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THE LANCET.

LONDON: SATURDAY, JULY 5, 1856.

THE COMMISSIONERS IN LUNACY AND THE "PRIVATE COMMITTEE."

CERTAIN anonymous documents, printed at page 23, call for

especial attention, because they are illustrative of the state ofour Lunacy Laws, and the condition of lunatics in this country.The circumstances which gave rise to these documents was the

issuing of a circular letter by the Commissioners in Lunacy,addressed to the proprietors of asylums, in which the Commis-sioners required the said proprietors to keep " a list of private"patients, with the sums received or agreed to be paid for"their maintenance respectively." The Board assigns as the

ground for making this request its desire to have " the means44of judging whether, regard being had to the incomes of’’ patients, proper allowances are made for their maintenance;"and also whether patients enjoy the accommodation and*’ comforts to which the payments made in their several cases’’ entitle them."

A doubt that occurs to us might be expressed, whether theBoard was bound to assign any reason at all for requiring this"return,." in order to consider the objections raised by thatim-

ponderable and intangible body, " the Private Committee onLunacy Laws." At first sight, it seems not a little question-able whether a document unowned by anybody, which bearsno authentic evidence of being the bonâ fide production ofmembers of the medical profession," admits of being use-fully discussed; but since a professional opinion on the letter ofthe Commissioners by Sir RICHARD BETHELL is embodied in it,we presume it may be inferred that this document is really thestatement of some proprietors of asylums, whether belonging tothe medical profession or not, who feel that they have agrievance. We think it at any rate desirable to examine the

question raised in a public light, and without reference to indi-viduals interested or non-interested, visible or invisible. We

will assume, then, that a compound individuality exists to

form the substance of this " Private Committee." What is

the objection taken to this request of the Commissioners?

With a candour that argues little skill, the Private Committee

puts forward a plea peculiarly calculated to raise distrust

against the proprietors of asylums, and to provoke perseverancein the demand. "It will at once be seen," says the Private

Committee, " that what is here required by the Commissioners"is nothing less than a return of the gross income of every"physician or surgeon who may be specially engaged in the"treatment of mental disease." We can imagine the lynx-eyed assessors of income-tax lying in wait for a revelation of thenames of the individuals who constitute this " Private Com-

mittee." The inquisitive officials would surely suspect that

gentlemen who evince such a sensitive anxiety lest the grossamount of their incomes should be revealed have not made

true and faithful returns to those disagreeable queries which itis the annual duty of assessors to address to us all. If we

could for a moment suspect that the Commissioners in Lunacycontemplated an alliance with the income-tax assessors, andwere seeking by means of this circular to elicit information asto the private affairs of any section of medical practitioners,with a view to checking their returns, we should be the first

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to denounce a proceeding so disingenuous and so contemptible.But the idea is preposterous. We believe that the reason

assigned by the Commissioners is the one that really actuatedthem, and we do not think they ought to be deterred from in-

sisting upon this return because the " Private Committee" is

unwilling to give that information to one department of theAdministration which it is undoubtedly bound, in law and inhonour, to give unreservedly to another.

Sympathise, therefore, with the " Private Committee" uponthis first ground we cannot. But it next relies upon the

supposed illegality of the request, and sets forth an " opinion"of the SOLICITOR-GENERAL, couched in most lawyer-likeobscurity, in support of this objection. With all diffidence

we decline to discuss the legal bearing of the matter with theSOLICITOR-GENERAL; but we do not entertain a doubt that, ifit were worth our while, we could lay the case before the

same distinguished lawyer in such a form as to obtain anotheropinion, opposite to the one just given.Then we come at last to the consideration of the question

on the broad principle of moral right and public interest. Is

it right and fitting in the interest of the lunatics who are con-fined, and in the interest of society, that the Commissioners inLunacy should be kept constantly informed as to the sumspaid for the support of lunatics in their confinement ? There

cannot be a moment’s hesitation as to the reply. The publichas an absolute right to know in what manner, for what cause,and on what terms, any individual citizen is deprived ofliberty. Every asylum-proprietor stands in the relation of a

public-officer ; he undertakes the safe keeping of certain of hisfellow-citizens; he is to all intents, quoad the custody of luna-

tics, a State-gaoler; he is accountable to the State; and can-not evade rendering up the fullest and most unreserved parti-culars of everything that concerns the momentous charge hehas undertaken. It is the duty of the Commissioners in

Lunacy to watch over and protect the insane. They cannotalways do this effectually without being in possession of fullinformation as to the circumstances which have led to the

incarceration of lunatics, as to the motives which may haveactuated those under whose authority the incarceration hasbeen effected, and as to the interest of those in whose custodythey are maintained. Everyone will admit that the sum

paid to the proprietor will, in many cases, illustrate the

character, motives, and interests of the parties at whose

interference an alleged lunatic has been confined; that a

knowledge of it will often enable the Commissioners to

ascertain whether the alleged lunatic has been wrongfullydealt by; whether, in short, he is not detained for a sum alto-

gether unsuitable to his means, and inadequate to the supplyof those comforts to which his station in life may entitle him.

It is no answer to this to plead, as the " Private Committee"does, that the Commissioners are only called upon to satisfythemselves that " every patient in an asylum has, irrespectiveof the sum paid for maintenance, every accommodation and’’ comfort which is consistent with his station in society." With-out knowing what snm is paid, the Commissioners would notalways find it easy to determine how far those conditions were

complied with; and they may reasonably doubt whether manyproprietors are to be found with generosity or philanthropyenough to provide for patients paying only fifteen shillings ora pound a week, comforts and appliances that must cost severaltimes that amount. The Commissioners probably know that

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a system of classification obtains in some asylums, based uponprinciples distinct from any pathological or social peculiaritiesin the patients, one, in fact, that is determined by the scale of

payment.Sincerely, therefore, do we hope that the Commissioners will

insist upon an accurate return of the sums paid for the mainte-nance of every patient in a private asylum. Too much cannot

be known of the circumstances that are held to justify the in-carceration of any member of the community. The private in-terests and feelings of the proprietors of asylums must not be ’,suffered to weigh in the scale against the great duty of pro-tecting those who are committed to their charge.

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DURING the session which has just closed, the proceedingsof the various Medical Societies in London offer few pointsfor comment. In the pages of THE LANCET will be found

reports of the transactions of most of these learned’ bodies.The reader is therefore in a position to arrive at a correctopinion as to what extent they have served the interests of the

profession. Altogether, with the exception of the Patho-

logical Society, the session can scarcely be called a prosperousone.

The Royal Medical and Chirurgical Society has been

deficient in papers of interest, and the discussions have occa-

sionally been meagre and spiritless. On more than one

occasion there has been scarcely a paper in the possession ofthe secretaries-a circumstance which is without a precedentfor the last fifteen years. A more striking illustration of theevils of contention amongst members of such a body couldscarcely be adduced. The worst enemies of a scientific

institution are those who engender feuds and personal dis-agreements in what should be a peaceful community. Let

us trust that, for the future, all such causes of injury willbe avoided.

Great complaints have been made by the authors of papersread before this Society, of what they have regarded as theexercise of undue favouritism in those selected for pub-lication. Without entering into this question further thanto remark that we fear there is too much ground for the

complaint, we gladly refer to some resolutions passed by theCouncil, and announced by the President at the last meeting,because, if carried out, they cannot fail to confer a benefit,not only on the Society, but on the Profession at large.In substance they are as follow :-

In future, an abstract of every paper read before the RoyalMedical and Chirurgical Society will be published in "Pro-ceedings," which are henceforward to be issued gratuitouslyto the Fellows.

A number will probably appear about every two months

during each session. Their frequency will of course, however,depend upon the quantity of matter supplied, and on theamount or length of communications forwarded for reading atthe meetings.

According to this new measure, every author is now certainto have his production at least recorded in the archives,whilst the publication in extenso of the more important paperswill proceed as usual in the " Transactions."Another feature in this innovation deserves mention-

namely, when writers have neither time nor sufficient mate-rials to indite essays intended for the opinions of referees,

they may still communicate, without any hesitation or the

fear of being forgotten, . single cases of interest, or brief

remarks intended solely for the " Proceedings."Should authors’do this, the above official document may

contain much valuable matter and useful facts, which might

have otherwise continued in oblivion.I The reports of papers, and subsequent discussions, givenin the Journals, will remain as heretofore.The Pathological Society is yearly increasing in importance,

and its " Transactions," embodying the entire proceedings ofthe Session, increase in interest with every succeeding volume.The fellows of the Society augment rapidly in numbers. An

impartial critic might, however, be inclined to animadvert onthe undue length to which some of the communications andreports extend. This evil, however, has already engaged theattention of the governing body, and will doubtless in succeed-ing Sessions be remedied.In the Medical Society of London, a new mode of electing

the office-bearers is now under trial. It is no doubt open to

many grave objections, but we think that it will eventuallywork for the interests of the Society; at all events, let it notbe condemned until further experience has demonstrated theinfluence which it will exert on the oldest Medical Society inthe metropolis.The various district Societies have been conducted with

spirit and energy, and many contributions of great value havebeen made by them to the science and practice of medicine.

UP to the present moment the Medical Reform Bill has

made no progress in Parliament. It has been placed twice ormore frequently in the "Orders of the day ;" but owing topress of business, has not yet been discussed in committee.The announcement of Mr. COWPER, that Government intendedto proceed with the measure this session, has made the oppo-nents of the Bill very active, and they are using every meansin their power to defeat or delay the Act. Looking at theunanimity of the committee who framed the report, and thedesire of the Government to settle the long-agitated questionof medical reform, it is probable that the opponents of the Billwill not succeed in their object.

MEDICAL REFORM.

REASONS FOR SUPPORTING THE " AMENDEDMEDICAL BILL;"

BY THE REPRESENTATIVES OF THE ROYAL COLLEGE OF

PHYSICIANS OF EDINBURGH.

THE following statement has been prepared at the requestof several influential members of the House of Gommons, andis to be considered as an attempt, at their suggestion, to em-body in a more permanent form the reasons stated orally by adeputation of the Royal College of Physicians of Edinburgh,at present in London, in favour of the Amended Medical Bill,and in reply to various objections made to them against theBill.The Amended Medical Bill has appeared to the College of

Physicians worthy of support, and they earnestly trust that itwill be passed in the present session of Parliament; because,

1st. It will put an end to the constant agitation which hasprevailed in the profession on the subject of medical reform formany years past.

2nd. It will secure in the fullest possible manner that equalityof privilege which has long been contended for.

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