John Murray's Royal Asylum

The statistics of insanity are perhaps more lacking in precision of terms than are those relating to any other human affairs. Chief among the elastically uncertain stands the term “recovery”. Yet on it depends the true history both in the positive and negative sense of our fight with the disease. Dr. Urquhart gives his interpretation of the term, and we consider that it is as fair and accurate as can be looked for:

“The number of readmissions (15) was unprecedented in the history of the asylum, and the number of those suffering from recurrence of mental disorder (22) was also disproportionate. In these observations the word ‘recovery’ is used to indicate those in whom there is re-establishment of mental soundness permitting of the return of the patient to his place in the world without requiring the care and supervision of others. The ‘lucid interval’ may prove to be of lifelong duration, it may last for years, or only for months. Doubts have been expressed regarding the propriety of liberty in many of these cases. It has been represented as a wrong to the lieges. This is a new phase of opinion. For many years we have been accustomed to accusations of undue detention in asylums, elaborate safeguards have been devised to protect the insane from that evil, and now the tide of opinion seems to be setting in the contrary direction. As the law stands there is no longer authority for the detention of a person after he ceases to be insane; and, in the great majority of cases, it would be an intolerable hardship to be detained indefinitely because of a possibility of untoward remote consequences. No doubt there are those, including many who have never been under custodial care, who should be limited in liberty of action under revised legal enactments; but the advo advocates of extreme measures will have to be content with less Spartan remedies than they formulate. The practice of discharge on recovery, or even on improvement, may entail occasional hardships, but on the whole it is appropriate to existing conditions.”