TREATMENTS OF ACQUIRED INSANITY, insanity terminates in recovery, in death, or in.chronic mania or chronic dementia. Accurate statistics of the two first-named terminations are unattainable, as a large number of patients are treated at home ; and asylum statistics do not therefore show the result overhead, only that of the more aggravated cases. The result of treatment in lunatic hospitals gives about 40 per cent., calculated on the admissions, which, however, include idiocy, chronic terminative insanity, and such acknowledged incurable forms of the disease as general paralysis. Timis figure does not of course represent the results of treatment of all the insanities, which, although there are no figures at command to support the assertion, may be fairly estimated at not less than 70 per cent., excluding idiocy. There is a general tendehcy of all insanities to shorten life ; as already noted, some are in themselves fatal, or render their subjects less able to withstand disease. Asylum statistics show from 7 to S per cent. per annum as the average mortality calculated on the numbers resident.

It is needless to attempt a description of the various phases of chronic terminative dementia and mania. Delusion may continue, or the patient may become more or less sottish and degraded in habits ; or, on the other hand, he may retain a considerable amount of mental power, still not sufficient to render him a responsible member of society. The great mass of the inmates of asylums belono-b to this class of lunatics, mostly harmless, yet precluded from mixing with the world as much for the convenience and safety of society as for their own benefit. A .small proportion are detained on account of their liability to suffer from recurrence of attacks of insanity, although they are not actually insane during the intervals. To this condition foreign authorities have applied the term folie circulaire, and some have asserted that it is the characteristic of certain cases ab initio. It is mostly confined to persons strongly hereditarily predisposed. The term explains itself : after intervals of comparative sanity, the patient manifests symptoms which run their course through the prodromal, the acute, and the demented stages, on again to recovery, in manner similar to a recent case.

Treatment.