Suggestions as to the expediency of erecting a public asylum for the insane, belonging to the counties of Cumberland & Westmorland : in a series of letters to Edward Williams Hasell, esq., chairman of the Quarter Sessions / by Richard Oliver.

Oliver, Richard

Date:: [1842-1843]

Credit: Suggestions as to the expediency of erecting a public asylum for the insane, belonging to the counties of Cumberland & Westmorland : in a series of letters to Edward Williams Hasell, esq., chairman of the Quarter Sessions / by Richard Oliver. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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$the principle upon which he hns made out hia tabular itate- menc. In every other establiiihment of thie nature, a con< •iderable number of patients are removed by their friends, for various reasons, not in a cured state; but it would appear from Mr. Wilkinson’s table, that eveiy patient who has been removed from Dunston Lodge alive, since the period of Its opening, eleven years ago, has been actua//^ cured. I have no hesitation in saying that, if such be tbo fact, the experience of this Asylum is, in this tcspect, perfectly unexampled ; and certainly ought not to have been passed over by Mr. Wilkinson without that special notice which its extreme singularity would unquestiouablr merit. As he hns not thought proper,] however, to assert positively that such is the case, we are fairly authorised, I apprehend, to inquire how far the gross amount of his recoveries may have been affected by the occurrence of such removals. The total number given under the head “ Cured ” is 175 ; under that of “Dead” 55;—and these two sums added together, and deducted from 297,—the total number adm iited,—leave 67—which was probably the number in the Asylum at the end of the year 1841 ; for three nioiiths after this period, the Magistiates’ Report states the number in the house to be 69. From these enumerations we are compelled to infet, then, either that no such removals as those above alluded to have taken place ; or that the accu- racy of the statement of recoveries hns been vitiated by the omission of those deductions from their amount, which the occurrence of such removals must have rendered necessary. Although Mr. 'Wilkinson has chosen to rest his casealmost exclusively on the supposed practicability of a comparison between the proportion of Recoveries to admissions in his own establishment on the one hand, and in certain other institutions on the other, it is well known to all who aie in the slightest degree familar with the statistics of insanity, that any such estimate of the proportionate number of Recoveries in different institutions, is a most fallacious and uncertain criterion of their respective merits. “ The object which is sought in the comparison of sta- tistical tables cannot be attained unless things similar are brought together ; and this certainly is not done by the mere compari.son of the aggregate results of various institu- tions, as regards the proportion of their recoveries to their admissions. We cannot, thcrefoie, draw from such statements any fair conclusion in regard to the treat- ment.”—T OKE. The writer whom I have just quoted, and whose intimate knowledge of this subject, cannot possibly admit of dis- pute, further affirms that the statistics of mortality \a our different institutions, admit of much more safe and cer- tain comparison than that of the Recoveries, inasmuch as the event on which the comparison is founded is wholly un- ambiguous, and the pecu'iar circumstances affecting the general health of the Patients at the lime of admission into the several establishments can bo pretty easily ascertained” — but he likewise slates that “ there can bo no useful in - ference drawn from the mere comparison of their respective proportions of deaths, to the numbers admitted into them.” * * “ The uncertainty which hns hitherto so generally prevailed as to the actual rate of mortality in the insane, may be attributed partly to the calculation having nearly always been made upon this erroneous method —that is, of a comparison between the numberof deaths and the number of admissions^ But “ as is now well known, the mortality of any class of people is only correctly expretsed by the$