Lastly in regard to that most important point, on which Dr. Fraser thus speaks:--
"'_The Influences which are at present operating on the Boarding out of Lunatics._-- ... The influences which, from my experience and observation, I believe to be operating upon these methods of provision for the insane, especially upon the pauper portion, seem to me to be as follows:--
"'1. The efforts of medical officers of institutions to discharge chronic lunatics whom they consider suitable for being cared for in private dwellings.
"'2. The action of inspectors of poor in either initiating the removal of suitable cases, or in seconding the efforts of medical superintendents in this direction.
"'3. The amount and accessibility of asylum accommodation in each district.
"'_The Action of Medical Officers of Asylums._-- ... Owing to my having had at one time the superintendence of the asylum for Fife and Kinross, I am able to deal more satisfactorily with the statistics of this district than with those of other parts of the country. From a return which I have been favoured with, I find that the efforts to send out patients in this district have been effective and successful. During 1880 there have been discharged improved eighteen patients, five of whom were committed to the care of friends, and thirteen of whom were placed under the guardianship of strangers....
"'The question which naturally suggests itself is--What would be the result were this practice possible in every institution, and in every district? On calculation I find that, had an equal proportion of the inmates of all asylums been similarly transferred to private care, no less than four hundred and three patients would have been removed from institutions to care in private dwellings, whereas the fact is that only sixty-eight were so transferred. Only one patient out of the eighteen who were transferred from the Fife and Kinross Asylum has had to be returned to the asylum, and he was one of those who were boarded with friends....
"'_The Action of Inspectors of Poor._--The efforts of medical superintendents of asylums may do much, but it must be recognized that the success and extension of the boarding system is largely, if not mainly, in the hands of the inspectors of poor. Their action is threefold: (1) they may initiate the removal of their chronic insane from institutions; they may co-operate with asylum officers in readily removing such lunatics as these officers intimate to be fit for being boarded out, and in procuring suitable guardians and homes for them; and (3) they may, by well-directed efforts, instead of hurrying every lunatic into an asylum, as the practice with some is, provide in like manner for those idiotic and insane paupers who, even when they first become chargeable, do not require asylum treatment and care....