On the Statistics of the Insane, Blind, Deaf and Dumb, and Lepers, of Norway.By Professor Holst. Translated from the Danish by A. S. OLIVER MASSEY, ESQ.

[Read before the Statistical Society of London, 21st June, 1852.]

In consequence of a proposal of the clergy, in 1825, to enquire into the condition of the insane in Norway, a royal commission was issued to consider measures for their amelioration. By this body it was deemed necessary to obtain as much information as possible regarding the insane in the whole kingdom, with the view to determine the number and extent of the establishments to be erected for their accommodation. This enumeration of the insane (the first which had been made) was undertaken by the clergy, independent of the general census, and the result of the inquiry was published by Professor Holst, pursuant to royal command, in 1828, under the title of a Report, Opinion and Proposal.

The next enumeration was made in 1835, in conjunction with the general census, and was taken in the towns by the magistrates and chief officers, and in the country by the parish priests, assisted by curates, tenants, schoolmasters, and assistants. This inquiry was induced by a desire on the part of the medical faculty that returns of the insane should be obtained at the same time with those from the financial, commercial, and customs departments of the kingdom.

These returns, which are now for the first time made public, were obtained separately from the rest of the census, the results of which were published in the Statistical Tables for the kingdom of Norway.

Each of these enumerations was taken on the same scheme, and the diseases classed under the four heads of mania, melancholia (monomania), dementia, and idiotia, and are thus characterized :

Mania, or those suffering from a general disquietude of mind, combined with more or less violence, passion, or periodical delirium.

Melancholia, or those having one fixed idea, or suffering from a partial loss of senses, unable to direct their attention except to one subject, or a particular class of subjects, but in other respects more or less

sane.

Dementia, or those suffering from general weakness or excitement of the intellectual faculties, and who, having been originally sane, have lost their senses in some ordinary manner.

Idiotia, or those who suffer from a more or less defective development of the intellect.

Notwithstanding that endeavours were made to render these characteristics so plain that even the incurable cases might be distinguished, that object was not fully attained. The commission had to regret, with regard to the enumeration of 1825, that many of the clergy had evidently confused the different kinds of madness with each other, especially mania, dementia, and idiotia; still the commissioners were enabled, in a number of cases, to rectify this confusion, many of the parish priests having made short notes of the most remarkable symptoms of those afflicted. Although this was calculated to serve as a guide to the design of the enumeration of 1835, it is not improbable that a similar, if not a greater confusion, took place in the latter,

especially when the want of discernment in the parties employed is taken into consideration, for it is hardly to be supposed that they possessed that degree of general intelligence and education which the clergy did, or bestowed the same judgment and attention upon the cases brought before them in the scheme of characteristics.

The number of insane in 1825 and 1835 must not, therefore, be looked upon as perfectly correct, as neither the clergy nor the people employed on the census could in all cases judge whether those returned as insane really were so; for although the latter were charged to examine strictly into the cases, it often took more time than those who had to carry out the census in the whole of their respective districts were able to afford. Still, although these enumerations could not, in all respects, be depended upon, those in Norway, which were carried out according to the public instructions, merit our attention.

In the subjoined table, the number of insane in 1835 are given for the towns and rural districts, classed under the several heads of disease and sex, to which has been added the population and the per-centage of insane.

It appears by this table that insanity prevails more among the male sex and in the rural districts.

Advantage was taken of the census of 1835 to enumerate the blind and deaf and dumb, and this enumeration may be regarded as more authentic, the definitions of blind and deaf and dumb being much more explicit.

The result of the enumeration of the blind was first published by Professor Holst, whereas a summary of the deaf and dumb was published in an account of the Deaf and Dumb Institution of Tkrondhjem.

The following table shows the number of blind in one eye and totally blind for the towns and rural districts, and the proportion per cent. of each class to the population :

It would appear by the foregoing table that the number per cent. of blind in one eye was more than twice as great in the rural districts as in the towns, and the totally blind about a third greater. This difference probably arises from the facility of obtaining medical assistance in the towns. The number of males blind in one eye was greater than the number of females, in the towns, by one-sixth, and in the rural districts, by one-half; while, on the contrary, the totally blind were found slightly to preponderate among the females both in the towns and rural districts.

An abstract of the enumeration of the deaf and dumb taken in 1835 is here appended, by which it will be seen that this malady prevails most among the males and in the rural districts.

In 1845, another enumeration was taken of the insane, blind, and deaf and dumb, in conjunction with the census, and on this occasion the lepers were enumerated. There are now, therefore, three enumerations of insane, two of blind and deaf and dumb, and one of lepers. Although this last was made by the same persons as took the former enumeration, the scheme was somewhat changed in consequence of the confusion which had taken place on the former occasion. The medical faculty having been consulted, they gave it as their opinion that it would be more simple to class all insanity in one table; but as the various descriptions of insanity require peculiar treatment, it would be desirable to obtain some knowledge of the class of disease, they considered that the former scheme of four classes might, without material inconvenience, be reduced to two, substituting two words peculiar to the Danish language, which would be readily understood by the enumerators, viz., "rasende," or those suffering from general wearing trouble in the intellect, combined with violence, rage, or fury; and "fjanter," or those suffering from a general weakness or absence of developed faculties.

The first include those classed under mania and melancholia in the former scheme, and the latter may be divided into idiotia, or those born insane, and dementia, or those who subsequently become so; and this arrangement would not materially influence the institutions.

The following table gives the number of insane for the towns and rural districts, classed in accordance with the last-mentioned scheme, to which has also been added the population for 1845, and the percentage of insane :

It will be observed, in the foregoing table, that there was a considerable preponderance of insane among females, and that insanity prevailed one-third less in the towns than in the rural districts.

In the enumeration of the blind, in 1845, the medical faculty were of opinion that the plan adopted in 1835, of distinguishing between the "blind of one eye" and those "totally blind," was unnecessary, as they considered that, for medical statistics, those cases only were important in which the patient was either totally blind, had only partial vision, or was unable to perform any work requiring sight; hence the class of "blind in one eye" was omitted; and the blind in this scheme corresponds with the totally blind in the former, and thus the two enumerations may be compared. (Vide page 254.)

The subjoined table gives the number of blind in 1845 in the towns and rural districts, and the proportion of blind per cent. to the population:

It will be seen by this table that blindness slightly preponderated in the female sex, and prevailed with far greater intensity in the rural districts than in the towns.

In the census of 1845, the deaf and dumb were also enumerated. In the abstract appended, it will be observed that this malady preponderated greatly among males and in the rural districts :

The table annexed gives an abstract of the enumeration of lepers in 1845, and exhibits the number in the towns and rural districts, their per-centage to population, and their condition, i. e., whether married or unmarried :

It would appear by the foregoing table that there were more lepers per cent. in the towns than in the rural districts, chiefly owing to the numbers who come from the country to the hospitals in towns; and that in the rural districts leprosy prevailed one-fourth more among males than among females. As respects the condition of the lepers, it will be seen that the proportion of married to unmarried was as 4 to 7.

The following table exhibits a comparison of the blind for the years 1835 and 1845: