COMPLAINTS RESPECTING THE RECENT ELECTION OF A PHYSICIAN TO THE ROYAL EDINBURGH LUNATIC ASYLUM.

LATE ELECTION TO THE EDINBURGH LUNATIC ASYLUM.

594

soldier remaining at the head of his troops after he has become a traitor, and has taken the pay and the colours of the enemy. Homoeopathicity, as they affectedly term it, is surely but another name for duplicity in all its partizans, whether of high or low degree.

A number of able

abstained from becoming candithe qualification of experience, they held themselves excluded by the advertisement; but thirtythree candidates presented testimonials, all of whom, with one or two exceptions, had been connected with public establishments for the insane. Ten appeared in person; the others relied on their testimonials. On the 10th of October, the ordinary managers appointed a committee, consisting of the two medical and three other managers, to strike off the least recommended Dr. THURCOMPLAINTS RESPECTING THE RECENT ELEC- eligible candidates. This committee " TION OF A PHYSICIAN TO THE ROYAL EDIN- NAM, the resident physician to the Retreat," near York, and Dr. ORR, of the Glasgow Infirmary, for two years assistant in BURGH LUNATIC ASYLUM. the Lunatic Asylum of that city. GREAT interest has been excited, and much surprise, disapWhen the election meeting took place, however, this recommendation was not attended to, but it was virtually voted, in and within the discussion, created, pointment, Scotland, in favour of Dr. SnAE, that experience was not essential, and last few weeks, by the circumstances attending a recent although he had no connexion with the management of election at the ROYAL EDINBURGH LUNATIC AsYLUM, when a any institution for the insane, he was elected, chiefly by the resident physician (Dr. SKAE) was appointed to fill that office votes of the ex-officio members of’the management and medical board, who had the least frequently attended the asylum, vacant by the retirement of Dr. M’KINNON. Amongst other and who consequently might be supposed least capable of of the qualifications most required. The reasons said journals of that country which have bestowed considerable judging to be those assigned for departing from the terms of the adverattention on the subject, is The Scotsman, from a recent number tisement were, that experience was not essential, and that the routine management of an asylum could be learned by a of which the subjoined digest of the facts is made :competent physician in a very short time. The answer given ROYAL EDINBURGH LUNATIC ASYLLM. was, that routine management was of all things to be avoided; This important institution was built chiefly by public sub- that its merits lay wholly on the surface; and that the way to scriptions, and is still supported by the public. It contains escape its evils was to appoint a physician combining scientific above400 patients. The Caledonian Mercury of -November 5, acquirements and high character with successful experience. states, concerning the recent choice of a resident physician to On all hands it was agreed, that if such a person was not to the institution, that the managers, after advertising for candi- be obtained, one combining scientific knowledge and skill, " must have had experience without experience, would be preferable to a man of mere dates, under the condition that in the treatment of the insane,"at length made " an appoint- routine. ment without any of the forms of an election. The situation On analyzing the votes, it appears that the majority of was presented to one whose main qualification must have been, the electors, both medical and non-medical, who had been in superior influence with the medical board, who had had charge the habit of taking an active personal interest in the asylum, of no public institution of the same kind, and whose name is expressed their belief that the whole of the requisite condiin no way connected with the subject of mental disease." tions were united, in more than one of the candidates, in such Inquiry into the circumstances has proved the following to a degree as to warrant the election of one of them; but the be a correct representation of them. numerical majority of the whole electors, consisting of mediThe direction is intrusted to twelve ordinary managers, (of cal and non-medical men, some of whom had not generally whom two are medical, Professor Christison and Dr. Scott,) attended to the institution, decided that this belief was wrong, who consult a medical board, consisting of the two Presidents and that Dr. SKAE, with other qualifications, but without exof the Royal Colleges of Physicians and Surgeons, three other perience, was preferable. In support of their views, this maprofessional men, and the consulting physician of the asylum, jority cited Dr. BROWNE and Dr. CONOLLY as examples of men as occasion requires; but neither of these six latter gentlemen appointed to asylums without, experience, and boasted of their has a vote. A vacancy in the office of resident physician eminence. It was shown, in reply, that the cases were not occurred through the resignation, on account of bad health, of analogous: first, because Dr. BROwNE had specially devoted Dr. M’kINNON, on Saturday, Nov. 11. In filling it up, the ordi- himself to the subject of insanity, from the very outset of his nary managers agreed that experience should be essential as a studies, had lived and travelled for many months with a genqualification in the candidates, more particularly because, tleman afflicted with iasanity, and had also studied the instito Dr. M’KINNON’S long absence, the fallen tutions for the insane in France and Italy, previously to into an unsatisfactory condition, and they conceived it neces- his being appointed to the asylum at Montrose, where his sary that the new superintendent should be able at once to experience was again enlarged, before he was elected at assume the reins, instead of having his experience, to acquire. Dumfries. Secondly, because Dr. CONOLLY had not only greatly In that decision they were joined by Dr. GILLESPIE, (the con- distinguished himself in his professorship, but had also devoted sulting physician,) Dr. ANDREW COMBE, (who has devoted much much attention to this subject, and published one of the best attention to insanity and the asylum,) and Dr. SIMSON, at that works on it before he was appointed to Hanwell. Whereas, time President of the College of Surgeons, (the two latter no similar proofs of prepared fitness could be brought forward being members of the medical board,) but who declined giving in behalf of Dr. SKAE ; and that under these circumstances the course pursued in the election was both erroneous and impolitic. any opinion as to the candidates. On the resignation of Dr. M’KINNON, a committee, consist- If the experienced candidates who offered themselves were ing of the ordinary medical managers, and two others, were really unfit for the office, the remedy was again to throw open appointed to select a successor. They recommended Dr. the situation for competition, unrestricted by any such condiBROwNE, of the Crichton Royal Institution, near Dumfries, tion ; that had Dr. SKAE then proved successful, no objection could have been expressed against his appointment; but that it who declined. The following advertisement was then inserted in the daily was unjustifiable to select him in the face of an advertisement under which he was not qualified even to compete. Without and medical journals :papers " ROYAL EDINBURGH LUNATIC ASYLUM.—The managers are disparaging Dr. SKAE, it is impossible to overlook the fact, that desirous of receiving applications for the office of the Resident the other candidates have also feelings which ought not to be Physician and Superintendent of this Institution, from gentle- wounded, and that, under the circumstances, the preference men holding a medical degree or diploma, and otherwise of an untried man implied in them an incapacity for the office, which required their being set aside-an inference as painful qualified: "Candidates must have had experience in the treatment of and derogatory to them, as, judging from the votes of the methe insane; but it is not indispensable that they should be dical managers, it was unjust and unmerited. married, the domestic arrangements being under the charge Finally, the institution has risen to such a magnitude, and of a matron. The salary &c. will be on a scale equal to that its importance as the metropolitan asylum is now so great, as of other similar institutions. There are at present upwards of an asylum and a medical school, that it becomes a duty to see that its management at once increases its utility, and four hundred patients in the Asylum. " Applications (accompanied by testimonials, &c.) addressed secures the confidence of that public to which constant appeals to John Scott, W.S., Treasurer of the Asylum, Edinburgh, are made in aid of the necessary funds. will be received till the 10th of October, soon after which the Of Dr. SKAE we know nothing personally,—nothing of his managers will fill up the vacancy. 1846." " Edinburgh, Sept. 7th, reputation, his skill, his competency. It is possible-and

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595 foregoing statement and opinions it would seem heard the account of it,after my return to London, in N ovem1840. In October, 1841, I sent in my testimonials to a probable-that in the new physician the managers have ber, as a candidate for the office of surgeon, and at dispensary, obtained the advantage of a man of business; a good director that time Dr. Lee gave me the following certificate :I have been well acquainted with Mr. Beck for several of the household affairs, an able classifier, a prompt, energetic, and I consider him highly qualified by his talents, proyears; of matters that he does understand ! active superintendent fessional attainments, and character, to fill the office of surBut in making this selection, perhaps they have over- geon to anv public institution. "ROBERT LEE, M.D., F.R.S., looked one important qualification. It is the misfortune of Fellow of the Royal College of Physicians, Physician to the British Lying-in Institution, &c. our establishments for insane persons to be designated So much for the time and motive of my introduction to Dr. "ASYLUMS." A workhouse is an asylum,—an almshouse is an Lee. the whole of 1842 I continued a frequent visitor asylum,—the great public institutions at Greenwich and at Dr. During Lee’s, and saw all his preparations, and his mode of disChelsea are asylums. Without doubt, a portion of every section. I also believed his statements to be correct, when, February, 1843, I became possessed of the uterus of a large building for the reception of lunatics is an asylum. But in woman who died from hæmorrhage at the full period of pregthe word AsvujM," when adopted for the general title of nancy. This uterus I offered to Dr. Lee; and upon his stating such establishments, is misused, and often with unfortunate that his time was so much occupied as to prevent him making effect. For, constantly calling those institutions "ASYLUMS," use of it, I undertook the dissection myself. This is a correct version of the artfully worded sentence, " Having expressed a at last it is forgotten that they are, or rather that they should desire to dissect the parts himself, I willingly gave up to him, be, HOSPITALS,—not almshouses, only, for the care of lunatics, as he has stated, the uterus of a woman who had died soon after from haemorrhage" — a sentence which has but hospitals for their cure—establishments for the treat- made delivery many suppose that I received the preparation from ment of insanity. To take care of the helpless is a good thing; Dr. Lee. i removed the uterus the day after the death of I with to cure them of disease which is amenable to medical art, is the woman; and as Dr. Lee had declined it, proposed, Dr. Lee’s knowledge and approbation, to make a preparation a better. But too often, that "better part" is forgotten, and of it for the museum of University College. A day or two that which should be a hospital becomes a mere dwelling-house. afterwards, having removed the preparation to the College, I met Dr. there, who approved of my intention. Now, So may it have happened at Edinburgh, that the directors, I declareSharpey that this was the first communication of any kind misled by a title, have chosen a steward possessing a phy- that I had had with Dr. Sharpey on the subject. In the face of these facts, with which Dr. Lee was perfectly sician’s diploma. When the next annual report of the he has sent forth the unfounded assertion that acquainted, Scotch Asylum is published, a more than usual interest will Dr. Sharpey instigated me to commence the inquiries; and attach to the " Table of Cures," and much pleasure be felt on now insinuates that, for unworthy motives, I obtained an introduction to him about December, 1842. I need scarcely finding that the directors have elected a competent physician, add, that both of these insinuations are without any foundainstead of an amiable companion for the matron. tion whatever. I regret being obliged to assure Dr. Lee that his motives for these insinuations are, by this time, too well understood. ON THE GANGLIA AND NERVES OF THE UTERUS. Having played this same game over more than once before, he has taught us the style of his tactics, which is, that as soon as he becomes aware of the tottering position in which any of (REPLY OF MR. BECK.) his pretended discoveries are placed, he seeks to turn the To the Editor of THE LANCET. scientific discussion of the subject by engaging in personal SIR,—It is- extremely painful to reply to personal attacks ; animosities and personal recriminations. It is further stated by Dr. Lee—" After a considerable but more painful to be obliged to intrude upon the profession with personal acts. Yet the unfounded charges and state- period, I was invited to see the progress he (Mr. Beck) had ments which Dr. Robert Lee makes in his late paper " On made, and was extremely mortified to find that the uterus the Ganglia and Nerves of the Uterus," published in your was immersed in-foul spirit and water, and in a half-putrid journal for November 21st, compel me to ask for space in your state." This is certainly a great mistake. That it was immersed in spirit and water is correct, for in that fluid I concolumns to reply to them. Dr. Lee insinuates again, that I was instigated by Dr. ducted mv first dissection, preferring it to alcohol, in conseSharpey to undertake my investigations into the anatomy of quence of its changing the appearance of the tissues much less the nerves of the uterus, through some unworthy motive or than that strong spirit which is used by Dr. Lee, aud at the motives, which are left undefined. It might be considered same time perfectly preserving the preparation. I cannot that the denial I have already given to this insinuation would produce this spirit and water to show that it was not " foul," be sufficient; yet, as Dr. Lee has endeavoured to support it but I am more fortunate in the preparation, a slight examinaby a series of wrong statements, I am compelled to follow him tion of which will show that it is not, nor ever has been, in a " half putrid state." As this is a matter of fact which can be through the principal of them. Dr. Lee also says, "About the same time, (December, 1842,) decided at any time, I can confidently appeal to the preparaMr. T. Snow Beck, who, some years before, had been a pupil tion, to show that it has always been in a state of perfect preof Dr. Sharpey at University College, and had obtained an servation, and that this statement is as unfounded as the introduction to me, frequently called at my house, and I others. Dr. Lee again says, " He (Mr. Beck) informed me that the showed him all my dissections of the nerves of the uterus." This passage, which is ambiguously worded, is evidently in- dilute alcohol was supplied by University College, at the tended to convey the insinuation that I obtained, about De- request of Dr. Sharpey, and that the expense already incurred cember, 1842, an introduction to Dr. Lee, as the commence- was so great that he was afraid to solicit another supply, and ment of a series of unworthy acts. How far this is correct that pure alcohol was out of the question." It might appear will appear from the following statement:unnecessary to notice this trifling statement,were it not to show

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In September 1836, I came to London, to commence my the general inaccuracy which prevails. I could not, and I feel medical studies, and brought with me a letter from my late assured I never did, sav anything so far from the facts. Had master, containing an account of the health of his wife, who I conducted the dissection at University College, as was origihad been in London the previous summer in order to consult nally intended, I should, as a matter of course, have been supan accoucheur-physician. This business-letter served as an plied with the spirit; but as it was removed to my house, I introduction to Dr. Lee, who during the sessions 1836-37, only received about one pint, with which the preparation was 1837-38, 1838-39, frequently invited me to his house, and upon covered in the first instance. The remainder was procured at whom I as frequently called without invitation. After passing mv own expense. Dr. Lee next states,"On examiningthe preparation, I found my examinations, in May, 1839, I visited the continental schools, where I continued until November, 1840. It was that the great bloodvessels, with all their accompanying during this period that the discussion on the nerves of the ganglia and nerves, had been cut away, and that the right uterus began, by Dr. Lee presenting a paper to the Royal hypogastric ganglion had been torn in pieces. I advised him Society in December, 1839, and it was from him only that I (Mr. Beck) to procure a proper supply of alcohol, and examine