PUNITIVE MEASURES IN THE TREATMENT OF THE INSANE.

580 at home at ease." Let him come out into the open with any facts and we will give them publicity and consideration. Meantime he must be regarded as a coward and not taken seriously. The plight of the poor and the sick in Liverpool and the efforts to improve it are a problem of constant interest to us, but it is not to be solved by stabs in the dark aimed at their medical advisers who get little "

p.

1111, and May 20th, p. 1376, of the current year. In issue of the latter date we showed, on the strength

our

of figures the accuracy of which will scarcely be impugned, that the registered mortality from malignant disease in England and Wales has at least doubled within the last 50 years z, among males, indeed, there has been an uninterruptedi increase from 195 per million of the male population in the earlier years to 571 per million in the later years of the last, pay and deserve the greatest respect. half-century. On the other hand, in THE LANCET of April. 22nd, we showed that within the same period the mortality’ AMERICAN VIEWS ON THE PREVALENCE OF from pulmonary consumption at all ages in England and, CANCER. Wales had fallen from a rate of from 2579 to 1532 perWE have received a lengthy communication from a legal million among males, and from 2774 to 1162 per million gentleman in Buffalo, U.S.A., in which the writer, who among females. It will thus be seen that in both cases. 1 tendency of the English national statistics is appends to his name the letters M.A., B.C.L., protests the 1 to confirm American experience as set forth in Dr. York that against the assertion of Dr. Roswell Park of New Roswell Park’s article in the Practitioner. There is, cancer is seriously increasing both in England and in the one aspect of the question which will, we areUnited States. Our American correspondent deprecates the however, I as be confident, he gratifying to our correspondent as it is. publication of Dr. Roswell Park’s views both because that both in the United States and to ourselves-viz., are believes them to be erroneous and because they producing in Great Britain scientific agencies are already at work a species of cancer scare both there and in this country. The subject of cancer prevalence in England and Wales has for the investigation of the nature and causes of this terrible. been dealt with recently in THE LANCETat considerable malady; and we shall both concur in hoping that effective length, and we would suggest a perusal of our article means may eventually be discovered of checking its progress-a feat which has’already been accomplished in the case of on the statistics of cancer if our correspondent should wish for detailed information as to what is known concerning the that not less dreadful complaint pulmonary tuberculosis. incidence of fatal cancer in this country during a long series of years. Although it is against our rule to publish letters on strictly medical subjects from non-medical writers, still, PUNITIVE MEASURES IN THE TREATMENT OF the to interest which to attaches having regard exceptional THE INSANE. the subject, we willingly insert a summary of the main DR. T. DRAPES, medical superintendent of the Ennispoints in our correspondent’s letter and we trust that our corthy District Asylum, Ireland, contributes to the July correspondent will acquit us of discourtesy to him in number of the Journal of Mental Science an article on the’ adopting that course. The April number of the Practi- subject-Are Punitive Measures Justifiable in Asylums ? On tioner contains an article on Cancer by Dr. Roswell Park, this question it appears that great diversity of views existsProfessor of Surgery in the University of Buffalo and those having the care and treatment of the insane. Director of the State Pathological Laboratory in New amongst Much of the disagreement seems to have arisen with regard York. In that article, which we have read with much to the meaning of the term " punishment." It would appearinterest, Dr. Roswell Park discusses the nature of cancer according to Dr. Drapes’s contention that punishment may and its prevalence in different parts of the world, but be of two kinds-positive or negative. "When we say to a more particularly in the United States of America; and childYou have been naughty ; you shall not have any inasmuch as the facts on which he relies are derived from sweets at dinner to-day,’ or‘You shall not go for a ride with. the returns of the State Board of Health, we should have the others,’ that is punishment of a negative kind, punishthought that they would be accepted in that country ment by deprivation, but as certainly punishment to the as beyond question. Passing by certain points of relatively child as if it took the positive form of bodily chastisement."’ minor importance, we note that the main inference which Similarly to treat a lunatic patient who had been refractory Dr. Roswell Park draws from his study of the New York or mischievous by stopping his regular allowance of tobacco statistics is to the following effect : That whereas the or disallowing his attendance at the dance or circus was mortality from malignant disease in the United States has punishment. "To say," continues Dr. Drapes, "that a liner enormously increased during the last half-century, the of action which in the one case is called, and meant tomortality from consumption, another prevalent national be, punishment, should in the other be styled ’treatment* scourge, has decreased even more rapidly during the same or ’aid to control ’ or any other plausible euphemism period. According to our legal correspondent the soundness is illogical."" The punishments which are meted’ of Dr. Roswell Park’s deductions has been called in quesout are in immediate relation to the (faulty) behaviour, tion in the columns of the Ne7v Fork Medical News by a relation which can be made quite intelligible to both Dr. John Pryor, another physician of Buffalo City, who the child and the insane. As degrees and depths of to have formed the opinion that Dr. Roswell seems are various and it would happen, variable Park’s facts and conclusions are alike unworthy of insanity that what might be keenly felt and keenly realised by, We have not seen the correspondence in confidence. one patient would scarcely affect another. The milder question, and consequently are unable to weigh the and kinds of mental of alienation, oddity and of evidence adduced on either side; but we may point grades need not be associated with irresponeccentricity, inevitably out, as a fact of some importance, that Dr. Roswell in On the other the hand the progress subject. Park’s conclusion concerning the recent terrible in- sibility of symptoms might continue till the patient-an actively crease of cancer and the concurrent decrease of tubersuicidal melancholiac or a raving maniac-is in a condition of culosis in the United States tallies singularly with the total mental and moral irresponsibility for his conduct. All experience of this country and we are surprised that our grades and degrees of mental alienation-and pari passu of correspondent, who is avowedly conversant with the lie between these extremes. In pararesponsibility-may literature of the subject, has omitted to notice our own noiaes there is often a relative mental soundness and observations to this effect in THE LANCET of April 22nd, integrity outside the special sphere of the particular ordominating delusion which he is under. "II have known," 1 THE LANCET, May 20th, 1899, p. 1376. ......

581 says Dr. sciences

Drapes, "many such cases to have very tender conquestions of right and wrong, who could not be induced to do a wrong action by any amount of persuasion." Cases of so-called moral insanity with little or no capacity for social sentiments and moral feelings, or with active perveron

are found in almost every in gaol more than once. have been of them asylum. " Many in which crime and insanity the borderland to They belong hold mingled sway. They are most difficult cases to deal with and in an asylum they not only act badly, often outrageously, themselves, but are active agents in demoralising others. And it is in this class of patients that punitive Several measures are often attended mith very good res1tlts." instances were given in illustration of these points. Mild methods, such as the deprivation of tea, of tobacco, and of amusements and dances, occasionally succeeded, but some of these cases required more radical measures, such as restraint by a camisole, or by gloves locked on the wrists, or by the application of the cold water-bath (including the cold shower-bath), often with the most salutary effects. In the discussion which followed the reading of the paper (at the spring meeting of the Irish Division of the MedicoPsychological Association in April, 1899) Mr. A. D. O’Connell Finegan recorded the good results of seclusion in one case where other means failed, Mr. P. Donnellan instanced cases where a little restraint and a little punishment (by deprivation) might be useful, and Dr. G. T. Revington acknowledged that they were justified in stopping all the pleasures and privileges of patients as a punitive measure. The infliction of any positive pain, however, could not be upheld. The deprivation of pleasure and seclusion he could approve of, and seclusion in a dark room was most effective in some

sions of

a

moral and sexual nature,

cases. ___

THE DEATH OF PROFESSOR BUNSEN. LAST week we announced the death of Professor Robert Wilhelm Bunsen at Heidelberg at the age of 88 years. Chemical science has thus sustained within a week the loss of two of its principal founders. We refer as well to the death of Sir Edward Frankland, a sketch of whose career we published in our last issue (p. 501). Some of the most brilliant discoveries recorded in the annals of chemistry are due to Bunsen. Some possess theoretical importance, others which will ever serve to keep his name in memory were of practical importance. Of theoretical importance we may mention his researches on the cacodyl compounds which established the existence of an arseniuretted radical in certain organic compounds. This discovery gave rise to the theory of radicals-groups behaving, so to speak, like elements upon which the superstructure of the enormous number of organic compounds now known to us rests. Bunsen succeeded Wohler as Professor of Chemistry in the Polytechnic School at Cassel, and it was Wohler, it will be remembered, who banished for ever the idea of vital force being concerned alone in the production of carbon compounds. He succeeded in constructing urea from purely inorganic materials, a synthesis which opened the way to a multiplicity of syntheses since successfully carried out by the patient labourers engaged in the field of organic research. Thus it is difficult to estimate the important influence which this achievement has exercised upon modern industries and upon modern life. Bunsen found the investigation of the architecture of organic compounds a fascinating study and his work bore fruit not less important than that of his e
sun, stars, and heavenly bodies, had not Bunsen brought to bear the aid of the spectroscope upon analysis. This discovery led him to other discoveries and he announced

the existence of hitherto unrecognised elements such as rubidium and caesium which were proved to occur in certain mineral waters. We now know the value of spectrum analysis in its application to the examination of rarefied gases under the influence of electric discharge, an application which has enabled chemists, as has been said,’’ to analyse the planetary system." We may even trace the discovery of helion by Professor Ramsay to the searching and selective power of the spectroscope, which Bunsen was the first to employ in microscopic chemical analysis. The enormous impetus which these and other discoveries have given to stellar chemistry it is still premature to estimate. Suffice it to add that fresh facts of the most interesting kind are daily being brought to light which tend to bring the chemistry of this and all other worlds under one classification. As is. well known, in the discovery of spectrum analysis Bunsen It is hardly necessary to was associated with Kirchoff. mention some of the other fruits of Bunsen’s labours, so well known have they become on account of their practical importance. As examples we may mention the battery, burner, vacuum pump, and photometer to be for ever known by his name. He was practically alsothe founder ofgas analysis by volumetric methods, and it was Bunsen, again, who suggested that freshly precipitated ferric hydrate would serve as an antidote in cases of poisoning by arsenic. Bunsen’s most important appointment was. the professorship at Heidelberg, and the university became famous as one of the most celebrated schools of chemistry in Europe. This school proved to be the nucleus of a band of pupils and investigators who have since placed chemical science on the sound and scientific basis which it now occupies. Greater tribute than this to the memory of the great chemist could not be paid. His work, indeed, and the fruits thereof will last for aye—MM’MM’MMM’M aere perennius.

STREET NOISES.

ON August 21st George Sims, a journalist, was charged at Clerkenwell Police-court with damaging a lamp. The circumstances of the case were that a mission service was being held outside the defendant’s house and according to the conductor of the mission service the defendant rushed across the road, knocked over a lamp, and sat upon a harmonium. According to the defendant’s evidence the noise woke him up. He went out and asked the preacher to stop and in the dark he fell against the harmonium and accidentally knocked over the lamp. Whether the occurrence was accidental or not much matter. We entirely sympathise does purposeful with the journalist whose rest was disturbed by the singing, preaching, and harmonium playing. Mr. Horace Smith is reported as saying to the defendant :I entirely sympathise with you in your endeavour to suppress noisy persons. If I had my way I would suppress all noise. It must be most annoying to hear people singing hymns or anything else when you want to rest. With regard to the facts of the case I am quite willing to believe the damage was accidental, but at the same time it must be understood that nothing justifies wilful damage. I sympathise with you. This sort of noise is intolerable and a mistake. I hope some way will be found of conducting these services without disturbing respectable people. At present the law is incomplete. There is no power given to a police magistrate to issue an injunction restraining people from pursuing such objectionable practices. Their intentions are good, but they do not benetit mankind under circumequally engaging subjects, and again his efforts were stances such as have been described. crowned with remarkable results which opened up an As we have often said before, the necessary noises in a large entirely new field of investigation. It is interesting to con- city like London are quite bad enough without residents template what the position of stellar chemistry would have having to suffer the infliction of totally unnecessary noises. been, or our extent of knowledge of the composition of the Street-preaching, "German " bands, piano-organs, and, above

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