellect, 
 the affections not unfrequently survive.^* 
 
 As this report may fall into the hands of persons, not 
 professionally interested in the subject, but who, never¬ 
 theless, may be brought into contact with persons suffer¬ 
 ing under an attack of insanity; it is to be hoped that 
 what has been said respecting the moral treatment of the 
 
 * For further information upon the moral and general management of the insane, 
 the reader is referred to the works of Haslam, Esquirol, and Prichard; to the “Descrip¬ 
 tion of the E.etreat,” p. 162, &c.; and the English edition of Jacobi “On the Construc¬ 
 tion and Management of Hospitals for the Insaneand also to the admirable reports 
 of Dr. Conolly, the Resident Physician at the Middlesex Lunatic Asylum, Hanwell. 
 
 G 
 
50 
 
 ST ATI STIC Ali 
 
 insane may be the means of preventing some of that 
 injudicious and even harsh conduct* which has occasionally 
 been found to exert an injurious effect upon the progress 
 of cases brought to the Retreat. The injudicious conduct 
 which has been alluded to is* no doubt* generally the 
 result of misapprehension* which can only be removed 
 by further knowledge of the subject; and hence it cannot 
 be too generally known that, in a large proportion of cases 
 of insanity* it is the moral department of mind*—the tem¬ 
 per and social feelings—which are the first to be affected. 
 And thus* as has been truly stated* “a thousand occasions of 
 painful and offensive intercourse have generally arisen be¬ 
 tween the insane person and his relations* before he has 
 obtained the excuse which admitted insanity affords/** 
 
 There are three subjects connected with the moral 
 management of disorders of the mind* which* from their 
 importance* cannot be passed over without a specific 
 notice. These are* firsts the question as to the personal 
 restraint of the insane; secondly* the number of officers 
 and attendants; and thirdly* the means for employment* 
 amusement* and exercise. 
 
 Personal restraint .—The subject of the coercion during 
 a refractory or violent state* or* in other words* the per¬ 
 sonal or membral restraint of the insane* has of late 
 attracted much attention. At the Retreat* from a very 
 early period* it has been regarded more or less in the 
 light of a necessary evil; and it has been one of the 
 objects of the managers of the institution* to resort to it 
 as seldom as practicable. The Treasurer of the institution* 
 writing so early as 1813* observes “with regard to the 
 necessity of coercion* I have no hesitation in saying* that 
 it will diminish or increase* as the moral treatment of the 
 
 * “Pathology of the Human Mind,” hy T, Mayo, M.D., 1838, p. 98, 
 
REPORT. 
 
 51 
 
 patient is more or less judicious/* But he immediately 
 adds; “we cannot; however; anticipate the most enlight¬ 
 ened and ingenious humanity will ever be able entirely 
 to supersede the necessity for personal restraint/* 
 
 Within the last two years; however, the officers of some 
 institutions have attempted; and; in some instances; 
 apparently with considerable success; to conduct the 
 management of even large hospitals for insane paupers; 
 without resorting to such means of restraint. The im¬ 
 portant experiment of this description^ which Dr. Conolly 
 is conducting at Hanwell; must on all hands be regarded 
 with extreme interest; as even if it fail in establishing 
 that personal restraint can in all cases be abolished; it 
 has already fully shewn that it may be much more fre¬ 
 quently dispensed with; both with safety and advantage 
 to the patient, than has hitherto been generally; if at all;, 
 suspected.* 
 
 The officers of the Retreat have not hitherto thought 
 it right to dispense altogether with the use of all mild and 
 protecting means of personal restraint; believing that; 
 independently of consideration for the safety of the attend¬ 
 ant, they may; in some cases; be regarded as the least 
 irritating^ and; therefore; the kindest method of controul. 
 But though this is the case; they readily admit that they 
 have derived advantage from the full consideration of the 
 subject which the attempts at Hanwell; Lincoln and 
 
 * Under this plan of management, various protective and ingenious measures, as 
 regards clothing and furniture, and the occasional seclusion of the more violent, are 
 substituted for direct personal restraint, by the strait-waistcoat and other means of that 
 description. But there can be no doubt that the success which has hitherto attended 
 the introductiou of this system at Hanwell, is, in a great measure, to be attributed to 
 the excellence of the general superintendence, by which “constant attention and gentle¬ 
 ness” are, perhaps as far as practicable, secured to the patients. “Fifty-fifth Report 
 of the Visiting Justices of the County Lunatic Asylum, at Hanwell,” 1840, p. 3. See 
 also ‘ ‘ Fifty-first Report .’* 
 
52 
 
 STATISTICAL 
 
 elsewhere have induced; and that they remain open to 
 further evidence on the subject. 
 
 Number of Officers and Attendants.—Table 44.—Omit¬ 
 ting any reference to the officers and domestic servants 
 at the Retreat, the number and description of whom, at 
 the present and previous periods, may be seen in the 
 table; a few remarks will be made upon the proportion 
 which the number of actual “attendants” bears to that of 
 patients. At the date of this report there were in the 
 different galleries and day rooms of the house, four male, 
 and nine female, attendants upon seventy-nine patients 
 of the general class. Of the female attendants, however, 
 four consist of young persons who act as assistants to the 
 responsible attendants. Including these, the proportion 
 for both sexes, is nearly that of one attendant to every six 
 patients. For the men, considered separately, the pro¬ 
 portion is less, and does not exceed one to eight. There 
 is, however, an additional upper male attendant, who 
 assists and superintends those who are engaged in agri¬ 
 cultural pursuits, during the day; and, in the evening, has 
 the care of such as have access to the library and reading 
 room; so that, if he be included, the proportion of attend¬ 
 ants on the men is nearly as large as that on the women, 
 or as one to every six or seven cases. 
 
 The proportion of attendants has increased considerably 
 during the last twenty-five or thirty years. In 1813 the 
 proportion was not more than one to twelve, and in 1828 
 not more than one to ten patients. The proportion now 
 existing is a very respectable one; and if all that is prac¬ 
 ticable in the treatment of the insane be accomplished, it 
 may be questioned whether in any institution, it should 
 ever be materially less; if we except indeed such as 
 strictly for paupers. 
 
REPORT. 
 
 53 
 
 With respect to patients of the more opulent class; who 
 pay for superior accommodation^ there are three male 
 attendants upon six or seven gentlemen; and six female 
 attendants upon five gentlewomen; one of the latter being 
 provided with two; one of whom acts as a companion and 
 upper attendant^ the other as a servant. 
 
 The importance of the duties performed by attendants 
 on the insane renders their selection and superintendence 
 a task of peculiar difficulty. For the moral and intellectual 
 qualities to be desired; though not always to be attained; 
 in all who come in contact with the insane are of no 
 ordinary kind. In their general character they most 
 nearly resemble those required in an instructor and guar¬ 
 dian of youth; though they are perhaps of a still more 
 peculiar description; and require the union of great kindness 
 of heart and of manners; with decision of character and 
 firmness of conduct. It may; at all events; be said with 
 as much propriety to the one as to the other; 
 
 “ Love, Hope, and Patience, these must be thy graces, 
 
 And in thine own heart let them first keep school.”* 
 
 It has also been found at the Retreat; as in other insti¬ 
 tutions; that unless the attendant; to a great extent; both 
 comprehends and enters into the spirit of the moral 
 treatment by which the officers of the institution are actu¬ 
 ated; the efforts of the latter will be too often imperfectly 
 carried out; and; in some cases; even altogether defeated. 
 It may be stated that three or four of the most efficient 
 and trustworthy attendants have been females; who had 
 recovered from attacks of mental disorder in the institu¬ 
 tion; and who were engaged in this capacity at their own 
 particular request. 
 
 * Coleridge’s “Love, Hope, and Patience in Education.” 
 
54 
 
 STATISTICAL 
 
 Modes of Employment and Amusement .— Tabled .—The 
 employment of the patients has been considered an object 
 of great importance at the Retreat; from its first institu¬ 
 tion; as the following passage will shew—“Of all the 
 modes by which the patients may be induced to restrain 
 themselves^ regular employment is perhaps the most 
 generally efficacious; and those kinds of employment are 
 doubtless to be preferred; both on a moral and physical 
 account, which are accompanied by considerable bodily 
 action; which are most agreeable to the patient, and 
 which are most opposite to the illusions of his disease.”* 
 In accordance with these views; the female patients have 
 always been employed; as much as possible; in sewings 
 knittings or domestic affairs; and; when convalescent; in 
 assisting the attendants. Although a considerable num¬ 
 ber of men have also been engaged in gardening; agricul¬ 
 tural; and other pursuits; and that with great advantage; yet 
 the proportion more or less regularly; actually employed; 
 was always; until a recent period; much less than that of 
 women. This arose from the circumstance of only a 
 small proportion having been accustomed to any mechan¬ 
 ical or agricultural pursuit; and from many being of the 
 more opulent and educated class; who would not willingly 
 engage in labour; and might feel degraded if compelled to 
 do so. 
 
 The managers of several hospitals for the insane; both 
 in Great Britain; and Ireland; and on the Continent; 
 have, within the last ten years; directed their attention 
 particularly to the provision of suitable occupation for the 
 patients; and have succeeded; especially in institutions 
 for paupers; in organizing a more general system of labour 
 and employment than had at that time been accomplished; 
 
 * “ Description of the Retreat/' p. 156. 
 
REPORT# 
 
 55 
 
 at least as regards the men^ at the Retreat. The effects 
 of this system^ in the asylums at Wakefield and Hanwell., 
 where it was introduced by the late Sir William Ellis,, in 
 the Scotch chartered^ and in the Irish District asylums^ 
 have been most happy both as regards the comfort and 
 general health of the patients,, if not also as promoting 
 the probability of recovery. Various mechanical and 
 handicraft employments have been introduced; but agri¬ 
 cultural occupations are those which have been most 
 uniformly found beneficial; and which have justified the 
 high opinion which had always been entertained of them^ 
 when used on a smaller scale^ at the Retreat. 
 
 Encouraged by the success of these institutions^ the 
 committee and managers of the Retreat determined,, two 
 or three years since^ to make an effort to introduce the 
 systematic employment of the the male patients in garden¬ 
 ing and other agricultural pursuits. For this purpose^ an 
 attendant was engaged to take the more immediate charge 
 of those who should go out to work. The number of men 
 who have been induced to engage in out of doors em¬ 
 ployment, and the quantity of work done during the 
 two seasons have^ perhaps^ both fully equalled previous 
 expectation. In the spring of the year^ 183 St, a grass 
 field of about two acres was dug out, and has since pro¬ 
 duced two very abundant crops of potatoes and other 
 produce. During the past year, twenty of the men have 
 been employed in agricultural and out-of-doors* pursuits 
 (Table 45); and on an average the daily number, more 
 or lessj so occupied has been about fourteen. When the 
 small proportion of the patients who,, prior to admission^ 
 have been accustomed to agricultural pursuits^ and the 
 consequent greater difficulty in inducing them to engage 
 in thein^ are considered^ the proportion so employed,, 
 
56 
 
 STATISTICAL 
 
 though not equal to that in several of the large pauper 
 institutions, must still be regarded as considerable. The 
 employment has evidently conduced to the comfort and 
 health of those who have engaged in it; and it has appeared 
 to promote the recovery of some. It may be stated that 
 some of the imbecile and nearly fatuous patients, who 
 had been in that state for many years, and had never been 
 known to employ themselves in anything, have been 
 induced to assist very materially in these engagements. 
 A workshop has also been provided, and when the 
 weather will not permit employment in the open air, some 
 of the men are occupied in simple mechanical pursuits, 
 such as the making of wooden hay-rakes, &c. It is satis¬ 
 factory to observe that no accident has resulted from 
 placing agricultural and other tools in the hands of the 
 patients. 
 
 A reading room, with a select library, consisting of 
 travels, natural history, biography, history, and moral 
 and religious writings has been opened for the men; the 
 more orderly of whom have access to it, under certain 
 regulations as to conduct and behaviour. The books in 
 this collection are also allowed to circulate amongst the 
 women; and patients of more extensive acquirements and 
 literary tastes have the opportunity of procuring the 
 works of nearly all standard authors, from two excellent 
 subscription libraries in the city. 
 
 Various games of skill, such as drafts, chess, &c.; and 
 the more active ones of cricket and quoits, form favourite 
 amusements with many of the men; whilst walks in the 
 grounds of the institution, and into the city and country 
 in the company of an attendant, and carriage exercise for 
 the higher class of patients, are frequently resorted to 
 with great apparent benefit, by those of both sexes. 
 
REPORT. 
 
 57 
 
 Dietary.—Table 46.—The diet of the patients at the 
 Retreat, has from its first establishment been liberal; and 
 has always included a fair; and of late years; perhaps; a 
 rather full allowance of animal food. If it is recollected 
 that at the time when the Retreat was established; the 
 very erroneous notion was much more prevalent than at 
 present; that insanity; at least when attended by much 
 excitement; was always to be treated by a spare diet and 
 other reducing measures; the more credit will appear due 
 to the discernment of the first superintendent and apothe¬ 
 cary; the late George Jepson; who acted so decidedly in 
 this respect; upon what; speaking generally; has now been 
 fully proved to be the correct view of this subject. 
 
 The description of food at the Retreat does not differ 
 from that generally in use by the middle class of society 
 in this country. With the exception of some of the de¬ 
 mented and fatuous patients; chiefly of the poorer class; 
 who have only three; the patients partake of four; meals 
 daily. Home-brewed beer; to the extent of a pint; or a 
 pint and a half; is allowed to such as desire it; when it is 
 not considered unsuitable in a medical point of view.* 
 
 It would be difficult to institute an accurate comparison 
 between the diet at the Retreat and that of other institu¬ 
 tions for the insane; in consequence of the peculiar 
 domestic arrangements of the former establishment. It 
 has always been one of the distinguishing features of the 
 economy of the Retreat; to endeavour to make the patients 
 feel; as much as possible; at home; and with this view the 
 diet has never been limited by weight and measure. 
 
 The meals are served much as in a private family; and 
 
 * It maybe interesting information to some, that several of the patients as well as 
 attendants at the Retreat have both signed and adhered to the pledge of total abstinence 
 from fermented and, alcoholic liquors. 
 
 G 
 
58 
 
 STATISTICAL 
 
 the attendant takes the head of the table, carves, and 
 helps all those whose diet has not been particularly pre¬ 
 scribed. No material restriction is placed upon the 
 quantity of food partaken of by each individual, unless 
 for medical reasons connected with the health of the 
 patient. 
 
 The most important feature in the diet at the Retreat, 
 consists in the large proportion of animal food which it 
 contains. The dinner consists principally of meat; 
 although vegetables and bread always, and puddings 
 generally, form part of the meal. Taking the average of 
 patients, officers and servants for the year 1839-40, the 
 mean weekly consumption of uncooked animal food was 
 not less than four and a half pounds for each indivi¬ 
 dual.* This may be estimated as equivalent to at least 56 
 ounces Av. of cooked meat, including bone; and this it 
 must be recollected is exclusive of cheese, which, in many 
 dietaries, is reckoned with the meat. This is a quantity 
 of solid animal food which appears to be at least double 
 or treble that which is generally allowed in the large county 
 asylums of this kingdom. The average consumption 
 by the higher class of patients., by the attendants, and 
 the servants, is probally somewhat more, and that by the 
 general class of patients somewhat less, than 56 ounces 
 per week. The quantity of butter, cheese, and milk con¬ 
 sumed by the patients is likewise large. 
 
 It may perhaps be fairly questioned whether the quan¬ 
 tity of solid animal food in the diet at the Retreat does not, 
 
 * The fresh butcher’s meat, consisting of prime joints, purchased during the year, 
 •weighed 24,4991bs.; the poultry, game, and fish were estimated at not less than l,7951bs t ; 
 and the pork killed on the premises at 2,6G01bs.; making a total of 28,9241bs. The 
 average loss of weight in the cooking appears to be about 29 per cent, for roast, and 16 
 per cent, for boiled, meat; and * ; it may be estimated at from 20 to 25 per cent, for all 
 kinds of meat. The average number of inmates of all descriptions, during the year, 
 including occasional visitors, docs not appear to have exceeded 123. (Tables 1 and 41.) 
 
REPORT* 
 
 59 
 
 in many cases; somewhat exceed the desirable amount; and 
 whether a larger proportion of pudding and other farina¬ 
 ceous articles; and of vegetables^ might not advantageously 
 be substituted for a portion of the meat now allowed at 
 dinner. Some such a change in the provision for the 
 table^ it may be stated; is at present under the considera¬ 
 tion of the officers and committee of the institution. 
 
 Medical Treatment—Table 47.—Although this would 
 not be the appropriate place to enter into any lengthened 
 or particular details relative to the more strictly medical or 
 therapeutic means employed at the Retreat; yet; for the 
 purposes of medical statistics; this report would be 
 decidedly defective; did it contain no allusion to them. 
 It is perhaps scarcely necessary to observe; that no uni¬ 
 form system of medical treatment is considered applicable 
 to the various cases that come under care; but that a 
 discriminating selection of remedies; according to the 
 physical indications y is the plan which the medical officers 
 of the institution endeavour to keep before their view; in 
 the treatment of each case. 
 
 It may be stated; that severe antiphlogistic or reducing 
 measures are seldom resorted to; and that it has been 
 found that where venesection and other means of the same 
 kind have been carried to a great extent before admis¬ 
 sion; the recovery has generally been more tedious; and; 
 perhaps; in some cases prevented. In cases; however; 
 of various forms in the recent stage; the cautious employ¬ 
 ment of local bleeding either by leeches or cupping; the 
 use of brisk purgatives and aperients; of evaporating 
 lotions to the head and stimulating pediluvia; followed 
 sometimes by blisters to the nape; has been very 
 frequently attended by decided advantage. Where the 
 physical signs of cerebral disturbance have been more 
 
60 
 
 STATISTICAL 
 
 marked^ a mild mercurial course with or without opiates^ 
 and carried only to incipient ptyalism has, in some cases 
 at least; been speedily followed by convalescence. In 
 cases of mania attended by much excitement; where the 
 general means first mentioned either appeared inapplicable; 
 or when tried; have not been followed by decided relief; 
 the tartarized antimony; in full or nauseating doses; has 
 not unfrequently appeared efficacious in removing the 
 excitement. Preparations of opium; and particularly 
 morphia and Dover’s powder; hyosciamus and other seda¬ 
 tives; are likewise frequently and successfully resorted tO; 
 in some cases of excitement; with the view of tranquil¬ 
 lizing the patient and producing sleep; without being 
 followed by those unpleasant symptoms which were 
 formerly thought to arise from their employment. 
 
 In cases of melancholia the warm bath continues to be 
 frequently found of great service; and when combined 
 with cold affusion or evaporating lotions to the head; has 
 likewise sometimes been thought of use in tranquillizing 
 the patient in some forms of excitement. The shower 
 bath; both as a sedative and as a tonic; and either tepid 
 or cold; is also frequently used; and with beneficial 
 results. 
 
 In a large proportion of cases; however; the medical 
 treatment is necessarily limited to the removal of symp¬ 
 toms; in other parts of the system; which have only an 
 indirect relation to the cerebral derangement. With 
 these views; bitters; aperients; diaphoretics; emmenagogues 
 and other appropriate remedies are frequently found of 
 service by acting upon; or restoring; the functions of the 
 stomach; bowels; skin; and uterine organs. There have 
 been a few cases; in which; from the first; it has been 
 found necessary to invigorate the tone; or support the 
 
REPORT. 
 
 61 
 
 power of the system by the use of a generous diet, qui¬ 
 nine, chalybeates, or other tonics; and even by that of 
 wine, porter, ammonia, and other stimulants or cordials; 
 and in which convalescence has speedily followed. 
 
 In conclusion it may be remarked, that on the whole, 
 the experience of the present medical officers favours the 
 conclusion that more is to be effected by the judicious 
 use of pharmaceutic means, than was thought practicable 
 by the earlier medical officers of the Retreat. At all 
 events, the following remark of Dr. Burrows, that ^in¬ 
 sanity was formerly in that asylum (the Retreat) scarcely 
 considered to be a remedial complaint; and, consequently, 
 medical aid was resorted to only when the patients were 
 afflicted with other disorders/ 5 * has, if ever applicable, 
 long ceased to be so to this institution. It is, however, 
 not improbable that the notion of a greater abandonment 
 of pharmaceutic treatment at the Retreat than actually 
 took place, may have arisen from the protest which was 
 made against all nostrums for insanity; and against that 
 empirical treatment which prevailed, under high medical 
 authority, of bleeding and administering aperients and 
 emetics, at stated periods, and to patients of all classes 
 indiscriminately. Apart indeed from these empirical 
 practices, it may well be doubted whether, in any public 
 institution, more discriminating medical attention pre¬ 
 vailed than at the Retreat, during the first ten or fifteen 
 years of its existence; the period to which Dr. Bur¬ 
 rows refers.f 
 
 * “ Commentaries on Insanity,” 1828, p. 558. 
 
 + It must be observed that I have the authority of my respected colleagues, the visit¬ 
 ing medical officers of the institution, Dr. H. S. Belcombe, and C. Williams, for stating 
 that this portion of the report has been submitted to their perusal; and that it meets 
 with their concurrence. 
 
62 
 
 STATISTICAL 
 
 § 10.- OF THE FINANCES OF THE INSTITUTION* 
 
 Those interested in the financial portion of the statistics 
 of Hospitals for the Insane, will find tables which exhibit 
 the weekly rates of payment on account of patients 
 (Table 48); the progressive increase in the value of the 
 property (Table 49), at intervals of ten years; and the 
 sources of income (Table 50), and heads of expenditure 
 (Table 51), for decennial periods since the establishment 
 of the institution. 
 
 JOHN THURNAM, 
 
 RESIDENT SURGEON. 
 
STATISTICAL TABLES 
 
 $ 1 .—General view of the experience of the Uetreat since its opening , in 1796. 
 
 Table 1.—Shewing the admissions, discharges, and deaths, tor the 
 year 1839—1840. 
 
 
 Male. 
 
 Fem. 
 
 Total 
 
 I Male. 
 
 Fem. 
 
 Total 
 
 Remaining in the Institution, Midsummer, 
 
 
 
 
 
 
 
 1839. 
 
 36 
 
 47 
 
 83 
 
 
 
 
 Admitted during the year. 
 
 9 
 
 8 
 
 17 
 
 
 
 
 Total under rare during the year. . . 
 
 
 
 
 45 
 
 55 
 
 100 
 
 Discharged 
 
 
 
 
 
 
 
 Recovered . 
 
 3 
 
 3 
 
 6 
 
 
 
 
 * Improved. 
 
 2 
 
 . 
 
 2 
 
 
 
 
 Died. 
 
 1* 
 
 
 1 
 
 
 
 
 Total discharged during the year.. 
 
 
 
 
 6 
 
 3 
 
 9 
 
 Remaining in the Institution, Midsummer 1840 . 
 
 
 
 39 1 
 
 52 
 
 91 
 
 Average numbers resident during the year.. . 
 
 ..... 
 
 
 ...,j 
 
 ! 3? 1 
 
 48 i 
 
 1 
 
 85 
 
 Table 2.—Shewing the admissions, discharges, and deaths, for the 
 forty-four years, 1796—1840. 
 
 
 
 
 
 Male. 
 
 Fem, 
 
 Total. 
 
 Admitted during the forty-four years .. . 
 
 
 
 
 282 
 
 333 
 
 615 
 
 
 Male. 
 
 Fem. 
 
 Total 
 
 
 
 
 Discharged 
 
 
 
 
 
 
 
 Recovered . 
 
 121 
 
 170 
 
 291 
 
 
 
 
 Improved .. 
 
 41 
 
 24 
 
 65 
 
 
 
 
 Unimproved. 
 
 11 
 
 18 
 
 29 
 
 
 
 
 Died . 
 
 70 
 
 69 
 
 139 
 
 
 
 
 Total discharged during the forty-four years. . . 
 
 
 
 243 
 
 281 
 
 524 
 
 Remaining Midsummer, 1840 . 
 
 
 
 
 39 
 
 52 
 
 91 
 
 Average numbers resident during the forty-four years 
 
 -•I, 
 
 [28.50 
 
 j 38.65 
 
 [67.15 
 
 * This patient was 76 years of age, and had resided in the Institution 43 years; having 
 been admitted in 1796, the year it was opened. 
 
Table 3.—Shewing the numbers admitted and discharged since the opening of the Institution, and 
 
 THE AVERAGE NUMBERS RESIDENT, WITH THE RESULTS OF TREATMENT ; ARRANGED IN DECENNIAL PERIODS FROM 
 MIDSUMMER, 1796, TO MIDSUMMER, 1840. 
 
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 4 
 
 S j 
 
 h 
 
 44 
 
 J 
 
 05 > 
 
 CO j 
 
 4 
 
 §1 
 
 CM 
 
 *— l > 
 
 4 
 
 ° 1 
 
 CM 
 
 i—l 
 
 l- 
 
 L 05 
 
 r 
 
 ADMITTED, 
 
 U 3 r 
 
 IB o r 
 
 -S a 
 
 « -H 
 
 P p * 
 
 H g " 
 
 5 ^ -> 
 
 
 t'- > 
 
 05 
 
 VO 
 
 CO > 
 
 j-s 
 
 2 1 CO 
 
 T—1 
 
 cm > 
 
 : 3 
 
 ! »o 
 
 CM 
 
 r-t -> 
 
 U 
 
 Leo 
 
 r 
 
 CO > 
 00 
 
 g ^ 
 
 u 
 
 Lvo 
 
 r 
 
 CO > 
 
 co 
 
 CO 
 
 CM 
 
 CO 
 
 CM •> 
 
 4 
 
 d P 
 
 <U r 
 
 1 
 
 i. 
 
 <1 i* 
 
 H O M 
 
 _ • 
 oo 
 
 ^ TjH J 
 
 4 
 
 CO ^ 
 
 2?J 
 
 VO 
 
 ^ J 
 
 i-1 
 
 1 ~ 
 
 CO 
 
 CO 1 
 . ® ! 
 ) — 
 
 1 CO I 
 
 00 J 
 
 N 
 
 th 4 
 CO 
 
 CM J 
 
 4 
 
 CO 
 
 CO 1 
 
 co ! 
 
 CM | 
 OO 
 
 CM J 
 
 4 
 
 PERIODS 
 
 OF 
 
 TEN YEARS. 
 
 
 CO 
 
 o 
 
 oo 
 
 J 
 
 CO 
 
 05 
 
 co co 
 
 r-t CM 
 
 OO CO 
 
 H r-t 
 
 1 1 
 
 co co 
 
 O r-t 
 
 OO oo 
 
 . i—t . y—i 
 
 CO Jj 
 
 ■s 1 
 
 I =; 
 
 T3 a 
 CO O r 
 
 CM ‘u 
 
 OO <u 
 
 u 
 
 p 
 
 O <& 
 
 .3 if 
 
 M «i 
 
 5 1 «w 
 
 ►>CO O . 
 
 CO ^ 1 
 
 00 O 
 
 -“I *C 
 
 a 
 Ot 
 
 o 
 
 00 
 
 A r-f 
 
 S 3 | 
 
 05 
 
 H 
 
Table 4.—Shewing the average proportions of the recoveries and deaths, during the decennial periods, 1796—1840: 
 
 DEDUCED FROM TABLE 3. 
 
 H 
 
 P$ 
 
 O 
 
 2 
 
 rage of Deaths 
 per cent, 
 tie Admissions. 
 
 Mean. 
 
 14.40 
 
 05 
 
 to 
 
 1-1 
 r—( 
 
 23.33 
 
 26.51 
 
 GO 
 
 xh 
 
 CO 
 
 22.60 
 
 Females. 
 
 7.14 
 
 15.87 
 
 26.02 
 
 05 
 
 r-1 
 
 Cl 
 
 26.47 
 
 20.72 
 
 
 O -4-J 
 
 
 
 
 
 
 
 
 
 
 M 
 
 O 
 
 o 
 
 i- 
 
 o 
 
 CO 
 
 Cl 
 
 
 
 <U 
 
 o 
 
 o 
 
 i-- 
 
 © 
 
 00 
 
 00 
 
 
 
 r cg 
 
 to 
 
 o 
 
 © 
 
 to 
 
 to 
 
 rjJ 
 
 
 
 
 Cl 
 
 
 Cl 
 
 d 
 
 
 Cl 
 
 
 Cd S ^ 
 
 O U S 
 
 Z 
 
 ° 
 
 a rg 
 
 <0 e+H 
 
 t> o 
 
 02 
 
 03 P3 
 
 ft <1 
 
 2 b g 
 
 3 ° * 
 a & 
 * w 
 
 c5 | 
 
 O 03 | 
 
 «H >H 
 
 . 03 
 
 O §L<0 
 
§ 2.— Of the. condition and previous history of the patients. 
 
 Table 5.—Shewing the numbers admitted and annually resident, con¬ 
 nected AND UNCONNECTED WITH THE SOCIETY OF FRIENDS. 
 
 PROFESSION OF RELIGION. 
 
 Numbers 
 
 admitted. 
 
 Mean numbers 
 annually resident. 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Male. 
 
 Fem. 
 
 Total. 
 
 Society of Friends and connected 
 
 
 
 
 
 
 
 WITH IT. 
 
 
 
 
 
 
 
 Members of the Society of Friends by 
 
 
 
 
 
 
 
 birth-right . 
 
 160 
 
 190 
 
 350 
 
 
 
 
 Persons who had joined the Society, 
 
 
 
 
 £ 24.13 
 
 34.77 
 
 58.90 
 
 but not educated in it. 
 
 9 
 
 14 
 
 23 
 
 s 
 
 
 
 Persons professing with, and, for the 
 
 
 
 
 
 
 
 most part,once members of the society 
 
 29 
 
 13 
 
 42 
 
 2.42 
 
 1.03 
 
 3.45 
 
 Total. 
 
 198 
 
 217 
 
 415 
 
 26.55 
 
 35.80 
 
 62.35 
 
 Unconnected with the Society of 
 
 
 
 
 
 
 
 Friends. 
 
 
 
 
 
 
 
 Persons attending their places of wor¬ 
 
 
 
 
 
 
 
 ship, but not otherwise connected 
 
 
 
 
 
 
 
 with the Society of Friends. 
 
 4 
 
 7 
 
 11 
 
 ) 
 
 
 
 Persons of other religious denomina¬ 
 
 
 
 
 y i.95 
 
 2.85 
 
 4.80 
 
 tions . 
 
 21 
 
 22 
 
 43 
 
 s 
 
 
 
 Total. 
 
 25 
 
 29 
 
 54 
 
 1.95 
 
 2.85 
 
 4.80 
 
 Total. 
 
 223 
 
 246 
 
 469 
 
 28.50 
 
 38.65 
 
 67.15 
 
 Table 6.—Shewing the numbers who had suffered from more than one 
 
 ATTACK OF DISORDER, WHEN FIRST ADMITTED INTO THE RETREAT. 
 
 DURATION OF DISORDER. 
 
 Society of Friends 
 and 
 
 connected with it. 
 
 Unconnected 
 with the 
 
 , Society of Friends. 
 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Class 3. Within 12 months, not first attack 
 Class 4. More than 12 months, not first 
 
 33 
 
 39 
 
 72 
 
 i 7 
 
 8 
 
 15 
 
 
 8 
 
 11 
 
 19 
 
 3 
 
 2 
 
 5 
 
 Total. 
 
 41 
 
 50 
 
 91 
 
 10 
 
 10 
 
 20 
 
Table 7. —Shewing tiie description of district from which the patients 
 
 HAVE BEEN RECEIVED. 
 
 DESCRIPTION OF DISTRICT. 
 
 Society of Friends 
 " and 
 
 connected with it. 
 
 Unconnected 
 with the 
 
 Society of Friends. 
 
 Male 
 
 Fem. 
 
 Total 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Cities and large towns . 
 
 97 
 
 131 
 
 228 
 
 14 
 
 17 
 
 31 
 
 Small towns and villages . 
 
 52 
 
 49 
 
 101 
 
 3 
 
 4 
 
 7 
 
 Rural districts. 
 
 49 
 
 37 
 
 86 
 
 8 
 
 8 
 
 16 
 
 % 
 
 Total. 
 
 198 
 
 217 
 
 415 
 
 25 
 
 29 
 
 54 
 
 Table 8.—Shewing the rank or profession of the patients. 
 
 RANK OR PROFESSION. 
 
 Society of Friends 
 and 
 
 connected with it. 
 
 Unconnected 
 with the 
 
 Society of Friends. 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Gentlemen and gentlewomen . 
 
 7 
 
 31 
 
 ~W~ 
 
 7 
 
 19 
 
 26 
 
 Clergyman of the church of England .... 
 
 . 
 
 
 • 
 
 1 
 
 
 1 
 
 Military officers. 
 
 . 
 
 
 . 
 
 2 
 
 
 2 
 
 Physician and surgeons. 
 
 6 
 
 
 6 
 
 1 
 
 
 1 
 
 Solicitor . 
 
 1 
 
 
 1 
 
 
 
 
 Architects and artists. 
 
 3 
 
 
 3 
 
 1 
 
 
 1 
 
 Literary persons. 
 
 1 
 
 i 
 
 2 
 
 1 
 
 
 1 
 
 School masters, teachers, and governesses 
 
 6 
 
 18 
 
 24 
 
 
 
 
 Merchants, &c. 
 
 4 
 
 , 
 
 4 
 
 3 
 
 
 3 
 
 Manufacturers. 
 
 13 
 
 . 
 
 13 
 
 2 
 
 
 2 
 
 Tanners and curriers. 
 
 6 
 
 . 
 
 6 
 
 
 
 
 Farmers, &c... 
 
 35 
 
 
 f (\o 
 
 2 
 
 
 
 Wives and daughters of farmers . 
 
 
 28 
 
 > DO 
 
 
 i 
 
 r 
 
 Agents, commercial travellers, and clerks 
 
 11 
 
 . 
 
 ^ 11 
 
 i 
 
 
 i 
 
 Chemists and druggists. 
 
 10 
 
 
 10 
 
 1 
 
 
 i 
 
 Persons in various descriptions of trade . . 
 
 44 
 
 4 
 
 f Q4. 
 
 2 
 
 2 
 
 u 
 
 Wives and daughters of persons in trade,&c. 
 
 
 46 
 
 \ 94 
 
 
 4 
 
 r 
 
 Ship captains and sailors . 
 
 3 
 
 
 3 
 
 1 
 
 
 i 
 
 House-keepers . 
 
 
 12 
 
 12 
 
 
 
 . 
 
 Seamstresses . 
 
 
 13 
 
 13 
 
 
 
 
 Shopmen and. shopwomen. 
 
 6 
 
 4 
 
 10 
 
 
 
 
 Domestic servants (one of the men an attend¬ 
 
 
 
 
 
 
 
 ant at the Retreat). 
 
 2 
 
 37 
 
 39 
 
 
 3 
 
 3 
 
 Mechanics and artizans. 
 
 26 
 
 
 26 
 
 
 
 
 Wives and daughters of mechanics, &c. .. 
 
 
 19 
 
 19 
 
 
 
 
 Shoemakers. 
 
 5 
 
 
 5 
 
 
 
 
 Tailors. 
 
 3 
 
 
 3 
 
 
 
 
 Weavers. 
 
 6 
 
 
 6 
 
 
 
 
 Exact rank unknown. 
 
 • 
 
 4 
 
 4 
 
 
 
 
 Total. 
 
 198 
 
 217 
 
 415 
 
 25 
 
 29 
 
 54 
 
T 9.—Shewing the actual and average ages of the patients at the origin of the mental.disorder, and at their 
 
 FIRST ADMISSION J AND.LIKEWISE THE MEAN, NUMBERS ANNUALLY RESIDENT AT DECENNIAL PERIODS OF LIFE. 
 
 p 
 
 < 
 
 £ 
 
 a 
 
 w 
 
 o 
 
 w 
 
 p 
 
 5s 
 
 All cases admitted. 
 
 Total. 
 
 iH OOtHCKMMtHCoI 
 O Ol Ol CO l>- © rH rH 
 
 i—* CO M CO Ci lO H 
 
 H rH rH 
 
 67.15 
 
 Mean 
 
 48.1 
 
 1 Fern. 
 
 CO H O ‘O H O D N 
 rH HlONiOO'OO 
 © rH 00 00 CD oi 
 
 38.65 
 
 Fem. 
 
 48.6 
 
 Male. 
 
 VO ©005 00M«DNCO 
 
 tq on^hco^nh 
 >0 CC (N 
 
 28.50 
 
 Male. 
 
 47.6 
 
 W P 
 p 2 
 
 W P 
 p p 
 w PH 
 p 
 § 
 p 
 
 A 
 
 < 
 
 8 
 
 Society of Friends 
 and 
 
 connected with it. 
 
 Total. 
 
 © O H r -1 05 CO ©^rH r-H 
 oi 00' c4 05 rjT r-H 
 
 r—1 rH i—( 
 
 62.35 
 
 Mean 
 
 48.9 
 
 Fem. 
 
 lOOHOOOOOCON 
 rH ^ 05 N O CD 
 
 CO CD 1>1 CO c4 
 
 o 
 
 00 
 
 vd 
 
 CO 
 
 Fem. 
 
 49.1 
 
 Male. 
 
 OO OCOHCONNNM 
 rH MK5 iMh»OMNh 
 co vd td vd co’ of 
 
 26.55 
 
 Male. 
 
 00* 
 
 rH 
 
 AGES AT FIRST ADMISSION. 
 
 . Unconnected 
 with the 
 
 Society of Friends 
 
 Total 
 
 . . CNhCO 05 05 CD rH H . . 
 
 rH 
 
 to 
 
 p 
 
 g3 
 
 05 
 
 00 
 
 CO 
 
 Fem. 
 
 . .HCOHOIOCO . . . 
 
 rH 
 
 29 
 
 s 
 
 <U 
 
 PH 
 
 o 
 
 rH 
 
 rH 
 
 Male. 
 
 • • rH O 00 CO rH rH rH • • 
 
 tH 
 
 25 
 
 Male. 
 
 34.1 
 
 Society of Friends 
 and 
 
 connected with it. 
 
 Total 
 
 . -^C5N0NkOfO(M(N . 
 H HCONkOrH H 
 
 i—l 
 
 to 
 
 rH 
 
 rH 
 
 Mean 
 
 39.2 
 
 Fem. 
 
 .HOOOCDMHWIOIN . 
 to rH rH CO <M 
 
 217 
 
 Fem. 
 
 39.9 
 
 1 
 
 Male. 
 
 .COrHCOOtOrHOJTH . . 
 
 rH to rH co Cd CM 
 
 198 
 
 Male. 
 
 cq 
 
 oo* 
 
 co 
 
 AGES AT ORIGIN OF DISORDER. 
 
 Unconnected 
 with the 
 
 Society of Friends. 
 
 Total 
 
 • HNHMCDCDH . . . 
 
 CM rH 
 
 54 
 
 Mean 
 
 32.8 
 
 Fem. 
 
 . rH i—1 rH VO tO CO . • . • 
 
 29 
 
 s 
 
 05 
 
 Ph 
 
 9*98 
 
 Male. 
 
 . .CD ONH . rH . . • 
 
 rH 
 
 25 
 
 Male. 
 
 28.3 
 
 Society of Friends 
 and 
 
 connected with it. 
 
 ! Total 
 
 * 
 
 rHOOVOlOCOCDrHiOrHH . 
 rH CO 00 CO rH CM 
 
 H 
 
 i 
 
 to 
 
 1 rH 
 
 Mean 
 
 rH 
 
 rH 
 
 CO 
 
 Fem. 
 
 HWHHNCOtOCOMH . 
 (NNrHMfNH 
 
 !>. 
 
 <M 
 
 Fem J 
 
 35.1 
 
 Male. 
 
 COtOrH^COCOC5(N(N . . 
 
 <M CO CO CO H H 
 
 198 
 
 Male. 
 
 tq 
 
 co* 
 
 co 
 
 AGES. 
 
 ■S . 8 . s : 
 
 >> • 
 
 OVOOOOOOOOOO ! 
 
 HH(NC0tH>0C0NX05O 
 
 b — — — — — 3 
 
 OOtOOOOOOOOO P 
 
 HH(NCOtJ<IOCON00 05 C" 1 
 
 g . 
 
 Pm 
 
 AVERAGE AGES. . . . 
 
 * These were cases of congenital idiotcy and imbecility, 
 t Except one of the men, these cases were more or less connected with a superannuated state of mind. 
 
Table 10. —Shewing the condition in reference to marriage. 
 
 CONDITION IN REFERENCE TO MARRIAGE. 
 
 Society of Friends 
 and 
 
 connected with it. 
 
 Unconnected 
 with the 
 
 Society ofFriends. 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Unmarried. 
 
 128 
 
 149 
 
 277 
 
 16 
 
 15 
 
 31 
 
 Married, but having had no offspring . 
 
 7 
 
 13 
 
 20 
 
 1 
 
 1 
 
 2 
 
 Married, with offspring. 
 
 49 
 
 33 
 
 82 
 
 5 
 
 8 
 
 13 
 
 Widowed, but having had no offspring .... 
 
 2 
 
 6 
 
 8 
 
 1 
 
 
 1 
 
 Widowed, with offspring . 
 
 12 
 
 16 
 
 28 
 
 2 
 
 5 
 
 7 
 
 Total. 
 
 198 
 
 217 
 
 415 
 
 25 
 
 29 
 
 54 
 
 § 3.— Of the probable causes of the mental disorder. 
 
 Table 11. —Shewing the numbers of persons in whom a hereditary ten¬ 
 dency TO INSANITY WAS KNOWN TO EXIST. 
 
 HEREDITARY PREDISPOSITION. 
 
 Society of Friends 
 and 
 
 connected with it. 
 
 Unconnected 
 with the 
 
 Society ofFriends. 
 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Hereditary on the paternal side. 
 
 17 
 
 18 
 
 35 
 
 2 
 
 2 
 
 4 
 
 Hereditary on the maternal side .. 
 
 16 
 
 22 
 
 38 
 
 1 
 
 1 
 
 2 
 
 Hereditary on both paternal and maternal 
 sides . 
 
 3 
 
 2 
 
 5 
 
 
 1 
 
 1 
 
 Hereditary, whether on paternal or maternal 
 side not known . 
 
 29 
 
 35 
 
 64 
 
 3 
 
 1 
 
 4 
 
 Known to be hereditary.. 
 
 65 
 
 77 
 
 142 
 
 6 
 
 5 
 
 11 
 
 Not known or stated to be hereditary . . 
 
 133 
 
 140 
 
 273 
 
 19 
 
 24 
 
 43 
 
 Total. 
 
 198 
 
 217 
 
 415 
 
 25 
 
 29 
 
 54 
 
 Table 12. —Shewing the numbers of persons in whom causes of the 
 mental disorder were, and were not, known or assigned. 
 
 DESCRIPTION OF ASSIGNED CAUSES. 
 
 Society of Friends 
 and 
 
 connected with it. 
 
 Unconnected 
 with the 
 
 Society ofFriends. 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Predisposing and exciting causes both assigned 
 
 66 
 
 86 
 
 152 
 
 11 
 
 16 
 
 27 
 
 Predisposing causes only assigned . 
 
 58 
 
 58 
 
 116 
 
 5 
 
 5 
 
 10 
 
 Exciting causes only assigned . 
 
 56 
 
 48 
 
 104 
 
 7 
 
 7 
 
 14 
 
 Neither predisposing nor exciting causes 
 
 
 
 
 
 
 
 known. 
 
 18 
 
 25 
 
 43 
 
 2 
 
 1 
 
 3 
 
 Total. 
 
 198 
 
 217 
 
 415 
 
 25 
 
 29 
 
 54 
 
Table 13. —Shewing the predisposing causes op the disorder, so far 
 
 AS THESE WERE STATED OR COULD BE ASCERTAINED. 
 
 PREDISPOSING CAUSES. 
 
 Society of Friends 
 and 
 
 connected with it. 
 
 Unconnected 
 with the 
 
 Society of Friends. 
 
 
 Male. 
 
 , Fem, 
 
 . Total 
 
 Male 
 
 . Fem 
 
 . Total 
 
 Physical causes. 
 
 Hereditary tendency, the only predisposing 
 cause known . 
 
 31 
 
 39 
 
 70 
 
 1 
 
 1 
 
 2 
 
 Fright to the mother, followed or not by 
 premature birth. 
 
 2 
 
 1 
 
 3 
 
 
 1 
 
 1 
 
 Congenital weakness of mind in various 
 degrees . 
 
 24 
 
 26 
 
 50 
 
 2 
 
 
 2 
 
 Decided congenital peculiarity of mind . . 
 
 17 
 
 16 
 
 33 
 
 2 
 
 4 
 
 6 
 
 Extreme degrees of melancholic, or nervous 
 temperament . 
 
 4 
 
 4 
 
 8 
 
 1 
 
 1 
 
 2 
 
 Lactation by a parent strongly predisposed 
 
 1 
 
 2 
 
 3 
 
 . 
 
 
 
 Period of senility (average age at attack 72 
 years) . 
 
 2 
 
 4 
 
 6 
 
 
 
 
 Insufficient exercise, or the stooping posture 
 
 2 
 
 
 2 
 
 
 
 
 Fever . 
 
 2 
 
 1 
 
 3 
 
 
 
 
 Pickets . 
 
 
 1 
 
 1 
 
 
 
 
 Apoplexy and paralysis. 
 
 i 
 
 1 
 
 2 
 
 
 
 
 Epilepsy. 
 
 4 
 
 
 4 
 
 
 
 
 Blindness . 
 
 1 
 
 1 
 
 2 
 
 
 
 
 Chorea. 
 
 
 1 
 
 1 
 
 
 i 
 
 i 
 
 Hysteria.. 
 
 i 
 
 4 
 
 5 
 
 
 2 
 
 2 
 
 Hypochondriacal tendency. 
 
 2 
 
 1 
 
 3 
 
 
 . 
 
 
 Dyspepsia and other disorders of the 
 stomach, &c. 
 
 6 
 
 12 
 
 18 
 
 1 
 
 1 
 
 2 
 
 Gouty and rheumatic disorders. 
 
 . 
 
 2 
 
 2 
 
 
 1 
 
 1 
 
 Inj udicious blood letting ..• 
 
 . - 
 
 1 
 
 1 
 
 
 
 
 Spermatorrhoea . 
 
 1 
 
 
 1 
 
 
 
 
 Irregular and suppressed catamenia. 
 
 
 7 
 
 7 
 
 . 
 
 
 
 Intemperance and free living . 
 
 7 
 
 • 
 
 7 
 
 5 
 
 1 
 
 6 
 
 Total. 
 
 108 
 
 124 
 
 232 
 
 12 
 
 13 
 
 25 
 
 Moral causes. 
 
 Neglected or perverted education ; in three 
 cases very indulgent, in one very rigid. . 
 
 4 
 
 
 4 
 
 
 1 
 
 1 
 
 Ill-regulated temper and disposition .... 
 
 4 
 
 7 
 
 11 
 
 1 
 
 2 
 
 3 
 
 Solitary mode of life. 
 
 
 1 
 
 1 
 
 
 
 . 
 
 Mental disquietude from various causes . . 
 
 3 
 
 7 
 
 10 
 
 i 
 
 3 
 
 4 
 
 Political enthusiasm. 
 
 1 
 
 # 
 
 1 
 
 l 
 
 . 
 
 1 
 
 Excitement connected with religious hopes, 
 fears, or speculations. 
 
 4 
 
 5 
 
 9 
 
 l 
 
 2 
 
 3 
 
 Total. 
 
 16 
 
 20 
 
 36 
 
 4 
 
 8 
 
 12 
 
 No PREDISPOSING CAUSES KNOWN . 
 
 74 
 
 73 
 
 147 
 
 9 
 
 8 
 
 17 
 
 Total. 
 
 198 
 
 217 
 
 415 
 
 25 
 
 29 
 
 54 
 
Table 14.— Shewing the exciting causes of the disorder, so far as these 
 
 WERE STATED OR COULD BE ASCERTAINED. 
 
 EXCITING CAUSES. 
 
 Society of Friends 
 and 
 
 connected with it. 
 
 Unconnected 
 with the 
 
 Society of Friends. 
 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Physical causes. 
 
 Fevers and febrile diseases. 
 
 8 
 
 8 
 
 16 
 
 1 
 
 
 1 
 
 Mechanical injuries of the head ........ 
 
 7 
 
 3 
 
 10 
 
 1 
 
 
 1 
 
 Inflammation of the brain. 
 
 4 
 
 2 
 
 6 
 
 . 
 
 c 
 
 
 Apoplexy and paralysis. 
 
 3 
 
 2 
 
 5 
 
 1 
 
 . 
 
 1 
 
 Epilepsy. 
 
 6 
 
 6 
 
 12 
 
 
 
 
 Neuralgia and cephalalgia. 
 
 2 
 
 
 2 
 
 
 
 
 Hysteria. 
 
 
 3 
 
 3 
 
 
 
 
 Dyspeptic and hepatic disorders . 
 
 2 
 
 9 
 
 11 
 
 1 
 
 1 
 
 2 
 
 Masturbation... 
 
 4 
 
 
 4 
 
 2 
 
 . 
 
 2 
 
 Irregular or suppressed catamenia . 
 
 . 
 
 9 
 
 9 
 
 
 1 
 
 1 
 
 Puerperal disorders . 
 
 
 5 
 
 5 
 
 
 4 
 
 4 
 
 Protracted, or suddenly subsiding lactation 
 
 
 2 
 
 2 
 
 
 
 
 Checked perspiration. 
 
 1 
 
 2* 
 
 3 
 
 
 
 
 Suppressed eruptive disorders. 
 
 • 
 
 3 
 
 3 
 
 
 
 
 Suddenly subsiding diarrhoea . 
 
 1 
 
 
 1 
 
 
 
 
 Long continued ill health. 
 
 
 2 
 
 2 
 
 
 
 
 Loss of sleep from fractured arm. 
 
 
 1 
 
 1 
 
 
 
 
 Severe scald in infancy. 
 
 i 
 
 
 1 
 
 
 
 
 Injudicious use of mercury . 
 
 2 
 
 
 2 
 
 
 
 
 Intemperate use of alcoholic and fermented 
 liquors. 
 
 16 
 
 3 
 
 19 
 
 2 
 
 1 
 
 3 
 
 Intemperate use of opium with spirits.... 
 
 
 2 
 
 2 
 
 
 
 
 Generally dissolute and dissipated conduct 
 
 2 
 
 
 2 
 
 • 
 
 
 
 Total. 
 
 59 
 
 62 
 
 121 
 
 8 
 
 7 
 
 15 
 
 Moral causes. 
 
 Joy from elated anticipations .. 
 
 2 
 
 
 2 
 
 1 
 
 
 1 
 
 Fear or terror . 
 
 6 
 
 2 
 
 8 
 
 
 
 . 
 
 Sorrow from the death of near relatives . . 
 
 5 
 
 13 
 
 18 
 
 
 2 
 
 2 
 
 Unhappy conjugal connexions. 
 
 1 
 
 6 
 
 7 
 
 
 3 
 
 3 
 
 Distress from other domestic trials. 
 
 2 
 
 12 
 
 14 
 
 
 
 
 Anxiety respecting a livelihood, or pecu¬ 
 niary losses. 
 
 19 
 
 12 
 
 31 
 
 
 2 
 
 2 
 
 Anxiety as to the success of business .... 
 
 3 
 
 1 
 
 4 
 
 7 
 
 
 7 
 
 Anxiety from perplexing trusteeships and 
 other affairs . 
 
 5 
 
 
 5 
 
 
 
 
 Disappointed plans and hopes. 
 
 2 
 
 2 
 
 4 
 
 
 1 
 
 i 
 
 Disappointed affections. 
 
 8 
 
 14 
 
 22 
 
 l 
 
 7 
 
 8 
 
 Disappointed matrimonial plans . 
 
 4 
 
 3 
 
 7 
 
 
 
 
 Great changes in the mode of life . 
 
 
 2 
 
 2 
 
 
 
 
 Excessive mental exertion . 
 
 2 
 
 
 2 
 
 
 
 
 Long and anxious nursing of sick relatives 
 
 
 3 
 
 3 
 
 
 i 
 
 *1 
 
 Remorse. 
 
 i 
 
 
 1 
 
 l 
 
 
 1 
 
 Excitement connected with religious hopes, 
 fears, or speculations. . 
 
 3 
 
 2 
 
 5 
 
 
 
 
 Total. 
 
 63 
 
 72 
 
 135 
 
 10 
 
 16 
 
 26 
 
 No EXCITING CAUSES KNOWN. 
 
 76 
 
 83 
 
 159 
 
 7 
 
 6 
 
 13 
 
 Total. 
 
 198 
 
 217 
 
 415 
 
 25 
 
 29 
 
 54 
 
 B 
 
§ 4.— Of the forms of mental disorder , and the general results of treatment , 
 modified by form of disorder, duration , and age. 
 
 Table 15 .— Shewing the forms of mental disorder on first admission. 
 
 . 
 
 FORMS OF DISORDER. 
 
 Society of Friends 
 and 
 
 connected with it. 
 
 Unconnected 
 with the 
 
 Society of Friends. 
 
 
 Male. 
 
 Fern. 
 
 Total 
 
 Male. 
 
 Fern. 
 
 Total 
 
 Mania. 
 
 
 
 
 
 
 
 Mania.. 
 
 62 
 
 58 
 
 120 
 
 11 
 
 8 
 
 19 
 
 Remittent and intermittent mania . 
 
 7 
 
 9 
 
 16 
 
 3 
 
 1 
 
 4 
 
 Hysterical mania .. I 
 
 
 5 
 
 5 
 
 . 
 
 1 
 
 1 
 
 Mania alternating with melancholy; (mania 
 predominating) ... 
 
 11 
 
 8 
 
 19 
 
 * 
 
 4 
 
 4 
 
 Total........ 
 
 80 
 
 80 
 
 160 
 
 14 
 
 14 
 
 28 
 
 Melancholia. 
 
 Melancholy. 
 
 22 
 
 37 
 
 59 
 
 2 
 
 5 
 
 7 
 
 Suicidal melancholy *.. 
 
 13 
 
 24 
 
 37 
 
 
 3 
 
 3 
 
 Religious melancholy. 
 
 14 
 
 14 
 
 28 
 
 i 
 
 
 1 
 
 Religious and suicidal melancholy *. 
 
 5 
 
 9 
 
 14 
 
 
 
 . 
 
 Hypochondriacal melancholy. 
 
 3 
 
 2 
 
 5 
 
 , 
 
 
 
 Melancholy alternating with mania ; (melan- 
 
 
 
 
 
 
 
 choly predominating). 
 
 4 
 
 9 
 
 13 
 
 . 
 
 1 
 
 1 
 
 Apathetic insanity ... 
 
 5 
 
 1 
 
 6 
 
 
 
 
 Total. 
 
 66 
 
 96 
 
 162 
 
 3 
 
 9 
 
 12 
 
 Monomania, or partial insanity. 
 
 
 
 
 
 
 
 Monomania of suspicion and fear. 
 
 8 
 
 9 
 
 17 
 
 
 1 
 
 1 
 
 Monomania of religion . 
 
 6 
 
 3 
 
 9 
 
 
 1 
 
 1 
 
 Monomania of drunkenness. 
 
 
 3 
 
 3 
 
 
 
 
 Monomania of various forms—pride, vanity, 
 
 
 
 
 
 
 
 imagination, &c. 
 
 8 
 
 11 
 
 19 
 
 
 
 
 Moral insanity . 
 
 2 
 
 2 
 
 4 
 
 • 
 
 
 
 Total. 
 
 24 
 
 28 
 
 52 
 
 
 2 
 
 2 
 
 Dementia. 
 
 
 
 
 
 
 
 Incoherence and imbecility . 
 
 9 
 
 8 
 
 17 
 
 6 
 
 4 
 
 10 
 
 Confirmed dementia, or fatuity. 
 
 13 
 
 3 
 
 16 
 
 2 
 
 
 2 
 
 Total. 
 
 22 
 
 11 
 
 33 
 
 8 
 
 4 
 
 12 
 
 Idiotcy, &c. 
 
 Congenital idiotcy. 
 
 
 
 
 
 
 
 1 
 
 1 
 
 2 
 
 
 
 
 Congenital imbecility.. .. 
 
 2 
 
 1 
 
 3 
 
 • 
 
 
 
 Total. 
 
 3 
 
 2 
 
 5 
 
 
 . 
 
 
 Delirium, simulating insanity. 
 
 
 
 
 
 
 
 Delirium tremens . 
 
 1 
 
 . 
 
 1 
 
 
 . 
 
 , 
 
 Delirium of fever . 
 
 2 
 
 
 2 
 
 
 • 
 
 
 Total. 
 
 3 
 
 
 3 
 
 . 
 
 
 
 Total. 
 
 198 
 
 217 
 
 415 
 
 25 
 
 29 
 
 54 
 
 * * There were eight cases of Melancholy and Mania alternating with each other, three 
 of Mania, one of Monomania, and one of Dementia, making thirteen additional persons, in 
 whom a suicidal propensity also existed. 
 
Table 17. —Shewing the numbers of cases admitted, discharged, and remaining, with the mean numbers annually resident; 
 
 ARRANGED IN CLASSES ; SO AS TO EXHIBIT THE INFLUENCE OF DURATION OF DISORDER UPON THE PROPORTION OF RECOVERIES, 
 
 
 Of these five cases, two (one of each sex,) are decidedly incurable : the other three promise recovery, 
 t Of these recoveries, 31, (U males and 20 females,) occurred in cases of the first attack. 
 
Table 18. _Shewing the numbers of cases admitted, discharged, and remaining ; arranged in decennial periods of life, upon 
 
 ADMISSION ; SO AS TO EXHIBIT THE INFLUENCE OF AGE UPON THE PROPORTION OF RECOVERIES, DEATHS, AND OTHER RESULTS. 
 
 REMAINING 
 
 1840. 
 
 Total 
 
 CO <MI 
 
 rH 
 
 a> 
 
 CO 
 
 rH 
 
 VO 
 
 1- 
 
 Fem. 
 
 CO vo CO VO CO CO . . 
 
 r1 H i—< 
 
 52 
 
 05 
 
 43 
 
 Male. 
 
 (M NO H . . 
 
 rH »H 
 
 05 
 
 CO 
 
 *>• 
 
 cq 
 
 co 
 
 DISCHARGED. 
 
 Total. 
 
 Total 
 
 MICO.—iGOOqcavo^ 
 cq CM H 05 00 CD H 
 
 T—1 I—I 
 
 524 
 
 49 
 
 VO 
 
 a 
 
 <u 
 
 fin 
 
 NOON^HOCOcq 
 ^ ic o 
 
 281 
 
 24 
 
 257 
 
 Male. 
 
 lOiOCSCOHCJOM 
 r-H CO ^ ^ CO (Ml 
 
 243 
 
 VO 
 
 eq 
 
 00 
 
 rH 
 
 (Ml 
 
 Died. 
 
 Total 
 
 ^Q^OOOKOOCO 
 
 H (M M cq M 
 
 05 
 
 CO 
 
 CO 
 
 rH 
 
 co 
 
 cq 
 
 H 
 
 Fem. 
 
 cqooto h|oco(N 
 
 05 
 
 co 
 
 co 
 
 CO 
 
 CD 
 
 Male. 
 
 (MCiTHMiOCqiOH 
 
 T—H pH pH t-H 
 
 o 
 
 r- 
 
 63 
 
 Unimproved. 
 
 Total 
 
 HNOOOCONM . 
 
 29 
 
 rH 
 
 rH 
 
 OO 
 
 rH 
 
 § 
 
 & 
 
 . cq O (M CO H H . 
 
 OO 
 
 rH 
 
 oo 
 
 o 
 
 Male. 
 
 H .pH . CO pH . 
 
 rH 
 
 rH 
 
 CO 
 
 GO 
 
 Improved. 
 
 Total 
 
 pH i—1 rH r-H 
 
 KO 
 
 CO 
 
 o 
 
 VO 
 
 VO 
 
 a 
 
 O) 
 
 fei. 
 
 . pH 00 CO GO CO t-H . 
 
 24 
 
 th 
 
 20 
 
 Male. 
 
 (MCOONOOH . 
 r-H 
 
 rH 
 
 CO 
 
 VO 
 
 CO 
 
 Recovered. 
 
 Total 
 
 lOCOh-NQCOCOH 
 rH GO CO »0 CO (M 
 
 291 
 
 VO 
 
 t-H 
 
 276 
 
 Fem. 
 
 lO lO 00 tH Ci CO H . 
 
 CO CO (Ml H 
 
 o 
 
 rH 
 
 CO 
 
 164 
 
 Male 
 
 o oo Oi co o go cq H 
 
 rH CO cq (M rH 
 
 rH 
 
 <M 
 
 rH 
 
 05 
 
 rH 
 
 ADMITTED.* 
 
 Total 
 
 1>«5 O t^CO 
 
 N io co cq oo N h 
 
 H T-H T—1 
 
 615 
 
 VO 
 
 CO 
 
 o 
 
 VO 
 
 VO 
 
 Fem. 
 
 OCOIOOtHCOOIN 
 
 pH t- It- 
 
 CO 
 
 CO 
 
 CO 
 
 CO 
 
 CO 
 
 o 
 
 o 
 
 CO 
 
 <u 
 
 § 
 
 1>(NC50W005(M 
 i— 1 GO l O *0 CO CO 
 
 282 
 
 cq 
 
 CO 
 
 o 
 
 VO 
 
 oq 
 
 W 
 
 e 
 
 ■< 
 
 From 10 to 20 years .. . . 
 
 „ 20 to 30 „ .... 
 
 „ 30 to 40 „ .... 
 
 „ 40 to 50 „ .... 
 
 „ 50 to 60 „ .... 
 
 „ 60 to 70 „ 
 
 „ 70 to 80 „ .... 
 
 „ 80 to 90 „ 
 
 Total. 
 
 UNCONNECTED WITH THE SO¬ 
 
 CIETY OF FRIENDS. 
 
 SOCIETY OF FRIENDS AND CON 
 NECTED WITH IT . . . * . , . 
 
 The numbers given as admitted at the respective ages consist of the ages at first admission, (see table 9) with the ages of the re-admitted added. 
 
Table 19.—Shewing the actual and average duration of residence in all cases admitted into the institution. 
 
 REMAINING 1840. 
 
 Total 
 
 rH d 
 
 rH 
 
 05 
 
 Mean 
 
 12.49 
 
 Fern. 
 
 ^ ^ ^ NO ^ 10 CO 
 rH 
 
 d 
 
 d 
 
 01 
 
 Ph 
 
 12.88 
 
 Male. 
 
 rH 
 
 05 
 
 CO 
 
 Male. 
 
 11.16 
 
 DISCHARGED. 
 
 Total 
 
 Total 
 
 ^CKNCOCOtOCOOOCOCOCOH 
 
 »OOOJ>IOWCOCO'^(NH 
 
 d 
 
 *0 
 
 Mean 
 
 d 
 
 *o 
 
 CO 
 
 a 
 
 <w 
 
 COCOHCO(MNON»Oa5^ . 
 
 281 
 
 a 
 
 01 
 
 CH 
 
 99*8 
 
 Male. 
 
 HMHiOTHOOC5HHN(MH 
 
 COt)(CO(NCOHH(MH 
 
 243 
 
 i 
 
 Male. 
 
 t*- 3 
 
 CO 
 
 CO 
 
 Died. 
 
 13 
 
 o 
 
 H 
 
 ^NW>OOMtHhh0COh 
 
 rH rH HHH(N(NH 
 
 05 
 
 CO 
 
 rH 
 
 Mean 
 
 CO 
 
 GO 
 
 oo* 
 
 a 
 
 3 > 
 
 Fh 
 
 NMCOHlO(MOHCOO)^ . 
 
 rH r—! 
 
 1 
 
 05 
 
 CO 
 
 Fern. 
 
 10.01 
 
 Male. 
 
 rH rH 
 
 o 
 
 Male. 
 
 CD 
 
 1-1 
 
 Unimproved. 
 
 Total 
 
 CO ^ (N kO CO CU> H . . . 
 
 05 
 
 d 
 
 Mean 
 
 3.06 
 
 Fern. 
 
 .“ . d d nh CO d *0 . . . . 
 
 00 
 
 rH 
 
 Fern. 
 
 3.19 
 
 Male. 
 
 CO (M (M .rH . • d rH « . . 
 
 H 
 
 rH 
 
 Male. 
 
 CO 
 
 00 
 
 d 
 
 Improved. 
 
 Total 
 
 COXXO^COQOH . • • 
 
 rH rH 
 
 1-0 
 
 CD 
 
 Mean 
 
 2.25 
 
 Fern. 
 
 . d tH co co co d .... 
 
 tH 
 
 d 
 
 Fern. 
 
 2.05 
 
 Male. 
 
 CO^^JN^COCOrtlH . « . 
 
 rH 
 
 Male. 
 
 2.37 
 
 Recovered. 
 
 Total 
 
 rHdCOCON^COHCO . . . 
 
 CON^COIOHHH 
 
 291 
 
 Mean 
 
 1.32 
 
 Fern. 
 
 COd05W©C5>OC5d . . . 
 
 rH ^ d d CO 
 
 o 
 
 w 
 
 rH 
 
 Fern. 
 
 98*1 
 
 Male. 
 
 COOOHHUOOOIOH . • . 
 
 rH CO r—( rH d 
 
 rH 
 
 H 
 
 Male. 
 
 d 
 
 rH 
 
 ADMITTED. 
 
 Total 
 
 OCOr)<VO(MO^COH(MCOO 
 
 CO 0^*00 ^ H CO O d H 
 
 615 
 
 Mean 
 
 o 
 
 GO 
 
 hH 
 
 Fern. 
 
 NOOdCOOHCOHHHQCO 
 
 d'^^id^oddcocor-H 
 
 CO 
 
 CO 
 
 CO 
 
 Fem. 
 
 O 
 
 i—l 
 
 »o 
 
 Male. 
 
 COiOdNOOHdOH^d 
 
 W^MdMHdCOdH 
 
 282 
 
 Male. 
 
 hH 
 
 tH 
 
 DURATION OF RESIDENCE. 
 
 ai «2 
 
 6 ~ ~ ~ ~ : 
 
 ■a -&>.~ : 
 
 ° ^ 
 
 flCOOVd^COQOOOOH 
 rH H d CO ^ H 
 
 ^OOOOOOOOOOO r-i 
 
 ScOOCiHdNWOOOOO "o 
 
 nd rH d CO ^ 
 
 Ejj S s s s * = : S * s 
 
 pH 
 
 AVERAGE DURATION OF RESI¬ 
 
 DENCE—IN YEARS. 
 
Table 20.—Shewing the actual and average duration of residence in cases discharged, recovered, and admitted at 
 
 DIFFERENT PERIODS OF DISORDER. 
 
 DURATION OF DISORDER WHEN ADMITTED. 
 
 FOURTH CLASS. 
 
 First or not first 
 
 attack, more than 12 
 
 months, 
 
 Total 
 
 rH 
 
 d 
 
 Mean 
 
 05 
 
 Fern. 
 
 .«OCOCOOOMH(M(MH . 
 
 oo 
 
 d 
 
 Fem. 
 
 1.97 
 
 Male. 
 
 H rl N H *0 H (N . . rH . 
 
 rH 
 
 Male- 
 
 96T 
 
 THIRD CLASS. 
 
 Not first attack, 
 within 12 months. 
 
 Total 
 
 t^rHiOCDOU-COd-tfCOCO 
 
 H CO <M H d 
 
 rH 
 
 CO 
 
 rH 
 
 Mean 
 
 1-47 
 
 Fem. 
 
 OQOOOHCOlO . .C3(M(N 
 
 i—( r—H rH rH rH 
 
 d 
 
 00 
 
 Fem- 
 
 1.45 
 
 Male. 
 
 ncon^onncomhhh 
 
 1—1 
 
 C5 
 
 Male. 
 
 1.50 
 
 SECOND CLASS. 
 
 First attack, above 
 3, within 12 months 
 
 Total 
 
 O CO GO i— 1 CO . H d . . 
 
 1—1 r—l 
 
 42 
 
 Mean 
 
 1.23 
 
 Fem. 
 
 . CO (M O O . rH »—1 . . 
 
 rH 
 
 Fem. 
 
 1.54 
 
 Male. 
 
 T^I>»TH-rH>OrH . * rH 
 
 CO 
 
 d 
 
 Male. 
 
 0.98 
 
 FIRST CLASS. 
 
 First attack, and 
 within 3 months. 
 
 Total 
 
 H lO CO CO i— 1 Cl .rH . . 
 
 H(MH rH 
 
 76 
 
 Mean 
 
 CO 
 
 o 
 
 Fem. 
 
 CO O Q . rH . . . . 
 
 rH 
 
 rH 
 
 Fem. 
 
 0.73 
 
 Male. 
 
 CO C5 C5 ''fl rH rH .i—l . . 
 
 CO 
 
 Male. 
 
 »o 
 
 00 
 
 o 
 
 DISCHARGED 
 
 RECOVERED, 
 
 Total 
 
 (M 00 CO N 00 C5 1C CO 
 
 CON-^COlCH 
 
 291 
 
 Mean 
 
 1.32 
 
 a 
 
 <u 
 
 Pm 
 
 COCIC5(MCOC5(NCOCOCO(N 
 
 HTf<0<MCO 
 
 170 
 
 Fem. 
 
 CO 
 
 CO 
 
 Male. 
 
 COOO^HOCWM(NH 
 rH CO rH rH OI 
 
 121 
 
 Male. 
 
 d 
 
 DURATION OF RESIDENCE. 
 
 m XIX | 
 
 g ^ % . 
 
 o 
 
 flOONNCOTHLONOlO ! 
 
 »H iH i—1 r^ 
 
 ^oooooooooo if 
 
 ^COCOQHfMCO^iCNo ^ 
 
 s *"* 
 
 3 a ^ 
 
 fee o 
 <£j 
 
 g 
 
 AVERAGE DURATION OF 
 RESIDENCE—-IN YEARS. 
 
Table 21.—Shewing the average proportion of recoveries in the dif¬ 
 ferent FORMS OF MENTAL DISORDER. DEDUCED FROM TABLE 16. 
 
 FORM of disorder when 
 
 ADMITTED 
 
 Average of Recoveries 
 per cent, 
 annually resident. 
 
 Average of Recoveries 
 per cent. 
 
 of the Admissions. 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 Mania. 
 
 13.12 
 
 10.93 
 
 11.81 
 
 51.56 
 
 55.03 
 
 53.43 
 
 Melancholia. 
 
 20.57 
 
 16.09 
 
 17.48 
 
 51.19 
 
 57.24 
 
 54.88 
 
 Monomania. 
 
 2.62 
 
 5.13 
 
 3.84 
 
 24.14 
 
 37.14 
 
 31.25 
 
 Dementia. 
 
 0.38 
 
 
 0.21 
 
 3.12 
 
 
 2.08 
 
 Average. 
 
 9.64 
 
 9.99 
 
 9.84 
 
 42.91 
 
 51.05 
 
 47.31 
 
 Table 22.—Shewing the average proportion of recoveries in cases of 
 
 RECENT AND LONGER DURATION WHEN ADMITTED : DEDUCED FROM TABLE 17- 
 
 DURATION OF DISORDER WHEN 
 ADMITTED. 
 
 Average of Recoveries 
 per cent. 
 
 annually resident. 
 
 Average of Recoveries 
 per cent. 
 
 of the Admissions. 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 First class. —First attack 
 and within 3 months. 
 
 50.96 
 
 43.91 
 
 46.86 
 
 77.77 
 
 80.39 
 
 79.16 
 
 Second class.— First attack, 
 above 3, within 12 months.. 
 
 17.74 
 
 5.30 
 
 8.63 
 
 47.91 
 
 44.18 
 
 46.15 
 
 Third class.— Not first at¬ 
 tack, and within 12 months.. 
 
 22.88 
 
 28.44 
 
 26.07 
 
 56.97 
 
 65.60 
 
 62.08 
 
 Fourth class. —First or not 
 first attack, and more than 12 
 months. 
 
 1.65 
 
 2.90 
 
 2.32 
 
 13.59 
 
 24.56 
 
 19.35 
 
 Average. 
 
 9.64 
 
 9.99 
 
 9.84 
 
 42.91 
 
 51.05 
 
 47.31 
 
 Table 23.—Shewing the average proportion of recoveries at decennial 
 periods of life, deduced from TABLES 9 AND 18. 
 
 AGE. 
 
 Average of Recoveries 
 per cent. 
 
 annually Resident. 
 
 Average of Recoveries 
 per cent. 
 
 of the Admissions. 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 From 10 to 20 years. 
 
 41.31 
 
 24.68 
 
 33.75 
 
 58.82 
 
 50.00 
 
 55.55 
 
 „ 20 to 30 „ . 
 
 21.11 
 
 24.86 
 
 23.00 
 
 46.34 
 
 61.64 
 
 53.55 
 
 „ 30 to 40 „ . 
 
 10.63 
 
 11.51 
 
 11.11 
 
 49.15 
 
 50.66 
 
 50.00 
 
 „ 40 to 50 „ . 
 
 9.52 
 
 8.83 
 
 9.09 
 
 46.00 
 
 48.57 
 
 47.50 
 
 „ 50 to 60 ,, . 
 
 4.38 
 
 7.74 
 
 6.47 
 
 30.30 
 
 53.70 
 
 44.83 
 
 „ 60 to 70 „ . 
 
 5.00 
 
 6.71 
 
 6.07 
 
 26.66 
 
 41.86 
 
 35.61 
 
 „ 70 to 80 „ . 
 
 1.84 
 
 0.88 
 
 1.35 
 
 22.22 
 
 16.66 
 
 20.00 
 
 „ 80 to 90 „ . 
 
 3.95 
 
 
 1.75 
 
 50.00 
 
 • 
 
 25.00 
 
 Average. 
 
 9.64 
 
 9.99 
 
 9.84 1 
 
 42.91 
 
 51.05 1 
 
 47.31 
 
 Average of recoveries in those only 
 
 WHO WERE OF 
 
 
 
 
 the Society of Friends or connected 
 
 » WITH IT. 
 
 44.80 
 
 54.66 
 
 50.18 
 
§ 6.— Of the readmissions , and history subsequent to discharge . 
 
 * Table 24.—Shewing the numbers of Persons and Cases readmitted. 
 
 , READMISSIONS. 
 
 Society of Friends 
 and 
 
 connected with it. 
 
 Unconnected 
 with the 
 
 Society of Friends. 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Admitted twice . 
 
 31 
 
 29 
 
 60 
 
 7 
 
 4 
 
 11 
 
 Ditto three times. 
 
 9 
 
 8 
 
 17 
 
 
 
 
 Ditto four times . 
 
 1 
 
 4 
 
 5 
 
 
 , 
 
 
 Ditto five times . 
 
 
 2 
 
 2 
 
 
 
 
 Ditto ten times . 
 
 
 2 
 
 2 
 
 
 
 
 Total number of persons readmitted .... 
 
 41 
 
 45 
 
 86 
 
 7 
 
 4 
 
 11 
 
 Total number of cases readmitted .... 
 
 52 
 
 83 
 
 135 
 
 7 
 
 4 
 
 11 
 
 Table 25.—Shewing the numbers of persons readmitted, with the 
 
 DURATION OF DISORDER WHEN FIRST ADMITTED, DISTINGUISHING THOSE WHO 
 HAD BEEN DISCHARGED RECOVERED. 
 
 DURATION OF ATTACK WHEN FIRST ADMITTED. 
 
 Had been 
 
 discharged 
 
 recovered 
 
 Had been 
 discharged not 
 recovered. 
 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Male. 
 
 Fem. 
 
 Total 
 
 First class. —First attack, and within three 
 
 
 
 
 
 
 
 months . 
 
 11 
 
 16 
 
 27 
 
 
 1 
 
 1 
 
 Second class. —First attack, above three 
 
 
 
 
 and within twelve months. 
 
 6 
 
 8 
 
 14 
 
 5 
 
 
 5 
 
 Third class.— Not first attack, and within 
 
 
 
 
 
 
 twelve months. 
 
 15 
 
 10 
 
 25 
 
 
 6 
 
 6 
 
 C First attack, and more than 
 
 
 
 -n j twelve months. 
 
 2 
 
 4 
 
 6 
 
 7 
 
 2 
 
 9 
 
 Fourth class. -< AT , 
 
 j Not first attack, and more 
 
 
 
 
 
 
 
 (_ than twelve months . . 
 
 1 
 
 2 
 
 3 
 
 1 
 
 
 1 
 
 Total. 
 
 35 
 
 40 
 
 75 
 
 13 
 
 9 
 
 22 
 
 
 
 Table 26.—Shewing the length of time after previous discharge, 
 
 WHICH HAD ELAPSED WHEN THE Cases WERE READMITTED. 
 
 CASES READMITTED, WITH THE LENGTH OF TIME 
 AFTER DISCHARGE. 
 
 Society of Friends 
 and 
 
 connected with it. 
 
 Unconnected 
 with the 
 
 Society of Friends. 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Male 
 
 Fem. 
 
 Total 
 
 Under 3 months. 
 
 10 
 
 10 
 
 20 
 
 1 
 
 1 
 
 2 
 
 From 3 to 6 months . 
 
 6 
 
 8 
 
 14 
 
 
 
 
 6 to 12 „ . 
 
 4 
 
 8 
 
 12 
 
 4 
 
 2 
 
 6 
 
 „ 1 to 2 years . 
 
 4 
 
 15 
 
 19 
 
 
 1 
 
 1 
 
 » 2 to 5 „ . 
 
 10 
 
 17 
 
 27 
 
 2 
 
 
 2 
 
 „ 5 to 10 „ . 
 
 8 
 
 12 
 
 20 
 
 
 
 
 ,, 10 to 20 „ . 
 
 8 
 
 10 
 
 18 
 
 
 
 
 „ 20 to 25 ,, . 
 
 2 
 
 3 
 
 5 
 
 
 
 
 Total. 
 
 52 
 
 83 
 
 135 
 
 7 
 
 4 
 
 11 
 
GUISHING THE STATE AS TO RECOVERY OR OTHERWISE WHEN PREVIOUSLY DISCHARGED. 
 
 S3 
 
 w 
 
 •a 
 
 73 05 ^ 
 
 £ 
 
 Total 
 
 05 H CO 
 
 r-H 
 
 CO 
 
 rH 
 
 a 
 
 'ONrJ 
 
 !>. 
 
 0) 
 
 
 GO 
 
 <0 
 
 CO (N 
 
 Ci 
 
 <5 
 
 ^ r-l 
 
 »o 
 
 o ~ 
 
 s-i p 
 
 > rv 
 
 2 S 
 
 CX,.r-t 
 
 a> p 
 
 P h-i 
 
 - '*3 
 P 
 
Of the history subsequent to discharge. 
 
 x 
 
 3 w 
 
 O w 
 
 pq PH 
 
 *a 
 
 to ^ 
 *< rt 
 
 P5 W 
 
 W 3 
 W H 
 H w 
 
 S W 
 
 W e3 
 
 rh H 
 
 3 * 
 
 ^ £ 
 
 P5 w 
 
 5 2 
 w a 
 
 H g 
 H W 
 
 « a 
 
 o H 
 
 g a 
 
 TO O 
 
 u S 
 
 r o 
 X pi 
 o pq 
 
 w a 
 
 LIVING, 1840. 
 
 Not recovered or 
 
 relapsed. 
 
 Total 
 
 . rH CM tH CM . 
 
 CO 
 
 rH 
 
 C5 
 
 CM 
 
 CM 
 
 Fern. 
 
 .HHIMH . 
 
 to 
 
 CM 
 
 to 
 
 <M 
 
 rH 
 
 Male 
 
 . • H (M rH . 
 
 rH 
 
 <M 
 
 rH 
 
 o 
 
 rH 
 
 Eetaining traces 
 of disorder. 
 
 Total 
 
 H (M CO CO . 
 
 CO 
 
 rH 
 
 rH 
 
 CM 
 
 o 
 
 CO 
 
 Fern 
 
 . rH <M rH rH . 
 
 to 
 
 <M 
 
 rH 
 
 00 
 
 Male. 
 
 rl H <M <M <M . 
 
 00 
 
 CO 
 
 rH 
 
 rH 
 
 22 
 
 Kecovery 
 
 permanent. 
 
 Total 
 
 HHIMH 
 
 00 
 
 4^ 
 
 rH 
 
 
 <M 
 
 CO 
 
 Fern. 
 
 HcqNCDOON 
 
 rH 
 
 41 
 
 <M 
 
 • 
 
 43 
 
 Male. 
 
 HiCO^CO(M 
 
 H 
 
 4^ 
 
 CO 
 
 CM 
 
 
 05 
 
 CO 
 
 NOT LIVING, 1840. 
 
 Not recovered or 
 relapsed. 
 
 Total 
 
 . , CO CO (M . 
 
 00 
 
 CO 
 
 00 
 
 rH 
 
 Male.j Fem. 
 
 . O H CM H . 
 
 rH 
 
 rH 
 
 4^ 
 
 (M 
 
 rH 
 
 3 .(MHH . 
 
 rH 
 
 <M 
 
 rH 
 
 4- 
 
 Eetaining traces 
 of disorder. 
 
 Total 
 
 hhimcohn 
 
 o 
 
 rH 
 
 CO 
 
 rH 
 
 27 
 
 Fem. 
 
 . rH <M CM . rH 
 
 co 
 
 4^- 
 
 rH 
 
 rH 
 
 ’ 
 
 Male. 
 
 rH . . rH rH rH 
 
 rH 
 
 CO 
 
 CO 
 
 CO 
 
 rH 
 
 
 Eecovery 
 
 permanent. 
 
 Total 
 
 HIMOOOCOIO 
 
 CM rH 
 
 rH 
 
 to 
 
 to 
 
 * 
 
 05 
 
 to 
 
 Fem. 
 
 rH 
 
 CO 
 
 CO 
 
 CO 
 
 
 CO 
 
 CO 
 
 jMale. 
 
 H05(MO(MH 
 
 rH 
 
 <M 
 
 <M 
 
 • 
 
 23 
 
 DISCHARGED. 
 
 Total 
 
 IOCOU5COOCD 
 
 CO CO H 
 
 CM 
 
 4>- 
 
 44 
 
 23 
 
 239 
 
 Fem. 
 
 HCOQN1XN 
 
 (MHHHH 
 
 rH 
 
 05 
 
 4^ 
 
 rH 
 
 rH 
 
 125 
 
 Male. 
 
 H lO O CO ^ 
 
 HHIMH 
 
 00 
 
 1- 
 
 27 
 
 C5 
 
 rH 
 
 rH 
 
 CONDITION AT, AND LENGTH OF TIME SINCE, 
 LAST DISCHARGE. 
 
 Recovered, under 1 year* 
 
 „ from 1 to 5 years 
 
 „ » 5 to 10 „ 
 
 „ „ 10 to 20 „ 
 
 „ „ 20 to 30 „ 
 
 j> jj 00 to 44 ,) 
 
 Total. 
 
 Improved, from 1 to 26 years .. 
 
 Unimproved, from 1 to 23 years 
 
 Total. 
 
 1 
 
 nr 
 
 •aaoHVHOSia 
 
 
 * The length of time since discharge, is calculated to Midsummer, 1840, if living j or otherwise to the period of death. 
 
§ 7.— Of the deaths , and average mortality. 
 
 Table 30. —Shewing the actual and average duration of residence in 
 
 THE INSTITUTION AT THE TIME OF DEATH. 
 
 DURATION of residence. 
 
 Society of Friends 
 and 
 
 connected with it. 
 
 Unconnected 
 with the 
 
 Society of Friends. 
 
 Male. 
 
 Fem. 
 
 Total. 
 
 Male. 
 
 Fem. 
 
 Total. 
 
 Under 3 months. 
 
 6 
 
 7 
 
 13 
 
 1 
 
 
 1 
 
 From 3 to 12 months . 
 
 14 
 
 7 
 
 21 
 
 1 
 
 2 
 
 3 
 
 „ 1 to 2 years. 
 
 4 
 
 4 
 
 8 
 
 1 
 
 1 
 
 2 
 
 „ 2 to 5 „ . 
 
 12 
 
 9 
 
 21 
 
 3 
 
 2 
 
 5 
 
 „ 5 to 10 „ . 
 
 9 
 
 10 
 
 19 
 
 1 
 
 1 
 
 2 
 
 „ 10 to 20 „ . 
 
 8 
 
 13 
 
 21 
 
 . 
 
 
 
 „ 20 to 30 „ . 
 
 7 
 
 9 
 
 16 
 
 
 
 
 „ 30 to 40 „ . 
 
 2 
 
 4 
 
 6 
 
 
 
 
 „ 40 to 44 ,, . 
 
 1 
 
 
 1 
 
 
 
 
 Total. 
 
 63 
 
 63 
 
 126 
 
 7 
 
 6 
 
 13 
 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 AVERAGE DURATION OF RESIDENCE. 
 
 8.22 
 
 10.65 
 
 9.44 
 
 2.69 
 
 3.23 
 
 2.94 
 
 Table 31. —Shewing the duration of disorder at the time of death. 
 
 duration of disorder. 
 
 Society of Friends 
 and 
 
 connected with it. 
 
 Unconnected 
 with the 
 
 Society of Friends. 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Male. 
 
 Fem 
 
 Total 
 
 Under 3 months. 
 
 2 
 
 
 2 
 
 
 
 
 From 3 to 12 months . 
 
 5 
 
 3 
 
 8 
 
 
 
 
 „ 1 to 2 years . 
 
 3 
 
 4 
 
 7 
 
 
 
 . 
 
 „ 2 to 5 „ .. 
 
 9 
 
 6 
 
 15 
 
 3 
 
 *3 
 
 6 
 
 „ 5 to 10 „ . 
 
 11 
 
 7 
 
 18 
 
 2 
 
 1 
 
 3 
 
 „ 10 to 20 „ . 
 
 11 
 
 17 
 
 28 
 
 1 
 
 2 
 
 3 
 
 „ 20 to 30 „ . 
 
 8 
 
 13 
 
 21 
 
 . 
 
 
 . 
 
 „ 30 to 40 „ . 
 
 6 
 
 11 
 
 17 
 
 
 
 
 „ 40 to 50 „ . 
 
 4 
 
 2 
 
 6 
 
 i 
 
 
 i 
 
 „ 50 to 60 „ . 
 
 4 
 
 
 4 
 
 
 . 
 
 
 Total. 
 
 63~~ 
 
 63 
 
 126 
 
 7 
 
 6 
 
 13 
 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 average duration of disorder. 
 
 16.74 
 
 17.89 
 
 17.31 
 
 TT75 
 
 6.83 
 
 9.34 
 
 Table 32. —Shewing the actual and average ages of those who have died 
 in the institution. 1796—1840. 
 
 AGE. 
 
 Society of Friends 
 and 
 
 connected with it. 
 
 Unconnected 
 with the 
 
 Society of Friends. 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Male 
 
 Fem. 
 
 Total 
 
 From 20 to 30 y 
 
 ears. 
 
 7 
 
 4 
 
 11 
 
 1 
 
 1 
 
 2 
 
 „ 30 to 40 
 
 ff . 
 
 9 
 
 5 
 
 14 
 
 1 
 
 2 
 
 3 
 
 „ 40 to 50 
 
 >> . 
 
 7 
 
 12 
 
 19 
 
 2 
 
 
 2 
 
 „ 50 to 60 
 
 >» . 
 
 14 
 
 11 
 
 25 
 
 1 
 
 1 
 
 2 
 
 „ 60 to 70 
 
 i* . 
 
 10 
 
 14 
 
 24 
 
 1 
 
 2 
 
 3 
 
 „ 70 to 80 
 
 >> . 
 
 9 
 
 10 
 
 19 
 
 
 
 
 ,, 80 to 90 
 
 it . 
 
 6 
 
 7 
 
 13 
 
 1 
 
 
 i 
 
 „ 90 to 97 
 
 tt . 
 
 1 
 
 
 1 
 
 
 
 
 Total. 
 
 63 f 63 
 
 ~126 
 
 7 
 
 6 
 
 13 
 
 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 MaleT 
 
 ~Fem. 
 
 Mean 
 
 AVERAGE AGE AT 
 
 DEATH. ! 
 
 54.8 
 
 58.1 
 
 56 5 
 
 1 49.0 
 
 46.3 
 
 ~ivr 
 
Table 33.— Shewing the average mortality in the different forms of 
 
 MENTAL DISORDER. DEDUCED FROM TABLE 16. 
 
 FORM OF DISORDER WHEN ADMITTED. 
 
 Average of Deaths 
 per cent. 
 
 of the Admissions. 
 
 Mean Mortality 
 per cent, 
 annually resident. 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 Mania. 
 
 17.18 
 
 18.79 
 
 18.05 
 
 4.37 
 
 3.73 
 
 3.99 
 
 Melancholia. 
 
 22.61 
 
 21.37 
 
 21.86 
 
 9.09 
 
 6.11 
 
 6.96 
 
 Monomania'. 
 
 31.03 
 
 25.71 
 
 28.12 
 
 3.37 
 
 3.55 
 
 3.46 
 
 Dementia. 
 
 53.12 
 
 25.00 
 
 43.75 
 
 6.58 
 
 1.87 
 
 4.45 
 
 Idiotcy. 
 
 33.33 
 
 
 20.00 
 
 6.31 
 
 
 2.87 
 
 Average. 
 
 24.82 
 
 20.72 
 
 22.60 
 
 5.58 
 
 4.05 
 
 4.70 
 
 Table 34.—Shewing the average mortality in cases of recent and 
 
 LONGER DURATION WHEN ADMITTED. DEDUCED FROM TABLE 17. 
 
 DURATION OF DISORDER WHEN 
 
 ADMITTED. 
 
 Average of Deaths 
 per cent. 
 
 of the Admissions. 
 
 Mean Mortality 
 per cent. 
 
 annually Itesident. 
 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 First class.— First attack, and 
 within three months . 
 
 11.11 
 
 9.80 
 
 10.41 
 
 7.33 
 
 5.36 
 
 6.19 
 
 Second class.— First attack, 
 above three, within twelve 
 months . 
 
 14.58 
 
 27.90 
 
 20.87 
 
 5.43 
 
 3.35 
 
 3.90 
 
 Third class.— Not first attack 
 within twelve months. 
 
 17.44 
 
 11.20 
 
 13.74 
 
 7.02 
 
 4.86 
 
 5.78 
 
 Fourth class.— First or not 
 first attack, more than twelve 
 months . 
 
 41.74 
 
 33.33 
 
 37.33 
 
 5.09 
 
 3.94 
 
 4.48 
 
 Average. 
 
 24.82 
 
 20.72 
 
 22.60 
 
 5.58 
 
 4.05 
 
 4.70 
 
 Table 35.—Shewing the average mortality at decennial periods of life. 
 DEDUCED FROM TABLES 9, 18, AND 32. 
 
 AGE. 
 
 Average of Deaths 
 per cent. 
 
 of the Admissions. 
 
 Mean Mortality 
 per cent. 
 
 annually resident. 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 Male, 
 
 Fern. 
 
 Mean 
 
 From 10 to 20 years. 
 
 11.76 
 
 20.00 
 
 14.81 
 
 
 
 
 „ 20 to 30 „ . 
 
 10.97 
 
 13.69 
 
 12.25 
 
 4.44 
 
 2.76 
 
 3.60 
 
 ,, 30 to 40 ,, . 
 
 23.72 
 
 13.33 
 
 17.91 
 
 3.66 
 
 2.12 
 
 2.82 
 
 „ 40 to 50 ,, . 
 
 24.00 
 
 22.85 
 
 23.33 
 
 3.72 
 
 3.11 
 
 3.35 
 
 ,, 50 to 60 ,, . 
 
 45.45 
 
 20.37 
 
 29.88 
 
 
 3.20 
 
 4.48 
 
 „ 60 to 70 „ . 
 
 40.00 
 
 34.88 
 
 36.98 
 
 6.88 
 
 5.97 
 
 6.33 
 
 „ 70 to 80 „ . 
 
 55.55 
 
 50.00 
 
 53.33 
 
 8.31 
 
 8.87 
 
 8.60 
 
 ,, 80 to 90 ,: . 
 
 50.00 
 
 100.00 
 
 75.00 
 
 20.66 
 
 23.74 
 
 22.09 
 
 „ 90 to 97 „ . 
 
 
 
 
 17.48 
 
 
 17.48 
 
 Average. 
 
 24.82 
 
 20.72 
 
 22.60 
 
 5.58 
 
 4.05 
 
 4.70 
 
 MEAN MORTALITY IN THOSE ONLY WHO WERE OF THE SOCIETY 
 
 
 
 
 of Friends or connected with it . . .. 
 
 
 
 5.39 
 
 3.99 
 
 4.59 
 
 
Table 36. —Shewing the diseases which proved fatal in the institution. 
 
 causes of death. 
 
 Society of Friends 
 and 
 
 connected with it. 
 
 Unconnected 
 with the 
 
 Society of Friends. 
 
 
 Male. 
 
 Fem. 
 
 Total 
 
 1 Male, 
 
 . Fem, 
 
 . Total 
 
 Diarrhoea. 
 
 1 
 
 
 1 
 
 1 
 
 
 1 
 
 Dysentery . 
 
 
 i 
 
 1 
 
 
 Influenza, of 1836-7 . 
 
 
 1 
 
 
 
 
 
 ,, with pneumonia 
 
 „ with diseased heart .. 
 
 Fever . 
 
 3 
 
 2 
 
 2 
 
 ^5 
 J 3 
 
 
 
 
 Erysipelas . 
 
 
 i 
 
 1 
 
 
 
 
 
 
 
 
 
 
 
 Epidemic and contagious diseases. Total 
 
 4 
 
 7 
 
 11 
 
 1 
 
 
 1 
 
 Apoplexy . 
 
 5 
 
 6 
 
 11 
 
 4 
 
 1 
 
 5 
 
 Paralysis. 
 
 1 
 
 
 1 
 
 1 
 
 1 
 
 Epilepsy. 
 
 3 
 
 2 
 
 5 
 
 
 1 
 
 1 
 
 Disease of brain. 
 
 2 
 
 1 
 
 3 
 
 
 
 
 
 
 
 
 
 
 Diseases of the brain and nervous 
 system. Total 
 
 11 
 
 9 
 
 20 
 
 5 
 
 2 
 
 7 
 
 Pleurisy . 
 
 1 
 
 
 1 
 
 
 
 
 Pneumonia. 
 
 6 
 
 
 6 
 
 
 
 
 Hydrothorax . 
 
 1 
 
 1 
 
 2 
 
 * 
 
 
 
 Asthma . 
 
 3 
 
 1 
 
 4 
 
 
 1 
 
 1 
 
 Consumption . 
 
 6 
 
 11 
 
 17 
 
 1 
 
 2 
 
 3 
 
 
 
 
 
 Diseases of the lungs and other organs 
 of respiration. Total 
 
 17 
 
 13 
 
 30 
 
 1 
 
 3 
 
 4 
 
 Diseases of the heart. Total 
 
 7 
 
 2 
 
 9 
 
 
 
 
 Gastritis. 
 
 1 
 
 4 
 
 5 
 
 
 
 
 Enteritis. 
 
 2 
 
 1 
 
 3 
 
 
 
 
 Peritonitis . 
 
 
 1 
 
 1 
 
 
 
 
 Ulceration of bowels. 
 
 i 
 
 l 
 
 1 
 
 1 
 
 2 
 
 
 
 
 Hernia. 
 
 2 
 
 
 
 
 Haemorrhage from stomach . 
 
 i 
 
 
 1 
 
 
 
 
 Cancer of stomach . 
 
 
 1 
 
 
 * 
 
 
 
 Cancer of colon, with faecal abscess. 
 
 
 x 
 
 i 2 
 
 
 
 
 Jaundice. 
 
 2 
 
 1 
 
 3 
 
 
 
 
 Abscess of liver . 
 
 
 1 
 
 1 
 
 
 
 
 
 * 
 
 
 
 
 
 
 Diseases of the stomach and other 
 
 ORGANS OF^DIGESTION . Total 
 
 8 
 
 12 
 
 20 
 
 
 
 
 Disease of the kidneys. Chronic nephritis 
 
 
 
 
 
 1 
 
 1 
 
 Disease of the uterus. Menorrhagia . . . 
 
 
 1 
 
 1 
 
 
 
 
 Dropsy.. 
 
 2 
 
 1 
 
 3 
 
 
 
 
 Abscess . 
 
 1 
 
 1 
 
 2 
 
 
 
 
 Mortification . 
 
 1 
 
 3 
 
 4 
 
 5 
 
 
 
 
 Atrophy . 
 
 3 
 
 6 
 
 
 
 
 Exhaustion (in two cases from travelling 
 to the Retreat) . 
 
 1 
 
 2 
 
 3 
 
 
 
 
 
 
 
 
 
 
 
 Diseases of various seats. Total 
 
 8 
 
 11 
 
 19 
 
 
 
 
 Old age, or natural decay (average age 79f) 
 
 3 
 
 8 
 
 11 
 
 
 
 
 Deaths by violence. Suicidal suspension. . 
 
 5 
 
 
 5 
 
 
 
 
 Total 
 
 63 
 
 63 
 
 126 
 
 7 
 
 6 
 
 13 
 
Table 37.— Shewing some of the diseases which have proved fatal to 
 
 THOSE WHO HAVE DIED SINCE THEIR DISCHARGE. 
 
 CAUSES OF DEATH. 
 
 Remaining 
 more or less 
 disordered. 
 
 Recovery 
 
 permanent. 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Diarrhoea. 
 
 1 
 
 1 
 
 2 
 
 
 
 
 Spasmodic cholera. 
 
 
 
 
 1 
 
 
 i 
 
 Fever . 
 
 
 i 
 
 1 
 
 2 
 
 
 2 
 
 Apoplexy. 
 
 i 
 
 1 
 
 2 
 
 
 3 
 
 3 
 
 Paralysis. 
 
 
 2 
 
 2 
 
 
 
 
 Inflammation of lungs . 
 
 
 1 
 
 1 
 
 
 
 
 Consumption . 
 
 2 
 
 1 
 
 3 
 
 2 
 
 2 
 
 4 
 
 Diseased heart ... 
 
 1 
 
 
 1 
 
 
 
 
 Diabetes. 
 
 1 
 
 
 1 
 
 
 
 
 Parturition. 
 
 
 
 
 
 1 
 
 1 
 
 Paramenia . 
 
 
 
 
 
 1 
 
 1 
 
 Cancer of the mammary gland. 
 
 . 
 
 
 
 
 1 
 
 1 
 
 Dropsy. 
 
 
 
 
 
 1 
 
 1 
 
 Suicide. 
 
 2 
 
 i 
 
 3 
 
 
 
 
 Homicide by an insane person. 
 
 1 
 
 
 1 
 
 
 
 
 Drowned accidentally. 
 
 1 
 
 
 1 
 
 i 
 
 
 i 
 
 Causes of death known. 
 
 10 
 
 8 
 
 18 
 
 6 
 
 9 
 
 15 
 
 Causes of death unknown. 
 
 10 
 
 18 
 
 28 
 
 17 
 
 27 
 
 44 
 
 Total. 
 
 20 
 
 26 
 
 46 
 
 23 
 
 36 
 
 59 
 
 Table 38. —Shewing the actual and average ages of those who have 
 
 DIED SINCE THEIR DISCHARGE FROM THE INSTITUTION J AND LIKEWISE THE 
 AVERAGE AGE AT THE FIRST ATTACK OF DISORDER. 
 
 AGE. 
 
 Remaining 
 more or less 
 disordered. 
 
 Recovery 
 
 permanent. 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Male. 
 
 Fem. 
 
 Total 
 
 From 20 to 30 years. 
 
 2 
 
 1 
 
 3 
 
 1 
 
 1 
 
 2 
 
 „ 30 to 40 „ . 
 
 3 
 
 1 
 
 4 
 
 3 
 
 4 
 
 7 
 
 ,, 40 to 50 „ . 
 
 4 
 
 5 
 
 9 
 
 4 
 
 8 
 
 12 
 
 „ 50 to 60 „ . 
 
 3 
 
 5 
 
 8 
 
 8 
 
 3 
 
 11 
 
 „ 60 to 70 „ . 
 
 3 
 
 5 
 
 8 
 
 2 
 
 8 
 
 10 
 
 „ 70 to 80 „ . 
 
 3 
 
 7 
 
 10 
 
 3 
 
 10 
 
 13 
 
 „ 80 to 89 „ . 
 
 2 
 
 2 
 
 4 
 
 2 
 
 2 
 
 4 
 
 Total. 
 
 20 
 
 26 
 
 46 
 
 23 
 
 36 
 
 59 
 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 AVERAGE AGE AT DEATH , . . 
 
 54. 
 
 60.4 
 
 57.6 
 
 55. 
 
 58.6 
 
 57.2 
 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 AVERAGE AGE AT FIRST ATTACK. 
 
 32.9 
 
 38.1 
 
 35.8 
 
 40.2 
 
 39.8 
 
 40.0 
 
Table 39.—Shewing the forms of mental disorder upon admission, with the changes that had taken place in them at 
 
§ 8 .— Of the cases remaining under care . 
 
 Table 40.— Shewing the duration of residence of those remaining in 
 
 THE INSTITUTION, MIDSUMMER, 1840. 
 
 duration of residence. 
 
 • 
 
 Society of Friends 
 and 
 
 connected with it. 
 
 Unconnected 
 with the 
 
 Society of Friends. 
 
 Male. 
 
 Fern. 
 
 Total. 
 
 Male. 
 
 Fem. 
 
 Total. 
 
 Under 3 months. 
 
 
 3 
 
 3 — 
 
 2 
 
 1 
 
 3 
 
 From 
 
 3 to 12 months . 
 
 4 
 
 2 
 
 6 
 
 1 
 
 1 
 
 2 
 
 
 1 to 2 years. 
 
 2 
 
 3 
 
 5 
 
 . 
 
 1 
 
 1 
 
 
 2 to 5 „ . 
 
 1 
 
 7 
 
 8 
 
 2 
 
 1 
 
 3 
 
 ” 
 
 5 to 10 „ . 
 
 10 
 
 5 
 
 15 
 
 1 
 
 2 
 
 3 
 
 
 10 to 20 „ . 
 
 8 
 
 13 
 
 21 
 
 1 
 
 3 
 
 4 
 
 
 20 to 30 „ . 
 
 4 
 
 2 
 
 6 
 
 
 
 
 ■ 
 
 30 to 40 „ . 
 
 2 
 
 5 
 
 7 
 
 
 
 . 
 
 it 
 
 40 to 43 „ . 
 
 1 
 
 3 
 
 4 
 
 
 
 
 
 Total. 
 
 32 
 
 43 
 
 75 
 
 7 
 
 9 
 
 16 
 
 Table 41.— Shewing the duration of disorder when admitted, and the 
 
 PROBABILITY OF RECOVERY OF THOSE REMAINING IN THE INSTITUTION, MID¬ 
 SUMMER, 1840. 
 
 DURATION of disorder when 
 admitted. 
 
 More or less hope of 
 recovery. 
 
 Little or no hope of 
 recovery. 
 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Male. 
 
 Fem. 
 
 Total 
 
 First class. — First attack, and 
 within three months . 
 
 1 
 
 2 
 
 3 
 
 1 
 
 1 
 
 2 
 
 Second class. — First attack, 
 above three, within twelve 
 months . 
 
 3 
 
 2 
 
 5 
 
 4 
 
 8 
 
 12 
 
 Third class. — Not first attack 
 within twelve months. 
 
 5 
 
 8 
 
 13 
 
 3 
 
 3 
 
 6 
 
 Fourth class. —First or not 
 first attack, more than twelve 
 months . 
 
 4 
 
 3 
 
 7 
 
 18 
 
 25 
 
 43 
 
 Total. 
 
 13 
 
 15 
 
 28* 
 
 26 
 
 37 
 
 63 
 
 ^Recovery does not appear^ robable in more than half this number,or in 6 males and 8 females. 
 
 Table 42. —Shewing the actual and average ages of those remaining 
 IN THE INSTITUTION, MIDSUMMER, 1840. 
 
 
 AGE, 
 
 1840. 
 
 Society of Friends 
 and 
 
 connected with it. 
 
 Unconnected 
 with the 
 
 Society of Friends. 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Male 
 
 Fem. 
 
 Total 
 
 From 10 to 20 years . 
 
 
 
 
 
 1 
 
 1 
 
 ) f 
 
 20 to 30 
 
 ff . 
 
 5 
 
 6 
 
 11 
 
 i 
 
 
 1 
 
 it 
 
 30 to 40 
 
 ff . 
 
 6 
 
 8 
 
 14 
 
 4 
 
 i 
 
 5 
 
 ff 
 
 40 to 50 
 
 ff . 
 
 9 
 
 8 
 
 17 
 
 2 
 
 4 
 
 6 
 
 tf 
 
 50 to 60 
 
 ff . 
 
 6 
 
 6 
 
 12 
 
 
 1 
 
 1 
 
 ff 
 
 60 to 70 
 
 ff . 
 
 6 
 
 11 
 
 17 
 
 
 2 
 
 2 
 
 ff 
 
 70 to 80 
 
 tf . 
 
 
 4 
 
 4 
 
 
 
 
 
 
 Total. 
 
 32 
 
 43 
 
 ~ 5 ~ 
 
 7 
 
 9 
 
 16 
 
 
 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 
 AVERAGE 
 
 AGE, 1840 . 
 
 45.2 
 
 49.0 
 
 47-4 
 
 1 35.5 
 
 44.3 
 
 40.4 
 
 D 
 
§ 9.— Of the internal economy and general management of the institution. 
 
 Table 44. — Shewing the numbers of officers and servants to the insti¬ 
 tution AT FOUR DIFFERENT PERIODS SINCE ITS ESTABLISHMENT. 
 
 NUMBER OF PATIENTS, OFFICERS, AND SERVANTS 
 AT EACH PERIOD. 
 
 OFFICE AND DESIGNATION. 
 
 1797. 
 
 15 patients. 
 
 1813. 
 
 63 patients, 
 and 12 of 
 higher class 
 
 1828. 
 
 82 patients, 
 and 12 of 
 higher class 
 
 1840. 
 
 79 patients, 
 and 12 of 
 higher class 
 
 Male. 
 
 Fem. 
 
 Male. 
 
 Fem. 
 
 Male. 
 
 Fem. 
 
 Male. 
 
 Fem. 
 
 Physician . 
 
 1* 
 
 
 1* 
 
 . 
 
 1* 
 
 
 1* 
 
 
 Surgeon . 
 
 
 
 
 
 1* 
 
 
 1* 
 
 
 Resident surgeon . 
 
 
 
 
 
 . 
 
 
 1 
 
 
 Superintendent . 
 
 1 
 
 . 
 
 1 
 
 
 1 
 
 
 1 
 
 
 Matron .. . . . 
 
 
 1 
 
 
 i 
 
 
 1 
 
 
 i 
 
 Superintendent’s pupil & assistant 
 
 
 
 . 
 
 
 1 
 
 
 . 
 
 
 Matron’s assistant. 
 
 . 
 
 
 
 l 
 
 
 i 
 
 
 i 
 
 Attendant on patients employed 
 
 
 
 
 
 
 
 
 
 in labour. 
 
 
 
 
 
 
 , 
 
 1 
 
 
 Attendants on patients in the 
 
 
 
 
 
 
 
 
 
 galleries, &c. 
 
 1 
 
 1 
 
 2 
 
 3 
 
 3 
 
 5 
 
 4 
 
 5 
 
 Junior assistants to female at¬ 
 
 
 
 
 
 
 
 
 
 tendants . 
 
 
 
 
 
 
 
 
 4 
 
 Attendants on patients of the 
 
 
 
 
 
 
 
 
 
 higher class. 
 
 
 . 
 
 1 
 
 1 
 
 3 
 
 3 
 
 3 
 
 6 
 
 Housemaid, cook, and assistants 
 
 
 2 
 
 
 3 
 
 
 5 
 
 
 5 
 
 Laundry-maids . 
 
 
 2* 
 
 
 2 
 
 
 3 
 
 
 3 
 
 Gardener. 
 
 i 
 
 
 1 
 
 
 i* 
 
 
 i* 
 
 
 Lodge-keeper, baker, &c. 
 
 
 
 1* 
 
 
 1* 
 
 . 
 
 1* 
 
 
 Farming servant. 
 
 ~~ 
 
 • 
 
 1* 
 
 
 1* 
 
 
 1* 
 
 
 
 
 6 
 
 ~8” 
 
 11 
 
 13 
 
 18 
 
 ~15~ 
 
 ~25~ 
 
 
 
 \ _ * 
 
 
 
 
 _/ 
 
 
 _ / 
 
 Total officers and servants.... 
 
 10 
 
 19 
 
 31 
 
 40 
 
 <*r 
 
 3 1 
 
 
 5 1 11 
 
 8 
 
 1 18 
 
 !0 | 
 
 25 
 
 
 
 
 
 j 
 
 
 
 
 
 Total residing in the house .. 
 
 r 
 
 7 
 
 16 
 
 26 
 
 35 
 
 * The non-resident officers and servants are distinguished hy asterisks. 
 
 Table 45.—Skewing the numbers employed, and the principal kinds of 
 EMPLOYMENT, DURING THE YEAR 1839-40. 
 
 Agricultural employments of the harder kindsf . 
 Agricultural employments of the lighter kindsf. 
 
 House-work... 
 
 House-work occasionally . ,... 
 
 Needle-work .... 
 
 Needle-work occasionally.. 
 
 Reading, &c. 
 
 Drawing, &c. 
 
 More or less employed .. 
 
 For the most part unemployed, except in taking exercise , 
 Total under care during the year 
 
 Male. 
 
 Fem. 
 
 Total 
 
 14 
 
 
 14 
 
 6 
 
 . 
 
 6 
 
 1 
 
 6 
 
 7 
 
 
 2 
 
 2 
 
 . 
 
 13 
 
 13 
 
 
 18 
 
 18 
 
 8 
 
 
 8 
 
 1 
 
 1 
 
 2 
 
 30 
 
 40 
 
 70 
 
 15 
 
 15 
 
 30 
 
 45 
 
 55 
 
 100 
 
 t These patients were generally in me open air me greater p 
 actually employed from two to seven hours out of the twenty-four. 
 
Table 46. —Shewing the ordinary diet of the institution. 
 
 CLASSOF CASESAND 
 AVERAGE NUMBER. 
 
 1839-40. 
 
 BREAKFAST. 
 
 DINNER. 
 
 TEA. 
 
 SUPPER. 
 
 1. Cases paying 
 for superior ac¬ 
 commodation. 
 
 No. 17. 
 
 Coffee ; bread 
 and butter, 
 toast, &c. 
 
 Roast or boiled 
 joints, potatoes, 
 &c. Plain, fruit, 
 or rice puddings. 
 Fish, game, or 
 poultry, when in 
 season. Beer or 
 water. 
 
 Tea; bread 
 and butter, 
 toast, &c. 
 
 Fruit pie, or 
 bread and cheese, 
 beer or water. 
 
 2 More orderly 
 and curable cases 
 of the general 
 class. No. 45. 
 
 The same. 
 
 The same; ex¬ 
 cepting game and 
 poultry; with oc¬ 
 casional hashes, 
 &c. 
 
 The same. 
 
 The same ; or 
 bread and milk, 
 or porridge. 
 
 3. Less orderly, 
 and mostly fatu¬ 
 ous cases. 
 
 No. 23. 
 
 Bread and 
 milk. 
 
 The same. 
 
 Women the 
 same, men 
 
 none. 
 
 Men the same, 
 women none. 
 
 Average weight of cooked animal food, (including bone,) per week, consumed by 
 each inmate; patients, officers, and servants, for 1839-40. 56oz. Av. 
 
 Table 47. —Shewing the principal means of medical treatment used in 
 
 THE INSTITUTION. 
 
 CLASS OF REMEDIES. 
 
 PARTICULAR REMEDIES. 
 
 Depletory and derivative 
 measures. 
 
 Leeches behind the ears, to the temples, epigastrium, 
 &c.; cupping to the nape; general bleeding very 
 rarely. Evaporating lotions to the head. Blisters. 
 Setons and issues occasionally. * 
 
 Sedatives, &c. 
 
 Digitalis; tartarized antimony, in full or nauseating 
 doses; mercurials to incipient ptyalism. 
 
 Opiates and other nar¬ 
 cotics. 
 
 Tincture and pills of opium; Dover’s powder ; Battley’s 
 liquor ; salts of morphia ; hyosciamus ; camphor. 
 
 Aperients. 
 
 Senna, with sulphate of magnesia; castor oil; calomel, 
 with rhubarb, jalap, or extract of colocynth ; pills of 
 aloes and myrrh ; compound decoction of aloes, &c. 
 
 Diaphoretics. 
 
 Acetate of ammonia and nitric ether ; nitrate of potass 
 and antimonial wine ; effervescing draughts. 
 
 Tonics and stimulants. 
 
 Bitter infusions and tinctures, with or without alkaline 
 salts ; quinine ; Griffith’s mixture, and other chalyb- 
 eates; porter ; wine ; alcohol; ammonia ; aromatic 
 confection &c. 
 
 Baths, &c. 
 
 Warm, cold, shower, hip, and foot baths. Dry frictions. 
 
§ 10.— Of the Finances of the Institution. 
 
 Table 48.—Shewing the rates of payment on account of the cases 
 ADMITTED DURING THE FORTY-FOUR YEARS, 1796—1840. 
 
 RATES OF PAYMENT. 
 
 Society of Friends 
 and 
 
 connected with it. 
 
 1 Unconnected 
 
 1 with the 
 
 Society of Friends. 
 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Gratuitously for a period not exceeding 
 one year in each case. 
 
 15 
 
 19 
 
 34 
 
 1 
 
 1 
 
 2 
 
 4 shillings per week . 
 
 59 
 
 92 
 
 151 
 
 1 
 
 2 
 
 3 
 
 8 „ ,y . 
 
 48 
 
 76 
 
 124 
 
 1 
 
 2 
 
 3 
 
 8 to 16 shillings per week . 
 
 64 
 
 69 
 
 133 
 
 1 
 
 
 1 
 
 16 to 21 „ „ . 
 
 10 
 
 12 
 
 22 
 
 
 2 
 
 2 
 
 1 to 2 guineas „ . 
 
 29 
 
 23 
 
 52 
 
 1 
 
 3 
 
 4 
 
 2 to 3 „ „ . 
 
 11 
 
 6 
 
 17 
 
 
 5 
 
 5 
 
 3 to 4 „ ,, . 
 
 10 
 
 3 
 
 13 
 
 20 
 
 12 
 
 32 
 
 4 to 5 „ „ . 
 
 3 
 
 
 3 
 
 5 
 
 6 
 
 11 
 
 5 guineas per week. 
 
 1 
 
 • 
 
 1 
 
 2 
 
 • 
 
 2 
 
 Total all cases admitted. 
 
 250 
 
 300 
 
 550 
 
 32 
 
 33 
 
 65 
 
 Table 49.—Shewing the value of the property of the institution at 
 
 SIX PERIODS SINCE ITS ESTABLISHMENT. 
 
 YEAR ENDING 
 SPRING 
 QUARTER. 
 
 
 DESCRIPTION 
 
 OF 
 
 PROPERTY. 
 
 
 Land and 
 buildings. 
 
 Furniture 
 and linen. 
 
 Farming 
 stock, and due 
 from patients, 
 &c. 
 
 
 £ 
 
 s. 
 
 d. 
 
 £ 
 
 S. 
 
 d. 
 
 £ 
 
 s. 
 
 d. 
 
 1797 
 
 5425 
 
 9 
 
 10 
 
 506 
 
 12 
 
 10 
 
 38 
 
 16 
 
 0 
 
 1806 
 
 7213 
 
 2 
 
 10 
 
 900 
 
 19 
 
 11 
 
 433 
 
 8 
 
 5 ; 
 
 1816 
 
 9469 
 
 0 
 
 11 
 
 1792 
 
 0 
 
 10 
 
 1168 
 
 14 
 
 4 : 
 
 1826 
 
 14622 
 
 2 
 
 3 
 
 1828 
 
 3 
 
 8 
 
 2144 
 
 11 
 
 4 : 
 
 1836 
 
 • 
 
 13510 
 
 11 
 
 9 
 
 1312 
 
 14 
 
 3 
 
 8155 
 
 5 
 
 9 : 
 
 1840 
 
 18231 
 
 4 
 
 3 
 
 1279 13 
 
 0 
 
 1 
 
 4600 
 
 11 
 
 1! 5 
 
 £ S. d. 
 
 3301 16 11 
 3172 15 8 
 1777 13 10 
 6 7 
 
 TOTAL VALUE OF 
 PROPERTY. 
 
 £ S, d. 
 
 2669 1 10 
 5374 15 5 
 10664 14 8 
 16094 10 7 
 21582 15 8 
 22026 6 9 
 
Table 50.—Shewing the income of the Institution for the forty-four 
 
 YEARS SINCE ITS ESTABLISHMENT. 
 
 PERIODS 
 
 
 
 
 HEADS OF INCOME. 
 
 
 
 
 
 
 
 
 OF 
 
 TEN YEARS. 
 
 From patients, 
 (including inter¬ 
 est from 1834.) 
 
 Legacies 
 
 and 
 
 annuities. 
 
 Annual 
 
 subscriptions. 
 
 Donations. 
 
 TOTAL INCOME. 
 
 
 £ 
 
 s. 
 
 d. 
 
 £ 
 
 s. 
 
 d. 
 
 £ 
 
 s. 
 
 d 
 
 £ 
 
 s. 
 
 d. 
 
 £ 
 
 s. 
 
 d. 
 
 1796-1806 
 
 8953 
 
 1 
 
 7 
 
 2921 
 
 11 
 
 0 
 
 466 
 
 4 
 
 0 
 
 4181 
 
 14 
 
 0 
 
 16522 
 
 10 
 
 7 
 
 1806—1816 
 
 16591 
 
 19 
 
 9 
 
 4194 
 
 10 
 
 10 
 
 696 
 
 19 
 
 0 
 
 3865 
 
 9 
 
 0 
 
 25348 
 
 18 
 
 7 
 
 1816—1826 
 
 24318 
 
 11 
 
 3 
 
 3962 
 
 12 
 
 6 
 
 3901 
 
 14 
 
 6 
 
 2100 
 
 2 
 
 1 
 
 34283 
 
 0 
 
 4 
 
 1826—1836 
 
 41388 
 
 4 
 
 6 
 
 4751 
 
 10 
 
 6 
 
 1109 
 
 3 
 
 0 
 
 391 
 
 11 
 
 0 
 
 47640 
 
 9 
 
 0 
 
 Period of four 
 years 
 
 16773 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1836—1840 
 
 9 
 
 5 
 
 877 
 
 19 
 
 0 
 
 0 
 
 0 
 
 n 
 
 36 
 
 0 
 
 0 
 
 17687 
 
 8 
 
 5 
 
 Period of forty- 
 four years. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1796—1840 
 
 108025 
 
 6 
 
 6 
 
 16708 
 
 3 lOf 
 
 6174 
 
 0 
 
 6 
 
 10574 
 
 16 
 
 1 
 
 141482 
 
 6 
 
 11 
 
 t Of this sum of £16708 35. 10d., £6635 7s. was raised upon annuities of 5 per cent., payable 
 during- the lives of the insurers. 
 
 J In consequence of the improved state of the funds, annual subscriptions on behalf of the institu¬ 
 tion have not been requested since the year 1830, 
 
 Table 51.—Shewing the expenditure of the Institution for the forty-four 
 
 YEARS SINCE ITS ESTABLISHMENT. 
 
 PERIODS 
 
 
 
 
 HEADS OF EXPENDITURE. 
 
 
 
 
 
 
 
 OF 
 
 TEN YEARS. 
 
 House expenses, 
 repairs, and 
 taxes. 
 
 Salaries and 
 wages. 
 
 Drugs. 
 
 
 Interest on debt, 
 up to 1834, and 
 to annuitants. 
 
 TOTAL 
 
 EXPENDITURE 
 
 
 £ 
 
 s. 
 
 d. 
 
 £. 
 
 s. 
 
 d. 
 
 £. 
 
 s. 
 
 d. 
 
 £. 
 
 S. 
 
 d. 
 
 £. 5. 
 
 d. 
 
 1796—1806 
 
 7255 
 
 17 
 
 7 
 
 1879 
 
 16 
 
 8 
 
 . 85 
 
 3 
 
 9 
 
 1840 
 
 14 
 
 6 
 
 11061 12 
 
 6 
 
 1806—1816 
 
 14446 
 
 5 
 
 3 
 
 3374 
 
 2 
 
 8 
 
 129 
 
 10 
 
 3 
 
 2121 
 
 10 
 
 6 
 
 20071 8 
 
 8 
 
 1816—1826 
 
 19115 
 
 4 
 
 3 
 
 5246 
 
 2 
 
 7 
 
 214 
 
 2 
 
 6 
 
 3256 
 
 8 
 
 4 
 
 27831 17 
 
 8 
 
 1826—1836 
 
 36733 
 
 3700 
 
 19 
 
 0 
 
 y 
 
 8450 
 
 17 
 
 2 
 
 371 
 
 16 
 
 0 
 
 2895 
 
 14 
 
 0 
 
 52152 3 
 
 11 
 
 Period of four 
 years. 
 
 0 
 
 19 
 
 
 
 
 
 
 
 
 
 
 
 
 1836—1840 
 
 11361 
 
 1930 
 
 y 
 
 4221 
 
 5 
 
 6 
 
 147 
 
 0 
 
 6 
 
 633 
 
 10 
 
 0 
 
 18293 15 
 
 10 
 
 Period of forty- 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 four years. 
 
 1796—1840 
 
 94543 
 
 3 
 
 8 
 
 23172 
 
 4 
 
 7 
 
 947 
 
 13 
 
 0 
 
 10747 17 
 
 4 
 
 129410 18 
 
 • 
 
 7 
 
 + Under the head of house expenses have been included the sums of £3700 and of £1930 195. 4 d. 
 which from 1835 to 1840, have been sunk in alterations and additions to the buildings ; and which 
 it was thought could not fairly be added to the value of the property. 
 
APPENDIX. 
 
 RTo» 1. 
 
 STATISTICS OF THE YORK LUNATIC ASYLUM, 
 
 The five following tables, A, B, C, D, E, which exhibit the 
 experience of the York Lunatic Asylum for a period of twenty-five 
 years and eight months, 1814—1840, were calculated from data, 
 kindly furnished by the resident medical officer ; and are published 
 with the permission of the committee of that institution. 
 
 It is thought that the results obtained at the York Lunatic 
 Asylum since 1814, may be more fairly compared with those at 
 the Retreat, than those of almost any other institution, and this 
 for the following reasons :—First, the patients are derived from 
 nearly the same ranks in society in both establishments. Secondly, 
 from their proximity to each other, and from some of the more 
 active members of the Retreat committee being also governors of the 
 Asylum, the practices and modes of treatment in the two institutions 
 have, no doubt, a certain reciprocal influence. And thirdly, and in 
 particular the diet table at the Asylum, though less so for the pau¬ 
 pers, is, on the whole, a very liberal one; and far more than average 
 domestic comforts are afforded to the patients. 
 
 In the comparison, however, of the results obtained at the two 
 institutions, it should be borne in mind that, in three circumstances, 
 the Retreat appears to have a very decided advantage over the 
 Asylum. In the first place, the site of the former is considerably 
 elevated, and on a dry, gravelly soil, which requires little artificial 
 drainage ; whilst the latter, though not to be considered in an un¬ 
 healthy situation, is raised but a few feet above the level of the river 
 Foss, and is situated in a flat district, which has, till of late, been 
 but imperfectly drained. Secondly, at the Retreat, the previous 
 habits of the patients must, on the whole, be regarded as much more 
 favourable to longevity and, perhaps, also to recovery, than are 
 those of the patients at the Asylum. Thirdly, it appears that, from 
 pecuniary and other considerations, patients are frequently removed 
 from the Asylum, by their friends or by the parish officers, to other 
 institutions, before sufficient time for recovery has been afforded: 
 this is a circumstance which seldom occurs at the Retreat. 
 
 The following sketch of the history and present state of this 
 Asylum has been compiled from the printed rules and reports, 
 and other authentic sources. 
 
 The York Lunatic Asylum was established by voluntary sub¬ 
 scriptions, in the year 1777 ; at a period when there existed but 
 two public institutions for the insane in the metropolis—the hospitals 
 of Bethlem and St. Luke’s ; and but two in the provinces, viz., one 
 at Newcastle and one at Manchester. It was designed chiefly for 
 
APPENDIX. 
 
 the relief of indigent lunatics, whether parish paupers or otherwise ; 
 and, also for those who, in consequence of limited circumstances, 
 cannot otherwise be supported without occasioning pressure to their 
 families. A certain number of affluent patients is also admitted, at 
 rates of payment proportioned to their abilities, with the view of 
 making up for the deficiency in the payments of the more neces¬ 
 sitous and parochial patients. Of the whole number of patients in 
 the asylum at the present time, about one-third consists of paupers ; 
 and, judging from the rates of payment, another third may be 
 regarded as belonging to the class of persons in limited circumstances, 
 and another to that of those from the more affluent ranks of society. 
 No patients are refused admission in consequence of the form of 
 mental disorder or its supposed incurability. 
 
 For many years after its institution, the York Lunatic Asylum 
 maintained a high character; but, perhaps in consequence of several 
 defects in its original constitution, it subsequently sank materially 
 in public estimation. Soon after the publication of the “ Description 
 of the Retreat,” in 1813, the then physician thought proper to 
 make a severe attack upon the author of that work, as having, by 
 his representations respecting the Retreat, cast reflections upon 
 other establishments. A long controversy in the newspapers took 
 place, which excited much interest; and which ended in the com¬ 
 plete revision of the rules for the government of the institution, in 
 the dismissal of every servant engaged in the care of the patients ; 
 and in the reorganization of the Asylum, and in the assimilation of 
 its management to that of the Retreat. 
 
 During the thirty-seven (36.9) years that the institution had 
 existed from its establishment, in 1777, to 1814, when the reform 
 which has been alluded to, took place, 2635 patients were admitted ; 
 of whom 2133 were discharged, and 399 died; and there remained 
 in the house, October 10th, 1814, 103 ; viz., 60 men, and 43 women. 
 The state of those discharged, as regards recovery or otherwise, in 
 consequence of the imperfect state of the registers, cannot be 
 ascertained. The average number resident during that period was 
 98.1 ; and the mean duration of residence for each patient admitted 
 was 1.37 year; for those discharged, 1.06 year; and for those re¬ 
 maining 1814, 9.94 years. 
 
 Since its reorganization in 1814, the York Lunatic Asylum has 
 fully redeemed its character; a system of labour, as a means of 
 promoting the comfort and cure of the patients, has recently been 
 introduced; and it is now to be regarded as a well conducted insti¬ 
 tution. As a striking proof of which, it may be mentioned, that 
 the mean mortality has been reduced from 11.00 (1777—1814) to 
 7.35 (1814—1840) per cent, annually resident.* 
 
 * Those acquainted with the history of the Asylum will be interested in knowing- that, 
 from evidence taken before a committee of the House of Commons in 1815, it appears that 
 during the first thirty-one years, 1777—1809, under the superintendence of the first physician 
 to the institution, the mortality was at the rate of 9.5 per cent. ; and that it rose during the 
 succeeding six years, 1809—1814, to 14.8 per cent, annually resident. 
 

 o 
 
 3 
 
 a, 
 
 rt 
 
 A 
 
 
© 
 
 -•T* 
 
 00 
 
 
 •< pq 
 
 u 3 
 
 1-3 M 
 fc w 
 
 g 3 
 
 5 
 
 B 
 
 EMAINING 
 
 1840. 
 
 Total 
 
 H^OMGOrHQOtOOOHIO^ 
 
 I—< H (M CO CO H 
 
 CO 
 
 CO 
 
 Mean 
 
 8.65 
 
 Fern. 
 
 H <N .COi-ht*i<M<MCO<m<M 
 
 H Cl Cl 
 
 N- 
 
 Fern. 
 
 c> 
 
 o> 
 
 A 
 
 
 Male. 
 
 ©COi<CllOOTt(CO0lOCOCl 
 
 hhhh 
 
 CO 
 
 oo 
 
 <u 
 
 'a 
 
 £ 
 
 cm 
 
 to 
 
 DISCHARGED. 
 
 3 
 
 o 
 
 EH 
 
 Total 
 
 
 cm 
 
 r-H 
 
 <M 
 
 rH 
 
 Mean 
 
 1.84 
 
 Fern. 
 
 NHCOOSOlCDOOHOCfiVfl 
 
 HClOOd^COClCOCl 
 
 530 
 
 S 
 
 a> 
 
 CH 
 
 to 
 
 CM 
 
 rH 
 
 Male. 
 
 I"- I>» 00 (M 1>» M 05 H !>. oo O CO 
 
 rH 
 
 682 
 
 Male. 
 
 O 
 
 o 
 
 CM* 
 
 T3 
 
 <U 
 
 s 
 
 . Total 
 
 W Cl H d Cl T-i 
 
 to 
 
 to 
 
 CM 
 
 Mean 
 
 CO 
 
 © 
 
 Fern, 
 
 HCDJxdlOCOlOHOJCOVO . 
 
 I s 
 
 Fem. 
 
 cO 
 
 05 
 
 CO 
 
 Male 
 
 NOOCDCOlOO'^COlOCOOiCO 
 
 Cl H H <M <M i—l t— 1 i—( 
 
 to 
 
 rH 
 
 Male. 
 
 4.06 
 
 Unimproved. 
 
 Total 
 
 CONXlOOH^CfiNKOH . 
 oiociHdcocociH 
 
 o 
 
 05 
 
 (M 
 
 Mean 
 
 <M 
 
 CM 
 
 (M* 
 
 Fern. 
 
 ‘OHCOt^OOCO'^HNM . . 
 
 d d H !—1 r— I r— ( 
 
 119 
 
 a 
 
 a> 
 
 Ph 
 
 O 
 
 CM 
 
 CM* 
 
 Male. 
 
 HCOlOHdOOOOOdH . 
 
 CO CO r—1 i — 1 H H d H rH 
 
 Ul 
 
 Male. 
 
 2.24 
 
 Improved , 
 
 Total 
 
 ^hhOhhtHCOIO . . . 
 
 ^ncohcohhh 
 
 236 
 
 Mean 
 
 1.18 
 
 Fern. 
 
 NOCOOdQ^^CO . . . 
 
 dCOH H 
 
 CO 
 
 rH 
 
 rH 
 
 Fem. 
 
 1.04 
 
 aJ 
 
 ■a 
 
 8 
 
 NHCOOOClOQd • • . CO 
 
 i-H rJH i—t r-H i—1 rH 1 (M 
 
 1 rH 
 
 Male. 
 
 o 
 
 CO 
 
 Recovered. 
 
 Total 
 
 «OO^dlOiHOCOH . . . 
 
 HdOOCO^HH 
 
 CO 
 
 tH 
 
 Mean 
 
 to 
 
 CO 
 
 o’ 
 
 Fern. 
 
 hH O Nt}( 00 U5 »0 H . . . 
 
 ^ O >0 H d 
 
 218 
 
 Fem. 
 
 N- 
 
 © 
 
 Male. 
 
 dCl^lOHCOlOrl . . . . 
 
 NO CO H d 
 
 CO 
 
 rH 
 
 <M 
 
 Male. 
 
 CO 
 
 to 
 
 o’ 
 
 ADMITTED. 
 
 Total 
 
 ‘OddCO^O»CNOiOON 
 
 NONNCOOOOOOdd 
 
 d Cl H rH rH rH 
 
 to 
 
 N- 
 
 CO 
 
 rH 
 
 Mean 
 
 CM 
 
 to 
 
 CM* 
 
 Fern. 
 
 QdOOdNdcoddNd 
 
 HdOidkoco^io^H 
 
 I— 1 rH 
 
 o 
 
 CO 
 
 Fem. 
 
 CO 
 
 cm’ 
 
 Male. 
 
 ood^dcoco^oococoio 
 
 oooo^»«ooio^hh 
 
 rH rH 
 
 768 
 
 Male. 
 
 2.40 
 
 DURATION OF RESIDENCE. 
 
 • w * • 
 
 • rd . 
 
 !i ss l *;***; 8 : 
 
 §a ^ rj 
 
 g'DOddW'OOOOOOO ” 
 
 « rH rH (M CO rtl q 
 
 c^ooooooooooo H 
 
 “cOOOHdCOVJOOOO 
 
 T3 rH Cl CO 
 
 * S = = 
 
 bo o 
 
 1 
 
 AVERAGE DURATION OF 
 
 RESIDENCE—IN YEARS. 
 
 -c 
 
Table C.—Shewing the mean numbers constantly resident at decennial 
 
 PERIODS OF LIFE, AND LIKEWISE THE AGES OF THOSE WHO HAVE DIED IN 
 
 the York Lunatic Asylum, 1814—1840. —Compare with Tables 9 and 32. 
 
 AGE. 
 
 Mean numbers 
 constantly resident. 
 
 Deaths at 
 different ages. 
 
 Male. 
 
 Fem. 
 
 Total 
 
 Male. 
 
 Fem 
 
 Total 
 
 From 10 to 20 years . 
 
 0.72 
 
 1.09 
 
 1.81 
 
 
 
 
 „ 20 to 30 „ . 
 
 9.19 
 
 6.34 
 
 15.53 
 
 ii 
 
 8 
 
 19 
 
 „ 30 to 40 „ . 
 
 16.02 
 
 11.53 
 
 27.55 
 
 37 
 
 11 
 
 48 
 
 „ 40 to 50 „ . 
 
 13.02 
 
 16.04 
 
 29.06 
 
 55 
 
 15 
 
 70 
 
 ,, 50 to 60 „ . 
 
 15.59 
 
 14.77 
 
 30.36 
 
 28 
 
 22 
 
 50 
 
 „ 60 to 70 „ . 
 
 12.77 
 
 9.71 
 
 22.48 
 
 25 
 
 15 
 
 40 
 
 „ 70 to 80 „ . 
 
 4.44 
 
 3.27 
 
 7.71 
 
 19 
 
 5 
 
 24 
 
 „ 80 to 86 „ . 
 
 • 
 
 0.50 
 
 0.50 
 
 
 4 
 
 4 
 
 Total. 
 
 71.75 
 
 63.25 
 
 135.0 
 
 175 
 
 80 
 
 255 
 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 AVERAGE AGE OF THOSE CONSTANTLY 
 
 
 
 
 
 
 
 RESIDENT, AND AT THE TIME OF 
 
 47.4 
 
 47.8 
 
 47.6 
 
 48.6 
 
 51.5 
 
 49.5 
 
 
 
 
 
 
 
 
 Table D.—Shewing the average proportion of recoveries, at decennial 
 periods of life, at the York Lunatic Asylum, 1814—1840. Deduced 
 FROM TABLES A AND C.-COMPARE WITH TABLE 23. 
 
 AGE. 
 
 Average of Recoveries 
 per cent. 
 
 annually resident. 
 
 Average of Recoveries 
 per cent. 
 
 of the cases treated. 
 
 Male 
 
 Fem. 
 
 Mean 
 
 Male. 
 
 Fem. | Mean 
 
 From 10 to 20 years. 
 
 „ 20 to 30 „ . 
 
 „ 30 to 40 „ . 
 
 ,, 40 to 50 ,, . 
 
 „ 50 to 60 „ . 
 
 „ 60 to 70 „ . 
 
 „ 70 to 80 „ . 
 
 Average. 
 
 80.55 
 
 17.30 
 
 14.29 
 
 17.35 
 
 6.73 
 
 2.97 
 
 2.47 
 
 45.87 
 
 41.16 
 
 17.51 
 
 10.66 
 
 7.65 
 
 4.73 
 
 0.91 
 
 60.22 
 
 27.04 
 
 15.68 
 
 13.66 
 
 7.18 
 
 3.82 
 
 1.94 
 
 48.38 
 
 26.79 
 
 25,43 
 
 30.05 
 
 27.83 
 
 20.40 
 
 23.07 
 
 54.50 
 
 50.00 
 
 33.76 
 
 33.33 
 
 27.10 
 24.49 
 
 11.11 
 
 52.83 
 
 37.63 
 
 28.75 
 
 31.38 
 
 27.45 
 
 22.44 
 
 18.18 
 
 11.56 
 
 13.42 
 
 12.43 
 
 27.73 
 
 35.91 
 
 31.34 
 
 AVERAGE OF RECOVERIES PER CENT. OF THE ADMISSIONS, 1814-40 
 EXCLUSIVE OF THOSE REMAINING IN THE ASYLUM, 1814 .... 
 
 30.08 
 
 38.65 
 
 33.88 
 
 Table E.—Shewing the average mortality at decennial periods of life, 
 at the York Lunatic Asylum, 1814—1840. Deduced from tables AandC. 
 -Compare with Table 35. 
 
 
 AGE. 
 
 Average of deaths 
 per cent. 
 
 of the cases treated 
 
 Mean mortality 
 per cent. 
 
 annually resident. 
 
 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 Male. 
 
 Fem. 
 
 Mean 
 
 From 1 0 tn 9,0 VPflTS .. 
 
 6.45 
 
 4.54 
 
 5.66 
 
 
 
 
 
 20 to 30 „ . 
 
 6.53 
 
 5.22 
 
 5.92 
 
 4.57 
 
 4.90 
 
 4.76 
 
 
 30 to 40 ,, . 
 
 26.89 
 
 8.44 
 
 15.80 
 
 8.98 
 
 3.64 
 
 6.78 
 
 ft 
 
 40 to 50 ,, . 
 
 29.01 
 
 15.15 
 
 23.38 
 
 16.43 
 
 3.61 
 
 9.35 
 
 ft 
 
 50 to 60 ,, . 
 
 31.95 
 
 21.49 
 
 26.47 
 
 6.99 
 
 5.75 
 
 6.38 
 
 ft 
 
 60 to 70 „ 
 
 44.89 
 
 22.44 
 
 33.67 
 
 7.59 
 
 5.97 
 
 6.89 
 
 ft 
 
 70 to 80 „ . 
 
 46.15 
 
 55.55 
 
 50.0 
 
 16.66 
 
 5.81 
 
 12.06 
 
 ff 
 
 ft 
 
 80 to 86 ,, . 
 
 
 
 
 . 
 
 30.00 
 
 30.00 
 
 Average. 
 
 22.78 
 
 13.17 
 
 18.54 
 
 9.49 
 
 4.91 
 
 7.35 
 
 MEAN 
 
 MORTALITY FOR 37 (36.9) YEARS, 1777- 
 
 -1814 ... 
 
 
 
 
 Tloo" 
 
APPENDIX. 
 
 Wo. 2. 
 
 STATISTICS OF RECOVERY AND MORTALITY IN HOSPITALS FOR THE INSANE. 
 
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