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That unfortunate clause, rendering permissive the amendment of informal papers, has been the source of never ending trouble to officers of asylums, public and private, and to the Secretary of the Commissioners in Lunacy.

In the article referred to, we stated, "We cannot think this section either a wise provision in itself, or consistent with the other parts of the statute. It has already been a fruitful source of irregularities. The act in fact contemplates the continual commission of misdemeanours by officers of asylums, and the 87 sec. is made to stultify the 73."

number of the house in which the examination took place, were omitted to be mentioned. Mr. Justice Coleridge reserved his judgment on this point of law, and on the 12th of February he gave his decision that the certificates were invalid in consequence of these omissions, and he ordered Mr. Greenwood to be discharged accordingly. Such is a brief outline of the train of circumstances which has sprung the mine upon the archives of admission papers treasured with such care in asylums and hospitals for the insane; and copies of which are guarded with jealous solitude in the muniment rooms of Whitehall Place. The Circular of the Commissioners [Feb. 14, 1855] on Lunacy trnly Under the old act the admission of patients brought states, "This decision, although immediately applica- with irregular and defective certificates was simply ble only to the particular case, has a wider and general refused, unless the superintendent was willing to bearing, and enunciates the principle upon which the incur the risks of a misdemeanour imposed on superior Courts of Law will, it is presumed, judge all him by the ignorance, stupidity, or wilfulneas of analogous questions of form." It enunciates in fact the some relieving officer or justice's clerk. Under the very simple and reasonable principle, that the validity new act it appears that he is expected to admit the of documents upon which an Englishman is to be patient, notwithstanding the misdemeanour; and as to deprived of personal liberty on the ground of insanity, the irregular and defective orders and certificates, he must be in strict and not in loose accordance with the is "to procure the same to be forthwith amended." statutary enactments of the legislature. If these enact- (Com. Circ., Dec. 31, 1853.) And when one of the ments have been made too intricate and complicated for Commissioners in Lunacy has approved the amenduse, the difficulty has not arisen with the persons whose ment, "such formal sanction" will serve "for the produty it is to interpret them, but with those by whom tection of superintendents and proprietors against vexthey were made. It has been stated, that Mr. Justice atious legal proceedings." (Com. Circ., Dec. 12, 1854.) Coleridge evaded the onerous and disagreeable duty If this unfortunate clause does not positively auof deciding between conflicting opinions as to the thorize the admission and detention of alleged lunatics sanity or insanity of Mr. Greenwood, by this decision upon informal certificates, at least it provides a facile on the point of law. That he shirked his straight for- remedy for such infractions of the law as often as they ward duty by taking a side path. But it must be re- occur. The inevitable result has been that they conmembered that the point of law was not mooted by stantly do occur. Few men will take more trouble the Judge, but by the counsel for the alleged lunatic, than they are compelled to take in such a matter and the Judge was compelled to decide upon it one as attention to the minutiae of a somewhat complicated way or another. If the opinion of Mr. Justice Cole- legal document. The consequence has been, that ridge is unsound in law it can be reversed. If his in-persons officially engaged in sending lunatics to asyterpretation of the enactment is correct, but notwith-lums, having been neither directly compelled by any standing this has a tendency to consequences which penal clause, nor indirectly compelled by the refusal will be of serious inconvenience to the public welfare, the only remedy lies in legislative interference and the amendment of the statute.

of admission to patients sent with informal papers, have neglected to make themselves acquainted with the requirements of the statutes. The operation of clause 87 has not been to protect superintendents and proprietors of asylums from vexatious proceedings, but to encourage the clerks of justices of the peace, relieving officers, and certifying medical men, in a careless and negligent unobservance of the statutory forms.

It has been urged that if a certificate is essentially correct, the omission of an unimportant particular ought not to invalidate it. But who is to decide as to that which is important and that which is unimportant in an Act of Parliament paper? If the address is unimportant is the date unimportant also? And if This clause has placed the officers of asylums in the the date, what other particulars are unimportant? We very invidious position of having constantly to select have little doubt that on reflection, it will appear to between the admission of patients brought to the door our readers, that in a document of this kind, no par- with informal papers; or the refusal of admission, and ticular can be deemed unimportant, which the Act of the infliction of annoyance on those sending them, and of Parliament requires to be stated. A matter which has possible injury to the patients themselves; contingenreceived the attention and the sanction of the Legisla-cies which it was known to be at their option to avoid. ture, cannot be despised as unimportant. Besides, The clause in question was inserted to avoid vexatious things apparently trivial in themselves make, in com-legal proceedings on account of the detention of a lunatic bination, an important whole.

We pointed out the difficulties and embranglements which were likely to occur from a lax employment of the proceedings and forms of admission, soon after the passing of the new Acts in a leading article in No. V of the Asylum Journal, to which we beg to recall the attention of our readers. The lapse of a few months has abundantly proved the justice of our apprehensions.

on informal certificates. But for the sake of this possible advantage it has been the fruitful source of trouble and irregularity. If this clause had been omitted, and if any officer of any asylum had been rendered unconditionally liable to a moderate penalty for admitting any patient on informal papers, an incalculable saving of labor, annoyance, and expense would have accrued. Medical men, justices of the peace and their clerks,

relieving officers, and clerks of boards of guardians, and all persons concerned in the transmission of an insane person from his home to an asylum, would have been compelled to conform to the strict letter of the statutory enactment. In all documentary matters people inevitably suffer more from any laxity or uncertainty of the law than from its stringency. In such affairs it is almost merciful to be strict.

Fourth Notice of the Eighth Report of the Commissioners in Lunacy, by JOHN CONOLLY, M.D.

I am sorry to find that my remarks on the use of restraints in the Kent Asylum were displeasing to Dr. Huxley; and can only say that my desire was to confine myself to the actual statements in his own Report. I was careful to mention his anxiety to have it understood with what strict limitation he employed any mechanical restraint at al'. Dr. Huxley may be assured, that nothing was further from my wish than to do him injustice or to give him uneasiness.

In a very short reply to the Commissioners by Dr. Simpson of the York Lunatic Hospital, he states, that he has had under his care "two or three of those happily rare and exceptional cases" in the management of which, "all other resources proving ineffectual," he was compelled to adopt a mild form of mechanical restraint." It is so evident that Dr. Simpson adopted it with reluctance, that it can only be hoped that such rare and exceptional cases will not long be met with in the York hospital.

It is not very improbable that the next point of law in this matter which will be mooted in the courts will be the meaning of that phrase in clause 87 of the statute: "No such amendment shall have any force or effect, unless the same shall receive the sanction of one or more of the Commissioners in Lunacy." And we shall not be surprised to learn that all the forms of admission which have undergone any amendment since the passing of the recent statutes, including the great majority of these documents, are essentially invalid either from such sanction not having been given to them at all, or from its not having been given in the right manner and at the right time. Most of our readers are well acquainted with the routine through which an informal certificate passes All who were interested in the modern method of during its progress of amendment. A copy of the managing lunatics without treating them as criminals, document is transmitted to the office of the Com- and in the abolition of chains and other apparatus now missioners in Lunacy, where it is examined by a clerk even rarely resorted to in prisons, must have looked, and returned by him to the clerk of the asylum with as I did fifteen years ago, with anxiety, to some exthe informality marked in red ink. The clerk of the pression of the opinion of Samuel Tuke, one of the asylum is informed that it is his duty to "procure" founders of the Retreat at York; and in whose Descripthe informal document "to be amended forthwith;" tion of that establishment, published in 1813, are still and although he is under no legal obligation, and has to be found more clearly and fully explained than in no legal power to do this, he endeavours, and gene- any other work, English or Foreign, the soundest rally succeeds, in obtaining the desired amendment. principles of treatment of the insane. When its veneA copy of the amended form is then transmitted to the rable author, (who still survives, full of years and the office of the Commissioners, and the business is con- honours which belong to those whose lives have been sidered to be settled. Now the question must arise, devoted to the good of mankind,) accompanied me whether this acceptance of a corrected copy at the round the wards at Hanwell, late in the autumn of office of the Commissioners in Lunacy is "the sanction 1839, I remember his start of surprise, not unmingled of one or more of the Commissioners in Lunacy," with an expression of grave anxiety, when, in answer within the meaning of the act. In our opinion no to his enquiry as to how many patients, out of 850, sanction is given by the mere acceptance of the copy. were that day in restraint, I was able to answer "not Sanction given at a later period, and subsequent to one." The successive Reports of the Retreat since the institution of proceedings for false imprisonment that time contained passages which, if not quite so and the like, cannot legalize past acts. So long as this determined as to satisfy my own impatience, sufficiclause is permitted to remain a part of the statute, it ently indicated the care, caution, and judgment, with would seem that the amended document itself, and not which the possibility or advantage of the entire abolithe copy, ought to be transmitted to the Commissioners tion of restraints had been considered. The reply in Lunacy, to receive their signature and formal sanc- made to the Commissioners by Dr. Kitching, the pretion; or at the very least, that a note specifying and sent medical superintendent of the Retreat, is equally sanctioning the amendment, and signed by a Com-expressive of the calm and unprejudiced manner missioner, ought to be transmitted to the clerk or proprietor of the asylum. For want of such a sanction, the Commissioners may any day find upon this point of law being raised by some astute barrister, that the great majority of insane patients placed under care and treatment in asylums, are and have been illegally detained, and that those who hold them in custody are liable to action for false imprisonment.

It a great pity that our new Lunacy Laws, which are admitted to be almost perfect, and eqnal to any thing in the whole body of the statutes, should any longer remain blurred by this stupid and mischievous .clause. [Section 87.]

in which this great question is viewed by him: and comprehends some important auxiliary points of treatment to which the opponents of the non-restraint system seem to pay far too little attention.

"The founders of the Retreat," says Dr. Kitching, "entertained the belief that more successful results might be obtained in the treatment of insanity, and the sufferings of patients more effectually alleviated by the agency of humane and moral influences than the public at large were prepared to attempt. They endeavoured, in the choice of the officers and attendants, that they should be animated with a feeling of kind sympathy towards the afflicted objects of their care; and it has always been their especial desire to dispense

with the use of mechanical restraint as much as restraint and of seclusion is another important feature, possible.

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as well as the greatest single improvement of the present time in the practice of asylums. Whatever be the station assigned to it in the order of modern improvements, no single change has brought in its train so many advantages to the insane as this.

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'They also wished to adopt, as nearly as the peculiar objects of this institution permitted, the arrangements of an ordinary family and home. It was thought that the advantage of striking the patient's mind on his entrance into the establishment with the perception of "In this institution the application of restraint is so arrangements altogether different from those to which small in amount, that the general practice and results he had been accustomed in private life, was not so would be unaffected by its formal abjuration. During great as that of showing him at once that he would the last five years only three cases have been under continue to enjoy the domestic comforts, at least to a treatment to which mechanical restraint has ever been great extent, of his own home. The improved moral applied, and of these, two were patients under surgical treatment carried with it an improved medical treat-care, whose lives were endangered by their propensity ment also, and there naturally followed improved to interrupt the healing process in local disease. architectural arrangements. All these, and other improvements conjoined, rendered mechanical restraint less and less necessary; and again, led to the adoption of non-restraint, as a practice, itself a result of more enlightened moral and medical views, because in many instances a cause of the improved condition of asylums. "The Retreat, although its first principles of treatment at once abolished all cruel forms of restraint, and although it has undoubtedly been beneficially influenced by the experiment of entire non-restraint made at Hanwell and elsewhere, has not considered it wise to pledge itself to the non-restraint practice as a principle, conceiving that there may still be exceptional cases in which mild restraint is the best and kindest, as well as the most scientific mode of dealing with them.

"Mania, and all the violent forms of insanity, are more successfully subdued by the medical treatment and structural adaptations of the present day, than by the strait-waistcoat and the restraint chair of the former times. The diminution of violence among the patients accomplished by these means is one of the most important results of modern days, and forms the key to a large share of the difference between asylums as they are, and as they were. Asylums were formerly constructed as if violence were the rule in the condition of lunatics; they are now constructed as if it were the exception, and it is the exception.

"Nor is this change due to any diminution having of late taken place in the proportion of maniacal to quiet

cases.

"Another very important circumstance which has greatly contributed to the advantage of the patients, is the increased number of attendants with which our wards are provided.

"In this institution the proportion of attendants has been nearly doubled of late years, and not only has their number been increased, but the general standard of education and competence has also been raised. By this means the patients have been under the constant observation and influence of persons better able to understand the initial indications of important states and changes, and to meet them by immediate application to the medical superintendent, or by such ministrations as their own experience might suggest. That the general tranquillity, comfort, and mental healthfulness of a company of patients must be greatly promoted by this means, no one who has seen its effects can doubt.

"The disuse of prolonged solitary confinement ought perhaps to rank next as an important improvement in the treatment of the insane. Nothing impedes the recovery of a patient so much, or tends to confirm bad habits already contracted, as the abuse of solitary confinement. If the patient be rude, boisterous, or dirty, solitary confinement, if continued, delivers him over to the full force of his tendencies, and strengthens those habits which it is the object of the treatment to eradicate. Seclusion is chiefly useful during the acute stage of mania, and in chronic cases for short periods of time, as a mode of discipline when a patient has committed some act which he knows to be a breach of good order, or proper subordination.

"If the patient be confined to the bed or chair by straps or waistcoat, it is impossible for him to attend duly to the calls of nature, and thus a familiarity with uncleanliness is established, and the sense of self-respect injured; but if the patients are afforded every opportunity of observing cleanliness and decency, and encouraged to appreciate them, a departure from them is comparatively rare. The more constant personal attentions to the habits of the patients procured by the increased proportion of attendants has also been greatly instrumental in producing the same result."

It is satisfactory to be able to conclude the notice of what may be termed public institutions for the insane with this extract. It is less so to turn from these institutions, in forty of which mechanical restraints are not employed, and in few or none of the other ten of which they are resorted to, except in cases of peculiar and extreme necessity, to the contemplation of the disproportionate number of private asylums in which the proprietors still habitually have recourse to them, lean upon them, and magnify their merits.

There are, it appears, 128 private asylums in England; and there is much reason to believe that mechanical restraints are used in no fewer of these establishments than ninety one. Of the proprietors of these 128 asylums, thirty seven only report that they use no restraints. Forty seven proprietors avow that they employ them. Forty four make no reply: and there is reason to conclude that they may be added to the forty seven.

Well knowing that several of the proprietors of private asylums, who still allow mechanical restraints to be resorted to, are neither to be suspected of any leaning towards cruelty, nor of any desire to economise in anything that relates to the comfort of their patients, ̈“The total or almost complete disuse of mechanical I can but deeply regret that accidental circumstances

have left them apparently as unacquainted with the and easily, without the miserable and cruel resources practice of our best public asylums as if no such in- of what he calls mild and judicious restraints; and that stitutions existed. Circumstances, equally accidental, frost-bitten limbs are unknown under the non-restraint have made many of them proprietors of asylums; system, and belong to that under which patients were and 'for this task every medical man considers himself chained or tied down in bed, left neglected all night; qualified. It is taken up as a good investment, a pro- badly clothed, badly fed, wet, dirty, wretched, and fitable business; the habits and practice of an asylum doomed to every misery which non-restraint has baare purchased together with the patients, and the strait-nished from our largest and best asylums. In small waistcoats figure in the inventory with the rest of the asylums in country places, twelve insane patients canfurniture.

If the zeal and philanthropy of the good Earl of Shaftesbury should ever prove successful as to the abolition of all private asylums, or if the feelings of the public should lead to the same inconvenient result, the responsiblity will rest with those private asylum keepers who, when the contrasted condition of the public asylums with their own is considered, cannot but appear to the public as most deficient in the humane appliances of treatment. The evils following the abolition of private asylums would, I believe, be many and great; but they are such as those only who know the general sentiments of the friends and families of patients can foresee or at present appreciate. But the apathy in many of these institutions, and the con| tented ignorance of the great progress made in public asylums within the last twenty years, are bringing on the catastrophe. Whether it shall be found that the private houses are generally ill-adapted for the residence of insane persons; or that the attendants are too few in number, and ill-qualifled for their task; or that the proprietor is too anxious for gain, or simply

not be managed without the strait-waistcoat. In a I will take, as a fair example of respectable asylums large asylum near London, twelve hundred patients of this description, the Driffold Asylum, at Sutton are admitted, and there is not a strait-waistcoat in the Coldfield; knowing Mr. Bodington to be as kind and house. It is a reproach, perhaps in some degree as candid a person as any holding a licence for an attaching to all medical men engaged in practice, to asylum. He has twelve private patients. He never, have been so indolent as not to acquaint themselves he says, "professed nor practised out and out the with the present state of our improved asylums: but system which is called and known as the "Non-re-in medical men professing to take care of the insane, it straint" mode of treatment." He thinks the theory is more than a reproach: it is a neglect of duty; has produced much advantage in the treatment and almost a crime. cure of lunacy; but, "like all imperfect theories when carried into practice," serious concomitant evils." He considers "the doctrine of total non-restraint to be an ultraism which overshoots the mark, and goes beyond the truth." Mr. Bodington then considers; first, “the best method of meeting, resisting, and overcoming the propensity to attack and destroy, which commonly appertains to mental derangement;" and he at once declares his "entire conviction, that the use of instruments of restraint, properly adapted, is the most efficacious and merciful way of meeting the difficulty." Proceeding with equal confidence, and I am compelled to add, with really incredible ignorance of the whole practice and resources of the non-restraint system, Mr. Bodington says: “There are the cases of the lunatics who will not keep their beds, but will be up even all through the night, and in severe frosty weather are in danger of being frost-bitten. No personal efforts of an attendant can be effectual in remedying this evil. The system of total non-restraint leaves these cases quite unprovided for. It is impossible to meet them otherwise than by a mild and judicious application of instrumental re-ignorant; the lingering abuses must and will be swept straint." And so this sincere superintendent, who believes he is discoursing wisely and humanely, goes on triumphing over the wild theory of "non-restraint." His opinions are, I believe, the opinions of the majority of proprietors of private asylums; his prejudices are theirs. He adds, however, that the foregoing remarks are the result of his experience in a small private establishment; and he admits that he has "no knowledge or experience of the practice followed out in our large public asylums.”

On what practical subject, I would ask, in the whole range of medicine, could medical men be found on the basis of the experience of a village dispensary, utterly to condemn the practice of the whole of our large London and Provincial Hospitals? It is in vain to argue with these gentlemen of non-restraint as of a theory. It is a practice; and they have not been at school late enough, or at all, to learn it. There is scarcely a medical superintendent of a public asylum in the kingdom who does not know that the propensity to`attack and destroy, the desire not to lie down in bed, and all the dreadful possibilities enumerated by Mr. Bodington, are met, daily, and nightly, and hourly,

away. Better arranged houses will be required; more and better attendants insisted upon; and some amount of education in a large asylum demanded as a qualification for taking the charge of lunatics in smaller

ones.

The proprietors of private asylums may be warned that they set their houses in order. At present, these asylums comprehend every degree of conceivable merit and demerit; according to the character of the proprietor. Some are truly admirable, and worthy of the age; others are still but miserable places of incarceration: but the good and the bad may be swept away together. It is much to be wished that in the visits of the Commissioners the attendants should be seen as well as the patients; and their proportion to the patients ascertained, as well as their character. Many of them, at present, belong to the dangerous classes of society; their appearance announces it; their effect on the terrified or disgusted patients, declares it; and their manners, habits, and conduct too surely and too frequently prove it. Nor is there a doubt in my mind that, from causes difficult perhaps to avoid, some private asylums are confided to the care of persons whose character and previous history afford no security for

their patients being well fed, well lodged, and hu- through his fever and restlessness, cannot govern himmanely managed.

self, a most merciful and beneficial means of cure, combined of course with medicines calculated to remove the symptoms; and my impression is, that, owing to the disuse of restraint through the cry raised against it, the opportunity of cure will be lost, the feverish stage pass into the chronic, and there will be more incurables."

Such are the convictions and apprehensions of a

Clever and cunning subordinates, in private asylums, often become inspired by the wish to set up for themselves. Possessing very little education, they consider themselves quite as experienced as the physician, and far more useful than he is; although he may have taught them all they know. They pursue a well-considered course; ingratiate themselves with the friends of the patients, and are profoundly obsequious to the Com-physician who, in the seclusion of a select private missioners, or to the Visiting Magistrates; and, when asylum, in the county of Lincoln, the county in which their plans are quite matured, find some excuse for Charlesworth and Hill have been his neighbours and discontent and quarrel; vilify or even defraud those contemporaries, is content to refer to the success of who have patronised them; and, having got a licence his predecessors. I should be sorry to treat any delifor a house of their own, defy the claims of duty and berate opinion of Dr. Willis with disrespect. But his of honour, and triumph with the power given to them argument might be extended to all the parts of the old to trade in lunatics. They may be avaricious, or even treatment. In the days of Dr. Willis's predecessors, severe and cruel to patients; but they deceive the the merciful effects of mechanical restraint were not Commissioners, who are incapable of conceiving such alone trusted to in the feverish stage of madness; not duplicity; and they are protected and perhaps even even although they included thirst, and dirt, and unpraised. There can be no sincerity for the proper wholesome air. An additional means was resorted to, treatment of patients in private asylums until a cer- which it is scarcely grateful to leave out of the list of tain preliminary education is required both in the soothing measures; the stripes and floggings which proprietors and attendants; and until, in cases in were practised, and which, it cannot be doubted or which the proprietors are not medical men, the houses denied, lessened the number of incurables, by increasare visited by well informed members of the profession. ing the mortality in the early stages of the malady. At present, any man, or any woman, not of notoriously At that time, the stripes and floggings were as much bad character, can obtain a licence, and take a house praised, in feverish and restless madness, as mechain any village where rents are low, and where a poor nical compression of body and limbs is now; and the subservient inexperienced practitioner is to be found, medical officers of the asylums in which non-restraint and thus possess all those chances of obtaining private is now denounced as " psychological quackery," might patients that should only be given to persons known to no less then have thought the abolition of the whip be capable of treating all the varieties of mental dis-"adapted to catch the unreflecting sentimentality of order. The evils of this system fall on the public; and after a time will no longer be endured.

the vulgar."

It is painful to know that such views are still entertained by a few physicians, who are men of education, but apparently proud of adhering to ancient severities; and who have wanted opportunities of visiting, or inclination to visit, the great asylums in which mechanical restraints have now for so many years been unknown; and to study, profoundly and honestly, the system they so condemn.

An examination of the replies from the private asylums shews, that the proprietors of all such of them as have been educated in the public asylums have disused restraints; (Dr. Sutherland, Dr. H. Munro, Dr. Davey, &c.) and that the most repectable of those who continue to advocate restraints, either confine their advocacy to cases of surgical difficulty, where it is not necessary to apologise for its use; or to cases Contrasted with such opinions and such expressions, in which patients injure themselves, undress them- I turn with satisfaction to the testimony of Dr. Sutherselves, &c.; cases in which the supporters of non-land, of whom it is unnecessary to say that he is one restraint believe all the difficulties can be better and more easily met without restraint. The replies are in general, temperately worded. One only, (from Heigham Hall, near Norwich), is characterised by a spirit and language unusual and unnecessary in the discussion of an important point of treatment. It is not my intention to examine these replies in detail, I shall merely refer to two or three of them.

of the highest practical authorities on such a subject. In his reply from Blacklands and Otto House, he says: "Perhaps no example is more striking than the method of treating acute cases of mania in former years, and at the present time. Formerly the patient was strapped down to his bed, and not allowed to move; the consequence of which was, that the horizontal position favoured the congestion of the brain, and added to the development of the already superabundant nerve-force; thus producing greater and greater irritation, followed by collapse, typhoid symptoms, and too often by death: whereas, now, by allowing the patient the free exercise of his limbs, he works off much of the nervous irritation, and by tiring himself out, will sometimes get to sleep even without a sedative."

Dr. Francis Willis, of Shillingthorpe, after candidly stating that he has only a few cases under his care, and those cases of many years' standing; and that he has "no new facts to communicate that can throw any light upon the advantage or disadvantage of restraint in the treatment of mental disorders," goes on to say; "The greater number of patients in the chronic state, require no mechanical restraint; but from my own experience, and that of my predecessors, who were most successful I strongly recommend this well-founded view to the in their treatment, I consider mechanical restraint, in consideration of all young practitioners in cases of the feverish stage of the disorder, when a patient, insanity. This is not a matter of mere ingenious argu

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