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THE RECENT INVASIONS OF CUMBERLAND.
348 individual. To his mind, whatever was necessary for en- coal industries. I have in the earlier portion of my remarks forcing primary vaccination was equally needed for the touched on different invaders who settled in this county ; secondary operation. At present the law was illogical in but in my own time I have seen an invasion and settlement that it ignored one-half of the protective powers of vaccina- in three localities by three different nationalities. I believe tion. He was firmly of opinion that more would be gained good results have followed from the one settlement so by moderate insistence on secondary than by relaxation of far as lunacy is concerned, negative so far from the second, The first is a settle. and positive harm from the third. primary vaccination. The following resolution, proposed by Dr. GROVES, and ment of railway officials, principally from Scotland, in seconded by Mr. GABSTANG, was then put to the section and Carlisle ; they are, of course, picked men, educated, carried nem. con.:" That, in the opinion of the Public reliable, and necessarily steady. The prosperity of the Medicine Section of the British Medical Association, it is Presbyterian churches in Carlisle is a testimony to this. desirable that calf lymph should be universally available The fact that many of the principal medical men in Carlisle from the Department of State." and all the bank managers but one are Scotch, and the fact that, in spite of the close proximity of Scotland, yet there are fewer Scotch patients than Irish in the asylum, bear out my PSYCHOLOGY. contention. The second set of settlers are Cornish and Add’l"ess by the P’I"eiJident of the Section. Welsh. So far they have made little impression on the disDr. J. A. CAMPBELL delivered an address upon Lunacy in trict beyond adding to its musical talent. The musical talent Cumberland and Westmorland. He said:-
1
is very deficient in the native of Cumberland and Westmor. —. 4-r.. r"I.n.....l’;....lr.. 0.........1;""1,, 1....",C’C been """011....;1 called I i— Carlisle has 1--...........welcome you to Carlisle. land ; until late years it has not been cultivated. Voices are the Merrie Citie," but the phraseology of olden times rather r harsh and unmusical. The third set of settlers may gave a different acceptation to the term "merrie" fromhave 1 valuable service from their labour, but have been, given what we now understand by it. It meant then the brave, Ii am an expensive importation-the Irish in the certain, the valorous city, but though this was then the meaning of coal ( and iron districts in the west. The Irishman who comes the word I trust that from your point of view you will 1 to this country and secures employment at high wages, it a "merrie citie" in the ordinary sense of the term, and from his home, his mother, his sweetheart, his reaway that during your short stay here the sun may 11 shine fair spected priest and confessor, is placed in a position he has on Carlisle wall"; if it does I am sure nothing shall be not been educated up to; he succumbs to the unwonted wanting on the part of the medical inhabitants of the city luxuries i and excesses. As a lunatic patient he is full of fight, and neighbourhood to prevent you from having "sunny and destructive qualities. Most of the troublesome noise, memories " of our meeting here. Since I began the study patients at Garlands Asylum are Irish, many of them come of lunacy and entered on its practical treatment from county Down, many from one place-Castlewellan. It thirty addresses on the subject have been given before the may be that Ireland sends us just the worst specimens she Medico-Psychological Association, and in this section 1has, but our experience of the Irish has been unfortunate. It twenty addresses have so far been delivered by some of theis said that their children show extreme aptitude at school, most eminent men who have been connected with our but I fear this settlement will produce a very unstable and specialty men who were able to clothe their thoughts unreliable i addition to the county stock. of wisdom in words of eloquence and wit. Now to one who then proceeded to an account of the [Dr. Campbell has either heard or read all these addresses it really Cumberland and Westmorland Asylum, giving many inbecomes a matter of extreme difficulty to choose a subject facts connected therewith, among others the which is not threadbare and to avoid what hasteresting T
&ic r ;
find
someJ
-
repeating already been better said. I sympathise with those who following :]BODILY DISEASES ; CAUSES OF DEATH. follow, for the difficulty which I feel will yearly increase. as the me to one of audience leads believe In the third year of the existence of the asylum a certain My experience that a diffuse address which touches on several topics, number of patients were attacked by dysentery and fifteen which affords an ample choice of subjects for a discussion, of them died. Dr. Clouston, the then superintendent, con. and which is not too exhaustively scientific, is best suited sidered the disease due to sewage exhalations, and con. for a section where exact scientific work, as shown by the tributed a valuable paper giving his views and an exprogramme of our secretaries, is to follow for several days. haustive account of the outbreak.l During 1874 eight cases I therefore, in accordance with my views, submit to you of enteric fever occurred ; three cases proved fatal. I was the following, trusting its defects will be pardoned and convinced that the ultimate cause of this outbreak was due excused on the plea that ’’ the environment of county to insufficiency of water, the proximate cause to the stoppage asylum life tends so much to make hard work go against the of a drain. The original water-supply had never either been grain." The highest study of mankind is man. The most adequate nor was free from suspicion of contamination, and important study of mankind may be fairly stated to be the this outbreak really occasioned a proper and pure supply of brain of man. Now in the treatment of all that appertains water to be got and caused the whole sanitary arrangeto mental diseases we in the practice of our specialty ments to be put in proper order, since which time we have require not only the knowledge of the practitioner of had an extraordinary immunity from intestinal ailments, with medicine, but much superadded knowledge, so that we may the exception of the rather wonderful case which I now relate. suitably apply all remedial means from surroundings, In 1892 a cesspool, which had been in use in the early history recreations, influences such as music and flowers, to occupa- of the asylum, and which had been used during the out. tions even so apparently monotonous as the wheeling of a break of dysentery I told you of, was, after being unused for wheelbarrow-where lack of intelligence, apathy, or absence twenty-six years (having been first filled with quicklime, then of manual dexterity necessitates such a rudimentary mode of left standing open to the air), being pulled down by a party employment. In our study of our patients, their physical of patients; one of the patients engaged in this work took conditions, their mental formation, and their hereditary ex- dysentery and died from it. That germs of disease can retain cellences or defects, we necessarily must pay attention to their vitality in a suitable nidus for unlimited periods is uthe mental and physical qualities of the sane population of questionable ; the history of anthrax proves this even more the district and make ourselves conversant with their racial strongly than most diseases. No death had occurred at characteristics. Garlands from dysentery, diarrhoea, or typhoid fever for [Dr. Campbell then proceeded to give an exhaustive and more than ten years until this death took place. The deathinteresting account of the racial peculiarities of the dales- rate from age is much increased ; from general paralysis it .i men and of the various customs, such as small holdings, lower, and from phthisis slightly less. I believe asylumintermarriage, and the effects of always living in the same caused phthisis is decreasing. Though we have had an district, which customs are all rather favourable to the occasional case of zymotic disease sent in we have hadnu spread of insanity. He then passed to] spread of such disease and none has originated. The only series of deaths of later years in this asylum which call for THE RECENT INVASIONS OF CUMBERLAND. remark was from an outbreak of pneumonia,2 caused, I conas a is The Westmorland county chiefly pastoral. sidered, by septic inhalation from razing an old and filthy industries are not of such magnitude materially to affect the population and the population is pretty stationary. set of farm buildings. Fourteen males and five females were There was a fall in the decade ending in 1881, but affected and the mortality was high. a considerable increase in 1891, probably due to the 1 Sewage Exhalations the Cause of Dysentery, Medical Times and residential attractions of the portion of the county Gazette, June, 1865. which
borders
Windermere.
It
is
far different
with
2
Remarks
on
Pneumonia
Cumberland, with its railway development and its iron and LANCET, March 19th, 1892.
as a
Cause of Death in Asylums, THE
1
is very deficient in the native of Cumberland and Westmor. —. 4-r.. r"I.n.....l’;....lr.. 0.........1;""1,, 1....",C’C been """011....;1 called I i— Carlisle has 1--...........welcome you to Carlisle. land ; until late years it has not been cultivated. Voices are the Merrie Citie," but the phraseology of olden times rather r harsh and unmusical. The third set of settlers may gave a different acceptation to the term "merrie" fromhave 1 valuable service from their labour, but have been, given what we now understand by it. It meant then the brave, Ii am an expensive importation-the Irish in the certain, the valorous city, but though this was then the meaning of coal ( and iron districts in the west. The Irishman who comes the word I trust that from your point of view you will 1 to this country and secures employment at high wages, it a "merrie citie" in the ordinary sense of the term, and from his home, his mother, his sweetheart, his reaway that during your short stay here the sun may 11 shine fair spected priest and confessor, is placed in a position he has on Carlisle wall"; if it does I am sure nothing shall be not been educated up to; he succumbs to the unwonted wanting on the part of the medical inhabitants of the city luxuries i and excesses. As a lunatic patient he is full of fight, and neighbourhood to prevent you from having "sunny and destructive qualities. Most of the troublesome noise, memories " of our meeting here. Since I began the study patients at Garlands Asylum are Irish, many of them come of lunacy and entered on its practical treatment from county Down, many from one place-Castlewellan. It thirty addresses on the subject have been given before the may be that Ireland sends us just the worst specimens she Medico-Psychological Association, and in this section 1has, but our experience of the Irish has been unfortunate. It twenty addresses have so far been delivered by some of theis said that their children show extreme aptitude at school, most eminent men who have been connected with our but I fear this settlement will produce a very unstable and specialty men who were able to clothe their thoughts unreliable i addition to the county stock. of wisdom in words of eloquence and wit. Now to one who then proceeded to an account of the [Dr. Campbell has either heard or read all these addresses it really Cumberland and Westmorland Asylum, giving many inbecomes a matter of extreme difficulty to choose a subject facts connected therewith, among others the which is not threadbare and to avoid what hasteresting T
&ic r ;
find
someJ
-
repeating already been better said. I sympathise with those who following :]BODILY DISEASES ; CAUSES OF DEATH. follow, for the difficulty which I feel will yearly increase. as the me to one of audience leads believe In the third year of the existence of the asylum a certain My experience that a diffuse address which touches on several topics, number of patients were attacked by dysentery and fifteen which affords an ample choice of subjects for a discussion, of them died. Dr. Clouston, the then superintendent, con. and which is not too exhaustively scientific, is best suited sidered the disease due to sewage exhalations, and con. for a section where exact scientific work, as shown by the tributed a valuable paper giving his views and an exprogramme of our secretaries, is to follow for several days. haustive account of the outbreak.l During 1874 eight cases I therefore, in accordance with my views, submit to you of enteric fever occurred ; three cases proved fatal. I was the following, trusting its defects will be pardoned and convinced that the ultimate cause of this outbreak was due excused on the plea that ’’ the environment of county to insufficiency of water, the proximate cause to the stoppage asylum life tends so much to make hard work go against the of a drain. The original water-supply had never either been grain." The highest study of mankind is man. The most adequate nor was free from suspicion of contamination, and important study of mankind may be fairly stated to be the this outbreak really occasioned a proper and pure supply of brain of man. Now in the treatment of all that appertains water to be got and caused the whole sanitary arrangeto mental diseases we in the practice of our specialty ments to be put in proper order, since which time we have require not only the knowledge of the practitioner of had an extraordinary immunity from intestinal ailments, with medicine, but much superadded knowledge, so that we may the exception of the rather wonderful case which I now relate. suitably apply all remedial means from surroundings, In 1892 a cesspool, which had been in use in the early history recreations, influences such as music and flowers, to occupa- of the asylum, and which had been used during the out. tions even so apparently monotonous as the wheeling of a break of dysentery I told you of, was, after being unused for wheelbarrow-where lack of intelligence, apathy, or absence twenty-six years (having been first filled with quicklime, then of manual dexterity necessitates such a rudimentary mode of left standing open to the air), being pulled down by a party employment. In our study of our patients, their physical of patients; one of the patients engaged in this work took conditions, their mental formation, and their hereditary ex- dysentery and died from it. That germs of disease can retain cellences or defects, we necessarily must pay attention to their vitality in a suitable nidus for unlimited periods is uthe mental and physical qualities of the sane population of questionable ; the history of anthrax proves this even more the district and make ourselves conversant with their racial strongly than most diseases. No death had occurred at characteristics. Garlands from dysentery, diarrhoea, or typhoid fever for [Dr. Campbell then proceeded to give an exhaustive and more than ten years until this death took place. The deathinteresting account of the racial peculiarities of the dales- rate from age is much increased ; from general paralysis it .i men and of the various customs, such as small holdings, lower, and from phthisis slightly less. I believe asylumintermarriage, and the effects of always living in the same caused phthisis is decreasing. Though we have had an district, which customs are all rather favourable to the occasional case of zymotic disease sent in we have hadnu spread of insanity. He then passed to] spread of such disease and none has originated. The only series of deaths of later years in this asylum which call for THE RECENT INVASIONS OF CUMBERLAND. remark was from an outbreak of pneumonia,2 caused, I conas a is The Westmorland county chiefly pastoral. sidered, by septic inhalation from razing an old and filthy industries are not of such magnitude materially to affect the population and the population is pretty stationary. set of farm buildings. Fourteen males and five females were There was a fall in the decade ending in 1881, but affected and the mortality was high. a considerable increase in 1891, probably due to the 1 Sewage Exhalations the Cause of Dysentery, Medical Times and residential attractions of the portion of the county Gazette, June, 1865. which
borders
Windermere.
It
is
far different
with
2
Remarks
on
Pneumonia
Cumberland, with its railway development and its iron and LANCET, March 19th, 1892.
as a
Cause of Death in Asylums, THE