transfer so valuable a property to another man's possession, and the modesty which did not disdain to mingle the rays a borrowed interest with its own glory.

of

ART. III. Report on Insanity and Idiocy in Massachusetts, by the Commission on Lunacy, under Resolve of the Legislature of 1854. Boston. 1855.

THE necessity of making further provision for the insane induced the Legislature of Massachusetts, in 1854, to create a commission for the purpose of collecting information on various points connected with the subject. The duties of this commission were stated under the following heads :

"To ascertain the number and condition of the insane in the State, distinguishing as accurately as may be between the insane, properly so considered, and the idiotic or non compos; between the furious and the harmless, curable and incurable, and between the native and the foreigner, and the number of each who are State paupers.

"To examine into the present condition of the Hospitals of the State for the insane, and see what number of patients can properly, with due regard to their comfort and improvement, be accommodated in said Hospitals.

"To see what further accommodations, if any, are needed for the relief and care of the insane.

"And, generally, to examine and report the best and most approved plans for the management of the insane, so far as the size and character of Hospitals, and the number of patients proper to be under one supervision, are concerned.

"To examine into the present condition of the State Lunatic Hospital at Worcester, and ascertain what kind and amount of repairs are needed, and at what probable cost, and consider the expediency of disposing of the said Hospital and the lands connected therewith, or any part thereof, and of recommending a site for the erection of a new Hospital or Hospitals. "To report the estimated proceeds of the sale of the present Hospital and grounds therewith connected at Worcester, if they deem such a sale desirable.

"To accompany their report with plans, specifications and estimates of cost of any new Hospital which they may recommend."

- pp. 9, 10

The commission consisted of Levi Lincoln, Edward Jarvis, and Increase Sumner, and their report was submitted to the Legislature of 1855. Dr. Jarvis's colleagues frankly state that not only was this document prepared by him, but that he also collected all the materials which give it any value. To say that he has executed his task remarkably well, would scarcely express its peculiar merit. It displays a perseverance in the pursuit of his object, a thoroughness of inquiry, and a clearness and precision in his ideas, not often witnessed in statistical investigations. Vital statistics have hitherto possessed an equivocal value, because they have often embraced points that are not proper objects of statistical expression. Incidents and events which necessarily convey the same idea to all may be numbered and classed, but phenomena that embrace many elementary facts more or less uncertain and variable, cannot be treated in this manner. A show of accuracy where accuracy is in the nature of things impossible, only leads to deception and error. For instance, the number of deaths in a community may be correctly ascertained, but when we undertake to specify and enumerate the particular diseases that produce death, we forget that we are dealing no longer with definite and tangible facts, but with matters of opinion as diverse and variable as the experience and education of the men who form them. And on the particular branch of inquiry now before us, we may correctly ascertain the sex, age, and occupation of the insane; but respecting the causes of their disorder, or the chances of recovery, no degree of research or professional skill can lead to results more satisfactory than that of a shrewd conjecture. To give them a statistical form is to make no real advance in knowledge. The common fallacy that, imperfect as they are, they still constitute an approximation to the truth, and therefore are not to be despised, is founded upon a total misconception of the proper objects of statistical inquiry, as well as of the first rules of philosophical induction. Facts -real and indisputable facts—may serve as a basis for general conclusions, and the more we have of them the better; but an accumulation of errors can never lead to the development of truth. Of course we do not deny that, in a mere matter of quantity, the errors on one side generally balance

the errors on the other, and thus the value of the result is not materially affected. What we object to is the attempt to give a statistical form to things more or less doubtful and subjective. The reports of hospitals for the insane for the last twenty years or more abound with this description of statistics, and yet it would be difficult to point to a single phenomenon of the disease in regard to which our information has been rendered thereby more definite and certain.

In executing their task, the commission wisely avoided, for the most part, all debatable ground, and confined their inquiries to facts that can have but a single meaning and are strictly pertinent to the object in view. The value of statistical results must depend very much on the authenticity of the facts and the thoroughness with which they are collected. The moment we have reason to distrust the authority, or to suspect that the investigation has been partial and limited, our confidence is gone. We see nothing before us but a useless array of numbers, worse than useless, perhaps, because calculated to propagate error. Warned by the failures of previous commissions created for similar purposes, they resorted to new methods, and pursued them with a tenacity that insured success. Guided by the Massachusetts State Register, they addressed a letter to every physician in every town, enclosing blank forms for recording the desired information, and soliciting their aid and co-operation. This was certainly an improvement on the previous practice of applying to the selectmen, or other municipal functionaries, whose acquaintance with the people is comparatively limited, and whose education and pursuits seldom fit them to collect and arrange an order of facts like the statistics of insanity. They considered that medical men had collectively every family in the State under their eye, and would be likely to know so peculiar a fact as the insanity of one of its members, while, the name of every patient being given, there was no danger of their enumerating the same case more than once. They were requested to give the names of all insane persons in their several towns, together with their sex, color, nativity, condition, prospects, and pecuniary means. It appears that nearly two thousand such letters were sent. Generally, the answers were returned early, but in

some instances a second, a third, and even a fourth letter was sent, amounting in all to eight hundred additional letters, explaining more fully the objects of the commission, and urging a compliance with their wishes. Sixty-five towns were visited by one of the commissioners, who saw the physicians, and obtained by word of mouth what could not be obtained by letter. From the medical profession they received ready and valuable assistance, besides replies to their letters, one gentleman, it is stated, having visited twelve towns to procure the requisite information. The fact that returns were obtained from every physician who was addressed, save four, leaving

out of the account those who were not in practice or had removed, strongly illustrates the perseverance of the commissioners and the promptness of the physicians. Two of the four delinquents proved to be irregular practitioners, and the other two gave their reasons for not complying with the request of the commission. In many instances, clergymen, sheriffs, overseers of the poor, jailers, and superintendents of hospitals in and out of the State, were addressed, with the same satisfactory result. For some time the town of Carver was the only one from which the returns were incomplete, one physician alone remaining silent. Thrice was he written to, and the aid of the postmaster and a neighboring physician invoked, before the reply came, that there was not a single lunatic within his range.

Never, perhaps, has a statistical inquiry been pursued with such ample provisions against error and imperfection, or with results more worthy of reliance. In all those respects which render such a work of any value, accuracy, completeness, and pertinence, we doubt if it has ever been surpassed. The census of Great Britain for 1851 includes, besides the pauper insane, only those in some establishment, and those under guardianship. In a census of France, a few years since, a large space was devoted to the insane; but the facts, though apparently extensive and elaborate, are obviously very incomplete. The census of the United States for 1840 presented the number, age, sex, color, &c. of the insane; but it abounded with errors of so remarkable a character, as to raise the suspicion that they were not entirely unintentional. The last

census was free from the gross faults of its predecessor, but, for reasons common to most inquiries of the kind, it fails to create much confidence in its results. Indeed, no amount of care or perseverance will succeed in obtaining such facts directly from the parties concerned. In a large proportion of cases the insanity of a person is not distinctly admitted by other members of his family, while those who are employed by the government to "take the census" are seldom fitted by their previous training to discern the lighter shades of mental disease. Insanity when manifested by noise and violence is easily recognized, but in a multitude of other forms it passes for only eccentricity or folly. More wisely, therefore, the commissioners employed a very different class of persons, who learned the facts they communicated, not by inquiring of others strongly disposed to conceal them, but by their own personal observation. In regard to some of the incidents reported, those which indicate conditions rather than objective facts, we will only say at present, that the returns are to be received with many grains of allowance, because here the highest degree of accuracy can be expected only from the highest professional attainments in this department of the art.

From the Report, it appears that in the autumn of 1854 there were within the limits of this Commonwealth 2,632 lunatics and 1,087 idiots, making a total of 3,719 insane persons. The whole population - supposing the rate of increase between 1840 and 1850, which was 33 per cent, to have since continued they estimate at 1,124,675, and this would give an average of 1 insane person to every 302 of the whole population. This is a larger proportion than has ever before appeared in any census of any community, American or European; from which we are obliged to admit one or both of the following facts,- either that insanity is more prevalent in Massachusetts than anywhere else, or that its dimensions have been more accurately gauged. The latter fact is undoubtedly true, but alone it will hardly account for the result in question. From the United States census of 1850, it appeared that the insane averaged 1 to 669 of the whole population of the country, and 1 to 402 of the whole population of Massachusetts. On the supposition that an equally accurate enumeration would show