| Year. | Admissions. | Ratio per 10,000 of admissions to the population. |
|---|---|---|
| 1869 | 10,472 | 4.71 |
| 1870 | 10,219 | 4.54 |
| 1871 | 10,528 | 4.62 |
| 1872 | 10,604 | 4.59 |
| 1873 | 11,212 | 4.80 |
| 1874 | 11,912 | 5.03 |
| 1875 | 12,442 | 5.19 |
| 1876 | 12,857 | 5.30 |
| 1877 | 12,969 | 5.28 |
| 1878 | 13,343 | 5.36 |
| 1879 | 13,101 | 5.20 |
| 1880 | 13,240 | 5.19 |
It would thus appear that in 1880 scarcely one patient more per 20,000 persons in England and Wales was freshly admitted into asylums, etc. Had there been no increase at all, after allowing for increase of population, the number admitted in 1880 would have been 12,011. It was, in fact, 13,240, i.e. 1229 more.
Taking the actual number of the insane in detention during the same years shows a very different result, for accumulation is here included, and swells the returns.
Thus:—
| Year. | Under care. | Ratio per 10,000 of number in detention to the population. |
|---|---|---|
| 1869 | 53,117 | 23.93 |
| 1870 | 54,713 | 24.31 |
| 1871 | 56,755 | 24.91 |
| 1872 | 58,640 | 25.42 |
| 1873 | 60,296 | 25.82 |
| 1874 | 62,027 | 26.23 |
| 1875 | 63,793 | 26.64 |
| 1876 | 64,916 | 26.78 |
| 1877 | 66,636 | 27.14 |
| 1878 | 68,538 | 27.57 |
| 1879 | 69,885 | 27.77 |
| 1880 | 71,191 | 27.94 |
In other words, there were eight more patients under care for every 20,000 of the population in 1880 than in 1869. Had there been no increase in the number in detention, after allowing for increase of population, the number in 1880 would have been 53,177. It was, in fact, 71,191, i.e. 18,014 more.
We have now traced step by step the remarkable progress effected in the asylum care of our lunacy population. In concluding this chapter I would, however, observe that it would be a grave and mischievous mistake to suppose that, most valuable as is the provision for the insane by asylums, there are not many cases which may be treated outside these institutions with the greatest advantage. Some patients are best cared for in their own homes, others in lodgings, and others in the houses of medical men. The extent to which non-asylum treatment can be carried out will be seen when we speak of Chancery patients. It will be observed that the number of single private patients is 448.
In regard to the location of pauper lunatics in private dwellings, it appears that while in England 6799, or 9.29 per cent., of their number live with their relatives or are boarded in private dwellings, nearly fifteen per cent. of insane paupers in Scotland are in private dwellings, inspected by the Lunacy Board.