470

THE LANCET.

LONDON: SATURDAY, MAY 15, 1852.

ABUSES OF LEGISLATION RELATING TO LUNACY.

ON former occasions we pointed out the anomalous and un-constitutional discord which is permitted to exist between the

criminal and the lnnacy laws. We have shown that when

personal liberty is forfeited through crime, the offender is com-mitted, after ample preliminary inquiry, to the custody of thepublic magistrate. On the other hand, we have seen that whenmental incapacity is imputed, the individual affected is liable tobe mysteriously removed from society by the private agents of theproprietor of a private establishment, at the instigation of almostany person who may be presumed to have some family or otherrelationship. We shall on another occasion trace into its details

this dangerous power, which an ill-considered law has given,almost uncontrolled, to one fellow-citizen over another.The private power which in the first instance is allowed to

sign the committal of an alleged lunatic to an asylum, is continuedover him throughout the whole period of his incarceration. It

dictates the place of his confinement, is at liberty to transfer himfrom one place of confinement to another, and is virtually thesole authority by which he can hope to be restored to liberty.And yet when a man’s right to personal liberty is lost from

mental incapacity, to whom is it lost ? Is it surrendered to

society, or does it become the property of those by whom he ismore immediately surrounded ?

In the gloomy period of feudal tyranny, crime was not held tobe a public wrong, but a private grievance, to be atoned forby pecuniary compensation. Despite the advance of learning,in defiance of the progress of political science, and the jealousprovisions for the security of personal liberty, the barbarousprinciple still survives; it has been recently affirmed in the

legislative acts which govern the care and treatment of lunatics.When mental infirmity renders an individual dangerous or

troublesome to his relatives or surrounding circle, by expressenactments, and still more by administrative interpretations, thatis held to be an affair simply between the parties immediatelyconcerned. The superior interests of society are altogetherpostponed. A studious secrecy interposes between the familydispute, the private arrangement by which one member is de-prived of personal liberty and civil rights, by which he is,perhaps, offered up as a sacrifice to the selfish interests of the

rest, and the judgment cf public opinion, which is, after all, themost effectual security against injustice. Public opinion, thebeneficial operation of which is so sensibly felt in preserving theintegrity and just administration of the law in all its ordinaryrelations to persons and property, is here jealously excluded. Athick, impenetrable veil shuts out all observation, and defies

inquiry. All is transacted under the shroud of darkness. The

noxious weeds that spring up in the noisome atmosphere whichknows no light, luxuriate in undisturbed security, protected, not

epressed, by the unreal semblance of official control.We shall resume this subject at some length in the ensuing

number of our journal.

IT was a thing to be expected that tke organs of those LifeAssurance Offices which have for years vilified the medical

profession, and refused all payments to medical men for the

reports upon which life assurance is necessarily -based, shouldrail loudly at the triumphant success which has attended thefoundation of the NEw EQUITABLE. But we were hardly pre.pared for the false and malignant abuse to which these organshave stooped in defending a rotten and indefensible cause.They might, however, have passed unnoticed; but we havebefore us one of these insurance papers, in which, after ex-hausting himself in misrepresentation of the NEw EQUITABLE,the writer makes the grossest attacks upon the medical prOMfession at large.We are told that °‘ the medical profession are seeking to

intimidate assurance offices, because they will not pay fees,"which they have not, either by promise, implication, or cus-tom, bound themselves to pay." We put it to our readers,whether the direct contrary be not the fact! - whether

assurance companies are not, by private slander, and by thevirulent efforts of pamphleteers and the life assurance press,aided by quacks of every kind and degree, endeavouring to" intimidate" the profession into giving medical reports to lifeoffices free gratis ? Have we not been threatened with loss of

patients, loss of character, and loss of all chance of ever be.coming medical referees of the non-paying office, if we dare torefuse gratis reports? Has it not been printed and circulatedthat lists are kept by the fraudulent offices of all those whoresist this intimidation, so that they may become markedmen ?

The scribe whom we quote goes on with advice to hismasters to continue their intimidation, and to resist such" unreasonable, such improper, and such indecent demands"as those made by medical men for payment for services ren.dered, and the value of which is not disputed.But these knavish advocates, fortunately, every time they

assault the medical profession, unwittingly furnish it with

good reasons for resisting the insults offered by the non-payingoffices. The writer in question is simple enough to tell us

that, Perhaps one-sixth of the entire number of lives pro-"posed for assurance are rejected on account of the pregnant" danger of the risk. Thus, if the demands of the medical"faculty were acceded to, a great portion of the funds of" assurance offices would be abstracted from their proper pur-

"pose-expended in paying for making inquiries into the" condition of some 4000 persons every year, who proved, oninvestigation ... to be ineligible assurers"’ rWe are glad to have these facts and figures before us.

Every medical man knows, as matter of experience, that whenhe gives a faithful report, and is the cause of the life of a

patient being declined, he runs an imminent risk of offendinghis patient. It is always a sore point, and frequently leads toloss of patients and valuable connexion. Yet this is the pointchosen by a sapient assurance scribe to illustrate the proprietyof not paying medical fees. The medical profession is calledupon to offend 4000 patients a year gratuitously, in order thatlife assurance companies may escape increased risks, and makea great show of bonuses, exorbitant divisions among share-holders, and have immense sums at their command to squanderin advertising, and vilifying the medical profession.But the best is yet to come. It is not merely the "itching

palms" of medical men which require exposure. We aretold inferentially of medical men,-

"That, like Jesuits, they not only set themselves up ashealers of the human body, but as poisoners of the human

471

mind. That arch-Jesuit, Loyola, laid it down as an instruc- means of testing the truth of this, they appeal with perfecttion to the members of the so-called Sacred College of confidenceJesus,’ that it should be one of the leading and charitable offices of the pastors of that vile body, who stalk among us in After doubting the past success of the NEW EQUITABLE, thehidden guise, but who make themselves felt wherever they present and future is of course painted in horrible colours byget an entrance or a meal, to render the members of the ,, Some of these gobe-mouches almostconnexion like inanimate to render the members of the the assurance scribes. Some of these almostconnaxion lilce inanimate bodies, without a mind or a soul.Have the members of the profession, let us ask, which should expect the office to be swallowed up by an earthquake. Itsbe the most liberal and at the same time the most un- ruin from day to day is predicted. Still it goes on, increasingprejudiced of all professions, determined to take a leaf from

./ day is predicted. Still it goes on, ? increasing

the great Jesuit’s text-book, and have resolved to deal with in business and professional and public confidence. We reallymen and women as inanimate bodies without a mind or a can assure the enemies of the office, though it will not be verysoul’"

satisfactory, that in the March last past, the first month ofThis is the slanderous trash which the non-paying offices

the second year of the NEW EQUITABLE, the amount received

delight to honour and reward. The advertising columns of the from premiums upon new policies issued during the month

paper which stoops to the infamy we have just quoted is was nearly double the monthly average of the preceding

week after week crowded with expensive advertisements from twelve months. We pledge ourselves for the truth of this

the non-paying offices. The money of shareholders and statement, in itself a sufficient reply to the falsehoods which

policy-holders can be squandered lavishly in a bad cause, but have been uttered, sometimes from wickedness, and sometimes

cannot be devoted to the fulfilment of the apophthegm that from ignorance.

"the labourer is worthy of his hire:’ In a pecuniary point of view, under the special circum-

The NEW EQUITABLE was during the first year of its stances of the medical profession, the two-guinea fee, instead

existence so successful,-beyond that of any office, ancient or of being an extravagance, is a most economical procedure. The

modern,-that the old assurance hacks cannot believe the support of the NEW EQUITABLE by the profession has stood in

annual report of the directors. What they cannot explain the stead of the immense expenses usually attendant upon the

they stoutly deny, and they declare that the auditors, establishment of large life offices. There are plenty of non-

directors, policy, and shareholders, have all lent themselves to paying offices who have, and who would again, spend, in

an enormous delusion. All are accused of a species of Hud- advertisements, agencies, and publications, twenty times the

sonian "cooking;" whereas the simple truth was only so amount paid by the NEW EQUITABLE to the medical profession,

astonishing as to look stranger than fiction before the eyes of to gain an equal amount of business. The non-paying offices

routine and prejudice. squander in the most reckless manner, in their race after

It is amusing to notice the contradictions into which the policies; but as they have set their faces against medical fees,

scribes of repudiation fall, in their agonized efforts to injure they will not do a simple act of justice, which they would find

the NEW EQUITABLE. At one time the average amount of the a most economical procedure.

policies of the NEW EQUITABLE, during the first year, which The most extravagant falsehoods have been propagated

stood between X500 and .E600, is declared to be impossible, respecting the Deed of Settlement. This document is said to

No office, it is said, could possibly obtain, in one year, policies be a parchment El Dorado, in which some of the ’Directors

of such a high average. Then the tack is changed, and it is are most liberally provided for. None know better than the

declared that the NEW EQUITABLE has taken enormous risks; , assailers of the NEW EQUITABLE, that the Deed of the Com-the truth being that it was only at the beginning of the present pany is public property, and may be seen at the Registrationyear that any single risk was retained by the NEW EQUITABLE office by the whole world. Let them refer to it, and they will

CorzraNy above .E1000. At another time it is pointed out- find that the sole remuneration of the Directors is the verytheoretically, of course-that the NEW EQUITABLE must neces-

lowest ever taken by the Directors of Life Offices. But it

sarily have a great number of nothing but .E100 policies, on better suited these railing gentry to impute dishonesty and

which the medical fee must prove ruinous. Anything but the extravagance than to ascertain the fact. It was easier to

truth is calculated, to show the ruin of the NEW EQUITABLE ; scribble falsehood than to learn the truth.

but that the truth is triumphantly in favour of that office, is Again, the Directors of the NEW EQUITABLE, as by law

denied altogether by the life assurance moralists. obliged, published a financial balance-sheet, up to the 31st of

At one time it is industriously and malevolently asserted December last. As the Company commenced operations at

that the NEW EQUITABLE is a delusion-that its directors lose the end of February, 1851, the first annual meeting could not,no opportunity of " bilking" medical men of their fees. This is of course, take place until the end of January, 1852. At this

to ruin the office, of course. In another breath, or another date the Directors submitted a report of the first year’s ope-sentence, it is declared that the two guineas are paid in every rations, including the business transacted in January and

case, and grave calculations are made of the vast sums thus February, 1852. Will it be believed that the dronish enemies

placed in the professional pocket. Of course this is an equally of the NEW EQUITABLE profess to have detected an immensecertain ruin, so that between Scylla and Charybdis the poor error

in the circumstance that more insurances had been

NEW EQUITABLE scarcely has a chance, according to these effected when the Directors issued their report to the share-

venerable croakers. The simple truth is, that in all cases in holders at the end of February, 1852, than when they sent inwhich proposers have been attended within a period of some their balance-sheet and transactions at the end of December,years by a medical man, the two-guinea fee has been invariably 1851, to the Government. The greater the business done in

forwarded with the list of queries. The directors of the NEW ’, January and March, the greater the mistake discovered by theEQUITABLE are foolish enough to believe that they have, by plotters against the NEW EQUITABLE ! Can any libel be more

these precautions, obtained a more select body of lives than transparent than the one we have here exposed ?

any other office in the kingdom. To the future, as the great -----------

472

THE Governors of the Bethlem Hospital have just issued aseries of regulations respecting the election and duties of a

Resident Physician in that establishment. The salary of thenew officer is to be £700 a-year, with pupils, fees, and otheradvantages, making the appointment worth at least £1000 petannum. This is well. Every encouragement is to be given tc

the study of insanity, and the desire expressed is, to render thisnoble hospital a school of mental pathology. We trust the

scheme will not be marred by anything savouring of nepotism 01unfair selection in filling up the appointment.We have but one criticism to offer. The qualificatior

demanded of candidates is, that they shall belong to one of thEnational Colleges of Physicians, or that they shall be M.D.’s oOxford, Cambridge, or Edinburgh. The University of London,the only University in which an examination in mental philo-sophy is imperative before taking the degree of Doctor oi

Medicine, is omitted! Why are graduates of the University o;

London, and fellows and members of the Colleges of Surgeonsexcluded by these regulations?

Sir ALEXANDER MORISON has carried his appeal from tht

supposed imputations upon his professional character as physi.cian to Bethlem, contained in a "confidential" report by thtCommissioners in Lunacy, before the public in the shape of aradvertisement. Dr. MONRO, the other physician, has conjointl3with his colleague made a formal remonstrance to the -Committetof Bethlem. They have received a reply to the effect that th(changes contemplated in the medical staff do not originate ir

the report of the Commissioners, but in a long-felt necessit)which has existed in the minds of the Governors.

In the mean time, both physicians are aggrieved, and fee:themselves condemned by a secret document based upon evi.dence of which they are studiously kept in ignorance. Car

there be a doubt as to the course that ought to be pursued? Le1

them challenge an open inquiry-a course of proceeding tha)alone can satisfy the public.

Reviews and Notices of Books.

A Pi-actictil Treatise on Clzerrtical Analysis, including Tables forCalculation. By H. ROSE. Translated from the FourthGerman Edition, by A. NORMANDY. 2 vols. 8vo. W. Teggand Co., London.

IT would be a work of supererogation to enlarge on the meritsof Rose’s celebrated work on " Chemical Analysis," of which thevolumes before us contain an elaborate and careful translation,together with the notes of Professor Peligot, who translated theoriginal into the French language. Mr. Normandy has executedhis task with care. The first volume contains an exposi-tion of the rules and processes which should be adopted in quali-tative analysis. The author has in this volume given the meansof distinguishing those substances only which are of more fre-quent occurrence; partly because they are more interesting thanthose which are rare, but partly also, and more especially, be-cause the descriptions of the processes which must be resorted tcin such cases would have been a great deal too intricate and

obscure had he supposed, in the compound to be examined, thesimultaneous presence of all the substances which might possiblybe contained in it. The second volume indicates the method tcbe followed in quantitative analysis ; and each simple body, witllthe exception of oxygen, is the subject of a separate chapterThe work is valuable, and will doubtless have an extensive circula-tion. The way in which the work is "got up" reflects credit orthe enterprising publishers.

* The correspondence has been transmitted to us by Dr. Munro.

A Sermon preached ixx the Parislz Church of St. Martin’s it theFields, on Sunday, March 28, 1852, in aid of the Funds of theMedical Benevolent College. By the Rev. H. MACKENZIE,Vicar. Pamphlet, pp. 23. London: Rivingtons.Tms is an eloquent appeal by an earnest and able advocate

in favour of the New College. The claims of the necessitous

medical practitioner on the public at large are placed in a

striking view before the reader. The profits of the sermon willbe devoted to the funds of the College. The following extractis pregnant with truth :-

"The third objection comes from society at large. Why arewe appealed to? Why do not the members of this professionprovide for their own needy brethren? To this it may be boldlyreplied, that we are appealed to of right. There is no classof society having such means of extensive, even of universal,usefulness, as the medical profession ; and I may add, that few,if any, can compare with it in the readiness with which that use-fulness is afforded. They come to us in the time of our bitterestneed and deepest sorrow. When they minister successfully tothe stricken health of our beloved ones, we feel as if no giftcould be large enough, no sacrifice great enough, to prove ourgratitude. But the time of danger passes over, and we forgetthe miseries we have endured, and the relief they have afforded! Men that look no farther than their outsides,’ writes Sir T.Browne, ’think health an appurtenance unto life, and quarrelwith their constitutions for being sick; but I that have examinedthe parts of man, and know upon what tender filaments thatfabric hangs, do wonder that we are not always so; and, con-sidering the thousand doors that do lead to death, do thank myGod that we can die but once.’ By how many of these thou-sand ’ doors might this life go ont, were it not for the prudentand careful skill which is afforded us by the knowledge andcare of the physician! And if we, in the time of our weaknessand our necessity, apply to them, then is it perfectly reasonablethat in the time of their necessity they should apply to us."

A List of Practitioners in Medicine and Surgery resident in Man-chester and within Twenty Miles of that Town. Preparedunder the direction of the Manchester Medico-Ethical A8swia-tion. 32mo, pp. 34. Manchester : rowlson and Son.

A VERY useful and carefully compiled little book, reflectingmuch credit on the executive of the Manchester Medico-Ethical Association. No doubt the members of that body, incommon with the legitimate members of the profession gene-rally, have felt disgusted at the parade made in the Quacks’Directory," of the "qualifications"! of homoeopaths, hydro-paths, mesmerists, and othcr such persons, and have thereforepublished this little work in self-defence. It will be seen,however, by an advertisement in this day’s LANCET, that aDirectory is in preparation in which this serious evil andinsult to the profession will be avoided. As the New

Directory will be prepared with the utmost care, and pub-lished at a reasonable price, it cannot fail to drive fromthe field a work so tainted with quackery as the onethat now insults the profession.

DISLOCATION OF THE HUMERI.

WILLIAM HENRY SMITH, F.R.C.S.

To the Editor of THE LANCET.

SIR,—In reply to an observation of Mr. Greenwood, of Brad-ford, in THE LANCET of May 1, on the three lately recordedcases of dislocation of both humeri, I beg to inform himthat my patient (for I questioned him to the effect at the time)had never before met with a similar injury to either joint. Hadit been otherwise, I shou’d have considered my report compara-tively devoid of interest.The accident of Ephraim R-, adduced by your correspondent,

cannot be considered a parallel case, inasmuch as both bones hadpreviously shown an erratic tendency, and the right appears tohave formed with the glenoid cavity, not a ball-and-socket, butliterally a cup-a2id-ball joint, having been displaced previouslyten or eleven times! We can therefore only wonder how theparts remained in situ for any length of time, under even themost ordinary exigencies of life.

I have the honour to be, Sir, your most obedient servant,

Clapham Rise, May 4th, WILLIAM HENRY SMITH, F.R.C.S.Clapham Rise, May 4th, 1852.