handsome specimen of architecture, and calculated to hold five hundred patients, stands on the top of a breezy hill, in the midst of artistically laid-out gardens. Inside it bears no resemblance to other pauper asylums I have visited: the whitewashed walls are papered over, the floor is every where covered with cocoa-fibre matting, and rare plants and birds occupy the windows, which are shaded by crochet-worked white curtains. In short, it is impossible to believe that you are in an asylum until you look at the patients. Mania is dreadful enough among the intelligent classes, but when it assails rustics the combination is hideous. I saw some faces which will haunt me for a long time, such an expression of ferocity and cunning did they bear. These, of course, were isolated instances, and the majority of the patients displayed a liveliness and mirth, I fancy, foreign to them prior to their affliction. Of the one hundred and forty patients admitted during the past year, forty-five were labourers or their wives, and twenty-six were female servants. Among the supposed causes of the disease, I may mention that thirty-one patients had hereditary mania, eighteen fell victims to intemperance, while poverty and want accounted for ten cases. Cruelty of husband is responsible for two cases, and two males went mad through confinement in gaol. Of the entire number of patients under treatment in the Asylum during 1861, who were 587 in all, seventy-five were discharged recovered, one was removed improved, two were removed unimproved, and forty-two died.

The principal reason why Brentwood Asylum is so satisfactory is because the management is entirely intrusted to Dr. Campbell, the medical superintendent. The magistrates, while exercising the proper control, place thorough confidence in their officer, and coöperate cordially in carrying out every improvement he suggests, feeling assured that it will conduce to the welfare of the patients. While at Colney Hatch the magistrates find it necessary to assert their authority by interfering in the most trifling details, and thus produce a general fussiness detrimental to the interests of the Asylum, their brethren in Essex leave Dr. Campbell's hands unfettered, and allow him a seat at their deliberations. The Middlesex magistrates, I fancy, would think that the end of the world had arrived, were such a proposition made to them. But the value of the system is shown in the results, and with far more unpromising material to work upon, Dr. Campbell has ended by establishing a system which probably has not its equal in Europe. He has two great specifics for insanity-work and relaxation. As the male patients are nearly all agricultural labourers, he employs them on the farm under the superintendence of the attendants, and all work with a will. This will be seen when I state that the gross profit made from the garden and farm during the past year was upwards of 8251. The dietary at this Asylum, as indeed at all I have visited, is ample, and the average cost per head a week last year was 10s. 63d.

Two things especially struck me while walking about the grounds: the first was, that the airing yards were turfed, and raised so high that a

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fosse was formed between them and the surrounding wall. In this way the prospect was unimpeded; and I may add that, in whatever quarter looked, a pleasant landscape met my eye, for Essex is not the ugly county it is usually supposed to be. The next thing was the cemetery, where each grave was surmounted by a neat cross, and by a simple arrangement could be recognised when friends expressed a desire to see the last restingplace of a patient. Trifles these, it will be said; but nothing is a trifle when we desire to follow the working of a system, and these slight facts but confirmed the high opinion I had already formed of the Brentwood Asylum and its medical superintendent. The only feeling that obtruded on my mind was that the treatment was too good for the class; but when we see the cheap rate at which it is maintained, I can only regret that it is not more generally adopted.

At the same time, Dr. Campbell acts on the principle that all work and no play makes Jack a dull boy: he has erected a neat private theatre, and his winter entertainments are regarded as an event in the vicinity. All the year round something in the shape of relaxation is going on; for it is now recognised that "amusement serves to carry the mind away from the contemplation of its own ills, and for a time at least to afford a salutary relief from the moody influences that grow within." I am pleased to state that the same principle is recognised at most pauper asylums; and though Colney Hatch may be behindhand for the present, I feel but little doubt that a change for the better will take place ere long. I was present at the Christmas ball given to the patients at that Asylum, and felt convinced, from the transient gleam of happiness which lit up many a face, that the patients were forgetting their sorrow.

Dr. Campbell intends to carry out even a greater innovation than any which have preceded it at Brentwood. Essex, too, finds that the accommodation for patients is insufficient, and that the hour is at hand when the builder will have to be called in. Instead of adding a costly wing, it is proposed that cottages should be built on the estate, in which the more harmless patients will reside in comparative freedom. This system has long existed at Gheel, and has been found to work well. Of course though, the practice that prevails there, by which the keeper, if compelled to leave two patients at home, couples them together like grayhounds by a chain passed through a hole in the wall, will not be adopted. Dr. Campbell appears very sanguine as to the result; and should it turn out as anticipated, it will cause a revolution among our country asylums. It is self-evident that patients will have a better chance of cure in this way, when left to their own resources, than when affected by the necessary monotony and regularity of an asylum ward, however cheerfully it may be fitted up.

I have thus, I hope, given a fair idea of the pauper asylums, both metropolitan and county, and it will not be necessary to pursue that branch of my subject further, though I feel tempted to diverge to the Derby and Cambridge Asylums, both of which, I hear on all sides, are

admirably managed. I will now turn to the second class, the hospitals for the cure of lunacy, of which we have two in London, Bethlehem and St. Luke's. The broad features of these hospitals may be portrayed in a few lines: patients are admitted for one year, on bailbond of two householders to remove them at a week's notice, if called upon to do so by the medical authorities. Only those patients are allowed admission who afford a reasonable prospect of cure, and Bethlehem adheres to this rule very strictly. It is modified to some extent at St. Luke's, as I will show when I visit that hospital.

I confess that it was with a slight heart-sinking that I rang the bell of Bethlehem, for it bears a bad name even at the present day, when all has been changed from darkness to light. Inside, however, the uncomfortable sensation at once wore off, and my feeling became one of unmingled admiration as I passed through ward after ward. It was not merely the comfort I saw lavished every where, but the constant desire to supply pleasing objects for the eye, that affected me. There was a profusion of flowers; magnificent aviaries stood in the window niches; the walls were concealed by pictures; in a word, wherever I turned I found something on which the eye rested with satisfaction, as it evidenced such intense consideration and adaptation of means to the end. The galleries are splendidly airy and spacious, and all paneled with wood, which removes any possible prison look. The male patients have a reading-room, and a magnificent billiard-room, as good as any to be found in a London Club; while the females have cheerful needle-rooms, pianofortes, and materials for drawing, painting, and making artificial flowers. But far beyond all this was the hopeful, glad look I saw on every face; and the manner in which the patients crowded round Dr. Hood proved how entirely he had gained their affections by his unremitting kindness, and attention to their wants and even caprices. In my visits to the asylums, I have found this one of the best tests of the condition of the patients; for, as a rule, they are extremely suspicious and retiring, and it takes a long time ere their confidence can be gained. The culinary arrangements are also first rate; and, in short, Bethlehem may be regarded as the earthly Paradise of lunatic patients. The result of this treatment is eminently satisfactory; for nearly seventy-six per cent are discharged annually as cured.

Still, it has not been so very difficult as might be supposed to attain this result. Bethlehem has, in round numbers, an income of 30,000%, and the average curable inmates are three hundred. I leave out of the calculation the criminal lunatics, who are placed here under arrangement with the authorities, for they will be shortly removed to an asylum which Government is building for the reception of prisoners of that description. I may mention as an historic fact, that I saw Oxford busily engaged in plastering, and apparently more sane than half the people we meet in a day's march; and perhaps he is so. It may be said that, with a right of selecting patients, and with an average of 1007. for the support of each,

any medical man could have attained the same results as Dr. Hood has done. It may be so, but at any rate great credit is due to that gentleman for hitting a blot: he has considered the accommodation of Bethlehem too good for the pauper lunatic, and recruits his patients among the middle classes. At the same time he is desirous of increasing his numbers, and has recently, I believe, laid a proposition before the Board that one hundred more patients should be admitted. I trust that he will only regard this as the thin edge of the wedge, for I am convinced that Bethlehem could afford accommodation for at least six hundred, especially when the criminals are removed. It will be almost needless to state that the patients have every sort of amusement in Bethlehem, and that Dr. Hood and his family, treating them rather as friends, spend many hours in cheerful conversation with them, which is found to produce the most satisfactory results.

What shall I say of St. Luke's? Alas, after a comparison with Bethlehem, longum abludit imago. I grant that it is in many respects a noble institution, and that every thing possible to improve it is carried out by the Committee and the indefatigable medical superintendent, Mr. Toller; but the smallness of its income has led to a modification of the original system. St. Luke's now offers a home to incurable patients at the rate of one guinea a week, and has thus to some extent established a competition with the private asylums. At the outset these patients were taken on a weekly payment of seven shillings, but it has been found necessary to increase the amount. In spite of every exertion to improve it, St. Luke's is a sadly depressing place to visit: the building, erected more than a hundred years ago, ignores those conditions of light and ventilation deemed so essential at the present day; and though I can speak in the highest terms of the attention Mr. Toller devotes to his patients, the excellence of the dietary, and the general comfort of the inmates, these external defects can never be eradicated till the building is entirely rebuilt. It is true that I visited it on a dark February day, which probably added much to the gloominess; but I do not imagine that St. Luke's would appear cheerful even on the brightest summer-day. In other respects, apart from the luxurious appliances of Bethlehem, the system appears much the same: an equal number of patients is discharged cured, and the musical entertainments, given through the winter-months once a fortnight, have been deservedly well spoken of by the press generally, and formed the subject of a drawing in a recent number of the Illustrated News. It is not too much to say, then, that every thing within human limits is done at St. Luke's to promote the comfort and recovery of the patients, and my only wonder is that such success is obtained under such depressing influences. The public would do much for this hospital if they would bestow a portion of their abundant charity upon it; for it is an institution the closing of which would be highly to be regretted, while the acknowledged benefit it produces is only limited by the pecuniary resources at its command.

I will now turn my attention to a peculiar class of asylums, generally called mixed, which are, to a certain extent, both public and private; that is to say, while they afford accommodation for paupers, they are the property of an individual, who at the same time receives private patients. Of these establishments there are, I believe, five in London, and I will select as my type Camberwell House, kept by Dr. Paul, where every facility was readily granted me for my investigation. It occupies the site of the old Naval School, since removed to New Cross, and the grounds and buildings are very spacious and excellently adapted to the object. These houses serve as a species of annexe to the County Asylums when the latter are full, though many London unions prefer sending their patients direct to them, under the impression that they will not only be more kindly treated, but also that they have a better chance of cure. The average rate of payment is the same as that at the County Asylums, and the fare decidedly better. But the great advantage of Dr. Paul's establishment is its homeliness: the patients move about from one room to another at perfect liberty, the only marked separation being of course between males and females, although they frequently come together for a dance. Throughout this establishment I noticed a prevalent cheerfulness, and the healthy appearance of the patients showed that they had no cause of complaint. I shall probably surprise some of my readers when I tell them that Dr. Paul's house in the Camberwell Road contains upwards of three hundred patients, private and pauper, and yet you might pass it any number of times before discovering the fact.

The private patients are virtually divided into three classes, according to the rate of payment, but I suspect that the distinction is merely nominal. The first-class patients have a carriage at their disposal, and are allowed to go out on parole in some cases; but the same liberal treatment as regards food, &c., is applied to all classes. Nothing, in short, can be more gratifying to the moralist than a ramble through Dr. Paul's establishment; for he finds on all sides evidences of the kindest treatment, and an amount of intelligent expenditure, proving that the proprietor regards his establishment from a more elevated point of view than a mere commercial speculation. I have dwelt on Dr. Paul's establishment, as it is the only one of this nature I have had opportunity to inspect; but I have no reason for believing that the other four in London are not equally well conducted. As the charges are so carefully graduated, there are but few families utterly unable to support a relative in a house of this sort, and they are certainly a great source of comfort to the middle classes. At the same time I must add that the percentage of cures at asylums of this kind is high (having regard to the class of patients admitted); for as the demands for admission are generally in excess of the accommodation, it is naturally to the interest of the proprietors to discharge a large annual number, and thus maintain the good character of their houses.

Of the highest class of private asylums I am unable to speak personally, for their proprietors are naturally chary of visitors; not that they