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stands last on the list of books at the head of this article. Dr Hughes Bennett has paid as much attention to the subjects treated of in it as any living man of his years, and has, therefore, every right to come before the students as their instructor. He has done so very successfully in this instance; the volume is replete with practical information, and the information is given in that form which will make it most useful and acceptable to the student.
Suggestions for the Future Provision of Criminal Lunatics. By Charles Hood, M.D. London, 1854. 8vo. Pp. 174.
The subject passed under review in the very excellent treatise of Dr Hood is one of increasing interest and importance. The legal provisions for the custody, care, and treatment of criminal lunatics have been hitherto confessedly most imperfect in this country, and little in accordance with the humane and enlightened principles which have been developed and brought into' Operation for the treatment of other classes of the insane. The most costly structures, with all the improvements in arrangement, heating and ventilation, which science can suggest, have been erected in almost every county in England for the pauper lunatics of the country. These asylums have been surrounded with beautiful pleasure grounds, gardens and farms, and furnished with every possible resource for the occupation, recreation, and amusement of the inmates, while the unfortunate sufferers from this malady who may have committed an act of homicide or assault in their frenzy, or who may have set fire to a hay rick, have been treated like common felons.
Until within the last few years Criminal Lunatics were kept in common gaols, and herded with the worst class of offenders, from whom they suffered every species of indignity and unkindness,—becoming the "objects of sport to their unfeeling fellow-prisoners, they were taunted, ridiculed and tormented by them, until, becoming irritated and goaded to desperation, they often committed the most shocking outrages."
Instead of their insanity affording them any advantage over responsible criminals, it placed them in a far worse position, as was
fiointed out by Sir George O. Paul in his evidence before the pariamentary committee in 1807. He adduced two cases in proof of this; in one of which the accused party was acquitted of the charge of perjury on the ground of insanity, and the other of assault on the same plea. In both cases the ordinary punishment would not have exceeded imprisonment for one or two years, but those individuals being ordered to be kept in custody till His Majesty's pleasure was known (as insane), their punishment amounted virtually to imprisonment for life.
In consequence of the report of the select committee of that year, the House of Commons presented an address to His Majesty praying for the erection of a separate prison for Criminal Lunatics. This movement resulted, after eight years' delay, in the addition of wards for the reception of sixty criminal lunatics into Bethlehem Hospital; and afterwards, so late as 1849, in a contract with a private asylum, for the reception of twenty-four patients of this class. These steps have, however, heen totally inadequate for the wants of the country, for it appears, from the reports of the Commissioners in Lunacy, that there were in 1852,436 Criminal Lunatics in England, and, although they are no longer now confined in common gaols, they are distributed through various county asylums and hospitals, private houses, and Bethlehem.
This distribution of criminal lunatics in England, although a great improvement on their condition as compared with that when they were confined in gaols, has led to results of an opposite but very distressing kind. "We have in Bethlehem, in the criminal establishment," says Dr Hood, " patients whose insanity at the time of committing the offence, clearly absolved them from any responsibility; we have others whose insanity prevented them being arraigned upon the charges libelled against them, and who, therefore, cannot, never having been tried, be considered guilty; others, again, have, under the influence of insanity, committed petty misdemeanours; and many of the patients to whom I have just alluded having partially recovered, conduct themselves rationally ami quietly. Among them are persons of good family, officers in the army and navy, literary men and artists, members of the learned professions; and many of these educated persons feel it an extreme hardship to be obliged to associate with convicted felons, who* insanity has only darkened and exaggerated the more revoltiiif.' features of their character."
If it is a hardship for criminal lunatics of different rank and character to be thus associated together, it is not less a hardship for other lunatics who have never committed any offence to be associated with criminals, some of whom have been convicted felons lying i" gaol at the time of their becoming insane, and some of whom may have committed acts of homicide or murder. To send criminal lunatics to a general asylum is attended with the worst effects Many of the inmates of asylums are extremely sensitive, and alive to all the ordinary feelings of humanity, and they feel deeply degraded and humiliated to find themselves placed in the same wards with persons such as those described. The moral effect of such an association upon patients labouring under melancholv, with feelings of remorse and self-condemnation, must, and is known to be. of the most injurious tendency. Such considerations as these ltd to the erection in Ireland some years ago of a central asvlum for the criminal lunatics of all Ireland, at Dundruiu near Dublin, aivi from the reports of the Irish Inspectors of Lunacy there is even eason to believe that it has answered the purpose for which it was reeted extremely well.1
In Scotland the evils arising from the association of criminal unatics with the ordinary inmates of asylums, led the Superintenlents of the public asylums there to refuse to receive them for many ears; it led also, about ten years ago, to efforts for the conversion >f the eastern department of the Edinburgh Asylum into a Criminal Vsylum for Scotland, but at that time the idea was abandoned in •onsequence of the impression that the number of such lunatics in he country was not so great as to justify such an expense as would « necessarily incurred. Since that period a department of the ieneral Prison at Perth has been set apart for the reception of Miminal lunatics, at least for such criminal lunatics as have been ound insane upon trial, and there are now in that part of the prison ibout forty patients of this class. This is a much worse arrangement than that which exists even in England at the present time, where these patients have at least the advantages which an asylum iffords for their treatment. It seems contrary to every principle of lumanity, and to the enlightened spirit which has animated our legislators in regard to England and Ireland, that the unfortunate victims of insanity who have come under the cognizance of the law, should in Scotland continue to be treated like common prisoners, and sent along with every description of felon, to live within the gloomy precincts of a common prison. We trust the time is not far distant when some steps may be taken to remove this evil and raise this unfortunate class of sufferers to the same enjoyments and means of :ure which they enjoy in Ireland, and in a great measure in England also.
In England there is reason to anticipate that, ere long, Government will legislate upon the alleged grievance. The Commissioners in Lunacy have repeatedly called the attention of the Lord Chancellor to the complaints which have been made against lunatic asylums being made receptacles for the class of patients denominated "criminal lunatics." They lately called for returns from ill the English asylum superintendents as to the evils resulting from this association, and the objections made to it by patients and their friends. On the 18th of March 1852, the Earl of Shaftesbury in the House of Lords, moved an address to Her Majesty, "praying that Her Majesty would be graciously pleased to take into consideration the expediency of establishing a State Asylum for the care and custody of those who are denominated criminal lunatics." The Earl of Derby, then at the head of Her Majesty's government, admitted the evils complained of, and gave assurances that the subject would not be lost sight of by Government, and under this assurance the motion was withdrawn.
The next session the subject was again brought under the notice
'Sixth Oeueral Report of the District Criminal and Private Asylums in Ireland. Dublin, 18"»3.
of the House of Lords by Lord St Leonards, who contended that it " was absolutely necessary that provision should be made for the care and maintenance of Criminal Lunatics;" one asylum in the north and one in the south of England he thought would be cient. "It would," he said, "be particularly necessary to the case of women afflicted after their confinement, who in a of aberration of mind, committed, he could not call it a crime, but a deed at which human nature shuddered. As the law now stood, when she ought to be in an hospital, and taken the greatest possible care ofj she was treated as a criminal to be tried by the laws of her country." His lordship, furthermore, bore his testimony to having witnessed the ill effects of allowing criminal lunatics to be associated with other harmless unfortunates of the same description, and added, that "those who supposed that persons who had lost their mind were not deeply impressed with everything which affected moral conduct were entirely mistaken."
We have brought this subject thus fully before our readers in the hope that through the efforts of some of them, when the prevision for criminal lunatics in England is again brought under discussion before parliament, something may be said or done to urge upon government the much stronger claims of Scotland on behah of her criminal lunatics now immured in a common prison.
Dr Hood, whose opportunities for forming a sound opinion on the subject, from the position he occupies as physician to Bethlehem Hospital, are very favourable, has given in the work before us a verr full view of the question as far as England is concerned, and some excellent practical suggestions as to the best mode of providing for this class of the insane.
We believe a great boon would be conferred upon Scotland if Government could still procure the old part of the Asylum at Morningsidc for a Criminal Asylum for Scotland. It is admirably adapted both by its internal arrangements and the advantages of the surrounding grounds and scenery for this purpose; and if it were conducted upon the same enlightened and benevolent principles as the present large pauper asylum there, the public of Scotland woulc have nothing left to wish for in regard to their so-called criminal lunatics. Being built originally for patients of a higher rank ot life, its arrangements are such that many of the objections Dr Ho>xi refers to as existing, against the mingling of ranks in Bethlehem Ho>
Eital, would be obviated, as patients of the better ranks could readilv e associated together and provided with separate apartments suitable to their station in life, while the pleasure grounds, gardens and occupations and amusements could not fail to tend to recovery, and completely to remove from the minds of all that they were regarded as prisoners and criminals.
A Memoir on Strangulated Hernia, from Cases occurring in the London Hospital. By Nathaniel Ward, F.R.C.S., Assistant Surgeon to the London Hospital, and Demonstrator of Anatomy. 1854. 8vo. Pp. 33.
This little memoir is of practical importance, being founded on the observation of cases'of hernia operated on during three years in the London Hospital. It consists first of a statistical analysis of 69 cases, viz., 43 femoral, 22 inguinal, and 4 umbilical; stating the side upon which the strangulation occurred, the period of strangulation, and contrasting the results of the cases in which the sac was opened, with those where the stricture was divided without opening .he sac. This part of the memoir will be found useful, by enabling surgeons to form an opinion as to the value of the extra-peritoneal >peration. At the same time we must keep in mind that when strangulation has existed for any length of time, or in other words, where here is any doubt as to the state of the strangulated intestine, the ixtra-peritoneal operation is inadmissible. It therefore excludes all lie unfavourable cases, whilst the cases for which it is deemed >roper, are just those early cases which would be likely to do well mder any plan of operation. As to the great risks of peritonitis n hernial operations, we should recollect that it may arise from the njury inflicted on the peritoneal coat of the intestines by the tight onstriction, independently of opening the sac, and we have seen atal peritonitis from this cause in a case in which we performed he extra-peritoneal operation, and where strangulation had only xisted for twenty-six hours. We do not make these remarks to lisparage that method of operating, for we have often practised it nth success, but we believe that the great point in operating for ernia is not so much the method of operating as early operation, nd avoiding undue attempts at reduction by taxis.
Mr Ward next makes some remarks as to the seat of stricture in imoral hernia, and states that, in his opinion, the fibres known by the ame of the ligament of Hey or Hesselbach are merely secondary npediments to reduction, and he considers that unless Poupart's or rimbernat's ligament be also divided, the division of these fibres would ot permit of reduction. We have had very considerable practical xperience both in dissections of the parts and in operating for ;moral hernia, and we have little hesitation in saying that division f Poupart's ligament to relieve the constriction is very seldom reuired, and if by the term Gimbernat's ligament be meant the apoeurotic fibres derived from the external oblique tendon as described y that anatomist, that will also seldom require division. The ructures which immediately invest and constrict the hernial swellig, are the falciform process, forming the lower margin of the rural arch, and its crescentic margin, the latter corresponding to le base of Gimbernat's ligament. Higher up in the canal, the eep lamina of the falciform process continuous with the fascia