The number of the Insane, and the legal provision requisite for their
protection, care, and treatment, are subjects which will always recommend
themselves to public attention and demand the interest alike of the
political economist, the legislator, and the physician. To the first, the
great questions of the prevalence of Insanity in the community, its
increase or decrease, its hereditary character, and others of the same
kind, possess importance in relation to the general prosperity and advance
of the nation; to the second devolves the duty of devising measures to
secure the protection both of the public and the lunatic, with due regard
to the personal liberty, and the proper care and treatment, of the latter;
to the last belongs the practical application of many of the provisions of
the law, besides the exercise of professional skill in the management and
treatment of the insane.
Moreover it will not be denied that, owing to the intimate manner in which
he is concerned with all that relates to the lunatic, with all the details
of the laws regulating his custody and general treatment, as well as with
the institutions in which he is detained, with the features of his malady,
and with all his wants, the physician devoted to the care of the Insane is
well qualified to offer suggestions and recommendations to the legislator.
Hence the present pages, in which the aim is to examine the present state
of lunacy; the advantages to be gained by early treatment; and the
adequacy of the existing legal provision for the Insane; and to offer some
suggestions for improving the condition, and for amending the laws
relating to the care and treatment, of this afflicted class of our
fellow-creatures.
The whole subject of the efficiency of the Lunacy Laws and of their
administration, occupies just now a prominent place in public attention,
owing to the rapid multiplication of County Asylums and the constantly
augmenting charges entailed by them; to the prevalent impression that
Insanity is rapidly increasing; to recent agitation in our Law Courts
respecting the legal responsibility of the Insane and the conditions under
which they should be subjected to confinement, and still more to the
proposed legislation on the matter during the present Session of
Parliament. It would be a great desideratum could the Lunacy Laws be
consolidated, and an arrest take place in the almost annual additions and
amendments made to them by Parliament; but, perhaps, this is next to
impracticable, owing to the attempts at any systematic, effectual, and
satisfactory legislation for the Insane, being really of very recent date,
and on that account subject to revisions enforced by experience of its
defects and errors. However, the present time appears singularly suited to
make the attempt at consolidation, so far as practicable, inasmuch as the
appointment of a special committee of the House of Commons on the Lunacy
Laws, furnishes the means for a complete investigation into existing
defects, and for receiving information and suggestions from those
practically acquainted with the requirements of the Insane, and with the
operations of existing enactments.
To fulfil the objects taken in hand, and, in the first place, to sketch
the present state of Lunacy in this country, it will be necessary to
investigate the number of the Insane, and the annual rate of their
increase; then to examine the extent of the present provision for them in
asylums and of probable future wants. This done, after a brief essay on
the curability of insanity, as a means of judging what may be done to
mitigate the evil, we shall review the present provision for lunatics,
point out its defects, and suggest various remedial measures, calculated
in our opinion to improve the condition of the Insane, diminish the evil
of the accumulation of chronic cases, and render asylums more serviceable
and efficient.
In carrying out our design, we shall be found in some measure occupying
ground already taken up by the Commissioners in Lunacy, and by some able
essayists in the Medical Journals. We do not regret this, although it may
deprive us somewhat of the merit of originality of conception and
elucidation, as it will strengthen our positions and enhance the value of
our remarks. Fortunately, too, we coincide generally with the opinions
from time to time put forth by the Lunacy Commissioners, to whom so great
merit is due for their labours in the interests of the insane, and for the
character and position our County Asylums enjoy in the estimation of our
own people and of foreign nations.
To attempt the character of a reformer when the affairs of Lunacy and
Lunatic Asylums are in such good hands may be deemed somewhat ambitious;
yet as sometimes an ordinary looker-on may catch sight of a matter which
has eluded the diligent observer, and, as the views and suggestions
advanced are the result of mature and independent thought, aided by
experience of considerable length, and very varied, the undertaking may,
we trust, be received with favour.
At all events, we flatter ourselves that the representation of the state
of Lunacy in England and Wales; the estimate of its increase and of the
provision made for it; the evils of workhouses as primary or permanent
receptacles for the Insane; the ill consequences of large asylums, and
some of the legal amendments proposed, are in themselves subjects
calculated to enlist the attention of all interested in the general
welfare of our lunatic population, and in the administration of the laws
and institutions designed whether for its protection or for its care and
treatment.