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sidered a very important one. A stout felt hat or a Scotch bonnet would last, barring accidents, for the best part of a generation. Flimsy articles of split straw and the like may prove expensive, but well made substantial head gear of whatever variety will last long enough to satisfy the most economical conscience.

In summing up our opinions, and in shewing upon what grounds they are founded, we may state that we have given fair trial to several forms of headdress for the insane.

We have for many years employed a cap for a special purpose, which we have not seen in use elsewhere. It serves to save epileptics from cuts and contusions on the head, received in sudden falls. The old-fashioned epileptic ring has somewhat strangely gone out of use, seeing that it was undoubtedly serviceable for the above purpose. It certainly had a somewhat uncouth appearance, and suggested ideas of the belt of Saturn or the halo of a Saint; but the objection urged against it, that by keeping the head hot, it caused fits to be more frequent, was probably Eight years ago all our male patients wore stout felt fanciful and unfounded. We are convinced that this hats, their price was 2s 4}d, their weight 13 oz.; while ring, modified and disguised as we employ it, has not new, their appearance was satisfactory. In wear, how-the slightest effect in increasing the frequency or ever, they were found to be heavy, hot, and even distressing in summer; they did not pack well, occupying much space, whether hung upon pegs or deposited upon tables for that purpose; some patients were apt to use them as depositories for rubbish of various kinds; when dilapidated by accident or design they were incapable of repair, and looked undeniably shabby. A hat with a fraction of a crown, and less than a fraction of a brim, may be a picturesque object in an Irish interior, but is little suggestive of discipline or comfort. These disadvantages were thought to be decisive, and the hat was abolished.

The substitutes introduced were the Scotch Lowland bonnet for winter, and a light linen cap for summer


The change was satisfactory. The Lowland bonnet is undoubtedly a most comfortable and efficient head-covering in cold and inclement weather; it also is not heavy, ventilates well, will bear washing and repair, and occupies little space. We have recently observed it in use in the new County Asylum for Warwickshire. We thought it, however, too hot for the use of insane patients in weather not decidedly cold. We endeavoured to obviate this objection by substituting linen caps during the summer months, but the change and storage of clothing is in itself an evil, and in this uncertain climate no one can tell when the weather will be hot, and when cold, or fix arbitrarily the proper season for change of clothing. We often have a second winter in May and a second summer in October. A pound of worsted on one's head may be more welcome in June than in April, and any one who tries to fix the proper time to leave it off may find himself worsted in the attempt. An attempt therefore was made to discover some habiliment which would meet the emergencies of all seasons, be cool enough in the summer solstice, and warm enough in the winter one. A cap made of fustian or of light coloured cloth, appears to fulfil these conditions. In shape it is like the forage cap used by officers in the army; the sides are cut deep and stiffened, so that the crown is maintained at a little distance from the vertex. At first this fustian is drab or stone colour, it soon, however, undergoes the fate of fustian of all kinds, in being washed out. When it becomes white the appearance is perhaps a little odd, but it is smart and cleanly looking a patent leather poke affords good protection to the eyes. Its weight is 4 oz., its cost, home made, 7d. After some years of trial, we can strongly recommend this white cap as peculiarly well suited for the use of the insane.


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severity of fits.

A ring is made of chamois leather to surround the head; it is then stuffed with best curled horsehair, which is secured into it in such a manner, that the ring is flattened, somewhat into the shape of a narrow quoit, the long diameter of the stuffed part being about two inches and a half, the short one about an inch less, the whole is covered with gray serge, which passes over the vertex, and converts the affair into a by no means ill-looking cap. It is secured in its place by a strap under the lower jaw, and sometimes by a second under the occiput. The weight varies from 8 to 10 oz. according to size. In making and fitting the cap, strict regard must not only be had to the shape of the head, but to the manner in which the patient is apt to fall; epileptics generally fall forwards; we had, however, a female patient who repeatedly cut open the scalp over the occiput by falls, until a bonnet with a padded crown was fixed upon her and its constant use insisted on.

Men, with more theory than experience, may say that it is the duty of attendants to prevent epileptic patients injuring themselves by falls. No doubt it is the attendant's duty to do so, as far as he is able; and, if every epileptic patient had the exclusive services of an attendant, and reserve attendants were kept to relieve guard during meal times and other necessary absences, no doubt injuries from epileptic falls could be entirely prevented. These arrangements, however, are reserved for the Utopia of lunatics.

That heavy falls from epilepsy are expected at Hanwell, and elsewhere, is shown by the care which has been taken to provide soft places for the poor people to fall upon. For this purpose court-yards have been paved with a very soft substance with a very hard name, of which the principle ingredients are cork and caoutchouc, upon which the epileptic may tumble without much hurting himself; that is, if the day happens to be warm, and he does not happen to fall upon a shady place, for, unfortunately, this substance when cold as a stone is almost as hard as a stone, and only becomes softish under the genial influence of warmth.

The caps above described really do save many a black eye, and many a laceration of the scalp; and we strongly and confidently recommend their use.

We have endeavoured to substitute for the horsehair, a tube of vulcanized india rubber; but find that nothing is saved in weight, and that nothing is gained except a most disagreeable smell and a great increase of cost.

Circular of the Commissioners in Lunacy suggesting her, bringing the intelligence that cholera was spreadPrecautions against Cholera.

The Commissioners in Lunacy have recently circulated among the superintendents and medical officers of asylums, a "series of observations and suggestions, with a view to guard against the inroads of cholera." We do not reprint them, because they must already be in the hands of most of our readers.

ing among the inmates of the workhouse, and that two persons had died from it that morning." That night E. F. was attacked with cholera. On the 22nd September, the 2nd, 6th, and 8th of October, four other patients were attacked by cholera, all in the same ward in which E. F. had been attacked by the disease; but after the 15th October, "no rute or bound seemed to afford any limit to the spread of the disease. Now here, now there, in the wards, or the offices; first one, then another, seemed, to use their own expressive term, death struck.'" The total number of deaths was, according to Dr. Corsellis, 98'; according to Dr. Wright, the visiting physician, 108.

The great experience which Mr. Commissioner Gaskell obtained in the management of the Manchester cholera hospital, during the first invasion of this country by the epidemic, conjoined with his intimate and practical knowledge of asylum matters, render any remarks on cholera, which have his sanction, The above facts, and many others which corroborate peculiarly valuable to us. The observations and sug- the teaching they afford, impress us with the belief, gestions do, indeed, bear upon them the stamp of that that a probationary ward, to be of any real service in authority which arises from exact and positive informa-guarding against the inroads of cholera, should be tion. One and only one of them, we think could be placed without the walls, and at some distance from an beneficially modified.

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Should it be thought to be inexpedient to imitate the successful determination of the Wakefield Visitors in 1832, and exclude patients "from an infected home or district," we believe that the only feasible precaution against the admission of cholera into lunatic asylums will be the establishment of a probationary house, not less than a quarter of a mile from the walls of the institution. Two or three ordinary cottages, or a detached house of moderate size, could without much difficulty be made to answer the purpose. We have always thought that the Visiting Justices of county asylums could expend four or five hundred pounds very judiciously, in building two or three cottages, which they could let at moderate rentals to their own artizans or married attendants, on condition that such buildings should be at their service whenever required to be made use of as an auxiliary ward. Besides cholera, there are other diseases, as small pox, dysentery, scarlet fever, which might make such an auxiliary house of the utmost utility, either as a probationary, or a hospital ward. In the position and construction of such buildings, the double purpose would require to be kept in view.-ED.

Whatever opinion may be entertained of the contagiousness of the disease, when once it has obtained a footing in any locality, we are convinced that the only vehicle for the conveyance of cholera between distant places is the human body. The first case or two in a district or institution can always be traced, but the clue is soon lost; either the subtile poison radiates in every direction to a certain distance, and impregnates all the susceptible; or like chlorine gas, it hangs together, and for a time is wafted about without diffusion. All experience proves, that although cholera may be shut out from the city, it cannot be shut out from the house; though it may be excluded from an institution, it cannot be confined to a ward. The terrible experience of the West Riding asylum should not be lost upon us. In the Report for 1851, it is stated: "When in the year 1832, the town and neigh- On the condition of the Grey Substance of the Brain bourhood of Wakefield, together with the House of after excessive mental exertion, by DR. ALBERS. Correction, in common with almost all parts of the In allusion to a statement made in the Psychological country, were visited by Asiatic cholera, the Visiting Journal, by Dr. F. Winslow, in an article entitled, Justices held a meeting, and as a precautionary mea-"The Over-worked Mind," that the grey substance sure made a resolution, that no patient should be undergoes softening, as a consequence of excessive received from an infected home or district. The mental exertion, Albers states, that he has dissected asylum then escaped without a solitary case, and the patients watched from the windows the numerous funerals of victims removed for interment, from the neighbouring suburbs of the town called East Moor." "The disease appeared in the neighbouring House of Correction in February, 1849, when sixteen prisoners died; and in the months of July and August, many severe cases were reported in the town of Wakefield and its suburbs. The inmates of the asylum continued in their ordinary state of health until the 17th of September, when E. F. was brought from the Morley Union Workhouse, the relieving officer who came with

the brains of several persons, who have, for many years, undergone great mental labour, and that, in all of these, he has found the cerebral substance unusually firm, the grey substance, as well as the convolutions, being remarkably developed. In several of these instances, a settled melancholia had taken possession of the mind during the later period of life. He believes, therefore, that, to produce a softened condition, some additional influence, beyond the mere over-exertion, is required.

Softening of the cortical substance is a frequent consequence of apoplexy of the convolutions, which

gives rise to numerous small depositions of blood, especially at the convex portions of the brain, being accompanied also by an atheromatous degeneration of the small arteries.

and noise in the head, dizziness, dimness of sight, shocking dreams, dread of sudden death, etc. Was ordered Pil. saponis co., gr. v., h. s., and a mixture of rhubarb and carbonate of ammonia, to counteract the constipating effect of the opium. Was quite well

In this latter condition, the quantity of fat is not only accumulated in the arteries, but also in the cere-in a month. "The opiate pill taken for about eighteen

bral substance itself. This degeneration is oftenest seen in gouty subjects, in whom it certainly is not attributable to excess of mental exertion. Several such cases, too, have been met with in rustic labourers.-Froriep's Tagesberichte, No. 696, from the British and Foreign Review.

On the Treatment of Incipient Mental Disease; from the Lectures of GEORGE JOHNSON, M. D., Assistant Physician to King's College Hospital.

nights in succession procured sound sleep, unbroken by the horrid dreams which had distressed him for the previous ten months; he was refreshed by this sleep, and quickly regained his usual state of health."

Three other interesting cases are recorded, illustrating the symptoms resulting from the influence of mental shock or anxiety, before they have passed into decided insanity or epilepsy.

The lecturer dwells npon the practical importance of noticing the different effects upon mind and body, which are produced by grief for past and present

A course of lectures delivered before the Royal Col-calamities, and by the dreadful anticipation of future lege of Physicians, by George Johnson, M.D., London, evil: the last mentioned influence being the most freand published in the recent numbers of the Medical quent and the most powerful. He also remarks, that Times and Gazette, contain many observations and "the effects of over work and anxiety upon persons opinions deeply interesting to the psychopathist. Dr. of strictly temperate, or even of abstemious habits, are Johnson states his chief object to be, a description of sometimes quite identical with the well known sympthose slighter derangements of the nervous system, out toms of delirium tremens. One of my patients, whose of which, in a certain proportion of cases, the more habits had for several years been temperate, was sufformidable diseases of the mind are gradually developed. fering, when he came under my observation, from His field of observation was extensive hospital and anxiety consequent upon the loss of money, and he dispensary practice, amongst the London poor, affording assured me that his dreams and spectral visions were abundant opportunities for observing their habits and then precisely similar to those which he had formerly habitations, and for obtaining a knowledge and a re-experienced, when he had delirium tremens from incord of many of their family histories. The results at which he arrives are,

1st. That in a large proportion of cases, the more formidable derangements of the nervous system have their origin in some form of mental shock or anxiety. 2nd. When the nature and the origin of these nervons disorders are detected sufficiently early, the more serious forms of disease may often be prevented, and the slighter derangements entirely recovered from.

3rd. The method of treatment best adapted for the prevention and cure of the diseases in question, admits of some variation in different cases, according to the nature and the cause of the symptoms; but there is one remedy, which, when given in the mode and with the precautions indicated, is more efficacious than all others combined. That remedy is opium.

temperance. He was quickly cured, too, by the treatment which would have been appropriate for delirium tremens." This similarity of symptoms arising from contrasting causes, he attributes to the existence of mental anxiety in both classes of cases, and he points out the essential importance of recognizing the fact, that in a large proportion of cases of delirium, there is a mental as well as bodily element. Whether in a man suffering from the effects of immoderate intellectual exertion, or in the overworked tailor or needlewoman, the mental anxiety will increase in a rapid ratio, as the gradual exhaustion of mind and body renders the attainment of the object so eagerly sought for, more difficult and doubtful. The lecturer states, that he has indicated these less obvious degrees of mental affection, in the spirit of the following

The first case he relates is one in which great ner-suggestion made by Dr. Latham: "Prior to diseases, vous disorder-sleep disturbed by frightful dreams and spectral visions, a painful sense of pressure on the vertex, and other symptoms of impending insanity, brought on by the drunkenness, failure in business, and death of a husband- were cured by five grain doses of compound soap pill at bed time, and daily exercise in the open air. The explanation of the cure being, that ten nights of sound sleep had sufficed to remove the wearing effects of many months of anxiety and restlessness.

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to their diagnosis, their history, and their treatment, prior to them and beyond them, there lies a large field for medical observation. It is not enough to begin with their beginning. There are things earlier than their beginning which deserve to be known. The habits, the necessities, the misfortunes, the vices of men in society, contain materials for the enquiry, and for the statistical systematizing study of physicians: fuller, far fuller of promise for the good of mankind, than pathology itself."

The third case is that of a shoemaker, who, together To the officers of asylums, who can rarely observe with his wife and five children, had had typhus fever the early developement of mental disease (since, before ten months before. They all recovered; but, at the their observation commences, the existence of insanity same time, and of the same disease he lost his brother, must have been sufficiently pronounced, to have been his mother, and his wife's father. Since this accu-certified to by others), the remarks of Dr. Johnson will mulation of illness and anxiety, he "has been unable be peculiarly interesting, if not novel. The prophyto rally himself,” has felt melancholy, has had pain | laxis of insanity is a great subject, and requires more

serious and scientific consideration than it has yet of declining health. He takes with him the best received, notwithstanding the "little book on a great wishes of his brother superintendents for his speedy subject," in which Mr. Barlow endeavours to shew, and complete recovery. that diseases of the mind are, or ought to be, under the control of the intelligent will.

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“Professor Albers, of Bonn, says of the so-called non-restraint system, that it may be beneficial in slight cases of insanity, but in the severe is useless, or actually prejudicial, by increasing, rendering more violent, and prolonging the malady, besides the harm it does to the existing cerebral disease. That circumstances of provocation and irritation must be increased by it. He has seen patients held by the hands of attendants for ten hours, without becoming quiet, who, in the jacket in a cell, became tranquil in from one to two hours. Injuries from bites, scratches, and blows, are common to attendants; and not seldom the patients will partake in the injuries; and, of necessity, struggling will take place between the two; and, what is very important, aversions arise in the patient against the attendant, and vice versâ.”—Froriep's Tagesberichte, No. 623.

[Many things which are not only possible, but are, as it were, naturalized in this country, appear to be impracticable on the continent. The total and beneficial abolition of restraint is one of them. Is this system, like constitutional government, suited to the Anglo-Saxon race alone? In Germany the power of moral influence is not understood, either in Asylums or out of them. Physical force pervades the country; and it would, indeed, be folly to expect that the merits of the non-restraint system should be recognized where even the sane portion of the community are drilled into order by soldiery and the police.-ED.]

After twenty-three years' service, as the Medical Superintendent to the Asylum for the West Riding of Yorkshire, Dr. Corsellis has retired, in consequence

J. S. Alderson, Esq., M. R. C. s., Medical Superintendent of the Asylum for Notts, has been appointed to succeed Dr. Corsellis. Mr. Alderson has had long experience in the duties of a Superintendent, having held that appointment in the York Asylum from 1841 to 1845; and, subsequently, the one at Nottingham, which he resigns for Wakefield. Previous to 1841, he was the Resident Surgeon to the Wakefield Dispensary. T. Morrison, Esq., M. R. C. S., Superintendent of the Montrose Lunatic Asylum, has been elected to succeed Mr. Alderson, at the Nottingham County Asylum.

The new Asylum Act which has come into operation this month, is of course in the hands of all the medical officers of asylums. The provisions of the Act, ficates in the admission papers, are yet for the most however, as they modify the form of the medical certipart unknown to general practitioners, to relieving officers, and to overseers. Patients are consequently still brought for admission under the old forms, which are obsolete. It would appear desirable to have a notice of the change of form inserted in the local papers of each county.

Professor Simpson, to whom mankind owe the discovery of the anaesthetic powers of chloroform, has related at a meeting of the Obstetrical Society, three cases which had come under his observation, in which in previous confinements, when chloroform had not been used, symptoms of puerperal mania had supervened; the last parturitions, however, which had been undergone under the influence of the anaesthetic, had been distinguished by entire freedom from any threatening of mental symptoms.



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BOTANICAL LETTERS. BY DR. F. UNGER. Translated by DR. B. PAUL. Numerous woodcuts. MANUAL OF ZOO-CHEMICAL ANALYSIS, Qualitative and Quantitative. By E. C. P. VON GORUP-BESANEZ, M.D., Professor of Chemistry at the University of Erlangen. Translated, with the co-operation of the Author, by. J. W.

SLATER. Numerous illustrations.

MICROSCOPE, and its application to Clinical, Physiological,
and Pathological Investigations. Delivered at the Pathological
Laboratory, by DR. LIONEL BEALE. Numerous illustrations.

COUNTY ASYLUM, DEVIZES, an Engineer. He must be fully competent to undertake the charge of the Steam Engine, Heating Apparatus, and the Repairs connected therewith. It is also desirable that he should have at least some acquaintance with the management of Gas Works. Wages, 15s. per week, with Board, Lodging, and Washing, on the Establishment, and the prospect of increase at the expiration of one year. No one need apply, who cannot bring satisfactory references as to ability and character. An unmarried man will be preferred. Application to be made personally or by letter, by the 26th of November, to DR. THURNAM, Superintendent, at the Asylum.

The Asylum, Devizes, Nov. 9, 1853.


SINNOT and ROPE BACK MATS of all the Common Sizes,

can be delivered, carriage free, at the nearest Railway Station to any English Asylum, in quantities not less than 3 cwt. Price for Sinnot Mats 4d. per lb. ; for Rope Back Mats 5d. per lb. Apply to the STEWARD of the DEVON COUNTY LUNATIC ASYLUM.

All communications for the forthcoming Number should be addressed to the Editor, DR. BUCKNILL, Devon County Lunatic Asylum, near Exeter, be

THE PRINCIPLES OF ARTISTIC ANATOMY. fore the 15th day of December next.

With nun erous original illustrations.

MANUAL OF PRACTICAL PHOTOGRAPHY, in its Special Application to Illustrated Literature. With numerous illustrations.

SAMUEL HIGHLEY, 32, Fleet Street, London.


W. & H. POLLARD, Printers, North Street, Exeter.



Published by Authority of

The Association of Medical Officers of Asylums and
Hospitals for the Ensane.

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New Enactments are printed in italics.


I. 8 and 9 Vict., c. 126, 9 and 10 Vict., c. 84, and 10 and 11 Vict., c. 43, repealed, but not to affect appointments, salaries, annuities, agreements, contracts, prosecutions, etc., entered into or made before the commencement of this Act.

As to the providing Asylums and appointment of Committee of Visitors.

II. The Justices of every County and Borough, not having a Lunatic Asylum, to provide one; and the Justices of the County, or Recorder of the Borough, to give notice, on or before the Sessions next after the 20th December, 1853, of the intention to appoint a Committee for that purpose. (ss. 2 and 3 of the old Asylum Act.)

III. Justices to appoint a Committee to superintend the providing an asylum, or to treat for uniting with some county, etc., or to effect one or other of such purposes. (s. 4, old Act.)

IV. Subscribers to any hospital for the insane empowered to appoint a Committee to treat for uniting with any county or borough. (s. 5, old Act.)

enter into agreement to unite with any other county or borough, or subscribers to any hospital. (s. 9, old Act.)

VI. Where Committee is already appointed, or proceedings for the appointment of a Committee have been commenced, it shall not be necessary to proceed afresh.

VII. Justices of Boroughs may contract with Committees of Visitors for the reception of the pauper lunatics of the borough, in consideration of a payment in gross or an annual or periodical payment. And the Justices of such Borough shall appoint a Committee from their number to visit the lunatics received into an asylum under such contract. Two members at least of such Committee to visit such lunatics once at least in every six months, and report thereon. The Justices during such visit to be accompanied, if they see fit, by some Physician, Surgeon, or Apothecary, not being the Medical Officer of the asylum, to be appointed by them and paid by Treasurer of Borough. The reports of such visits to be entered in the records of Sessions of the borough, and be open to inspection of Commissioners in Lunacy. While under such contract the borough not required to provide an asylum for itself.

VIII. Boroughs now contributing to a county asylum, deemed to have an asylum, but can separate from a county upon giving six months' notice. (s. 10, old Act.)

IX. Every borough, not having six Justices besides the Recorder, to be annexed to the county, in which it is situate, for the purposes of this Act. The Recorder to appoint two Justices to be members of the The contribution of such

V. Committee of Visitors of existing asylum may Committee of Visitors.

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