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spermatozoa met with in the fluid were very numerous, and were seen in a living state, not only by myself, but also by Mr. F. Wood, surgeon, of Brownlow Street, and Mr. John Quekett, of the College of Surgeons.

In this, as in the former cases, the fluid contained a few blood globules, transparent cysts, spermatic granules, and scales of epithelium.

This patient has been tapped a second time, and the fluid presented the same appearances as on the first occasion. It was examined, not only by myself, but also by Drs. Burrows and Russell, as well as by Messrs. Lawrence, Stanley, Paget, &c.

At present I am unacquainted with any facts that will satisfactorily account for the circumstances under which the spermatozoa in the preceding cases departed from their natural abode, and acquired a "local habitation" in the situation in which they were discovered; but the probability is, that the cases will be presented to me again, when I shall have an opportunity of further investigating the

matter.

It may, however, be as well to state here, that the testicle having been wounded in the operation, would in no way explain the fact, for spermatozoa fully formed, and in an active state, are rarely met with in the human testis, and even in the epididymis or vas deferens there never exist, at one time, as far as I have had opportunities of judging, sufficient spermatozoa to yield anything like the vast number that were present in the cases of hydrocele adduced

above. In two cases of abscess communicating with the epididymis, which I have had under my observation lately, one of them a patient of Mr. Lawrence, in St. Bartholomew's Hospital, there have passed off very few spermatozoa. Spermatic granules have come away in great number.

STATISTICS

OF

BETHLEM HOSPITAL,

WITH

REMARKS ON INSANITY.

BY JOHN WEBSTER, M.D.,

CONSULTING PHYSICIAN TO ST. GEORGE'S AND ST. JAMES'S DISPENSARY, &c.

READ JUNE 27TH, 1843.

THE subject of insanity, at all times an interesting matter of inquiry to medical men, has of late engaged so much attention, and there prevails such a general desire for information respecting the disease, especially when any additional facts are brought forward in its illustration, that I am led to believe a statistical report of the principal occurrences met with at Bethlem Hospital, during the last and present century, may be of some use, particularly if the tables are so arranged as to give as well the number of admissions as the deaths, and the proportion of patients reported cured, during different periods, but of the same comparative duration. These classified statements are accompanied by a few general remarks on insanity; and, lastly, an account is

given of the chief pathological changes of structure observed on the dissection of seventy-two insane patients which have been recently performed in that hospital.

Tabular documents of the kind alluded to, when obtained from authentic sources, cannot prove otherwise than useful; and as the records of the above institution are replete with valuable information, I have thought it might be advantageous to lay the present communication before the Royal Medical and Chirurgical Society, where I trust it will be received, not as a paper containing much that is new upon the subject under discussion, but rather as an attempt to contribute a few data respecting the prevalence of insanity in the metropolis, its curability, and pathology; believing that the facts stated will assist, as well those actually engaged in the study and treatment of mental diseases, as also the investigations of physicians only taking a general interest in questions of that description.

With the view of promoting these objects, I would therefore beg to bring under the notice of the Fellows several tables recently compiled from the registers kept at Bethlem Hospital. Before, however, doing so, it is but just towards Mr. Nicholls, the present efficient Steward of the establishment, to state, that I have received great assistance from that officer, when drawing up the tables accompanying the statements, upon which many of the deductions in the present paper are virtually founded. Indeed, without his co-operation in supplying the requisite official

returns, I should scarcely have been able to accomplish the task I have now undertaken, which I fear may still seem somewhat diffuse, from the different numerical calculations it contains.

According to the ancient records fortunately still preserved in the archives of Bethlem Hospital, it appears that 22,897 insane patients, exclusive of incurable and criminal lunatics, have been admitted into the above asylum since the year 1683. But as it would prove tedious, if not superfluous, to include so extensive a field of inquiry in the present remarks, they will be confined to the detail of the principal occurrences met with in that charity during the last hundred years. In pursuing this investigation, the number of patients received into Bethlem Hospital, with the total amount of cures, and the actual deaths reported, as also the per centage calculated on each, will be enumerated under separate heads; embracing, however, different periods of twenty years in each division; the first commencing the 1st of January, 1743, and the last terminating the 31st of December, 1842. It is, nevertheless, right to mention, that, owing to defects in some of the official registers of the institution, the exact number of patients discharged cured from Old Bedlam, and the amount of deaths which took place in one or two of the years prior to 1748, could not be accurately ascertained, and are therefore given from a comparison with the results of subsequent years. Still, the number of admissions reported are correct, as well as every other particular in these tables;

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