In the thirteenth number of this Journal, May, 1855, we published an article on the accumulation of chronic lunatics in asylums, in which we recommended that further accommodation should be provided when needful, not by enlarging the existing buildings, but by the erection of distinct houses built on a simple plan, retaining as much as possible the ordinary arrangements of English homes. We recommended this arrangement on the experience derived from the occupation by patients of two small houses originally built for offices; these small houses or cottages, as they are called, are cheerful and homelike, and patients much prefer residing in them to the wards; their efficiency for the accommodation of tranquil patients and the simplicity of their construction, led us to advise on the score of economy, that further accommodation for chronic patients should be provided by establishing lunatic colonies, the cost of which we calculated “at the rate of 48 for each patient, or from one-fourth to one-seventh part of the relative cost per head, at which county asylums have been erected.”∗

Every practical alienist will admit the great importance of the application to his specialty of the principles of Surgery, inasmuch as those corporeal defects and casualties, which are often connected with, and are prone to result from disturbance of the mind, the “noble guest of the flesh,” must have forced themselves upon his attention in a multitude of his cases.

Mr. President,—I need not tell you, Sir, nor the Fellows of this Society, that the study of the human mind is a subject which has occupied the attention of the greatest philosophers of every age; nor need I remind you how long that study was enveloped in the shades of mysticism, bewildered in the mazes of metaphysical subtilty, amid the dogmata of conflicting systems. It is to Locke that we are so much indebted for dispelling the mysticism of the schoolmen. Unshackled from the tyranny of ancient names, and regardless alike of Aristotle and his categories, Locke discarded the syllogism, and instituted a searching analysis of the phenomena of thought.

At a time when the provisions for the care and treatment of pauper lunatics are almost completed in compliance with the legislative enactments of 1845, cavillings are heard, not as to minor details or local discrepancies, but against the first lines, the root and trunk-growth of the scheme. County asylums have arisen in every shire, attended in many instances by their satellite borough institutions, and some men, not ignorant on these matters, have looked on, and pronounced the arrangements to be good, very good; some, perhaps prejudiced, or short-sighted, or inexperienced, have gone so far as to say, that in no country in the world could similarly well ordered provisions for the maintenance and recovery of the poor insane be found, as we see raised at distances of twenty or thirty miles apart, over the length and breadth of this favored land of ours. Each institution a ready recipient of every needy being, whose taint, or toil, or trouble, or perhaps vice, if this precedes insanity, has reduced him to knock at the friendly door. Once admitted—every one who has bowels that can be sympathetically affected by the miseries of others, to a sufficient degree to induce him to care for, and to look into the plans adopted for the amelioration of the afflicted, can satisfy himself of the real good offered, and the benefit likely to be conferred by admission into one of these havens of rest. He will find within a well-planned building, divided into separate compartments exactly suitable for almost every phase of the disease to be treated; every arrangement for ventilation, warmth, and cleanliness; means for the regular elaboration and punctual distribution of a carefully devised dietary, every thing ready to hand; every appliance that modern notions suggest for the medical and moral treatment of the insane, and for the individual and personal and separate watching, nursing, and complete and effectual treatment of each unfortunate inmate.

Epilepsy, says Aræteus, “is an illness of various shapes, and horrible;” and Hippocrates, who existed five hundred years before him, in one of his terse aphorisms, states that those fits “which come on after twenty-five years of age, for the most part terminate in death.’” Lucretius, who lived in an age intervening between these two distinguished physicians, has with marvellous power pourtrayed the fearful symptoms of this apalling malady. Although a poet, and not a physician, his lines are equal in accuracy of delineation to those of the greatest pathologist.

Living in what may be said to be in a country which forms the link between civilisation and barbarism, so favored by nature, so neglected by man, where we have constantly so much before us to admire and so much to condemn, we have naturally been led to enquire into the condition of the poor lunatic in this city of the Sultan, into the state of him, whom mental and bodily disease has overtaken in its worst form; whom the public in some countries are disposed to honour as a gifted being, and whom in others they are inclined to look upon as the especial object of divine vengeance and torture.

A Report read before the Association of Medical Superintendents of American Institutions for the Insane at the Annual Meeting, 1857. From the American Journal of Insanity.

The world is scarcely twelve months older since it was astonished and distressed by the Report of the Scottish Lunacy Commission. Scottish members of parliament were eloquently indignant at its plain spoken exposure, of the penurious and cruel neglect, to which the insane poor of that country were subject; people were grieved and scandalized, that such a state of things could be possible in the present day, and the English press was by no means lenient in its censures upon a public economy, which could degenerate into a system of wide-spread cruelty. It is, however, a wholesome practice in contemplating the failings of others, to permit them to remind us of our own past transgressions, and of our present short-comings. The insane poor of Scotland were treated with barbarous neglect, because the state had omitted to extend to them its protection; and they were consequently provided for on principles of pauper economy, in the manner most consistent with the views of those who dole out the poor rate to its destitute recipients. But a few short years since, the pauper insane of rich and civilized England were equally unprotected by special enactments of parliament. They were maintained out of the poor's rate in the manner which seemed best to the poor-law officers. How this was done is to some extent recorded in the parliamentary enquiries of 1815, and in the early reports of the Commissioners in Lunacy. It was found by dire experience, that the custody of the insane poor could not be entrusted to those who are compelled by law to find the funds for their maintenance. The legislature interfered, and by wise and humane enactments, transferred all custodian power over the pauper insane, from overseers and guardians of the poor, to the county magistracy, to that influential, wide-spread, and educated justiciary, to whom so large a share in the administration of English law and justice is committed. Under these enactments, the English County Asylums have been erected and managed in a manner which has met with the highest approval of the public. The deficient accommodation, however, of these asylums and the rapid increase of pauper lunacy, again brings prominently forward the question of the custodianship of the insane poor. In every part of the country, frequent applications are made, for the discharge of so-called “chronic and harmless lunatics” from county asylums, in order that they may be detained in custody in union houses. The poor-law board returns for last year shew that there are no less than 8,600 insane paupers at present confined in union houses, being more than one-half as many as the pauper inmates of county and borough asylums. For the most part the insane inmates of union houses, are distributed among the sane inmates. Far be it from us to stigmatize the companionship of the insane, as necessarily degrading and painful. Under skilful management it is certain that the habits of many insane persons are as little offensive, and their companionship as unobjectionable, as that of persons in whom the reason holds it throne. But in union houses where skilful management of the insane is impossible, the promiscuous association of pauperism and insanity is every way objectionable. It is a flagrant injustice to those sane persons, whom misfortune has thrown upon the support of the poor's rate, to be compelled to associate by night and day with the dirty and drivelling idiot, with the moping melancholiac, or the chronic madman, who may appear to be harmless and safe, but whom many serious and fatal accidents in union houses and elsewhere, proves to be most untrustworthy under the unhappy circumstances of hunger, neglect and irritation. To the insane pauper, the run of the union house in place of care and treatment in an asylum, is a thorough denial of his rights; rights to which he has a claim, as well-founded as the clergyman has to his tythes, or the landlord to his rent, or the tenant to the usufruct of his land.