Nottingham Hospitals History


President of the Nottingham Medico-Chirurgical Society



Evan Powell, City Asylum, Mapperley Hill, Nottingham M.R.C.S. (England) L.S.A., 1873 (University College)  Medical Superintendant, City Asylum, Mapperley Hill, Nottingham. Member,Medical Psychology Association, and the Nottingham Medico-Chirurgical Society. Late, Assistant Medical Officer, Kent County Lunatic Asylum, Barming Health. Assistant Mdical Officer, Essex County Asylum, and Assistant Medical Officer, North Wales Asylum.

Medical Directory 1915





Delivered on 7th November 1906

“Prevention of Insanity”

At a meeting of this society held on November 7th Mr. E. Powell, the President, gave an address on the Prevention of Insanity. He said that the ratio of certified cases to the general population had risen steadily from 1 in 536 fifty years ago to 1 in 319 ten years ago, and even to 1 in 283 at the beginning of the present year. The explanation lay partly in a diminished death-rate and partly in an increasing accumulation of incurable cases in asylums. Many of such cases could quite well have remained at home under ordinary rural conditions but the continuous growth  of urban areas drove them into asylums. Such increase was almost wholly confined to the pauper classes. Dealing with preventable cases, he said that the most important of all was heredity predisposition, which could be clearly traced in at least 22 per cent of the cases admitted. The second most important cause was the abuse of alcohol. Amongst women the amount of insanity due to drink was steadily increasing and in towns like Nottingham, where female labour was largely employed, the percentage was higher than elsewhere. Stimulants must be prescribed to neurotic subjects only with the greatest caution. The third most important preventable cause was syphilis, which played such a leading part in the production of general paralysis. As compared with 30 years ago the cases admitted to asylums today numbered fewer acute maniacs but a larger proportion of melancholic and senile cases. Adolescent insanity was increasing in connection with overstrain. It was, therefore, to be regretted that the usual educational curriculum was so little elastic with respect to the special needs of any children who were slightly defective, especially when so much compulsion was applied to education. In the insanity of middle aged men business worries bore an important part and premonitory symptoms, such as loss of sleep and appetite, general irritability, and a tendency to worry over trifles, should never be neglected.