SCOTLAND.
The annual meeting of the Association of Medical Officers of Asylums and Hospitals for the Insane, was held last week, in one of the rooms of the University of Edinburgh. In his preliminary discourse, the retiring President, Dr. Forbes Winslow, after some remarks on legislation affect- ing the medical profession, dwelt on the state of the law of lunacy, and signalized some of its defects.
"There always has been a great outcry against the power which the law places in the hands of two qualified medical practitioners. Primo facie, there are undoubtedly grave objections to this clause. To meet the objec- tions raised, and to place this matter beyond all further cavil and dispute, I would suggest the appointment of educated, respectable, and experienced practitioners, delegated with quasi-judicial and magisterial functions, to be summoned for the purpose of counter-signing the certificates of the medical men, thus sanctioning, if they thought proper, the proposed measure of confinement. These Inspectors of Lunacy, or medico-legal jurists, might be appointed to preside over certain districts in the metropolis as well as in the provinces. Beins' unconnected with and unknown to the relations and friends of the patient, and strictly independent of the medical men called in by the family to certify to the fact of insanity, I feel assured that the signatures of gentlemen holding such independent official appointments would relieve the public mind of all undue anxiety relative to the unjust confinement of persons alleged to be insane I think the law with regard to the confinement of persons in private lodgings and in unlicensed houses to be too stringent in its operation. There is a vast amount of in- cipient insanity and morbid conditions of mind connected with obscure brain disease that require, with a view to the adoption of efficient medical tura- tiVe treatment, to be removed temporarily from the irritation and excite- ment' often necessarily incidental to a continuance among relations and friends. In many of these eases no progress towards recovery can be made until the patient is taken from home, and ceases for a time to be a free agent. Under kind and skilful treatment these patients rapidly recover; but in order to effect so desirable a consummation, it is essential that they should be placed among strangers and under judicious control. Is it not unwise, I would ask, that the law should make it imperative that this class of mental invalids should be formally certified to be insane, and registered as such at the office of the Commissioners in Lunacy ? The fact of a patient being placed under temporary restraint whilst suffering from an attack of transient mental aberration does not at all affect his social position should he recover and return home to his family ; but the position of this patient woold be materially altered if he has been certified to have been insane, and visited as such by the gentlemen appointed by the act of Parliament to examine all persons legally confined as lunatics. I am quite satisfied that there are many patients who are kept at home under great disadvantages, as far as the question of recovery is concerned, in consequence of this strin- gent provision of the law. So great is the horror which some sensitive persons exhibit at the bare mention of a certificate of lunacy, that they have confessed' a determination rather than submit to what they con- ceived to be a seriously damaging stigma, to abandon all idea of bringing those near and dear to them within the range of remedial measures ! Could not some modification of the law be suggested to meet this class Of ease? Would not the public be sufficiently protected from the improper interference of their friends and relations if every person admitting such uncertified eases into his house or lodgings were compelled to make a return of the fact to the proper authorities—viz., the Commission- ers on Lunacy, or to the district medicalinspector, medical jurist, officer of mental health, or by what other name it may be thought proper to designate these official personages ; I have known patients to drive up to the door of the asylum and beg to be received within its walla, being painfully and acutely conscious of the necessity of close supervision. Great have been the lamentations when they have been informed that they could not be ad- mitted even for one night into the asylum without being certified by two medical men to be in an insane state of mind. I have known such persons take the printed form of admission, and go themselves to medical men in the neighbourhood and beg them to sign the legal certificate of insanity. Why should there not be some alteration of the legislative enactment to remedy this defect In such cases I would compel the patient to sign, in the presence of a Justice of the Peace, Di-Magistrate, a paper to the effect that he, in consequence of mental indisptisit; freely., voluntarily, and without compulsion, places himself in a licensed dsylum for the treatment of the in- sane. A copy of this document, with all the particulars of the ease, should be transmitted to the Commissioners of Lunacy within a few hours of ad- mission. If it were thought de,sirable for the protection of the public that these patients should go to the Commissioners themselves and obtain their authority for entering the agyitusi• ita'patients uncertified to be insane, no Possible objection can be raised to this course of procedure."
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