"At two of the most ancient and celebrated institutions of the same kind in Great Britain, the per centage of recent cases cured, has been from 34 to 54. In our own country, at two highly respectable institutions, the recent cases cured have amounted to from 25 to 51 per cent."

With respect to the chronic cases, Dr. Todd remarks," that the Connecticut Retreat is opened with a broader latitude of admission than is common to other institutions."

"The far-famed Retreat at York in England, professedly devoted to similar objects, admits no idiots, nor maniacal cases reduced to low grades of mental dilapidation. Of the thirty-four chronic cases stated in the present report, nineteen are of the identical description which would have been excluded by the practice of that excellent institution. The remaining fifteen cases on the list, constituted the whole amount in that class, who were properly within the scope of curative treatment, and of this number, only a few were allowed to remain with us through the requisite term of trial prescribed, in such instances, by most other institutions. Six months' residence in the Retreat, has been thought by many who have placed their diseased friends in the Institution, to be a liberal allowance of time for deciding the question of recovery, in cases of 10 years' duration. As if the chaos of illusions, teeming for years in a distempered imagination, and revived with innumerable repetition, by the unexhausted workings of insanity, might be swept at once from the tablets of the mind, by a professional recipe; or the stormy passions of confirmed madness, already threatening the very foundations of intellect, might be hushed and subdued by the sovereign touch of some Esculapian trident! He who seeks for events, not in miracles nor in magic, but in the operation of settled laws, will comprehend why years of persevering effort must be required for the cure of long established cases of insanity; and although he ought never to be sanguine in his hopes, yet, if his mind be endowed with a tact to perceive the subtle individualities of a case, and detect them under the disguise of a general character, he will feel that such a case is marked as distinct and separate from its class, and completely exempted from the general rules of treatment and prognosis: should he have learned to distinguish a derangement of mental functions from a destruction of mental organs, where insanity in the one case is disease, in the other death of intellect; then he may occasionally have the unspeakable satisfaction to discover, here and there, a case on the melancholy list, where the still "glimmering embers of a nearly extinguished intellect" may be kindled, and nursed into a clearer and brighter flame, by the delicate and dextrous administration of long continued and well adjusted moral and intellectual remedies.

"After all, it is an affecting truth, confirmed by the experience of nearly all Lunatic Asylums, that, with every advantage of time, means, and skill,

the proportion of recoveries in this description of patients, rarely exceeds six or eight in the hundred. With this disheartening fact in view, the Retreat had not ventured to anticipate the good fortune it has realized in the recovery of four out of fifteen cases from this class, amounting to the ratio of 26 per centum. While it unfeignedly deplores the sad destiny of those who still remain unrelieved by its exertions, it cannot but feel consoled and supported by the consideration of its comparative success in a class of cases, where the nearest approach to hope is often only a negation of despair."*

FRIENDS.-The ASYLUM for the Insane near Philadelphia, was founded by that religious denomination in imitation of the "Retreat" at York. It is erected in a retired situation, and on elevated ground, five miles from the city of Philadelphia, and one mile from Frankford. The buildings are of stone, and consist of a centre edifice with two wings. The centre building is 60 feet front and three stories high. The wings are each 100 feet front and two stories high. Long galleries divide the ranges of rooms from each other.

The doors have each a moveable small door in the pannel, to be opened from without. The windows of each room have cast-iron frames, and they are so constructed as to be darkened at pleasure. The edifice is warmed by heated air sent through flues issuing from stoves or large ovens, built in the arches of the basement of each wing.

To the buildings are attached workshops for the patients, and the whole are surrounded by airy grounds.

The patients are classified into the harmless and the violent and noisy; the latter are not allowed to come out of their rooms, while the former eat at table with the superintendant and his family. The diet is uniformly good, no meagre days being allowed, but neither spirituous nor fermented liquors are permitted. The only modes of coercion are, if neces

* Report of the Physicians of the Connecticut Retreat for the Insane, from the opening of the Institution, April 1, 1824, to April 1, 1825.

Third Report of the Directors of the Connecticut Retreat for the Insane, presented to the Society May 11, 1827. Hartford, 1827. 8vo. pp. 11. No report of the second year has been published.

sary, the shower bath, immersion in water, or the strait waistcoat.

"On every Sunday evening, all the male and female patients, except one or two who are permanently secluded, are collected together in their day-rooms, where a portion of scripture is read to them. This exercise seldom meets with any interruption from them, but on the contrary, there is great silence and quiet.”

We have neglected to mention, although that of course will be understood from the name of this institution, that Friends or Quakers only are admitted as patients.

After this brief sketch of the police of the Asylum, we add the following statistical details, given by Mr. Waln.

Admitted, from the opening of the Asylum in May

1817, to the month of March 1825,

158

53

23

17

. 9

21

35

158

Annual average number of patients during eight years, 19 Annual average number for five years ending in 1825, 311 Average number during the year ending in March 1825, 33*

Besides these institutions, there are others of high reputation in the United States, but of which we have not been able to obtain any authentic account. We would particularly mention the asylum connected with the Pennsylvania Hospital. While the late Dr. Rush was in attendance, the cures

* An Account of the Asylum for the Insane, established by the Society of Friends, near Frankford in the vicinity of Philadelphia. By Robert Waln, jun. (Philadelphia Journal of the Medical and Physical Sciences, Vol. I. New series.)

are said to have borne a very large proportion to the number admitted.

A brief comparison between the results obtained in our asylums with those of Europe, will form a proper conclusion to this paper. And first of the

According to Casper, who has examined the returns from the principal hospitals and asylums in England and France, the mean of cures are as follows:

In France, out of 100 insane,

In England, out of 100 insane,

We are, however, in doubt as to the propriety of some of the data assumed by this author, and it will hence be more satisfactory to notice the separate reports of institutions.

In the Cork Lunatic Asylum, from
Jan. 1, 1798 to June 30, 1818, 1431
At the Salpetriere and Bicetre, in

France, the cures amount to
2-5ths of the whole,‡

* American Medical Review, 1826. Vol. III. P. 13.

+ Hallaran's Practical Observations on Insanity, 2nd. edition.

+ Edinburgh Medical and Surgical Journal, Vol. XXVIII. P. 230. Idem.

At Bethlem, London, (1817 to 1820,)*

54.00

46.00

St. Luke's, London, (1800 to 1819,)*
The average deduced in 1817, from the experience

of 15 Asylums and Hospitals in Great Britain
and Germany, and comprising nearly 14,000
admissions, wast

Proportion of cured, in Recent and Old Cases.

38.00

These may be compared with the result in the

Retreat near York, (from 1796 to 1819.)

SEX. This is not distinguished, except in the Bloomingdale and Connecticut Reports. They stand as follows:

* Burrow's Inquiry into certain Errors relative to Insanity, p. 20. + Edinburgh Review, Vol. XXVIII. p. 459. We refer those who are curious on this point, to the extensive tables in the works last quoted. As it would be improper to copy these in detail, we have only selected some of the more general results.

Burrows, pages 281, 48, and 20.