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usually admitted into asylums in a recent, and therefore the most curable stage of the disease. "Of the patients about whom" says Gooch, "I have been consulted, I know only two who are now, after many years, disordered in mind, and of them, one had already been so before her marriage.'

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[In concluding these Lectures, it is proper to state that the treatment of mental diseases, and their relation to forensic medicine, (here omitted,) form a part of the course as delivered in the York school of medicine.]

Annual Reports of County Lunatic Asylums and Hospitals of the Insane in England and Wales. Published during the year 1856.

Although these annual pamphlets necessarily go over much the same ground time after time, they contain a variety of matter instructive to the alienist and to the statist, and interesting not merely to the professional philanthropist, but to all who feel an earnest interest in public measures taken to meet the ever-increasing demands of public suffering on the efforts of an advancing civilisation, to remedy the evils which attend its progress, follow in its train, and perhaps are caused, in no slight degree, by the pressure of its wheels. Yet civilization rides in triumph on no Juggernaut car, ruthlessly destroying, and guided by priests, reckless of the suffering humanity which welters crushed beneath. It recognises ever-increasing duties and cares; and as the poet had a tear of pity, even for the poor field mouse rendered houseless by the coulter of his plough, so true civilization sympathises with the pain, and binds the wounds of those who suffer in mind or body in the inevitable press of its onward progress.

This is eminently proved by the large and generous public expenditure incurred in the treatment of the insane poor, and by the general interest taken in the measures adopted for the alleviation of their miseries. But a few years ago insanity was swept into obscure holes and corners, to be out of sight, and, if possible, out of mind. To-day it has become a great interest. Hundreds of thousands are annually expended in the maintenance of public institutions for its treatment. Its interests are presided over by a Government * Cited approvingly by Pritchard, in his Treatise, p. 309.

Commission, whose noble Chairman has acquired a reputation
not less unique than distinguished, as the recognised protector
of feeble and suffering humanity, whether in mills and
ragged schools at home, or in benighted heathendom abroad.
In every county it commands the disinterested attention of
numerous country gentlemen, visiting and controlling the
institutions appropriated to its use. Of these institutions, it
may be truly said that, taken as a whole, they are a magnificent
expression of the benevolence and public spirit of the age.
In appearance many of them are truly palatial, and would
seem to justify the lines of M. Scribe upon Bethlem :
"A vos Fous il ne manque rien,

Ils sont le plus heureux du monde ;
En France ou les traite moins bien;
Chez nous portant l'espèce abonde ;
Que j'aime ces ombrages frais!
Si chez vous (cela m'intéresse,)
La Folie habite un palais,

Commont loge-t-on la Sagesse ?"

The first report, in alphabetical order, is that of the Bedford Asylum, which, perhaps, comes as little near the idea of a lunatic palace as any institution of the kind within the limits of the four seas; but the spirit of improvement is awake and stirring in the county. In our last notice we had the pleasure of recording the commencement of a new régime in this asylum, which had thrown over the old fears, and prejudices, and economies, which rendered the Bedford one of the small number of county asylums still adhering in practice and theory to the old system, which substituted force for treatment. The present report records a still further advance, in the resolution of the county magistrates to abandon the old and imperfect asylum, and to erect a new and commodious one on a new site.

The report of the visitors is occupied by the record of the formal proceedings needful to the dissolution of partnership between the counties of Bedford, Hertford, and Huntingdon, and the borough of Bedford, in the property and maintenance of the existing institution; and in setting forth the terms of the agreement between the three counties for the joint erection of the new asylum.

The medical superintendent, Mr. Denne, refers with satisfaction to the results of increased occupation of the patients in agriculture, building, and trades; to the "removal of the prison-like division walls of the airing courts;" to "a nightwatch organised on both sides of the house, and the numerous

advantages derived from that source." He refers in the following judicious terms to one of the most onerous and important of a superintendent's duties:

"The choice of attendants being one of the most important duties in the management of an asylum, our best attentions have been directed to that point; always looking to high moral standing, a certain amount of education, added to firmness of purpose, combined with benevolence; so as to enable them to lead with calmness, control by kindness, and amuse with cheerfulness. And it affords me pleasure to state that their duties in general, have been diligently and efficiently performed."

He says that "every available opportunity for recreation beyond the bounds of the asylum has been taken advantage of, such as the regatta, races," &c.; and that unbounded expressions of gratitude from the patients have been elicited by the privilege of taking country walks, a privilege which in not a single instance has been abused by the slightest indecorum. Another indication of the enterprise and intelligence which distinguish the new management of this asylum, is afforded in the formation of a brass band among the attendants, which is likely to be attended with much good as a diversion to the patients, and a break in the monotony of asylum life."

The report of the chaplain has puzzled us a little, as the medical opinions of clerical gentlemen are rather apt to do. He remarks "that the number of burials in the cemetery of the asylum has been unusually large, which I conceive is attributable to the fatality of the season, because the number of sickly patients has appeared to me to be fewer than usual." It certainly is very kind of the Rev. Mr. Swan to give the medical superintendent the benefit of the fatality of the season, in explanation of the increased number of burials taking place from a smaller proportion of sickly patients; but would it not have been in better taste if the clerical gentleman had confined his observations to matters more immediately connected with his own duties? We feel ourselves the more compelled to throw out this suggestion because Mr. Swan expresses his opinion, "that when a new asylum shall be built, and new arrangements made, a resident chaplain would be a great advantage to the institution, especially if one could be found uniting to other qualifications a competent knowledge of Church music." Mr. Swan had in the previous paragraphs pretty clearly announced his own proficiency in this qualification which he considers so essential for an asylum chaplain; and he had stated that the chanting and singing were greatly improved, the Church tunes well selected, and the

apparent excitement of the patients thereby prevented. We cannot concur, however, in the pre-eminent importance which he attaches to this pleasing part of the Church of England ceremonial. And as Mr. Swan designates clergymen as "ministers," it is scarcely probable that he is an upholder of the "Gregorian Chants," and the "Hymnal Noted." We trust that if the visiting justices adopt his suggestion, and, in opposition to the opinion and practice of the visitors in every other county in the kingdom except one, should appoint a resident chaplain to their new asylum, that that officer will have far higher clerical qualifications than "a competent knowledge of Church music," qualifications which Mr. Swan himself doubtless possesses.

Bethlem Hospital.-The report of this royal, ancient, and wealthy institution, is, as usual, both interesting and suggestive. Dr. Hood states, that of the patients admitted "the education was superior in 28, good in 45, and moderate in 122; in other words, we find that 195 persons were admitted who could appreciate being spared the additional pain of being associated with those who had never enjoyed the refining influence of education, and for whom such ample accommodation is provided, free of cost, by every county." Dr. Hood has urged upon the governors of Bethlem the desirability of reserving the benefits of that institution for the insane poor of the educated classes. We have recently been informed that he has at length succeeded in his laudable efforts, and that the wards of Bethlem are no longer to be made use of by the parsimonious authorities of metropolitan parishes as a sort of gratuitous appendage to the county asylums. An asylum for the poor, but not pauper insane of the edu cated classes, is urgently needed; and we are truly happy to find that the resources of Bethlem are at length to be applied to the supply of this great social want. We trust that the. benefit thus conferred upon the middle classes will be made cosmopolitan, and not metropolitan. At present Dr. Hood says, that of 215 admissions 195 were from London and its immediate neighbourhood. It is to be regretted that the benefits of this wealthy institution-wealthy from public grants-have not been made more available to the use of the general population of the country. Bethlem Hospital belongs little less to the country at large, than Greenwich or Chelsea Hospital; and it is earnestly to be hoped that in their new regulations the governors will bear in mind the wants and the interests of the middle class insane residing beyond the bills of mortality. If, as Dr. Hood seems to think, the re

sources of the friends of patients sent to Bethlem are commonly so small that the expenses of a short railway journey cannot be met by them, surely, out of the magnificent income of the hospital, some moderate sum might be set apart to assist in defraying such expenses. But whether this is done or not, there can be no doubt that facilities should be offered for the admission of patients coming from distant parts of the country, without the intervention of local influence.

Dr. Hood is a warm advocate of the convenient situation of the hospital, and shews a strong disposition to break a lance with those who differ from him in this opinion. "Much has been said by those who consider that every lunatic asylum ought to be surrounded by ploughed fields and green lanes, and much that has been said might very well have been spared." We believe that the Commissioners in Lunacy have expressed this opinion more earnestly and pertinaciously than any one else has done. They have dwelt upon it year after year to the governors of the sister hospital of St. Luke's. The answer of the St. Luke's governors is, that their hospital is held upon terins by which the property is forfeited when its use as an asylum is discontinued, and that their funds are insufficient to bear this loss, and the expenses of establishing a new asylum in a more suitable situation. Neither

of these objections can be urged by the governors of Bethlem, who may, if they think fit, sell their present building for any suitable purpose, and whose income last year amounted to the gross sum of £32,366 9s. 2d. Dr. Hood's arguments against a country site for the hospital are open to dispute. 1. He thinks that patients would be quite unable to bear the expense of a journey to a distant asylum." But a distant asylum has never been recommended, and a railway fare of a few miles into the country costs less than a cab fare from Islington or Brompton to Bethlem. 2. "The institution is to be regarded in the light of a hospital rather than as an asylum; nor must we exaggerate the beneficial influence of country air and scenery in restoring a disordered reason, and forget how very much successful treatment depends upon resources, especially of a moral nature, which may be carried out as effectually in London as in any other place." There is, however, this difference between this hospital and a general hospital, that the patients belonging to the former can be taken half a dozen miles by railway without detriment to themselves or others; whereas, to a patient being carried to a general hospital with crushed limbs or

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