Billeder på siden
[merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][merged small][merged small][ocr errors][merged small][merged small][merged small][merged small]

Our First Birthday.

At the end of each year of labor, the workman, in whatever field his efforts may be expended, is accustomed to survey the results and to estimate his progress. The merchant takes stock of his goods, the agriculturist calculates his gains and re-values his cattle and crops, the politician counts his party, and the student contemplates the more noble acquisitions of mind.

We therefore need no better excuse than custom and utility at the end of the first year of our editorial labors for briefly commenting upon the progress of the Asylum Journal, and estimating to what extent it has fulfilled the purposes for which it was established.

Its aims and objects were stated to be, "to afford a medium of intercommunication between men engaged in the construction and management of asylums, in the treatment of the insane, and in all subsidiary operations." That this object has been attained is evident from the fact that the numbers of the year contain on an average in each number two original papers, contributed by gentlemen who are or have been the medical superintendents of public asylums. The Editor experiences profound gratification in pointing to this proof that the main purpose of the Asylum Journal has been attained, and in thanking the gentlemen who have rendered him this invaluable assistance. The contents of the past numbers may for the most part be classified under the following heads: Leading Articles, Original Communications and Lectures, Reviews, and News.

In the first, the principles of lunatic management

and the acts of public bodies of men officially engaged in the control of that management are discussed. The Non-restraint system and the Norfolk Asylum business are examples of these two legitimate subjects of discussion. The Editor alone is responsible for this portion of the Journal, in conducting which he is conscious of having held fast by that which appeared to him true and just. Certain principles of management which he has deemed of vital importance to the well-being of the inmates of asylums he has maintained perhaps with more earnestness than persons holding opposite views might approve of; but in doing so he has scrupulously avoided expressions, which rightly considered, could by any possibility give personal annoyance to any one. That excellent and estimable men often identify themselves with erroneous and mischievous principles must ever be a peculiar subject of regret to any person of right feeling, whom circumstances may have placed in active hostility to those principles; and if against this may be set off the consideration that, the best men are the most worth convincing, it must be acknowledged that little thanks are given even by them: indeed, good men are generally the hardest to convince of any intellectual error, and are apt to suffer more than others in the process. A selfish man abandons a mistake immediately you succeed in proving to him that it is one; but the errors of one whose feelings are noble and generous indicate a more deeply rooted perversion of the intellectual faculties, since they exist in defiance of the instinctive logic of a good heart.

The original communications comprehend articles

The meeting took place at the Smithsonian Institution, Washington, on the 9th of May last. It was attended by twenty-one medical officers of public asylums, and by one of a private asylum. Dr. Bell, of the Mc'Lean Asylum, Mass., was President. The business was commenced by Dr. Buttolph's resignation of the office of secretary being accepted, and by Dr. Nichols being appointed to that office, pro tem.; a Committee being appointed to nominate a permanent


on the pathology and treatment of disease, like the cussions are reported very briefly and the papers read admirable papers of Dr. Boyd and Dr. Arlidge; are only named, the account of the business of the communications on matters of asylum utility; and meeting occupies twenty pages. a third class, which forms a new and peculiar feature in this Journal, namely, descriptive accounts of public asylums and hospitals. The descriptions of the Kent, the Lincolnshire, and the Coton Hill Asylums are of a kind to prove both interesting and instructive to all persons on whom the construction, the arrangement, and the management of such institutions may devolve. We hope that these descriptions will, from time to time, be continued, and that they will embrace, not only modern institutions, in which the buildings are nearly all that could be desired; but that they will also include many of the older asylums, in which grave architectural and local imperfections have been, to a great extent, obviated by the skilful arrangements of the superintendents. It will scarcely be denied, by any one conversant with such matters, that at the present time some of the most comfortable asylums are among the least commodious; a fact arising, in some degree, from the greater age of the more imperfect buildings, and the consequent accumulation in them of fittings and furniture; and for the rest, in the necessity which was imposed on their superintendents to supply the shortcomings of the architect by the more liberal employment of the upholsterer. Certainly the asylums, from which the greatest amount of instruction is to be derived, are those in which the greatest number of difficulties have been overcome.

Another class of contents are the lectures of eminent mental physicians, of which our present number contains an example.

A fourth class are reviews of books on insanity, and its allied subjects. These are necessarily brief, partaking more of the nature of notices than of stated reviews; and the pressure of other matter makes us willing to leave this department to other journals for whose pages elaborate reviews are more suited.

A class of contents to which we attach much importance, and which we hope to see developed, is one for which it is difficult to find a name. We mean the multifarious little matters of practical utility, ranging from pins and needles upwards. The utilioria, by which the ship is kept neat, and cleanly, and comfortable. Little matters, but of great importance to the well-being and economy of a large institution, and, not unfrequently also, to the health and the safety of the patients.

The decease of Drs. Bullock and Stewart, two members of the Association, since the last meeting, was then announced, and two members were appointed "to prepare memoirs of the deceased to be recorded in the journal of proceedings," and resolutions expressive of condolence with their friends. Measures which appear to us not less unusual than they are graceful and deserving of imitation. We know not how it is to be accounted for, but the fact is evident that our brethren on the other side of the Atlantic, engaged in the same specialty as ourselves, are animated by more cordial sympathies, by a stronger esprit de corps than we have.

A paper by Dr. Harlow was then read, on the heating apparatus of the Main Asylum, and on the relative merits of steam and hot water for this purpose. This paper gave rise to a lively discussion, which occupied the remainder of the morning, and was continued at the evening session. It terminated in the appointment of a committee to investigate the subject and report to the next meeting.

Dr. Kirkbride then read a paper "On the importance of precision and accuracy in the use of terms for insanity, and instructions for its treatment." He objected strongly to calling a sick man moon-struck, or, in other words, a lunatic. He also objected to the terms asylum and retreat, keeper and cell.

Dr. Stribling thought the term, hospital for the insane, very objectionable; as, in his State, a hospital "was regarded as a resort for paupers, the outcast, and friendless; and nothing would be more revolting to the feelings of a Virginian than to be taken to an institution with such a name." Dr. Brown remarked, that many of our institutions for the insane had rooms no better than prison cells, and he believed it best to call things by their right names. He thought the

We have inserted notices of legal proceedings affect-practice of calling institutions by the name of their ing asylum management; such as convictions for the ill-treatment of lunatics, and other similar matters. But we have hitherto abstained from reporting medicolegal trials, feeling that the intricate questions involved would require more space for their satisfactory discussion than we could afford to spare.

principal benefactors, as in the case of the Mc'Lean and Butler Hospital, or by some pleasant local name, as in the case of the Bloomingdale Asylum, convenient and unobjectionable. Dr. Tyler said, the citizens of New Hampshire, besides employing the usual variety of synonymes to designate the institution under his charge, styled it an Insanery.

This discussion will remind our readers of similar

Proceedings of the Ninth Annual Meeting of the ones which have taken place in this country. We

We condense, from the July number of the American
Journal of Insanity, the following account of the above
meeting. In the American journal, although the dis-

cannot but think that, in relation to the employment of words so rooted in the language as asylum and lunatic, objections are futile, if not frivolous. The term asylum is a sacred one, signifying a sanctuary, a refuge from the spoiler; and we trust that our great

public institutions for the insane are truly worthy of it.
The term hospital, according to its primary use, ought
to be restricted to charitable institutions, which county
asylums and private asylums are not. A hospital no
more signifies a place for the cure of disease than an
asylum does. There are the Greenwich and Chelsea
Hospitals, for instance. Dr. Tyler's amusing Yankee- | the Chief Magistrate of the country.
ism, Insanery, is a very good word; and we recommend
those who don't like asylum, to adopt it. It is ex-
pressive, implies nothing untrue; and, as it closely
resembles our own common and excellent term in-
firmary, it comes nearest of any to the designation of a
place of cure. We have said thus much on the subject
of this logomachy, because we have been well rated for
designating this publication by a name, which an early
resolution of the Association condemned and doomed
to be put down. But, in an old country, an old word
takes a mighty deal of putting down. We apprehend
that the oldest human traces in this world of ours are
words. Notwithstanding the discoveries in the gas
works at New Orleans, we do not doubt that the first
man was verily called Adam, and that, whatever may
be the Talmudic name of his first wife, the mother of
the human race was called Eva. What, excepting
geological antiquity, can compare with this?

Dr. Bell read a paper on "spiritual manifestations." The Business Committee announced invitations to the Association, to visit several public institutions, which were accepted. The forenoon of the third day of the meeting being set apart for that purpose, and also to visit the Presidential Mansion, to pay their respects to

As for the word lunatic, its etymology is, doubtless, based upon an old and somewhat foolish notion of our forefathers; but, if we are to discontinue the use of all words against which this objection can be made, new languages will have to be constructed, for all existing ones will become too much impoverished either for common or scientific use. What would be thought of members of the Medico-Chirurgical or the Royal Societies, if they gravely proposed to discontinue the use of the word artery, because it was founded upon the erroneous belief that these vessels contained air; or that of the word spirit, because it originated in the notion that the soul of a man was identical with his breath. Such propositions would, doubtless, be laughed at, as useless and puerile. Even the word keeper is not in itself an opprobious one. The Lord Keeper of Scotland, for instance. It was even appropriate, as applied to the keepers of the insane in past years, because they sedulously kept away from their duties. But, since their conduct has rendered the term infamous, it may well, under present circumstances, be objected to and avoided.

On the second day the members of the Association, accompanied by the Secretary of the Interior, occupied the forenoon in a visit to the National Hospital for the insane in process of erection, and met at five, P.M., for the transaction of business. A committee was appointed to recommend a time and place for the next meeting of the Association.

Dr. Ray read a paper on "The effect of etherization on the nervous system in the treatment of disease." In the discussion on this paper, nine of the Members stated that they had used ether and chloroform in the treatment of insanity. On the whole, their opinions of these agents do not appear to have been very favourable. Dr. Stribling thought that, "superintendents were unwilling to use an agent so powerful and dangerous, and of unestablished if not doubtful utility, feeling that they had rather fail to cure a dozen than to kill one."

On the third day of meeting, the President "called the attention of the Members to a modification of the crib or covered bedstead, planned by Dr. Gray, of the hospital for the insane at Utica, intended for the confinement of restless patients at night." This seems to have been the identical bedstead not long ago introduced at Bethlem. How strange it is that discoveries so often suggest themselves to different persons at the same time. Leverier's planet, and sun painting are instances of this fact; Leucocythemia is another. And the ingenious adaptation of a large box with a ventilating lid to the uses of a bedstead for irritable and restless lunatics having taken place about the same time at the hospitals for the insane at Utica and Bethlem, is a new proof of this frequent and remarkable coincidence of scientific discovery. refrain from expressing our opinion as to the probable comfort of these shut-down cribs or hutches, but should either one of the inventors unfortunately be troubled with feverish and restless nights, we trust that he will just for once try his own invention, and report upon it. Could Perillus have reported on the sensations experienced in the interior of his bull, he might have cowed the genius of posterity, by shewing the perilous nature of invention; and when the Doctors have reported their personal experiences of the coveredin bedstead for restless patients, we shall be better able than at present to decide whether its use is consistent with the humane treatment of the insane.


Dr. E. Jarvis read a paper "On the tendency of the unbalanced mind to produce insanity," for which he received great compliments. The President regretted that gentlemen had not prepared more essays; there had been a falling off in this respect for many years. It was suggested by Dr. Kirkbride, that they should prepare their papers immediately on their return home, and it was agreed that the President should assign to each Member a subject for an essay.

Dr. Curwen read a paper "On certain classes of cases of mental derangement," in which he deprecated the still too frequent practice of bleeding in acute mania, and deplored the inadequacy of ordinary stimulants to restore the energies of a system prostrated by depletion and hurrying down to death or incurable dementia. Several speakers deplored the consequences of bleeding, &c., practised upon patients before admission; an expression of feeling to which we are sure the superintendents in this country will most heartily respond. Dr. Stribling thought that Rush's teaching fifty years ago "had been the cause of much mischief in the treatment of the insane." He spoke highly of the benefit he had derived from the free application of morphine to blistered surfaces. Dr. Waddell stated that, "in high maniacal excitement his plan was to administer tartar emetic in doses of from six to eight or ten grains, which operated both as an emetic and cathartic. Before a reaction takes place

applications of cold water are made to the head, and at evening an anodyne is given. These doses produce for a short time great prostration, but this soon passes away, leaving the patient generally in a quiet and comfortable situation."

pressing the thanks of the Association to various persons who had promoted the purposes of the Meeting, and to whom the Members were indebted for attentions and courtesies; to the President of the United States for his courtesy and kind attentions; to the Secretary of the Interior, &c.

Dr. Walker said, "he had ascertained that in seIveral of the cases which had come under his obser- The President paid a high compliment to the Jourvation in which free blood-letting had been resorted nal of Insanity, as a periodical honourable to the to, the lancet was employed by Irish surgeons, such as specialty, and deserving the patronage of medical came to this country in emigrant ships, volunteering men throughout the country. Dr. Kirkbride subtheir services to pay their passage, and not by Amer-mitted the following resolution, which was adopted, icans, by whom the practice had been abandoned. "Resolved: that this Association, fully appreciating He found brandy and morphine the best combination the important service rendered the profession and in such cases." We suspect that Dr. Walker belongs to the Know-nothing Society, and is not partial to the Irish; for whatever may be the attainments of medical men in the new world, we can assure him that there is no school in the old world which turns out medical men more thoroughly and practically educated than the capital city of Ireland, and we cannot but believe that he has drawn his conclusion from a small number of exceptional instances.

the insane in the United States, by the American Journal of Insanity, do most cordially recommend that periodical to the patronage of the members of the medical profession and others interested in the subject, and trust that those who have heretofore kept up its publication with such commendable liberality, will secure its permanent continuance, and that our Members be earnestly urged to contribute freely to its columns.

of the Association in attending the Annual Meetings, offered the following preamble and resolution, which were read and adopted.


On the subject of stimulants several of the Members Dr. Worthington, on behalf of the Committee recomplained of the difficulty they experienced in pro-lating to the payment of the expenses of the members curing old and pure liquors, to keep up the strength of their patients. Liquors of a deleterious quality were largely manufactured at New York. Dr. Bell would recommend it to the authorities of the different institutions for the reception of the diseased to make a selection of the best wines, brandies, &c., and to store them away for a period of thirty, forty, or fifty years, so that the patients might have them pure and unadulterated"!

Dr. Nichols made some observations on the pathology of insanity, and predicted "that we were on the eve of the demonstrable discovery, that all insanity is proximately owing to a derangement of the functional activity of the cerebral organ, as the generator of what we are accustomed to call nerve power or nervous fluid."

Whereas, the meetings of this Association have been attended since its commencement by nearly all the superintendents of our institutions for the insane, and whereas, there is a want of uniformity among the different institutions, in regard to the payment expenses incurred by the superintendents in attending these meetings, from which the institutions represented have derived important benefits:

"Therefore resolved, As the sense of this Association, that the travelling and all necessary expenses of the superintendents in attending its meetings ought to be paid by the institutions which they represent."

On motion of Dr. Kirkbride, the Association then adjourned to meet in the city of Boston, on the 4th of May, 1855, at 10 A.M.

Dr. Brown stated that, "Dr. Burnett, one of the most accomplished microscopists in America, had made examinations of the brain of persons who had In concluding this account of the meeting of the died in a state of chronic insanity, but had been American Association of Asylum Superintendents, a unable to discover any change of structure whatever, comparison between its energetic usefulness and the or any sign to indicate that it did not belong to an torpid existence which has until recently been characindividual whose mind was not affected." Dr. B. teristic of the corresponding Association in this coundesired to know the experience of the Members in the try, forces itself upon our observation. This comuse of the prolonged warm baths recommended by the parison cannot be drawn by any English superinFrench, who retain their patients by mechanical fix-tendent, animated by one spark of patriotism, without tures in warm baths for periods varying from six to eighteen hours. Dr. Kirkbride thought that such baths would prove very quieting, so much so indeed, that the patient never afterwards would be a source of trouble to either physicians or attendants. In his own treatment he had used the bath one or two hours at a time with benefit, taking great care that the temperature of the water should not exceed 98°. With reference to bleeding in the treatment of insanity, Dr. Kirkbride remarked, that of the 2,700 patients who had been under his care during the last thirteen years, he had not used the lancet in a single instance with

reference to the state of mind.

On the fourth day resolutions were adopted, ex


exciting feelings, which we will not designate by the
ugly names of shame and envy, but which must ne-
cessarily be more allied to them than otherwise.
English Association is older than the American one;
its list of members is far more copious; and yet,
until lately, its existence has scarcely served a more
useful purpose than to point a moral.
What the
American Association is, the above account will im-
perfectly shew. What the English Association has
been we are almost ashamed to confess.
not, however, look back with unavailing regret on
the time which is irretrievably gone; but let us
take good heart from the noble example set us by
our brethren in the new country, and endeavour to

Let us

emulate them, in making our Association an active earnest reality; a bond of union between men engaged in the same arduous and embarassing pursuit; a source of friendly intercommunication, of practical knowledge, and of scientific enlightenment. Some incidents in the above account, too obvious to need specification, forcibly point to the honor and the power which an united action affords to a body of practical and scientific men; but, without which, they may readily remain subject to misapprehension, to neglect, and to the oppression of many petty influences derogatory to their position and damaging to their usefulness.

Alleged Evasion of Justice, by the Reception of a Criminal into an Asylum.

Towards the close of the late Parliamentary Session Lord Dudley Stuart piqued the curiosity of all persons interested in asylum matters by enquiring of the Secretary for the Home Department, whether he could afford information respecting an evasion of justice by the admission of a criminal into the Norwich Lunatic Asylum. Lord Palmerston replied that the fullest investigation should be made. We have hitherto refrained from referring to the circumstances thus alluded to, because only partial information has until recently been attainable, and even that has been obscured by the expression of much personal feeling. A long and earnest discussion at the Norwich City Sessions on the 24th ult., puts us in possession of all the details, and of the minutes of the Visiting Justices, before whom a full and careful investigation took place. Reduced to their briefest expression, the circumstances appear to be as follow.

Two years ago, the Rev. Mr. H., a clergyman living near Wymondham, was charged before Mr. Cann, a magistrate, with an attempt to violate a girl under twelve years of age. Mr. Cann signed a warrant of committal against Mr. H., but believing that he was insane, he caused his friends to be informed that if "something was done within a certain time, the warrant should not issue to be executed." Mr. Cann, the magistrate's clerk and the son of the magistrate, stated that his father did this "in consequence of the station in life of Mr. H. Probably, had he been a poor man, the case would have been different. The usual course would be to prove the offence first, and afterwards to consider the plea of insanity." This strange admission on the part of a magistrate's clerk has been severely commented upon, amounting as it does to the avowal, that Mr. Cann would administer different laws to the rich and the poor. We think better of Mr. Cann's father than his son does, and we firmly believe, that the course adopted would not have been different had the culprit been a poor man. Had such been the case, the most humane and judicious thing which Mr. Cann, Senr., could have done, would have been to call in the aid of a medical man, and if his opinion coincided with his own, to send the lunatic without delay to the county asylum. Such a course of procedure is in fact the very one recommended by the Commissioners in Lunacy in their recent Report. It would have been well if Mr. Cann,

Senr. had at this stage of the proceedings obtained the assistance of a medical man. Instead of which we find Mr. Nichols, the proprietor of the Heigham Hall Asylum in chase of the needful medical certificates, stating, that if Dr. Hull would give the certificate "it would be hundreds a year in his pocket."

The visitors having considered the statements and documents submitted to them, agreed to the following resolutions:

"First, That the Rev. Mr. H., by being placed in the asylum under the circumstances appearing on this enquiry, was rescued from the gripe of the law on a criminal charge.

[blocks in formation]


Third, That in the opinion of the visitors Mr. H. is not a proper person to have been appointed, or to continue to officiate as chaplain to the asylum.

"(Signed,) Samuel Bignold, Mayor; J. H. Barnard, Edward Willett, Horatio Bolingbroke, John Sultzer, Samuel S. Beare, C. M. Gibson, F.R.C.S."

The Rev. Mr. H. was admitted a patient into Heigham Hall Asylum in July 1852; on the following 4th of September he was discharged, and appointed chaplain to the asylum, the duties of which office he has fulfilled until a recent period.

In the animated discussion which took place at the Norwich Sessions on this subject, much stress was laid on the infraction of the law committed in making Mr. H. a boarder at the asylum without his having first been personally examined by two of the Commissioners in Lunacy, and their assent in writing obtained, to his remaining in the house as a boarder; such procedure being enjoined by the statute. It is plain, however, that no concealment of his position from the Commissioners was attempted, as an entry in the Visitors' book was made by Mr. Commissioner Campbell, on the 10th of May, 1853, to this effect: “Divine service is performed in the house by a clergyman resident in the asylum.”

Under these circumstances the "infraction of the law," if this irregularity is thought to be deserving of so harsh a name, does not appear in a very heinous light; irregularities, indeed, of a similar nature, arising from hitches in the working of the statutes, are of frequent occurrence; for instance, in the amendment of informal orders of admissson, which in strictness are illegal unless they receive the written sanction of the Commissioners, and which nevertheless do not receive them.

The opinion of the Recorder was given in the following terms: "In this case a very peculiar responsibility rests upon me; because, by a special provision of the act of parliament on the subject, the new license cannot be granted unless I sign it. This is a great responsibility, because other gentlemen may, perhaps, feel disposed to act as I act; and I am now obliged to sign this license, and to acknowledge that I am, to a certain extent, authorising a person to keep a lunatic asylum who has violated the law. This is a serious responsibility; but as the magistrates here all say that Dr. Ranking, the new proprietor, is a most respectable

« ForrigeFortsæt »