efore when it was the game of royalty chiefly, because there are now
more people living from the work of others.

The unusual mental action of the insane not infrequently expresses
itself by suicide. The analysis of three hundred deaths from suicide
showed pathological changes in the brain in forty-three per cent, and
when we think that mental disturbances are very often without
recognizable anatomical changes after death, the percentage is very
large. In another analysis of one hundred and twenty-four suicides
forty-four of these were mentally affected to various degrees. Five of
the men and seven women were epileptics, in ten of the families there
was hysteria, twenty-four of the men and four of the women were
chronic alcoholics.

It is extremely difficult at the present time to say whether insanity
is increasing. Statistics in all lands giving the numbers committed to
insane hospitals show on their face a great increase, but so many
factors enter into these statistics that their value is uncertain.
There is now an ever-increasing provision for the care of the insane.
Owing to the recognition of insanity as a part of nervous disease and
its separation from criminality there is no longer the same attempt to
conceal it as was formerly the case, and hospitals for the insane are
no longer associated with ideas of Bedlam. It is generally believed
that modern conditions in the hurry and excitement of life, and the
extreme social differences, the greater urban life, the greater
extension of factory life, all tend to an increase in insanity, but
there is no absolute proof that this is true. We know very little
about insanity in the Middle Ages, but the conditions then were not
conducive to a quiet life. There prevailed then as now excess and
want, luxury and poverty, enjoyment and deprivations, balls and dinner
parties and other features of the social game. There were factions in
the cities, public executions, not infrequent sieges, scenes of
horror, epidemics, famines, and all these combined with religious
superstition and the often unjust and cruel laws should have been
factors for insanity. There were actual epidemics of insanity
affecting masses of the population, as shown in the children's
crusade, the Jewish massacres and the dancing mania in the Rhine
provinces. Where civilization seems to be the highest, statistics show
the most insane, but this most probably depends upon better
recognition of the condition and bett