Is American Insanity Increasing? a Study

Abstract

I read, at the time of its publication in 1886, and again in 1890, after a visit to Dr. Tuke in London, his first paper on the “Alleged increase of insanity,” and I await with much expectation the full text of his recent paper on the same topic. The conclusion that I draw from the statistics there presented (in 1886) is not exactly the same that my friend Dr. Tuke draws. I distrust very much the records of first attacks; so far as my observation goes—extended now over a period of 30 years, and many thousand cases of insanity whose certificates I have separately examined—there is nothing in the proverbially doubtful statistics of the insane more dubious than those affecting to give the date of a “first attack.” Even for purposes of comparison, year by year, they have scarcely more value than a mixture of pounds sterling, years of our Lord, bushels of wheat, and a few other numbers jumbled together in an account, so totally varying are the judgments and the exactness of the certifiers who set down the alleged “first attack.” Until these variances can in some way be reduced by the better observation of the asylum physician, I, for one, am inclined to leave the tabulation of “first attacks” where good sense has long left the asylum tables of “causes of insanity.” One may possibly be as good as the other, but neither can throw any clear light on the real facts of insanity.