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it would have been better had Mr. Snape been present when he ordered the thirty minutes' bath for the first time. I meant to say that when a medical man orders a remedy of this description for the first time, it is better to be present to watch the effects; and althongh I do not stay to observe the effects of a shower bath when I order it, because, according to the manner in which I prescribe it, it is not a new method of treatment, yet when I first introduced the inhalation of chloroform to check the paroxysms of mania, I always stopped to watch the effects upon the patient. As I said before the magistrates, the great problem to be solved is the best mode of treating the paroxysm; and a man is not to be condemned for a failure in one case, if he has conscientiously adopted a plan of treatment which has proved beneficial in fifty others, however much such treatment may differ from that of other medical men."

ANNUAL MEETING OF THE ASSOCIATION OF MEDICAL SUPERINTENDENTS OF AMERICAN INSTITUTIONS FOR THE INSANE.

The Meeting was held at New York, on the 18th of May, and following days. Thirty-three Members of the Association were present.

The

A paper was read by Dr. Tyler, on "The Care of the Violent Insane," which was followed by an interesting discussion in regard to the kind and amount of personal or muscular restraint which is best calculated to promote the comfort and restoration of the insane of all classes. prevailing opinions of the members of the Association were strongly to the effect that no class of patients should be confined in cells, but in chambers as large and as inviting in their construction as those for the convalescent; that the seclusion of the violent insane by day should be infrequent, and generally of the briefest practicable duration; and that neither muscular restraint nor seclusion should ever be subject to the judgment and control of subordinate officers or attendants.

Dr. Gray presented the plans of an institution for insane convicts, and entered into an explanation of the steps taken. in regard to provision for this class of the insane in New York. In 1854, a law was passed directing the removal of convicts from the asylum at Utica, and of those convicts found insane in the prisons, to a separate building in connection with one of the prisons. In 1857, a law was passed authorising the prison inspectors to proceed to the erection of a proper building, and an appropriation of 20,000 dollars was made for that object. The plan presented has been ac

cepted, and the building will be commenced on the 1st of June next.

Dr. Jarvis made some remarks in reference to the importance of sending reports of institutions for the insane to the public libraries of colleges, antiquarian and historical societies, that the history of what has been and is being done for the insane in this country, might be as widely read as practicable, and that by the most intelligent members of society, and offered the following resolution:

Resolved, That this Association recommend to its members to send all their past and future reports to some public institutions and libraries in each State for permanent preservation; the list to be prepared by a committee of this Association, and published in the Journal of Insanity.

The resolution was adopted; and on the motion of Dr. Kirkbride, Dr. Jarvis was named a committee to carry the objects of the resolution into effect.

Fears were expressed by Drs. Kirkbride, Butler, Fouerden, and others, that patients in our institutions subject to homicidal impulses, were too freely allowed axes and other tools, which were liable to be used as weapons of personal violence.

Drs. Butler and Jarvis related the cases of persons subject to insane or homicidal impulses, who had warned their friends against giving them a liberty which they at times considered themselves liable to abuse.

The following is an authentic table of all the insane institutions in North America, their location, proprietors, physicians, and number of patients :

INSTITUTIONS FOR THE INSANE IN

NORTH AMERICA.

No. of Patients

170

1 Maine State Lunatic Hospital, Augusta-J. M. Harlow, M.D., Superintendent

...

...

2 New Hampshire State Lunatic Asylum, ConcordJohn E. Tyler, M.D., Superintendent

...

3 Vermont State Lunatic Asylum, BrattleboroughW. H. Rockwell, M.D., Superintendent

...

4 Massachusetts State Lunatic Hospital, WorcesterMerrick Bemis, M.D., Superintendent

...

5 Mc'Lean Asylum, Somerville, Mass.-Chauncey Booth, M.D., Superintendent

...

6 Massachusetts State Lunatic Hospital, TauntonGeo. G. S. Choate, M.D., Superintendent

170

400

390

200

...

330

it would have been better had Mr. Snape been present when he ordered the thirty minutes' bath for the first time. I meant to say that when a medical man orders a remedy of this description for the first time, it is better to be present to watch the effects; and althongh I do not stay to observe the effects of a shower bath when I order it, because, according to the manner in which I prescribe it, it is not a new method of treatment, yet when I first introduced the inhalation of chloroform to check the paroxysms of mania, I always stopped to watch the effects upon the patient. As I said before the magistrates, the great problem to be solved is the best mode of treating the paroxysm; and a man is not to be condemned for a failure in one case, if he has conscientiously adopted a plan of treatment which has proved beneficial in fifty others, however much such treatment may differ from that of other medical men.'

ANNUAL MEETING OF THE ASSOCIATION OF MEDICAL SUPERINTENDENTS OF AMERICAN INSTITUTIONS FOR THE INSANE.

The Meeting was held at New York, on the 18th of May, and following days. Thirty-three Members of the Association were present.

A paper was read by Dr. Tyler, on "The Care of the Violent Insane," which was followed by an interesting discussion in regard to the kind and amount of personal or muscular restraint which is best calculated to promote the comfort and restoration of the insane of all classes. The prevailing opinions of the members of the Association were strongly to the effect that no class of patients should be confined in cells, but in chambers as large and as inviting in their construction as those for the convalescent; that the seclusion of the violent insane by day should be infrequent, and generally of the briefest practicable duration; and that neither muscular restraint nor seclusion should ever be subject to the judgment and control of subordinate officers or attendants.

Dr. Gray presented the plans of an institution for insane convicts, and entered into an explanation of the steps taken. in regard to provision for this class of the insane in New York. In 1854, a law was passed directing the removal of convicts from the asylum at Utica, and of those convicts found insane in the prisons, to a separate building in connection with one of the prisons. In 1857, a law was passed authorising the prison inspectors to proceed to the erection of a proper building, and an appropriation of 20,000 dollars was made for that object. The plan presented has been ac

cepted, and the building will be commenced on the 1st of June next.

Dr. Jarvis made some remarks in reference to the importance of sending reports of institutions for the insane to the public libraries of colleges, antiquarian and historical societies, that the history of what has been and is being done for the insane in this country, might be as widely read as practicable, and that by the most intelligent members of society, and offered the following resolution:

Resolved, That this Association recommend to its members to send all their past and future reports to some public institutions and libraries in each State for permanent preservation; the list to be prepared by a committee of this Association, and published in the Journal of Insanity.

The resolution was adopted; and on the motion of Dr. Kirkbride, Dr. Jarvis was named a committee to carry the objects of the resolution into effect.

Fears were expressed by Drs. Kirkbride, Butler, Fouerden, and others, that patients in our institutions subject to homicidal impulses, were too freely allowed axes and other tools, which were liable to be used as weapons of personal violence.

Drs. Butler and Jarvis related the cases of persons subject to insane or homicidal impulses, who had warned their friends against giving them a liberty which they at times considered themselves liable to abuse.

The following is an authentic table of all the insane institutions in North America, their location, proprietors, physicians, and number of patients :

INSTITUTIONS FOR THE INSANE IN

NORTH AMERICA.

1 Maine State Lunatic Hospital, Augusta-J. M. Harlow, M.D., Superintendent

...

...

2 New Hampshire State Lunatic Asylum, ConcordJohn E. Tyler, M.D., Superintendent

...

3 Vermont State Lunatic Asylum, BrattleboroughW. H. Rockwell, M.D., Superintendent...

...

No. of Patients

170

...

170

400

...

390

200

330

...

4 Massachusetts State Lunatic Hospital, Worcester-
Merrick Bemis, M.D., Superintendent
5 Mc'Lean Asylum, Somerville, Mass.-Chauncey Booth,
M.D., Superintendent

...

6 Massachusetts State Lunatic Hospital, TauntonGeo. G. S. Choate, M.D., Superintendent

7 Boston Lunatic Hospital, Boston, Mass.-Clement A. Walker, M.D., Superintendent

...

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8 Butler Hospital, Providence, R. I.-Isaac Ray, M. D. Superintendent

...

9 Hartford Retreat for the Insane, Hartford, Conn.John S. Butler, M.D., Superintendent

...

...

...

10 Dorchester Private Asylum, Mass.-Edward Jarvis, M.D., Proprietor

11 Pepperrell Private Nervous Invalid Asylum, Mass. Drs. Cutter and Howe, Proprietors

...

12 Provincial Lunatic Asylum, Toronto, C. W.-J. Workman, M.D., Superintendent

...

...

13 Asylum for Insane Convicts, Kingston, C. W.—J. P. Litchfield, M.D., Superintendent

...

14 Quebec Lunatic Asylum, Quebec-Drs. Douglass, Morrin and Freemont, Proprietors and Managers

15 Provincial Lunatic Asylum, New Brunswick-J. Waddell, M.D., Superintendent

...

16 Nova Scotia Hospital for Insane, Halifax-Jas. R.
De Wolf, M.D., Superintendent. Building.
17 Newfoundland Lunatic Asylum, St. John's-H. B.
Stabb, M.D., Superintendent ...

...

18 New York State Lunatic Asylum, situated at Utica, in Oneida county-Medical Superintendent, Dr. John P. Gray, average

...

170

150

210

460

50

360

150

50

... 455

19 Bloomingdale Asylum for the Insane, situated at Bloomingdale, on New York Island--Physician, Dr. D. Tilden Brown, average...

...

20 New York City Lunatic Asylum, situated on Blackwell's Island-Physician, Dr. M. H. Rawney,

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21 Sanford Hall, Flushing, Long Island-Gen. A. Macdonald and Mrs. Dr. J. Macdonald, Proprietors; B. Ogden, M.D., and J. W. Barstow, M.D., Physicians 22 Brigham Hall, Canandaigua, New York-Geo. Cook, M.D., Proprietor

...

160

600

40

20

23 Pennsylvania Hospital for the Insane, at Philadel-
phia Thomas S. Kirkbride, M.D., Physician
24 Pennsylvania State Lunatic Hospital, at Harrisburg
-John Curwen, M.D., Physician

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25 Friend's Asylum for the Insane, at Frankford,Joshua H. Worthington, M.D., Physician

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26 Insane Department of Philadelphia Almshouse—A. B. Campbell, M.D., Physician ...

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