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Table shewing the Numbers and Proportion of each Ser, out of 71,800 Cases, admitted into various Asylums.
33. Bethlem, all cases . . . . .
Whether in this asylum an unusually large provision has been made for females, and consequently a larger proportion of applications for the admission of men have been rejected, or whether in the county of Dorset any peculiar causes are actually in operation which are capable of explaining such an exception to a general law, I am at present unable to determine. Having thus shewn that, in the principal hospitals for the insane in these kingdoms, the proportions of men admitted is nearly always higher, and in many cases much higher, than that of women; and as we know that the proportion of men in the general population, particularly at those ages when insanity most usually occurs, is decidedly less than that of women, we can have no grounds for doubting that men are actually more liable to disorders of the mind than women. It is always satisfactory when those reasonable conclusions, which we have previously formed from general considerations of the nature and tendencies of the particular causes which are in operation in any class of facts, are confirmed by accurate statistical inquiry. From a just consideration of the differences in the physical and moral constitution, as well as in the generally prevailing external circumstances of the two sexes in civilized communities at the present day, it was, I think, à priori, highly probable that men should possess a somewhat greater liability to mental disorders than women; and this was a conclusion at which, independently of any statistical inquiry, the ancient physicians had even arrived. And it is thus important to observe, that it was by a faulty application of the methods of statistical analysis to this question, by the deservedly distinguished Esquirol, that a contrary conclusion was come to by that diligent, but, in statistical questions, not always accurate, inquirer; and that it has been chiefly on his authority, and on that of authors who, on this subject, have copied from him, that we have been in danger of admitting the erroneous doctrine that women are more liable to insanity than men. It is still highly probable that different countries,” and perhaps even the same country at different periods, as well as different communities and different ranks and classes in the same country, may vary very much as regards the proportion in which men suffer from insanity more than women. Thus, it appears tolerably well ascertained that a larger proportion of women, relatively to the other sex, become insane in France as compared with England. Though, as we have seen, this is less certain as respects the metropolis when compared with the rest of this country. In this respect, we have seen that the statistics of our own metropolis appear to resemble those of France, rather than those of the rest of England. In this point of view, the experience of the Society of Friends is not without considerable interest. At first sight it might appear that, in this community, women are actually more liable to insanity than men; for, without any greater facility existing for the admission of females, the number of women, members of that society, who have been
* The above table shews that, during 15 years at the asylum at Schleswig, Holstein, the proportion of men admitted exceeded that of women by 52 per cent. ; and at Siegburg, near Bonn, on the Rhine, during 9 years, by 78 percent. According to the official return of Dr. Holst, the existing number of the insane throughout Norway, in the year 1825, was in the proportion of 1 to 508% of the male, and 1 to 597% of the female population.
admitted into the Retreat has exceeded that of men by 18 per cent, or, in other words, only 45 men have been admitted to 55 women.” But it is requisite to know the relative proportions of the two sexes in the Society of Friends, as a body, before we shall be justified in determining that insanity is really more prevalent amongst the females of that community. . By returns, however, from all parts (each “monthly meeting”) of England and Wales, it appears that in the Society of Friends the excess of women over men, at all ages, amounts to about 20 per cent. ; and there can be little or no question that the excess of adult females is still greater.f Indeed, after 15 years of age, before which insanity seldom occurs, we can, I think, scarcely estimate the excess of females over males in this community at less than from 30 to 35 per cent. And thus assuming, as there is every reason for doing, that, as respects the proportions of the two sexes attacked, the experience of the Retreat represents that of the Society at large, it will appear that, in this community, there are still from 10 to 14 per cent. more men than women attacked with mental derangement. This is an excess on the side of men, considerably less probably than that which prevails in the kingdom generally. The progressive accumulation of females in an hospital for the insane is well illustrated by the experience of the Retreat; where, at the end of 45 years, the women exceeded the men by 30 per cent. ; and where the average number of women resident during the whole period was 35 per cent, higher than that of men. At the asylum for the Society of Friends at Frankford, Pennsylvania,i (1817–42) the proportion of men admitted exceeded that of women by 7 per cent. But in the general population of Pennsylvania and the adjacent states, in common more or less with nearly all newly-settled countries, the proportion of males exceeds that of females by about 4 per cent., and, at from 20 to 40 years of age, by 6 per cent. There, however, may be, and probably is, less difference in this respect in the Society of Friends in the states alluded to, or the women may even preponderate in this commumitv. i. nearly all points of view it may, in conclusion, be stated, that women have an advantage over men in reference to insanity; for not only do they appear to be somewhat less liable to mental derangement than men, but, when they become the subjects of it, the probability of their recovery is on the whole greater, and that of death very considerably less. After recovery from a first attack, however, the probability of a relapse, or of a second attack, is perhaps somewhat greater in women than in men. Still the more favourable results, as regards the * The numbers in the table refer to cases of all descriptions admitted at the Retreat; but the proportions are the same when members of the Society of Friends are separately considered. + This larger number of women in the Society of Friends may, no doubt, be chiefly attributed to the larger proportions of men who emigrate, and leave the Society, and are disunited from it, for, on an examination of the registers of the Society from 1800 to 1837, I find that the births registered were in the proportion of 105.7 males to 100 females; viz. 8207 boys and 7759 girls. In the whole of England - and Wales, in three years, 1šiš. the births registered were in the proportion of 104.8 boys to 100 girls.-" Fourth Report of the Registrar-General,” 1842, ... 9. 10. - r; This asylum is more particularly appropriated to the Society of Friends in the states of Pennsylvania, New Jersey, and Delaware; but patients from other states are also admitted. 2 Y
female sex in all these particulars, appears to be much less marked at
the Retreat than in nearly every other institution with which I am
acquainted. This is worthy of notice, as it is probably due to the greater
general regularity of life in the men of this community as compared with
that of men in the community at large ; or, at least, than in those parts
of it which furnish inmates to the asylums compared. Retreat, York, August, 1844.
Notes on the Report of the Royal Commissioners on the Operation of the Poor Laws in Scotland, 1844. By J. P. Alison, Esq., M.D. [Read before the Statistical Section of the British Association at York, October 1st, 1844.] DR. AL1son stated, that as the result of many of his own observations and inquiries, and those of others who had associated themselves with him to investigate this matter statistically in Scotland, had been read in the Statistical Section of the British Association, he was anxious to lay before them some extracts from the evidence, lately printed as an Appendix to the Report of the Royal Commissioners, who had been appointed to inquire into that subject, by which he thought that those previous statements were amply confirmed; but that in laying these results before the Section, he would confine himself to facts, and as nearly as possible to statistical facts, and abstain from all discussion of remedial measures. He said that, on one point the result of the inquiries of the Commissioners appeared at first sight to be at variance with his previous statements, viz., as to the number of poor, natives of country districts, who burden the larger towns in Scotland. It appears that, in general, about two-thirds of the regular paupers in those towns are not natives, and there is a general complaint in the towns, of this burden falling on them, in consequence of the defective relief in country districts, and of the law of settlement by three years’ residence; but the Commissioners report that there had been much exaggeration in those statements, and that there are few paupers in the towns who have not lived there many years; therefore, that an extension of the term requisite for obtaining a settlement would make little difference in this respect. On this he observed, that he had always represented the great mass of poor from the country, who resort to the towns in Scotland, as “coming originally in search of work,” and afterwards becoming burdensome, not in the first instance as paupers, on the parish lists, but as destitute poor, subsisting, for the most part, on voluntary charity, either of individuals or associations; and had explained how greatly the number of the destitute poor in Scotland exceed the number of regular p. ; therefore, that the result of the inquiries of the Commissioners, eing nearly confined to the statistics of the paupers, does not invalidate his previous assertion. In illustration of this, he pointed out six different classes of persons, often reduced to extreme destitution in Scotland, but who do not in general appear on the lists of paupers at all, and referred to the evidence published by the Commissioners in proof of this; and of all those he asserted, that they are found chiefly in the towns, seeking either for occasional employment, or for voluntary charity. He explained, l. The case of the able-bodied unemployed poor. 2. The case of the temporarily disabled by sickness or injury. 3. The case of applicants for the legal relief, to whom that relief is long delayed. 4. The case of those to whom relief is refused, because the Kirk Sessions “have not funds in hand” for them. 5. The case of those whose settlement is disputed, and interim relief refused. , 6. The case of the “dissipated and undeserving poor,” and their children, who are “kept at bay” by the parochial authorities; in consequence of which he said he had known various instances of children dying of the effects of cold and hunger. Having thus explained the fallacy of the statement of the Royal Commissioners on this point, he proceeded to say that on all other points the evidence taken by the Commissioners not only amply confirmed his former statement, but in several instances exceeded his anticipation; and in proof of this he read extracts from the evidence as to the following particulars; almost all of those extracts being from the evidence of clergymen, magistrates, or other public functionaries. 1. The extent of destitution in many of the towns, the privations, as to food, fuel, and clothing, endured by many of the inhabitants, and the necessity of mendicity to support life, both in the case of regular paupers, and of persons excluded, on the grounds above stated, from the legal relief; especially in the case of able-bodied persons and their families, often of good character, and reduced by circumstances quite beyond their control. 2. The extent of vagrancy, consequent especially on depressions of trade in the manufacturing districts, extending from the Borders even to the Orkney Islands, and forcing on many practical observers the conviction, that some fund should be provided for supporting the unemployed at home. 3. The diffusion of fever, particularly of that new form of fever which has sprung up since 1842, almost exclusively in Scotland, and prevailed to an unprecedented extent, which has been proved by individual inquiries, extending to above 1,700 persons, to affect that minority of the population who are destitute and unemployed, not only in a larger proportion, but in an absolutely greater number than all the rest of the community; and has very frequently been diffused through the country by the destitute vagrants just mentioned. 4. The very inadequate allowances to widows, and the frequent neglect of orphans, and the consequence, distinctly resulting from this cause, and from the absence of any legal protection to the unemployed, in the increased temptation to crime. This was stated as the general result of observations made in all the gaols in Scotland, but was especially illustrated by tables, furnished by Mr. Brebner, governor of the gaol at Glasgow, one of which comprised 258 cases of persons committed to that gaol in one year, of whom he could say with certainty, that it was want, and not inclination, which led them to commit crimes; and others gave the particulars of no less than 79 persons, 72 of them females, who in one year became voluntary inmates of the gaol, secluding themselves from the world, and submitting to the discipline of a prison, for the sake of the protection it afforded. Many others sought a similar protection, and could not be admitted; and it having been thought necessary to dismiss these voluntary prisoners, as unfit inmates of a gaol, more than half of them returned in a short time as criminals, the sacrifice to which