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proper use of the liberty allowed them, or of the edged tools put into their hands.
“ Man is so much of a social being, and depends so much on the sympathy, esteem, and co-operation of his fellows, that, as one of a body, he will submit cheerfully to tasks and duties, against which, if proposed to him as an individual or as one of a tew, he would unhesitatingly rebel. Disease may modify this tendency of the mind, but cannot destroy it; and the practical physician does not fail to avail himself of its power in the management of the insane. Many will at first refuse to work in the fields or in the garden, particularly if unaccustomed to manual labour, who, seeing others do go with cordiality and pleasure, will gradually allow their resolution to give way, and ere long become as zealous as they were previously backward. One of the chief advantages of large establishments, is the great facility they afford of turning out numbers to every kind of employment, so as to subject an individual who refuses to exert him. self to all the disadvantages of singularity, which the insane dislike even more than persons of sound mind.
“ Where there is any difficulty in engaging patients of a higher class in bodily labour, much good may still be done by engaging them as much as possible in the employments to which they were formerly accustomed. Billiards, bowls, walking, reading, writing, and music, are then valuable resources, and may be made to constitute the business of the day; care being always taken to turn the talents of the patient to a useful account, whenever an opportunity occurs, so as to give him as frequently as possible the consciousness of filling his place as a member of society.
“ In the smaller, and especially in private asylums, dedicated to the middle and higher classes of society, the presence of a NUMEROUS BODY OF INTELLIGENT AND EDUCATED ATTENDANTS, is a great desideratum. The patients are too few in number to operate on each other by example, and their habits are not in harmony with any manual employments. By placing numerous attendants among them, who would act systematically in endeavouring to engage them in useful labour, at first of a very light description, and to rouse them by example and cheerful encouragement, a good deal might be done ; but as in such retreats, the patients are generally persons of a more intelligent and refined description than in the larger asylums, the attendants, to be on a par with them, would require to possess proportionally higher moral and intellectual qualifications, so as to fit them for being companions and friends, as well as guardians, of the inmates. The expense of providing a sufficient number of qualified persons will long be an obstacle to their being obtained; but if the importance of the provision were once fully appreciated, and its success demonstrated, it can scarcely be doubied that this difficulty would be surmounted. Every year, we hear of large legacies being left to Lunatic Asylums by the benevolent, and if one of these were bequeathed to the first public institution that should introduce such a system, we should not have to wait long to see the example generally followed. The wealthier classes are, indeed, directly interested in the experiment, as their ranks afford proportionally the greatest number of victims; and if the disease were once treated on such principles, there would be much less reluctance to seek early advice, and consequently much more success in combating its attacks.
“ Pinel has said that thirty years' experience had taught him that a striking analogy subsists between the art of educating and training the young and that of managing the insane, as the same principles are applicable to both. Natural activity, unwearied kindness, tact and firmness, are eminently useful in both situations; but they are productive of their fullest advantages only when reinforced by an accurate acquaintance with the laws which regulate the mutual influence of mind and body, with the nature and sphere of the primitive mental powers, and with the methods and objects by which cach may be soothed into repose or stimulated to activity—in other words, by an intimate knowledge of human nature and of the philosophy of mind.
« But it will be asked, What fortunate establishment possesses attendants endowed with such excellent qualifications, and where are such persons to be found by any one who wishes to procure their assistance ? The answer must be, Nowhere; but as a necessary consequence, it may with equal truth be affirmed, that nowhere is the treatment of insanity so successful as it would be, were such assistants provided in sufficient numbers to mix with and exert a constant and active influence on the patients. In some retreats, an approximation to this desideratum is made in the frequent admission of visitors, who, actuated by kindness and intelligence, seek the society of the insane, devote ihemselves to their relief and comfort, and, by gaining their confidence and shewing a sympathy with their situation, succeed in dispelling morbid associations and restoring health and tone to the dis ordered mind. In these asylums, the proportion of cures is proportionally greater than in others apparently as well regulated, but in which no effort is bestowed in active moral treatment. In the Connecticut Retreat, this system has been carried as far as the present state of knowledge will permit, and with the best effects; the proportion of cures in recent cases being nine out of ten of all admitted. At present, indeed, no amount of funds could command the services of a sufficient number of properly qualified assistants; but, nevertheless, it is important that the
deficiency be made known, that we may make provision for supplying it, and not proceed, contented with our present means, as if they were already adequate. The tendency of the human mind is to become accustomed to existing defects, and never to think of remedying them, till some accidental occurrence displays their magnitude and turns the attention to further improve.
“ As matters now stand, the higher classes of lunatics are in one sense the most unfortunate of all. Accustomed at home to the refinements of educated and intelligent society, to the enjoyments arising from change of scene, to horse and carriage exercise, and to the command of numerous sources of interest, they find themselves transported to an asylum where they may be no doubt be treated with kindness, but where they are necessarily cut off from many of the comforts to which they have been accustomed, and must encounter prejudices, feelings, and modes of thinking and acting, to which they are strangers, and with which they cau have no sympathy. Being there restricted almost exclusively to the society of keepers, who, from their rank, education, and manpers, cannot be considered qualified to gain their confidence or elicit friendly interchange of sentiment, the patients are, in a great measure, deprived of that beneficial intercourse with sound minds which is indispensable to health, and of the numerous opportunities which such intercourse presents for gradually stirring up new interests and leading to new trains of thought. The medical attendant, indeed, is often the only being to whom patients of this class freely unburden their minds, and from whom they can seek comfort ; but unfortunately, in most establishments his visits are so few and short, that they can scarcely be reckoned as part of an efficient moral regimen.
“ The poorer patients, on the other hand, although too much left to their own society, have still the advantage of being, to a certain extent, in daily communication with minds in harmony with their own both in feeling and in intelligence; as the keepers are always men of the same rank, education, and manners, as themselves. They consequently are less sensible of the change in their situation, and feel less acutely any actual indignities to which they may be exposed.
Experience has already shewn that great benefit arises to the insane from the frequent association and sympathy of persons of tact, intelligence, and kindness, who feel a real interest in the happiness of the patients, and visit them from a wish to soothe and comfort them, and not from mere idle curiosity. Nothing tends so much as this to break down the formidable barrier which still separates the disordered in mind from the sympathies of society, and to dispel those sinful prejudices which stamp insanity with the stigma of crime, and impel us to shroud its victims in obscurity and neglect.
“ It may be said, " That is all true, and very proper for medical men to know, but why introduce it into a book intended for the general reader? My answer is, that I introduce it here purposely, 'because it is from among the public that the directors and managers of institutions for the insane are chosen ; and so long as they remain umacquainted with the wants of the patients, little can be done to provide a remedy. Medical men may direct, but society must co-operate, and cheerfully and earnestly take a part in the good work. Besides, there are thousands of warm-hearted beings who would delight in this very duty, if they only knew how to set about it; and they can be reached only by writings addressed to the general public.”
That he may not be considered as either tvo severe in pointing out existing defects, or too visionary in his conceptions of the improvements required, Dr Combé contrasts the Pauper Lunatic Asylum at Hanwell with that in Edinburgh, and gives a brief account of Esquirol's system of management at Ivry, near Paris. In commenting on the defects of the Edinburgh Asylum, he gives every credit to the managers of the institution. “ I am quite aware," says he, "of their anxiety to better the condition of the patients, and that they have already done more than could have been conceived possible with their imperfect means. But it is on this very account,--that the public may be stirred up to provide the necessary funds,--that I am so anxious to direct attention to the miserable accommodation; for I cannot help considering the asylum, in its present state, as a disgrace to the metropolis of the country.
Just as we were sending of this article to the printer, there was handed to us the Fourteenth Report of the Directors of the Dundee Lunatic Asylum, for the year ending 31st May 1894. That asylum is admirably conducted ; and the report is of so gratifying a nature, and so strikingly confirms many of the observations of Dr Combe, that we shall present our readers with an extract from it in next Number.
We saw it mentioned in a newspaper, some months ago, that the province of Antwerp possesses, instead of a lunatic asylum, a lunatic village. It is called Gheel, and the poor creatures are allowed to roam at large in it; and where their infirmity does not incapacitate them, the inhabitants give them work. Many districts in the Netherlands send their lunatics to reside in this village, and pay for their board and clothing It is said to be found, that for one cure effected under confinement, ten are brought about by kindness and the absence of coercion. We shall be obliged to any correspondent who can send us farther information respecting the village of Gheel.
PROCEEDINGS OF SOCIETIES.
1. The Phrenological Society.
21st November 1833.—Dr William Gregory read an account of the progress and prospects of Phrenology in Paris.-Mr Robert Cox read Notes, chiefly historical, on the philosophy of apparitions ; and correspondence between himself and Mr G. M. Schwartz of Stockholm, in September last, regarding casts of the heads of two Laplanders, and of the skull of a Swedish criminal. Dr Gregory explained the characteristics of the individuals under mentioned, casts of whose heads were presented by him to the Society. Letters from the Rev. Thomas Liddell and Donald Gregory, Esq. Sec. A. S., relative to skulls presented by them, were read. The following donations were laid on the table :—Seven skulls of Thugs or Stranglers of Central India ; presented by George Swinton, Esq. late Chief Secretary to the Supreme Government in India. Casts of the heads of two Laplanders, and of the skull of a Swedish criminal; presented by Mr G. M. Schwartz of Stockholm. Six skulls of Druids, from the Hebrides; presented by Donald Gregory, Esq. Skull found in April 1833 under the foundation of the old steeple of Montrose ; presented by the Rev. Thomas Liddell. Cast of the head of Linn, a pugilist and parricide ; presented by Dr M Donnell of Belfast. Cast of the head of a musical child, a Negro, and a Charruas Indian savage of South America ; presented by Dr William Gregory. Additional plate illustrative of the Théorie des Ressemblances ; presented by the Chevalier da Gama Machado. American edition of Dr Spurzheim's work on Physiognomy; presented by Nahum Capen, Esq. Boston, United States.-An application by Mr John Ritchie, 6. Hill Square, for admission as an ordinary member, was read; also a letter from Mr William Slate, resigning as a member of
5th December. - The following gentlemen were elected OfficeBearers for the ensuing year :-George Combe, President ; George Monro, Bindon Blood, John Anderson jun. and Arthur Trevelyan, Vice-Presidents ; James Crease, Patrick Neill, John F. Macfarlan, Lindsay Mackersy, Charles Maclaren, and Henry M. T. Witham, Councillors; Dr William Gregory, Secretary ; Robert Cox, Conservator of the Museum ; D. Campbell, Clerk.
-Mr Simpson read Observations on the phrenological standard of civilization. Donation : “ Discours de la Mission du Philosophe au Dix-neuvième Siècle, &c. &c. par le Docteur Fos.