fested after the first night passed under restraint. Nor the feeding instrument was used, as described in my was it possible for me to disconnect the improvement Report. I find it difficult to reconcile the notion of and the only ostensible means thereof, from the relationship of cause and effect. If I could have procured lying down by any other means than that used, all may believe that I would not have resorted to restraint. But when life is flickering in the wasted body and a single thing seems possessed of the nature of a remedy, it is not a time to be bound by any restrictive, foregone conclusion (however meritorious that might be, as long as practicable and entailing no risk); it is, however, the time to sacrifice every private wish to the safety of the patient.

exciting temptation out of variety in food, with the cause why all food was rejected; viz. an overwhelming sense of unworthiness and desire of making expiation. Amongst the sane, absorbing emotions often destroy all appetite. They do not simply render the palate hard to please, and demand its temptation; they destroy the power of appreciating food, inclusive of all its varieties. Is the reign of delusion in insanity less absolute than the occasional abstraction in the healthy mind? I should think not; and I see no psychological impropriety in reasoning from the one to the other.

ever is still not in accordance with the fact. I do not allow the newly-admitted to sleep, whilst they are unknown to us, otherwise than alone, for a plain reason.

Dr. Conolly proceeds to speak of the success which in similar cases, had attended the application of a blister Dr. Conolly seems to think that the plan of assobehind the neck, the use of a tepid shower bath, not ciating suicidal with other patients in the bedrooms, too violent, sedative medicines, variously prepared is not followed in the Kent Asylum, for the sake of food, and very patient persuasion. The blister I will the security which it offers. His idea is probably try willingly, next time, on his recommendation. But founded on the case of restraining to prevent the comon what ground of professional reasoning is blister-mission of suicide, and on the case of actual suicide, ing to afford relief in these cases? Have we deep both mentioned in my last Report, and both patients seated congestion, calling for counter-irritation or local | having occupied single rooms. The concurrence may depletion; or is the blister to act as a stimulating ir-seem to afford ground for his conclusion, which, howritant? The blue skin, sluggish circulation, and general coldness of surface, the injected conjunctivæ, the œdematous ankles and feet, seem to me to offer no evidence of congestion within the skull, but rather the opposite state, and to tell their history thus: first, In the case restrained, the first attempt at suicide cerebral energy was reduced by an ever present idea, was made on the third night after admission; and, exciting terror and banishing sleep; next, the heart, from its nature (knocking the head against the bedparticipating in this reduction, and soon further en- stead), the padded-room was resorted to. On the feebled by the want of healthy blood (due to the same second attempt, at the end of one month, a strip of cause as the emaciation), failed, to a great extent, in binding, torn from a mattress, was used for strangling. carrying on the circulation; and, last, the consequent Very close watching was employed as a safeguard, absence of the due movement and supply of blood—and to its faithful performance we were indebted for a healthy blood-in the brain, reacted on that organ, timely detection. In the variety of this patient's largely hastening the exhaustion. What is the first resources, coupled with the extreme earnestness of her thing necessary to the relief of a heart labouring, not attempts, I could see little prospect of security in any with too much blood, but with too little power? but the last resource. In the case of suicide, the Lying down, which takes off from both heart and woman had been resident twelve days, which may or arteries the weight of their contents; and the brain may not be thought too long a period for judging of is that portion of the body which can profit the most the existence of an inclination hurtful to other perby the horizontal position. Dr. Conolly recommends sons, of which there was some slight evidence in the sedatives. I freely used them throughout (under the history of the case. These isolated instances have great disadvantages, however, of the resistance to swal-misled Dr. C. as to the general practice. lowing, and of the sustained erect posture), but not without conjoining stimulants. I do not hesitate to express my belief, that a sedative cannot take effect in such cases, without a stimulant. For a sedative to act, the organ must be in a condition, greater or less, to be laid at rest. In a state of almost lifelessness, it can hardly assume an artificial condition, the taking on of which is an act of life. But a stimulant, applying first to the heart, and through the circulation reviving cerebral function, may enable the brain to recover power and sensitiveness approaching to what it possesses in health; and then the combined sedative may obtain a response. The "tepid shower-bath, not too violent," would, I believe, at that stage, have killed the patient outright. Whether a course of such baths, at an earlier period, might have done good, I am not prepared to say.

Variously prepared food, and all the patient persuasion we could muster, had entirely failed before

This question of restraining has unfortunately become too controversial. The ground of dispute has been narrowed to the single proposition of 'All or none.' At a time when party has gone out of fashion, must a domestic question have its settlement deferred by a spirit very like that of the partisan? Are not all men striving to dispense with what all would rather do without? The tables are being turned, and restraint transferred from the insane to those who yet withhold entire conformity with extreme opinion; because of some opposing convictions affording the prospect of a more temperate settlement of the point in dispute, when time may have sifted all the human incentives that help to determine opinion, and rejected any which may have been found not to harmonize with the indisputable truth. It has seemed to me a bad thing to have to stand or fall by a rigid opinion, except in reference to an eternal truth; an opinion that may admit no fellowship without identity,

waxy, very like that of a lying-in woman who had suffered from profuse flooding.

The colour did not begin to fade in the parts first affected until the early part of this month, and fresh spots are still coming out lower down the leg. The patient has been in bed all the time, but one day thinking a little change desirable I prevailed upon her to get up. The consequence was an attack of syncope, from which I had some difficulty in rousing her.

and which must denounce every approach short of uniformity, as being no approach at all. All men have been striving for years, in asylums, to get rid of restraint. It is utterly distasteful to them; to him who must still acknowledge the necessity of restraining and act upon it, as to the most ardent disciple of non-restraint. There is, there can be no doubt of this; and, may the question be allowed to rest. The active elements for its settlement are at work, and will infallibly prevail in the right direction; but time must be allowed. It might seem enough for the prime of life of one generation to have witnessed the grand step already taken and secured. The disuse of re-extending from the two forefingers nearly to the wrist, straining for any but surgical or medical purpose is a settled conviction, not susceptible of disturbance. Let it be well remembered that with the riddance of restraint for any object not in the legitimate way of medical treatment, or preservation from self-injury under circumstances of great extremity, the old wrong has been redressed.

The other patient is also a married woman, paralysed and demented, age 35. Three weeks ago I noticed a slight purple discoloration on the back of each hand,

both just alike. Two days after the nurse reported a large bruise on the left gluteus, about which she was very much concerned, not knowing how it had been caused. Had I not been prepared for this, and recognised the nature of the affection I might have blamed the nurse unjustly. In this case the marks did not spread much further and they have now nearly disappeared.

Two years ago a circumstance occurred in connection with these marks, which at the time gave me a great deal of annoyance.

A private patient who was paralytic, and so unmanageable at home that for five days before she came she had been tied in bed with cords, was admitted covered with what I then, knowing the restraint to which she had been subjected, very naturally considered to be bruises. They soon went off, but two months afterwards similar marks appeared under circumstances which prohibited the supposition of their being the result of violence. They spread rapidly, and soon affected more or less nearly every part of the body. In this condition she was seen by her friends, who thought the marks were caused by violence, and I was unable to convince them to the contrary. In a fit of indignation the husband removed her, and, as you may suppose, the whole family did not fail to talk loudly of the gross treatment to which she had been subjected. I have, however, the satisfaction to think that they subsequently changed their opinion, for not very long afterwards I was asked to take her back again, but of course refused.

I give you these cases without comment,
And remain, dear Sir,
Very truly yours,

THOS. GREEN.

I have at this time under my care two cases so strikingly corroborative of your opinion, that these marks are pathological changes and not produced by violence, that I am induced to trouble you with them. One is a married woman, 48 years of age, who within the last 8 years has had five or six attacks of acute recurrent mania, from the last of which she recovered several months ago, but since then she has been much depressed, rational in her acts and language, but unusually quiet and inert. On the 23rd of Nov. I found her complaining of pain in the back and right To the Editor of the Asylum Journal. groin, and on the following day I was told that there was a large bruise in the groin; on examining the part I found a uniform purple discoloration as large as the palm of my hand, upon and to the right of the angle of the pubis. The patient was certain that she had not been struck or injured in any way. Her pulse was rather frequent, tongue clean but dry, face a little flushed, skin somewhat hot; she said the pain in the parts had kept her from sleeping. In the course of the next few days the discoloration gradually spread down the inside and back of the thigh, preceded and accompanied by pain. On the 8th ult. it covered nearly the whole posterior part and back of both thighs, and at this time a little sponginess of the gums was first observed. The face had become blanched and

Birkfield, Ipswich, Jan. 10. Dear Sir, I have much pleasure in being able to confirm your opinion as to the causes of discolorations of the skin resembling bruises, noticed in the last number of the Asylum Journal, as the same thing occurred to a patient of mine on board the ship of which I was surgeon. The man was a private in the 9th Lancers, and one of a detachment of Queen's troops of which I had medical charge during the voyage from India. He was invalided for chronic dysentery and general cachexia, and after having been about a week on board, I discovered, what, at the time, I thought was a bad bruise, on the outer side of the thigh and leg.

Knowing how awkward soldiers are at sea, I thought SPIRIT RAPPINGS: PHYSIOLOGICAL EXPLANATION it probable that the man might have hurt himself OF THE SOUNDS.-Dr. Schiff, of Frankfort, has dewhilst getting into his hammock, though he had no recollection of having done so. I therefore took him into hospital and put him into a swing cot, where he could not possibly receive any injury; but I was surprised a few days after to find the arm of the opposite side discolored in exactly the same way. I then considered this appearance might arise from a generally debilitated and impoverished state of the system, and as you say in your case, from blood dyscrasia, so I put him on a nutritious diet, fresh meat and potatoes, with port wine, and gave him at the same time iron in small doses. Under this treatment the man improved much, and the discolorations gradually disappeared, though they returned three or four times during the voyage, but never to the same extent as at first.

voted much patience and labor to the investigation of the source from whence arises the sounds, which the credulous imbeciles of this enlightened age attribute to the unquiet ghosts of their defunct grandmamas. His investigations have been rewarded by the discovery that they are produced at will through the medium of the tendon of the peroneus longus muscle. Our readers will remember that this tendon passes through a groove behind the external ankle bone. Dr. Schiff discovered that, by a little practice, this tendon can be slipped out of this groove, and slipped in again, producing the noise in question. M. Dechambre, writing in the Gazette Hebdomadaire, states that, in his presence, Dr. Schiff beat a measure in this manner to the tune of the Marseillaise. It is through the medium of their own malleoli that deceptive females I have given you these particulars merely to shew have been hammering at the ear of public folly; that these appearances are not confined to the insane, these Medeas who came from the country of Barand also because I thought you might feel interested num's woolly horse with avaricious intent upon the in the case. golden fleece of the English donkey.

I am, dear Sir, faithfully yours.
W. B. TAIT.
The Editor of the Asylum Journal.

presenting him with a testimonial. Already, a handsome amount has been subscribed; Thos. Mackinlay, Esq., of Soho Square, being Honorary Treasurer to

the Committee.

Appointment.

TESTIMONIAL TO DR. DIAMOND, OF THE SURREY COUNTY ASYLUM.-The services rendered by Dr. Diamond to photography, and especially in its application to archæology, and the frank and liberal manner in which he has communicated his improveETHERISATION EMPLOYED TO DETECT SIMULATED ments to others practising the art, have incited a INSANITY. In one of those admirable Medico-Legal numerous and influential body of photographers and Reports which enrich the pages of the Annales Psy-archeologists to mark their sense of obligation by chologiques, M. Morel concludes, "I declare on my conscience that Caroline Dugont is insane. But desiring to establish this couviction by every possible means of arriving at certainty, I have submitted her to etherisation. It was desirable to ascertain whether the abnormal indifference, and the automatism of her acts would disappear under a temporary change of DR. WILLIAM NIVEN, Assistant Medical Officer of physiological conditions. That which occurred was the Essex County Lunatic Asylum, has been a sucas follows: When etherised, not so as to produce cessful candidate in the recent Examinations for coma, but to the stage of irritation, Caroline be- Medical Appointments in the East India Company's came very gay. She told us that she had been Service. The thoroughly scientific and practical promised in marriage to M. Quissel [a delusion]. She knowledge of insanity, which Dr. Niven has acquired did not deny her theft, but said that she had always in the Essex Asylum, will be of the utmost value to been foolish, and knew not what she was about. Her that portion of the Indian public with which he will imagination momentarily excited, carried her into her be brought into contact. His late appointment is now favorite sphere of matrimonial ideas; she laughed, was joyful, and the expression of stupidity usual to her physiognomy disappeared. But when this state of excitement, which seemed a moment of remittence, had once passed, the patient relapsed into her ordinary state of half-stupor." October, 1854.

vacant.

Society for Improving the Condition of the Insane.-In our last number, p. 159, we confounded this Society with another private Society, known as the Alleged Lunatics' Friend Society. We are informed that this is an error, and that the two Societies are distinct, and for distinct purposes.

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All Communications for the forthcoming Number should | be addressed to the Editor, DR. BUCKNILL, Devon County Lunatic Asylum, near Exeter, before the 15th day of March next.

Published by SAMUEL HIGHLEY, of 32, Fleet Street, in the Parish of Saint Dunstan-in-the-West, in the City of London, at No. 32, Fleet Street aforesaid; and Printed by WILIAM AND HENRY POLLARD, of No. 86, North Street, in the Parish of Saint Kerrian, in the City of Exeter. Thursday, February 15, 1855.

The Want of a Military Lunatic Asylum. If legislative enactments, having reference to the care and treatment of the insane in this kingdom, can, of late years, be said to have been grounded upon any one broad principle, it is this, that insane persons, whose maintenance is provided from public funds, shall receive care and treatment in public establishments, directed by salaried officials, and under the inspection and control of public bodies. On this principle it is that the recent Asylum's Act renders it compulsory upon every county and borough, to provide a public asylum for its poor, and invests the Secretary of State with large and summary powers to enforce compliance. It is the operation of this principle which has removed pauper lunatics from almost all licensed houses throughout the country, and has brought the latter, with a few exceptions, to the more legitimate condition of private asylums. The legislature has imposed this broad principle upon the community at large. It has left freedom of action to the Government alone, of which the Government has taken and is taking an advantage, which is by no means edifying.

While the Legislature has been emptying licensed houses, Government has been filling them. While the former has been removing the insane poor from the custody of speculators, the latter has been farming out all the insane patients who are charged upon its funds. Government farms some of its criminal lunatics to

CORRESPONDENCE, &c.

page

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189

DR. BALMANNO'S FEEDING APPARATUS, by T. PRITCHARD,
M.D. of Abingdon Abbey, Northamptonshire
NEW UTENSIL for ASYLUM USE, by JAMES WILKES, Esq.,
Medical Superintendent of the Stafford Lunatic Asylum, 190
The COMMISSIONERS' CIRCULAR respecting ADMISSION PAPERS 190
REPORT of the TRIAL and CONVICTION of a MAN for the ILL
USAGE of his LUNATIC WIFE
ASYLUMS FOR CRIMINAL LUNATICS. LORD ST. LEONARDS on
LUNACY BILLS before PARLIAMENT

190

192

the governors of Bethlem, and the remainder to Mr. Finch, the proprietor of Fisherton House.

The ratepayers of the county of Essex having placed their pauper lunatics under the care of Mr. Bias, of Grove Hall, the Legislature interferes, and compels them to build a county lunatic asylum at great cost, to which the Essex lunatics are removed.

The vacancies so created are speedily filled up by the intervention of Government, which closes the Military Asylum at Great Yarmouth, and in its turn farms a hundred or so of lunatics to Mr. Bias. The Legislature compels every county and borough to withdraw its insane from the licensed houses, and to provide private asylums for their care and treatment, while it permits the Government not only to continue its old contracts for the custody of its lunatics, but even to enter into new ones, and to shut up the asylums which it did possess. If it is cheaper for Government to farm out its insane soldiers to Mr. Bias, and its insane criminals to Mr. Finch, and thereby to save the cost of buildings and of official staffs, it was also cheaper to the counties and boroughs to farm out their insane dependants to the keepers of those licensed houses which are now closed to them by the operation of Acts of Parliament.

Apart from the question of principle, it may well be doubted whether the accommodation available at Mr. Bias's licensed house will suffice for the requirements of our army, more than doubled in numbers as it has recently been, and exposed to the fearful strain of a

gigantic war. Of the men who survive the sufferings sent under a Corporal's guard to their remote parochial

settlements, or will they, like ordinary laborers fallen sick, become in the first instance chargeable to the parish in which the malady first occurs to them?

of the Crimea, and the more gloomy horrors of Scutari, how many will return to this country with mental faculties impaired or perverted? and of how many will the mental powers give way during the incessant It must not be forgotten that while Her Majesty's drill, by which soldiers are being manufactured at land forces are unprovided with any lunatic accomhome in the briefest possible period? In all pro-modation, except a few cells, at Fort Clarence, bability the numbers will be large: yet the only (a sort of ravelin,) an excellent asylum has been asylum which Government did possess for the treat-provided for the insane seamen of the Royal Navy. ment of insane soldiers has been closed, and the only The Lunatic Asylum at Haslar, though small, may vie substitute which the military authorities have thought with any institution in the kingdom in completeness fit to provide is a contract with the keeper of a and skilful management. Why does not Government licensed house, situated in the purlieus of the east end enlarge this asylum and send insane soldiers to it; of London, with contracted boundaries and soot-laden thus avoiding the expense of a double staff for two atmosphere; laboring in fact under those disadvantages small asylums? Why should the red coats be treated of locality, on account of which the Commissioners in so differently to the blue jackets when they become Lunacy are endeavouring to close various borough insane? They have both been servants of the Queen, asylums. It is but fair to state, that under all these and defenders of the country, and although these disadvantages Mr. Bias has conducted his asylum with have fought on land and the others by sea, this elesuch liberality, and has displayed so much judgment mental difference is no reasonable ground of distincin the selection of men skilful and devoted to their tion when they stand on the common chaos of insanity. duties as medical attendants, that he has deserved and enjoyed the marked favour of the Commissioners in Lunacy. Our observations, therefore, are very far from bearing any personal application to him, or any objection to Grove Hall as his asylum. We only argue against the violation of a principle by those who should be most forward to maintain it.

Medical Certificates, and Orders of Admission. A recent decision of Mr. Justice Coleridge, respecting the invalidity of a medical certificate of insanity, because the name of the street, and the number of the house wherein the examination took place, were not The want of asylum accommodation is beginning therein stated, has profoundly affected the serenity of to be manifested by an exceedingly unfair proceeding the persons most interested in the strict observance of on the part of the military authorities. Soldiers who the statutes on lunacy. This decision, the legal correcthave become insane within a limited period of their ness of which has not been disputed, invalidates a large enlistment are 66 discharged, in consequence of being number, perhaps the majority, of the documents under found unfit for further service." It is only a few which, lunatics placed in confinement since the passing days since we admitted an insane soldier who had just of the late Acts are detained. The case upon which before been sent from his regiment to his parish in a Mr. Justice Coleridge's decision occurred was that state of destitution. We believe that such cases have of Mr. Greenwood, an aged gentleman of large probeen of rare occurrence up to the present time, but perty resident at Todmorden. He was unmarried if the evil is not checked, and if no Military Asylum but had several natural children, to one of whom, is provided, it is far from improbable that they will a daughter, he was much attached. It is stated that rapidly increase. It will be a monstrous injustice if he had expressed a desire to bequeath some of his the military authorities are permitted to discharge property to this daughter; whereupon his brothers insane soldiers as incapable of further service, and caused him to be admitted into a private lunatic to send them to their parishes, in charge of a corporal, asylum named the Billingdon Retreat. He was conin a state of destitution, or at most with a few fined in this asylum a day and a night without certifishillings of marching money in their pockets. The cates. The day afterwards he was removed to a public act also is obviously illegal under the poor law, unless house in a neighbouring town, at which he was seen by the disease is permanent and incurable, In cases of two medical men who examined him, and certified to curable insanity such a removal would not be per- his insanity; but they omitted in their certificates to mitted from one parish to another: and supposing the state the name of the street, and the number of the soldier to have no further claim upon the Government, house in which their examination took place. Through upon the occurrence of insanity, it would seem that the intervention of personal friends, Mr. Greenwood he ought strictly to become chargeable to the parish was brought to London under authority of a writ of in which he was stationed at the time of the attack, as habeas corpus granted by Mr. Justice Coleridge. Here in other instances of accidental and removable disease. he was examined by various medical men expert and This is a serious question also as it affects the non-expert. Among the former were Dr. A. SutherMilitia. Now this force is embodied, and the regi-land whose affidavit testified to his insanity, and Dr. ments are removed to localities far from the districts Forbes Winslow and Sir Alexander Morrison, whose in which they were raised, what will be done with the cases of lunacy occuring in their ranks? Will Government send them to Mr. Bias's Asylum, or will the poor fellows be made paupers directly they become insane ? And if the latter, will they be “discharged as being unfit for further service," and

op nions and affidavits were quite the other way. When the case came on for discussion on Saturday the 10th of February last, Mr. Serjeant Wilkins on behalf of the alleged lunatic raised the question of the validity of the two medical certificates in which, as we have before stated, the name of the street, and the