Availing ourselves now of the first Report of the Commissioners[243] who were appointed under the foregoing Act, we shall present a statement of the number and distribution of the insane in Scotland on the 1st of January, 1858.
| Location. | Males. | Females. | Total. | Private. | Paupers. |
|---|---|---|---|---|---|
| In public asylums | 1226 | 1154 | 2380 | 786 | 1596 |
| In private asylums | 330 | 415 | 745 | 219 | 526 |
| In poor-houses | 352 | 487 | 839 | 6 | 833 |
| In private houses | 810 | 974 | 1784 | — | 1784 |
| Total | 2718 | 3030 | 5748[244] | 1011 | 4739 |
The above table does not include private single patients; their number could not be accurately ascertained.
The Commissioners, as might be expected, report the state of the insane to have altered little since the Report of the Royal Commission. In the pauper licensed houses, if not in others, the overcrowding was great, though diminishing. "The patients, when within doors, are generally found sitting in cheerless rooms, ranged on benches, listless and without occupation; and when out of doors, they are usually lounging sluggishly about the airing-courts, or are crouching in corners." Among favourable indications noted by the Commissioners it is pleasant to read the following:—"Mechanical restraint has been entirely banished from the licensed houses, and patients who are recorded in the Report of the Royal Commissioners as almost always under restraint, are now habitually free from their bonds. The improvement in the condition of these cases under the more humane treatment now in use has been most remarkable, and is especially exemplified in the case of A. S——, a patient in M—— Asylum."
Subsequent Acts were passed, called for by the experience of the Commissioners in regard to the working of the Act of 1857, some imperfections in which were naturally discovered in the course of years.
The Lord Advocate and Sir George Grey brought in a Bill in 1862 to make further provision respecting lunacy in Scotland, which received the royal assent July 29 (25 and 26 Vict., c. 54).
By this Act, consisting of twenty-five sections, the Board was empowered to license lunatic wards of workhouses; to sanction the reception of pauper lunatics in workhouses; to grant special licences for reception in houses of not more than four lunatics; to grant licences to charitable institutions for imbecile children without fee; to sanction detention of pauper lunatics in asylums beyond the limits of their district; to take such steps as the Board may consider requisite towards providing accommodation for the district, etc., etc. Not to cite other sections, certain provisions of the recited Acts as were inconsistent with the Act were repealed, and the General Board of Commissioners was, of course, continued.
In their Report of this year (1862) the Commissioners observe, relative to the supposed increase of insanity, "Judging from the evidence which the tables afford, the increase is almost entirely due to the accumulation of the numbers of the insane, and certainly not, to any marked degree, to a greater disposition in modern times to mental disease; for while in the years 1858, 1859, 1860, and 1861, the admissions into asylums scarcely varied in number, the patients resident in such establishments showed every year a large and steady increase. Thus, on January 1, 1858, their number amounted to 3765; on January 1, 1859, to 4114; on January 1, 1860, to 4350; and on January 1, 1861, to 4462."
We have already noted the fact that more idiocy appears to be found in the counties least exposed to mental activity. In this Report, however, the Commissioners state that, as regards lunacy, its occurrence is considerably more frequent in urban than in rural districts. The word occurring is here used advisedly in contradistinction to existing lunacy. The explanation offered by the Commissioners is that there is a greater proportion of recoveries and deaths taking place among the patients of the rural district. They contrast the number of pauper lunatics intimated from urban populations with the number intimated from rural districts, and they find that in the former, the occurrence of pauper lunacy as compared with its occurrence in the latter, is as 100 to 54, whereas the proportion of existing pauper lunatics, January 1, 1861, in the corresponding districts was as 100 to 106. The Commissioners regarded as urban those parishes containing towns, or parts of towns, having more than 20,000 inhabitants, and as rural all other parishes.
We need not dwell on the Act passed in 1864 (27 and 28 Vict., c. 59) to continue the Deputy Commissioners in Lunacy in Scotland, and to make further provision for their salaries and the clerk of the Board.