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SENILE INSANITY
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SENILE See also:INSANITY .-States of See also:mental enfeeblement are always the result of failure of development or of structural changes in ~n1k the cortical See also:grey See also:matter of the See also:brain. If the enfeeble-Insanity. merit is due to failure of development or brain damage occurring in See also:early See also:life, it is spoken of as See also:idiocy or imbecility. Every See also:form of insanity which occurs after a certain See also:period of life is See also:apt to be regarded by some observers as senile, but although the failing mental See also:power may See also:colour the See also:character of the symptoms it cannot be regarded as correct to designate, for instance, a recurrent form of See also:mania as senile merely because it necessarily manifests itself in a subject who has lived into the senile period. On the other See also:hand, many persons first suffer from mental derangement at an advanced period of life without at the same See also:time manifesting any marked failure of mental power, while others only See also:manifest their insanity as a result of the decay of their mental faculties. From this statement it will be seen that senile insanity is a complex of different conditions, some of them accompanied by dementia, others without dementia. Senile Dementia is distinguished occasionally 'into " senile " properly so called, and " presenile " dementia, which supervenes at See also:middle See also:age or even• earlier. The occurrence of dementia is sometimes preceded by an acute hallucinatory phase, accompanied by mania or See also:melancholia; but as a See also:general See also:rule, in the presenile cases, by See also:neurasthenia, indifference, and mental apathy which extends to a disregard for the See also:ordinary conventions and the means of subsistence. It has pithily been remarked that the age of a See also:man is the age of his See also:blood-vessels. The two conditions of senile and presenile dementia cannot therefore be separated scientifically. From a clinical point of view, however, the two are distinguishable in so far as their symptoms are concerned, for the presenile cases are more See also:complete and the See also:process of dementia achieves its consummation earlier and quicker, while in the senile the See also:gradual disease of the See also:arteries and the slow decay of the mental faculties offer a different background for the manifestation of mental symptoms. Moreover, the senile patients more frequently See also:present symptoms of recurrent attacks of acute insanity, a more pronounced emotionalism, and a greater tendency to restlessness at See also:night. The presenile cases, on the other hand, except at the commencement of their malady, are usually See also:free from acute and troublesome symptoms and present chiefly an.apathetic indifference and irresponsiveness on the mental See also:side, and on thephysical side a neurasthenic and enfeebled bodily See also:state. In both conditions memory is greatly impaired. Added to senile dementia there is often found a See also:condition of mania or melancholia or even of systematized delusional insanity. The See also:chief symptoms of the maniacal attacks are the See also:great motor restlessness and excitement, which are worst during the night time. See also:Sleep is almost always seriously disturbed, and the patients rapidly become exhausted unless carefully nursed and tended. The, actions of senile maniacs are often puerile and foolish, and they may exhibit impulses of a homicidal, suicidal or sexual character. The melancholic cases are also extremely restless, and their emotion is loudly expressed in an uncontrollable manner. They often have delusions of persecution. Their cries and groans have an automatic character, as if the patient, though compelled to utter them, did not experience the mental See also:pain which he expressed. They also, many of them, eat their See also:food ravenously, although a few obstinately refuse it. The senile delusional cases may manifest any of the classical forms of See also:paranoia described above, but their delusions are of a rudimentary and unfinished type. The most See also:common of all senile delusions is that they are being robbed. They therefore often hide their small valuables in corners and out-of-the-way places, and as their memories are very defective they are afterwards unable to find them. Others, who live alone, See also:barricade their doors and try to prevent any one entering for fear of thieves. Delusions of ambition in senile subjects are usually of a very improbable and childish character. Hallucinations are generally present in the senile delusional cases. The treatment of senile insanity is from the medical point of view not hopeful; it resolves itself largely into instructions for careful See also:nursing, suitable feeding, and the See also:protection of the patient from all the See also:physical dangers to which he may be exposed. See also:Statistics.-The statistics of lunacy are merely of See also:interest from a sociological point of view; for under that See also:term are comprised all forms of insanity. It is needless to produce tables illustrative of the relative See also:numbers of lunatics in the various countries of See also:Europe, the systems of See also:registration being so unequal in their working as to afford no trustworthy basis of comparison. Even in Great See also:Britain, where the systems are more perfect than in any other See also:country, the tables published in the See also:Blue Books of the three countries can only be regarded as approximately correct, the difficulty of registering all cases of lunacy being insuperable. On the 1st of See also:January 1907, according to the returns made to the offices of the Commissioners in Lunacy, the numbers of lunatics stood thus on the registers:- See also:Males. See also:Females. Totals. See also:England and See also:Wales . . 57,176 66,812 123,988 See also:Scotland 8,594 8,999 17,593 See also:Ireland 12,254 11,300 23,554 See also:Gross See also:total 78,024 87,111 165,135 These figures show the ratio of lunatics to 100,000 of the See also:population to be 354 in England and Wales, 312 in Scotland, and 538 in Ireland. Numbers of Lunatics on the 1st of January of the years 1857-1907 inclusive, according to Returns made to the Offices of the Commissioners in Lunacy for England and Wales, Scotland and Ireland. Years. England Scotland. Ireland. and Wales. 1858 5,823 1859 36,762 6,072 186o 38,058 6,273 1861 39,647 6,327 1862 41,129 6,398 8,055 1863 43,118 6,386 7,862 1864 44,795 6,422 8,272 1865 45,950 6,533 8,845 1866 47,648 6,730 8,964 1867 49,086 6,888 8,962 1868 51,000 7,055 9,086 1869 53,177 7,310 9,454 187o 54,713 7,571 Io,o82 1871 56,755 7,729 10,257 1872 58,64o 7,849 10,767 1873 60,296 7,982 10,958 Years. England Scotland. Ireland. and Wales. 1874 60,027 8,069 I1,326 1875 63,793 8,225 11,583 1876 64,916 8,5o9 11,777 1877 66,636 8,862 12,123 1878 68,538 9,097 12,380 1879 69,885 9,386 12,585 188o 71,191 9,624 12,819 1881 73,113 10,012 13,062 1882 74,842 10,355 13,444 1883 76,765 10,510 13,882 1884 78,528 10,739 14,088 1885 79,704 10,918 14,279 1886 80,156 11,187 14,590 1887 80,891 11,309 14,702 1888 82,643 11,609 15,263 1889 84,340 11,954 15,685 1890 86,067 12,302' 16,159 1891 86,795 12,595 16,251 1892 87,848 12,799 16,688 1893 89,822 13,058 17,124 1894 92,067 13,300 17,276 1895 94,081 13,852 17,665 1896 96,446 14,093 18,357 1897 99,365 14,500 18,966 1898 101,972 14,906 19,590 1 899 105,086 15,399 20,304 1900 106,611 15,663 20,863 1901 107,944 15,899 21,169 1902 110,713 16,288 21,630 1903 113,964 16,658 22,138 1904 117,199 16,894 22,794 1905 '19,829 17,241 22,996 1906 121,979 17,450 23,365 1907 123,988 17,593 23,554 There is thus an increased ratio in England and Wales of lunatics to the population (which in 1859 was 19,686,701, and in 1907 was estimated at 34,945,600) of 186.8 per See also:Ioo,000 as against 3 54.8, and in Scotland of 15.7 as against 312 per Ioo,000. The Irish figures on the same basis have increased from 130.9 in 1862 to 538.1 in 1907. The publication of these figures has given rise to the question whether lunacy has actually become more prevalent during the last twenty years, whether there is real increase of the disease. There is a See also:pretty general consent of all authorities that if there has been an increase it is very slight, and that the apparent increase is due, first to the improved systems of registration, and secondly (a far more powerful See also:reason) to the increasing tendency among all classes, and especially among the poorer class, to recognize the less pronounced forms of mental disorder as being of the nature of insanity. Thirdly, the See also: The See also:Pathology of Mind (1895) ; Bevan See also:Lewis, A See also:Text-See also:Book of Mental Diseases (1899); Clouston, Clinical 'Lectures on Mental Diseases (1892); Kraepelin, Psychiatrie (1893); See also:Krafft-Ebing, Lehrbuch der Psychiatrie (3893); Regis, A See also:Practical See also:Manual of Mental See also:Medicine (See also:London, 1895); Magnan, Lecons cliniques sur See also:les maladies mentales (1897); Mendil, Leitfaden der Psychiatrie (1902); See also:Mercier, A Text-Book of Insanity (1902); Lewis C. See also:Bruce, Studies in Clinical Psychiatry (1906); See also:Macpherson, Mental Affections (1899); Brower-See also:Bannister, Practical Manual of Insanity (1902); See also:Ford See also:Robertson, Text-Book of Pathology in Relation to Mental Diseases (1900). (J. B. T.; J. Mx.; L. C. B.) II. LEGAL ASPECTS The effect of insanity upon responsibility and See also:civil capacity has been recognized at an early period in every See also:system of See also:law. See also:Roman Law.-In the Roman See also:jurisprudence its consequences were very fully See also:developed, and the provisions and terminology of that system have largely affected the subsequent legal treatment of the subject. Its leading principles were See also:simple and well marked. The insane See also:person having no intelligent will, and being thus incapable of consent or voluntary See also:action, could acquire no right and incur no responsibility by his own acts (see Sohm's Inst. Roman Law, 3rd ed. pp. 216, 217, 219); his person and See also:property were placed after inquiry by the See also:magistrate under the See also:control of a See also:curator, who was empowered and See also:bound to See also:manage the property of the lunatic on his behalf (Sohm, p. 513; See also:Hunter, Roman Law, pp. 732-735). The different terms by which the insane were known, such as demens, furiosus, fatuus, although no doubt signifying different types of insanity, did not in Roman law infer any difference of legal treatment. They were popular names, which all denoted the complete deprivation of reason.
See also:Medieval Law.-During the middle ages the insane were little protected. Their legal acts were annulled, and their property placed under control, but little or no attempt was made to supervise their See also:personal treatment. In England the wardship of idiots and lunatics, which was annexed before the reign of See also:Edward II. to the See also: The public See also:attention was strongly attracted to the miserable condition of the insane incarcerated in asylums without any efficient check or inspection; and at the same time the medical knowledge of insanity entered on a new phase. The possibility and advantages of a better treatment of insanity were illustrated by eminent physicians, Philippe See also:Pinel in See also:France, H. See also:Tuke in England, See also:Bond, B. See also:Rush and I. See also:Ray in the United States; its physical origin became generally accepted; its mental phenomena were more carefully observed, and its relation was established to other mental conditions.
See also:Modern Law.-From this period we date the commencement of legislation such as that known in England as the Lunacy Acts, which aimed at the regulation and control of all constraint applied to the insane. Hitherto, the criteria of insanity had been very See also:rude, and the See also:evidence was generally of a loose and popular character; but, whenever it was fully recognized that insanity was a disease with which physicians who had studied the subject were peculiarly conversant, See also:expert evidence obtained increased importance, and from this time became prominent in every case. The newer medical views of insanity were thus brought into • contact with the old narrow conception of the law courts, and a controversy arose in the See also: The term non compos mentis is as old as the See also:statute De praerogativa regis (1325), and is used sometimes, as in that statute, to indicate a See also:species contrasted with idiot, sometimes (e.g. in Co. Litt. 246 (b)) as a genus, and afterwards, chiefly in statutes See also:relating to the insane, in connexion with the terms " idiot " and " lunatic " as a word ejusdem generic. The word " idiot " (Gr. 'ZStos, a private person, one who does not hold any public See also:office, and i u.'or7s, an ignorant and illiterate person) appears in the statute De praerogativa regis as fatuus naturalis, and it is placed in contradistinction to non compos mentis. The " idiot " is defined by See also:Sir E. See also:Coke (4 See also:Rep. 124 (b)) as one who from his nativity, by a perpetual infirmity, is non compos mentis, and Sir M. See also:Hale (Pleas of the See also:Crown, i. 29) describes idiocy as " fatuity a nativitate See also:vet dementia naturalis." In early times various artificial criteria of idiocy were suggested. See also:Fitzherbert's test was the capacity of the alleged idiot to See also:count twenty pence, or tell his age, or who were his See also:father and See also:mother (De natura brevium, 233). See also:Swinburne proposed as a criterion of capacity, inter alia, to measure a yard of See also:cloth or name the days in the week (Testaments, 42). Hale propounded the sounder view that " idiocy or not is a question of fact triable by See also:jury and sometimes by inspection " (Pleas of the Crown, i. 29). The legal incidents of idiocy were at one time distinct in an important particular from those of lunacy. Under the statute De praerogativa regis the king was to have the rents and profits of an idiot's lands to his own use during the life of the idiot, subject merely to an See also:obligation to provide him with necessaries. In the case of the lunatic the king was a trustee, holding his lands and tenements for his benefit and that of his family. It was on See also:account of this difference in the legal See also:con-sequences of the two states that on inquisitions distinct writs, one de idiota inquirendo, the other de lunatico inquirendo, were framed for each of them. But juries avoided finding a See also:verdict of idiocy wherever they could, and the See also:writ de idiota inquirendo See also:fell into desuetude. A further See also:blow was struck at the distinction when it came to be recognized even by the legislature (see the Idiots See also:Act 1886) that idiots are capable of being educated and trained, and it was practically abolished when the Lunacy Regulation Act 1862, in a See also:provision reproduced in substance in the Lunacy Act 1890, limited the evidence admissible in See also:proof of unsoundness of mind on an See also:inquisition (without See also:special leave of the See also:Master trying the case) to a period of two years before the date of the inquiry, and raised a See also:uniform issue, viz. the state of mind of the alleged lunatic at the time when the inquisition is held.
The term " lunatic," derived from the Latin See also:luna in con-sequence of the notion that the See also:moon had an See also:influence on mental disorders,' does not appear in the statute-book till the time of See also: 247 (a), 4 Rep. 124 (h)). Hale defines " lunacy " as " interpolated " (i.e. intermittent) dementia accidentalis vet adventitia, whether total or (a description, it will be observed, of " partial insanity ") quoad hoc vet illud (Pleas of the Crown, i. 29). In modern times, the word " lunacy " has lost its former precise signification. It is employed sometimes in the strict sense, sometimes in contra-distinction to " idiocy " or " imbecility "; once at least—viz. in the Lunacy Act 189o—as including " idiot "; and frequently ' The word for " lunatic " in several other See also:languages has a similar See also:etymology. Cp. Ital. lunatico, Span. alunado, Gr. QeXnvu uK t (epileptic), Ger. mondsuchtig.in See also:conjunction with the vague terms " unsound mind " (non-sane memory) and " insane." See also:Section 116 of the Lunacy Act 1890 has by implication extended the meaning of the term lunacy so as to include for certain purposes the incapacity of a person to manage his affairs through mental infirmity arising from disease or age. " Imbecility " is a state of mental weakness " between the limits of See also:absolute idiocy on the one hand and of perfect capacity on the other " (see 1 See also:Haggard, See also:Eccles. Rep. p. 401). 1. The Criminal Responsibility of the Insane.—The law as to the criminal responsibility of the insane has pursued in England a curious course of development. The views of Coke and Hale give the best exposition of it in the 17th century. Both were agreed that in criminal causes the act and wrong of a madman shall not be imputed to him; both distinguished, although in different See also:language, between dementia naturalis (or a nativitate) and dementia accidentalis or adventitia; and the main points in which the writings of Hale See also:mark an advance on those of Coke are in the elaboration by the former of the See also:doctrine of " partial insanity," and his See also:adoption of the level of understanding of a See also:child of fourteen years of age as the test of responsibility in criminal cases (Pleas of the Crown, i. 29, 30; and see Co. 4 Rep. 124 (b)). In the 18th century a test, still more unsatisfactory than this " child of fourteen " theory, with its See also:identification of " healthy immaturity " with " diseased maturity " (Steph. Hist. Crim. Law, ii. 150), was prescribed. On the trial of Edward See also:Arnold in 1723 for firing at and wounding See also:Lord See also:Onslow, Mr See also:Justice See also:Tracy told the jury that " a prisoner, in order to be acquitted on the ground of insanity, must be a man that is totally deprived of his understanding and memory, and doth not know what he is doing, no more than an See also:infant, than a See also:brute or See also:wild beast." In the beginning of the 19th century a fresh statement of the test of criminal responsibility in mental disease was attempted. On the trial of Hadfield for See also:shooting at See also:George III. in See also:Drury See also:Lane See also:Theatre on 15th May 1800, Lord Chief Justice See also:Kenyon charged the jury in the following terms: " If a man is in a deranged state of mind at the time, he is not criminally answerable for his acts; but the material part of the case is whether at the very time when the act was committed the man's mind was sane." The practical effect of this ruling, had it been followed, would have been to make the question of the See also:amen-ability of persons alleged to be insane to the criminal law very much one of fact, to be answered by juries according to the particular circumstances of each case, and without being aided or embarrassed by any rigid See also:external See also:standard. But in 1812, on the trial of See also:Bellingham for the See also:murder of Mr See also:Perceval, the First Lord of the See also:Treasury, Sir See also: The points affirmed by the Rules that must be noted here are the propositions that knowledge of the nature and quality of the particular criminal act, at the time of its See also:commission, is the test of criminal responsibility, and that delusion is a valid exculpatory plea, when, and only when, the fancies of the insane person, if they had been facts, would have been so. The Rules in Macnaughton's case are open to serious See also:criticism. They ignore, at least on a literal See also:interpretation, those forms of mental disease which may, for the present purpose, be roughly grouped under the heading " moral insanity," and in which the moral faculties are more obviously deranged than the mental—the affections and the will, rather than the reason, being apparently disordered. The test propounded with reference to delusions has also been strenuously attacked by medical writers, and especially by Dr Maudsley in his See also:work on Responsibility in Mental Disease, on the ground that it first assumes a man to have a delusion in regard to a particular subject, and then expects and requires him to reason sanely upon it. It may be pointed out, however, that in thus localizing the range of the See also:immunity which insane delusion confers, the criminal law is merely following the course which, Inutatis mutandis, the civil law has, with general See also:acceptance, adopted in questions as to the contractual and testamentary capacity of the insane. The Rules in Macnaughton's case have, as regards moral insanity, undergone considerable modification. Soon after they were laid down, Sir (then Mr) James Fitz-James See also:Stephen, in an See also:article in the Juridical Papers, i. 67,on the policy of maintaining the existing law as to the criminal responsibility of the insane, foreshadowed the view which he subsequently propounded in his See also:History of the Criminal Law, ii. 163, that no man wild was deprived by mental disease of the power of passing a fairly rational See also:judgment on the moral character of an act could be said to " know " its nature and quality within the meaning of the Rules; and it has in See also:recent years been found possible in practice so to manipulate the test of the criminal responsibility which they prescribed as to afford protection to the accused in the by no means infrequent cases of insanity which in its literal interpretation it would leave without excuse. In Scotland the Rules in Macnaughton's case are recognized, but, as in England, there is a tendency among judges to adopt a generous construction of them. Mental unsoundness in-sufficient to See also:bar trial, or to exempt from See also:punishment, may still, it is said, be present in a degree which is regarded as reducing the offence from a higher to a See also:lower See also:category,—a doctrine first practically applied in Scotland, it is believed, in 1867 by Lord Deas; and the fact that a prisoner is of weak or See also:ill-regulated mind is often urged with success as a plea in mitigation of punishment. The See also:Indian Penal See also:Code (Act XLV. of 1860, § 84) expressly adopts the See also:English test of criminal responsibility, but the qualifications noted in the case of Scotland have received some measure of judicial acceptance (see See also:Mayne, Crim. Law Ind., 3rd ed., pp. 403-419; See also:Nelson, Ind. See also:Pen. Code, 3rd ed., pp. 135 et seq.). The Rules in Macnaughton's case have also been adopted in substance in those colonies which have codified the criminal law. The following typical references may be given: 55 and 56 Vict. (Can.) c. 29, § II; 57 Vict. (N.Z.), No. 56 of 1893, § 23; No. rot of 1888 (St See also:Lucia), § 5o; No. 5 of 1876 (See also:Gold See also:Coast), § 49 (b) ; No. 2 of 1883, See also:art. 77 (See also:Ceylon); No. 4 of 1871, art. 84 (Straits Settlements). On the other hand, a departure towards a recognition of " moral insanity " is made by the See also:Queensland Criminal Code (No. 9 of 1899), § 27 of which provides that " a person is not criminally responsible for an act " if at the time of doing it " he is in such a state of mental disease . . . as to deprive him ... of capacity to control his actions ": and the law has been defined in the same sense in the Cape of Good See also:Hope in the case of See also:Queen v. See also:Hay (1899, 16 S.C.R. 290). The Rules were rapidly reproduced in the United States, but the modern trend of American judicial See also:opinion is adverse to them (see Clevenger, Med. See also:Jur. of Ins. p. 125; See also:Parsons v. State (1887) 81 See also:Ala. 577).
On the See also:Continent of Europe moral insanity and irresistible impulse are freely recognized as exculpatory pleas (see the See also:French Code Penal, § 64 ; Belgian Code Penal, § 71; See also:German Penal Code, § 51; See also:Italian Penal Code, §§ 46, 47).
Not only is insanity at the time of the commission of an offence a valid exculpatory plea, but supervening insanity stays the action of the criminal law at every See also:stage from See also:arrest up to punishment. High See also:treason was formerly an exception, but the statute making it so (33 See also:Hen. VIII. c. 20) was repealed in the time of See also: Luns. Act 1884, and See also:Hansard, 3rd See also:series, vol. ccxc. p, 75; 139 See also:Corn. Jo. pp. 336, 340, 344). The Lunatics' Removal (See also:India) Act 1851 provides for the removal to a criminal lunatic asylum in Great Britain of persons found guilty of crimes and offences in India, and acquitted on the ground of insanity. Similar provisions with regard to colonial criminal lunatics are contained in the Colonial Prisoners' Removal Act 1884; and the policy of this statute has been followed by No 5. of 1894 (New See also:South Wales), and Ordin. No 2 of 1895 (See also:Falkland Islands). Indian law (see Act V. of 1898, §§ 464–475) and the See also:laws of the colonies (the Cape Act No. 1 of 1897 is a typical example) as to the trial of lunatics are similar to the English. In Scotland all the criminal lunatics, except those who may have been removed to the ordinary asylums or have been discharged, are confined in the Criminal Asylum established at See also:Perth in connexion with H.M.'s General See also:Prison, and regulated by special acts (23 & 24 Vict. C. 105, and 40 & 41 Vict. C. 53). Provision similar to the English has been made for prisoners found insane as a bar to trial, or acquitted on the ground of insanity or becoming insane in confinement. In New See also:York, See also:Michigan and other American states there are criminal lunatic asylums. Elsewhere insane criminals are apparently detained in state prisons, &c. The statutory rules as to the maintenance of criminal lunatic asylums, the treatment of the criminal insane, and the plea of insanity in criminal courts in See also:America, closely resemble English practice. 1It has sometimes been stated that this power, which ought clearly, in the interests alike of prisoners and of the public, to be exercised with caution, is in fact exerted in an unduly large number of cases. The following figures, taken from the respective volumes of the Criminal Judicial Statistics, show the number of criminal lunatics certified insane before trial. In 1884-1885, out of a total of 938 criminal lunatics, 169 were so certified; in 1885-1886, 149 out of 890; in 1889-1890, 108 out of 926; in 1890-1891, 95 out of 900; in 1894, 78 out of 738; in 1895, 84 out of 757; in 1896, 88 out of 769; in 1897, 85 out of 764; in 1898, 17 out of 209; in 1899, 13 out of 159; in 1900, 12 out of 185; in 1901, 15 out of tog; in 1902, 7 out of 233; in 1903, II out of 229. The only special point in Continental law calling for See also:notice is the system by which See also:official experts report for the guidance of the tribunals on questions of alleged criminal irresponsibility (see, e.g., the German Code of Penal See also:Procedure, § 293, and cp. § 81). 2. Insanity and Civil Capacity.—The law as to the civil capacity of the insane was for some time influenced in Great Britain by the view propounded by Lord See also:Brougham in 1848 in the case of Waring v. Waring, and by Sir J. P. See also:Wilde in a later case, raising the question of the validity of a See also:marriage, that, as the mind is one and indivisible, the least disorder of its faculties was fatal to civil capacity. In the leading case of See also:Banks v. Good-See also:fellow in 1870, the See also:court of queen's See also:bench, in an elaborate judgment delivered by Chief Justice Cockburn, disapproved of this doctrine, and in effect laid down the principle that the question of capacity must be considered with strict reference to the act which has to be or has been done. Thus a certain degree of unsoundness of mind is not now, in the See also:absence of undue influence, a bar to the formation of a valid marriage, if the party whose capacity is in question knew at the time of the marriage the nature of the engagement entered into (but see 51 Geo. III. c. 37 as to the marriage of lunatics so found by inquisition). Again, a man whose mind is affected may make a valid will, if he possesses at the time of executing it a memory sufficiently active to recall the nature and extent of his property, the persons who have claims upon his See also:bounty, and a judgment and will sufficiently free from the influence of morbid ideas or external control to determine the relative strength of those claims. So far has this rule been carried, that in 1893 See also:probate was granted of the will of a See also:lady who was a See also:Chancery lunatic at the date of its See also:execution, and died without the inquisition having been superseded. (See also:Roe v. Nix, 1893, p. 55.) It is also now settled that the simple con-See also:tract of a lunatic is voidable and not void, and is binding upon him, unless he can show that at the time of making it he was, to the knowledge of the other party, so insane as not to know what he was about. (Imperial See also:Loan Co. v. See also: Supervening insanity is no bar to proceedings by or against a lunatic See also:husband or wife for See also:divorce or separation for previous matrimonial offences. It does not avoid a marriage nor constitute per se a ground either for divorce or for judicial separation. But See also:cruelty does not cease to be a cause of suit if it proceeds from disorderly affections or want of moral control falling See also:short of See also:positive insanity; and possibly even cruelty springing from intermittent or recurrent insanity might be held a ground for judicial separation, since in such case the party offended against cannot obtain protection by securing the permanent confinement of the offending See also:spouse. Whether insanity at the time when an alleged matrimonial offence was committed is a bar to a suit for divorce or separation is an open question; and in any event, in order that it may be so, the insanity must be of such a character as to have prevented the insane party from knowing the nature and consequences of the act at the time of its commission. The laws of Scotland, Ireland, India (see, e.g., Act IX. of 1872, § 12), the colonies and the United States are substantially identical with English law on the subject of the civil capacity of the insane. The German Civil Code (0569) recognizes the lunacy of a spouse as a ground for divorce, but only where the malady continues during at least three years of the See also:union, and has reached such a See also:pitch that intellectual inter-course between the spouses is impossible, and that every prospect of a restoration of -such association is excluded. If one of the spouses obtains a divorce on the ground of the lunacy of the otherthe former has to allow See also:alimony, just as a husband declared to be the See also:sole guilty party in a divorce suit would have to do (§§ 1585, 1578)- 3. The Jurisdiction in Lunacy.—In order to effect a change in the status of persons alleged to be of unsound mind, and to bring their persons and property under control, the aid of the jurisdiction in lunacy must be invoked. Under the unrepealed statute De Praerogativa Regis (1325) the care and custody of lunatics belong to the Crown. But the Crown has, at least since the 16th century, exercised this See also:branch of the prerogative by delegates, and principally through the Lord See also:Chancellor—not as See also:head of the Court of Chancery, but as the representative and delegate of the See also:sovereign. Under the Lunacy Acts 1890 and 1891, the jurisdiction in lunacy is exercised first by the Lord Chancellor and such of the Lords Justices and other judges as may be invested with it by the sign-manual; and, secondly, by the two Masters in Lunacy, appointed by the Lord Chancellor, from members of the bar of at least ten years', See also:standing, whose duties include the holding of inquisitions and See also:summary inquiries, and the making of most of the consequential orders dealing with the persons and estates of lunatics. See also:County court judges may also exercise a limited jurisdiction in lunacy in the case of lunatics as to whom a reception order has been made, if their entire property is under £200 in value, and no relative or friend is willing to undertake the management of it; in See also:partnership cases where the See also:assets do not exceed £500; and upon application by the guardians of any union for See also:payment of expenses incurred by them in relation to any lunatic. Persons of unsound mind are brought under the jurisdiction in lunacy either by an inquisition de lunatico inquirendo, or, in certain cases which will be adverted to below, by proceedings instituted under §116 of the Lunacy Act 1890, which is now the great practice section in the Lunacy Office. Prior to 1853 a special commission was issued to the Masters in each alleged case of lunacy. But by the Lunacy Regulation Act of that year a general commission was directed to the Masters, empowering them to proceed in each case in which the Lord Chancellor by order required an inquisition to be held. This procedure is still in force. A special commission would now be issued only where both Masters were personally interested in the subject of the inquiry, or for some other similar reason. An inquisition is ordered by the judge in lunacy (a term which does not, for this purpose, at present include the Masters, although this is one of the points in regard to which a change in the law has been suggested, on the See also:petition generally of a near relative of the alleged lunatic. The inquiry is held before one of the Masters, and a jury may be summoned if the alleged lunatic, being within the jurisdiction, demands it, unless the judge is satisfied that he is not competent to form and See also:express such a wish; and even in that case the Master has power to See also:direct trial by jury if he thinks See also:fit on See also:consideration of the evidence. Where the alleged lunatic is not within the jurisdiction the trial must be by jury; and the judge in lunacy may direct this mode of trial to be adopted in any case whatever. A few points of general interest in connexion with inquisitions must be noted. In practice See also:thirty-four jurors are summoned by the See also:sheriff, and not more than twenty-four are empanelled. Twelve at least must concur in the verdict. Counsel for the petitioner ought to act in the judicial spirit expected from counsel for the See also:prosecution in criminal cases. The issue to be determined on an inquisition is " whether or not the alleged lunatic is at the time of the inquisition of unsound mind, and incapable of managing himself and his affairs " (a special verdict may, however, be found that the lunatic is capable of managing himself, although not his affairs, and that he is not dangerous to others); and without the direction of the person holding the inquisition, no evidence as to the lunatic's conduct at any time being more than two years before the inquisition is to be receivable. This See also:limitation, both of the issue and of the evidence, was imposed with a view to preventing the recurrence of such cases as that of Mr See also:Windham in 1861-1862, when the inquiry ranged over the whole life of an alleged lunatic, See also:forty-eight witnesses being examined on behalf of the petitioners and ninety-one on behalf of the respondents, while the See also:hearing lasted for thirty-four days. For the purpose of assisting the Master or jury in arriving at a decision, provision is made for the personal examination of the alleged lunatic by them on See also:oath or otherwise, and either in open court or in private, as may be directed. The proceedings on inquisition are open to the public. When a person has been found lunatic by inquisition he becomes subject to the jurisdiction in lunacy, and remains so (unless he succeeds in setting aside the verdict by a " See also:traverse "— a proceeding which ultimately comes before, and is determined by, the King's Bench See also:Division in London or at the assizes) until his recovery, when the inquisition may be put an end to by a procedure technically known as " supersedeas," or by his death. The results of the inquisition are worked out in the Lunacy Office. The control of the See also:estate, and, except where he was found incapable of managing his property only, of the person of the lunatic is entrusted to committees of the estate and person, who are appointed by, and accountable to, the Master in Lunacy, and whose legal position corresponds roughly with that of the tutors and curators of the civil law. The See also:committee of the estate in particular exercises over the property of the lunatic, with the See also:sanction or by the order of the Master, very wide See also:powers of management and See also:administration, including the raising of See also:money by sale, See also:charge or otherwise, to pay the lunatic's debts, or provide for his past or future maintenance, charges for permanent improvements, the sale of any property belonging to the lunatic, the execution of powers vested in him and the performance of contracts relating to property. The alternative method of bringing a person of unsound mind under lunacy jurisdiction was created by § 116 of the Lunacy Act 1890. The effect of that section briefly is to enable the Master, on a See also:summons being taken out in his See also:chambers and heard before him, to apply the powers of management and administration summarized in the last preceding See also:paragraph, without any inquisition, to the following classes of cases: lunatics not so found by inquisition, for the protection or administration of whose property any order was made under earlier acts; every person lawfully detained, within the jurisdiction of the English courts, as a lunatic, though not so found by inquisition; persons not coming within the foregoing categories who are " through mental infirmity arising from disease or age " incapable of managing their affairs; persons of unsound mind whose property does not exceed £2000 in value, or does not yield an See also:annual income of more than £100; and criminal lunatics continuing insane and under confinement. In Scotland the insane are brought under the jurisdiction in lunacy by alternative methods, similar to the English inquisition and summary procedure, viz. " See also:cognition," the trial taking See also:place before the Lord See also:President of the Court of Session, or any judge of that court to whom he may remit it, and a jury of twelve—see 31 & 32 Vict. C. 100, and Act of See also:Sederunt of 3rd See also:December 1868—and an application to the Junior Lord Ordinary of the Court of Session or (43 & 44 Vict. c. 4, § 4) to the Sheriff Court, when the estate in question does not exceed boo a year, for the See also:appointment of a curator bons or judicial See also:factor. The powers of the Lord Chancellor of Ireland with regard to lunatics are generally similar to those of the English Chancellor (see the Lunacy Regulations (Irelapd) Act 1871, 34 & 35 Vict. c. 22. and the Lunacy (Ireland) Act 1901, 1 Ed. VII. c. 17; also Colles on The Lunacy Regulation (Ireland)Act) . The main feature of the French system is the provision made by the Civil Code (arts. 489-512) for the See also:interdiction of an insane person by the Tribunal of First Instance, with a right of See also:appeal to the Court of Appeal, after a preliminary inquiry and a report by a family See also:council (arts. 407, 408), consisting of six blood relatives in as near a degree of relationship to the lunatic as possible, or, in See also:default of such relatives, of six relatives by marriage. The family council is presided over by the loge de Pair of the See also:district in which the lunatic is domiciled. This system is also in force in See also:Mauritius. There are provisions, it may he noted, in Scots law for the interdiction of lunatics, either voluntarily or judicially (sec See also:Bell's Principles, § 2123). The German Civil Code provides for insane persons being made subject to guardianship (vormundung), on conditions similar to those of Scots and French law (see Civil Code, §§ 6, 104 (1896, 1906), 645-679). In the United States the fundamental procedure is an inquisition conducted on practically the same lines as in England. (Cf. See also:Indiana, Rev. Stats. (1894) §§ 2715 et seq.; See also:Missouri, Annot. Code (1892) §§ 2835 et seq.; New See also:Mexico, General Laws (1880) c. 74 §§ 1 et seq.). 4. Asylum Administration.—Asylum administration in England is now regulated by the Lunacy Acts 1890 and 1891. Receptacles for the insane are divisible into the following classes: (i.) Institutions for lunatics, including asylums, registered hospitals and licensed houses. The asylums are provided by counties or boroughs, or by union of counties or boroughs. Registered hospitals are hospitals holding certificates of registration from the Commissioners in Lunacy, where lunatics are received and supported wholly or partially by voluntary contributions or charitable bequests, or by applying the excess of the payments of some patients towards the maintenance of others. Licensed houses are houses licensed by the Commissioners, or, beyond their immediate jurisdiction, by justices; (ii.) Workhouses—see article POOR LAW; (iii.) Houses in which patients are boarded out; (iv.) Private houses (unlicensed) in which not more than a single patient may be received. A person, not being a pauper or a lunatic so found by inquisition, cannot, in ordinary cases, be received and detained as a lunatic in any institution for the insane, except under a " reception order " made by a county court judge or stipendiary magistrate or specially appointed justice of the See also:peace. The order is made on a petition presented by a relative or friend of the alleged lunatic, and supported by two medical certificates, and after a private hearing by the judicial authority. The detention of a lunatic is, however, justifiable at common law, if necessary for his safety or that of others; and the Lunacy Act 1890, borrowing from the lunacy law of Scotland, provides for the reception of a lunatic not a pauper into an asylum, where it is expedient for his welfare or the public safety that he should be confined without delay, upon an " urgency order," made if possible by a near relative and accompanied by one medical certificate. The urgency order only justifies detention for seven days (the curtailment of this period to four days is proposed), and before the expiration of that period the ordinary procedure must be followed. " Summary reception orders" may be made by justices otherwise than on petition. There are four classes of cases in which such orders may be made, viz.: (i.) lunatics (not paupers and not wandering at large) who are not under proper care and control, or are cruelly treated or neglected; (ii.) See also:resident pauper lunatics; (iii.) lunatics, whether pauper or not, wandering at large; (iv.) lunatics in workhouses. (As to pauper lunatics generally, see article PooR LAW.) A lunatic may also be received into an institution under an order by the Commissioners in Lunacy; and a lunatic so found by inquisition under an order signed by the committee of his person. The chief features of English asylum administration requiring notice are these. See also:Mechanical restraint is to be applied only when necessary for surgical or medical purposes, or in order to prevent the lunatic from injuring himself or others. The privacy of the See also:correspondence of lunatics with the Lord Chancellor, the Commissioners in Lunacy, &c., is secured. Provision is made for See also:regular visits to patients by their relatives and See also:friends. The employment of males for the custody of females is, except on occasions of urgency, prohibited. Pauper lunatics may be boarded out with relatives and friends. Elaborate provision is made for the official visitation of every class of receptacle for the insane. The duties of visitation are divided between the Commissioners in Lunacy, the Chancery Visitors and various other visitors and visiting committees. There are ten Commissioners in Lunacy—four unpaid and six paid, three of the latter being barristers of not less than five years' standing at the date of appointment, and three medical. The Commissioners in Lunacy, who are appointed by the Lord Chancellor, visit every class of lunatics except persons so found by inquisition. These are visited by the Chancery Visitors. There are three Chancery Visitors, two medical and one legal (a See also:barrister of at least five years' standing at the date of his appointment),who are appointed and removable by the Lord Chancellor. The Chancery Visitors (together with the Master in Lunacy) form a See also:Board, and have offices in the Royal Courts of Justice. In addition to these two classes of visitors, every asylum has a Visiting Committee of not less than seven members, appointed by the See also:local authority; and the justices of every county and See also:quarter-sessions See also:borough not within the immediate jurisdiction of the Commissioners in Lunacy annually appoint three or more of their number as visitors of licensed houses. Provision is made for the discharge of lunatics from asylums, &c., on recovery, or by habeas corpus, or by the various visiting authorities. Any person who considers himself to have been unjustly detained is entitled on discharge to obtain, free of expense, from the secretary to the Lunacy Commissioners a copy of the documents under which he was confined. The Irish [Lunacy Acts 1821–1890; Lunacy (Ireland) Act rgorl and Scottish [Lunacy Acts 1857 (20 & 21 Vict. c. 71), 1887 (5o & 5r Vict. c. 39)] asylum systems present no feature sufficiently different from the English to require See also:separate notice, except that in Scotland " boarding out " is a regular, and not merely an incidental, part of asylum administration. The " boarding out " principle has, however, received its most extended and most successful application in the See also:Gheel See also:colony in See also:Belgium. The patients, after a few days' preliminary observation, are placed in families, and, except that they are under ultimate control by a See also:superior commission, composed of the See also:governor of the See also:province, the Procureur du Roi and others, enjoy complete See also:liberty indoors as well as out of doors. The patients are visited by nurses from the infirmary, to which they may be sent if they become seriously ill or unmanageable. They are encouraged to work. The See also:accommodation provided for them is prescribed, and is to be of the same quality as that of the See also:household in which they live. Clothing is provided by the administration. In the French (see laws of 30th See also:June 1838 and 18th December 1839) and German (see. See also:Journal of See also:Comparative Legislation, n.s. vol. i. at pp. 271, 272) asylum systems the main features of English administration are also reproduced. The lunacy laws of the See also:British colonies have also closely followed English legislation (cf. See also:Ontario, R.S. 1897, cc. 317, 318; See also:Manitoba, R.S. 1902, c. 8o; See also:Victoria (No. 1113, 189o); New See also:Zealand (No. 34 of 1882 and Amending Acts); Mauritius (No. 37 of 1858). In America the different states of the Union have each their own lunacy legislation. The See also:national See also:government provides only for the insane of the See also:army and See also:navy, and for those residing in the District of See also:Columbia and in See also:Alaska. The various laws as to the reception, &c., of the insane into asylums closely resemble English procedure. But in several states the verdict of a jury finding lunacy is a necessary preliminary to the See also:commitment of private patients (See also:Kentucky, Act of 1883, c. 900, § 14; Mary-See also:land, R.S. 1878, c. J3, § 21; See also:Illinois, R.S. 1874, c. 85, § 22). The era of real hospitals for the insane began in the 19th century. There had been established here and there in different parts of the See also:world, it is true, certain asylums or places of restraint before the beginning of the 19th century. We find mention in history of such a place established by monks at See also:Jerusalem in the latter part of the 5th century. There is evidence that even earlier than this in See also:Egypt and See also:Greece the insane were treated as individuals suffering from disease. See also:Egyptian priests employed not only See also:music and the beautiful in nature and art as remedial agents in insanity, but recreation and occupation as well. A See also:Greek physician protested against mechanical restraint in the care of the insane, and advocated kindly treatment, the use of music, and of some sorts of manual labour. But these See also:ancient beneficent teachings were lost sight of during succeeding centuries. The prevailing See also:idea of the pathology of insanity in Europe during the middle ages was that of demoniacal See also:possession. The insane were not sick, but possessed of devils, and these devils were only to be exorcised by moral or spiritual agencies. Medieval See also:therapeutics in insanity adapted itself to the etiology indicated. See also:Torture and the cruellest forms of punishment were employed. The insane were regarded with abhorrence, and were frequently See also:cast into chains and dungeons. Milder forms of mental disease were treated by other spiritual means—such as pilgrimages to the shrines of certain See also:saints who were reputed to have particular skill and success in the See also:exorcism of evil See also:spirits. The See also:shrine of St Dymphna at Gheel, in Belgium, was one of these, and seems to have originated in the 7th century, a shrine so famed that lunatics from all over Europe *ere brought thither for miraculous healing. The little See also:town became a resort for hundreds of insane persons, and as long ago as the 17th century acquired the reputation, which still exists to this See also:day, of a unique colony for the insane. At the present time the See also:village of Gheel and its adjacent farming hamlets (with a population of some 13,000 souls) provides homes, board and care for nearly 2000 insane persons under medical and government supervision. Numerous other shrines and See also:holy See also:wells in various parts of Europe were resorted to by the mentally afflicted—such as Glen-na-See also:Galt in Ireland, the well of St Winifred, St See also:Nun's See also:Pool, St Fillans, &c. At St Nun's the treatment consisted of plunging the patient backwards into the See also:water and dragging him to and fro until mental excitement See also:abated. Not only throughout the middle ages, but far down into the 17th century, See also:demonology and See also:witchcraft were regarded as the chief causes of insanity. And the insane were frequently tortured, scourged, and even burned to death. Until as See also:late as the middle of the 18th century, mildly insane persons were cared for at shrines, or wandered homeless about the country. Such as were deemed a menace to the community were sent to ordinary prisons or chained in dungeons. Thus large numbers of lunatics accumulated in the prisons, and slowly there See also:grew up a sort of distinction between them and criminals, which at length resulted in a separation of the two classes. In time many of the insane were sent to cloisters and monasteries, especially after these began to be abandoned by their former occupants. Thus " See also:Bedlam " (See also:Bethlehem Royal See also:Hospital) was originally founded in 1247 as a priory for the brethren and sisters of the Order of the See also:Star of Bethlehem. It is not known exactly when lunatics were first received into Bedlam, but some were there in 1403. Bedlarh was rebuilt as an asylum for the insane in 1676. In 1815 a committee of the House of See also:Commons, upon investigation,. found it in a disgraceful condition, the medical treatment being of the most antiquated sort, and actual inhumanity practised upon the patients. Similarly the Charenton Asylum, just outside See also:Paris, near the See also:park of See also:Vincennes, was an old monastery which had been given over to the insane. Numerous like instances could be cited, but the interesting point to be See also:borne in mind is, that with a general tendency to improvement in the condition of imbeciles upon public charge, idiots and insane persons came gradually to be separated from criminals and other paupers, and to be segregated. The process of segregation was, however, very slow. Even after it had been accomplished in the larger centres of See also:civilization, the condition of these unfortunates in provincial districts remained the same. Furthermore, the transfer to asylums provided especially for them was not followed by any immediate improvement in the patients. Twenty-five years after Pinel had, in 1792, struck the chains from the lunatics huddled in the Salpetriere and Bicetre of Paris, and called upon the world to realize the horrible injustice done to this wretched and suffering class of humanity, a See also:pupil of Pinel, See also:Esquirol, wrote of the insane in France and all Europe: " These unfortunate See also:people are treated worse than criminals, reduced to a condition worse than that of animals. I have seen them naked, covered with rags, and having only See also:straw to protect them against the See also:cold moisture and the hard stones they See also:lie upon; deprived of See also:air, of water to quench thirst, and all the necessaries of life; given up to mere gaolers and left to their surveillance. I have seen them in their narrow and filthy cells, without See also:light and air, fastened with chains in these See also:dens in which one would not keep wild beasts. This I have seen in France, and the insane are every-where in Europe treated in the same way." It was not until 1838 that the insane in France were all transferred from small houses of detention, workhouses and prisons to asylums specially constructed for this purpose. In Belgium, in the middle ages, the public executioner was ordered to expel from the towns, by flogging, the poor lunatics who were wandering about the streets. In 1804 the Code See also:Napoleon " punished those who allowed the insane and mad criminals to run about free." In 1841 an investigation showed in Belgium thirty-seven establishments for the insane, only six of which were in good order. In fourteen of them chains and irons were still being used. In See also:Germany, England and America, in 1841, the condition of the insane was practically the same as in Belgium and France. These facts show that no great advance in the humane and scientific care of the insane was made till towards the middle of the 19th century. Only then did the actual See also:metamorphosis f asylums for detention into hospitals for treatment begin to take place. Hand in hand with this progress there has grown, and still is growing, a tendency to subdivision and specialization of hospitals for this purpose. There are now hospitals for the acutely insane, others for the chronic insane, asylums for the criminal insane, institutions for the feeble-minded and idiots, and colonies for epileptics. There are public institutions for the poor, and well-appointed private retreats and homes for the See also:rich. All these are presided over by the best of medical authorities, supervised by unsalaried boards of trustees or managers, and carefully inspected by Government lunacy commissioners, or boards of charities—a contrast, indeed, to the gaols, shrines, holy wells, chains, tortures, monkish exorcisms, &c., of the past! The statistics of insanity have been fairly well established. The ratio of insane to normal population is about x to 300 among civilized peoples. This proportion varies within narrow limits in different races and countries. It is probable that intemperance in the use of See also:alcohol and drugs, the spread of venereal diseases, and the over-stimulation in many directions induced by modern social conditions, have caused an increase of insanity in the rgth as compared with past centuries. The amount of such increase is probably very small, but on superficial examination might seem to be large, owing to the See also:accumulation of the chronic insane and the See also:constant upbuilding of asylums in new communities. The imperfections of census-taking in the past must also be taken into account. The modern hospital for the insane does See also:credit to latter-day civilization. Physical restraint is no longer practised. The day of chains—even of wristlets, covered cribs and strait-jacketsis past. Neat dormitories, cosy single rooms, and sitting- anddining-rooms please the See also:eye. In the place of See also:bare walls and floors and curtainless windows, are pictures, See also:plants, rugs, birds, curtains, and in many asylums even the barred windows have been abolished. Some of the wards for milder patients have unlocked doors. Many patients are trusted alone about the grounds and on visits to neighbouring towns. An air of busy occupation is observed in sewing-rooms, See also:schools, shops, in the See also:fields and gardens, employment contributing not only to See also:economy in administration, but to improvement in mental and physical conditions. The general progress of medical See also:science in all directions has been manifested in the See also:department of psychiatry by improved methods of treatment, in the way of sleep-producing and alleviating drugs, See also:dietetics, physical culture, hydrotherapy and the like. There are few asylums now without pathological and clinical laboratories. While it is a far cry from See also:title prisons and monasteries of the past to the modern hospital for the insane, it is still possible to trace a resemblance in many of our older asylums to their ancient prototypes, particularly in those asylums built upon the so-called See also:corridor See also:plan. Though each See also:generation contributed something new, antecedent See also:models were more or less adhered to. Progress in asylum See also:architecture has hence advanced more slowly in countries where monasteries and cloisters abounded than in countries where fixed models did not exist. Architects have had a freer hand in America, See also:Australia and Germany, and even in Great Britain, than in the See also:Catholic countries of Europe. Germany approaches nearest to an ideal standard of provision for the insane. The highest and best idea which has yet been attained is that of small hospitals for the acutely insane in all cities of more than 50,000 inhabitants, and of colonies for the chronic insane in the rural districts adjacent to centres of population. The psychopathic hospital in the See also:city gives easy and speedy See also:access to persons taken suddenly ill with mental disease, See also:aids in early diagnosis, places the patients within reach of the best specialists in all departments of medicine, and associated, as it should be, with a medical school or university, affords facilities not otherwise available for scientific See also:research and for instruction in an important branch of medical learning. A feature of the psychopathic hospital should be the reception of patients for a reasonable period of time, as sufferers from disease, without the formality of legal commitment papers. Such papers are naturally required for the detention and restraint of the insane for long periods of time, but in the earlier stages they should be spared the stigma, delay and complicated procedure of commitment for at least ten days or two See also:weeks, since in that time many may convalesce or recover, and in this way See also:escape the public See also:record of their infirmities, unavoidable by present judicial procedures. There should be associated with such hospitals for the acutely insane in cities out-See also:door departments or dispensaries, to which patients may be brought in still earlier stages of mental disorder, at a period when early diagnosis and preventive therapeutics may have their best opportunities to attain good results. In Germany a psychopathic hospital now exists in every university town, under the name of Psychiatrische xilinik. Colonies for the chronic insane are established in the country, but in the neighbourhood of the cities having psychopathic hospitals, to receive the overflow of the latter when the acute stage has passed. The true colony is constructed on the principle of a farming See also:hamlet, without See also:barracks, corridored buildings, or pavilions. It is similar in most respects to any agricultural community. The question here is one of humane care and economical administration. Humane care includes medical supervision, agreeable home-life, recreation, and, above all things, regular manual and out-of-door occupation in See also:garden, See also:farm and See also:dairy, in the See also:quarry, See also:clay-See also:pit or well-ventilated See also:shop. Employment for the patients is of immense remedial importance, and of great value from the standpoint of economical administration. In the colony system the small cottage homes of the patients are grouped about the centres of See also:industry. The workers in the farmstead live in small families about the farmstead See also:group of buildings; the tillers of the See also:soil adjacent to the fields, meadows and gardens; the .brickmakers, quarrymen and artizans in still other cottages in the neighbourhood of the scenes of their activities. In addition to these See also:groups of cottages, which constitute the See also:majority of the buildings in the village, an infirmary for bedridden, excited and crippled patients is required, and a small hospital for the sick. All the inhabitants of the colony are under medical supervision. A laboratory for scientific researches forms a highly important part of the equipment. The colony is not looked upon as a See also:refuge for the incurable; it is still a hospital for the sick, where treatment is carried on under the most humane and most suitable conditions, and wherein the precentage of recoveries will be larger than in asylums and hospitals as now conducted. In respect of the See also:establishment of colonies for the insane upon the plan outlined here, Germany has, as in the case of the psychopathic hospital, led the world. It has been less difficult for that country to set the example, because she had fewer of the conditions of the past to fight, and with her the progress of medical science and of methods of instruction in all departments of medicine has been more pronounced and rapid. Among the German colonies for the insane, that at Alt-Scherbitz, near See also:Leipzig, is the See also:oldest and most successful, and is pre-eminent in its See also:close approach to the ideal village or colony system. In 1899 See also:Professor Kraeplin of See also:Heidelberg stated (Psychiatric, 6th edition) that the effort was made everywhere in Germany to give the exterior of asylums, by segregation of the patients in separate home-like villas, rather the See also:appearance of hamlets for working-people than prisons for the insane, and he said, further, that the whole question of the care of the insane had found See also:solution in the colony system, the best and cheapest method of support. " I have myself," he writes, " had opportunity to see patients, who had lived for years in a large closed asylum, improve in the most extraordinary manner under the influence of the freer See also:movement and more independent occupation of colony life." In America the colony See also:scheme has been successfully adopted by the state of New York at the See also:Craig Colony for Epileptics. at Sonyea and elsewhere. That the tendency nowadays, even outside of Germany, in the direction of the ideal standard of provision for the ihsane is a growing one is manifested in all countries by a gradual' disintegration of the former huge See also:cloister-like abodes. More asylums are built on the See also:pavilion plan. Many asylums have, as it were, thrown off detached cottages for the better care of certain patients. Some asylums have even established small agricultural colonies a few See also:miles away from the See also:parent plant, like a See also:vine throwing out feelers. What is called the boarding-out system is an effort in a similar direction. Patients suffering from mild forms of insanity are boarded out in families in the country, either upon public or private charge. Gheel is an example of the boarding-out system practised on a large See also:scale. But the ideal system is that of the psychopathic hospital and the colony for the insane. 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