224

THE LANCET.

LONDON: SATURDAY, MARCH 3, 1860.

THE CASE OF ALFRED L. GODFREY, AN ALLEGED LLTNATIC.

THE best laws constitute but a feeble security for the libertyof the citizen unless the most jealous vigilance be exercisedover their administration. It is hardly, we believe, pretendedby any one that our Lunacy Laws are of the very best. That

the administration of them requires watching, the perusal ofthe case of ALFRED LAzARUS GODFREY will satisfy all persons.Mr. ALFRED GODFREY is a young man of good education; hehas been employed as a solicitor’s clerk, and is the son of aMr. GODFREY LAZARUS who is represented to be a wholesalejeweller in Clerkenwell. The father and brother appear to

have arrived at the conclusion that ALFRED GODFREY was of

unsound mind, and that he ought to be confined. It is not

necessary to examine the grounds upon which this opinion wasformed, because we are willing for the present to suppose thatit was honestly entertained. The immediate object is to tracethe mode in which the machinery of the Lunacy Laws wasworked to effect-what seemed a legitimate object-his in-carceration. We need scarcely say that, presuming the state-ment to be correct that the father was a well-to-do trades-

man, the proper course would be to call in successively twoqualified medical practitioners; that these gentlemen, havingseparately examined the alleged lunatic, should, if satisfied ofthe existence of lunacy, certify their opinion. These medical

certificates, together with the order of the father, would con-stitute the proper legal authority for the reception of the

patient at Bethlehem or St. Luke’s, or in some private asylum.In this manner he was first taken to Bethlehem on the 22nd of

November last. It is stated that admission was refused on the

ground that the lunacy had existed more than twelve months.The method ultimately preferred was to treat ALFRED GODFREYas a pauper lunatic, and to employ the police-court as the mediumfor transferring him to a lunatic asylum. If the father were

himself a pauper, and unable to support his son under his

heavy affliction, this course would be justified; and perhaps onthis plea it may yet be justified. The case, however, pro-ceeds. ALFRED GODFREY applied for a summons against thekeeper who had taken him to Bethlehem on a charge of assault.It was then brought out that the unfortunate man, rejectedfrom Bethlehem, had been equally cast out by his friends, andwas wandering destitute about the streets. The magistrate,Mr. TYRWHITT, kindly advised him to apply to the work-house. He did so, expecting kind treatment, but was imme-diately taken to the lunatic ward-a step eminently calcu-lated to prove injurious to a person of sensitive mind sufferingunder recent excitement. In the course of the investigationbefore the police-court, we get an instructive illustration

of the ideas which persons of the keeper’s calling entertainas to what constitutes restraint. The complainant allegedthat he was grossly ill-used. The defendant (the keeper)replied that "he did not ill-use him; he put the handcuffson him, but did not restrain him." (!) Mr. TYRWHITT, askinghim " Do you not call putting on of handcuffs restraint?"is answered "No." (!) !) It would be really interesting to learnwhere, in this keeper’s judgment, restraint begins. Whether it

was at that stage satisfactorily proved that ALFRED GODFREYhad been properly detained, that his alleged insanity had beenestablished, we do not clearly see. But the Magistrate, in

dismissing the keeper, said " that nothing could be more

’’ proper than the way in which the complainant had conducted

"himself, and he (Mr. TYRWHITT) could only wish that every" one who came to that court would act in the same manner."

It was urged upon the father and brother to take him home;but both are reported to have exclaimed " We will not receivehim." On the 2nd of December, we find him again before the

magistrate, in the charge of the relieving officer. Mr. TYR.

WHITT then, acting in strict conformity with evidence, and

having before him the certificate of a surgeon, authorizes thecommittal of ALFRED GODFREY as a pauper patient to ColneyHatch. We think it right to lay the certificate before our

readers. We firmly believe it was drawn up in goodfaith :-

The undersigned H. J. B., &c., having examined AlfredLazarus at the Clerkenwell Police Court, certifies that he is alunatic, and a proper person to be taken charge of, on thefollowing grounds-viz. :

" 1st. Facts indicating insanity observed by myself.-Inca-"1st. Facts indicating kind of business; always craving forpable of attending to any kind of business; always craving forfood; eating largely, and immediately declaring he has nothad any; restless and sleepless at night; and great excita-

bility."2nd. Other facts indicating insanity communicated to me

by others.-His father, brother, and aunt......state that he hasbeen ill and incapable of following his usual employment fortwo years; that he is always demanding food, eating enor-mously, and then declaring he is starving; gets up in themiddle of the night and wanders about the streets; that hehas a delusion of his name being altered by the Queen."

We remember that when Lord ST. LEONARD’S Bills were

before Parliament, we strongly enforced the necessity of dis-

tinguishing in lunacy-certificates the facts observed by thecertifier and those communicated to him by others. This oughtto furnish a great security for precision of observation andvigilance in drawing up a certificate. This example will showhow widely different may be the spirit and the execution of a

law. A gentleman after an interview of a few minutes withan alleged lunatic in a police-court is enabled to testify, asfacts observed by himself, that the person " was always crav-" ing for food, eating largely, and immediately declaring he"has not had any;" and we find the same facts reproducedamongst those related by others. This certificate, however,satisfied the magistrate, and ALFRED GODFREY was taken toColney Hatch. He was admitted on the 2nd December, and

discharged on the 13th January. He is now at large. Whywas he discharged, first from Bethlehem after being detaineda few minutes, next from Colney Hatch after being detained sixweeks; and why is he now suffered to be at large ? Not, wepresume, because his insanity is clear. The history of the caserenders this essential point extremely doubtful. The only spe-cific delusion alleged is, that he believes the QUEEN has alteredhis name from LAZARUS to GODFREY. The fact appears to be,that he and other members of his family have actually used thename of GODFREY for years past. And we suspect the Jewish

community will not be ready to admit that changing one’sname is evidence of insanity.But whether we conclude or not that ALFRED GODFREY was

actually insane on the 22nd of November, and on the 2nd of

December last, when he was taken to Bethlehem and Colney

225

THE EFFICACY OF QUARANTINE.

Hatch, we see in his case abundant cause for the vigilant careof the public and the press, lest the Lunacy Laws be wrestedfrom their true purpose. It was not satisfactorily establishedin this case that ALFRED GODFREY was, in the legal sense ofthe term, a pauper: it is denied that he belongs to the parishof Clerkenwell. The parish has a right to be protected againsta charge which, by the law of nature and of the land, shouldfall upon private individuals. The alleged lunatic has a rightto demand that all those precautions which the law providesfor his welfare shall be observed.

Apart from its general and public bearings, we feel boundto say that the case of ALFRED GODFREY is one deserving ofspecial commiseration. We see a young man of nervous tem-

perament, of good education, of very sensitive mind, labouringunder illness and excitement,-so marked as to be taken for

insanity,-first handcuffed, and taken forcibly to Bethlehem;next thrust amongst idiots and epileptics in the insane wardof a workhouse; we see him taken before a police-court, andcommitted to Colney Hatch; we see him dismissed,-cast adriftupon the world without a home, without resources, his mindtortured by the apprehension that the wrongs he has endured-the greatest of which is the tenacious imputation of insanity-will ruin his future prospects. We cannot help thinkingthat the course pursued towards him was not that best calcu-lated to subdue the morbid cerebral excitement under which

he was said to be labouring. If he be not now insane, thiscircumstance must be accepted as presumptive evidence thathe never has been insane; for surely what he has undergone isenough to test a strong brain. Has he been dealt with accord-

ing to the strict letter of the law? Whatever be the reply tcthis question, it cannot be doubted that he has been subjectedto much cruel and unnecessary suffering. We trust that the casewill yet receive some further sifting.

As it is with the things of matter so it is with the things ofmind. The laws of the progress and changes of the moral andsocial world are very similar to those which preside over themutations of the material and physical world. There is at

least a singular analogy between them. In both, extremes arefollowed by their opposites, the one condition leading on, moreor less quickly it may be, but still with unvarying certainty,to the other. When the night is darkest the dawn is nearest.The torpor of winter is succeeded by the active movements of

spring, and the very energy and exuberance of these move-ments are proportionate to the completeness and duration ofthe torpor which existed before. Storms clear a stagnantatmosphere, and calms follow in the wake of violent hurricanes.How often, too, have wide-spread fatal epidemics preceded amore than ordinarily healthy year, or even a series of years !And so it has been with the movements and revolutions of

social life. Good comes out of evil. Things when worstbegin to mend. The " dark ages" ushered in an epoch of un.usual mental activity and enlightenment. It was when super-stition reached its acme, and clerical usurpation over all

thought and will was supreme, that the Reformation brokeforth. Tyranny brings discontent and rebellion in its train,and when the strain and pressure go beyond a certain force,the confining restraint is snapped asunder. There is a point inthe course of error and injustice that almost inevitably bringsabout a reaction, if not a total revolution.

Now something of this sort has occurred in reference to a

subject of no small social interest, which is beginning to attractmuch more notice, not only in the medical profession, butamongst the public generally, than it has hitherto done, andseems now likely to be investigated with that attention whichits importance deserves: we mean, the value of Quarantineas a prophylactic against the introduction of foreign diseases,and as a protection to the public health. It is certainly not alittle curious that a question based upon, and springing directlyout of, medical doctrine, on one, too, of the most interestingand important branches of professional research-the develop-ment and spread of epidemic disease-should have been so gene-rally ignored. How is this ? It is not so much as even named

in more than one of the comprehensive dictionaries, or sys-tematic treatises on Medicine, published of late years; and,with the exception of the Reports of the first General Board ofHealth in this country, our medical literature is all but barrenof information on the subject. But what mere scientific curiosityor interest for professional truth has failed to excite, has been

brought about by the force of absurdity and the recoil of out-

raged common sense. The very extravagance of the follies

committed by the different Mediterranean States during theautumn of 1858,-when it was first rumoured that the plaguehad broken out on the Barbary coast,-in their alleged appre-hension that the dreaded disease might possibly (however re-mote or visionary the possibility seemed) be carried to theirown shores by ships, or goods, or persons, whether the ships,and goods, and persons, were quite healthy or not, and whetherthere could be even the ghost of a suspicion that any chance of

þ mischief or danger could be fancied to exist on board—fortu-l nately brought things to a crisis in public opinion as to the im-

mediate and urgent necessity that the entire subject of Quaran.tine, in all its varied relations, should be fully and systematicallyinquired into: to ascertain, in the first place, the actual state of

existing regulations and practice in different countries; to dis-cover, as far as possible, the results of the system hithertopursued; and then to consider, fairly and temperately, whatreforms the welfare of the general health, as well as the inte-rests of commerce and public convenience, justly called for.On no one could the task be more fitly devolved, and by

none, probably, could it be undertaken with greater prospectof successful issue, than by the National Association for thePromotion of Social Science, ranking as it does amongst itsmembers men of all grades in society, as well as of all shades of

opinion, political and scientific, and which has succeeded incommanding the active sympathy and support of some of themost influential statesmen of the day. The profession is awarewhat steps have been taken to carry into effect the resolutionof the Association, adopted at their meeting in Liverpool, inthe autumn of 1858, and what a large amount of informationhas already been obtained, chiefly through British consuls re-siding in foreign ports, and the governors of our scattered cole-nies, as well as from the Medical Departments of the Armyand Navy. We await the results of the analysis of this evidencewith no small degree of interest, as it cannot fail to be highlyinstructive in the detail of facts, and the record of wide-spreadexperience, derived from authentic sources, whatever may bethe eventual conclusions of the Committee on the difficult ques-tion of Quarantine legislation and practice.

Meanwhile, the extravagant proceedings in some of the con-tinental ports, more particularly in Lisbon, to which we drew

226

attention in a recent number of THE LANCET,-when the Boardof Health there, by a stroke of the pen, declared the entirecoast of Brazil, between 2000 and 3000 miles in extent, to beinfected with yellow fever, merely because the disease wasknown, or believed, to exist in one or two ports of that king-dom,-serve to keep the subject prominently before the public;and all the more as no city in Europe has of late years so

severely and fatally suffered from the very epidemics againstwhich Quarantine is peculiarly and specially directed as Lisbon-from cholera in 1855 and 1856, and from yellow fever in 1856and 1857,-notwithstanding the extraordinary vigilance and

stringent rigour of their precautionary regulations upon allarrivals from foreign places.But it is not in this country alone that the subject is exciting

unusual interest amongst the medical profession and others atthe present time. Our brethren across the Atlantic have had

the start of us; for it is now more than three years ago that a

Convention of Medical Delegates from the different States ofthe Union was held in Philadelphia, to consider the workingand results of Quarantine in their country, in the hope of rec-tifying its many acknowledged abuses and irregularities, andof establishing, if possible, a uniform and rational system in alltheir great commercial ports. Two annual meetings have beenheld since, at Charleston in 1858, and last year at New York.The proceedings in the latter city created a lively sympathy,not only amongst medical men, but amongst many of the lead-ing merchants, shipowners, and others interested in the pros-perity of commerce and international communication, and whoare, therefore, desirous of removing all unnecessary or extrava-

gant burdens and restrictions upon freedom of transit betweendifferent countries. Might not the Committee of the House ofCommons, which has just been appointed on the motion of Mr.W. S. LINDSAY, on the subject of our mercantile marine, havetheir attention directed, with advantage, to the considerationof a question which involves on many occasions, not merelymuch inconvenience and vexatious delay, but, also, heavy ex-penses and serious loss on the shipping interest ?

IT is a favourite employment of moralists to demonstrate theconnexion between sin and suffering, and to convince us thatour physical misfortunes are due to our moral shortcomings.The ethical teacher may find an advantage in pointing out that

" Of our pleasant vicesThe gods make whips to scourge us."

But surely it is hardly permitted to the surgeon to rejoice overthose sufferings, and to feel or to express the hope that theday might never come when science should have the power ofanticipating or of completely relieving them. The sternest

homilists have found reason to admire the disposition of eventswhich grants to human skill the power to assuage the pangs ofhuman infirmity and disease, appointed or preordained thoughthey be. But the doctrine which was enunciated on the sub-

ject of syphilis in the rooms of the Medico-Chirurgical Societyat their last meeting is sterner and more pitiless. Mr. SOLLY

expressed his conviction that syphilis is a disease destined to

punish fornication. He looked forward with pain to the possi-bility of extinguishing syphilitic disease, since fornication wouldthen, in his opinion, become general. It is evident that moral

and mental ameliorations go for nothing in this argument, inwhich theology is strangely mixed with therapeutics. It is

not probable that any surgeon will be seriously daunted in his

researches on the cure of syphilis by the fear of deluging theworld with sin. Something more than a mere expression ofindividual conviction is necessary, in any case, to assure us

that a particular disease is designed in the Providential schemeto hold in check a particular moral offence; and no one needfear to destroy the soul by healing the body.

So far as concerns the influence on the future of syphiliticpractice and study,-to which, if we are not mistaken, Mr.SOLLY has contributed his quota,-there is little fear that this

dogma will have great vogue or power. But we wish to pro.test against the confusion of therapeutic with theological con.siderations. Let the man who is by profession a healer do hisduty honourably and fully. Let him heal to the utmost, andin all cases. He need not fear to be in antagonism with theDivine Law; still less need he fear to upset the universalscheme.

It is only necessary to consider the difficulties in which asurgeon would involve himself who should for a moment assent

to propositions such as that’of Mr. SOLLY. If syphilis be, in.deed, the Divine scourge which we should hope never to seeremoved, then it must be, in degree, wrong to interfere withits action. We cannot see how a man holding these views can,with a clear conscience, prescribe blue pill for a chancre, oriodide of potassium for nocturnal pains. By what right doeshe stop the process of the chancre which has its appointedbitterness, and the nightly agony which brings repentance’tAt any rate, it is evident that even if Mr. SOLLY resigns himselfto the immorality of frustrating providential decrees by thetreatment of venereal cases on the principles which have beenlaid down by others, we must never expect any such boon athis hands as an advance in the therapeutics of syphilis. Never.

theless, we shall be content to receive a veritable prophylacticfor syphilis, such as is vaccination against small-pox, as a boonto humanity little less important than that which has conferredimmortality on JENNER.

Medical Annotations."i’e auid nimi8."

THE CAMBRIDGE MEDICAL DEGREES STATUTE.

1 a congregation held on the 24th ultimo the statute on thesubject of medical examinations and degrees, in which certainalterations had been made by the Council, was promulgatedafresh. Dr. Child, of Exeter College, proposed as an amendment,that the degrees of B. M. and D. M. should be conferred together,but that the University privileges attaching to the latter shouldnot be enjoyed until the expiration of ten years from matricu-lation. Mr. Shirlgy, of Wadham, objected to the clause bywhich candidates who had taken first- or second-class honoursin the Natural Science School are excused from a portion ofthe medical examination. The Dean of Christchurch (Dr.Liddell) replied to these objections. The Master of Baliol

proposed amendments.The chief requirements of the Medical Degrees Statute (the

amendments to which, or a portion of them, were accepted bythe Hebdomadal Council, and which will cause the repromulga-tion of the statute before it can be submitted to congregation)are as follows:-That all candidates for medical degrees musthave passed all the examinations for the degree of B.A., andmust produce proof of having studied medicine for four years:that all who have passed these examinations may be admittedto the status of student in medicine similar to that of S.C.L :