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steam spray.) The two projections from the main building Imarked X and Y in the plan are a student’s room and a Icasualty-room. Running beneath all the corridors and all thepavilions is a subterranean passage, in which are the coal-aiikl to which all the various shoots and lifts andstaircases descend. The hot-water pipes travel along theceilings of these passages, and the heated air in it has a

tendency to ascend into the building. On that accountit will be very necessary to attend to the purity of the airin this passage. There is a special passage leadingunderground to the mortuary and the pathological depart-ment, &o that the dead, in their transit to the deadhouse,are as little as possible exposed to the gaze of the

living. The fixing of the big hot-water pipes in the vaultedsummit of this passage has rendered it just not highEnougl for the safety of the heads of porters of average sizewho may have to work in it. Beneath the southern ends ofthe south (medical) pavilions are day-rooms for the patients.We may notice, in passing, the existence of a dry shed forthe carriages of the staff while waiting for their owners, anda lawn tennis ground for the residents. In such a hugebuilding, occupyina several acres of ground, the means ofready communication are quite necessary, and we believethat it has been arranged to place every part of the buildingin telephonic communication with the others. There aresuitable wa2’!lOn’J for the coals. and admirable trucks (de-signed by Surgeon-Major Fasson, the superintendent of theinfirmary) for the dinners. These trucks have a metal liningwhich is filled with hot water, while the interior is occupiedb,y specially-designed tins, and in point of fact the patientsget their dinners as hot as possible, notwithstanding thatthe distance from kitchen to wards is rather great. The centrebuilding (marked A on the plan) is occupied bv an entrancehall, treasurer’s. office, board-room, &c. Here, also, are somespecial wards set aside for ovariotomy, and at the top of thisbuilding are the female " Lock" wards ; while in the clocktower itself, reached by a stone spiral staircase, up or downwhich no patient could possibly be carried, is a room for ex-amining and operating upon female patients suffering fromvenereal disease. This last room is an instance (and we arebound to suv that such instances are not common in thisbuilding) of how matters of internal convenience have occa-sionally to give way to the external style of a building.There are no separation wards in the new infirmary for

contagious or infectious cases. The infirmary drains intothe town sewers, and the managers are under an obligationnot to discharge the sewage from infectious patients intotheir drains. For the present the old infirmary building isused for infectious cases, and when this building is sold somefresh arrangement will have to be made.Besides the main building, which we have described at,

we fear, a tedious length, there are certain subsidiary de-tached buildings which need to be mentioned. There aretwo entrance lodges on the north side; a house for the Isuperintendent has been provided on the east side, facing IMeadow-walk; while on the north-west side of the groundare the laundry, the boiler-house, the mortuary, and thepathological department. The laundry is not yet complete,and the boilers and heating apparatus are not yet quite outof the hands of the contractors. A huge chimney belchingsmoke, however, already indicates that scientific institutionsare as little able to accomplish a complete combustion offuel as are the most ignorant of mill-owners. The patho-logical department is very complete and well appointed.The post-mortem theatre appears to be well planned, andfitterl with every convenience. We were particularly struckwith the construction of the post-mortem tables. These areof slate, revolving on an iron pivot, the pivot also servingthe purpose of a drain. Above each table is a circle of gas-jets for use in winter, and from the centre of this circlecomes the flexible tube for the supply of water, a combina-tion of gas-pipe and water-pipe being so arranged that onepipe appears to serve both purposes.The total cost up to the present time of the buildings, site,

and furniture, has been about ;1;;340,000. The total numberof natients’ beds is 570.

In conclusion, we have to acknowledge the great courtesyreceived from everyone to whom we have applied for in-formation concerning the building which we have beendescribing. To Mr. Peter Bell, Surgeon-Major Fasson, andMr. Bryce, the architect (who furnished us with a sketch-plan, and gave us much of his valuable time as well), weare especially indebted. We have, it will be observed,dealt with the subject in a purely critical spirit. Many of

the points to which we have taken exception are not peculiarto the Edinburgh Royal Infirmary, but are common to most" pavilion hospitals which exist at present. It is becausewe believe the pavilion hospital to be susceptible of muchimprovement that we have been at the pains of using themost recent of them as a means of pointing out what webelieve to be the shortcomings of this class of buildings.Many of the points we have raised are no doubt fairlyarguable. We have raised them in the interest of those whoinhabit, build, and work in hospitals. The EdinburghRoyal Infirmary is certainly one of the finest and besthospitals in the country, but it would be a mistake to regardit as perfection, and for future hospital builders to becontent with merely imitating it.

LUNACY REPORTS FOR 1879.

THE issue of the Thirty-fourth Annual Report of the

English Commissioners in Lunacy affords the best availablematerials for considering the proportion and distribution oflunacy in England and Wales during 1879. The total recordednumber of lunatics, idiots, and persons of unsound mind inEngland and Wales on Jan. 1st last was ’il,191, showing anincrease of 1306 upon the registered number on the first dayof 1879. Presuming the proportional prevalence of lunacyto be stationary, it is evident that the number of lunaticsin a rapidly increasing population, like that of England,would steadily increase. It is impossible, therefore, to

judge of the increase or decrease of lunacy without takinginto account the proportion of lunatics to population. Inthe second table of the lunacy report just issued, it

appears that the ratio of registered persons of unsound mindhas continuously increased from 18 67 per 10,000 in 1859, to27’94 on the lst January last. The proportion, which was18-67 per 10,000 on the first day of 1859, and 23’93 at thebeginning of 1869, further rose to 27’77 on January lst, 1879,while it was, as before stated, 27’94 on the first day of thisyear. Without attempting now to discuss how far the trueincrease or decrease of lunacy in England and Wales can beestimated from the recorded numbers of persons certified orreturned as of unsound mind by a variety of authorities, it iswell to note that the proportion of lunatics and idiots to popu-lation showed an average annual increase of 2’8 per cent. inthe ten years 1859 to 1869, while in the second decade 1869-79the annual increase in the proportion did not average morethan 1’6 per cent.; the increase per cent. during 1879 did notexceed 0 6 per cent. There is a marked decline, therefore,in the rate of increase of the registered insane, which if main-tained must soon turn the increasing to a decreasing rate. If it

were possible to make due correction in the returns for theeffect of more complete registration and report of cases oflunacy in recent years, owing partly to the tendency ofpublic opinion in the direction of in-door instead of out-door poor-law relief, and partly to the State aid which inrecent years has been given towards the cost of lunatics inasylums, it is doubtful whether the apparent increase oflunacy would not disappear. One of the most importantconsiderations with reference to lunacy, regarded as a dis-ease, is its distribution or varying incidence in differentlocalities and populations. The lunacy report, however,does not afford satisfactory materials for the study of thispart of the subject. It is true that tables are given showingthe registered number of pauper lunatics in each of thecounties of England and Wales ; the reader, however, isleft to calculate for himself the proportion of lunacy topopulation in the several counties, which is the only truemeasure of lunacy. It is unfortunately impossible to dis-tribute private lunacy to the different counties, and weare therefore driven to accept the proportions of pauperlunatics as a measure of the prevalence of lunacy. Wehave noted that the total proportion of lunacy, private andpauper, was equal to 27’9 per 10,000 of the population inEngland and Wales on lst January last. If we excludethe private lunatics we find the proportion of pauper

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lunacy to be 24-9 per 10,000. We have been at the trouble the subject from the Leavesden and Caterham reports. Itto calculate this proportion of pauper lunacy in the different appears from the Scotch report that on the 1st Januarycounties, and fiud the usual wide variations. ’ London- last the registered number of lunatics was 9624, showingthat is, registration London-continues to show the largest a further increase of 238 upon the numbers at theproportion of lunacy, equal to 36 3 per 10,000. This excess beginning of previous years. The number of lunatics toof registered lunacy in the metropolis affords the strongest 10,000 of the population was 25 8, against 27 9 in Eng.evidence that liberal provision of asylum accommodation laud and Wales. This proportion of registered lunaticshas a marked tendency to promote the registration of lunacy, has steadily increased year by year from 19 2 in 1858. InIn no other part of England and Wales is the provision of one respect the Scotch statistics of lunacy ditfer materiallyasylum accommodation so proportionally large as in the from those for England and Wales. We have shown thatmetropolis; this is mainly owing to the erection of the in England the rate of increase of lunacy is a decreasingasylums for idiots and harmless lunatics at Leavesden, rate ; in Scotland, however, an ascending rate of increaseCaterham, and Darenth. In England and Wales, exclusive still prevails. The increase during the five years endingof the metropolis, the proportion of pauper lunacy did not 1870, compared with the preceding five years, was equal toexceed 23’0 per 10,000, against 36’3 in London. The pro- 4’8 per cent. ; while in the two succeeding quinquenniads,portional incidence of pauper lunacy shows marked variations ending 1875 and 1880, the increase was respectively 6’5 andin the several counties ; the proportion per 10,000 of the 8’7 per cent. The Scotch statistics bearing upon tne distri.population did not exceed 13 6 and 15 6 in Durham and bution of lunacy compare most favourable with the meagreStafford, whereas it ranged upwards to 35 0 in Wiltshire, materials on this branch of the subject in the report of35’3 in Oxfordshire, and 37’4 in Herefordshire. We may the Commissioners for England. In the Scotch report isprobably return to the discussion of lunacy distribution in given a complete and well-arranged summary of the propor-England and Wales, but will note in passing that, contrary tional amount of pauper lunacy in each of the countiesto most other diseases, lunacy shows the greatest prevalence during the twenty years ending 1880. It appears that thein agricultural populations, and the smallest prevalence in annual average of pauper lunatics per 10.000 of the popula-those counties in which the proportion of urban population tion during the last qiiinqueniiiad, 1876-80, ranged in theis the largest. On the lst of January last 64’7 per cent. of several counties from 6’9 and 9’6 in Selkirk and Shetlandthe pauper lunatics in England and Wales were in asylums, to 25’8 in Bute, 25’9 in Argyll, and 29 9 iu Kinross. Thehospitals, aud licensed houses ; 25 9 per cent. were in work- difficulties, however, in the way of a useful comparisonhouses (including the inmates of the asylums at Leavesden, of the statistics of single counties are very properly urgedCaterham, and Darenth) ; and the remainder, or 9’4 percent., in the report before us, and the statistics of twowere residing with relatives or others. In 1859, no less than groups of counties, Highland and Lowland, are suggested18’2 per cent. of pauper lunatics were residing with relatives for comparison and consideration. The proportion of theor others; since then this proportion has steadily declined. If insane of all classes on January 1st, 1879, was equalthe imbeciles at Leavesden, Caterham, and Darenth he in- to 31’6 per 10,000 of the population in the Highlandeluded with the inmates of other asylums, the proportion of counties, whereas it did not exceed 20’1 in the Lowlandthe insane under treatment in special institutions at the be- counties. This marked excess of lunacy in the Highlandginning of this year becomes 71’7 per cent., and the proportion and more purely rural population corresponds with theretained in workhouses, which was 25’1 per ceut. in 1859, is result of similar comparisons in England, where, if we ex-reduced to 18’9. The proportions of pauper lunatics main- elude the metropolis, we find a far greater ratio of insanitytained in asylums, in workhouses, and residing with relatives prevailing in the rural counties than in those counties inand others in the various counties of Englaud and Wales, which the largest proportions of the population are urban inshow marked variations, which want of space forbids us now character. We can only on the present occasion refer to oneto discuss. It may be pointed out, however, that only 55’0 other branch of the subject as dealt with in the Scotchper cent. of the pauper lunatics in Gloucestershire, and report, the proportional asylum and other treatment of the55’9 per cent. in Nottinghamshire, were under treatment in pauper insane. On January 1st last, of the 7957 registeredasylums at the beginning of this year, and the proportion pauper lunatics, 4569, or 57’4 per cent., were in Royal andof lunatics residing with relatives and others was so large as district asylums; 1229, or 15’4 per cent., in parochial17’2 per cent. in Norfolk, 17"6 in Wiltshire, and 21’0 in asylums; 676, or 8 per cent., in workhouse lunatic wards;Herefordshire. We shall defer to another notice a discussion 1415, or 17’8 per cent., in private dwellings, and 68 inof the rates of mortality prevailing among the insane during training schools. The main point of difyreiiee betweenlast year, but regret to. find that the report just issued these proportions and those prevailing in England consistsaffords no more satisfactory materials for its discussion in the fact that 17’8 per cent. of the pauper lunatics in Scot-than previous reports. The approximate ages of the insane land were residing with relations and others, and were underpopulation and of the decedents is absolutely essential, in no kind of control or efficient supervision, while the propor-order to arrive at the true excess rate of mortality due to tion similarly conditioned in England ’id not exceed 9’4 perinsanity. For this purpose the ages of the insane admitted cent. at the beginning of this ear. We shall have occasionto asylums in a single year are comparatively useless. We again to refer to this subject when we consider the varyinghave on more than one occasion expressed our conviction results of treatment in asylums anrl otherwise, with refer.of the complete futility of the information given in recent ence to proportional recovery and mortality.reports on so-called causes of insanity. These statements, -.

often little better than mere guesses, are worse than uselessas a guide to the scientific study of the true causes of in- CHARTERHOUSE SCIENCE AND ART SCHOOL ANDsanity. LITERARY INSTITUTE.-The Winter Session of this, theFrom a statistical point of view the Twenty-second Annual largest Science School in the United Kindgom, will, under

Report of the General Board of Commissioners in Lunacy for the continued presidency of the Rt-v. J. J. R1)(lgers (V.C.Scotland is, in many respects, superior to the report recently of the London School Board), commence on Saturday, theissued by the Commissioners for England. Not only are the 25th of September. During the late Session about 800tables more complete and better arranged, but in the report students availed themselves of the privileges afforded byitself the statistics are more thoroughly discussed and turned this Institution, and of this number nearly 600 presentedto account. In one respect, however, we regret that the themselves for examination and were successful in ob-Scotch figures are as defective as those in the English report. tainingno less than 140 Queen’s Prizes awarded by theNo infomation is given as to the ages of the registered Science and Art Department of South Kensington. At alunatics, or of the ages of the decedents ; and without such nominal fee instruction of a practical character is given ininformation it is impossible to obtain completely satisfactory most of the sciences, whilst in Art, at an equally low rate,mortality statistics of the insane population. It may be students, under the direction of four competent instructors,hoped that the Scotch Commissioners may see their way to can be advanced in their studies. Those who aim atgive information on this point in future reports. The most becoming proficient in Chemistry (Organic and Inorganic)complete statistics of lunacy which have come under our have the opportunity of working in a well-fitted laboratorynotice are those somewhat recently issued by the Metro- capable of holding sixty students. Aspirants for Universitypolitan Asylums Board, relating to the inmates of the honours can, at a small expense, be assisted in theirasylums at Leavesden, Caterham, and Darenth during 1879. studies. Lessons in Latin, Greek, French, German, andThe Commissioners in Lunacy, both for England and Scot- Music are given by well qualified teachers. Full parti-land, will do well, when their next reports are under prepa- culars can be had of the Organising Secretary, Mr. C.ration, to incorporate a few of the tables on this branch of Smith.